Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 1
Copyright January 1st, 2011 by Alan Aragon Home: www.alanaragon.com/researchreview Correspondence: aarrsupport@gmail.com
2 After over a half-century of study, were still debating about protein requirements. By Alan Aragon
5 Enhanced amino acid sensitivity of myofibrillar protein synthesis persists for up to 24 h after resistance exercise in young men. Burd NA, et al. J Nutr. 2011 Feb 2. [Epub ahead of print] [Medline]
6 Protein choices targeting thermogenesis and metabolism. Acheson KJ , et al. Am J Clin Nutr. 2011 J an 12. [Epub head of print] [ a Medline]
7 Daily consumption of vitamin D- or vitamin D + calcium-fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized clinical trial. Nikooyeh B,, et al. Am J Clin Nutr. 2011 Feb 2. [Epub head of print] [ a Medline]
8 Branched-chain amino acid supplementation lowers perceived exertion but does not affect performance in untrained males. Greer BK. et al. J Strength Cond Res. 2011 Feb;25(2):539- 44. [Medline]
9 Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response. Perez-Pozo SE, et al. Int J Obes (Lond). 2010 Mar;34(3):454-61. [Medline]
11 Things I learned in 2010 (mostly serious edition). B
y Alan Aragon
14 Interview with world record-holding competitive eater Pete Czerwinski (AKA Furious Pete). B
y Alan Aragon
15 An update has been made in the December 2010 issue.
Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 2
After over a half-century of study, were still debating bout protein requirements. a
By Alan Aragon __________________________________________________
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ntro & background I spend a lot of time browsing fitness-related online message boards (its a big part of my job, so I have a good excuse). Though it may seem like a closed case, protein requirements for the purpose of optimizing training adaptations are still debated heatedly to this very day. This isnt without good reason to fight, otherwise these debates would stop surfacing so frequently. To state the obvious, one side argues in favor of lesser amounts, while the other side argues for greater intakes. Less obvious is the fact that different scenarios/goals create different demands, and the current body of research has not horoughly investigated all scenarios. t
Instead of discussing food sources or subtypes, it will be assumed that were discussing high-quality protein. For a thorough discussion of protein quality, see Millward et al. 1 Its also assumed that were discussing the healthy population, since the protein requirements of certain disease states may not necessarily apply here. As much as possible, Ill avoid adjacent topics such as effects on kidney & bone, which would warrant their own article at best, and at worst just pull the current article off-topic. Timing issues were covered last month, so this article will be looking specifically at protein amount.
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trength & endurance research versus the RDA The current RDA for protein for adults is 0.8g/kg. This amount is defined as sufficient ...to meet the known nutrient
needs for practically all healthy people 2 According to the latest Dietary Reference Intake (DRI) report, more than this is not necessary, even for endurance or strength athletes. To quote them directly (keep in mind that this is from a 2005 publication): 3
In view of the lack of compelling evidence to the contrary, no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise.
Given such a recent authoritative dismissal of recommendations above the RDA, its understandable that folks who maintain a textbook knowledge of nutrition will fall on the conservative side. Those who stay more current with the scientific literature will definitely take issue with the claim that the RDA is sufficient for all, including strength and endurance athletes. The most recent scientific literature reviews and position stands collectively list a range of 1.2-2.0g/kg, 4-7 with one review pushing the upper end of its recommendation to 2.2g/kg. 8 These figures exceed the RDA by 50-175%. Given this abundance of contrary research, its plainly false to claim that the RDA is sufficient or optimal for most athletes and physically ctive individuals. a
Non-athlete populations can also benefit from protein intakes beyond the RDA. For example, in a tightly controlled 14-week trial, Campbell et al observed that elderly subjects consuming the RDA for protein (0.8g/kg) experienced a significant loss of mid-thigh muscle area, despite consuming their projected maintenance kcals. 9 Notably, these subjects age ranged 55-77 years, and the RDA for adults older than 70 remains at 0.8g/kg. Keep in mind that this study & several others were published years before the latest DRI report, so they had ample time to make adjustments in their recommendations but failed to do so. I, for one, am extremely curious about whether or not the RDA for protein will be updated in the next edition. As long as the RDA remains unchanged, the textbook worms (as opposed to the Pubmed worms) have at the very least, a perceived authoritative basis for their beliefs.
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ower needs: energy maintenance & surplus Certain circumstances decrease the demand for protein. When overall kcals are adequate for maintaining or gaining bodyweight, protein demands are lower compared to when a kcal deficit is sustained chronically for weight loss. 7 A seldomly discussed potential cause for reduced protein demand is habitual or maintenance-level (as opposed to progressive) exercise over time. Nearly 3 decades ago, Butterfield and Calloway found that individuals subjected to chronic exercise actually showed an increase in the efficiency of dietary protein utilization, despite consuming only 0.57g/kg. 10 This adaptive protein economy was indicated by an increase in nitrogen balance as the study progressed. However, its important to note that this increased efficiency was seen under caloric balance & surplus conditions, with low-intensity exercise. Subsequent research using more physically demanding protocols has yielded different results, which Ill discuss in the forthcoming section.
Even for the goal of gaining muscular size (& strength), protein demands decrease as athletes progress toward their potential. In the earlier stages of an athletes development, dietary protein surpluses are more prone to be used for muscle protein synthesis. This is why I favor setting goals based on target bodyweight, which is a surrogate measure of target lean mass. As the athletes level of hypertrophy increases, so does the proximity to the ceiling of growth for the given programming phase. The curve of progress slows down and flattens out as equilibrium is reached. In short, advanced athletes need (proportionally) less protein to maintain their mass than they needed to attain it. Bearing this in mind, some researchers can take their conservative stance a bit too far. For example, Ill quote a review y Phillips: 11 b
...in highly trained powerlifters and bodybuilders, in whom muscle mass is high but stable, it is unlikely that their dietary protein requirements are elevated much more than those of a edentary person. s
In support of the above claim, Phillips cites research by Tarnopolsky et al, who found that elite bodybuilders were able to maintain their lean body mass at a protein intake of 1.05 g/kg, which indeed was significantly less than their habitual intake of 2.7g/kg, yet only slightly more than the sedentary controls who consumed 0.84 g/kg. However, Phillips neglected to mention the short duration of the study period (10 days), the small sample size (6 bodybuilders), and the fact that 2 of the 6 fell into negative nitrogen balance by the 10th day. Furthermore, Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 3
Tarnopolsky et al noted that certain conditions such as levels of very high training intensity, reduced energy intake, and reduced proportion of carbohydrate can potentially drive up protein equirements above what they observed in their study. r
On a related note, Phillips mentions that carbohydrate is protein-sparing. In academic & sports nutrition circles, this is another way of saying that carbs help the body retain muscle protein. The support for this clich is research by Richardson et al, who found that a diet with twice the proportion of carbs than fat preserved nitrogen balance better than a diet with equal proportions of carbs and fat. 13 This protein-sparing effect was more pronounced in subjects who lost weight than those who gained weight. However, the big confounder here is that protein intake was set low (0.57 g/kg), which greatly compromises the relevance of this data, which continues to be referenced by folks on the carb-happy side of the fence. As well soon see, while carbohydrate has a protein-sparing effect under certain conditions, its actually dietary protein that has the most potent protein-sparing effect.
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igher needs: energy deficit (or increased training demand) The benefits of increasing protein beyond the RDA become concretely apparent when an energy deficit is imposed, and these benefits are enhanced with the inclusion of training. For example, in a 10-week trial, Layman et al compared the RDA (0.8g/kg) with double that (1.6g/kg). 14 The high-protein group lost less lean mass and more fat mass. Blood lipid profile and glucose control improved to a greater degree in the high-protein group as well. A subsequent study by Layman et al with the same diet set-up included two extra treatments that had a structured exercise regimen (5 days of walking, 2 days of resistance training per week). 15 Only the training group consuming double the RDA preserved lean mass. The high- protein groups in each study reported greater satiety. Meckling & Sherfey saw no lean mass losses in any groups when they compared a 1:1 and 3:1 ratio of carbohydrate to protein probably due to instrument error; BIA was used). 16 (
A notable detail is that both of the diets in Layman et als research were 1700 kcal. As such, they were not severe in their energy restriction; thus its unsurprising that only 1.6g/kg plus exercise (including resistance training) was able to prevent lean mass loss. Along these lines, Demling & Desantis subjects were able to maintain and even gain lean mass & strength in a mild energy deficit (20% below predicted maintenance) by consuming 1.5g/kg and undergoing an exercise regimen that ncluded resistance training. 17 i
Given the above, its not surprising that when Noakes et al put non-exercising subjects on a 1377 kcal diet of either 34% protein (1.3 g/kg) or half of that, neither treatment preserved lean mass. 18 Oddly, there was no significant difference in body composition change between groups. Predictably, the higher- protein group showed a greater reduction in triacylglycerol levels. In a study by Leidy et al comparing 30% protein diet (1.4g/kg) versus 18% (0.8g/kg) within roughly 1530 kcals, 19 the igh protein group lost less lean mass. h
Pikosky et al examined the effect differing protein intakes under an exercise-induced energy deficit (1000 kcal was expended on top of maintenance diet conditions). 21 The group consuming 1.8g/kg was able to maintain nitrogen balance while the consuming 0.9g/kg fell into negative nitrogen balance. However, this studys 1-week deficit period may have been too short to raw any firm conclusions. d
As mentioned in the previous section, during a chronic energy surplus or maintenance, the demand for protein to protect against lean tissue loss decreases. However, if the nature of the training (volume and/or intensity) is progressive, then protein needs can remain high rather than progressively diminish as long as ncreased demands are presented. i
Collectively, this body of research suggests that for individuals who are not already well-trained or possessing a high level of athletic conditioning, consuming protein at approximately 1.5g/kg is the minimum amount required to prevent loss of lean mass in an energy deficit as long as a resistance training program is in place. Without the training, preventing lean losses would drive up the protein requirement.
