Author Archives: SNI

Interview with Stacy Sims PhD CISSN

SNI: From the standpoint of rehydration, is there an ideal percentage of carbohydrate that is needed when consuming fluids? Is there a combination of carbohydrates that is ideal?
Stacy: In my experience working with athletes, they are so focused on calories that they don’t pay attention to the fact that what they are drinking contributes to FUELING, not HYDRATION.

Let me explain.

In science speak: During prolonged exercise, fluid and salt losses through sweating reduce plasma volume which leads to heart rate drift in association with hyperthermia and reductions in performance. Oral rehydration with water reduces the loss of plasma volume and lessens heart rate drift and hyperthermia. Moreover, the inclusion of sodium in the rehydration solution to levels that double those in sweat (i.e., around 90 mmol/l Na+) restores plasma volume when ingested during exercise, and expands plasma volume if ingested pre-exercise.

In real person speak: During exercise you lose water and salt through sweat. When you lose this water and salt, the watery part of your blood also drops. With less water in your blood, the blood is more viscous, thus you end up with a higher heart rate, lower power production, and a greater rise in core temperature->all leading to fatigue, reduced performance, and the dreaded power decline when it counts the most: at the end of a race.

There is a competition within the body when you start to exercise: Your muscles and your skin fight for your blood. Blood goes to the muscles for metabolic function. Blood goes to the skin to get rid of the heat produced by the working muscles. As body water drops, this competition becomes more fierce, and the skin blood flow will win out- Primarily because heat is a greater threat to the body than keeping the muscles working (which produces heat..).

The fatigue you experience is that drop in blood flow to the muscle- basically you have less metabolism functioning plus protein denaturing (the contractile proteins denature, aka stop working, in muscle temperatures >~39’C).

“Ok” you say, “But I’m drinking so I should be able to circumvent this blood volume problem.”

BUT here is where things go south. It’s what you’re drinking that’s making you dehydrated.

The mass market out there has the message that when you drink a 4-8% carbohydrate solution with sodium (~220mg sodium per liter) you are taking care of your hydration and fueling needs. The focus is always on carbohydrate availability and calories. (If you do a literature search on hydration and carbohydrate for endurance exercise you will find the hydration research is really carbohydrate availability in the form of liquid calories.)

I’m here to tell you, as a physiologist that specializes in hydration, thermoregulation, and performance; this is a misleading and incorrect message.

Let’s look at two key factors needed to pull fluid into the body’s fluid spaces:
1) You need what you are drinking to have an osmolality below that of blood. (osmolality is the amount of solutes in a solution. The more active solutes in a fluid, the higher the osmolality. Blood sits ~285mOsm)
2) You want what you are drinking to meet the physiological needs of fluid absorption- this means that you want your fluid to have fluid co-transporters: the intestinal cell membranes use sucrose, glucose, and sodium (Na+) as facilitators to get fluid across the cells into the water spaces of the body.

Now let’s look at the nutritional aspects of a typical sports drink:
– 5-6% carbohydrate solution
– Osmolality of ~300-320mOsm
– Sugars: maltodextrin, fructose, sucrose
– Sodium: ~220mg per liter

With the higher osmolality than blood, the physiological response is to pull water from within the vascular spaces of the body to “dilute” higher osmolality. This creates a net gradient of water leaving the body into the digestive system. Problem: effective dehydration and GI distress.

The 5-6% solution provides exogenous carbohydrate but not in the levels needed to sustain longer term endurance exercise without energy fluctuations (you want 4-6 calories per pound of body weight of mixed macronutrient food- different rates of oxidation/breakdown means a greater time and titration of fuel to the body)

The maltodextrin and fructose are notorious for causing GI distress; free fructose (e.g. not from sucrose) has to go through the hepatic portal vein to the liver to be processed, and no rate limiting effect for this free fructose will cause a “dumping” of fructose into the system, leading to major GI distress. Maltodextrin exits the stomach quickly, but in the intestines, pulls water into the digestive tract = GI distress (aka diarrhea!)

Sodium and sucrose- these are the only two potential “helpers” in fluid absorption, BUT by the nature of the osmolality of the 5-6% solution, the net gradient of fluid is to come from within the body into the gut, thus the sodium and sucrose work with this gradient to facilitate fluid movement through the intestinal cell membranes into the GI tract.

SNI: Should protein be in a rehydration drink? Yes, No, Maybe so?

Stacy: Post exercise is a key window for several things; primarily being maximum effect on muscle synthesis and glycogen recovery. The “critical” window for high quality protein intake is the 30 min post exercise; this is also part of the critical rehydration window- start rehydrating to decrease the negative effects on the immune system. I’m bending towards the question in a roundabout way to say Yes, protein is beneficial for rehydration just as it is essential for muscle reparation and synthesis. A small inclusion of protein in a low carbohydrate-concentration rehydration drink does facilitate plasma volume expansion, increases absorption of electrolytes and boosts levels of plasma proteins, which promote long term hydration after exercise. Keep in mind, however, rehydration post-exercise is different from rehydration from a long day at work, not drinking. The protein promotes muscle reparation, but also adds calories. Being cognate in the timing of your nutrients becomes critical for recovery and body composition changes.

SNI: What are your thoughts on caffeine? It is commonly held that caffeine is a dehydrating agent. What’s the science say?

Stacy: Ah, “Black Gold”… Caffeine is a great addition to any endurance athlete’s arsenal for performance. There are three ways caffeine may provide ergogenic effects. First, the central nervous system is directly stimulated by caffeine (blocking receptors for adenosine and increasing plasma catecholamines), which helps reduce the sensation of fatigue, increases alertness, and increases muscle recruitment. Second, caffeine has been shown to improve endurance through the increased utilization of fat as a fuel and sparing carbohydrate utilization (a.k.a glycogen sparing effect); and most recently, it has been demonstrated that caffeine increases the calcium content of skeletal muscle, thus enhancing the strength of muscle contraction. Caffeine & Hydration – Staying hydrated, while important for humans at all levels of activity, is especially important for athletes during vigorous exercise. Historically, athletes have been advised against consuming caffeine because of caffeine’s mild diuretic effect. However, a point often missed is that any fluid, including water, will also have a mild diuretic effect. In a review of hydration and caffeinated beverages, Lawrence Armstrong, PhD concluded that “it is unlikely that athletes and recreational enthusiasts will incur detrimental fluid-electrolyte imbalances if they consume caffeinated beverages in moderation and eat a well-balanced diet.” Contrary to popular belief, research has shown that caffeinated beverages can and do contribute to hydration.

SNI: For the endurance athlete who just ran, cycled or swam for 2 hours, what would YOU suggest they consume immediately post workout to promote fluid balance, glycogen repletion and skeletal muscle recovery? Do you have a ‘Stacy Sims recovery’ cocktail?

Stacy: There are two options here, one is nonfat greek yogurt with manuka honey within 30 min post exercise to address the nutritional needs of the muscle (yogurt is great for whey and casein, potassium, sodium, calcium, magnesium; manuka honey provides a bit of extra carbohydrate with natural immune boosting properties), then over the course of 2 hours, slowly rehydrate with a 1.5% glucose-sucrose solution with 200mg potassium and 100mg sodium per 16oz at a rate of 0.15oz per pound of body weight per hour. The second option (and my “go-to”) is OsmoNutrition’s Acute Recovery. It is an organic, high quality (no hormones, non-GMO) protein recovery drink. It is unique as well as it doesn’t have any antioxidants in it and it has a wee bit of green tea extract for caffeine. As much hype as there is around antioxidants, you really don’t want them close to the end of exercise as antioxidants impede mitochondrial adaptations to endurance exercise stress. And the wee bit of caffeine helps facilitate glycogen repletion ~66% over protein+carbohydrate alone. In addition to this drink (again within 30 min post exercise), I recommend the same dosage of the 1.5% solution per above. Trying to cover both nutritional needs of the body with rehydration needs requires the separation of food and fluid.. Post exercise the first point to cover is protein and carbohydrate; the second aspect to cover is total fluid recovery. The window for muscle recovery is much smaller than fluid recovery; thus pay attention to the acute recovery needs first to maximize the adaptations induced from the exercise stress.
SNI: What do YOU personally consume pre, during and post-workout?

Stacy: Ah! I’m not training much right now as work and my new daughter take most of my time; but when I do head out, I usually have the pre covered by my most recent meal, during I use Osmo Active hydration with real food (I tend to like homemade protein bites or power cookies…) and post exercise, Osmo Acute recovery.

SNI: What athlete do you admire the most and why?

Stacy: There are so many great role models and inspirational women out there, including some of my own clients; but I’m going to pull a name out of the past: Gabrielle Reece. She was my role model when I first discovered competitive sport and I still admire her for everything she has accomplished. Not only is she a world class athlete, she is a strong role model for athletic, career driven moms- not a super woman, but close enough!

BIO: Dr. Stacy Sims, MSc, PhD

Exercise Physiologist-Nutrition Scientist, CISSN
CRO-Research Scientist
Osmo Nutrition

Stacy served as an exercise physiologist and nutrition scientist at Stanford University from 2007-2012 where she worked as an environmental exercise physiologist and nutrition scientist specializing in recovery, and nutritional adaptations for health, body composition, and maximizing performance. During the past decade Stacy has worked as an environmental physiologist and nutrition specialist for top professional cyclists, ultraswimmer Jamie Patrick, the Garmin/Slipstream Pro Cycling Team, USA Cycling Olympic Team (BMX and women’s track cycling), Team Tibco, Flying Lizard Motorsports, and Team Leopard-Trek, among others. Stacy earned a BA from Purdue University, an MSc from Springfield College, a doctorate from University of Otago, and was a postdoctoral research fellow in cardiovascular disease prevention, thermoregulation, and women’s health at Stanford University. Stacy raced crew as an undergraduate at Purdue University, raced Ironman at an elite level in the early 2000s but now competes as a Cat 1 road cyclist and an elite XTerra triathlete.

Soccer Players: To Squat or Not To Squat?

GOOOOAAAALLL! We’ve got one question for all of you soccer players…Do you SQUAT? Although we are not expecting any answers back at the moment, we do hope you are saying yes to your computer screen while reading this. It’s not a coincidence if you are reading this and questioning, “Well, why should I squat if I do indeed play soccer?” In all honesty, we could sit here and explain all the great benefits of squats, but that could take a whole other article itself to school everyone on. Instead, we would like to breakdown a study that the great Chris Beardsley and Bret Contreras discovered. The study is about strength training increasing power and speed for elite soccer players. So, if you are a soccer player or coach soccer players we highly recommend you sit back, relax, turn off the soccer on the flat screen for a bit and take some notes.

If you are a current soccer player or former soccer player, you should know that the sport involves movements that involve speed and power. Ask any Strength and Conditioning coach how important those two elements are for athletic performance. We promise they will tell you it is very damn important for sports performance. If you want to be the best, you have to train like the best!

Back to our original question, if you play soccer do you squat? We asked this question because the study we are about to break down by Keiner et al. shows strong correlations that sprint performance and leg strength can improve by doing both back squats and front squats. Man, if only we knew this back in our days when playing futbol, aka soccer. We probably would have been bending it like Beckham 😉

SO WHAT DID THE RESEARCHERS DO?

The researchers wanted to track the development of 30m sprint performance in youth soccer players over a 2-year strength training intervention. So, they recruited 134 elite soccer players, not world cup stars ladies and gents. The players were

subdivided into three age-groups (A, B and C cohorts) and the average ages of each group were 17, 15 and 13, respectively. To be very clear here, the participants in each cohort were divided into two groups. One group (Strength training group [STG]) was subjected to regular soccer training in addition to strength training twice a week for 2 years. The other group (Control group [CG]) completed only the regular soccer training.

