3.8 vs. 2.3 g/kg Protein + Exercise to Improve Body Comp. | Digestive Enzymes to Pimp Vegan Proteins | High Protein vs. MUFA Meals for GLP1 | ISSN Research Review '15 #3

3.8 vs. 2.3 g/kg Protein + Exercise to Improve Body Comp. | Digestive Enzymes to Pimp Vegan Proteins | High Protein vs. MUFA Meals for GLP1 | ISSN Research Review '15 #3

build muscle digestive enzymes enzymes GLP-1 high protein ISSN15 ISSN2015 lose fat PEA pea protein rice rice protein vegan vegetarian

"If some is good, more is better!" Unfortunately, this simple maxime does rarely apply when it comes to the physiological response to certain foods and/or supplements. For protein, however, it appears as if the relation holds - at least as long as protein does not become the only energy source in your diet.

I guess by now I can simply skip the lengthy introduction telling you about how I didn't want to cherry pick only three out of more than twenty newsworthy studies that were presented at the Twelfth International Society of Sports Nutrition (ISSN) Conference and Expo in 2015, when I started writing this series right (click here if you have missed the previous articles)?

Well, that's good because it leaves more room for a brief preview of the studies I am about to discuss in today's third serving of the SuppVersity ISSN Research Review 2015 - studies that are all related (in one way or another) to increased protein intake. Either in overweight or obese people, for whom higher protein meals increase the post-prandial increase of the "satiety hormone" GLP-1, or in vegans, vegetarians and everyone else who wants to make the most of his vegetable protein sources (pea and rice protein, to be precise) by adding digestive enzymes to the mix, or - last but not least - gymrats who ramp up their protein intake from 2.3 to 3.8 g/kg body weight to see even more pronounced improvements in body composition.

Read more about ISSN and other studies at the SuppVersity

Vitargo, Red Bull, Creatine & More | ISSN'15 #1

Pump Supps & Synephrine & X | ISSN'15 #2

High Protein, Body Comp & X | ISSN'15 #3

Keto Diet Re- search Update | ISSN'15 #4

The Misquantified Self & More | ISSN'15 #5

BCAA, Cholos-trum, Probiotics & Co | ISSN'15 #6

• High protein, high GLP-1, ... highly beneficial? As a SuppVersity reader you are aware of the far-reaching metabolic effects of GLP-1 on appetite (suppression | Näslund. 1999), glucose and fat metabolism, as well as thermogenesis (Lejeune. 2006). Against that background, you will know that the small, but statistically significant increase in GLP-1 Franklin et al. (2015) observed in their latest study which compared the effects of a high protein and high mono-unsaturated fat meal on the well-known incretin hormone may have significant long-term effects even though the blood glucose levels of the study's twenty-four overweight or obese participants (male/female: 12/12; age: 38.7 ± 15.3 (mean ± standard deviation) years; BMI: 31.6 ± 4.0kg/m²), who consumed isocaloric meals containing either 35.2% energy from fat and 20.7% from monounsaturated fat (HMF meal) or 31.9% energy from protein (HP meal), did not trigger differences in post-prandial glucose levels at 30, 60, 120, and 180 min.
  
  

  

  Figure 1: Levels of active GLP-1 in response to high protein (HP) or high MUFA (HMF) meals (Franklin. 2015).

  To believe that "simply eating more protein" is going to solve all your weight problems, though, would be short-sighted - especially for the overweight obese for whom the study at hand as well as previous studies investigating the effects of GLP-1 on glucose metabolism suggest that they may benefit to a lesser extent from protein induced increases in GLP-1 than lean individuals, in whom the "satiety hormone" will trigger much more pronounced β-cell responses that in in patients with sign. insulin resistance and pre- or full-blown type 2 diabetes (Kjems. 2003).
  
  If that sounds like you, using the high(er) protein meals in conjunction with an energy restricted diet to lose weight and thus to improve your insulin sensitivity can obviously still be beneficial. Without a planned, reasonable caloric deficit, however, high(er) protein intakes alone are probably not going to "cut it" (all puns intended).

Even if weight loss is the goal, training fasted and thus hungry does not appear to provide significant benefits. Learn more about this longstanding myth and the reality in my write-up of Schoenfeld et al's seminal paper on fasted cardio and fat loss. A paper that finally had a long-standing and die-hard fat loss myth tumble.

Are you hungry before your workouts? In this case you may be interested in the results of a paper by Nystrom et al.' who suggest that athletes have to use "more proactive strategies [...] to optimize training adaptations". Why's that? Well, of the 481 (240 women, 241 men) NCAA Division I athletes representing eleven intercollegiate sports from three universities in three athletic conferences (i.e., Atlantic 10, Atlantic Coast Conference, Conference USA) who participated in the researchers investigation into the nutrient timing habits of Division I NCAA athletes, 79% reported feeling hungry prior to training, practice or competition - and that despite the fact that most of them had breakfast. It is thus well possible that the amount and types of foods athletes eat before their workouts do still receive (too) little by athletes and their athletic departments which often provide post-workout meals, but fail to do so pre-workout.

• Pimp my plant protein - digestive enzymes can do the trick! Despite the fact that pea and other protein powders have become widely (and cheaply) available over the past years, vegan and vegetarian athletes and gymrats are still having a harder time satisfying their protein requirements than their omnivore competition or gym-buddies. Against that background and in view of the fact that more and more athletes are "going vegan" or at least vegetarian, the latest study by Julie Minevich (2015) and colleagues from the University of Tampa and the formulators, manufacturers and vendors of digestive enzymes and respective supplements from Chemi-Source and Increnovo LLC, was in fact published quite timely. A study that was designed...

  "to investigate if co-ingestion of a plant protein specific digestive enzyme blend (Digest-All® VP, a proprietary enzyme blend consisting of protease 6.0, protease 4.5, peptidase, bromelain and alpha-galactosidase, Chemi-Source, Inc., Oceanside, CA) can reduce the significant differences in amino acid appearance in the blood between plant and animal proteins" (Minevich. 2015).

