Supplement Doctor's Blog

Actually, nothing is better than sex. But hey, I got you to read this article.

Has your doctor told you to lay off the coffee? Well if he or she did, then clearly they’re dummies. Coffee is one of the best drinks for you! Drink more coffee and the risk of death from heart disease goes down. And besides, that caffeine fix in the morning is better than bad sex or a good donut.

Here’s the study: Coffee contains various compounds that have recently been reported to exert beneficial health effects. However, the conclusion of its relation with mortality has not yet been reached. In this study, we aimed to investigate the associations between coffee consumption and all-cause and cause-specific mortality in Japan. We included 37,742 participants (18,287 men and 19,455 women) aged 40-64 y without a history of cancer, myocardial infarction, or stroke at baseline in our analysis, based on the Miyagi Cohort Study initiated in 1990. The outcomes were mortality due to all causes, cardiovascular disease (CVD), and cancer. During the 10.3 y of follow-up, 2454 participants died, including 426 due to CVD and 724 due to cancer. In women, the multivariate hazard ratios (HR) (95% CI) for all-cause mortality in participants who drank coffee never, occasionally, 1-2 cups (150-300 mL)/d, and >/=3 cups/d were 1.00, 0.88 (0.73-1.06), 0.82 (0.66-1.02), and 0.75 (0.53-1.05), respectively (P-trend = 0.04). For CVD mortality in women, the multivariate HR (95% CI) were 1.00, 0.56 (0.36-0.86), 0.48 (0.29-0.80), and 0.45 (0.20-1.03), respectively (P-trend = 0.006). Of the specific CVD diseases, there was a strong inverse association between coffee consumption and mortality due to coronary heart disease (CHD) in women (P-trend = 0.02) but not in men. Death due to cancer was not associated with coffee consumption in either men or women, except for colorectal cancer in women. Our results suggest that coffee may have favorable effects on mortality due to all causes and to CVD, especially CHD, in women.

Reference:

J Nutr. 2010 Mar 24. [Epub ahead of print]

Coffee Consumption and Mortality Due to All Causes, Cardiovascular Disease, and Cancer in Japanese Women. Sugiyama K, Kuriyama S, Akhter M, Kakizaki M, Nakaya N, Ohmori-Matsuda K, Shimazu T, Nagai M, Sugawara Y, Hozawa A, Fukao A, Tsuji I. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.

We know creatine is safe for those with normal renal function. What about someone with one kidney and mild renal dysfunction? Mmm...inquiring minds want to know?
Well according to this recent study, short term creatine supplementation had no effect (i.e. no harm) in such an individual.

It currently is unknown whether creatine supplementation is safe for people with or at risk of kidney disease. We report on the short-term effects of creatine supplementation on kidney function in a young man with a single kidney and mildly decreased glomerular filtration rate (GFR). A 20-year-old man who had undergone unilateral nephrectomy and presented with mildly decreased GFR without kidney damage underwent a trial with 35 days of creatine supplementation (20 g/d for 5 days followed by 5 g/d for the next 30 days) and had his kidney function monitored. After the intervention, (51)Cr-EDTA clearance (pre, 81.6 mL/min/1.73 m(2); post, 82.0 mL/min/1.73 m(2)), proteinuria (protein excretion: pre, 130 mg/d; post, 120 mg/d), and electrolyte levels were unchanged. Albuminuria, serum urea level, and estimated creatinine clearance were decreased (pre, 4.6 mg/d; post, 2.9 mg/d; pre, 37 mg/d; post, 28 mg/dL; and pre, 88 mL/min/1.73 m(2); post, 71 mL/min/1.73 m(2), respectively), whereas serum creatinine level was slightly increased (pre, 1.03 mg/dL; post, 1.27 mg/dL), falsely suggesting kidney function impairment. This prospective report suggests that short-term creatine supplementation may not affect kidney function in an individual with a single kidney, mild decreased GFR, and ingesting a high-protein diet (ie, 2.8 g/kg/d). This finding

Reference
Am J Kidney Dis. 2010 Mar;55(3):e7-9. Epub 2010 Jan 8.
Effect of short-term high-dose creatine supplementation on measured GFR in a young man with a single kidney. Gualano B, Ferreira DC, Sapienza MT, Seguro AC, Lancha AH Jr.
Laboratory of Nutrition and Metabolism Applied to Exercise, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil. gualano@usp.br

 

Whey protein great for reducing post-meal glucose and insulin and reducing food intake!

As you well know, a diet high in unprocessed carbs such as all vegetables and fruits, combined with plenty of protein (e.g. fish, beef, milk, chicken, etc) and unsaturated fats (e.g. avocado, fish fat, nuts of all kinds, olive oil, etc) is the best way to attain a lean physique and heck, attain health (if you care about that). Most of us are motivated by vanity.

Anyhow, eating 6 small meals a day, spaced out evenly is important as well. And the most important meal of the day is not breakfast, but is in fact what you consume pre, during, and post exercise. Whey is a great protein source during the nutrient timing period. In fact, an interesting study, just hot off the press, gives us more insight into this amazing protein. In essence, they found that whey protein consumed before a meal reduces food intake, post-meal blood glucose and insulin, and the ratio of cumulative blood glucose to insulin AUCs in a dose-dependent manner.

BACKGROUND: Dairy protein ingestion before a meal reduces food intake and, when consumed with carbohydrate, reduces blood glucose. OBJECTIVE: The objective was to describe the effect of whey protein (WP) or its hydrolysate (WPH) when consumed before a meal on food intake, pre- and postmeal satiety, and concentrations of blood glucose and insulin in healthy young adults. DESIGN: Two randomized crossover studies were conducted. WP (10-40 g) in 300 mL water was provided in experiment 1, and WP (5-40 g) and WPH (10 g) in 300 mL water were provided in experiment 2. At 30 min after consumption, the subjects were fed an ad libitum pizza meal (experiment 1) or a preset pizza meal (12 kcal/kg, experiment 2). Satiety, blood glucose, and insulin were measured at baseline and at intervals both before and after the meals. RESULTS: In experiment 1, 20-40 g WP suppressed food intake (P < 0.0001) and 10-40 g WP reduced postmeal blood glucose concentrations and the area under the curve (AUC) (P < 0.05). In experiment 2, 10-40 g WP, but not WPH, reduced postmeal blood glucose AUC and insulin AUC in a dose-dependent manner (P < 0.05). The ratio of cumulative blood glucose to insulin AUCs (0-170 min) was reduced by >/=10 g WP but not by 10 g WPH. CONCLUSIONS: WP consumed before a meal reduces food intake, postmeal blood glucose and insulin, and the ratio of cumulative blood glucose to insulin AUCs in a dose-dependent manner. Intact WP, but not WPH, contributes to blood glucose control by both insulin-dependent and insulin-independent mechanisms.

Reference
Am J Clin Nutr. 2010 Apr;91(4):966-75. Epub 2010 Feb 17. Effect of premeal consumption of whey protein and its hydrolysate on food intake and postmeal glycemia and insulin responses in young adults. Akhavan T, Luhovyy BL, Brown PH, Cho CE, Anderson GH.

 

Besides the fact that creatine enhances muscle protein gains, improves exercise performance, aids cognitive function, protects against brain trauma, and helps performance under heat stress, let's add the fact that it may also "contribute to an increased exercise performance mediated by increased ability to cope with training-induced increases in oxidative stress." Pretty cool for a molecule found naturally in meat.

BACKGROUND: Creatine is a key intermediate in energy metabolism and supplementation of creatine has been used for increasing muscle mass, strength and endurance. Creatine supplementation has also been reported to trigger the skeletal muscle expression of insulin like growth factor I, to increase the fat-free mass and improve cognition in elderly, and more explorative approaches like transcriptomics has revealed additional information. The aim of the present study was to reveal additional insight into the biochemical effects of creatine supplementation at the protein and metabolite level by integrating the explorative techniques, proteomics and NMR metabonomics, in a systems biology approach. METHODS: Differentiated mouse myotube cultures (C2C12) were exposed to 5 mM creatine monohydrate (CMH) for 24 hours. For proteomics studies, lysed myotubes were analyzed in single 2-DGE gels where the first dimension of protein separation was pI 5-8 and second dimension was a 12.5% Criterion gel. Differentially expressed protein spots of significance were excised from the gel, desalted and identified by peptide mass fingerprinting using MALDI-TOF MS. For NMR metabonomic studies, chloroform/methanol extractions of the myotubes were subjected to one-dimensional 1H NMR spectroscopy and the intracellular oxidative status of myotubes was assessed by intracellular DCFH2 oxidation after 24 h pre-incubation with CMH. RESULTS: The identified differentially expressed proteins included vimentin, malate dehydrogenase, peroxiredoxin, thioredoxin dependent peroxide reductase, and 75 kDa and 78 kDa glucose regulated protein precursors. After CMH exposure, up-regulated proteomic spots correlated positively with the NMR signals from creatine, while down-regulated proteomic spots were negatively correlated with these NMR signals. The identified differentially regulated proteins were related to energy metabolism, glucose regulated stress, cellular structure and the antioxidative defence system. The suggested improvement of the antioxidative defence was confirmed by a reduced intracellular DCFH2 oxidation with increasing concentrations of CMH in the 24 h pre-incubation medium. CONCLUSIONS: The explorative approach of this study combined with the determination of a decreased intracellular DCFH2 oxidation revealed an additional stimulation of cellular antioxidative mechanisms when myotubes were exposed to CMH. This may contribute to an increased exercise performance mediated by increased ability to cope with training-induced increases in oxidative stress.