The strength training group performed their workouts on non-consecutive days and the exercises varied between the parallel front and back squats during the week and also performed bench presses, deadlifts, neck presses, and exercises for the trunk muscles as well as the standing row.

Squat training for the strength-training group was periodized such that following initial technique training, the subjects started with a hypertrophy training block, which comprised 5 sets of 10 repetitions with 3-minutes rest between each set.

The next training block comprised a strength period of 5 sets of 6 repetitions with 3-minutes rest between each set followed by an additional training block of 5 sets of 4 repetitions with 5-minutes rest between each set. The researchers measured 30m sprint times, including splits every 5m, and maximum 1RM front and back squat strength after two years of training.

SO WHAT HAPPENED AFTER ALL OF THIS?

For Maximum Strength, the researchers reported that the strength-training subgroups of all three age-groups displayed greater improvements in the front and back squat 1RMs than the control sub-groups.

For 30m Sprinting Performance, the researchers found that in the A and C groups, the strength-training sub-group displayed significantly better reductions in sprint time than the control sub-group at each 5m split time between 5m and 30m. They found that in the B group, there was a significant difference between the strength-training and control sub-groups at the 5m, 20m and 25m splits.

Correlations: the researchers performed a correlation analysis and found that there was a significantly positive but moderate relationship between strength gains in 1RM expressed relative to body weight and improvement in sprint performance in all age groups. The correlations were highest for the first 15m of sprinting, indicating the greater importance of squat strength for accelerating rather than maximal speed sprinting.

WHAT DID THE RESEARCHERS CONCLUDE?

The researchers concluded that a strength training program involving front and back squats led to a positive improvement in the sprinting performances of young soccer players. Pretty cool. Right?

WRAPPING THIS ALL UP

As you can see the research doesn’t lie. Of course there were limitations, but all studies have limitations. And, at the end of the day if those do not agree with these findings, that’s ok too because science is always open to debate. We can definitely tell you from anecdotal experience that squats and front squats will 99.9% of the time increase speed, power, hypertrophy, strength, and overall athletic performance. In other words, we highly agree and approve of this study by Keiner et al. So, just too briefly recap, if you are a soccer player, coach, or just an overall jock, we highly recommend you implement some sort of squat variations into your training regimen to maximize your full potential. Don’t get us wrong here ladies and gents, we are not asking you to go load up a squat bar and max out for 500 lbs. We are simply saying whether its conventional back squats or front squats that you chose to do, do them with proper precautions, make sure you squat deep, and don’t be afraid to progressively overload. And hey, if you squat more often, maybe you will score more GOOOOOAAAAALLLLLSSSS than the famous “Pele” did.

About The Authors:

Chris and Eric Martinez, CISSN, CPT, BA, also known as the “Dynamic Duo” operate a world class personal training and online training business “Dynamic Duo Training,” They’re also fitness and nutrition writers, fitness models, and coaches that love helping people reach their goals. Their philosophy is “No excuses, only solutions.”

Visit them at:

References:

1). Influence of a 2-year strength training programme on power performance in elite youth soccer players, by Sander Keiner, Wirth and Schmidtbleicher, in European Journal of Sport Science, 2012.

2.) Chris Beardsley and Bret Contreras, 2012.

Way More to Whey than Big Muscles

By Brad Dieter MS CISSN CSCS.

Whey protein (WP) supplementation has recently gained popularity amongst athletes as it is reported to improve athletic performance. WP is a popular dietary protein supplement purported to provide improved muscle strength and body composition due to greater a compliment of essential amino acids and branched chain amino acids and to result in greater biological value (1-4). Additionally, WP supplementation has shown to reduce oxidative stress through increasing endogenous glutathione production and improve compromised gut health associated with intense exercise (5-8). While the a majority of the research and topics covered in this post are WP supplementation specific, I want to remind everyone that whole foods sources of whey protein may be superior in terms of nutrient synergy than WP supplementation; however, the research surrounding that issue is not well established.

Increase Strength and LBM – Most athletic events are reliant upon force production of muscles, with greater ability to produce force associated with improved performance. As force is equal to mass x acceleration (F=M*A), increasing the muscle mass is the most common way athletes aim to increase force production. Skeletal muscle hypertrophy requires proper resistance training and nutritional status in which muscle protein synthesis (MPS) exceeds muscle protein breakdown (MPB). One of the major concepts in the literature surrounding skeletal muscle hypertrophy is the idea of net protein balance (NPB). NPB is defined as MPS minus MPB (NPB = MPS – MPB). Thus, if MPS is greater than MBP, skeletal muscle hypertrophy will occur (9). One of the critical factors influencing MPS and MBP is the availability of amino acids (10, 11). WP supplementation is a source of high biological value amino acids and has been purported to increase muscle mass and strength.

There is an extensive body of research surrounding the efficacy of WP supplementation in increasing strength and muscle mass. The results of the research are not entirely unequivocal; however, a significant amount of evidence suggests that WP increases both strength and muscle mass (12-15). Additionally, researchers have recently shown that the constituents of whey protein upregulate the cell signaling pathways responsible for muscle protein synthesis and muscle hypertrophy, specifically the mTOR pathway (16).

Whey Protein and Glutathione – Oxidative stress refers to an imbalance between antioxidant defense systems and production of reactive oxygen species (ROS) (17). Oxygen consumption during heavy exercise can increase up to 100 times normal resting levels, thus increasing the production of free radicals and resulting in oxidative stress. Although the data are not unequivocal, evidence exists showing increased free radical production and cellular damage following heavy exercise (18). Athletes are at a higher risk of elevated oxidative stress due to the increased pro-oxidative process they expose themselves to than their non-athletes counterparts (19). The increased levels of ROS produced during heavy exercise must removed by the body’s endogenous antioxidant system in order to maintain oxidative balance

Glutathione, the most abundant and important antioxidant, is a tripeptide synthesized from the amino acids L-cysteine, L-glutamic acid, and glycine (20). It is the most important redox couple and plays crucial roles in antioxidant defense, nutrient metabolism, and the regulation of pathways essential for whole body homeostasis (21). Additionally, glutathione serves as a regulatory compound in the activation of the circulation agents of the immune system, lymphocytes (22). It is apparent that glutathione is a critical compound in maintaining health and glutathione deficiency has been linked to numerous pathological conditions including, cancer, neurodegenerative disorders, cystic fibrosis, HIV and aging (23). Glutathione is of particular interest in the athletic population as the concentration of glutathione varies considerably as a result of nutritional limitation, exercise, and oxidative stress.

The intense physical demands of athletics places athletes’ bodies under high levels of physiological stress. Glutathione plays a critical role in maintaining normal redox status during exercise (24, 25). Furthermore, exhaustive exercise has been shown to reduce glutathione status (24, 25, 26), thus indicating the need for bolstered levels of glutathione in athletes. Researchers have shown that the amino acid cysteine is the rate-limiting factor in glutathione synthesis (27, 28). Therefore, the inclusion of cysteine rich protein sources may prove efficacious in increasing glutathione synthesis rates by providing ample amounts of cysteine to the amino acid pool. Supplementation with free cysteine is not advised however as it spontaneously oxidized and has shown to be toxic (29). Dietary sources of cysteine present as cystine (two cysteines linked by a disulfide bond) are more stable than free cysteine and properly digested. WP supplements, including WP isolate and WP concentrate are protein sources rich in cysteine and deliver cysteine to the cells via normal metabolic pathways (30,31). By providing abundant cysteine, WP supplementation allows cells to replenish and synthesize glutathione without adverse effects (31) (Figure 1.). Thus, WP supplementation may serve to bolster the endogenous production of glutathione and improve oxidative stress in athletes.

The use of WP supplementation to mitigate a training-induced decline in blood glutathione levels has been studied extensively. Researchers have shown that WP supplement is beneficial in maintaining normal physiological levels of glutathione in athletic and non-athletic populations in response to exercise (32-34). Furthermore, researchers have shown that WP improves the athlete’s ability to deal with acute oxidative stress and WP may serve as a safe and effective alternative source of antioxidants for prevention of athletic injuries and sickness caused by excessive reactive oxygen species (ROS) (35). The research regarding WP supplements and glutathione status supports the use of WP in athletics to improve health status in athletes by augmenting the endogenous antioxidant system.

Whey Protein and Immune Function – Strenuous exercise and heavy training regimens are associated with depressed immune cell function (36-40). Furthermore, inadequate or inappropriate nutrition can compound the negative influence of heavy exertion on immunocompetence. Suppression of the immune predisposes the individual to an increased risk of infection.

Athletes increase both the volume and intensity of their training a certain stages of the season that may result in a state of overreaching or overtraining. Recent evidence has emerged indicating that immune function is indeed sensitive to increases in training volume and intensity. Although the research has not shown that athletes are clinically immunocompromised during these periods of depressed immune function, it may be sufficient to increase the risk of contracting common infections.

As the components of the immune system are highly dependent on amino acids, endogenous and dietary amino acids can impact the state of the immune system. In comparison to other protein sources, research shows that whey proteins are unique in their ability to promote strong immunity through several beneficial compounds including: glutamine, α-lactalbumin and β-lactoglobulin, and minor fractions such as serum proteins, lactoferrin, as well as a series of immunoglobulins (41-43).

Whey Protein and Gut Health – Intense physical exercise leads to reduced splanchic blood flow, hypoperfusion of the gut, and increased intestinal temperatures (44). Reduced intestinal blood flow and high intestinal temperatures during intense exercise can lead to intestinal barrier dysfunction through increased permeability of the tight junctions (5, 8). The increased permeability of the intestinal wall leads to invasion of Gram-negative intestinal bacteria and/or their toxic constituents (endotoxins) into the blood circulation (45-47). Endotoxins are highly toxic lipopolysaccharides (LPS) of the outer cell wall of Gram-negative bacteria. LPS are a major trigger in vivo for the host immune response via induction of the cytokine network (45). (Jeukendrup, et al., 2000). This process, endotoxemia, can result in increased susceptibility to infectious- and autoimmune diseases, due to absorption of pathogens/toxins into tissue and blood stream (48).

The field of intestinal permeability is relatively and long-term prospective studies have yet to clearly identify the potential hazards of chronic, low-grade levels of intestinal permeability. However, recent research has established a link between intestinal permeability and a host of autoimmune diseases including Chron’s disease, Hashimoto’s Thyroditis, lupus erythmatosis, psoriasis, and rheumatoid arthritis (49-53). Additionally, intestinal permeability has been associated with mental illness including schizophrenia and depression (54,55).

As previously mentioned, tight junctions constitute the major component of gut barrier function and acts as physical and functional barrier against the paracellular penetration of macromolecules from the lumen (56,57). Therefore, the regulation of tight junction permeability is critical in maintaining gut integrity and reducing the exposure of the body to endotoxins. The amino acid glutamine is critical in maintaining the integrity of these tight junctions (56). Glutamine, the most abundant amino acid in the blood, is considered a “conditionally essential” amino acid (Figure 2.) (56). Under normal conditions glutamine is produced in sufficient quantities in the body to maintain the normal physiological functions. However, under stressful situations, such as exercise, endogenous production of glutamine insufficient and the body must rely on exogenous sources of glutamine to meet its requirements.