  To this ends, 11 resistance-trained male subjects (age: 21.4 ± 1.5 years, body weight: 82.5 ± 3.9kg, height: 177.3cm ± 6.1cm | average training status of 2.3 years ± 1.9 years) were randomly assigned to receive either 60 g of whey protein concentrate, or the same amount of protein in form of a 70:30 blend of pea and rice protein concentrates (Veg), either alone or alonside the enzyme blend Digest-All® VP in a double-blind, crossover study. All supplements were provided on an empty stomach after a 12 hour overnight fast. The three testing sessions, in which blood was drawn immediately prior to, and at 30 minutes, 1, 2, 3, and 4 hours following consumption of the supplements, were separated by a washout period of 7 days.
  

  

  Figure 2: Time to achieve peak amino acid levels and total amount of amino acids that made it to the blood stream with whey protein, the pea + rice mix and the pea + rice mix w/ digestive enzymes (Minevich. 2015).

  Ok, I have to admit that the differences are not exactly staggering and the standard deviations (see error bars) are large, but still. One potentially important determinant of skeletal muscle metabolism, the time it takes for the serum levels of essential amino acids - including leucine - to peak, i.e. T_max in Figure 2, was visibly improved by the addition of digestive enzymes to the otherwise comparatively slow digested rice + pea protein mix (if you look at the error bars, you will see that this was just a "trend", though).
  
  If you also take into account that the digestive enzyme blend brought the area under the EAA curve (see Figure 2) and the peak amino acid levels (not shown in Figure 2) of the vegetable protein blend up to the same level as it was observed with whey protein, it would seem as if the study would provide the missing evidence of the usefulness of proteases and co. for people who want to make the absolute most of their vegetable protein supplements - what is missing, obviously, is data that would allow us to quantify the downstream effects on muscle gains and other practically relevant study outcomes.
• High protein + training = WIN?! You will certainly remember the impressive results of Antonio et al.'s 2014 study on the effects of a 4.4g/kg protein diet on the body composition healthy resistance-trained men and women (learn more). Right after said study had been published the authors promised a follow up that would combine a similarly high protein intake with a controlled exercise intervention and... voila! The first results of this study were presented at this year's ISSN meeting.
  
  For the corresponding experiment, Ellerbroek et al. recruited forty-eight healthy resistance-trained men and women in their early twenties. who consumed either 2.3g/kg body weight per day (NP) or 3.4g/kg body weight per day (HP) of dietary protein during the treatment period. Moreover, all subjects participated in a split-routine, body part heavy resistance-training program. Training and diet (everyday) logs were kept by each subject.

Learn everything about the previous study.

Don't worry! I am going to write a full review of this study as soon as it will be published. In theory I would have had to skip it just like the other studies, but since I would have been mad at me if for doing that if I were you, I decided to give summarize the little information you can find in the abstract. Against that background I hope you will understand that I will refrain from making any definite conclusions until I've read the full-text. The abstract does after all lack a lot of potentially relevant information, such as the type of workouts, the way the subjects achieved the increase in protein intake (dietary or supplemental protein), the adherence, actual protein, carb & fat intakes, etc.

• As the scientists point out in the results section of the abstract, their two-time point (Pre, Post) by two-group (NP, HP) repeated-measures analysis of variance (ANOVA) showed (a) significant time by group (p ≤ 0.05) changes in body weight with weight gains and loss in the normal and high protein groups, respectively (1.3 ± 1.3 kg NP, -0.7 ± 4.0 HP), as well as reductions in total and relative body fat in both groups (-0.3 ± 2.2 kg NP, -1.7 ± 2.3 HP), and % BF (-0.7 ± 2.8 NP, -2.4 ± 2.9 HP) - both as you can see in Figure 3 with significant advantages for the HP group.
  

  

  Figure 3: Changes in body weight, fat and fat free mass in the normal and high protein groups during the diet + training intervention; mind the error bars = high inter-individual differences (Ellerbroek. 2015).

  In the absence of any form of ill health effects due to the high protein intake (both groups consumed significantly more than the recommended daily allowance of 0.8g/kg), Ellerbroek et al. also found a significant time effect for the increase in fat-free mass  (1.5 ± 1.8 NP, 1.5 ± 2.2 HP), 1-RM on the bench and squats and vertical jump and pull-up performance - albeit without significant diet-induced inter-group differences.

So what's not in this issue? Poster presentations I decided not to discuss "at length" in this issue are the allegedly interesting presentation by Galvan et al. on the "[e]ffects of 28 days of two creatine nitrate based dietary supplements on bench press power in recreationally active males." Just as it was the case for the previously referenced studies on BCAAs, I'd rather wait for the full-text to be published before I make up my mind on whether creatine nitrate is the first form of "advanced creatines" that's actually worth it's money (unlike the rest of the pack | Jäger. 2011).

Blocking Inflammation is Like Cho- king the Fire: Long Term Weight-, Visceral- and Android-Fat Gain in Human Study Emphasizes Essential Role of TNF-α in Metabolic Control!

The same must be said of a study by Detzel, et al. (2015) in which the researchers compared the effects of functional animal proteins on mTOR and endotoxins like , pro-inflammatory compounds, that arise as a consequence of intense training. There's no debating: The way serum the derived protein supplements (BioBeef, SerumPro, and SuperSerum) were capable of neutralizing endotoxin is is interesting, but to comment on the practical usefulness of blending of high-quality protein sources with functional serum protein supplements (SuperSerum and SerumPro) the abstract that does not provide numbers to assess the relevance of the reductions in IL-8 cytokine production by THP-1 monocytes is simply not sufficient | Comment!