REFERENCE
J Int Soc Sports Nutr. 2010 Feb 4;7(1):9.
Creatine-induced activation of antioxidative defence in myotube cultures revealed by explorative NMR-based metabonomics and proteomics.
Young JF, Larsen LB, Malmendal A, Nielsen NC, Straadt IK, Oksbjerg N, Bertram HC.
Department of Food Science, Faculty of Agricultural Sciences, University of Aarhus, Denmark. JetteF.Young@agrsci.dk.

You've heard the mantra:  Don't eat saturated fat because it causes heart disease.  Well, its seems odd that if you scour the scientific literature, no such consensus exists.  Is it possible that physicians have duped the American public for nearly 4 decades?  Uh, yeah.  Here is a study (a meta-analysis) which basically concludes that there is no significant evidence to show that saturated fat is associated with heart disease.  I betcha, it's when folks eat processed crappy carbs (which BTW was not part of the human food supply for most of our existence) that makes you fat and heart-disease prone.  Though I do love those Cinnabons they sell at airports. 

BACKGROUND: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health. OBJECTIVE: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies. DESIGN: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD. RESULTS: During 5-23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results. CONCLUSIONS: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

Reference:  Am J Clin Nutr. 2010 Mar;91(3):535-46. Epub 2010 Jan 13. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.

We know that isoenergetic (same calories) diets that are higher in protein and lower in carbs (same amount of fat) will result in greater fat loss and less loss of lean body mass.  If you're goal is to be fat slob, eat bread, cookies, pies, and watch the Lifetime channel.  Well, if you take overweight diabetics, it is still better to put them on a high protein diet (when will the AHA and ADA change their stupid stance on these diets?).  In fact, a high protein diet lower triglycerides more and improves blood pressure better than the lower protein variety.  The moral of the story:  Eat Protein!

Background/Objectives:  There is controversy over dietary protein's effects on cardiovascular disease risk factors in diabetic subjects. It is unclear whether observed effects are due to increased protein or reduced carbohydrate content of the consumed diets. The aim of this study was to compare the effects of two diets differing in protein to fat ratios on cardiovascular disease risk factors. 

Subjects/Methods:A total of 17 obese (body mass index (BMI) ranging from 31 to 45 kg/m(2)) volunteers with type 2 diabetes (DM2), aged 46+/-3 years, consumed two diets, each for 4 weeks, with 3 weeks of washout period in a random, blind, crossover design. The diets were: (1) a high-protein low-fat diet (HP-LF, with 30% protein, 50% carbohydrates and 20% fat) and (2) a low-protein high-fat diet (LP-HF, with 15% protein, 50% carbohydrates and 35% fat). Their effects on fasting glycemic control, lipid levels and blood pressure, and on postprandial glucose and insulin responses after a standard test meal at the beginning and end of each dietary intervention were analyzed. 

Results:  Both diets were equally effective in promoting weight loss and fat loss and in improving fasting glycemic control, total cholesterol and low-density lipoprotein (LDL) cholesterol, but the HP-LF diet decreased to a greater extent triglyceride (TG) levels (P=0.04) when compared with the LP-HF diet. HP-LF diet improved significantly both systolic and diastolic blood pressure when compared with the LP-HF diet (P<0.001 and P<0.001, respectively). No differences were observed in postprandial glucose and insulin responses.

Conclusions:  A protein to fat ratio of 1.5 in diets significantly improves blood pressure and TG concentrations in obese individuals with DM2.

 

Reference:  Eur J Clin Nutr. 2010 Mar 10. [Epub ahead of print]; A high-protein low-fat diet is more effective in improving blood pressure and triglycerides in calorie-restricted obese individuals with newly diagnosed type 2 diabetes.; Papakonstantinou E, Triantafillidou D, Panagiotakos DB, Koutsovasilis A, Saliaris M, Manolis A, Melidonis A, Zampelas A.

[1] Department of Dietetics and Nutrition Sciences, Harokopio University, Athens, Greece [2] Second Department of Internal Medicine, Research Institute and Diabetes Center, Athens

Creatine - ya ever heard of it? Yea yea...I know. You take it like a little boy eats candy on Halloween night. Pray tell, why do folks get so bent outta shape about creatine? You'd think this stuff was as harmful as sticking your head in an oven or running through a crowded shopping mall with a pair of scissors or skinny dipping in a pool of sharks. But heck, check out this study showing that creatine is even safe in those with Parkinson disease.

Study summary: The food supplement creatine (Cr) is widely used by athletes as a natural ergogenic compound. It has also been increasingly tested in neurodegenerative diseases as a potential neuroprotective agent. Weight gain is the most common side effect of Cr, but sporadic reports about the impairment of renal function cause the most concerns with regard to its long-term use. Data from randomized controlled trials on renal function in Cr-supplemented patients are scarce and apply mainly to healthy young athletes. We systematically evaluated potential side effects of Cr with a special focus on renal function in aged patients with Parkinson disease as well as its current use in clinical medical research. Sixty patients with Parkinson disease received either oral Cr (n = 40) or placebo (n = 20) with a dose of 4 g/d for a period of 2 years. Possible side effects as indicated by a broad range of laboratory blood and urine tests were evaluated during 6 follow-up study visits. Overall, Cr was well tolerated. Main side effects were gastrointestinal complaints. Although serum creatinine levels increased in Cr patients because of the degradation of Cr, all other markers of tubular or glomerular renal function, especially cystatin C, remained normal, indicating unaltered kidney function. The data in this trial provide a thorough analysis and give a detailed overview about the safety profile of Cr in older age patients.

Nutr Res. 2008 Mar;28(3):172-8.
Long-term creatine supplementation is safe in aged patients with Parkinson disease.
Bender A, Samtleben W, Elstner M, Klopstock T.
Department of Neurology, University of Munich-Klinikum Grosshadern, 81377 Munich, Germany. andreas.bender@med.uni-muenchen.de

 

You know how the fat on a girl's behind is different than the kind of fat that dangles from the posterior aspect of the arm? Okay, well now that I have your attention; did you know that the thermic effect of a meal high in polyunsaturated fat is higher than one in monounsaturated fat which in turn is higher than a meal high in saturated fat? Pretty nifty eh

BACKGROUND & AIMS: To compare the acute effects of three fatty meals with different fat quality on postprandial thermogenesis, substrate oxidation and satiety. METHODS: Twenty-nine healthy men aged between 18 and 30 years participated in a randomised crossover trial comparing the thermogenic effects of three isocaloric meals: high in polyunsaturated fatty acids from walnuts, high in monounsaturated fatty acids from olive oil, and high in saturated fatty acids from fat-rich dairy products. Indirect calorimetry was used to determine resting metabolic rate, respiratory quotient, 5-h postprandial energy expenditure and substrate oxidation. Satiety was estimated by using visual analogue scales and measuring caloric intake in a subsequent ad libitum meal. RESULTS: Five-h postprandial thermogenesis was higher by 28% after the high-polyunsaturated meal (p=0.039) and by 23% higher after the high-monounsaturated meal (p=0.035) compared with the high-saturated meal. Fat oxidation rates increased nonsignificantly after the two meals rich in unsaturated fatty acids and decreased nonsignificantly after the high-saturated fatty acid meal. Postprandial respiratory quotient, protein and carbohydrate oxidation, and satiety measures were similar among meals. CONCLUSIONS: Fat quality determined the thermogenic response to a fatty meal but had no clear effects on substrate oxidation or satiety.

Reference
Clin Nutr. 2009 Feb;28(1):39-45. Epub 2008 Nov 17.
Acute effects of three high-fat meals with different fat saturations on energy expenditure, substrate oxidation and satiety.
Casas-Agustench P, López-Uriarte P, Bulló M, Ros E, Gómez-Flores A, Salas-Salvadó J.
Human Nutrition Unit, Biochemistry and Biotechnology Department, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.

 

Bottom line: If you cut calories, make sure you eat lots of protein; because if you do not, you'll lose lean body mass. That would be like losing frequent flier miles. It really sucks.

PURPOSE: To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. METHODS: In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. RESULTS: Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. CONCLUSIONS: These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

Reference
Med Sci Sports Exerc. 2010 Feb;42(2):326-37.
Increased protein intake reduces lean body mass loss during weight loss in athletes.
Mettler S, Mitchell N, Tipton KD.
School of Sport and Exercise Sciences, University of Birmingham, Birmingham, United Kingdom.