Glutamine supplementation has been shown to improve gut permeability through restoration of tight junction integrity caused by a variety of physiological stressors through multiple molecular mechanisms (58-60). Additionally, glutamine supplementation has proven effective in reducing exercise induced intestinal permeability (61). WP is a rich source of glutamine and researchers have shown that WP supplementation is capable of reducing intestinal permeability (62,63). Therefore, WP may be beneficial in reducing exercise induced intestinal permeability and the risk of endotoxemia and autoimmune disorders.

Summary

Whey protein is an excellent source of a wide range of amino acids and additional nutrients that are beneficial to health. Whey protein has been shown to increase lean body mass in conjunction with resistance training, bolster glutathione status, have immunomodulatory effects and improve gut health. A healthy, well balanced diet may be enhanced with whey protein through either whole food sources or occasional whey protein supplements.

Bibliography

1) Burke, D. G., Chilibeck, P., Davison, K., & Candow, D. (2001). The effect of whey protein supplementation with and without creatine monohydrate combine with resistance training on lean tissue mass and muscle strength. International Journal of Sport Nutrition and Exercise Metabolism , 11, 349-364.

2) Coburn, J. W., Housh, D., Malek, M., Beck, T., Cramer, J., Johnson, G., et al. (2006). Effects of leucine and whey protein supplementation during eight weeks of unilateral resistance training. Journal of Strength and Conditioning Research , 20 (2), 284-291.

3) Frestedt, J. L., Zenk, J., Kuskowski, M., Ward, L., & Bastian, E. (2008). A whey-protein supplement increases fat loss and spares lean muscle in obese subjects: A randomized human clinical study . Nutrition & Metabolism , 5 (8), 1-7.

4) Willoughby, D. S., Stout, J., & Wilborn, C. (2007). Effects of resistance training and protein plus amino acid supplementation on muscle anabolism, mass, and strength. Amino Acids , 32 (4), 467-477.

5) Lambert, G. P. (2009). Stress-induced gastrointestinal barrier dysfunction and its inflammatory effects. Journal of Animal Science , 87 (E. Supplement), E101-E108.

6) Low, P. L., Rutherfurd, K., Gill, H., & Cross, M. (2003). Effect of dietary whey protein concentrate on primary and secondary antibody responses in immunized BALB/c mice . International Immunopharmacology , 3 (3), 393-401.

7) Micke, P., Beeh, K., Schlaak, J., & Buhl, R. (2001). Oral supplementation with whey proteins increases plasma glutathione levels of HIV-infected patients. European Journal of Clinical Investigation , 31 (2), 171-178.

8) Pals, K. L., Chang, R., Ryan, A., & Gisolfi, C. (1997). Effect of running intensity on intesttinal permeability. Journal of Applied Physiology , 82, 571-576.

9) Hulmi, J. J., Lockwood, C., & Stout, J. (2010). Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein . Nutrition & Metabolism , 7 (51).

10) Dickinson, J. M., & Rasmussen, B. (2011). Essential amino acid sensing, signaling, and transport in the regulation of human muscle protein metabolism. Current Opinion in Clinical Nutrition & Metabolic Care , 14 (1), 83-88.

11) Li, J. B., & Jefferson, L. (1978). Influence of amino acid availability on protein turnover in perfused skeletal muscle . Biochimica et Biophysica Acta , 544 (2), 351-359.

12) Esmarck, B., Andersen, J., Olsen, S., Richter, E., Mizuno, M., & Kjaer, M. (2001). 18. Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans. Journal of Physiology , 535, 301-311.

13) Cribb, P. J., Williams, A., Carey, M., & Hayes, A. (2006). The effect of whey isolate and resistance training on strength, body composition, and plasma glutamine. International Journal of Sports Nutrition and Exercise Metabolism , 16 (5), 494-509.

14) Buckley, J. D., Thomson, R., Coates, A., Howe, P., DeNichilo, M., & Rowney, M. (2010). Supplementation with a whey protein hydrolysate enhances recovery of muscle force-generating capacity following eccentric exercise . Journal of Science in Medicine and Sport , 13, 178-181.

15) Tipton, K. D., Elliot, T., Cree, M., Wolf, S., Sanford, A., & Wolf, R. (2004). Ingestions of casein and whey proteins result in muscle anabolism after resistance exercise. Medicine and Science in Sports and Exercise , 36, 2073-2081.

16) Hulmi, J. J., Tannerstedt, J., Selanne, H., Kainulainen, H., Kovanen, V., & Mero, A. (2009). Resistance exercise with whey protein ingestion affects mTOR signaling pathway and myostatin in men. Journal of Applied Physiology , 106, 1720-1729.

17) Sachdev, S., & Davies, K. (2008). Production, detection, and adaptive responses to free radicals during exercise. Free Radical Biology & Medicine , 44 (2), 215-223.

18) Adams, A. K., & Best, T. (2002). The role of antioxidant in exercise and disease prevention. The Physician and Sports Medicine , 30 (5), 2002.

19) Lowery, L. (2001). Antioxidants supplements and exercise. In J. Antonio, & J. Stout (Eds.), Sport Supplements (pp. 260-278). Philidelphia, PA: Lippincott, Williams and Wilkins.

20) Thomas, J. A. (1999). Oxidative stress and oxidant defense. In M. Shils, J. Olson, M. Shike, & A. Ross (Eds.), Modern Nutrition in Health and Disease (pp. 751-782). Baltimore, MD: Lippincott Williams & Wilkins.

21) Wu, G., Fang, Y., Yan, S., Lupton, J., & Turner, N. (2004). Glutathione metabolism and its implications for health. Journal of Nutrition , 134, 489-492.

22) Droge, W. (1996). Modulation of the immune response by cysteine and cysteine derivatives. Italian Society for Parenteral and Enteral Nutrition , 14, 1-4.

23) Townsend, D. M., Tew, K., & Tapiero, H. (2003). The importance of glutathione in human disease. Biomedicine & Pharmacotherapy , 57, 145-155.

24) Li, J. J., & Fu, R. (1992). Responses of glutahtione system and antioxidant enzymes to exhaustive exercise and hydroperoxide. Journal of Applied Physiology , 72 (2), 549-554.

25) Kerksick, C., & Willoughby, D. (2005). The antioxidant role of glutathione and n-acetyl-cysteine supplements and exercise-induced oxidative stress. Journal of the International Society of Sports Nutrition , 2 (2), 38-44.

26) Gohil, K., Viguie, C., Stanley, W., Brooks, G., & Packer, L. (1988). Blood glutathione oxidation during human exercise. Journal of Applied Physiology , 64 (1), 115-119.

27) Lyons, J., Rauh-Pfeiffer, A., Yu, Y., Lu, X., Zurakowski, D., Tompkins, R., et al. (2000). Glood glutathione synthesis rates in health adults receiving a sulfur amino acid-free diet. Proceedings of the National Academy of Sciences of the United States of America , 97 (10), 5071-5076.

28) Rathbun, W. B., & Murray, D. (1991). Age-related cysteine uptake as rate-limiting in glutathione synthesis and glutathione half-life in the cultured human lens. Experimental Eye Research , 53 (2), 205-212.

29) Meister, A. (1984). New aspects of glutathione biochemisty and transport selective alterations of glutathione metabolism. Nutrition Reviews , 42, 397-410.

30) Chitapanarux, T., Tienboon, P., Pojchamarnwiputh, S., & Leelarungrayub, D. (2009). Open-labeled pilot study of cysteine-rich whey protein isolate supplementation for nonalchoic steatohepatitis patients. Hepatology , 24, 1045-1050.

31) Sindayikengera, S., & Xia, W. (2006). Nutritional evaluation of caseins and whey proteins and their hydrolysates from Protamex. Journal of Zhejian University Science B , 7 (2), 90-98.

32) Mariotti, F., Simbelie, K., Makarious-Lahham, L., Huneau, J., Laplaize, B., Tome, D., et al. (2004). Acute ingestion of dietary proteins improves post-exercise liver glutathione in rats in a dose-dependent relationship with their cysteine content. Journal of Nutrition , 134, 128-131.

33) Middleton, N., Jelen, P., & Bell, G. (2004). Whole blood and mononuclear cell glutathione response to dietary whey protein supplementation and trained male subjects. International Journal of Food Science Nutrition , 55 (2), 131-141.

34) Vatani, D. S., & Golzar, F. (2012). Changes in antioxidant status and cardiovascular risk factors of overweight young men after six weeks supplementation of whey protein isolate and resistance training. Appetite , 59, 673-678.

35) Xu, R., Liu, N., Xu, X., & Kong, B. (2011). Antioxidative effects of whey protein on peroxide-induced cytotoxicity. Journal of Dairy Science , 94 (8), 3739-3746.

36) Gleeson, M. (2007). Immune function in sport and exercise. Journal of Applied Physiology , 103, 693-699.

37) Gleeson, M., McDonald, W., Cripps, A., Pyne, D., Clancy, R., & Fricker, P. (1995). The effect on immunity of long-term intensive training in elite swimmers . Clinical & Experimental Immunology , 102 (1), 210-216.

38) Baj, Z., Kantorski, J., Majewska, E., Zeman, K., Pokoca, L., Fornalczyk, E., et al. (1994). Immunological status of competitive cyclists before and after the training season. International Journal of Sports Medicine , 15 (6), 319-324.

39) Bury, T., Marechal, R., Mahieu, P., & Pirnay, F. (1998). Immunological status of competitive football players during the training season. International Journal of Sports Medicine , 19 (5), 364-368.

40) Shepard, R. J., Rhind, S., & Shek, P. (1994). Exercise and the immune system. Natural killer cells, interleukins and related responses. Sports Medicine , 18 (5), 340-369.

41) Cribb, P. J. (2005). U.S. whey proteins in sports nutrition. U.S. Dairy Export Council.

42) Cribbs, P. J. (2004). Whey proteins and immunity. U.S. Dairy Export Council.

43) Walzem, R. M., Dillard, C., & German, J. (2002). Whey components: millennia of evoluation create functionalities for mammalian nutrition: What we know and what we may be overlooking. Critical Reviews in Food Science and Nutrition , 42 (4), 353-375.

44) Qarnar, M. I., & Read, A. (1987). Effects of exercise on mesenteric blood flow in man. Gut , 28, 583-587.

45) Jeukendrup, A. E., Vet-Joop, K., Sturk, A., Stegen, J., Senden, J., Saris, W., et al. (2000). Relationship between gastro-intestinal complaints and endotoxaemia, cytokine release and the acute-phase reaction during and after a long-distance triathlon in highly trained men. Clinical Science , 98, 47-55.

46) Lambert, G. P. (2008). Intestinal barrier dysfunction, endotoxemiz, and gastrointestinal symptons: the ‘canart in the coal mine’ during exercise-heat stress? Medicine and Sport Science , 53, 61-73.

47) Van Deventer, S. J., & Gouma, D. (1994). Bacterial translocation and endotoxin transmigration in intestinal ischaemia and reperfusion. Current Opinions in Anaesthiology , 7, 126-130.

48) Lamprecht, M., Bogner, S., Schippinger, G., Steinbauer, K., Fankhauser, F., Hallstroem, S., et al. (2012). Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial . Journal of the International Society of Sports Nutrition , 9 (45), 1-13.

49) Sasso, F. C., Carbonara, O., Torella, R., Mezzogiomo, A., Esposito, V., deMagistris, L., et al. (2004). Ultrastructural changes in enterocytes in subjects with Hashimoto’s thyroiditis . Gut , 53 (12), 1878-1880.