References:

• Detzel, Christopher J., et al. "Functional animal proteins activate mTOR and bind pro-inflammatory compounds." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P35.
• Ellerbroek, Anya, et al. "The effects of heavy resistance training and a high protein diet (3.4 g/kg/d) on body composition, exercise performance and indices of health in resistance-trained individuals-a follow-up investigation." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P37.
• Franklin, Brian, et al. "The effect of meal composition on postprandial glucagon-like peptide-1 response in overweight/obese participants." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P12.
• Galvan, E., et al. "Effects of 28 days of two creatine nitrate based dietary supplements on bench press power in recreationally active males." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P17.
• Jäger, Ralf, et al. "Analysis of the efficacy, safety, and regulatory status of novel forms of creatine." Amino Acids 40.5 (2011): 1369-1383.
• Lejeune, Manuela PGM, et al. "Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber." The American journal of clinical nutrition 83.1 (2006): 89-94.
• Näslund, E., et al. "Energy intake and appetite are suppressed by glucagon-like peptide-1 (GLP-1) in obese men." International journal of obesity 23.3 (1999): 304-311.
• Nystrom, M. G., et al. "Nutrient timing habits of Division I NCAA athletes." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P33.
• Minevich, Julie, et al. "Digestive enzymes reduce quality differences between plant and animal proteins: a double-blind crossover study." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P26.

Synephrine More Ergogenic, Than Thermogenic? Pump Supps Revisited - L-Arginine, L-Citrulline and Respective Whey-Peptides & -Nitrates | ISSN Research Review '15 #2

Synephrine More Ergogenic, Than Thermogenic? Pump Supps Revisited - L-Arginine, L-Citrulline and Respective Whey-Peptides & -Nitrates | ISSN Research Review '15 #2

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Synephrine, arginine, citrulline - Which pre-workout ensures that you're "on fire"?

As I pointed out previously, my initial idea to cherry pick only the most interesting study results that were presented in form of of poster presentations at the Twelfth International Society of Sports Nutrition (ISSN) Conference and Expo in 2015 didn't work out. The number of interesting studies is is simply too much for a single SuppVersity article to discuss them all.

Accordingly, I am now posting the 2nd serving of what is going to be a multi-part series of articles with brief discussions of the most significant results of the >20 studies and short references to those that didn't make the SuppVersity cut in this, previous and future installments of this series for one reason or another.

Read more about ISSN and other studies at the SuppVersity

Vitargo, Red Bull, Creatine & More | ISSN'15 #1

Pump Supps & Synephrine & X | ISSN'15 #2

High Protein, Body Comp & X | ISSN'15 #3

Keto Diet Re- search Update | ISSN'15 #4

The Misquantified Self & More | ISSN'15 #5

BCAA, Cholos-trum, Probiotics & Co | ISSN'15 #6

• Synephrine More Ergogenic Than Thermogenic? There was not just one, but two poster presentations and a full paper that has been published only days ago on synephrine containing supplements at the ISSN meeting and on the ISSN website, respectively. Synephrine? Yes, that's the supplemental non-starter, ah... I mean allegedly powerful fat burner from orange peels. The one with promising fat loss results in rodents, but discouraging results in practice.
  
  Luckily, the studies that were presented in form of posters by scientists from the Texas A&M University (Jung. 2015 & Dalton. 2015) at the ISSN meeting did not deal with synephrine as fat burner. Rather than that, Jung et al. and Dalton et al. took a look at the short- and long-term safety of synephrine as a pre-workout. A pre-workout that contained either 3g beta alanine, 2g creatine nitrate, 2g arginine AKG, 300mg N-acetyl tyrosine, 270mg caffeine, and 15mg Mucuna pruriens, alone (PLA) or the same baseline ingredients and synephrine.
  

  

  Figure 1: Number of reps on sets 1-3 & 4-6 in the control and treatment conditions (Ratamess. 2015)

  Now, the fact that some synephrine in your preworkout won't kill you is not really exciting. I have to admit that. What is exciting... at least sort of, though is the fact that the questionable thermogenic turned out to be an effective ergogenic in the already published and thematically related study by Ratamess and colleagues (Ratamess. 2015). A study that shows that p-synephrine of which previous studies indicate that it is a potent, but highly selective β-3 adrenoreceptor may nor be the best fat burner (the good old ephedrine was a pan-receptor activator and clenbuterol & co target the β-3 receptor, maybe that's also why the fat loss results are rather disappointing) , but at least an underestimated ergogenic.

Is p-synephrine different from synephrine? That's a good question without a clear question. Most supplements that list synephrine on the label actually contain P-hydroxy-α-{methylaminomethyl}-benzylalcohol aka p-synephrine, a protoalkaloid compound that differs from m-synephrine and o-synephrine structurally and comes in form of to stereoisomers in most supplements - the l-enantiomer and the d-enantiomer as the racemate d,l-synephrine. While the latter have been shown to be present in bitter orange, other forms, like the m,s-isomer may are suspected to be adulterations from synthetic phenylephrine supplement producers use to "spike" (Allison. 2005) their products (I assume this was not the case with the samples the researchers in the study at hand used, but the chaos wrt to the types of synephrine puts a huge "?" behind the assumption that you'll see the same effects from any given synephrine or synephrine + caffeine supplement. 

• As the data in Figure 1 goes to show you, the p-synephrine supplement, which was administered to twelve healthy, college-aged men at a dosage of 100mg either alone (S) or in conjunction with 100 mg caffeine (SCF) for three days. On the day on which the subjects participated in a standardized resistance exercise protocol consisting of 6 sets of squats for up to 10 repetitions per set using 80 % of their one repetition-maximum (1RM) with 2 min of rest in between sets, the supplement was ingested 45 minutes before the workout. In comparison to the placebo treatment synephrine alone triggered a significant increase in total repetitions and volume load. When synephrine was combined with 200 mg of caffeine, it also increased the mean power and velocity of squat performance. What did not change in response to either synephrine alone or caffeine and synephrine, though, were the blood lactate levels or the rate of perceived (RPE) exertion the subjects reported on the usual visual analogue scales.
  