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ncreased needs for athletic subjects in an energy deficit Unlike the abundance of studies on overweight, obese, and deconditioned subjects, the literature specifically examining the protein needs of already well-trained athletic subjects put in hypocaloric conditions is surprisingly scarce. To my knowledge, only 3 studies to-date fit these criteria.
The earliest is by Walberg et al, who compared the effect of 0.8g/kg with 1.6g/kg on weight lifters. 22 Although no significant differences in body composition were seen, the higher-protein treatment kept nitrogen balance positive while the lower-protein treatment allowed it to fall into the negative, which would indicate an increased risk for muscle loss over time. Regardless of the positive nitrogen balance shown in the higher protein group, both groups lost lean mass; just more was lost in the ower-protein group. l
Next up, Mourier et al set out to test the effect of a BCAA- enriched treatment, but also tested different protein levels under hypocaloric conditions, and saw primarily a fat loss advantage in the high-protein BCAA-enriched treatment. 23
Over two decades elapsed before the publication of the next study on athletic subjects in hypoenergetic conditions. Mettler et al compared 1.0 g/kg with 2.3 g/kg and saw significantly less lean mass loss in the higher-protein group. 24 The fact that lean mass loss occurred at all opens the possibility that even 2.3 g/kg wasnt enough, and a higher proportion of protein may have completely guarded against LBM loss. An alternate possibility is that the deficit (60% of maintenance needs) is too aggressive for lean mass retention in well-trained/athletic subjects regardless of proportional intake of protein.
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onclusions, applications, & future directions Its gradually becoming apparent that optimal protein requirements for athletes and physically active folks vary rather widely, depending on a number of factors. The most recent reviews and position papers collectively list a range of 1.2- 2.2g/kg. The demand for a surplus of protein intake diminishes as the hypertrophy and/or strength goal draws closer, and Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 4
maintenance is approached, while an efficiency of utilization occurs. However, the initiation of an increased level of physiologic stress (ie, higher training intensity and/or volume) can re-establish inefficiency, thus raising protein demand.
Theres a lack of solid or consistent justification for different protein requirements between strength and endurance athletes. The only thing thats relatively certain is that the RDA of 0.8 g/kg is often insufficient to prevent adverse effects on body composition and various metabolic indexes when compared to greater amounts (approximately 1.5 g/kg and up). In light of the latest research indicating the anticatabolic benefit of intakes as high as 2.3 g/kg, the academics need to swallow their pride and admit that the cheesy physique media were not out of line in their traditional recommendation of a gram per pound. This is especially true, considering that physique sports involve periodic phases of prolonged and often severe energy deficits. In my practice, protein usually fluctuates somewhere between 2- 3g/kg (0.9-1.36g/lb) of target bodyweight, which is a proxy for lean mass, with a small safety margin. Im not squeamish about going as low as 1.2g/kg (0.54g/lb) for some individuals who either are not in an energy deficit, or are simply not focused on gaining or retaining muscle. As a trivial tidbit, anyone who wants to balk at the higher end of what I work with (3.0g/kg), a recent 3-week trial by J akobsen et al found this exact dose (but applied to total bodyweight) to better improve reaction time than 1.5 g/kg. 25 As for clinical concerns, no adverse effects were seen on albuminuria or creatinine clearance.
Its worth mentioning that the assessment of protein requirements is quite an art in itself, since much of it is based on nitrogen balance, which has its fair share of limitations. The most consistent error is an overestimation of nitrogen status. In recognizing its shortcomings, the use of metabolic tracers concurrently with nitrogen measurement is being done to narrow he error margin. t
My personal preference would be to see more assessments of performance & body composition endpoints, since nitrogen balance and molecular data can often be immaterial. What would hold more practical weight than nitrogen balance data or micro- markers of proteolysis would be to test how well strength and/or endurance can be maintained on various protein levels during prolonged energy deficits. Such investigations are scarce at best. Id also like to see the comparative effects of solid versus powdered proteins, as well as isolated amino acids versus whole proteins (in either powder or flesh form) on both body composition and performance.
Another interesting line of investigation would be to compare linear and nonlinear distributions of protein throughout the week. For example, 3.0 g/kg on 3 days & 1.5 g/kg 4 days versus 2.14 g/kg each day of the week. Rounding out my wish list would be studies examining the impact of varying protein intakes while on versus off creatine (and other common supplements or drugs), and how the outcomes might vary depending on chronic energy balance.
Overall, its apparent to me that we have an abundance of data to give sound practical recommendations for protein intake in various conditions. However, due to a general disregard for context when discussing protein requirements, I sense that the debating is far from over.
References
1. Millward DJ , et al. Protein quality assessment: impact of expanding understanding of protein and amino acid needs for optimal health. AmJ Clin Nutr. 2008 May;87(5):1576S-1581S. [Medline] 2. National Research Council: "Recommended Dietary Allowances. Protein and Amino Acids," 10th ed. Washington DC: National Academy Press, pp.52 77,1989. 3. Institute of Medicine. Dietary Reference Intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. The National Academies Press, Washington DC, 2005. [full report - PDF] 4. Kreider RB, Campbell B. Protein for exercise and recovery. Phys Sportsmed. 2009 J un;37(2):13-21. [Medline] 5. Rodriguez NR, et al. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Am Diet Assoc. 2009 Mar;109(3):509-27. [Medline] 6. Campbell B, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2007 Sep 26;4:8. [Medline] 7. Tipton KD, Wolfe RR. Protein and amino acids for athletes. J Sports Sci. 2004 J an;22(1):65-79. [Medline] 8. Wilson J , Wilson GJ . Contemporary issues in protein requirements and consumption for resistance trained athletes. J Int Soc Sports Nutr. 2006 J un 5;3:7-27. [Medline] 9. Campbell WW, et al. The recommended dietary allowance for protein may not be adequate for older people to maintain skeletal muscle. J Gerontol A Biol Sci Med Sci. 2001 J un;56(6):M373-80. [Medline] 10. Butterfield GE, Calloway DH. Physical activity improves protein utilization in young men Br J Nutr. 1984 Mar;51(2):171-84. [Medline] 11. Phillips SM. Protein requirements and supplementation in strength sports. Nutrition. 2004 J ul-Aug;20(7-8):689-95. [Medline] 12. Tarnopolsky MA, et al. Influence of protein intake and training status on nitrogen balance and lean body mass. J Appl Physiol. 1988 J an;64(1):187- 93. [Medline] 13. Richardson DP, et al. Quantitative effect of an isoenergetic exchange of fat for carbohydrate on dietary protein utilization in healthy young men. AmJ Clin Nutr 1979;32:2217. [Medline] 14. Layman DK, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003;133:4117. [Medline] 15. Layman DK, et al. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr. 2005;135:190310. [Medline] 16. Meckling KA, Sherfey R. A randomized trial of a hypocaloric high-protein diet, with and without exercise, on weight loss, fitness, and markers of the metabolic syndrome in overweight and obese women. Appl Physiol Nutr Metab. 2007;32:74352. [Medline] 17. Demling RH, DeSanti L. Effect of a hypocaloric diet, increased protein intake and resistance training on lean mass gains and fat mass loss in overweight police officers. Ann Nutr Metab. 2000;44(1):21-9. [Medline] 18. Noakes M, et al. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. AmJ Clin Nutr. 2005;81:1298306. [Medline] 19. Leidy HJ , et al. Higher protein intake preserves lean mass and satiety with weight loss in preobese and obese women. Obesity (Silver Spring). 2007 Feb;15(2):421-9. [Medline] 20. Walberg J L, Leidy MK, Sturgill DJ , Hinkle DE, Ritchey SJ , Sebolt DR. Macronutrient content of a hypoenergy diet affects nitrogen retention and muscle function in weight lifters. Int J Sports Med. 1988;9(4):2616. [Medline] 21. Pikosky MA, et al. Increased protein maintains nitrogen balance during exercise-induced energy deficit. Med Sci Sports Exerc. 2008 Mar;40(3):505-12. [Medline] 22. Walberg J L, Leidy MK, Sturgill DJ , Hinkle DE, Ritchey SJ , Sebolt DR. Macronutrient content of a hypoenergy diet affects nitrogen retention and muscle function in weight lifters. Int J Sports Med. 1988;9(4):2616. [Medline] 23. Mourier A, et al. Combined effects of caloric restriction and branched- chain amino acid supplementation on body composition and exercise performance in elite wrestlers. Int J Sports Med. 1997 J an;18(1):47-55. [Medline] 24. Mettler S, et al. Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc. 2010 Feb;42(2):326- 37. [Medline] 25. J akobsen LH, et al. Effect of a high protein meat diet on muscle and cognitive functions: A randomised controlled dietary intervention trial in healthy men. Clin Nutr J an 2011 [in press] [Clin Nutr]