50) Caradonna, L., Amati, L., Magrone, T., Pellegrino, N., Jirillo, E., & Cacavvo, D. (2000). Invited review: Enteric bacteria, lipopolysaccharides and related cytokines in inflammatory bowel disease: biological and clinical significance . Journal of the International Endotoxin Innate Immunity , 6 (3), 205-214 .

51) Apperloo-Renkema, H. Z., Bootsma, H., Mulder, B., Kallenberg, C., & van der Waajj, D. (1994). Host-microflora interaction in systemic lupus erythematosus (SLE): colonization resistance of the indigenous bacteria of the intestinal tract. . Epidemiiology and Infection , 112 (2), 367-373.

52) Hamilton, I., Fairris, G., Rothwell, J., Cunliffe, W., Dixon, M., & Axon, A. (1985). Small intestinal permeability in dermatological disease. QJM , 56, 559-567.

53) Smith, M. D., Gibson, R., & Brooks, P. (1985). Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis. The Journal of Rheumatology , 12 (2), 299-305.

54) Wood, N. C., Hamilton, I., Axon, A., Khan, S., Quirke, P., Mindham, R., et al. (1987). Abnormal intestinal permeability. An aetiological factor in chronic psychiatric disorders? . The British Journal of Psychiatry , 150, 853-856.

55) Maes, M., Kubera, M., & Leunis, J. (2008). The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinology Letters , 29 (1), 117-124.

56) Rao, R. K., & Samak, G. (2012). Role of glutamine in protection of intestinal epithelial tight junctions. Journal of epithelial biology and pharmacology , 5, 47-54.

57) Mitic, L. L., & Anderson, I. (1998). Molecular architecture of tight junctions. Annual Review of Physiology , 60, 121-142.

58) Wilmore, D. W., Smith, R., O’Dwyer, S., Jacobs, D., Ziegler, T., & Wang, X. (1988). The gut: A central organ after surgical stress. Surgery , 104, 917-923.

59) Peng, X., Yan, H., You, Z., Wang, P., & Wang, S. (2004). Effects of enteral supplementation with glutamine granules on intesinal mucosal barrier function in severe burned patients. Burns , 30, 135-139.

60) Kozar, R. A., Schultz, S., Bick, R., Poindexter, B., DeSoignie, R., & Moore, F. (2004). Enteral glutamine not but alanine maintains small bowel barrier function after ischemia/reperfusion injury in rates. Shock , 21, 433-437.

61) Hoffman, J. R., Ratamess, N., Kang, J., Rashti, S., KElly, N., Gonzalez, M., et al. (2010). Examination of the efficacy of acute L-alanyl-L- glutamine ingestion during hydration stress in endurance exercise . Journal of the International Society of Sports Nutrition , 7 (8).

62) Kotler, B. M., Kerstetter, J., & Insogna, K. (2013). Claudins, dietary milk proteins, and intestinal barrier regulation. Nutrition Reviews , 71 (1), 60-65.

63) Benjamin, J., Makharia, G., Ahuja, V., Rajan, K. D., Kalaivani, M., Gupta, S. D., et al. (2012). Glutamine and whey protein improve intestinal permeability and morphology in patients with Chron’s disease: A randomized controlled trial. Digestive Diseases and Sciences , 57 (4), 1000-1012.

Interview – Kurtis Frank and Sol Orwell of Examine.com

SNI: Roughly a decade and a half ago, folks who espoused eating differently than what was advised and promoted by the AND (formerly ADA- American Dietetic Association) and AHA (American Heart Association) were often vilified. In fact, folks who espoused eating less carbs (gasp!) were targeted as charlatans, quacks, and folks who promoted early death. Why do you think many in the ‘food industry’ are so resistant to new ideas such as consuming a ‘lower carb’ diet? In fact, why are many of them resistant to the notion of taking supplements on a regular basis?

Kurtis: Both the food industry (in this sense, persons who recommend eating a certain way) and the supplement industry are industries characterized by two main things in my mind: They are industries that have set a poor precedent in how much the public can trust them, either due to an apparent inability to deliver on promises (eat X to achieve Y) or have otherwise been outright shown to repeatedly violate consumer trust and safety for profit (the supplement industry does not have a good track record in this regard). Both industries are not one time purchases, but lifetime repeated purchases. Many people will take a leap of faith when it comes to a single purchase, but the fact that you repeatedly spend money on these can lead to a prolonged financial drain

Because it is well established that people will give you money and they have gotten used to giving away this money with little to no evidence or proof to back the claim we have gotten a lot of (for lack of a better term) scum working in these industries undermining how much faith consumers can put in us.

When a new concept comes to the table that actually is scientifically valid, consumers are mixed as to whether they will throw money at the concept or to be highly skeptical. The idea of ‘fool me once, shame on you; fool me twice, shame on me’ comes to mind. Not many consumers can delineate what is based on good evidence and what is based on absolutely nothing, so regardless of the topic introduced it will be met with both resistance and forerunners. Supplements are in a worse position here since there is a horrible turnover rate of a ‘new’ compound every other month giving incredibly promises that even the best reference drugs cannot do. The ‘latest and greatest’ supplement (such a misnomer, greatness takes decades to establish) is merely just something to keep the gears of consumerism continuing. Which really sucks. There are some great compounds out there but the fact that this consumer cycle exists does nothing but degrade public faith in supplements and destabilizing any potential of the supplement industry (or put another way, the ‘preventative’ branch of western medicine that targets people not in a clinically ill state) to actually be something good to society. I don’t blame consumers at all for their hesitation against new diets and especially against supplements, the state of the industries currently suck.

Sol: I’m going to go with psychology in this. We have confirmation bias, and its children: persistence of discredited beliefs, asymmetric insight, backfire effect, and attitude polarization. Summed up, once someone’s made their mind up, it’s hard to change it. You could even argue that it’s a form of psychological sunk cost – once you’ve put so much energy into believing and defending a theory, it’s hard to let go of it. I think attitude polarization is a big one – a person is less likely to admit/agree that they were wrong when the other person is being a combination of condescending and hostile. Just because you’re right doesn’t mean you have to be a jerk.

As for supplements – naturalistic fallacy. That sums it up neatly.

SNI: Your website, Examine.com, has a lot of cool information (and accurate too). What “aha moment” led to you (Sol) to get involved in a field of study that has about as much to do with web development as teaching a fish to climb trees?

Sol: I cannot really say there was a singular moment I can look back and identify. I was losing weight. I was learning. I was taking notes on a variety of subject matters – entire books, hormones, macronutrients, etc. I had originally wanted to do this myself, but realized it was a bit beyond me. So then I offered the idea to Kurtis. He didn’t really have the technical know-how, so a bit after that we agreed to come and work together. We work together. You can say he’s the brains and I’m the looks.

SNI: For both of you, what are the top 5 supplements you’d recommend for overall general health and fitness?

Kurtis: Hard to come up with a top 5, as even these following supplements can be overruled if there is a certain condition affecting an individual that requires attention.

Vitamin D and Magnesium both need a spot in the top five, due mostly just to the common deficiencies in society. Other nutrients can also be deficient for some persons, but Vitamin D and Magnesium tend to be the hardest to get via a mixed diet.

I’d also put a protein powder in the top 5, although I don’t care which one to be honest (I like casein for the sole reason it is versatile in cooking and food preparation, but a rice/pea combination intrigues me due to being very similar in AA composition to whey but has the potential to be much cheaper and free of allergens).

As for the last two? This gets tough as I can think of about a dozen or so molecules that would be this important assuming a pre-existing ‘state’ of sorts.

Creatine will be here, since although it isn’t a vital nutrient it appears to benefit most people with no apparent side effects of clinical significance; it branches into both the neural and physical realms, which is very nice.

Bacopa Monnieri is my final one. Odd, as it isn’t a common recommendation. It is probably the cognitive enhancer with the largest body of evidence in otherwise healthy humans right now, and chronic usage of Bacopa appears to reliably increase cognition. Although the specific parameters of cognition that Bacopa improves still need to be ironed out and the mechanisms need to be proven, a reliable increase in cognition is rare and especially for one that works in otherwise healthy people and I would recommend Bacopa to all people not currently on pharmaceuticals (solely as we don’t yet know drug-herb interactions with Bacopa).

Sol: Vitamin D. I live up in Toronto, and the overcast winter kills me (and the spring rains too). If there is anything I find notable, it’s Vitamin D.

ZMA. Going to cheat and put those together. On an anecdotal level, I find it helps me with sleep quality (I find falling asleep easy), and also keeps that libido of mine revved.

Fish oil. Kurtis and I may not agree 100% on this being up here, but as someone who is older (relatively) to Kurtis, I find that I feel a lot less weary when I take it. Anecdotally my friends and family tend to agree.

Creatine. The more research done on it, the more useful it appears. It’s an obvious deficiency, and it’s cheap.

Protein powder. Beyond the usefulness of more protein in the average person’s diet, I honestly love using it to taste things. ON cake better, Trutein Cinnabun, etc. They make for delicious popsicles, cheesecakes, milkshakes, etc.

If I can bonus a sixth one in, lifting weights. I guess really it should be #1 – except for injuring yourself (in which case usually you have yourself to blame); it’s the ultimate health booster.

SNI: Kurtis, as a group, RDs are often taught hook, line and sinker the typical mantra of “eat lots of carbs, whole grains are the greatest thing on earth, and protein is bad for your kidneys” (I still hear this in academic circles of dietetics departments). Why is that?

Kurtis: There are a few possible reasons, none of which I can outright prove however, that I think may contribute to this. I’m going to intentionally ignore any possible influence of the USDA or ‘Big agriculture’ mainly because I don’t have a good reason to suspect them and do not want to open that can of worms. Thankfully, I have seen in my recent training that the hate on protein has gone down a little bit (so perhaps this is a notion held by previous generations) and although the hate on dietary fats has been reduced a little bit it still seems present. Those two ‘hatreds’ may merely be a reason why carbs are so touted, since it seems like everything is going to kill you but carbs are apparently less implicated than the other two.

Additionally, there is a big reliance on epidemiological research in dietetics relative to how much importance (I believe) should be placed on interventions. Admittedly, interventions in diets are hard to do (requiring an overhaul of lifestyle in which lack of adherence is met by poor self-reporting of dietary intake, otherwise doing a clinically controlled study where all food is supplied to the subject is horrendously expensive and likely not feasible) but a lot of evidence and teaching in dietetics relies on this epidemiology. There is indeed evidence that saturated fats and protein are correlated with adverse health effects as they are both survey markers of a subpar diet (those eating more carbs without exceeding calories tend to be health conscious, those who eat more protein and fats tend to be consuming more fast food).

Getting false positives from epidemiology research may underlie the recompensatory recommendation of carbohydrates as the ‘best’ macronutrient, and since past recommendations are in line with this recommendation there isn’t a lot of cognitive dissonance to fight against.

Finally, there is also a seeming lack of accountability that dietitians are held up to. If a client fails, it is very easy for the dietitian to find reasons to either blame the client (bad to do, although it happens with poor adherence) or otherwise can just claim that ‘it must have not worked for you’ before switching to a ‘lifestyle’ approach (merely make the client happy with their dietary intake and hopefully life in general). Some negative reinforcement or fear of giving the wrong information can propel finding the right information, and this seems to lack with dietary interventions in general since you can never really be faulted quantitatively for giving the wrong information.

I mean, if a doctor gives the wrong medication and it hurts a client that doctor is held accountable and they them self probably feel horrible for doing so. If a dietitian gives the wrong information, you cannot really prove that on a case by case basis due to the lack of controlling variables and as such cannot blame the dietitian. If you’re not apparently doing anything wrong, why change your ways?