  For me personally, that's a surprising result. For the scientists it "indicate[s that] supplementation with S and SCF can enhance local muscle endurance during resistance exercise" (Ratamess. 2015); and I have to admit: They are right. One thing you should keep in mind, though, is that unlike caffeine, where you often see reductions in RPE and thus an effect you will feel, synephrine will - even if it works - do its purported "magic" more subtly.
• The Latest on "Pump Supplements" - Creatine, Arginine, Citrulline, Nitrates -- To make sure that this series is not turning into a 12-part article, I will address the results of Moon's, Suzuki's and Vogel's results in one item (since Moon's paper basically summarizes the results of studies by Falcone and Joy, I won't discuss those separately) .
  
  

  

  Figure 2: Increases in blood flow volume (BFV) 33 minutes after the ingestion of 1.87g of RC, 3.67g of CP (citrulline content 1.87g), 1.87g of RA, or 3.07g of AP (arginine content 1.87g) before 3 sets of 15 arm curls (Moon. 2015).

  Moon et al.'s comparison of citrulline's and arginine's ability to increase the exercise-induced vasodilation and blood flow yielded unsurprising results that confirm that citrulline-based ingredients are more effective than arginine-based ingredients for modulating vasodilation and blood flow. Now that alone wouldn't be news-worthy if the scientists had not tested the effects of both, rawe L-citrulline (RC) and raw L-arginine (RA) and, citrulline and arginine bound to a whey peptide (CP and AP, respectively).
  
  I guess I am not going to surprise you, when I tell you that regular arginine was the worst vasodilator in this quartet. What is more surprising, though, is the extent to which the peptide bonding increased the vasodilating effects of regular citrulline and even arginine. With the the former producing 2x higher increases in vessel diameter and 9% higher increases in blood glow volume than regular citrulline (let's not even mention regular arginine | see Figure 2) the effects are pronounced enough to be potentially "feelable" and "visible" during a workout.
  
  

  

  Citrulline & Glutathione - GSH Amplifies & Prolongs CIT's NO Boosting Effects During + After Biceps Workout | learn more.

  Against that background I would be curious to see, whether the likewise recently reported performance enhancing effects of citrulline Suzuki et al.'s observed in twenty two well-trained young men who consumed 2.4 g / day of L-citrulline or placebo for 7 days and they took 2.4 g of L-citrulline or placebo 1 hour before 4 km cycling time trial on day 8 would be enhanced by bonding citrulline to whey peptides.
  
  I mean, if citrulline-whey-peptides appear to offer the same effects citrulline does, but at a higher efficacy, their beneficial effect on cycling time trial performance of which the Suzuki et al. argue that it was mediated by an up-regulation of plasma NO availability should be superior to that of raw citrulline, as well, right?
  
  And now that we are already talking about what really matters, i.e. performance enhancements, not increases in blood flow, it would also be interesting to see a follow up on the last "pump supplement" study to be mentioned in this installment of the ISSN Research Review: A study by Vogel et al.'s on the vasolidating effects of an arginine-nitrate based pre-workout supplements that shows significant increases in brachial artery diameter. Increases that are quantitatively similar to those Moon et al. observed for citrulline-whey-peptides in the previously discussed study. That does not mean, though that they are equally effective, though. To be able to say that we would need a study in which both agents are compared head-to-head. Unless this study is done and a follow up on Vogel's study proves that the increases in blood flow will actually produce significant performance gains, the only thing I can say about arginine nitrate is: It's interesting, but with respect to its ergogenic effects more studies have to be done.

You don't believe citrulline can do anything for you? Check this out: 8g/day Citrulline Increase Leg Workout Performance - More Reps on Leg Press, Hack Squat & Leg Ext. in Exp. Gymrats (more)! It is thus by no means useful for "cosmetic pumps", only 

Studies that didn't make the cut in this issue are Brooke Bouza et al.'s study on the exercise and calorie information on menus (Bouza. 2015) as well as O'Conner et al.'s tart-cherry study (O'Connor. 2015). That's not because there were methodological issues or something. It's much simpler: The notion that "exercise and calorie information on menus is not enough to improve food choices in Hispanic adults" (Bouza. 2015) is about as unsurprising as the word "potentially" (O'Connor. 2015) in the conclusion of O'Connor's study is daunting. And by the way, now that you know that tart cherry "potentially increases running performance and attenuates post-race markers of inflammation" you actually know the most relevant finding of O'Connor's study, right? | Comment on Facebook!

References:

• Allison, D. B., et al. "Exactly which synephrine alkaloids does Citrus aurantium (bitter orange) contain?." International journal of obesity 29.4 (2005): 443-446.
• Bouza, Brooke, et al. "Exercise and calorie information on menus is not enough to improve food choices in Hispanic adults." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P3.
• Dalton, R., et al. "Safety and efficacy of a pre-wrkout dietary supplement with and without synephrine." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P5.
• Falcone, Paul H., et al. "Acute hemodynamic effects of L-arginine, arginine nitrate, and arginine peptide on exercise-induced vasodilation and blood flow in healthy men." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P10.
• Joy, Jordan M., et al. "A comparison of raw citrulline and citrulline peptide for increasing exercise-induced vasodilation and blood flow." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P18.
• Jung, Y. P., et al. "Effects of 8 weeks pre-workout dietary supplement ingestion with and without synephrine on blood chemistry panel." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P4.
• Moon, Jordan R., et al. "A comparison of citrulline and arginine for increasing exercise-induced vasolidation and blood flow." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P6.
• O'Connor, A., et al. "Short-term powdered tart cherry supplementation encircling an acute endurance challenge potentially increases running performance and attenuates post-race markers of inflammation." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P7.
• Suzuki, Takashi, et al. "Oral L-citrulline supplementation enhances cycling time trial performance in healthy well-trained males." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P52.
• Vogel, Roxanne M., et al. "Acute hemodynamic effects of a multi-ingredient performance supplement on brachial artery vasodilation and blood flow volume following elbow flexion exercise in healthy young men." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P28.