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Enhanced amino acid sensitivity of myofibrillar protein synthesis persists for up to 24 h after resistance xercise in young men. e
Burd NA, et al. J Nutr. 2011 Feb 2. [Epub ahead of print] [Medline]
BACKGROUND: We aimed to determine whether an exercise- mediated enhancement of muscle protein synthesis to feeding persisted 24 h after resistance exercise. We also determined the impact of different exercise intensities (90% or 30% maximal strength) or contraction volume (work-matched or to failure) on the response at 24 h of recovery. METHODS: Fifteen men (21 1 y, BMI =24.1 0.8 kgm(-2)) received a primed, constant infusion of l-[ring-(13)C(6)]phenylalanine to measure muscle protein synthesis after protein feeding at rest (FED; 15 g whey protein) and 24 h after resistance exercise (EX-FED). Participants performed unilateral leg exercises: 1) 4 sets at 90% of maximal strength to failure (90FAIL); 2) 30% work-matched to 90FAIL (30WM); or 3) 30% to failure (30FAIL). RESULTS: Regardless of condition, rates of mixed muscle protein and sarcoplasmic protein synthesis were similarly stimulated at FED and EX-FED. In contrast, protein ingestion stimulated rates of myofibrillar protein synthesis above fasting rates by 0.016 0.002%/h and the response was enhanced 24 h after resistance exercise, but only in the 90FAIL and 30FAIL conditions, by 0.038 0.012 and 0.041 0.010, respectively. Phosphorylation of protein kinase B on Ser473 was greater than FED at EX-FED only in 90FAIL, whereas phosphorylation of mammalian target of rapamycin on Ser2448 was significantly increased at EX-FED above FED only in the 30FAIL condition. CONCLUSION: Our results suggest that resistance exercise performed until failure confers a sensitizing effect on human skeletal muscle for at least 24 h that is specific to the myofibrillar protein fraction. SPONSORSHIP: Supported by a grant from the Natural Sciences and Engineering Research Council of Canada
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tudy strengths This study examined a number of understudied parameters affecting muscle protein synthesis. While the combined effects of exercise and feeding have often been studied in the immediate-term (1-4 hours postexercise), a less studied effect is protein feeding on muscle protein synthesis 24 hours later. Also, a topic of great controversy is whether or not its optimal to take sets to failure. This study adds to this body of knowledge by comparing failure vs work-matched protocols of different intensities (Ill touch upon the limitation here in a bit). Another notable design strength was the measurement of varying types of muscle protein synthesis (mixed, sarcoplasmic, and myofibrillar). Recreationally active subjects with prior resistance training experience were used, minimizing the variability of response inherent with untrained subjects.
Study limitations
The most glaring limitation is the short-term nature of the trial. Its not certain how any of the outcomes would manifest in terms of size and strength gains over a period of weeks or months. Another limitation was the choice of intensities compared (30% vs 90% of 1RM). A relatively recent, exhaustive review by Wernbom et al, found that the greatest rate of hypertrophy tended to occur at 60-85% of 1RM. 1 Notably, the Wernbom review examined the (admittedly limited) body of research that measured concrete endpoints such as muscle cross-sectional area. Given that this sweet spot lies between the intensities compared in the present study, its puzzling why the authors did not include or employ a moderate-intensity arm. This design limitation was also seen in a previous study by Burd et al, which oddly enough found that 30% of 1RM was more effective than 90% 1RM for stimulating acute measures of muscle anabolism. 2
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omment/application The primary finding of this study was that exercise-induced increases in muscle protein synthesis and molecular signaling via protein feeding persisted for at least 24 hours after the resistance training bout. Furthermore, this sensitizing effect of exercise was seen most prominently in the treatments where sets were taken to failure, with no significant difference between the 30% & 90% of 1RM conditions. The authors stressed the importance of measuring different protein fractions, since, myofibrillar muscle protein synthesis was seen in both the 30% & 90% of 1RM treatments, but no significant effects were seen in mixed and sarcoplasmic muscle protein. This specificity toward the myofibrillar fraction of muscle protein carries is important since sarcoplasmic constituents might be more subject to hydration flux. This carries the implication that research neglecting to examine the changes in a range of muscle protein ractions may be susceptible to false-negative results. f
The authors assert that regardless of intensity, the recruitment of type II fibers during resistance training is critical for maximizing muscle protein synthesis. They propose that this is achievable through maximal fiber activation, which in this case was seen by taking the sets to failure. To quote them directly, We speculate that protocols eliciting maximal fiber recruitment (i.e. both type I and type II fibers using manipulations of load and volume to induce fatigue) during exercise are critical to optimize the sensitivity of muscle to protein feeding for at least 24 h ostexercise recovery. p
With the above said, the authors admit that given the current studys methods, its not possible to definitively conclude that the muscular receptivity to feeding after exercise is fiber type- dependent. In support of the speculation that this is so, they cite research by Robergs et al, 3 who found that resistance training at 35% of 1RM (work-matched with a comparative treatment of 70% of 1RM) indeed was able to recruit type II fibers. They continue to speculate that the present studys protocol was able to recruit type II fibers in the lower-intensity (30% of 1RM) treatment due to a longer activation period, and not necessarily ue to percentage of 1RM per se. d
These findings lend further refutation to the common idea of an anabolic window typically described as a short period postexercise wherein feeding of protein and/or carbohydrate has special effects on anabolism. As discussed in last months nutrient timing update, this window of opportunity is a non-issue in most cases where daily macronutrient targets are hit. The present study indicates a much wider window (at least 24 hours). Protein choices targeting thermogenesis and metabolism. Acheson KJ , et al. Am J Clin Nutr. 2011 J an 12. [Epub ahead of print] [Medline]
BACKGROUND: Dietary proteins stimulate thermogenesis and satiety more than does carbohydrate or fat; however, less is known about the differences between protein sources. OBJECTIVE: The objective was to determine the differential effects of 3 proteins on energy metabolism, satiety, and glucose control. DESIGN: Energy metabolism, satiety, and glucose control were measured in 23 lean, healthy subjects on separate occasions, before and 5.5 h after consumption of 4 isocaloric test meals in a randomized, double-blind, crossover design. Three meals consisting of 50% protein (whey, casein, or soy), 40% carbohydrate, and 10% fat and a fourth meal consisting of 95.5% carbohydrate were compared with a glucose meal that provided the same glucose load as the protein meals. RESULTS: The thermic effect was greater after the whey (14.4 0.5%) than after the casein (12.0 0.6%; P =0.002) and soy (11.6 0.5%; P =0.0001) meals and was greater after the whey, casein, and soy meals than after the high-carbohydrate meal (6.6 0.5%; P <0.0001). Cumulative fat oxidation tended to be greater after the whey meal (16.2 1.1 g) than after the soy meal (13.7 1.0 g; P =0.097) and was greater after the whey and soy meals than after the high-carbohydrate meal (10.9 0.9 g; P <0.05). The glycemic response to glucose was attenuated 32% by the proteins (P <0.001) at the expense of a greater insulin response after whey than after glucose (154%; P =0.02), casein (143%; P = 0.07), and soy (151%; P = 0.03). Subjective appetite sensations indicated that casein and soy were more satiating than whey (P <0.01), but whey was more "liked" compared with casein and soy (P = 0.025 and P = 0.09, respectively). CONCLUSIONS: he results suggest that different protein sources could be used to modulate metabolism and subsequently energy balance. SPONSORSHIP: Supported by Nestec SA, Vevey, Switzerland. Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 6
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tudy strengths This study addresses the interesting question of how different protein types may affect thermogenesis, satiety, and fat oxidation. This can have important implications for diet design with the goal of weight/fat loss in mind (at least in theory). A high degree of control was necessary to execute this study. Subjects attended the Metabolic Unit on the day before each test and consumed a lab-provided menu for breakfast, lunch, and dinner. This was repeated with exactly the same ingredients on the days before each of the other tests. After the evening meal, subjects spent the night in the Metabolic Unit. Meals were designed on the realistic side, although a bit low in fat. Each meal was 20% of the projected daily kcal requirement, and consisted of 50% protein, 40% carbohydrate, and 10% fat.