SNI: What are your long-term goals with Examine.com?

Kurtis: Personally, I want the database to be as large as possible and as popular as possible so we can take the largest body of applicable evidence and then apply a hefty serving of harmonization and Occam’s Razor to it. Having a database is a magnitude better than having a blogroll or a news feed which disregards past evidence to cater to an ADHD mentality, but the only downside of a database is that we can get too complex pretty quickly.

My long term goal is to make Examine the largest database of supplemental information that is both accurate and digestible.

Then, from there, the large amount of data can be compared against itself to compare one supplement to another and find relative weaknesses with them (ie. do a search in Examine on phytoestrogens and rank their relative potencies, see which ones are found in serum after ingestion, see which ones are actually a concern and not relative to one another). When the database gets large enough, it can begin to be used by researchers to guide hypothesis’ and some trials and hopefully some better information gets discovered because of it.

If financial success ever occurs, I would love to give most of it right back to research; particularly on some topics where there is a single factor causing a hole in the data and its investigation could harmonize the data (ie. the molecule you eat in a supplement is not detected in serum or in urine but there are apparent bioactivities; what is the metabolite causing these effects?)

Sol: To replace Wikipedia as the standard when people link to supplements. Down the road I would love for us to also contribute to the scientific literature (and more than just via meta studies), but right now, I want us to be *the* juggernaut of supplements. I would also love if more people contributed. The system is setup so that anyone can participate in three ways:

-They can submit studies directly to us: http://examine.com/contribute/study/ – if you see something new and/or interesting, send it our way. The less time we have to spend looking for new papers, the better!

-Discussion. Every supplement has a “discussion” page – if something needs to be clarified, or if something is wrong, or if something is missing, let us know. All discussions are kept public so it can be enlightening for everyone

-Contribute directly. Every supplement can be directly contributed to. All edits will be approved via us before going live, but each supplement page keeps historical records for every version ever published (similar to Wikipedia). We’ve had updates, but we would love more.

If I go to the ISSN conference in CO and I hear someone tell someone else “Just Examine It” I will be as happy as a school girl around Bieber (and if that analogy is off, damn do I feel old now).

SNI: Ginger or Mary Ann (if this reference escapes you, I forgive you;-)

Kurtis: Thanks for forgiving me in advance, I don’t get this reference.

Sol: Do we look old? Sheesh!

As an immigrant (I moved to Canada when I was 14), I had to do with TV that was usually 10-25 years behind the curve. So I get the Gilligan’s Island reference. On the other hand, I was too young to really understand the personalities. Doesn’t really matter – I’m a redhead man myself, so Ginger wins by a mile.

SNI: Clearly, you date Ginger but you marry Mary Ann

SNI: If you could be a superhero, who would it be and why? I’m partial to the Green Lantern myself

Kurtis: Ironman. The general idea of being an otherwise normal human but elevating yourself to superhero status via your intellect and creations really appeals to me, and I like Ironman more than Batman in part due to the suit used (Iron shooting from its palms versus punching people in armored spandex) and the general disposition of the characters. I would rather simply have people aware of who I am and be self sufficient rather than hide in a mansion with a butler away from the eye of the public. Robert Downey Junior may also have had an influence on this decision.

Sol: I’ve always identified with Wolverine. Short, hairy, Canadian, believes he is the best at what he does. True story: when I was figuring out what to change my name to (I legally changed my full name), “Logan” was on the shortlist!

BIOs – Kurtis Frank graduated from the University of Guelph with a bachelor’s degree in Applied Human Nutrition. His research work on Examine.com began while still a student, and upon graduation in spring of 2012, gathering and analyzing research on supplementation and nutrition became his fulltime job. A recreational bodybuilder and powerlifter, Kurtis has a passion for dietary supplements due to a desire to harmonize the discord between the preventative and rehabilitative potential of some dietary supplements and the seemingly lack of interest of the medical community in incorporating dietary supplements in to preventative medicine. As an addendum to this, a great many supplements with inefficacy or insufficient data need to be purged before the diamonds in the rough can be exposed.

Sol Orwell has a different story than most. Dabbling in web development while still in high school, he found he had a knack for building websites that were both useful and popular. He incorporated his first business while still studying computer engineering at the University of Toronto. In his mid-20s, he opted to “retire”, freeing up time to do what he wanted, whenever he wanted. Transforming from fat to fit, he began to investigate the whys and hows behind nutrition, health, and fitness. It was this research that lead to Examine.com, the culmination of thousands of hours of research into anatomy and nutrition.

Clam Bam Thank You Ma’am: Be Aware of Your Derriere!

A quick and easy exercise guide on HOW and WHY to work all THREE of your Butt Muscles by Natalia Sikaczowski, SPT.

Everyone knows the Glutes are the powerhouse of the body. They help us run, jump, sprint, and squat. Butt, what exactly makes up that powerhouse? It is the combined actions of three muscles that make up ‘The Glutes’ and allow for multiplanar motions of the hip and control of the thigh. The obvious gluteus maximus, which usually gets all the applause, is key in extension of the hip, providing stability to the pelvis and, well…just looking good. However, the other two muscles glut medius and minimus also offer a significant contribution during movement, sport, and prevention of injury.

The action of glut med and glut min for the purpose of this article is essentially the same. When the hip is extended, i.e., in standing, both muscles act to bring the leg away from midline; or ‘abduct’ the thigh. They also externally rotate the thigh. When the hip is flexed, i.e., sitting, due to the orientation of the muscle fibers the action of the glut med and min changes to internally rotate the thigh. When we are standing on one leg, i.e., during walking, running, or sprinting, their principle action is to keep the hips level and aligned by not allowing the pelvis to dip down to the opposite side. Maintaining proper muscle activation timing and strength is imperative for correct movement patterns, exercise, and allowing the glut max (and many other muscles) to perform its job by assisting in optimal alignment of the femur and stabilization of the spine.

Weakness of glut max, med, or min will predispose athletes to increased risk of knee, hip, and back injuries as well as delayed neuromuscular response time and abnormal functional movement patterns. A prime example of weakness of these muscles can be seen when one performs a single leg squat. If the thigh begins to bow in and internally rotate, instead of staying in line with the toes, you can bet your bottom dollar max, med, and min are on a coffee break. In fact, most people that already have hip, knee, or back problems also have a weak glut med and min.

So how do we wake these muscles up to get our max potential out of our back side? In a recent article published in the Journal of Orthopaedic and Sports Physical Therapy, eleven common glut exercises were tested to see which ones made the med and min work the hardest. Regardless of whether your goal is to strengthen, sculpt, or rehabilitate, the five exercises below were found to have the strongest contractions in the targeted muscles; giving you the most bang for you booty!

The Top Five for Keeping Glut Med and Glut Min Alive!

#5 – Hip extension on all fours: While on forearms and knees, keeping the knee bent, extend one leg upward so the foot faces the ceiling. *Note: to progress this exercise, straighten and lift the leg that is extending so it is parallel to the floor.

#4 – Side Laying Leg Raise: Lay on one side with the body in a straight line: lift the top leg up, keeping the foot parallel to the ground so that the ankles are roughly 12 inches apart from each other. Make sure not to bring the leg forward or to rotate the hips forward or backward. *Note: to progress, maintain the elevated position and move the leg in 10 clockwise then 10 counterclockwise mini-circles.

#3 – Single Leg Bridge: Lie on your back with one knee bent with the foot flat on the ground with the other leg straight. Lift your buttocks off the ground with the leg that is bent, keep the opposite leg elevated. Return to starting position. *Note: to progress this exercise, add a 5-10 sec hold with each rep. Make sure the hips do not drop to one side.

#2 – The Two Step: Tie a resistance band around ankles. While in a slight squat position take 10 small side steps in one direction, reverse. Keep steps wide enough so the band is tight during the whole exercise. Make sure to lift each foot up off the ground while stepping. Do not let the foot drag. *Note: to progress, lower the body into a deeper squat.

#1 – The CLAM (everyone’s favorite): Lay on your side with your knees slightly bent, keeping your feet together rotate the top leg upward, bringing the knee toward the ceiling. *Note: to progress this exercise, tie a resistance band around the knees.

BOOTY BONUS:

Don’t Forget about Glut Max! Here’s a great challenging exercise to target the terrific trifecta of Glute Max, Med, and Min: Stand on one leg, while bending the knee reach down with the opposite arm towards the ground (stopping about 8 inches from the ground), with the leg on that same side reach back diagonally as far as you can while maintaining balance.

The Short and Sweet of it All:

The glute max, med, and min give huge contribution to our body’s strength, stability, and power both during sport and functional movements of daily life. During these exercise you are strengthening the muscles, but also improving neuromuscular timing and activation yielding better core stability and postural alignment. It is important to combine the above isometric exercises which isolate the glutes into an appropriate training program which also involves functional movement.

Biography: Natalia Sikaczowski is a third year Physical Therapy Student in the Doctoral Program at University of Miami. Prior to PT school Natalia worked as an accomplished personal trainer and group exercise instructor in Chicago, IL. Natalia is particularly interested in developing ‘pre-hab’ programs based on functional movement screens to help athletes prevent injury from occurring due to pre-existing muscular compensation and imbalances. Natalia recently assisted in a research regarding upper extremity injuries in major league baseball pitchers as related to foot arch angles and single leg dynamic balance.

Contact: FunctionalPTTraining@gmail.com

Subscribe to my Blog: FunctionalPTTraining.blogspot.com

Twitter: PrehabPT

Calcium and Fat Loss

With the increasing popularity of dairy free diets – Palaeolithic – and growing fear of coronary artery calcification, dietary calcium (Ca²⁺) intakes are decreasing. Low calcium intakes not only have implications for bone health, recent evidence has indicated Ca²⁺ may regulate body fat content, and increased Ca²⁺intakes may actually enhance fat loss when combined with moderate energy restriction (Zemel et al. 2005). It is interesting to note that a number of studies are now illustrating the fact that high milk intakes seem to have certain abdominal anti-obesity effects regardless of the individual’s physical activity (Abreu et al. 2013). Reports have also indicated an inverse association between frequency of milk consumption and body mass in children (Barba et al. 2005). Such evidence clearly highlights the influence of dietary calcium Ca²⁺ intake on body fat content.

Mechanisms

Inadequate Ca²⁺ intake has been associated with increased body mass index and body fat content, suggesting dietary Ca²⁺ intake may have certain anti-obesity properties. Various studies have demonstrated a key role of intracellular Ca²⁺ in regulating adipocyte lipid metabolism. It appears dietary calcium modulates circulating calcitriol, which in turn is responsible for the regulation of adipocyte intracellular calcium. Using the agouti mouse model Zemel et al. (2000) reported the influence of intracellular Ca²⁺ on the accumulation of fat and obesity in these animals. This mechanism alludes that low dietary Ca²⁺ intakes result in an increase in 1,25-dihydroxy vitamin D which in turn stimulates Ca²⁺ influx into the adipocyte (fig.1). Increased dietary Ca²⁺ via parathyroid hormone (PTH) chronically lowers intracellular Ca²⁺ in the adipocyte. Thus either directly, or perhaps via insulin intracellular Ca²⁺ would regulate the expression of fatty acid synthase (FAS) – a key enzyme in the regulation of lipid deposition. In addition increased dietary calcium also stimulates adipose tissue lipolysis via its influence on cAMP production and thus the phosphorylation of hormone sensitive lipase (HSL). Intracellular Ca²⁺ results in a decrease in thermogenesis and reciprocal stimulation of lipogenesis, inhibition of lipolysis and thus causing an expansion of adipocyte triglyceride stores. Increased levels of 1,25-dihydroxy vitamin D levels is also responsible for the redistribution of body fat to the abdomen through the stimulation of cortisol. Increased dietary Ca²⁺ would also suppress 1,25-dihyroxy vitamin D levels, thus supposedly inhibiting adiposity and promoting weight loss (Zemel, 2009).