 

If you still think all proteins are the same, then you probably think Madonna is a virgin and that the Americas were discovered by Dora the Explorer.  Here’s an interesting study showing that egg protein hydrolysates can actually improve brain function!  Look out Mensa.

 

Reduced brain serotonin function is involved in stress-related disturbances and may particularly occur under chronic stress. Although serotonin production directly depends on the availability of its plasma dietary amino acid precursor tryptophan (TRP), previously described effects of tryptophan-rich food sources on stress-related behavior are rather modest. Recently, an egg protein hydrolysate (EPH) was developed that showed a much greater effect on brain TRP availability than pure TRP and other TRP-food sources and therefore may be more effective for performance under stress. The aim of the present study was to investigate the effects of EPH compared to placebo protein on plasma amino acids, stress coping and performance in subjects with high and low chronic stress vulnerabilities. METHODS: In a placebo-controlled, double-blind, crossover study, 17 participants with high and 18 participants with low chronic stress vulnerabilities were monitored for mood and performance under acute stress exposure either following intake of EPH or placebo. RESULTS: EPH significantly increased plasma TRP availability for uptake into the brain, decreased depressive mood in all subjects and improved perceptual-motor and vigilance performance only in low chronic stress-vulnerable subjects. CONCLUSIONS: The acute use of a TRP-rich egg protein hydrolysate (EPH) is an adequate method to increase plasma TRP for uptake into the brain and may be beneficial for perceptual-motor and vigilance performance in healthy volunteers.

 

Reference

Clin Nutr. 2010 Feb 16. [Epub ahead of print]

Effect of tryptophan-rich egg protein hydrolysate on brain tryptophan availability, stress and performance. Markus CR, Verschoor E, Firk C, Kloek J, Gerhardt CC.

 

Pressurized Whey protein can help those with cystic fibrosis.   It always amazes me how parents of teenage athletes are so ‘frightened' by the prospect of their kid taking a whey protein supplement.  It would be like a fish being afraid of water or Santa Claus liking nice girls more than naughty ones.  Just doesn't make sense

Cystic fibrosis (CF) is characterized by malnutrition, chronic pulmonary inflammation, and oxidative stress. Whey protein is rich in sulfhydryl groups and is recognized for its ability to increase glutathione and reduce oxidative stress. Previously, we have shown that supplementation with whey increased intracellular glutathione levels in patients with CF. We have subsequently shown that hyperbaric pressure treatment of whey protein promotes the release of novel peptides for absorption, increases intracellular glutathione in healthy subjects, and reduces in vitro production of interleukin (IL)-8. We hypothesized that pressurized whey supplementation in children and adults with CF could have significant nutritional and anti-inflammatory benefits. A pilot open-label study of 1-month dietary supplementation with pressurized whey in CF patients was undertaken to assess the effects. Twenty-seven patients with CF (nine children, 18 adults) were enrolled. The dose of pressurized whey was 20 g/day in patients less than 18 years of age and 40 g/day in older patients. Anthropometric measures, pulmonary function, serum C-reactive protein (CRP), whole blood glutathione, and whole blood IL-8 and IL-6 responses to phytohemagglutinin (PHA) stimulation were measured at baseline and at 1 month. Three adults withdrew (one with gastrointestinal side effects, two with acute infection). Both children and adults showed enhancements in nutritional status, as assessed by body mass index. Children showed improvement in lung function (forced expiratory volume in 1 second). The majority of patients with an initially elevated CRP showed a decrease. PHA-stimulated IL-8 responses tended to decrease in the adults. Whole blood glutathione levels did not change. Thus, oral supplementation with pressurized whey improves nutritional status and can have additional beneficial effects on inflammation in patients with CF.

Reference

J Med Food. 2010 Feb;13(1):77-82.

Dietary supplementation with pressurized whey in patients with cystic fibrosis.

Lands LC, Iskandar M, Beaudoin N, Meehan B, Dauletbaev N, Berthiuame Y.

Division of Pediatric Respiratory Medicine, Montreal Children's Hospital-McGill University Health Centre, Montréal, Québec, Canada. larry.lands@muhc.mcgill.ca

Interesting study. If you want to gain muscle mass, it is best that you avoid doing endurance training. Often times it negates the effects of heavy resistance training. For instance, in the group that did weight training only, fast twitch fibers increased in size but didn't change in the group that combined strength and endurance training. Ergo, if the goal is size, minimize the endurance stuff.

Both strength and endurance training have several positive effects on aging muscle and physical performance of middle-aged and older adults, but their combination may compromise optimal adaptation. This study examined the possible interference of combined strength and endurance training on neuromuscular performance and skeletal muscle hypertrophy in previously untrained 40-67-year-old men. Maximal strength and muscle activation in the upper and lower extremities, maximal concentric power, aerobic capacity and muscle fiber size and distribution in the vastus lateralis muscle were measured before and after a 21-week training period. Ninety-six men [mean age 56 (SD 7) years] completed high-intensity strength training (S) twice a week, endurance training (E) twice a week, combined training (SE) four times per week or served as controls (C). SE and S led to similar gains in one repetition maximum strength of the lower extremities [22 (9)% and 21 (8)%, P<0.001], whereas E and C showed minor changes. Cross-sectional area of type II muscle fibers only increased in S [26 (22)%, P=0.002], while SE showed an inconsistent, non-significant change [8 (35)%, P=0.73]. Combined training may interfere with muscle hypertrophy in aging men, despite similar gains in maximal strength between the strength and the combined training groups.

Reference:
Scand J Med Sci Sports. 2009 Dec 18. [Epub ahead of print] Effects of combined endurance and strength training on muscle strength, power and hypertrophy in 40-67-year-old men. Karavirta L et al. Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland.

 

Krill are shrimp-like crustaceans that are approximately 1 to 6 centimeters long. They live is the ocean, where they feed mainly on phytoplankton. They're near the bottom of the food chain and are eaten by whales, seals, penguins, squid and fish. http://altmedicine.about.com/od/herbsupplementguide/a/krilloil.htm

And guess what, this stuff can jack up EPA and DHA levels probably just as good as gorging on salmon at the sushi bar.

Antarctic krill, also known as Euphausia superba, is a marine crustacean rich in both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We tested the hypothesis that krill oil would increase plasma concentrations of EPA and DHA without adversely affecting indicators of safety, tolerability, or selected metabolic parameters. In this randomized, double-blind parallel arm trial, overweight and obese men and women (N = 76) were randomly assigned to receive double-blind capsules containing 2 g/d of krill oil, menhaden oil, or control (olive) oil for 4 weeks. Results showed that plasma EPA and DHA concentrations increased significantly more (P < .001) in the krill oil (178.4 +/- 38.7 and 90.2 +/- 40.3 micromol/L, respectively) and menhaden oil (131.8 +/- 28.0 and 149.9 +/- 30.4 micromol/L, respectively) groups than in the control group (2.9 +/- 13.8 and -1.1 +/- 32.4 micromol/L, respectively). Systolic blood pressure declined significantly more (P < .05) in the menhaden oil (-2.2 +/- 2.0 mm Hg) group than in the control group (3.3 +/- 1.5 mm Hg), and the response in the krill oil group (-0.8 +/- 1.4 mm Hg) did not differ from the other 2 treatments. Blood urea nitrogen declined in the krill oil group as compared with the menhaden oil group (P < .006). No significant differences for other safety variables were noted, including adverse events. In conclusion, 4 weeks of krill oil supplementation increased plasma EPA and DHA and was well tolerated, with no indication of adverse effects on safety parameters.

References
Nutrition Research. 2009 Sep;29(9):609-15. Krill oil supplementation increases plasma concentrations of eicosapentaenoic and docosahexaenoic acids in overweight and obese men and women. Maki KC et al. Provident Clinical Research, Bloomington, IN 47403, USA; Provident Clinical Research, Glen Ellyn, IL 60137, USA. kmaki@providentcrc.com

 

What the heck is Sea Tangle?  Apparently, it is a commercial seaweed (aka Laminaria japonica) which was introduced into China in the late 1920s from Hokkaido, Japan. Between the 1950s and the 1980s kelp production in China increased from about 60 to over 250,000 dry weight metric tons annually, making China the largest producer of Laminaria. http://www.fao.org/docrep/field/003/ab724e/AB724E00.htm

 

Well this stuff was given to women in a recent study.  And it might help you lose weight.  But there’s one caveat with this study. They had no control group.  Nevertheless, it’s worth a read.