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tudy limitations This type of study just begs for a longer-term follow-up, preferably one involving a structured training program. The subjects used in this study were lean, but sedentary. The additive or interactive effects of training and feeding would provide some potentially valuable data. Although the 5.5 hr test period was reasonably long; it wasnt quite long enough for the elevations of each parameter to return to baseline. This criticism circles back to the need for a follow-up trial lasting several weeks in order to assess the impact on what really matters in this case - body composition.
Comment/application
As shown above, the protein-containing meals predictably stimulated more energy expenditure than the carbohydrate meal. Importantly, the whey protein meal evoked more energy expenditure than the casein or soy meal, whose responses did not significantly differ. Fat oxidation was greatest in the whey group, with casein, soy, and carbohydrate placing below it (respectively). Although the tendency was in favor of whey, not statistically significant differences in fat oxidation were seen among the 3 protein meals. Glycemic effect was not significantly different among the protein meals. When expressed as the glycemic index the 4 treatments measured as follows: glucose (100%), whey (33%), casein (36%), soy (32%), isocaloric high-carbohydrate meal (129%). Whey elicited a greater insulin response than the rest of the protein-containing meals, and predictably more so than the glucose treatment which had an equal amount of carbohydrate as the protein meals (see below):
Its notable that the whey treatments effect on fat oxidation was greater than the rest of the protein-containing meals despite its greater stimulation of insulin. A potential explanation for this is the whey treatments higher glucagon response following the insulin response, but the authors cite work questioning the role of glucagon in the regulation of adipose tissue lipolysis. 4 Casein and soy were more satiating than whey, which is somewhat unexpected, given past research finding whey more satiating than casein. 5 Adding to the equivocal body of data, recent research found casein to be more satiating than soy or whey, but found soy to have the highest thermic effect, and whey to elicit the lowest respiratory quotient (indicating greater fat oxidation). 6
While these results are interesting, theres a lack long-term trials comparing these proteins specifically for weight/fat loss.
Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 7
Daily consumption of vitamin D- or vitamin D + calcium-fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized linical trial. c
Nikooyeh B,, et al. Am J Clin Nutr. 2011 Feb 2. [Epub ahead of print] [Medline] BACKGROUND: Low serum concentrations of 25- hydroxyvitamin D [25(OH)D] have been associated with impaired glucose tolerance and diabetes. DESIGN: Ninety diabetic subjects were randomly allocated to 3 groups to consume plain yogurt drink (PY; containing no vitamin D and 150 mg Ca/250 mL), vitamin D-fortified yogurt drink (DY; containing 500 IU vitamin D(3) and 150 mg Ca/250 mL), or vitamin D +calcium-fortified yogurt drink (DCY; containing 500 IU vitamin D(3) and 250 mg Ca/250 mL) twice per day for 12 wk. Fasting serum glucose (FSG), glycated hemoglobin (Hb A(1c)), homeostasis model assessment of insulin resistance (HOMA-IR), serum lipid profile, and percentage fat mass (FM) were assessed before (baseline) and after the intervention. RESULTS: RESULTS: In both the DY and DCY groups, mean serum 25(OH)D(3) improved (+32.8 28.4 and +28.8 16.1 nmol/L, respectively; P <0.001 for both), but FSG [-12.9 33.7 mg/dL (P =0.015) and -9.6 46.9 mg/dL (P =0.035), respectively], Hb A(1c) [-0.4 1.2% (P <0.001) and - 0.4 1.9% (P <0.001), respectively], HOMA-IR [-0.6 1.4 (P = 0.001) and -0.6 3.2 (P < 0.001), respectively], waist circumference (-3.6 2.7 and -2.9 3.3, respectively; P <0.001 for both), and body mass index [in kg/m(2); -0.9 0.6 (P < 0.001) and -0.4 0.7 (P = 0.005), respectively] decreased significantly more than in the PY group. An inverse correlation was observed between changes in serum 25(OH)D(3) and FSG (r =-0.208, P =0.049), FM (r =-0.219, P =0.038), and HOMA- IR (r = -0.219, P = 0.005). CONCLUSIONS: CONCLUSION: Daily intake of a vitamin D-fortified yogurt drink, either with or without added calcium, improved glycemic status in T2D patients. This trial was registered at clinicaltrials.gov as NCT01229891. SPONSORSHIP: Supported by the National Nutrition and Food Technology Research Institute.
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tudy Strengths This study is conceptually strong because it simultaneously examines two major health issues in the world today. According to Holick, 7 an estimated 1 billion people on Earth have varying degrees of vitamin D deficiency. Diabetes is considered the worlds most widespread endocrinologic disorder. Aside from being a randomized controlled trial & not merely observational, an important design strength missing from previous studies was a sufficiently large dose (500 IU) of a bioavailable form of vitamin D (cholecalciferol). Compliance was bolstered by checking consumption check-off charts, counting empty bottles, and weekly phone communication with the research staff.
Study limitations
Bioelectrical impedance analysis (BIA) was used to assess body composition. BIA has questionable accuracy compared to dual- energy X-ray absorptiometry (DXA). 8 BIA may be adequate for tracking differences in groups, but not individuals. 9 As mentioned by the authors, intake of the yogurt drinks were self- reported by the subjects, and no practical approach was used to control the intakes. Dietary intake monitoring was minimal. A 24-hour recall questionnaire was used to assess dietary intake at the start and end of the trial, and this has obvious reliability limitations. Furthermore, although this trial was longer than most of its predecessors, the authors considered 12 weeks a potential limitation of what might be seen beyond that duration.
C
omment/application Vitamin D status was suboptimal in 70% of the subjects at the start, and this was reduced to 15% by the trials end. Expectedly, no change in vitamin D status occurred in the non-fortified plain yogurt (PY) group. A significant decrease in serum insulin, glucose, HOMA-IR (indicating improved insulin sensitivity), and HbA1c (indicating improved glucose tolerance) occurred in the D-fortified yogurt group (DY) and the D+calcium-fortified ogurt group (DCY), but not so with the PY group. y
No significant differences were seen among the groups with respect to energy or macronutrition. On the outset of the trial, the subjects were instructed to consume a weight-maintenance diet based on the American Diabetes Association (ADA) guidelines. 10 However, these guidelines are still stuck in the aging carbohydrate-dominant paradigm. This is ironic, since type 2 diabetes is essentially a malfunction of carbohydrate metabolism. The ADA guidelines call for a protein intake of 15- 20% of total kcals. In the first place, protein recommendations should be based on either lean body mass or a surrogate such as ideal body weight). Secondly, this recommendation opens up the possibility for deficiency, especially in the event of hypocaloric regimes. Finally, the ADA doesnt issue a concrete recommendation for total fat, but they call for a maximum of 10% of kcals from saturated fats, and roughly 10% from polyunsaturated fats. No concrete recommendations for carbohydrate are given, which again, is ironic. Assuming that another 10% of total kcals might come from other fats, this still leave carbohydrate as the dominant macronutrient. One of the simplest, most reliable tactics for improving glycemic control in iabetics is reducing the intake of usable carbohydrate. 11,12 d
Given the large proportion of vitamin D-deficient subjects entering the trial, as well as the known positive association of vitamin D with improved glycemic status, its not too surprising that this correlation was confirmed in this controlled intervention. However, whats intriguing is the decreased waist circumference and bodyweight in the DY & DCY groups compared to the PY group. Taking a closer look, although these differences were statistically significant, the actual changes were modest, especially for a 12-week duration. Specifically, the PYs weight decrease was 0.1 kg, compared to the 2.1 kg & 1.1 kg decreases in DY & DCY, respectively. As for waist circumference, the differences were similarly unremarkable. PYs decrease was 1.1 cm, compared to the 3.6 cm & 2.9 cm in DY & DCY, respectively. Confidence in the reproducibility of these results is difficult, given that dietary intake was self- reported. Thus, correcting vitamin D deficiency appears to improve glycemic control, and possibly body composition as well, but Id like to see further confirmation of the latter parameter in research with tighter dietary control. Branched-chain amino acid supplementation lowers perceived exertion but does not affect performance in ed males. Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 8
untrain Greer BK. et al. J Strength Cond Res. 2011 Feb;25(2):539-44. [Medline] BACKGROUND/ OBJECTIVE: The purpose of this study was to determine whether branched-chain amino acid (BCAA) supplementation affects aerobic performance, ratings of perceived exertion (RPE), or substrate utilization as compared with an isocaloric, carbohydrate (CHO) beverage or a noncaloric placebo (PLAC) beverage. DESIGN: Nine untrained males performed three 90-minute cycling bouts at 55% &OV0312;o2 peak followed by 15-minute time trials. Subjects, who were blinded to beverage selection, ingested a total of 200 kcal via the CHO or BCAA beverage before and at 60 minutes of exercise or the PLAC beverage on the same time course. RPE and metabolic measurements were taken every 15 minutes during steady-state exercise, and each of the trials was separated by 8 weeks. Plasma glucose and BCAA concentrations were measured pre- and post- exercise. RESULTS: A greater distance (4.6 0.6 km) was traveled in the time-trial during the CHO trial than the PLAC trial (3.9 0.4 km) (p <0.05). There was no difference between the BCAA (4.4 0.5 km) and PLAC trials. RPE was reduced at the 75-minute and 90-minute mark during the BCAA trial as compared with the PLAC trial. There were no significant differences found for the trial vs. time interaction in regard to respiratory exchange ratio. CONCLUSIONS: Thus, CHO supplementation improves performance in a loaded time-trial as compared with a PLAC beverage. BCAA supplementation, although effective at increasing blood concentrations of BCAA, did not influence aerobic performance but did attenuate RPE as compared with a PLAC beverage. SPONSORSHIP: Not listed.
