ONLINE DRIVERS MEDIA

Its nice to be lean, but is it really worth ruining your health? I dont think so, but everyone is the architect of his / her own future.

I want to say in advance that youd better not read this article if you belong to the ever-increasing number of carbophobs (people who are afraid of carbohydrates) who have been so indoctrinated by the confusing information on the Internet that they are willing to close their eyes to all objective data.

In view of the fact that you kept reading, I assume that you (a) dont belong to this group of blockheads or are (b) a blockhead who is about to scroll down to the comment section to start raving about how bad carbohydrates are, pointing out that "you just have to eat a ketogenic diet to live happily ever after" - spare me this bullshit, please!
Its scaremongering bullshit like that due to which more and more non-athletes develop what Can Zhao et al. describe in their latest paper in the peer-reviewed scientific Journal of Sport and Health Science as "exercise-associated menstrual dysfunction" aka EAMD (Zhao. 2014).

For those who have read the SuppVersity Athlete Triad Series, its no news that menstrual irregularities and amenorrhea in female athletes is closely linked to the imbalance between energy intake and exercise-associated energy requirement (Williams. 2001). Accordingly Zhao et al. wanted to investigate, ...

"[...]whether carbohydrate supplements can reverse EAMD and protect against exercise-induced impairment in ovary as an important part of HPO axis regulation and rebalances the energy intake and energy expenditure to support the reproductive function" (Zhao. 2014).

Now the bad news is that they did this in rodents. 45 healthy mature 2-month-old female Spraguee Dawley rats, to be precise. This sounds idiotic, but in view of the fact that the experimental procedure required that "subjects" are sacrificed in the course of the study its quite reasonable to use rodents, not ladies.

Figure 1:  Treadmill running schedules show the specific timeline and various treatments of each groups (Zhao. 2014)

Figure 1 shows a graphical overview of the study protocol which involved an identical initial exercise period in the course of which the speed of the treadmill was continuously increased for six weeks.

At the end of this initial 6-week study period, the female rats, the ovary epithelial cells of the rodents showed significant abnormalities. At the end of week 9, the follicular cells of the rodents in group E contained swollen mitochondria with broken cristae.

Similar exercise-induced mitochondrial damages were also observed in the EAMD rats with post-exercise rest. In the rodents in group O and G, however, Zhao et al. observed a significant recovery of exercise-induced mitochondria impairment. They showed significant reduction of swollen endoplasmic reticulum and Golgi complex, and increases in abundant organelles, irrespective of whether they had been fed a 30% glucose or 30% oligosaccharide diet.

Normalization of organ changes and hormones w/out increase in energy intake

In contrast to the previously hinted at prejudices, the addition of simple sugars to the rodent diet did not lead to an increase in energy intake - in spite of the fact that the goal was a 30% increase in energy intake from glucose / oligosaccharide supplements, the total energy intake was not higher than in the non-exercised control group (see Figure 2).

Figure 2: Changes in energy intakes in each group throughout 9 weeks study (Zhao. 2014).

In conjunction with the significant improvement in GnRH, LH, FSH and estrogen its thus more than unlikely that a comparable increase in "sugar" intake in human females would trigger the increase in body fat many women fear so much that they are willing to run around tired and infertile for years, although most of them know that reducing the exercise volume and normalizing their eating behavior would solve the problem once and for all.

Figure 3: Relative levels (% of control) of GnRH, FSH, LH, E2 and Progesterone (P) after 9 weeks (Zhao. 2014)

Interestingly, the saccharide polymers (oligosaccharides), which are also commonly found on the plasma membrane of animal cells, where they can play a role in cell–cell recognition, did a slightly better job than glucose, when it comes to the restoration of normal hormone levels (see Figure 3).
Reference:

• Qiang, Xu, Chao YongLie, and Wan QianBing. "Health benefit application of functional oligosaccharides." Carbohydrate Polymers 77.3 (2009): 435-441. 
• Tomten, S. E., and A. T. Høstmark. "Energy balance in weight stable athletes with and without menstrual disorders." Scandinavian journal of medicine & science in sports 16.2 (2006): 127-133. 
• Williams, Nancy I., et al. "Longitudinal Changes in Reproductive Hormones and Menstrual Cyclicity in Cynomolgus Monkeys during Strenuous Exercise Training: Abrupt Transition to Exercise-Induced Amenorrhea 1." Endocrinology 142.6 (2001): 2381-2389. 
• Zhao, Can, et al. "Effects of carbohydrate supplements on exercise-induced menstrual dysfunction and ovarian subcellular structural changes in rats." Journal of Sport and Health Science (2014).