 

This study was conducted to evaluate the effects of a body weight control program with supplementation of sea tangle (20 g/day) on 22 female college students. The contents of the program for 8 weeks contained diet therapy, exercise and behavioral modification through nutrition education. Body composition, dietary habit scores, serum lipid profiles, daily nutrient intakes and the quality of life were assessed at the beginning and at the end of the program. Average age of subjects and height were 20.8 years and 161.9 cm, respectively. After 8 weeks, there were significant reductions in body weight, body fat mass, percent body fat, waist-hip ratio and BMI. The dietary habit score such as a balanced diet, regularity of mealtime, overeating, eating while watching TV or using the computer and eating salty food were increased significantly. Serum lipid levels such as total cholesterol level, LDL-cholesterol level and triglyceride level were decreased but not significantly. There were decreases in intake of energy, protein and fat and increases in intakes of dietary fiber, folic acid, calcium and potassium from the beginning to the end of the program. There were significant improvements on subcomponents of quality of life; physical functioning, general-health and vitality. The limitation of this study was the fact that there was no control group, but an overall evaluation suggests the 8-week body weight control program consisting of diet therapy, exercise and behavioral modification with supplementation of sea tangle would be helpful to improve the body composition, dietary habits, daily nutrient intakes and quality of life in Korean female college students.

 

Reference

Nutr Res Pract. 2009 Winter;3(4):307-14. Epub 2009 Dec 31. Evaluation of 8-week body weight control program including sea tangle (Laminaria japonica) supplementation in Korean female college students. You JS, Sung MJ, Chang KJ. Department of Food and Nutrition, Inha University, 253 Youghyun-dong, Nam-gu, Incheon 402-751, Korea.

 

 

My advice:  get some sun!  (sorry if you live in Cleveland or Seattle); if you don't get enough sun, take at least 2000-4000IUs of Vitamin D daily; and once again, this study demonstrates how silly the current RDA is for this amazing vitamin.

Context: Vitamin D insufficiency has now reached epidemic proportions and has been linked to increased body fat and decreased muscle strength. Whether vitamin D insufficiency is also related to adipose tissue infiltration in muscle is not known. Objective: The objective of the study was to examine the relationship between serum 25-hydroxyvitamin D (25OHD) and the degree of fat infiltration in muscle. Design: This was a cross-sectional study. Outcome Measures and Subjects: Measures were anthropometric measures, serum 25OHD radioimmunoassay values, and computed tomography (CT) values of fat, muscle mass, and percent muscle fat in 90 postpubertal females, aged 16-22 yr, residing in California. Results: Approximately 59% of subjects were 25OHD insufficient (/=30 ng/ml). A strong negative relationship was present between serum 25OHD and CT measures of percent muscle fat (r = -0.37; P < 0.001). In contrast, no relationship was observed between circulating 25OHD concentrations and CT measures of thigh muscle area (r = 0.16; P = 0.14). Multiple regression analysis indicated that the relation between 25OHD and muscle adiposity was independent of body mass or CT measures of sc and visceral fat. Percent muscle fat was significantly lower in women with normal serum 25OHD concentrations than in women with insufficient levels and deficient levels (3.15 +/- 1.4 vs. 3.90 +/- 1.9; P = 0.038). Conclusions: We found that vitamin D insufficiency is associated with increased fat infiltration in muscle in healthy young women.

Reference:

J Clin Endocrinol Metab. 2010 Feb 17. [Epub ahead of print]
Vitamin D Status and Its Relation to Muscle Mass and Muscle Fat in Young Women.
Gilsanz V, Kremer A, Mo AO, Wren TA, Kremer R.
Departments of Radiology (V.G., A.K., A.O.M., T.A.L.W.) and Orthopaedic Surgery (V.G., T.A.L.W.), Keck School of Medicine, University of Southern California, Los Angeles, California 90027; and Department of Medicine (R.K.), McGill University Health Center, McGill University, Montréal, Québec, Canada H9X 3V9.

Dietary fat itself is something that has gotten a bad rap. The misinformation propagated by the American Heart Association and American Dietetic Association certainly hasn't helped. But let's face it, the science indicates otherwise. To wit, here are some tidbits for you to chew on.

1. Fat from nuts and legumes are healthy. One study determined the effects of chronic peanut consumption on diet composition as well as serum lipids, magnesium and homocysteine concentrations in free-living subjects under different conditions of peanut intake a 30-week cross-over study. Energy intake from fat was increased through greater intake of MUFA (monounsaturated fat) and polyunsaturated fatty acids, while saturated fatty acid intake remained relatively stable under all conditions. What happened? Regular peanut consumption lowers serum triglycerides and increases the consumption of nutrients associated with reduced heart disease risk.(1)

2. EPA, an omega-3 fatty acid, helps blood vessels. Eicosapentaenoic acid (EPA) was tested to see if it improved metabolic vasodilation evoked by exercise in patients with coronary artery disease (CAD). Forearm blood flow (FBF) was measured by strain gauge plethysmography in 10 patients with stable CAD, before and 3 months after oral treatment with EPA (1,800 mg/kg). These results indicated that long-term treatment with EPA improves both endothelium-dependent and exercise-induced forearm vasodilations in patients with CAD and that this mechanism may be related to nitric oxide.(2)

3. Omega-3 fatty acids can be used to treat pain. Yes indeed! A group of clinicians reported their experience in a neurosurgical practice using fish oil supplements for pain relief. From March to June 2004, 250 patients who had been seen by a neurosurgeon and were found to have nonsurgical neck or back pain were asked to take a total of 1200 mg per day of omega-3 EFAs (eicosapentaenoic acid and decosahexaenoic acid) found in fish oil supplements. A questionnaire was sent approximately 1 month after starting the supplement. Fifty-nine percent discontinued taking their prescription NSAID medications for pain. Sixty percent stated that their overall pain was improved, and 60% stated that their joint pain had improved. Eighty percent stated they were satisfied with their improvement, and 88% stated they would continue to take the fish oil. So there you have it! Omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain in this selective group.(3) Bottom line: eat lots of fish!

4. Omega-3 fatty acids make you happy! Scientific research has shown that low frequency of fish eating was statistically significantly associated with depression in women, but not in men.(4) So if your girlfriend, wife, or both seem a little grumpy, take ‘em to a sushi restaurant and feed ‘em sashimi!

5. Diacylglycerol is a natural component of edible oils that has metabolic characteristics that are distinct from those of triacylglycerol. And get this; it may even help you lose fat! A recent study was conducted at an outpatient clinical research center. The subjects were fat men and women. Food products (muffins, crackers, soup, cookies, and granola bars) containing diacylglycerol or triacylglycerol oil and having the same fatty acid composition were incorporated into a reduced-energy diet (2100-3350-kJ/d deficit) for 24 weeks. Percentages of change in body weight, fat mass and intraabdominal fat area were determined. They discovered that foods containing diacylglycerol oil promoted weight loss and body fat reduction.(5) Wow. Fat that helps fat people lose fat.

6. Olive oil has been very very good to me (and you!) Yes, in a study looking at 7,368 male and female Spanish university graduates (the SUN Project), they were followed for a median period of 28.5 months. Their study showed that a high amount of olive oil consumption is not associated with higher weight gain or a significantly higher risk of developing overweight or obesity in the context of the Mediterranean food pattern.(6) So there you have it. Eat olive oil. It won't make you fat.

7. DHA is good for your brain, esp. your child's brain. The important physiological function of docosahexaenoic acid (DHA) vis a vis child development has been studied. Infants whose mothers had a supplement of DHA during pregnancy and lactation had kids with better physical development, visual acuity and intelligence.(7) So if your wife is prego, give her some DHA. Your kids will be bigger and smarter.

8. In one study, four weeks of krill oil supplementation increased plasma EPA and DHA and was well tolerated, with no indication of adverse effects on safety parameters.(8) BTW, krill are those little shrimp that sea mammals love to eat.

References
1. Alper CM, Mattes RD. Peanut consumption improves indices of cardiovascular disease risk in healthy adults. J Am Coll Nutr 2003;22:133-41.
2. Tagawa T, Hirooka Y, Shimokawa H, et al. Long-term treatment with eicosapentaenoic acid improves exercise-induced vasodilation in patients with coronary artery disease. Hypertens Res 2002;25:823-9.
3. Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol 2006;65:326-31.
4. Timonen M, Horrobin D, Jokelainen J, Laitinen J, Herva A, Rasanen P. Fish consumption and depression: the Northern Finland 1966 birth cohort study. J Affect Disord 2004;82:447-52.
5. Maki KC, Davidson MH, Tsushima R, et al. Consumption of diacylglycerol oil as part of a reduced-energy diet enhances loss of body weight and fat in comparison with consumption of a triacylglycerol control oil. Am J Clin Nutr 2002;76:1230-6.
6. Bes-Rastrollo M, Sanchez-Villegas A, de la Fuente C, de Irala J, Martinez JA, Martinez-Gonzalez MA. Olive oil consumption and weight change: the SUN prospective cohort study. Lipids 2006;41:249-56.
7. Meng LP, Zhang J, Zhao WH. [Relationship between maternal DHA intake and DHA status and development of fetus and infant]. Wei Sheng Yan Jiu 2005;34:231-3.
8. Maki KC, Reeves MS, Farmer M, et al. Krill oil supplementation increases plasma concentrations of eicosapentaenoic and docosahexaenoic acids in overweight and obese men and women. Nutr Res 2009;29:609-15.

 

(1)  Okay, soy doesn’t suck too bad.  If you’re a vegan, it’s pretty much your only good choice. 