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tudy strengths After a redundancy of non-caloric placebos for comparison against BCAA in previous research, this is perhaps the first study to compare the effect of a BCAA beverage to an isocaloric treatment on aerobic performance (a total of 200 kcal of each treatment). A repeated measures design alleviated some of the degree of compromise in statistical power inherent in a small sample (9 subjects). Detailed dietary intake records were taken 3 days prior, and the day of each training session, and analyzed with software. Subjects were instructed to maintain similar dietary patterns throughout the study. As an extra measure of control, dietary choices on exercise testing days were not permitted to change. A final strength was the use of a time trial, where after a 90 minute steady-state period, the subjects completed as much distance as possible within a 15 minute period. This is more reflective of actual race conditions than merely measuring time-to-exhaustion.
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tudy limitations Subjects competed the exercised tests after a 4-hour fast. This would have been fine if a standardized meal (preferably dosed proportionally to individual lean mass) was consumed prior to the fast. A lack of standardization here opens up the possibility of variations in residual amino acid levels in circulation from the previous meal. Thus, testing in an overnight-fasted state would actually have been more appropriate in this case. The study measured acute effects, so longer-term effects remain speculative. Comment/application
As shown above, the BCAA (lowest line) treatment lowered the rating of perceived exertion (RPE) beyond placebo at the 75 & 90 minute mark, whereas this effect of carbohydrate (middle line) did not reach statistical significance. The authors noted that since this reduction in RPE via BCAA did not translate to improved performance, ...the central fatigue hypothesis may not be a relevant issue in humans when exercise duration is less than 105 minutes at intensities of 55% VO2 peak or below.
The authors conceded that the idea of increased blood levels of BCAA reducing tryptophan entry into the brain & inhibiting central fatigue is not likely to occur, at least in the conditions tested. To give a bit of background, brain levels of serotonin are affected by blood tryptophan levels, and the hypothesis is that large, neutral amino acids like BCAA can compete with tryptophan to cross the blood-brain barrier. Tryptophan is converted to 5-hydroxytryptophan, and finally to serotonin, which is associated with fatigue and the onset of sleep. Alas, BCAAs widely assumed inhibitory effect on central fatigue was not apparent here, but according to a review by Gleeson, 13 this shouldnt necessarily be expected to occur in the first place. To quote him directly, The assumption that increased fTRP uptake leads to increased serotonin synthesis and activity of serotoninergic pathways (i.e., increased synaptic serotonin release) is a rather large leap of faith. He goes on to present the logical proposition that if this hypothesis is correct, then the converse must be true for tryptophan supplementation. That is, supplemental tryptophan should hypothetically increase brain serotonin production and thus induce central fatigue, and adversely affect endurance. However, the evidence thus far has repeatedly shown tryptophan supplementation to have no detrimental effect on training performance. 14,15
While its tempting to assume that BCAA is a perfect replacement for carbohydrate due to its lower RER & RPE, the carb group nevertheless covered a greater cycling distance in the time trial than the BCAA group although not to a degree of statistical significance. The take-home application of this studys outcomes would be to combine carbohydrate and BCAA (or an easily absorbed BCAA-rich protein source such as whey isolate) pre- and/or during endurance training to maximize work output and minimize muscle protein breakdown.
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Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric a
cid in the hypertensive response. Perez-Pozo SE, et al. Int J Obes (Lond). 2010 Mar;34(3):454-61. [Medline]
BACKGROUND: Excessive fructose intake causes metabolic syndrome in animals and can be partially prevented by lowering the uric acid level. We tested the hypothesis that fructose might induce features of metabolic syndrome in adult men and whether this is protected by allopurinol. METHODS: A randomized, controlled trial of 74 adult men who were administered 200 g fructose daily for 2 weeks with or without allopurinol. Primary measures included changes in ambulatory blood pressure (BP), fasting lipids, glucose and insulin, homeostatic model assessment (HOMA) index, body mass index and criteria for metabolic syndrome. RESULTS: The ingestion of fructose resulted in an increase in ambulatory BP (7+/-2 and 5+/-2 mm Hg for systolic (SBP) and diastolic BP (DBP), P<0.004 and P<0.007, respectively). Mean fasting triglycerides increased by 0.62+/-0.23 mmol l(-1) (55+/-20 mg per 100 ml), whereas high- density lipoprotein cholesterol decreased by 0.06+/-0.02 mmol l(-1) (2.5+/-0.7 mg per 100 ml), P<0.002 and P<0.001, respectively. Fasting insulin and HOMA indices increased significantly, whereas plasma glucose level did not change. All liver function tests showed an increase in values. The metabolic syndrome increased by 25-33% depending on the criteria. Allopurinol lowered the serum uric acid level (P<0.0001) and prevented the increase in 24-h ambulatory DBP and daytime SBP and DBP. Allopurinol treatment did not reduce HOMA or fasting plasma triglyceride levels, but lowered low-density lipoprotein cholesterol relative to control (P<0.02) and also prevented the increase in newly diagnosed metabolic syndrome (0-2%, P=0.009). CONCLUSIONS: High doses of fructose raise the BP and cause the features of metabolic syndrome. Lowering the uric acid level prevents the increase in mean arterial blood pressure. Excessive intake of fructose may have a role in the current epidemics of obesity and diabetes. SPONSORSHIP: Support for this publication was provided by generous funds from the Mateo Orfila Foundation.
Study strengths
With many current investigations concentrating their focus on the potentially adverse health effects of fructose, this recent study was (and still is) timely. This is perhaps the first study to examine the effect of fructose-mediated increases in uric acid, and whether this occurrence can be mitigated pharmacologically (via allopurinol, a drug commonly used to treat gout). A relatively large sample (74 subjects) was used. Subjects made 3 lab visits per week and were screened for side effects and checked for compliance via submission of empty fructose containers.