Existing evidence

A short-term Ca²⁺ supplement study on mice revealed Ca²⁺ intakes of 1.2% total energy lead to a 51% reduction in lipogenesis and a fivefold stimulation of lipolysis, resulting in a 29% decrease in body weight and a 36% decrease in fat mass (Zemel et al. 2000). She Ping-Delfos & Soares (2011) also reported an acute dose of high Ca²⁺ (543.2mg) at breakfast significantly increased whole body fat oxidation (p<0.02) and dietary induced thermogenesis (p<0.01) when compared to a low Ca²⁺ (248.2mg) breakfast. In a randomized, controlled, crossover study conducted in a whole room calorimeter Melanson et al. (2005) reported a high Ca²⁺ (~1,400mg/day^-1 as dairy) diet suppressed calcitriol and resulted in a 30g/day-1 (270 kcal/day^-1) increase in fat oxidation. Similarly a high Ca²⁺ (1000mg/day^-1) diet increased diet induced thermogenesis over two successive meals, and more significantly the mean 1-year change in whole body fat oxidation was greater in the high Ca²⁺ group compared to low Ca²⁺ group (<800mg/day^-1) (Gunther et al. 2005). However, more recent evidence using abdominal subcutaneous microdialysis indicates that Ca²⁺ (~1,400mg/day^-1 as milk mineral) for 5-weeks did not stimulate lipolysis, glycerol turnover or fat oxidation (Bortolotti et al. 2008).

Some studies suggest that those with habitually low Ca²⁺ (<600mg/day^-1) intakes benefit more from Ca²⁺ supplementation, as when Ca²⁺ deficiency exists the efficiency of Ca²⁺ absorption is improved (Soares et al. 2011). Further, Ca²⁺ supplements seem to augment fat oxidation to a greater degree than dairy Ca²⁺ (Gonzalez et al. 2012). This despite the fact that dairy Ca²⁺ appears to be more effective in weight and fat loss trials, possibly owing to the synergistic effects of the bioactive components within dairy.

Conclusion

Existing evidence suggests chronic (<7-days) high Ca²⁺ (~1,300mg/day^-1) intake increases fat oxidation, which when combined with moderate energy restriction (-500kcal/day^-1) may result in fat loss (Gonzalez et al. 2012).

Future research should aim to validate new evidence that fat oxidation is increased following acute Ca²⁺ intake, and distinguish the long-term effects of a high- Ca²⁺ diet on the rate of fat oxidation.

References

Abreu, S., Santos, R., Moreira, C., Santos, P., Vale, S., Soares-Miranda, L., et al… (2013). Relationship of milk intake and physical activity to abdominal obesity among adolescents. Pediatric Obesity, [ahead of print].

Barba, G., Troiano, E., Russo, P., Venezia, A., & Siani, A. (2005). Inverse association between body mass and frequency of milk consumption in children. British Journal of Nutrition, 93, 15 – 9.

Bortolotti, M., Rudelle, S., Schneiter, P., Vidal, H., Loizon, E., Tappy, L., & Acheson, K. (2008). Dairy calcium supplementation in overweight or obese persons: It’s effects on markers of fat metabolism. American Journal of Clinical Nutrition, 88, 877 – 885.

Gunther, C. W., Lyle, R. M., Legowski, P. A., James, J. M., McCabe, L. D., McCabe, G. P.,… & Teegarden, D. (2005). Fat oxidation and its relation to serum parathyroid hormone in young women enrolled in a 1-y dairy calcium intervention. American Journal of Clinical Nutrition, 82, 1228 – 1234.

Jawadwala, R. (2011) Dietary Calcium – A potential ergogenic aid? Book chapter in Duncan M. J. (Ed.) Trends in Human Performance Research. New York: Nova Science Publishers.

Melanson, E., Donahoo, W., Dong, F., Ida, T., & Zemel, M. (2005). Effect of low- and high-calcium dairy-based diets on macronutrient oxidation in humans. Obesity Research, 13, 2102-2112.

She Ping-Delfos, W., & Soares, M. (2011). Diet induced thermogenesis, fat oxidation and food intake following sequential meals: Influence of calcium and vitamin D. Clinical Nutrition, 30, 376 – 383.

Soares, M. J., Ping-Delfos, W. C. S., & Ghanbari, M. H. (2011). Calcium and vitamin D for obesity: a review of randomized controlled trials. European Journal of Clinical Nutrition, 65, 994-1004.

Zemel, M. B., Shi, H., Greer, B., Dirienzo, D., & Zemel, P. C. (2000). Regulation of adiposity by dietary calcium. The Journal of the Federation of American Societies for Experimental Biology, 14, 1132-1138.

Zemel, M.B., Richards, J., Milstead, A., & Campbell, P. (2005). Effects of calcium and dairy on body composition and weight loss in African-American adults. Obesity Research,13, 1218–1225.

Zemel., M. (2009). Proposed role of calcium and dairy food components in weight management and metabolic health. The Physician and Sportsmedicine, 37, 29 – 39.

Bio: Matt is the Lead Performance Nutritionist at PurePharma, and also runs his own business, Nutrition Condition UK. He holds a BSc (Honours) degree in Sport & Exercise Science, and an MSc in Nutrition Science. In 2010 Matt completed a 12-month Performance Nutrition internship with the Welsh Rugby Union, which allowed him an in depth insight into the practical application of the nutrition knowledge he gained at university. He continues to work closely with the Welsh Rugby Union through the North Wales region RGC 1404. As Lead Performance Nutritionist at PurePharma he is responsible for the development and delivery of all the nutrition related information both on the website and in product marketing material, and also plays a major role in product innovation.

Through his own Performance Nutrition business, Nutrition Condition he delivers frequent Health & Wellbeing Workshops to corporate and personal clients advising on how best to develop a sound, scientifically structured nutrition programme free from fads and marketing bias. Nutrition Condition also delivers Performance Nutrition services to professional athletes.

Matt can be contacted on matt@purepharma.com or matt@nutritioncondition.com

For regular updates follow Matt on Twitter @mattncuk.

Interview – Melody Schoenfeld CSCS CMT RKC

SNI: In your two decades of personal training, what is the single most common mistake people make it not achieving their fitness goals?

Melody: Not training with me. But seriously, folks. I would say not addressing the food issue is usually number 1. People think if they do extra pushups, the chocolate cake they ate for breakfast won’t matter. It just does not work like that. At least 70% of the equation is diet. You simply will not reach your goals if you don’t clean up what you consume.

SNI: You speak multiple languages. How does one say in all of these languages: “I’m a fat lazy slob and make too many excuses not to exercise.” LOL. Ok, seriously, you’ve heard all the excuses for not exercising. Are there any legitimate reasons NOT to exercise?

Melody: Full body cast (although I’d say you can still wiggle your earlobes). Full bed rest pregnancy. Having a raging case of Ebola.

In any event, all this stuff is temporary, and it’s best to get moving again as soon as your body allows you to. And don’t use your age as an excuse. The older you are, the more important it becomes.

SNI: What ‘diet’ or eating plan would you recommend for the average soccer mom who just wants to look better in her blue jeans? Paleo? High carb? Vegan?

Melody: Although I am personally 100% vegan and have been for 13 years, it’s not for everyone, and it’s not a mandate for optimal health. The main blueprint I recommend is this:

-eat seasonally, locally, organically, and as close to nature as possible

-go extremely heavy on the veggies, especially the dark green and bright orange ones.

-avoid added sugars.

-don’t be afraid of healthy fats.

-eat fresh fruit, especially berries.

-grains and meat/poultry/fish should not make up the bulk of your diet.

SNI: What are your top 10 favorite healthy foods to eat?

Melody: Dark green leafies like kale/chard/spinach/watercress, broccoli, orange sweet potatoes, cauliflower, avocadoes, raw cacao (I make really good sugar-free chocolates!), beans, spaghetti squash, Brussels sprouts, chia seeds. Also, this sprouted nut mix stuff called “Mango Goji Fire” they have in the bulk bni at Whole Foods. I know that’s 11, but it needed to be mentioned, because NOM.

SNI: It’s the start of 2013; give our audience your top 5 tips for achieving their fitness goals.

Melody:

1) Write your goals down.

2) Make small, short-term (3 weeks or less), realistic goals that will lead up to the bigger goal (so, for instance, if you want to lose 30 lbs, your first short-term goal could be “quit soda”)

3) Reward yourself (non-food based!) when you achieve your mini-goals. Do not reward yourself if you don’t.

4) Just because it’s on the internet does not make it true– check your facts when researching exercises and dietary changes.

5) KEEP A POSITIVE ATTITUDE. The mental aspect plays a huge role in your success, no matter what your goal.

http://www.flawlessfitness.com

http://www.melodyschoenfeld.blogspot.com

Energy Drink Dumba$$es

By Jose Antonio PhD FISSN, FNSCA, CSCS. There are some things that are just annoying. Stepping on chewing gum. Emails from Nigeria asking for $1,000 so they can transfer a $1,000,000 to your bank (Really? What dope falls for this?). Hitting every red light as you make your way home. Celebrity confessions. Having to actually watch a TV show with the commercials (thank god for TiVo!). And reading the numbskull articles written by the mainstream press on pretty much all things related to sports nutrition. Runner’s World, a magazine that I actually enjoy reading (yeah, don’t tell anyone), posted on their website an article entitled “Sports Nutrition Group Doubts Claims of Energy Drink Makers.” http://www.runnersworld.com/drinks-hydration/sport-nutrition-group-doubts-claims-energy-drink-makers I’m thinking; hey, I wonder who that group is. Inquiring minds need to know. And guess what, it’s the International Society of Sports Nutrition! The ISSN is the leading academic society that studies sports nutrition and supplements and I’m the head honcho. I’ll at least give Runner’s World credit for citing the Position Paper that we recently published. But that’s pretty much where the credit ends.

The Runner’s World interpretation of our article is so wrong. Why? Because my colleagues and I wrote the dang thing. I think we’d know BETTER than anyone what the correct interpretation is! To wit: Here’s the headline – “Sports Nutrition Group Doubts the Claims of Energy Drink Makers.” Uh no. In fact, if you read #3 of the Position Paper’s abstract it says the following: “Consuming ED 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance.” That my friends is THE most important point. The drinks work! We can argue over the why and whether it’s the ingredients or combination thereof, but the bottom line is that as an ergogenic aid, the stuff will help you perform better.

And then we have the Dawn Report which states that the number of emergency room visits involving energy drinks has increased. The implication is that energy drinks must be hurting thousands of people, right? Well as they say in Alabama, shitfire Bubba, that ain’t no proof!

http://www.samhsa.gov/data/2k13/DAWN126/sr126-energy-drinks-use.htm Since when did emergency room visits become a substitute for scientific studies? Did I miss something in my years of studying the frickin’ scientific method? To fall for the moronic trap that sensational headlines are a substitute for honest-to-goodness critical thinking would be like judging a fish by its ability to climb trees. As I tell my super-smart students at Nova Southeastern University in beautiful South Florida, read the data. Read the science. Whenever you see headlines such as this, instead of believing it hook, line and sinker, instead immerse yourself in the actual studies and decide for yourself. Because one day you’ll write a scientific paper and then some journalist with about as much science training as your pet Beagle will tell you how it should be interpreted. Ok enough of this. Time to consume copious quantities of caffeine-filled java.