2.  If you have a fat girlfriend, make her eat more protein. A recent study compared the interaction of 2 diets (high protein, reduced carbohydrates vs. low protein, high carbohydrates) with exercise on body composition and blood lipids in women during weight loss. The study was a 4-monthweight loss trial; they found that a diet with higher protein and reduced carbohydrates combined with exercise additively improved body composition during weight loss.(2)  So if your lady is a little chubby around the boootay, make her a protein shake.  And just say no to donuts.  And tie a rope around her waist and put her on a treadmill. And…well, you get the drift.

3. I wish there was a market for protein supplements for pet rodents.  Yes, there are so many friggin’ rat studies that it makes you wonder if someone is getting rich giving rats foods and supplements to make them leaner, more muscular rats! For instance, one study supports the conclusion that a high-protein diet reduces energy intake and adiposity and that whey protein is more effective than red meat in reducing body weight gain and increasing insulin sensitivity in these ugly creatures.(3) To all you 'Ben' lovers, I apologize.

4. Eating lots of protein is not bad for your kidneys.  On the other hand, holding your pee is.  In this study, scientists investigated body-builders (4) and other well-trained athletes with high and medium protein intake, respectively, in order to shed light on this issue of whether it really does mess up kidney function. To conclude, according to these eggheads, it appears that protein intake under 2.8 grams daily per kg body weight does not impair renal function in well-trained athletes. (5) And yes, holding your pee isn’t good for you.

5.  Whey is fast and casein is slow.  Casein is better. Okay, so what.  (See #6).

The speed of absorption of dietary amino acids by the gut varies according to the type of ingested dietary protein. This could affect postprandial protein synthesis, breakdown, and deposition. For instance, net leucine balance over a 7 hour period after the meal of casein or whey was consumed, found that it was more positive with casein than with whey.(6) So casein is better?  Maybe.  Maybe not. 

6.  Oops...sorry.  Whey is better.  This study didn’t just look at what happens during the first 7 hours.  I mean who really gives a shit what happens during the first few hours.  It is MUCH more important if you examine what happens over days, weeks, months, and perhaps years!  A recent study examined the effects of supplementation with two proteins, hydrolyzed whey isolate (WI) and casein (C), on strength and body composition during a 10 week, supervised resistance training program in 13 male bodybuilders.  The WI group achieved a significantly greater gain in lean mass than the C group and a significant loss in fat mass compared to the C group.  The WI group also achieved significantly greater improvements in strength compared to the C group in each assessment of strength.  And to top it off, when the strength changes were expressed relative to body weight, the WI group still achieved significantly greater improvements in strength compared to the C group.(4)  So there you have it, in the long run, whey is better (perhaps) than casein.  That is if you’re interested in getting bigger, faster, and stronger. 

---

References

1. Phillips SM, Hartman JW, Wilkinson SB. Dietary protein to support anabolism with resistance exercise in young men. J Am Coll Nutr 2005;24:134S-9S.
2. Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA. Dietary Protein and Exercise Have Additive Effects on Body Composition during Weight Loss in Adult Women. J Nutr 2005;135:1903-10.
3. Belobrajdic DP, McIntosh GH, Owens JA. A high-whey-protein diet reduces body weight gain and alters insulin sensitivity relative to red meat in wistar rats. J Nutr 2004;134:1454-8.
4. Cribb PJ, Williams AD, Carey MF, Hayes A. The effect of whey isolate and resistance training on strength, body composition, and plasma glutamine. Int J Sport Nutr Exerc Metab 2006;16:494-509.
5. Poortmans JR, Dellalieux O. Do regular high protein diets have potential health risks on kidney function in athletes? Int J Sport Nutr Exerc Metab 2000;10:28-38.
6. Boirie Y, Dangin M, Gachon P, Vasson MP, Maubois JL, Beaufrere B. Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci U S A 1997;94:14930-5.

Recently, potential antioxidants (vitamin E, polyphenols, etc) have received much attention as potential anti-atherosclerotic agents (i.e. fighting heart disease). Among the polyphenols with health benefit properties, resveratrol, a phytoalexin of grape, seems promising for protecting the blood vessel walls from oxidation, inflammation, platelet aggregation, and thrombus formation.1 Huh? Let me explain. The so-called French paradox refers to the fact that people in France have relatively low frequency of heart disease despite the fact that they stuff themselves full of butter and smoke like yesterday's chimney.

Believe it or not, the phenomenon was first noted by Irish physician Samuel Black in 1819. For instance, the average French person consumed 108 grams per day of fat from animal sources in 2002 while the average American consumed about 72 grams. The French eat four times as much butter, 60 percent more cheese and nearly three times as much pork. They definitely love their fat! Who can blame ‘em. Fat tastes darn good. And with the recent discovery of the ‘new' fat ‘taste' receptor published in the Journal of Clinical Investigation, it makes sense why we love the feel of fat in our mouths.

So what explains this bizarre paradox of eating lots of saturated fat, yet having lower levels of heart disease and perhaps better health overall? It's called wine my friends. And more specifically, the active ingredient in red wine is something called resveratrol. This amazing ingredient found in grapes and red wine is well known for its positive effects on longevity in yeasts, worms and flies. Hey, you gotta start somewhere and scientists always like studying these ‘simple' organisms first before moving on to the more complicated hominid variety (i.e. us). Also, resveratrol has been shown to have anti-cancer and anti-inflammatory effects.2, 3. Another study demonstrated that resveratrol and quercetin have novel nonsteroidal anti-inflammatory activity that may have applications for the treatment of inflammatory diseases.4

More importantly, this ingredient could have profound effects on the health of women. Resveratrol and trans-resveratrol (i.e. the ‘trans' version is a slightly different molecular configuration of the resveratrol molecule) are powerful phytoestrogens, present in the skins of grapes and other plant foods and wine. As you may know, phytoestrogens are naturally occurring plant-derived non-steroidal compounds that are functionally and structurally similar to steroidal estrogens, such as estradiol, produced by women. Conventional hormone-replacement drugs may cause serious adverse effects including stroke and gallbladder disease, and a host of other maladies such as endometrial, uterine and breast cancers. So where does resveratrol fit in?

But resveratrol isn't just for women. There are animal studies which show that sperm count and plasma testosterone is higher in animals that consume resveratrol!5 So suffice it to say that drinking one glass of red wine a day is something I'd recommend for improved health and wellness.

Side Bar
What is it?
Resveratrol is a chemically referred to as a polyphenolic phytoalexin. It's found in the skin of red grapes and red wine.
What does it do?
Resveratrol has been show to have a number of beneficial health effects such as anti-cancer, anti-aging, anti-inflammatory as well as cardioprotective effects.
Commonly Consumed Dose for Efficacy
Reservartrol - A glass of red wine daily; (Note: it isn't clear at this point what the minimal or optimal human dose of resveratrol is [when taken as a supplement]

References
1. Delmas D, Jannin B, Latruffe N. Resveratrol: preventing properties against vascular alterations and ageing. Mol Nutr Food Res. May 2005;49(5):377-395.
2. Valenzano DR, Cellerino A. Resveratrol and the pharmacology of aging: a new vertebrate model to validate an old molecule. Cell Cycle. May 2006;5(10):1027-1032.
3. Delmas D, Lancon A, Colin D, Jannin B, Latruffe N. Resveratrol as a chemopreventive agent: a promising molecule for fighting cancer. Curr Drug Targets. Apr 2006;7(4):423-442.
4. Donnelly LE, Newton R, Kennedy GE, et al. Anti-inflammatory effects of resveratrol in lung epithelial cells: molecular mechanisms. Am J Physiol Lung Cell Mol Physiol. Oct 2004;287(4):L774-783.
5. Juan ME, Gonzalez-Pons E, Munuera T, Ballester J, Rodriguez-Gil JE, Planas JM. trans-Resveratrol, a natural antioxidant from grapes, increases sperm output in healthy rats. J Nutr. Apr 2005;135(4):757-760.

 

L-Carnitine and the Androgen Receptor

Most of you probably remember L-carnitine being touted as a ‘fat burner' way back in the days when little girls idolized Madonna. Instead, we have found that carnitine may indeed be much more diverse and impressive than previously thought. First off, what is L-carnitine? This ingredient is made in the body from the amino acids lysine and methionine, and is needed mainly to transport fatty acids into mitochondria the powerhouse of cells. Many consider L-carnitine as a "conditionally essential" nutrient. So here's the science of this amazing compound.