Study limitations
As acknowledged by the authors, the trial length was short (2 weeks). The experiment was not properly blinded. That is, investigators and staff were aware of which participants were receiving allopurinol. This opens up the possibility of expectation bias from the investigators as well as the subjects. Another limitation was the lack of a non-fructose carbohydrate comparison treatment, which excludes the possibility of claiming that fructose is uniquely adverse amidst the range of commonly consumed carbohydrates. Furthermore, the subjects randomized to allopurinol had higher baseline levels of uric acid and BP, and also tended to have worse baseline measures of the metabolic syndrome. This may have yielded a falsely low herapeutic effect of the drug. t
Dietary intake was assessed via food frequency questionnaire (FFQ), which is the standard tool for dietary intake assessment in large epidemiological studies due to their relative ease of administration & lack of expense. However, they are limited by their retrospective nature and reliance on subjects memory/perception of serving sizes and food types. Importantly, FFQs often lack validation against objective reference methods involving biomarkers that eliminate reporting bias. For example, Schatzkin et al compared FFQ with doubly labeled water (DLW the gold standard of assessing energy intake) during a 2 week period and concluded the following: 16 Our results indicate that the FFQ cannot be recommended as an instrument for evaluating the absolute intakes of energy and protein in relation to disease. In another example of its shortcomings, Schaefer et al found that FFQs did not reliably estimate intakes of dietary fat or cholesterol. 17 Notably, this assessment failure occurred in subjects on diets containing foods of known composition. In other words, the inaccuracy could not be blamed on exotic foods or obscure recipes and combinations. In yet another example, Kristal et al went as far as titling their critical review, Is it time to abandon the Food Frequency Questionnaire? 18 They definitely thought so.
Comment/application
The supplemental 200g dose of fructose evoked multiple characteristics of the metabolic syndrome (increased fasting triglycerides, decreased insulin sensitivity and decreased HDL). Allopurinol was able to lower LDL-C, but was not able to counteract the impairment in insulin sensitivity or increase in triglyceride and fasting glucose. A novel finding of this study was that the high intake of fructose was able to raise 24-hour ambulatory blood pressure in humans. Interestingly, this effect is only apparent in close proximity to the fructose ingestion (during waking/ambulatory hours). Allopurinol blocked the increase in both 24-hour ambulatory diastolic blood pressure and daytime systolic & diastolic blood pressure brought on by the xperimental fructose load. e
These outcomes may initially seem like a cause for panic, but its important to maintain the proper perspective. A common thread among fructose studies is the use of an artificially high dose. In the present study, 200g fructose was imposed, adding to a habitual daily intake of 55g. The total fructose intake of 255g (34% of total kcal) is nearly four times the average intake in the United States, which Marriott et al recently estimated to be 9.1% of total kcal. 19 Those inclined to consume the extra 200g fructose per day would be able to achieve it with 10 cans of non- diet soda per day. Frankly, those who actually do that have far greater problems than fructose per se.
Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 10
1. Wernbom M, et al. The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans. Sports Med. 2007;37(3):225-64. [Medline] 2. Burd NA, et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. Plos ONE. 2010;5(8):e12033 [Plos ONE] 3. Robergs RA, et al. Muscle glycogenolysis during differing intensities of weight-resistance exercise. J Appl Physiol. 1991 Apr;70(4):1700-6. [Medline] 4. Miles J M, J ensen MD. Does glucagon regulate adipose tissue lipolysis? J Clin Endocrinol Metab. 1993 J ul;77(1):5A-5B. [Medline] 5. Hall WL, et al. Casein and whey exert different effects on plasma amino acid profiles, gastrointestinal hormone secretion and appetite. Br J Nutr. 2003 Feb;89(2):239-48. [Medline] 6. Alfenas Rde C, et al. Effects of protein quality on appetite and energy metabolism in normal weight subjects. Arq Bras Endocrinol Metabol. 2010 Feb;54(1):45-51. [Medline] 7. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 J ul 19;357(3):266-81. [Medline] 8. Pineau J C, et al. Validation of ultrasound techniques applied to body fat measurement. A comparison between ultrasound techniques, air displacement plethysmography and bioelectrical impedance vs. dual-energy X-ray absorptiometry. Ann Nutr Metab. 2007;51(5):4. [Medline] 9. Pateyjohns IR, et al. Comparison of three bioelectrical impedance methods with DXA in overweight and obese men. Obesity (Silver Spring). 2006 Nov;14(11):2064-70. [Medline] 10. Franz MJ , et al. Nutrition principles and recommendations in diabetes. Diabetes Care. 2004 J an;27 Suppl 1:S36-46. [Medline] 11. Haimoto H, et al. Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes. Nutr Metab (Lond). 2009 May 6;6:21. [Medline] 12. Haimoto H, et al. Long-term effects of a diet loosely restricting carbohydrates on HbA1c levels, BMI and tapering of sulfonylureas in type 2 diabetes: a 2-year follow- up study. Diabetes Res Clin Pract. 2008 Feb;79(2):350-6. [Medline] 13. Gleeson M. Interrelationship between physical activity and branched-chain amino acids. J Nutr. 2005 J un;135(6 Suppl):1591S-5S. [Medline] 14. van Hall G, et al. Ingestion of branched-chain amino acids and tryptophan during sustained exercise in man: failure to affect performance. J Physiol. 1995 Aug 1;486 ( Pt 3):789- 94. [Medline] 15. Stensrud T, et al. L-tryptophan supplementation does not improve running performance. Int J Sports Med. 1992 Aug;13(6):481-5. [Medline] 16. Schatzkin A, et al. A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker- based Observing Protein and Energy Nutrition (OPEN) study. Int J Epidemiol. 2003 Dec;32(6):1054-62, [Medline] 17. Schaefer EJ , et al. Lack of efficacy of a food-frequency questionnaire in assessing dietary macronutrient intakes in subjects consuming diets of known composition. Am J Clin Nutr. 2000 Mar;71(3):746-51. [Medline] 18. Kristal AR, et al. Is it time to abandon the food frequency questionnaire? Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2826-8. [Medline] 19. Marriott BP, et al. National estimates of dietary fructose intake increased from 1977 to 2004 in the United States. J Nutr. 2009 J un;139(6):1228S-1235S. [Medline]
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T
hings I learned in 2010 (mostly serious edition). By Alan Aragon ____________________________________________________
I announced on Facebook that this issue would contain a review of Tim Ferriss latest book, 4 Hour Body. Well, soon after that announcement, I received an email from one of my ex-clients and current AARR subscribers really hoping for a things I learned in the previous year retrospective like Ive been doing Since 2008. This pretty much stopped my plans in their tracks, for a couple of reasons. First of all, its a potentially more valuable & less frivolous writeup than a critique of some over- the-top pop diet book. Secondly, based on some of the responses, it became apparent that a fair amount of my readers have already gotten their hands on Ferriss latest material, or have already gotten a good whiff of it second-handedly from other critiques. I still may give it a wringing-out at some point, but I figured that can wait. Lets cover the important stuff first. Here comes a random assortment of things (both on & off-topic) that I learned in the past year. Some of it is video footage, and ome of it may contain links that are not work-safe. s
1. In professional sports, you would assume that the health of the athletes come first. This isnt always the case; in fact, it often doesnt deviate far from the typical corporate churnm & burnm routine. The longer an athletes career is, the bigger pay he (or she) will potentially end up commanding. So, theres not a huge incentive for the leagues powers- that-be to do what they can to max-out the longevity of their athletes. Why make sure that the athletes properly recover from injury when theres always a new crop of talented, injury-free rookies who will gladly play for a fraction of the pay that the guys with seniority expect. This quote by my friend & colleague Tom Vachet (trainer of more pro athletes than anyone I know) captures the sentiment well: At the end of the day, the process of healing an injury requires a combination of smart medicine and patience. Unfortunately, as I stated previously, patience is one of the rarest commodities in the locker and training rooms of collegiate and professional sports,
2. Paleos are very passionate, but many of them have a few screws loose upstairs. Thats not a winning combination. A perfect example is an unknown blogger named J ohn Berne, vented to himself (since apparently no one reads his blog) about my skepticism toward the Paleo diet. I mentioned in a recent Fitcast podcast that the current research comparing Paleo to other regimes does not match macronutrients between treatments (Paleo groups either eat more protein or less carbs). Unsurprisingly, he selectively listened, and mistakenly thought that I claimed there was no research comparing Paleo with an isocaloric treatment. Oh well, he thinks he got me on that one, citing a study by Lindeberg et al, 1 who found that the Paleo diet better improved glucose tolerance in patients with ischemic heart disease than a Mediterranean diet. But just like I mentioned, the Paleo diet had 42% less carbohydrate than the Mediterranean diet, so of-fawking-course glucose tolerance improvement would be more pronounced in the lower-carb treatment. Alas, theres nothing to stop the Paleos from attributing these effects to their beloved diet-religion rather than the more logical explanation that carbohydrate reduction has multiple enefits for certain populations. b
But wait, heres the best part of his rant he actually antasizes about killing me. Get a load of this: f
The only acceptable way I can see to deal with Alan for viciously and callously attacking our dietary lifestyle is for all Paleo adherents to immediately decide to, upon meeting him, kill or maim him. One of us is bound to succeed eventually. Like a jihad, only in English. Or maybe a good old fashioned crucifixion. You don't see enough of those anymore. No, I'm kidding. Seriously, I'm kidding.