Reference: The 2013 International Society of Sports Nutrition position stand: energy drinks http://www.jissn.com/content/10/1/1

Saturated Fat – Not Guilty!

By Scott Robinson. There’s some serious confusion about saturated fat, and whether it is bad for the heart and is associated with diseases such as diabetes, stroke, and cancers.

The demonization of saturated fat began about 100 years ago, when a researcher fed a rabbit a high cholesterol carnivore diet and observed that its arteries became blocked with plaque. However, this really took shape in the Fifties with the Seven Countries study by Ancel Keys(1), who reported that a higher saturated fat intake was associated with a higher cholesterol level and a higher rate of heart disease. The basic premise on which this condemnation lies is that saturated fat (found in foods such as meat, eggs, dairy products, coconut and palm oil) raises cholesterol which in turn, increases the risk of clogged arteries (atherosclerosis). Subsequently, the emergence of low-fat diets and ‘fat-free’ foods has spread with whipping speed and sweep with millions of people deciding to put low fat items into their shopping trolley in the belief that it is doing them good. But is fat, specifically saturated fat, the real criminal here or have we been somewhat misguided by company-funded research, fat-phobic conventional medical wisdom and the advertising prowess of a concept that now encompasses a multi-million dollar industry?

Saturated Fat is Essential for a Healthy Life

Fatty acids play several key roles in the body; they are essential components of all cell membranes, they are responsible for the absorption of the fat-soluble vitamins A, D, E and K, and include the essential n-3 and n-6 poly-unsaturated fatty-acids (PUFA).

The evidence that saturated fat is bad is limited. In fact, contemporary research states quite the opposite. A recent meta-analysis of prospective cohort studies(2) showed that the intake of saturated fat is not associated with an increased risk of coronary heart disease, stroke or those two combined (i.e. cardiovascular disease, CVD) before(2) or after(3) adjustment for serum total cholesterol. What’s more, an eloquent study published in the journal Nutrition(4), where researchers looked at the average intake of saturated fat in 41 European countries in 1998 (the latest available data) and the age-adjusted risk of mortality from heart disease, revealed something quite remarkable:

More saturated fat, less heart disease; less saturated fat, more heart disease!

That is, as percentages of saturated fat increased, rates of death from heart disease fell. For example, France who consumed the most saturated fat (15.5% of diet) had the lowest rate of heart disease in all of Europe, whereas Bosnia and Herzegovina who consumed very little saturated fat (<4% of diet) had the highest incidence of heart disease. It is worth baring in mind that ecological data such as this doesn’t necessarily prove that saturated fat can protect against heart disease, but it can more or less disprove a theory as let’s face it, it’s difficult to believe that saturated fat is a major contributor to heart disease when Europeans who are consuming it in abundance are so much healthier, without exception.

So, who is the Culprit?

A comprehensive review of studies on saturated fat, carbohydrates and cardiovascular disease by Kuipers et al. in 2011(5) purported that it is the accumulation of saturated fat in body lipids which should concern us and not the damaging effects of dietary saturated fat per se. Take for instance a study published in Lipids(6) which found that when subjects with the metabolic syndrome were fed either a low-CHO/high fat diet with high saturated fat content or a high-CHO/low-fat diet with low saturated fat content, the low-CHO/high-saturated fat diet resulted in lower saturated fat levels in plasma lipids compared with the high-CHO/low-saturated fat diet. What’s more, an analysis of studies found that replacing saturated fat by CHO with a high glycemic index was associated with a whopping 33% increased risk of myocardial infarction(7). Such findings suggest that replacing saturated fat with carbohydrate in the diet, particularly those with a high glycemic index, may increase risk of heart disease.

N-6 vs. N-3 PUFA

Epidemiological and clinical studies show that PUFA plays a key role in the protection against CVD which has led to the suggestion that replacing saturated fat with PUFA is beneficial to cardiovascular health. A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction found that replacing 5 en% saturated fat by 5 en% PUFA reduces the risk of coronary heart disease by 9.1% (8). Interestingly, Kuipers et al. (5) reported that the replacement of SAFA with n-6 PUFA (notably linoleic acid) shows no health benefit and may actually signal towards increased CVD risk which tells us that the protective role of PUFA in the diet lies with n-3 PUFA!

Take-Home Message:

Going ‘low-fat’ isn’t a particularly good option for weight loss nor health and well-being. Fat forms an essential component of the diet and there is increasing evidence to suggest that increasing saturated fat to ~15% total daily intake isn’t hazardous to heart health and may indeed provide a protective effect against heart disease. It is worth noting that many fat-free or low-fat foods are crammed with artificial sugars and sweeteners and therefore many of us who do go ‘low-fat’ often replace fat with carbohydrates; the consequences of which appear to be an increased risk of heart disease as well as other uncommunicable diseases such as diabetes and cancers. It goes without saying that we must not over-indulge ourselves with saturated fat, but eating less dietary carbohydrate (particularly those with a high-glycemic index), trans-fatty acids and linoleic acid, while increasing the consumption of fish, red meat, vegetables and fruit may be an attractive means of keeping our heart healthy.

‘Our genes should be well adapted to eating ~15% saturated fat – 2 x that recommended as maximum by USDA, yet as much as the healthiest populations in Europe’ Coincidence?

References:

Keys A. B. (1980). Seven countries: a multivariate analysis of death and coronary heart disease. London, England: Harvard University Press, Cambridge Massachusetts.

Siri-Tarino, P. W., Sun, Q., Hu F. B., et al. (2010). Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. American Journal of Clinical Nutrition, 91, 535-46.

Scarborough, P., Rayner, M., van Dis I., et al. (2010). Meta-analysis of effect of saturated fat intake on cardiovascular disease: over-adjustment obscures true associations. American Journal of Clinical Nutrition, 92, 458-464.

European cardiovascular disease statistics (2008 edition). British Heart Foundation Health Promotion Research Group Department of Public Health, University of Oxford and Health Economics Research Centre, Department of Public Health, University of Oxford.

Kuipers, R. S., de Graaf, D. J., Luxwolda, M. F., Muskiet, M. H. A., Dijck-Brouwer, D. A. J, & Muskiet, F. A. J. (2011). Saturated fat, carbohydrates and cardiovascular disease. Netherlands, The Journal of Medicine, 69, 372-378.

Volek J. S., Phinney, S. D., Forsythe, C. E, et al. (2009). Carbohydrate restriction has a more favourable impact on the metabolic syndrome than a low fat diet. Lipids, 44, 297-309.

Jakobsen, M. U., Dethlefsen, C., Joensen, A. M., et al. (2010). Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. American Journal of Clinical Nutrition, 91, 1764-8.

Stampfer, M. J., Sacks, F. M., Salvini, S., et al. (1991). A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction. New England Journal of Medicine, 325, 373-81.

Bio: Scott is a Doctoral Researcher in Exercise Metabolism at the University of Birmingham, UK. He holds a First Class Honours degree in Sports Science and a Masters with Distinction in Sports Physiology. He currently works as a Nutrition advisor for Myprotein UK who are the UK’s number one online sports nutrition company. For regular updates on the latest in exercise metabolism and nutrition, follow Scott on Twitter @scottrobinson8 or if you have any questions please feel free to email him slr247@bham.ac.uk

Didn’t your trainer teach you any manners?

Didn’t your trainer teach you any manners?

A guide to the unwritten rules of working out in a public gym

NEW YORK – Since weight loss tops New Year’s resolution lists year after year, gyms across the country are swarmed with newcomers each January. As any regular gym-goer can attest, the first few months of the year bring out all kinds of newly inspired fitness fanatics, many of whom could use a lesson in gym etiquette.

Thanks to a fed up gym regular, now we have a guide.

Bombarded by inconsiderate behavior at the Manhattan gyms she frequents, attorney and long-time fitness buff Lori Pines put down the dumbbells and wrote The Little Book of Gym Etiquette: A Handbook for Dealing with Annoying People at the Gym (January 2013, $8.95).

Pines addresses the culprits of “gym rage” among the regulars, and point newcomers to six helpful rules of gym etiquette:

1. Don’t be a slob

2. Don’t be a hog

3. Don’t be a space invader

4. Don’t be a super-talker

5. Don’t be a grouch

6. Don’t be an exhibitionist

“This is a topic every gym-goer has thought about at some point,” says Pines, who is tired of seeing empty water bottles litter the gym floor and listening to loud phone talkers barely breaking a sweat on the stationary bikes.

In The Little Book of Gym Etiquette, she cites the “3 C’s” everyone should know before a gym workout: be clean, considerate and cheerful. Following these three simple rules will, according to Pines, keep everyone in the gym satisfied.

With satirical descriptions and hilarious illustrations, Pines pokes fun at stereotypical offenders—the slobs, hogs, space invaders, super-talkers, grouches and exhibitionists—while simultaneously promoting fitness and encouraging readers to be accommodating.

“Let’s face facts—it isn’t easy getting to the gym. You have to walk or drive there, change your clothes, psych yourself up for the pain and exertion, and then clean yourself up and change your clothes afterwards,” Pines writes. “The last thing we need is a further deterrent to getting to the gym. That’s why there is nothing more annoying than having to deal with people who don’t know how to behave there.”

LORI PINES is a lawyer and avid gym-goer who loves her daily workout and thinks everyone is entitled to a peaceful, energizing session at the gym. She lives with her husband and two athletic children in New York City.

A Quick Q & A with Lori Pines

Author of The Little Book of Gym Etiquette

What are the 6 rules of gym etiquette?

1. Don’t be a slob

2. Don’t be a hog

3. Don’t be a space invader

4. Don’t be a super-talker

5. Don’t be a grouch

6. Don’t be an exhibitionist

What inspired you to develop these rules?

This book practically wrote itself while I was working out at various gyms. All I had to do was look around, and I couldn’t help but notice many incredible breaches of gym etiquette. Some of what I saw was funny, and some was just plain disgusting. I knew I just had to write about the topic.

What gym etiquette gaffe bothers you the most?

Each of the six rules is very important, but if I had to pick one, I would say the hogs probably annoy me the most.

What is the biggest offense you’ve ever witnessed at the gym?

I see violations every day like people leaving their dirty towels and used water bottles around the gym, but the biggest offense I witnessed was a guy juggling hard rubber balls on the treadmill. He said he was trying to develop extra balance.

The HCG Diet

by Brad Dieter, MS, CISSN, CSCS. For most people the start of a new year is a time to plan a radical change and become healthier and happier while trying to lose weight and get in better shape.

Typically these goals are associated with a dramatic change in diet and exercise with many adopting extreme measures to get quick results. Perhaps the most dramatic and extreme diet strategy currently on the market is the HCG diet. The HCG diet has been well advertised and has been taking the diet world by storm. In fact, I personally have known quite a few people who have used the diet in attempts to lose weight.

The HCG diet is not new, in fact it has been around since the 1960’s. It is something I have been reading about for quite some time and feel like I really need to address it before thousands more “give it a shot” because they feel it is safe and it would not hurt to try. Well, I am here to set the facts straight and hopefully open your eyes to the danger of using hormone manipulation to see quick results when attempting to lose weight.

What is HCG and the HCG Diet?