Vitargo™, Red Bull™ + Co. Research - Are They Worth It? Beef Can Keep Up W/ Whey For Gains! "Creatine Loading" = Too Much of a Good Thing - ISSN Research Review '15 #1

Vitargo™, Red Bull™ + Co. Research - Are They Worth It? Beef Can Keep Up W/ Whey For Gains! "Creatine Loading" = Too Much of a Good Thing - ISSN Research Review '15 #1

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When you're running on a treadmill it obviously takes more than one serving of Red Bull or other commercial energy drinks to kickstart your workout performance | learn more below.

Initially I wanted to cherry pick only the most interesting study results that were presented in form of of poster presentations at the Twelfth International Society of Sports Nutrition (ISSN) Conference and Expo in 2015. After looking at the research that is - as of now - only available in form of (albeit often detailed) abstracts, I decided that there are way too many interesting studies to cover only three of them in depth or all of them only cursory. Accordingly, I decided to start a SuppVersity Mini Special with this being the first out of 3-4 issues in which I will briefly discuss the most significant results of those of the roughly two dozen studies, I (a) believe are of greatest interest to you and (b) feel comfortable talking about without having all the details in form of the still to be published full texts.

Read more about ISSN and other studies at the SuppVersity

Vitargo, Red Bull, Creatine & More | ISSN'15 #1

Pump Supps & Synephrine & X | ISSN'15 #2

High Protein, Body Comp & X | ISSN'15 #3

Keto Diet Re- search Update | ISSN'15 #4

The Misquantified Self & More | ISSN'15 #5

BCAA, Cholos-trum, Probiotics & Co | ISSN'15 #6

• The latest research on Vitargo(TM) -- The mere fact that the latest study on Vitargo(TM) was presented in "three servings", on the latest ISSN meeting, i.e. (1) on the glucose and insulin response (Almada. 2015), (2) on the incretin response (Anzalone. 2015) and (3) on the power output during a subsequent bout of resistance exercise (Van Eck. 2015), could raise some concerns about the objectivity of the results, but is as Patrick Jacobs kindly reminded me common scientific practice.. So, let's put the skepticism aside and take a look at the study design and results.
  
  

  

  Post-Workout Glycogen Repletion | Read the my overview article.

  Sixteen resistance trained men participated in a double-blind, placebo-controlled, randomized crossover study, which consisted of three testing sessions, each separated by one week. In sessions 1-3, subjects completed a glycogen depleting cycling bout of 60 minutes at 70% VO2 max, followed by six, one-minute sprints at 120% VO2 max.
  
  Immediately post-exercise subjects ingested a placebo (PLA), or a low molecular (LMW) or high molecular weight (HMW) CHO (=Vitargo(TM)) solution (10%) providing 1.2g/kg body weight CHO; assigned randomly. Blood samples were taken prior to ingestion and every ten minutes for 2h.
  
  For the "first" and "second" serving of the study this was enough. These mini-presentations dealt with the insulin, glucose and incretin response to the two supplements, only. For the "third serving", however, the scientists included performance data from a subsequent bout of exercise, during which the participants did 5 sets of 10 repetitions of back squats (75% 1RM) "as explosively as possible" (if subjects paused for more than 2 seconds or were unable to complete a rep, resistance was lowered by 13.6 kg | Van Eck. 2015).
  

  

  Figure 1: Overview of the most relevant results (LMW = low molecular weight CHO vs. HMW = Vitargo (TM) high molecular weight CHO) from Almada (2015), Anzalone (2015) and Van Eck (2015).

  As you can see in my overview of the most relevant results, the scientists did not find practically meaningful differences in study I-II. In study III, which compared the effects of low to high molecular weight carbohydrates (LMW vs. HMW) on squat performance 2h after the glycogen-depleting workout, this was slightly different:

  "HMW conferred a likely beneficial effect in Sets 4 and 5 (92.5% and 88.7% likelihood, respectively), compared to PLA; while ingestion of LMW conferred only a possibly beneficial effect (68.7%) and likely beneficial effect (83.9%) in Sets 4 and 5, respectively" (Van Eck. 2015).

  And still, if you read the conclusion, "the ingestion of a HMW CHO solution providing 1.2 g/kg CHO may allow athletes to sustain power output in a subsequent resistance training session when time between training sessions is limited" (Van Eck. 2015), carefully, you will notice the words "likely" and "possibly" which signify the putative nature of the effect. What may be even more relevant than that, is yet that few of you will do glycogen-depleting exercises at 4:00 pm and hit the gym again for an intense leg workout at 6:00 pm. Accordingly, the practical relevance of the "sustained power output" Van Eck et al. observed is probably restricted to a small group of professional athletes. For people who fall into this category or strength athletes training twice a day, though, using Vitargo (TM) may in fact offer significant benefits.
• Beef and whey support lean mass gains similarly effectively -- If you are asking yourself if beef isolate protein is a good or at least decent replacement for whey, the post-workout protein supplementation "gold standard" some people can't use due to its (albeit low) lactose content, a recent study from the University of Tampa (Sharp. 2015) has the answer you are looking for.
  

  

  Figure 2: Relative improvements in muscle size (hypertrophy) and body fat (fat loss) in response to beef isolate or whey protein supplementation; expressed relative to maltodextrin placebo (Sharp. 2015).

  As the data in Figure 2 tells you, it will make a good replacement! If we go by the average increase in lean mass and loss of fat mass, the beef isolate that was consumed in amounts of 2x20g per day either immediately after each of the 5 weekly workouts (3 resistance training, 2 cardio; 8 weeks total, daily undulating periodization) or at a similar time in the day, you may even argue that the beef protein had the overhand over its "milky" competitor. If we take the individual variations into account, though, the 1% lean mass and almost 3% fat loss advantage (DXA values) of the beef protein turns out to be statistically non-singifican.
  