3. The 1g of protein per pound of bodyweight guideline is still viewed in most academic circles as a grossly excessive artifact of bodybuilding lore. Even until the present, this guideline is bashed as being unsubstantiated anecdote. However, its finally beginning to gain legitimate scientific support in scenarios where athletes are subjected to prolonged hypocaloric conditions. 2
4. Nutrient timing around training has its place but that place is more limited than I previously thought. Acute studies have shown promise of timing protein or amino acids for the goal of enhancing resistance training adaptations. But as far as longer-term studies go, to my knowledge, only 2 studies with matched total protein content (including supplemental protein) have seen positive results, 3.4 while 5 have shown zippo. 5-9 As things stand, its highly premature (& possibly downright useless) to nitpick over perfect placement of nutrients around the resistance training bout if youre already nailing your macronutrient targets for the day.
5. Supplemental BCAA has been successfully used to stimulate appetite in patients with anorexia. 11 Its a common practice among certain athletes to supplement the diet with BCAA while sustaining an energy deficit for weight loss. The hope is that supplemental BCAA will minimize muscle loss. For those with severe hunger issues, simply getting enough whole intact protein (which contains BCAA anyway) might better serve their goals than pouring fuel on the fire of an already-raging appetite, regardless of the small savings in kcals from isolated BCAA.
6. Rats are a poor model for human nutritional physiology, especially when it comes to carbohydrate metabolism. De novo lipogenesis (DNL) is the pathway by which carbohydrate is converted to fat. Rodents are far more prone to DNL than humans, which makes carbohydrate dosing comparisons between humans and rats an exercise in wishful speculation. To illustrate this quantitatively, heres a quote a review by Sievenpiper et al: 12
Whereas DNL contributes 6070% TG in rodents, it only contributes <5% TG in humans, under longer term, isocaloric, high-carbohydrate feeding conditions. Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 12
7. Vitamin D deficiency is widespread, 13 but the state of panic in the current slew of lay articles is not relayed as such in recent systematic reviews. 14,15 For preserving normal glucose control & insulin sensitivity and other measures of cardiometabolic health, the research supports attempts to guard against deficiency rather than mega-dosing. To eiterate my own practical recommendations: r
A more logical/methodical approach would be to get the test done first to see if youre within the normal range of 30.0-74.0 ng/mL This range translates to 74.8-184.7 nmol/L (multiply the units listed in ng/mL by 2.496 if you need to convert to nmol/L). If youre out of range, you can make gradual adjustments (via diet, supplementation, or increased sun exposure, or a combination). Either way, if youre concerned enough, its wise to get your doctors opinion.
A more subjective but simpler shotgun approach would be to take supplemental vitamin D 3 (cholecalciferol) dosed at 1000-2000 IU per day. 16
8. Trans fatty acid (TFA) hysteria is generally overblown, particularly in physically active populations whose diets consist predominantly of whole and minimally processed foods, and arent running unused caloric surpluses resulting in over-fatness. While TFA in excess pose a host of health concerns, theres no strong causal evidence indicating the grave danger of moderate intakes. 17,18 This would especially apply within the context of an overall healthy set of lifestyle habits. Furthermore, it appears that ruminant-derived TFA (from meat & dairy foods) poses less of a health threat than industrially-derived TFA (from the hydrogenation of vegetable oils). 19 Ultimately, these compounds have to be put into the right perspective, and Meister & Kava do that perfectly in this quote: TFAs are not poison; they are simply one of several dietary factors that affect blood lipid levels, and blood lipid levels are only one of several major factors that influence the risk of heart disease.
9. Resistance training is the confirmed champ of exercise modes when it comes to the treatment & management of type 2 diabetes. While the benefit of resistance training on the markers of diabetes was seen as far back as the early 2000s, enough research has accumulated for us to conclude that its indispensable in the optimization of treatment particularly for patients with impaired glucose control. 20
This would undoubtedly translate positively for the prevention of diabetes in those who are predisposed to the disease.
10. At a protein dose (25g whey) known to maximally stimulate muscle protein synthesis, additional carbohydrate (50g maltodextrin) was unable to further enhance net muscle protein balance after resistance training. 21 This finding wasnt entirely too surprising given the work by Greenhaff et al showing a rather modest upper threshold of insulin elevation (15-30 mU/l) for maximally inhibiting muscle protein breakdown. 21 The 25g protein dose raised insulin to roughly 19 mU/l, so it was right within that range of this appaently saturable response. r
Since the average bodyweight of the subjects used in this study was 80 kg, the 25g protein dose works out to being 0.31g/kg. Of course, endurance goals can be a different story from the goal of muscle anabolism. Its important to note that this outcome may be limited to the training volume used, which was relatively low (4 sets, 8-12 reps to failure on the knee extension). Another caveat to this acute research is that its still preliminary and thus far unconfirmed by longer-term trials. Nevertheless, the practical message from this data is that carbohydrate is not necessarily the crucial/indispensable postexercise nutritional component that its traditionally perceived to be, as long as sufficient protein is consumed to max-out the anabolic response.
11. The infamous Shake Weight (official site here, warning: video w/sound automatically plays) prompted one of the funniest Saturday Night Live skits in the history of the show (best quality version here, warning: strong sexual innuendo, not safe for work). If you havent seen this before, prepare to spit some coffee on your keyboard.
12. Apparently, the body is rather militant about survival and driven toward homeostasis in ways we shouldnt be too surprised about. For example, the body works extra hard to make sure your muscle wont fly off of your bones if you train in a fasted state. Deldicque et al found that at the molecular level, the anabolic response to a carb/protein/leucine postexercise meal was amplified to a greater degree with fasted training rather than fed training conditions. 22 Although this is likely a compensatory response rather than a means to promote a greater net rate of muscle anabolism, its a response that potentially neutralizes the threat of muscle catabolism commonly presumed to occur with fasted training. This is yet another bit of research that just begs for a non-acute follow-up trial.
13. I can disappear from blogging for 3 months, really suck at social networking, and still have a decent career in fitness. Hallelujah & thank you all.
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eferences 1. Lindeberg S, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia. 2007 Sep;50(9):1795-807. [Medline] 2. Mettler S, Mitchell N, Tipton KD. Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc. 2010 Feb;42(2):326-37. [Medline] 3. Esmarck B, Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans. J Physiol. 2001 Aug 15;535(Pt 1):301-11. [Medline] 4. Cribb PJ , Hayes A. Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exerc. 2006 Nov;38(11):1918-25. [Medline] 5. Keim NL, et al. Weight loss is greater with consumption of large morning meals and fat-free mass is preserved with large evening meals in women on a controlled weight Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 13
reduction regimen. J Nutr. 1997 J an;127(1):75-82. [Medline] 6. Verdijk LB, et al. Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. m J Clin Nutr. 2009 Feb;89(2):608-16. [Medline] 7. Burk A, et al. Time-divided ingestion pattern of casein- based protein supplement stimulates an increase in fat-free body mass during resistance training in young untrained men. Nutr Res. 2009 J un;29(6):405-13. [Medline] 8. Hoffman J R, et al. Effect of protein supplement timing on strength, power and body compositional changes in experienced resistance trained men. Int J Sport Nutr Exerc Metab. 2009 Apr;19(2):172-85. [Medline] 9. Wycherley TP, et al. Timing of protein ingestion relative to resistance exercise training does not influence body composition, energy expenditure, glycaemic control or cardiometabolic risk factors in a hypocaloric, high protein diet in patients with type 2 diabetes. Diabetes Obes Metab. 2010 Dec;12(12):1097-105. [Medline] 10. Laviano A, et al. Branched-chain amino acids: the best compromise to achieve anabolism? Curr Opin Clin Nutr Metab Care. 2005 J ul;8(4):408-14. [Medline] 11. Sievenpiper JL, et al. Heterogeneous effects of fructose on blood lipids in individuals with type 2 diabetes: systematic review and meta-analysis of experimental trials in humans. Diabetes Care. 2009 Oct;32(10):1930-7. [Medline] 12. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 J ul 19;357(3):266-81. [Medline] 13. Alvarez J A, Ashraf A. Role of vitamin d in insulin secretion and insulin sensitivity for glucose homeostasis. Int J Endocrinol. 2010;2010:351385. [Medline] 14. Pittas AG, et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med. 2010 Mar 2;152(5):307-14. [Medline] 15. Thompson AK, et al. Trans fatty acids, insulin resistance and diabetes. Eur J Clin Nutr. 2010 Oct 27. [Epub ahead of print] [Medline] 16. Heaney RP. Vitamin D: criteria for safety and efficacy. Nutr Rev. 2008 Oct;66(10 Suppl 2):S178-81. [Medline] 17. Odegaard AO, Pereira MA. Trans fatty acids, insulin resistance, and type 2 diabetes. Nutr Rev. 2006 Aug;64(8):364-72. [Medline] 18. Motard-Belanger A, et al. Study of the effect of trans fatty acids from ruminants on blood lipids and other risk factors for cardiovascular disease. Am J Clin Nutr. 2008;87:593- 599. [Medline] 19. Strasser B, et al. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports Med. 2010 May 1;40(5):39. [Medline] 20. Staples AW, et al. Carbohydrate does not augment exercise- induced protein accretion versus protein alone. Med Sci Sports Exerc. 2010 Dec 1. [Epub ahead of print]. [Medline] 21. Greenhaff PL, et al. Disassociation between the effects of amino acids and insulin on signaling, ubiquitin ligases, and protein turnover in human muscle. Am J Physiol Endocrinol Metab. 2008 Sep;295(3):E595-604. [Medline] 22. Deldicque L, et al. Increased p70 phosphorylation during intake of a proteincarbohydrate drink following resistance exercise in the fasted state Eur J Appl Physiol. 2009 Nov 18. [Epub ahead of print] [Medline]
Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 14
Interview with world record-holding competitive eater ete Czerwinski (AKA Furious Pete). P
By Alan Aragon __________________________________________________
AA: First off, thanks for doing this interview. I've been a fan of competitive eating for quite some time, ever since Takeru Kobayashi first started owning the hotdog eating competition way back. How did you get introduced to competitive eating, and what actually was the turning point where you decided to nter a formal competition? e
PC: I discovered competitive eating by accident really. I went out for breakfast with some buddies after a night of drinking and we all wanted something greasy to eat. Most of us ordered a dish called the "Linebacker" which had two of every breakfast item you could ever think of. I polished off my dish before anyone got through a quarter of theirs, so my buddy Mike said he would give me $40 to try and double the record, which was 2 plates...and so I did by eating 4.