Human Chorionic Gonadtropin (HCG) is a hormone obtained from the placenta of pregnant women and is very closely related in structure and function to luteinizing hormone. HCG is primarily used by physicians in their clinics to treat infertility in women (1).

The premise of the HCG diet is relatively simple and can be summarized quite briefly. On the HCG diet one must take HCG either by inject or through oral supplementation and limit your caloric intake to 500 calories a day. The HCG is purported to suppress your appetite to make the 500 calorie a day diet possible while avoiding hunger and to increase lipolysis.

Here are the requirements of the HCG diet in terms of weight loss.

In the diet program, you have to finish the HCG diet program utilizing HCG weight loss products. The dieters have to be actually committed to the diet program in order for it to be effective. The HCG diet program strategy requires an extremely low-calorie diet plan of a maximum of 500 calories each day. The program requires one to take control of your urge for food well.

What does Science Say?

Now we move on from description and explanation to the science. First, I want to discuss the properties of the diet sans HCG. When one limits their caloric intake to 500 calories a day, you are essentially undergoing starvation and your body begins to mobilize its energy stores in order for your body to continue running properly. The energy stores your body mobilizes are the fatty acids stored in your adipocytes (fat cells). HCG aside, this type of extreme caloric restriction should, in theory bring about rapid fat loss.

Now add in the HCG supplementation. HCG is purported as an appetite suppressant with one of its key contributions to this diet making it possible eat this way without succumbing to debilitating hunger. From an extensive review of the literature, I found that the research out there does not support this claim, nor is there an adequate mechanism to explain why it might work this way (2).

For argument’s sake, let’s say that HCG is indeed an effective appetite-suppressant. Is this healthy? Again, I would have to argue that this is not, and may prove to be deleterious to our health. Our appetite is a complex mechanism that has evolved over millions of years and is vital to our health. Our appetite is designed to tell our body when we need nourishment, and in a healthy, non-processed food diet, our cravings are designed to let us know what nutrients we need. I am of the opinion that suppressing appetite through hormonal manipulation and altering this mechanism is unwise, and may have long lasting effects on your brain-gut axis.

Additionally, HCG is claimed to increase the “fat-burning” of the calorie restriction. The theory behind this is that it “reprograms” the hypothalamus to increase fat oxidation. Is this true? There is no mechanistic description in the literature supporting this claim. Furthermore, I would speculate it might actually promote the opposite, especially in women. Female physiology generally favors higher levels of body fat (within healthy levels) for fertility. In fact, women who are extremely lean often have trouble becoming pregnant. If the HCG hormone is used to treat infertility, may increase fat storage over the long haul not be a possible side effect? Again, this is pure speculation and I might be missing the mark, but from the people I have seen use this diet they have indeed recovered their fat stores immediately after the diet and have actually ended up with a higher body fat percentage after their experience with HCG. This anecdotal evidence may be a place to start with research examining the long-term effects on the hormonal status of individuals who have utilized this dietary strategy for weight loss.

HCG has another secret, most cancers also produce HCG. One of the basic laboratory tests for cancer involves screening for HCG. While I could spend quite some time exploring the mechanisms of HCG and cancer, I will be brief and mention that, as per my understanding, cancers secrete HCG in order to direct nutrition and substrates to fuel their growth. However, currently, no scientific research has found a cause and effect of HCG use and cancer but the concept is intriguing. For more reading on HCG and cancer please refer to the following article (4).

What Does the Research Say for HCG and Weight Loss?

Here is perhaps my favorite of all the articles regarding the HCG diet. In a beautifully articulated argument from a paper published in March of 2012, titled “An unfortunate resurgence of human chorionic gonadotropin use for weight loss”, the authors stated, “Given that HCG has no demonstrated weight loss effects and has potential safety concerns, it is incumbent upon the scientific and clinical community in the obesity field to educate their patients about the lack of efficacy and potential risk of off -label HCG use and to speak out strongly against its use” (2).

The authors of this paper also comment on the role the HCG injections may have in the development of prostatic hyperplasia and prostrate carcinomas, gynecomastia, male breast carcinoma, leimyoma, and exacerbation of endometriosis.

A Meta-Analysis conducted on the efficacy of the HCG diet in 1995 stated the following “We conclude that there is no scientific evidence that HCG causes weight-loss, a redistribution of fat, staves off hunger or induces a feeling of well-being. Therefore, the use of HCG should be regarded as an inappropriate therapy for weight reduction” (3).

As much as I do not always agree with the FDA, in regards to their position on HCG supplementation for weight loss, I couldn’t agree more.

“The United States Food and Drug Administration has stated that over-the-counter products containing hCG are fraudulent and ineffective for weight loss. They are also not protected as homeopathic drugs and have been deemed illegal substances”.

If you are going to dedicate 2013 to becoming healthier, losing the extra weight, and exercising more, I implore you to seek healthier, more effective options. Seek out credible resources, develop a long-term plan, and focus on the health aspect of your goals; the others will fall in line once you find yourself in better health. The HCG diet is not one of those resources and in fact, may alter your metabolic processes to a point where “righting” the ship will be more difficult than had you not utilized the product/diet plan.

References

(1) Hoffman JR, Stout JR. Performance Enhancing Substances in Essentials of Strength and Conditioning. Eds. Baechle TR, Earle RW.2008. Human Kinetics, Champaign, IL

(2) Lovejoy JC, Sasagawa M. An unfortunate resurgence of human chorionic gonadotropin use for weight loss. Int J Obes. 2012;36(3):385–386.

(3) Lijesen GKS, Theeuwen I, Assendelft WJJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol, 1995:40: 237-243

(4) Stenman U-H, Alfthan H, Hotakainen K. Human chorionic gonadotropin in cancer. Clinical Biochemistry. 2004;37(7):549–561.

BIO: Brad is a Ph.D. student at the University of Idaho studying Sport Ethics and Exercise Science. He received his M.S. degree in biomechanics from the University of Idaho and is a Certified Sports Nutritionist (CISSN) and a Certified Strength and Conditioning Specialist (CSCS). He has experience as a nutrition and fitness consultant, a collegiate strength coach, and a trauma representative in the orthopedic industry.

Hypovitaminosis D and Body Fat

by Chantal Charo Ph.D. Vitamin D or the “sunshine vitamin” has seen a lot of popularity lately thanks to discoveries about deficiencies in the general population. Shocking data from the National Health and Nutrition Examination Survey (NHANES) demonstrate that more than 90% of the non Caucasian population and 75% of the Caucasian population of the United States suffer from vitamin D insufficiency. What exactly does Vitamin D do?

Vitamin D plays a role in bone metabolism and calcium homeostasis and many researchers have shown the benefits of vitamin D supplementation in preventing bone loss and muscle injury in older women. However, in recent years it has become clear that the health risks associated with low levels of Vitamin D go beyond age related diseases. Hypovitaminosis D is linked to an increased risk of osteoporosis, diabetes, cardiovascular diseases, and cancer. Much of the growing interest in vitamin D was caused by its association with obesity, a known risk factor for the chronic conditions described. A study published in the journal Nutritional Research showed that excessive administration of vitamin D lead to a significant decrease in body fat of rats. In this study, researchers separated rats into two groups: one overfed mostly with calories from fat, and the other group overfed with a sugar rich diet. Each of these groups was split in half, with one half receiving a “sub-optimal” dose of Vitamin D and the other receiving 10,000 IE of Vitamin D, and a slightly higher amount of calcium than what the other group received. The results of this study were surprising; researchers found that even though the rats were overfed, administering large dose of Vitamin D and calcium resulted in weight loss and hypertrophy compared to the group that received the sub optimal doses of Vitamin D. Data from this study demonstrated a correlation of high doses of Vitamin D and protein synthesis. They claim that the rats receiving the high Vitamin D and calcium doses manufactured more of a protein that helps muscles burn fat for energy which lead to the decrease in body fat and increase in musculature. However, this study was clearly done in rats, not in humans. Nevertheless, similar results were obtained from studies done in humans. it is now well established that low vitamin D status, may increase body fat and that increasing Vitamin D levels may inhibit adipogenesis . And, reciprocally, a modest weight loss of 10% could increase the levels Vitamin D according to Holecki M.’s group. It has even been suggested that Vitamin D supplementation contributes to both upper and lower body muscle strength and could be used to preserve age related muscle loss. Muscle cells contain vitamin D receptor and several studies have demonstrated that serum levels of Vitamin D correlate with improved physical performance. On the other hand, people with insufficient or deficient levels of Vitamin D are likely to have fatty muscles because of an increase in fat infiltration. Obviously, this information is valuable for everyone not only for both dieters and fitness enthusiasts- who wouldn’t want to lose fat and gain some definition? All it takes, according to these studies, is a adding a couple of Vitamin D/Calcium pills to your diet. However, should you supplement your diet with Vitamin D? Vitamin D is synthesized when the skin is exposed to UV from the sun, or it is obtained from food, especially fatty fish. Moderately increasing Vitamin D by diet or sun exposure is harmless. Although rare, excess Vitamin D can cause toxicity by causing hypercalcemia, or an increase of calcium build up in the blood, kidney problems and death. Toxic doses for Vitamin D are not yet established, however, reports show that a dose of 50 000 IU or greater for several months can cause Hypervitaminosis D related toxicity. The RDA of Vitamin D is 600 IU/day. As always, talk to your doctor before taking vitamin and mineral supplements.

BIO

Dr. Chantal Charo is an assistant professor of virology and immunology and a licensed sports nutritionist from Miami, FL. She is an interdisciplinary biomedical researcher with a particular focus on women’s health. Her research studies and teaching interests include insulin resistance, the biological pathways by which IGF-1 affects gynecological cancers, Vitamin D, the metabolic syndrome, PCOS, female athlete triad syndrome, microRNAs, breast and ovarian cancer. Dr. Charo is also involved in many clinical trial, including a Phase I trial for metastatic ovarian cancer. Chantal earned her Ph.Ds. in Biomedical Sciences and Cancer Biology from the University of Texas Houston and the UT MD Anderson Cancer Center; and she holds an M.Sc in Biomedical Sciences and a B.S. in biology with a minor in chemistry. As sports nutritionist trained with a leading supplement company, Dr. Charo investigated the effects of carbohydrate intake and hormonal balance in women, as well as the Euthyroid Sick syndrome and the female athlete. Chantal hosts a medical segment on a local daily talk show which aims at promoting awareness to women and combating health illiteracy. In support of her research, Chantal has received fellowships from National Cancer Institute, the National Institute of Health and more. She is a Fellow of the American Association of Cancer Researchers, the American Pancreatic Association and the American Breast Cancer Association, and was the recipient for many outstanding scientist awards.

REFERENCES

Holick MF 2004 Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition;79(3):362-371. Siddiqui SM 2008 Dietary intervention with vitamin D, calcium, and whey protein reduced fat mass and increased lean mass in rats. Nutritional Research ;28(11):783-790.

Holick MF 2003 Vitamin D: a millennium perspective. J Cell Biochem 88:296–307

Mithal A 2009 Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820

Kuchuk NO, van Schoor NM, Pluijm SM, Chines A, Lips P 2009 Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701

Hewison M 2008 Vitamin D and innate immunity. Curr Opin Investig Drugs 9:485–490

Holick MF 2008 Vitamin D: a D-lightful health perspective. Nutr Rev 66:S182–194

Koutkia, P. 2001 Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med.; 345 (1): 66-7.

Vieth, R. 2006 Critique of the considerations for establishing the tolerable upper intake level for vitamin D: critical need for revision upwards. J Nutr. 136 (4): 1117-22.