  The same goes for differences in strength gains, of which the researchers found that they were identical not just in the two supplement, but also in the supplement and control groups. The lack of additional power during the bench press test may, as the researchers point out, be ascribed to both increases in neural and morphological adaptations" (Sharp. 2015) which would "negate" (ibid.), or as I would phrase it, 'override' potential additive effects of any of the protein supplements (whey and beef, alike).
• Energy drinks a waste of money on the treadmill? At first sight, the results of the latest study by Sanders et al. (2015) do in fact suggest that energy drinks were a total waste of money for those of you who are consuming them before a regular cardio workout on the treadmill. After all, none of the tested drinks lead to statistically significant improvements in either perceived treadmill exercise performance or running economy assessed via oxygen consumption at 70% treadmill exercise.

In contrast to treadmill running, the performance during a cycling time-trial can be improved by the consumption of an energy drink - a potential explanation for the difference may be that the subjects in the Ivy study consumed 2x  more Red Bull than the subjects in Sanders' study.

Energy drinks don't work? Well, the overall research shows a more diverse picture. While a previous study by Astorino et al. (2012) and a similar study by Candow et al. (2009) that tested the effects of Red Bull on repeated sprint performance and its effects on time to exhaustion, respectively, yielded similarly disappointing results, Ivy et al. (2009) and Forbes et al. (2007) found benefits. More specifically, the researchers observed significant increases in upper body muscle endurance (yet no effect on anaerobic peak or average power during repeated Wingate cycling tests in young healthy adults | Forbes. 2007) and improved cycling time-trial performance (without concomitant increase in perceived exertion | Ivy. 2009) - albeit with 2x more Red Bull than in the study at hand (500ml vs. 250ml).

• Now, some of you may argue that all you care about when you buy an energy drink is that it makes it easier for you to hit your target time on the treadmill. Well, I can understand that, but in view of the fact that neither of the caffeine laden 8.4 oz. Red Bull®, 16 oz. Monster Energy ®, 2 oz. 5-hour ENERGY® drinks affected the subjects subjective rates of perceived exertion, it does appear questionable that these drinks can actually help you.
  
  It does thus stand to reason that Sanders et al. conclude that the "results [of their latest study] do not support manufacturers' claims regarding their product's ability to boost performance" (Sanders. 2015). The scientists are yet also right that it would be necessary to find out whether time trial or time to exhaustion sprint and endurance performance benefit, as respective studies may be better suited to reliably "assess if these energy drinks can, in fact, improve exercise performance" (ibid.) - and in view of the fact that previous studies with corresponding outcomes yielded conflicting results (see blue box above), I can fully subscribe to that: We need more (non-sponsored) quality studies ;-)
• More evidence that creatine loading is not the way to go -- In Gann et al.'s latest study, fourteen (Cr = 7, Pl = 7) non-resistance-trained (i.e. < thrice weekly, 1 year prior) men between the ages of 18-30 were randomly assigned by age and body weight to orally ingest a powdered dextrose placebo or creatine monohydrate (Gann. 2015).
  
  After baseline strength and body composition testing procedures, participants ingested creatine or placebo at a dose of 0.3g/kg lean body mass/day (≈ 20-25g/day) for a 5 day loading phase immediately followed by a 42-day maintenance phase at a dose of 0.075g/kg lean body mass/day (≈ 5-7g/day). The participants followed a periodized 4 day per week resistance-training program split into two upper body and two lower body workouts per week, for a total of 7 weeks. Blood and muscle samples were obtained at Day 0, 6, 27, and 48. Statistical analyses were performed utilizing separate two-way ANOVA for each criterion variable employing a probability level of ≤ 0.05.
  

  

  Figure 3: Don't be fooled by shiny ads! While there is evidence that some forms of creatine will be faster absorbed than creatine monohydrate, only the addition of dextrose (and ALA or baking soda) have actually been shown to increase the muscular retention of creatine in experiments (Jäger. 2011) 

  As you'd expect, the addition of creatine lead to significant increments in total body mass (p = 0.03) and lean body mass (p = 0.01). What creatine did not do, though, was to affect the amount of body fat the subjects were carrying around. The latter decreased to a similar extent in both groups in response to resistance training, alone (p = 0.001) - without any effect of creatine supplementation. Much to my personal surprise, the same was the case for the subjects' muscle strength, which was - likewise - increased to the same extent in both groups.
  
  So what? Well, in contrast to the uncommon lack of effect on muscle strength, the lack of effect on body fat is sad, but had to be expected. Both findings are yet not why this study made the SuppVersity Cut. That is or rather was Gann's observation that the loading phase lead to significant increases in of urinary creatine (p = 0.036), and urinary creatinine (p = 0.01) in the creatine group compared to placebo. This "excess amounts of serum and urinary creatine and urinary creatinine content" (Gann. 2015) provides further evidence that the (still common) practice of creatine loading is useless and 100% safe certainly only in the short term. In the long term, however, I'd highly suggest that you avoid super-dosing on creatine - I mean, why would you want to use 20g per day, when 3-5 g per day is enough (Wilder. 2001) and more than will "lose" once the creatine levels of your muscles are saturated (the exact washout time is unknown, but studies indicate it may be >40 days of consuming no creatine at all | Deldicque. 2008)?

Intra-workout BCAA supplements are marketed specifically to resistance trainees. If they do have anti-catabolic effects, though, those are - just like potential fatigue reducing effects - significantly more likely to occur in endurance trainees | learn more

What else? In the bottom line of this mini-series I will briefly reference those studies that did not make the SuppVersity Cut for various reasons. Studies like those on the benefits of BCAAs, for example (Kephart. 2015 or Mumford. 2015). For this kind of study I would need the full-text, not just the abstract to tell you how relevant conclusions like the "BCAA supplement did not appear to enhance recovery benefits compared to a CHO control", "a few areas of performance were bolstered to a point of practical importance"(Kephart. 2015) or "BCAA supplementation [...] may benefit immune function during a prolonged cycling season" (Mumford. 2015), actually are. As soon as the corresponding full papers you have published I will obviously make good for any performance-relevant information I may be missing by ignoring the abstracts, today | Comment on Facebook!