Fact: L-carnitine L-tartrate (LCLT) increases androgen receptor content. In this study, 10 resistance-trained men supplemented with LCLT (equivalent to 2 g of L-carnitine per day) or placebo (PL) for 21 days and provided muscle biopsies for AR or androgen receptor determinations. Subsequently, they performed two resistance exercise (RE) protocols: one followed by water intake, and one followed by feeding (8 kcal.kg body mass, consisting of 56% carbohydrate, 16% protein, and 28% fat). They discovered that feeding after RE increased AR content, which may result in increased testosterone uptake, and thus enhanced luteinizing hormone secretion via feedback mechanisms; and 2) LCLT supplementation upregulated AR content, which may promote recovery from RE.(1) In other words, it looks like LCLT can promote anabolic processes by increasing levels of the steroid receptor for testosterone, the AR. Not only can it jack up the AR, but L-carnitine L-tartrate (LCLT) supplementation beneficially affects markers of post-exercise metabolic stress and muscle damage. Eight healthy men were supplemented with 0 g, 1 g, and 2 g of LCLT for 3 weeks and then performed a bout of resistance exercise (5 sets of 15-20 repetition maximum with a 2-min rest between sets) with associated blood draws. They found that both the 1- and 2-gram doses were effective in mediating various markers of metabolic stress and of muscle soreness. Accordingly, the "use of LCLT appears to attenuate metabolic stress and the hypoxic chain of events leading to muscle damage after exercise."(2)

Bottom line: Elevating your blood levels of testosterone is just ONE way to boost your muscle's anabolic processes. By increasing levels of the androgen receptor, which makes it easier for your cells to take in the steroid hormone testosterone, you can in essence sensitive your muscles more so. Thus, turning you into an anabolic, muscle-building machine.

References
1. Kraemer WJ, Spiering BA, Volek JS, et al. Androgenic responses to resistance exercise: effects of feeding and L-carnitine. Med Sci Sports Exerc 2006;38:1288-96.
2. Spiering BA, Kraemer WJ, Vingren JL, et al. Responses of criterion variables to different supplemental doses of L-carnitine L-tartrate. J Strength Cond Res 2007;21:259-64.

 

Supplement Round Up

Little blue friend

Viagra, the little blue pill, helps you exercise; and I’m sure you’re thinking of the horizontal tango, right?  Okay, maybe I was too.  But it does help you with ‘real’ exercise!  In a recent study, 16 healthy subjects were included in a randomized, double-blind, placebo-controlled, cross-over study on the effects of 50-mg sildenafil (Viagra®)on echocardiographic indexes of the pulmonary circulation and on cardiopulmonary cycle exercise in normoxia (i.e. normal oxygen levels), in acute normobaric hypoxia (fraction of inspired O2, 0.1), and then again after 2 weeks of acclimatization at 5000 meters on Mount Chimborazo (Ecuador). In normoxia (normal oxygen levels), sildenafil had no effect on maximum VO2 or O2 saturation. In acute hypoxia (low concentrations of oxygen), sildenafil increased max oxygen uptake from 27  to 32 mL/min/kg and O2 saturation from 62% to 68%.  Thus, the little blue pill increases exercise capacity in acute normobaric hypoxia and that this is explained by improved arterial oxygenation, rather than by a decrease in right ventricular afterload.¹  Or in English, this stuff helps you perform when you got low levels of oxygen.  So if I hold my breathing during…oh, never mind.

Supplements are good for the older set too

Scientists evaluated the response of various muscle- and bone-adaptation parameters to 24 weeks of strength training in healthy, early postmenopausal women when a nutrient supplement (protein, carbohydrate, calcium, and vitamin D) or a placebo supplement (a minimum of energy) was ingested immediately following each training session.  Ya see, nutrient timing for old women too!  At inclusion, each woman was randomly and double-blindedly assigned to a nutrient group (NUT) or a placebo group (CON).  NUT improved concentric and isokinetic muscle strength from 6 to 24 weeks by 9% whereas CON showed no change.  Only NUT improved lean body mass over the 24 weeks.  So here you have proof that taking a dietary supplement results in superior improvements in muscle mass, muscle strength, femoral neck bone mineral density, and bone formation during 24 weeks of strength training. The observed differences following such a short intervention emphasize the significance of post-exercise nutrient supply on musculoskeletal maintenance.²  This contributes to an ever growing body of evidence showing the utility of dietary supplements. 

Add protein to carbs – it works even better

Scientists looked at the impact of protein co-ingestion with carbohydrate on muscle protein synthesis (i.e. muscle protein gain) during resistance type exercise. Ten healthy males were studied in the evening after consuming a standardized diet throughout the day. Subjects participated in 2 experiments, in which they ingested either carbohydrate or carbohydrate with protein during a 2hour resistance exercise session. Subjects received a bolus of test drink prior to and every 15 min during exercise.  What happened? Protein co-ingestion lowered whole-body protein breakdown rates by 8.4% compared to the ingestion of carbohydrate only, and augmented protein oxidation and synthesis rates by 77and 33%, respectively.  As a consequence, whole-body net protein balance was negative in CHO, whereas a positive net balance was achieved following the CHO+PRO treatment.  In accordance, mixed muscle protein fractional synthetic rate was 49% higher following protein co-ingestion in CHO+PRO vs CHO treatment, respectively.  So even in a fed state, protein co-ingestion stimulates whole-body and muscle protein synthesis rates during resistance type exercise.³  One of Antonio’s rules of sports nutrition – NEVER decrease protein intake.

Whey protein for muscle mass

Scientists studied the effects of consuming whey protein on skeletal muscle protein turnover in the post-exercise period. Eight healthy resistance-trained young men participated in a double-blind randomized crossover trial in which they performed a unilateral leg resistance exercise workout (EX: 4 sets of knee extensions and 4 sets of leg press; 8-10 repetitions/set; 80% of maximal), such that one leg was not exercised and acted as a rested (RE) comparator. After exercise, subjects consumed either an isoenergetic (same calories) whey protein plus carbohydrate beverage (WHEY: 10 g protein and 21 g fructose) or a carbohydrate-only beverage (CHO: 21 g fructose and 10 g maltodextran). They found the following:   a small dose (10 g) of whey protein with carbohydrate (21 g) can stimulate a rise in muscle protein synthesis after resistance exercise in trained young men that would be supportive of a positive net protein balance, which, over time, would lead to hypertrophy.⁴  Carbs alone?  They suck. 

 

References

1.            Faoro V, Lamotte M, Deboeck G, et al. Effects of sildenafil on exercise capacity in hypoxic normal subjects. High Alt Med Biol. Summer 2007;8(2):155-163.

2.            Holm L, Olesen JL, Matsumoto K, et al. Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength and bone formation in postmenopausal women. J Appl Physiol. May 8 2008.

3.            Beelen M, Koopman R, Gijsen AP, et al. Protein co-ingestion stimulates muscle protein synthesis during resistance type exercise. Am J Physiol Endocrinol Metab. Apr 22 2008.

4.            Tang JE, Manolakos JJ, Kujbida GW, Lysecki PJ, Moore DR, Phillips SM. Minimal whey protein with carbohydrate stimulates muscle protein synthesis following resistance exercise in trained young men. Appl Physiol Nutr Metab. Dec 2007;32(6):1132-1138.

 

 

And to further prove that a calorie is NOT just a calorie, guess what happens when you overfeed on peanuts versus candy? That's right, you get fat on candy whereas peanuts increases your metabolic rate.  Go figure, eh?  It's great reading...check it out!

Scand J Clin Lab Invest. 2009;69(5):598-605. Two weeks of overfeeding with candy, but not peanuts, increases insulin levels and body weight.  Claesson AL, Holm G, Ernersson A, Lindström T, Nystrom FH.  Department of Medical and Health Sciences, Diabetes Research Centre, Faculty of
Health Sciences, Linkoping University, Linkoping, Sweden.

OBJECTIVE: To study the effects of snacking based on fast acting carbohydrates
(candy) or fat and protein (peanuts) in a prospective randomized, parallel
intervention study. METHODS: Basal metabolic rate (BMR) and cardiovascular risk
factors were measured before and after hyper-alimentation by addition of 20
kcal/kg (84 kJ/kg) body weight of either candy or roasted peanuts, to the regular
caloric intake, for two weeks in healthy subjects. Eleven men and 14 women
completed the randomized study. RESULTS: Energy-intake increased similarly in the
groups (candy: +46.1+/-35%, peanuts: +46.8+/-28% p=0.96). Body-weight (candy: from 67.3+/-7.6 kg to 68.1+/-7.3 kg, p=0.01, nuts: from 68.7+/-6.1 kg to
69.0+/-5.7 kg p=0.3) and waist circumference increased significantly only in the
candy group. At the end of the study LDL cholesterol (candy: 2.6+/-0.4 mmol/l
peanuts: 2.1+/-0.4 mmol/l, p=0.005) and ApoB/ApoA-1-ratio (candy: 0.68+/-0.16
peanuts 0.53+/-0.11, p=0.01) were higher in the candy group than in the peanut
group. On the other hand, BMR increased only in the peanut group (candy: from
6.657+/-1.1 MJ/24 h to 6.762+/-1.1 MJ/24 h, p=0.3 nuts: from 6.896+/-0.98 MJ/24 h to 7.256+/-1.1 MJ/24 h, p=0.02). CONCLUSION: Two weeks of snacking based on peanuts does not cause the same negative metabolic effects as an isocaloric diet in which the snacking is based on short acting carbohydrates in the form of candy in non-obese healthy subjects.