After I got into doing more eating stuff I managed to break the world record for a 72oz steak by eating it in 7 minutes. When I posted that, I got asked to go down to California for the Collegiate Nationals Eating Championships (where I won my first contest).
AA: What accomplishments or milestones in competitive eating re you most proud of, and why? a
I must say that getting the Guinness World Record for a 72oz steak in 6:48 was a huge achievement. I made it official and it feels good!
AA: Are you self-taught, or did you have some sort of coach or mentor help you gain a high level of skill in competitive eating?
PC: Self taught and to be honest I still don't know if I am doing things right haha.
A
A: Who are your top 3 favorite eaters? PC: Patrick "Deep Dish" Bertoletti, Takeru Kobayashi and Paul "Porkslap" Arcaria.
AA: Do you have an off-season, and a formal in-season preparation protocol? What tactics do you employ to get ready or an event in the days leading up to it or the day of the event? f
I don't really have an on or off season, I just do competitions when they appear, but most happen to be in the summer. My prep is pretty simple, I drink a lot of water all the time and before a contest I increase it to 12-15 liters the night before to expand my stomach. Other than that there really isn't much other rep. p
AA: Could you please fill us in on a typical day's eating for you, when you're not doing a competition? If you can list acros too, that would be great. m
PC: I couldn't give you an exact macro specification because I never follow one. I eat 6-8 times a day and every meal contains lean protein and healthy fats. I usually eat between 4000 - 5000 calories, mainly because my gym training is pretty intense all the time. I stick mainly to foods like chicken, eggs, whey, nuts, avocados, veggies and oats.
AA: How many days do you weight train per week, how many ays cardio & how long? d
PC: I don't do much cardio as I incorporate CrossFit into my workouts (yeah go ahead and laugh, I enjoy it and it keeps me lean). I do strongman training most of the time in the gym and then bodybuilding once a week or once every two weeks to keep the physique in check (size). I try to stick to 5 days of training a week. Each training session will be between 30 to 120 minutes long.
AA: Haha, yeah, Crossfit can have its comic moments, thats or sure. What training split are you currently following? f
PC: I deadlift very heavy once a week, squat heavy once a week and do heavy chest once a week. All other workouts are kept lighter and I do higher volume and do workouts for time.
AA: What goes on in your mind when you are in the midst of competition? How do you stay motivated to keep going & finish trong? s
PC: Well simply put I am doing these contests for MONEY. If I don't win or finish strong I will be going home with no pay check...which is a waste of a contest. I try to stick to a rhythm if I can for the entire duration of the contest and make sure that I am ahead of the other competitors all the time. But mainly its the fact that I'm there for the money and that is a big enough push to win.
AA: What was the most difficult eating challenge you've ever one, and why was it so difficult? d
PC: A pound of butter in 3 minutes or a bottle of olive oil in 90 seconds...Do I really need to explain why these were so difficult!
AA: Interesting, it seems that perhaps taste or texture, and not necessarily volume, can be key factors posing the challenge. Speaking of volume, do you ever fear your stomach might rupture in the midst of competition? What fears or concerns do ou have to deal with in this sport - if any? y
PC: I try not to think of that. I mean I have done this for 4 years now and I haven't had problems. I have had checkups and doctors just simply call me a freak...haha. I have been on TV shows where they show my stomach before and after and I simply have a lot more folds in my stomach to allow for massive expansion when I am eating a lot.
AA: What was the most embarrassing or strangest thing you've itnessed while doing a competition? w
PC: Probably facing up against Kobayashi this past summer. I went slice for slice with him for the first 7 minutes then I couldn't keep up. I had a terrible technique of just stuffing my AA: Please feel free to add anything you feel I should have sked but left out. mouth and meanwhile he had it down pat by eating two bites, then drinking water and keeping that up for the entire contest. But this is the contest that is making me a better eater today! a
I'd really like to thank my main sponsor BodyBuilding.com because without them things would have been a lot harder with ating contests. I owe them a lot. Editors note: Pete got 2nd Place behind winner Takeru Kobayashi on in a pizza-eating contest on August 22. Heres a photo blog of the highlights, and heres a video. e
I would also like to say no one should ever TRAIN to become a competitive eater. If you have the natural talent then go with it, but don't practice eating all the time in an effort to become one because it is really unhealthy to do, and you can easily choke and die...which is obviously not good.
AA: I've always wondered why some of the top competitive eaters are actually quite lean, when the normal expectation is for them to be obese from practicing their craft. Why do you hink this is so? t
AA: Thanks, Pete! Great food for thought (couldnt resist). PC: Well there is some theory of something called the "fat belt" which limits bigger eaters to be able to expand their stomachs fast. As a lean eater I am able to breathe better and like I said my stomach can expand much more easily.
AA: Please pardon this question, but I have to ask it.... Do competitive eaters throw up their food afterwards, or do they literally let it digest & eliminate normally? What do you do ersonally?
p
PC: I don't know what everyone does. I know a lot do throw up. I am 100% honest with this question always (I know a lot of eaters aren't). My throw up ratio is 50-50. If I am eating a straight meat product then I feel fine after and well I got my protein in me for the day. However, If I am eating something really saucy then I sure as hell am not feeling good after a contest and I do whatever I need to do to make myself feel better!
AA: Your candidness is appreciated on that. Shifting gears, what sort of career & media opportunities have opened for you ince you've started winning competitions?
s
PC: I've done a bunch of TV shows since I've started winning. I've had a documentary made about my life which has been in a ton of film festivals around the world. It's called "The Story of Furious Pete" and people have been loving it! From Anorexia to a Pro Eater. Very Ironic, I know...
AA: Is competitive eating something you plan to make a full- time career out of, or do you see it more as a hobby?
PC: Well I have to keep things quiet but I have a BIG project coming up which will make eating my career for awhile. A
n update has been made in the December 2010 issue. I recently added (& discussed) another study in last months nutrient timing update. Please re-download it if you downloaded it shortly after it was originally posted.
A
A: Do you have a regular day job? PC: I just finished grad school (Master in Manufacturing Engineering), and because of this project I have I don't have a regular full time job.
Im not a theologian or a mathematician (both of whom could probably tear apart this video) but I found it interesting nonetheless. AA: Congrats on completing your grad degree Can you please provide my readers with any info on up-coming projects or links you'd like them to check out?
PC: For sure! I upload crazy videos all the time on youtube: http://www.youtube.com/user/furiouspete123 If you have any questions, comments, suggestions, bones of contention, cheers, jeers, guest articles youd like to submit, or any feedback at all, send it over to aarrsupport@gmail.com. My website: http://www.furiouspete.com Alan Aragons Research Review J anuary 2011 [Back to Contents] Page 15