References:

• Almada, Anthony L., et al. "Effect of post-exercise ingestion of different molecular weight carbohydrate solutions. Part 1: The glucose and insulin response." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P30.
• Astorino, Todd A., et al. "Effects of red bull energy drink on repeated sprint performance in women athletes." Amino acids 42.5 (2012): 1803-1808.
• Anzalone, Anthony J., et al. "Effect of post-exercise ingestion of different molecular weight carbohydrate solutions. Part II: The incretin response." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P31.
• Candow, Darren G., et al. "Effect of sugar-free Red Bull energy drink on high-intensity run time-to-exhaustion in young adults." The Journal of Strength & Conditioning Research 23.4 (2009): 1271-1275.
• Deldicque, Louise, et al. "Kinetics of creatine ingested as a food ingredient." European journal of applied physiology 102.2 (2008): 133-143.
• Forbes, Scott C., et al. "Effect of Red Bull energy drink on repeated Wingate cycle performance and bench-press muscle endurance." International journal of sport nutrition and exercise metabolism 17.5 (2007): 433.
• Gann, Joshua J., et al. "Effects of a traditionally-dosed creatine supplementation protocol and resistance training on the skeletal muscle uptake and whole-body metabolism and retention of creatine in males." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P2.
• Ivy, John L., et al. "Improved cycling time-trial performance after ingestion of a caffeine energy drink." International journal of sport nutrition 19.1 (2009): 61.
• Jäger, Ralf, et al. "Analysis of the efficacy, safety, and regulatory status of novel forms of creatine." Amino Acids 40.5 (2011): 1369-1383.
• Kephart, Wesley C., et al. "Ten weeks of branched chain amino acid supplementation improves select performance and immunological variables in trained cyclists." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P20.
• Mumford, Petey, et al. "Effects of sub-chronic branched chain amino acid supplementation on markers of muscle damage and performance variables following 1 week of rigorous weight training." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P29.
• Sanders, Gabriel J., et al. "The effect of three different energy drinks on oxygen consumption and perceived exertion during treadmill exercise." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P1.
• Sharp, Matthew, et al. "The effects of beef protein isolate and whey protein isolate supplementation on lean mass and strength in resistance trained individuals-a double blind, placebo controlled study." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P11.
• Van Eck, Leighsa E., et al. "Effect of post-exercise ingestion of different molecular weight carbohydrate solutions. Part III: Power output during a subsequent resistance training bout." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P32.
• Wilder, Nathan, et al. "The effects of low-dose creatine supplementation versus creatine loading in collegiate football players." Journal of athletic training 36.2 (2001): 124.

Testosterone Gel Augments Increases in Lean Mass Gains (+3.9kg in 6 Months) in Older Intensely Training Men, but Testim Blocks Decrease in Marker of Heart Disease Risk

Testosterone Gel Augments Increases in Lean Mass Gains (+3.9kg in 6 Months) in Older Intensely Training Men, but Testim Blocks Decrease in Marker of Heart Disease Risk

bioavailable testosterone build muscle CD36 health heart health lose fat testim testo gel testosterone TRT

Building muscle becomes increasingly harder, the older you get. While there's no evidence that any of the overpriced natty T-boosters can solve this problem, Testim(R) can. That's at least what a recent Danish study shows.

If you believe in what you read in the ads for testosterone boosters, all you'd have to do to get jacked was to increase your testosterone levels by a few percentages.

In view of the fact that it took transdermal testosterone gels and a 100% increase in bioavailable testosterone (most T-boosters boast of boosting total testosterone by 20-40%) in a recent study from the Odense University Hospital and the University of Southern Denmark (Glintborg. 2015) to trigger - albeit significantly - muscle gains of +3.5 kg in older subjects on a high intensity resistance training regimen, it is highly questionable how capable the average "natural muscle builder" really is ... but let's not rant and rather take a look at what really works (for the elderly, at least).

If you want to build muscle forget T-booster and optimize your protein intake 

Protein Timing DOES Matter!

5x More Than the FDA Allows!

Protein requ. of athletes

High EAA protein for fat loss

Fast vs. slow protein

Whey vs. Pea Protein

So, the study at hand was actually not designed to elucidate the effects of testosterone on lean mass gains or fat loss, but rather to investigate testosterone's ability to augment or block the exercise-induced reductions in soluble CD36 a protein. CD36??? Well, I have to admit this is not exactly the best known inflammatory protein, but in view of the fact that it has been associated with the obesity induced increase in atherosclerosis risk (Handberg. 2006), it is an important one.

To quantify said effects, a group of Danish scientists measured the changes in soluble CD36 (sCD36) and body composition in response to a testosterone treatment (TT) and/or strength training (ST) in men with low-normal testosterone levels (Glintborg. 2015).

Table 1: Baseline characteristics of the subjects | TT, testosterone treatment; (ST) strength training. Data presented as median (interquartile range); No significant differences, Mann-Whitney test between groups. Bio T, Bioavailable testosterone; LEFM, lower extremity fat mass; SAT, subc. adipose tissue; VAT, visc. adipose tissue (Glintborg. 2015).

All in all, the researchers recruited 54 men aged 60–78 years with testosterone levels below 7.3 nmol/L (that's the usual cut-off for hypogonadism differential diagnosis) and waist circumferences above 94 cm for a randomized double-blinded, placebo-controlled study in which the subjects were assigned to four different groups:

• the testosterone aka TT group in which the subjects were treated with 50–100 mg/day of testosterone from Testim per day (n= 20),
• the placebo aka PLA group in which the subjects were treated in which the subjects received an identically looking placebo supplement (n= 18),
• the strength training aka ST group in which the subjects followed a standardized progressive heavy strength training program (n= 16), and
• the combined groups with ST + TT or ST + PLA

To determine the success of the interventions, the scientists used both, the levels of soluble CD36 (sCD36) and determined the total and regional fat mass by Dual X-ray absorptiometry (DEXA) and magnetic resonance imaging (MRI) after three (half-way) and six months (end of the intervention).

Figure 1: Changes in body composition (left) and bioavailable testosterone levels (right | Glintborg. 2015).