You know the Keep It Simple Stupid principle. I'm a big fan of it. Maybe it's because I'm lazy. Or maybe it's because I don't think nutrition should be about advanced mathematics. Or perhaps both. My wife says I'm lazy. But I call it efficient. The definition of efficient is doing something with the least amount of effort. Okay, you're right. Lazy is a synonym. Anyhow, when it comes to improving body composition, I'm a firm believer in adopting simple strategies first. Besides exercising more, which is simple but painful, there are other easy things to do. A recent study in the Nutrition & Metabolism Journal exemplified this tenet.1 In this study, a bunch of lab geeks examined the physiological response to 10 weeks of combined aerobic and resistance exercise (EX) versus exercise + minimal nutrition intervention designed to alter the macronutrient profile. Most importantly, this nutrition intervention did NOT involve energy restriction! So they could still eat like pigs or pigeons if they so desired.

They used a commercially available high-protein/low-carbohydrate and low-fat, nutrient-dense food supplement (EXFS); versus control (CON). The nutrient profile of the supplement was as follows: 1 serving equaled 300 kcal, 5 g of fat, 25 of carbs, and 40 g of protein with roughly 50% of the RDA for vitamins and minerals. So they took 38 sedentary, overweight subjects and randomly assigned them to either CON (control), EX (exercise only), or EXFS (exercise plus the food supplement). EX and EXFS participated in supervised resistance and endurance training (2x and 3x/wk, respectively); EXFS consumed 1 shake/d (weeks 1 and 2) and 2 shakes/d (weeks 3-10). So what happened? Remember that it is the EXFS group that is taking the supplement. As expected, the EX and EXFS significantly decreased fat mass (-4.6% and -9.3%, respectively), with a greater decrease in EXFS than EX and CON. Muscle mass increased only in EXFS. Time-to-exhaustion during treadmill testing increased in EX (+9.8%) but was significantly less than in EXFS (+21.2%). Total cholesterol and LDL decreased only in the EXFS (-12.0% and - 13.3%). So what do you make of this information?

First of all, the very simple addition is to just eat more protein. You'll be in better shape and you'll have less body fat! Yes, if you grew up on a farm eating beef, chicken, pork, and every other piece of skeletal muscle you could get your hands on, then you were well on your way to big biceps and massive quads. But in this study, there was no crazy diet involved; no counting carbs; no counting fat, and no counting sheep. Thank god. So for all practical purposes, this means that if your initial goal is to lose body fat, and perhaps improve exercise capacity, just drop your carbs and eat more protein. Also, this study goes to the heart of why so many dietary interventions fail in the long run. And that's because they're so damn complicated. South Beach, North Beach, Atkins, Fatkins. I mean who has time to figure out these diets? Eat more protein. In fact, I'd suggest you try the new Protein Rush.  It tastes damn good and it has 40 grams of protein per serving. Hey, it beats eating 4 hot dogs for the equivalent amount of protein.

References
1. Lockwood CM, Moon JR, Tobkin SE, et al. Minimal nutrition intervention with high-protein/low-carbohydrate and low-fat, nutrient-dense food supplement improves body composition and exercise benefits in overweight adults: A randomized controlled trial. Nutr Metab (Lond). 2008;5:11.

 

When it comes to bodybuilding SIZE DOES MATTER. You're goal is to make Godzilla proud. So how do you achieve the massive thighs of Godzilla and the trunk-like arms of King Kong? Needless to say there are several aspects to producing large muscles that you should know. Skeletal muscle has the unique ability to adapt in a highly specific manner to different forms of exercise. Think of the marathon runner with skinny legs, torso, and arms. His muscles are chockfull of mitochondria (the aerobic powerhouse of the cell). On the other hand, bodybuilders are the opposite. They have very large muscles. This is due primarily to an increase in muscle fiber SIZE. But we can't rule out that at the highest levels (e.g., Dorian Yates, Ronnie Coleman, Popeye the Sailor Man), it may be possible to increase muscle fiber number. But for most of us, getting larger muscle FIBERS rather than a greater number of fibers is the way to go.

 

MUSCLE FIBER TYPES
Skeletal muscle is made up of two basic fiber types: fast-twitch and slow-twitch. Slow fibers have a slow contraction velocity, produce less tension, but have a high endurance capacity. Fast-twitch fibers generate the most tension (i.e., great for power/strength development) and have the fastest contractile velocity;on the other hand, they fatigue quickly. It actually is a little bit more complicated than that; you could get into the different subtypes of fast fibers etc. But for the purposes of bodybuilding, keep in mind that your goal is to make ALL fibers types bigger. And the primary key to that is lifting heavy (or for us science geeks, subjecting your muscle fibers to very high tension).

NEURAL ADAPTATION
According to the size principle of motor unit recruitment, the smallest motor units (i.e. slow-twitch or Type I) are recruited before the larger motor units (i.e., fast-twitch - Type IIa , Type IIx). But we know that it is possible to recruit our fast fibers, even at relatively low weights (30-60% of max). But in order to MAXIMALLY target all fibers, it's a good idea to occasionally lift very heavy weights (1-3 repetitions maximum). Another thing to keep in mind is that strength and size are NOT necessarily related. Why? Because enhanced motor unit recruitment and/or a greater firing frequency of your nerves can by itself increase strength.

 

HORMONAL RESPONSE

Although levels of blood testosterone and growth hormone have been found to be enhanced during an acute bout of bodybuilding exercises, it isn't known if this has any long-term significance. With regards to a chronic adaptation, serum hormones in elite endurance athletes (swimmers) and elite weightlifters increased slightly (+1.2% swimmers, +2.1% weightlifters) over a one year period. In well-trained distance runners, however, serum testosterone is much lower than untrained men. So what do you make of this? Don't do lots of aerobic exercise! It'll drop your testosterone faster than a bullet train.

SHAPING YOUR MUSCLES
Although many scientists have scoffed at the idea that you can shape your muscles via specific exercises, there is evidence which shows otherwise. For example, in college age women who performed isotonic knee extension exercise three times a week for eight weeks, they had a preferential hypertrophy (growth) of the rectus femoris and vastus lateralis muscles in comparison to the vastus medialis and intermedius muscles. In another study, sixteen weeks of unilateral triceps exercises (consisting of the French press exercise) resulted in significant growth in the middle region of the triceps muscle; however, there was no change in the proximal or distal end of the muscle. So it's clear that you can cause specific regions of a muscle to grow. The science in this area is still in its infancy; however, you can often figure out what works best for YOU by trial and error. So don't hesitate to mix up your exercises to get a maximal growth effect.

SIDE BAR
Increase muscle fiber size or number?
There are two ways by which new skeletal muscle fibers can be formed. First, large fibers can split into two or more smaller fibers (i.e., fiber splitting) and second, satellite cells can undergo mitosis and fuse with each other resulting in de novo fiber formation. So we know conclusively that a mechanism exists for skeletal muscle fibers to increase in number. But what is the experimental evidence?
We do know that birds, cats, and rats can increase fiber number. So why not Homo sapiens? Well, we CAN increase fiber number. But it'll probably take more of an effort than your average bodybuilder is willing to put out. Also, the role of anabolic steroids in augmenting fiber number is an area that needs further exploration. For now, go for bigger muscle fibers...and if you're lucky, maybe fiber number will go up a little bit.

Bottom Line: Size Matters...both in the gym and between the sheets.

Reference
Antonio J. Nonuniform response of skeletal muscle to heavy resistance training: can bodybuilders induce regional muscle hypertrophy? Journal of Strength and Conditioning Research. 2000, 14(1):102-113.

That's right! This smelly stuff may actually be good in reducing LDL cholesterol.  Well at least in rabbits anyhow:)

Abstract
Background: Exaggerated postprandial spikes in blood glucose and lipids induce proportional increases in oxidative stress, which acutely trigger impairment endothelial, inflammation and increased risk of future cardiovascular events.In this research, we have investigated acute effects of vinegar intake on some of the biochemical atherosclerosis risk factors in high cholesterol fed rabbits to see if we can find a probable protective value for it.

Methods:The rabbits were randomly divided into four groups: normal diet, high cholesterol diet (%1cholesterol), %1 cholesterol with 5ml vinegar (low dose), %1 cholesterol with 10ml vinegar (high dose). After fasting for 12-15 hours, blood samples were taken to determine baseline values. Three hours after feeding, blood samples were collected again to investigate acute effects of vinegar intake on the measured factors.

Results: Using high-dose vinegar with cholesterolemic diet caused significant reduce in LDLcholesterol (LDL-C), oxidized-LDL (ox-LDL), malondialdehyde (MDA), total cholesterol (TC) and apolipoprotein B (ApoB) in comparison with hypercholesterolemic diet. Consumption low-dose vinegar with cholesterolemic diet induced a significant decrease in fibrinogen and glucose compared to hypercholesterolemic diet. Level of serum nitrite, nitrate, triacylglycerol (TAG), HDL-cholesterol (HDL-C), apolipoprotein A (ApoA), serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetate transaminase (SGOT) and C-reactive protein (CRP) were not significantly difference in
low and high doses vinegar with cholesterolemic diet compared to hypercholesterolemic diet. A significant difference was observed for LDL-C, ApoB100 and TC between low and high doses vinegar.