As you can see in Figure 1, the testosterone treatment augmented the increases in lean mass in response to the standardized high intensity resistance training protocol that involved 3 supervised resistance training workouts per week (minimum two workouts) consisting of 5-min bicycling for warm-up (approximately 100 W) plus a standardized full body workouts (6-10 reps at the respective RMs, weights were increased progressively) with leg presses, knee extensions, leg curls, chest presses, latissimus pull downs, back extensions, and crunches.

And the effect was not just statistically, but also practically significant: Instead of the meager 0.6 kg without testosterone treatment, the subjects on T-gel gained a whopping 4.5 kg (that's +650%). That's truly impressive.

Dose response relationship of muscle gain (in kg) per mg of testosterone enanthate from previous SV article; the white line indicates a dose that would probably have produce testosterone levels identical to baseline (calculated based on Bhasin. 2001 | learn more!)

Beware of jumping to conclusions! In view of the age and the low baseline testosterone levels of the subjects it is unwarranted to assume that you or anyone else in the prime of his year (and testosterone production ;-) will see the same, or even similar increases in size gains as the 60y+ agers in the study at hand. Addition due to user question: It is also not necessarily certain that the same results will be seen with any other form of administering T. If you achieve stable high-normal T levels with injectables, though, it is pretty sure that people with initially low T-levels will benefit. I highly suggest you read my article "Quantifying the Big T" if you want to know more about the dose-response ratio (also in young men) | read it!

What was less impressive were the changes in body fat: While both TT and ST had beneficial effects on the total amount of body fat (-1.4kg in the TT group vs. +1.2 kg, -0.8kg and -0.7kg in the PLA, ST and ST + TT groups, respectively), there were no significant decreases in waist circumference a primary marker of metabolic disease risk and indicative of the amount of "bad" visceral fat you're carrying around - a result of which we are going to see that it is in line with the lack of effect on the previously mentioned artherosclerosis risk marker CD36.

Figure 2: In spite of the fact that the atherosclerosis risk factor sCD36 usually correlates with obesity, its reduction by exercise was blunted by the provision of exogenous testosterone even though the fat loss in the ST + TT group did not differ significantly from that in the ST + PLA (testosterone-free) training group (Glintborg. 2015).

While the latter, i.e. CD36 and thus the putative artherosclerosis risk, improved significantly in the resistance training group (without T-gel), the addition of 50-100mg of transdermal testosterone appears to reverse or impair the exercise-induced improvements in artherosclerosis risk and entail the risk of an unwanted increase in this allegedly important CVD risk marker. The obvious question is thus: How significant is the increase in sCD36 in the testosterone treated "best+ agers"?

Figure 3: Scientists believe that the association between CD36, atherosclerosis, diabetes and CVD is mediated by its effects on macrophage foam cell formation (Febbraio. 2001).

So, is TRT dangerous? Well, atherosclerosis is only one out of several diseases in which sCD36 is elevated. Increased CD36 has also been associated with the development of metabolic diseases such as type 2 diabetes, and overall cardiovascular disease (Febbraio. 2001). In view of the fact that this correlation appears to have a mechanistic background that relates to the way CD36 stimulates macrophage foam cell formation, it is hard to discount the ill effects of testosterone on CD36 as irrelevant. Against that background, we would yet have to expect that studies investigating the long-term effects of testosterone treatment on atherosclerosis and CVD risk show distinct risk increases. This, however, is not the case - at least not consistently.

Rather than being associated with a distinct increase in CVD risk, the available data on the effects of testosterone treatment on heart health shows both positive, as well as negative effects (Haddad. 2007). Along with the publication of several very recent studies, an updated meta-analysis by Morgentaler et al. (2015) even suggests that the tides, which have long been "anti-TRT" are now turning so that the "[c]urrently available evidence weakly supports the inference that testosterone use in men is not associated with important cardiovascular effects" (Morgentaler. 2015).

Eventually, we or rather patients and clinicians will yet need more and larger randomized trials of TRT being used in men at risk for cardiovascular disease to better inform the safety of long-term testosterone use. Studies that measure only the short-term response of alleged markers of CVD risk, such as CD36 in the study at hand, are eventually of little use, when it comes to finding a definitive answers to the question whether TRT increases CVD risk. What they can tell us, though, is that TRT is a powerful tool to alleviate and reverse the age-related decline in muscle mass - in isolation and, even more so, in conjunction with high intensity resistance training | Comment!

References:

• Bhasin, Shalender, et al. "Testosterone dose-response relationships in healthy young men." American Journal of Physiology-Endocrinology And Metabolism 281.6 (2001): E1172-E1181.
• Febbraio, Maria, David P. Hajjar, and Roy L. Silverstein. "CD36: a class B scavenger receptor involved in angiogenesis, atherosclerosis, inflammation, and lipid metabolism." Journal of Clinical Investigation 108.6 (2001): 785.
• Glintborg, Dorte, et al. "Differential effects of strength training and testosterone treatment on soluble CD36 in aging men: Possible relation to changes in body composition." Scandinavian journal of clinical and laboratory investigation ahead-of-print (2015): 1-8.
• Haddad, Rudy M., et al. "Testosterone and cardiovascular risk in men: a systematic review and meta-analysis of randomized placebo-controlled trials." Mayo Clinic Proceedings. Vol. 82. No. 1. Elsevier, 2007.
• Handberg, Aase, et al. "Identification of the Oxidized Low-Density Lipoprotein Scavenger Receptor CD36 in Plasma A Novel Marker of Insulin Resistance." Circulation 114.11 (2006): 1169-1176.
• Kvorning, Thue, et al. "Mechanical Muscle Function and Lean Body Mass During Supervised Strength Training and Testosterone Therapy in Aging Men with Low‐Normal Testosterone Levels." Journal of the American Geriatrics Society 61.6 (2013): 957-962.
• Morgentaler, Abraham, et al. "Testosterone therapy and cardiovascular risk: advances and controversies." Mayo Clinic Proceedings. Vol. 90. No. 2. Elsevier, 2015.