Conclusion: This study suggest that vinegar, might have some acute effects on biochemical risk factors of atherosclerosis and a probable protective value can be considered for its postprandial use.

Reference:

http://www.lipidworld.com/content/9/1/10

This is interesting.  If you wt train on a ketogenic diet (very high fat, adequate protein, and very low carb) you will lose a lot of body fat but gain no LBM. But if you switch the ratio to something closer to a 40:30:30 (give or take) ratio, you can gain more LBM but not lose fat.  Things that make you go mmmm...

 

Abstract
Background
The aim of the present study was to compare the effects of 10 weeks resistance training in combination with either a regular diet (Ex) or a low carbohydrate, ketogenic diet (Lc+Ex) in overweight women on body weight and body composition.

Methods
18 untrained women between 20 and 40 years with BMI ≥ 25 kg*m-2 were randomly assigned into the Ex or Lc+Ex group. Both groups performed 60-100 min of varied resistance exercise twice weekly. Dietary estimates were based on two 4-day weighed records. Body composition was estimated using Dual Energy X-ray Absorptiometry. Fasting blood samples were analyzed for total-, HDL- and LDL-cholesterol, triacylglycerols, and glucose.

Results
16 subjects were included in the analyses. Percentage of energy (En%) from carbohydrates, fat and protein was 6, 66, and 22 respectively in the (Lc+Ex) group and 41, 34, 17 in the Ex group. Mean weight change (pre-post) was -5.6 ± 2.6 kg in Lc+Ex; (p<0.001) and 0.8 ± 1.5 kg in Ex; (p=0.175). The Lc+Ex group lost 5.6 ± 2.9 kg of fat mass (p=0.001) with no significant change in lean body mass (LBM), while the Ex group gained 1.6 ± 1.8kg of LBM (p=0.045) with no significant change in fat mass (p=0.059). Fasting blood lipids and blood glucose were not significantly affected by the interventions.

Resistance exercise in combination with a ketogenic diet may reduce body fat without significantly changing LBM, while resistance exercise on a regular diet may increase LBM in without significantly affecting fat mass. Fasting blood lipids do not seem to be negatively influenced by the combination of resistance exercise and a low carbohydrate diet.

Reference:

http://www.nutritionandmetabolism.com/content/7/1/17 

Want to supercharge your moods, energy level and be healthier to boot? And I'm not off my rocker. Some scientists now believe vitamin D is the pre-eminent vitamin. It does so many good things that to not supplement it would be akin to taking a parachute when you go sky diving. Not smart, eh. We know for example that vitamin D deficiency is an increasingly described phenomenon worldwide, with dramatic effects on calcium metabolism and bone health. Vitamin D deficiencies have also been associated with a variety of not so good things. Things that make you want to curl up into a ball, pig out on donuts, and watch TiVo'd reruns of the Sopranos. For instance, you might have a greater risk of bowel and colonic cancer, arthritis, diabetes and heart disease.

In recent decades, there has been increased awareness of the impact of vitamin D on muscle morphology and function; In the early part of 20th century, athletes and coaches felt that ultraviolet rays had a positive impact on athletic performance, and abracadabra, that's why we love the sun. Well sort of. The bikinis help too.

"Both cross-sectional and longitudinal studies allude to a functional role for vitamin D in muscle and more recently the discovery of the vitamin D receptor in muscle tissue provides a mechanistic understanding of the function of vitamin D within muscle."(1)

Also, vitamin D supplementation has been shown to improve tests of muscle performance, reduce falls, and possibly impact on muscle fiber composition and morphology in vitamin D deficient older adults.(2) Another study found that vitamin D was significantly associated with muscle power and force in adolescent girls.(3)

The bottom line is this: the RDA for vitamin D is paltry (200-600IUs daily); that would be like walking across the Sahara desert with bottle of Jack Daniels and expecting it to hydrate you for the long march. Instead, get out in the sun! Expose your body at least 3 times per week to 30 minutes of good UV light. And if you live in a cruddy place like Cleveland or Seattle where there are about as many sunny days as there are hairs on a bald man's head, then supplement my friend. Take at least 2000-4000IUs per day.

References
1. Hamilton B. Vitamin D and Human Skeletal Muscle. Scand J Med Sci Sports 2009.
2. Ceglia L. Vitamin D and its role in skeletal muscle. Curr Opin Clin Nutr Metab Care 2009;12:628-33.
3. Ward KA, Das G, Berry JL, et al. Vitamin D status and muscle function in post-menarchal adolescent girls. J Clin Endocrinol Metab 2009;94:559-63.

 

Suffice it say that the single most studied dietary supplement that has been proven to build muscle and enhance power and strength is none other than creatine, specifically, creatine monohydrate. We know this amazing compound increases the size of slow and fast twitch muscle fibers. We also know that it can help performance for athletes who are interested in strength-power or muscular endurance. But one function that many are not aware of, is its ability to promote recovery. For example, we know that eccentric exercise-induced damage leads to reductions in muscle force, increased soreness, and impaired muscle function. 

Creatine monohydrate's (Cr) ergogenic potential is known; yet few studies have directly examined the effects of Cr supplementation on recovery after damage. A recent study looked at the effects of Cr supplementation on muscle proteins and force recovery after eccentrically-induced muscle damage in healthy individuals. http://www.jissn.com/content/6/1/13 Remember that it is the eccentric or negative contractions that promote muscle damage.

In this study, 14 untrained male participants (22.1 ± 2.3 yrs, 173 ± 7.7 cm, 76.2 ± 9.3 kg) were randomly separated into 2 supplement groups: i) Cr and carbohydrate (Cr-CHO); or ii) carbohydrate (CHO). Participants consumed their supplement for a period of 5 days prior to, and 14 days following a resistance exercise session. Participants performed 4 sets of 10 eccentric-only repetitions at 120% of their maximum concentric 1-RM on the leg press, leg extension and leg flexion exercise machine. Plasma creatine kinase (CK) and lactate dehydrogenase (LDH) activity were assessed as relevant blood markers of muscle damage. Muscle strength was examined by voluntary isokinetic knee extension using a Cybex dynamometer. So what did they find?

The Cr-supplemented group had significantly greater isokinetic (10% higher) and isometric (21% higher) knee extension strength during recovery from exercise-induced muscle damage. Also, plasma CK activity was significantly lower (by an average of 84%) after 48 hrs, 72 hrs, 96 hrs, and 7 days recovery in the Cr-supplemented group. According to the study's authors, the major finding of this investigation was a significant improvement in the rate of recovery of knee extensor muscle function after Cr supplementation following injury. So think about it. Cr isn't just for muscle-building. It is also one of the best recovery agents on the market! Many of the VPX products such as NO-Shotgun have efficacious doses of creatine.

So what are you waiting for?

 

Protein - Not Just a Muscle-Builder; Great for Women

A recent study from the Journal of the International Society of Sports Nutrition (http://www.jissn.com/content/7/1/4 ) proves once again how important dietary protein really is. In this study, fifteen normal weighted women involved in recreational resistance training and aerobic training were recruited for the study (mean age 28.5 yr). They were randomized into two groups. The 1 KG group (energy deficit 1100 kcal/day) was supervised to reduce body weight by 1 kg per week and the 0.5 KG group (energy deficit 550 kcal/day) by 0.5 kg per week, respectively. In both groups protein intake was kept at least 1.4 g/kg body weight/day and the weight reduction lasted four weeks. At the beginning of the study the energy need was calculated using food and training diaries. The same measurements were done before and after the 4-week weight reduction period including total body composition (DXA), serum hormone concentrations, jumping ability and strength measurements. What did they find? During the 4-week weight reduction period there were no changes in lean body mass and bone mass, but total body mass, fat mass and fat percentage decreased significantly in both groups. This is important because one of the worst things that can happen to you when you diet is to lose precious lean body mass. To prevent it, eat more protein. In fact, the changes were greater in the 1 KG group than in the 0.5 KG group in total body mass, fat mass and fat percentage. After the 4-week period there were no changes in strength performance in 0.5 KG group, however in 1 KG maximal strength in bench press decreased while endurance strength in squat and counter movement jump improved. It is concluded that a weight reduction by 0.5 kg per week with ~1.4 g protein/kg body weight/day can be recommended to normal weighted, physically active women instead of a larger (e.g. 1 kg per week) weight reduction because the latter may lead to a catabolic state. Vertical jumping performance is improved when fat mass and body weight decrease. Thus a moderate weight reduction prior to a major event could be considered beneficial for normal built athletes in jumping events.

From a practical standpoint, anytime you calorically restrict, make sure you get plenty of protein or amino acids. Protein Rush and Power Shock are two excellent products that can fulfill those requirements.