Voluntary & NMES contractions for Monster Quads?

You are always looking for new ways to improve your training outcome? Scientists from the Department of Physiotherapy at the University Cardenal Herrera-CEU might have something for you, then. In their latest study, V. Benavent-Caballer, P. Rosado-Calatayud, E. Segura-Ortí, J.J. Amer-Cuenca, and J.F. Lisón tried to elucidate, whether conducting low intensity resistance training in conjunction with  neuromuscular electrical stimulation (NMES) would provide not just an additional growth stimulus, but also corresponding increases in physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks 22 in exactly those subjects researchers will resort to, when theyre looking for generous funding for studies the outcome of which is not going to pay off in form of scripts for a new patentable drug: Older adults living in a geriatric nursing home.
What? Yeah... I have to admit, the subjects are not exactly bodybuilders and a regular high intensity control is missing, but even if it wasnt for the necessary fact that youll belong to the group of "older adults" in 50 years from now, the results of the study at hand would still have a certain relevance for younger trainees. Why? Well, something that makes the elderly grow will certainly do the same in young people. Whether it does so at the same or even higher rates than "regular" strength training will obviously have to be elucidated in future studies.

Table 1: Subject characteristics;  VC = volitional contraction; NMES = neuromuscular electrical stimulation; NMES+ = NMES superimposed onto voluntary contraction. SD = standard deviation (Benavent-Caballer. 2014)

For now, all I can tell you is that the three weekly supervised 30-35 min exercise sessions the 89 participants of the study at hand performed in the course of this 16-week study lead to significantly more pronounced strength and size gains, when the exercise was performed using both voluntary contractions and the forced contractions, the researchers produced by attaching their subjects to the surface electrodes of a portable NMES devices (TensMed S82).
The four adhesive surface electrodes (5 × 5 cm) were placed on the distal medial and proximal lateral portions of the subjects anterior thigh, when they performed their three sets of knee extensions (15 reps each) in a single-leg fashion with 3-minute rest between sets.

Figure 2: Changes in muscle strength (hand grup) and size (rectus femoris), as well as changes in parameters of physical functioning in response to the three training modalities (Benavent-Caballer. 2014)

The participants were instructed to raise the weight in 1 s (concentric phase), keep a full knee extension for 3 s (isometric phase) and slowly lower the weight in 2 s to the starting position (eccentric phase). Each contraction was followed by a 2-second rest period, and the training intensity was set at 40% of 1RM... and yeas, this sounds pretty much like peak contractions, an intensity technique which may in fact be the reason that the old trainees in the study at hand recorded highly significant increases in muscle size even when the peak contraction or rather the whole movement was not superimposed with NMES which was delivered with a ramp-up time of 1 s increasing intensity as the knee was extended from 90° to full extension that was followed by 3 s keeping the knee in full extension and 2 s of a ramp-down with gradually decreasing intensity (see Figure 2, yellow).
References:

• Babault N, Cometti G, Bernardin M, et al. "Effects of electromy ostimulation training on muscle strength and power of elite rugby players." J Strength Cond Res 21 (2007): 431-7.
• Bezerra, Pedro, et al. "Effects of unilateral electromyostimulation superimposed on voluntary training on strength and cross?sectional area." Muscle & nerve 40.3 (2009): 430-437.
• Brocherie F, Babault N, Cometti G, et al. "Electromyostimulation training effects on the physical performance on ice hockey players." Med Sci Sports Exerc 37 (2005): 455-60.
• Delitto A, Brown M, Strube MJ, et al." Electrical stimulation of quadriceps femoris in an elite weight lifter: a single subject experiment." Int J Sports Med 10 (1989): 187-91.
• Dervisevic E, Bilban M, Valencic V." The influence of low-frequency electrostimulation and isokinetic training on the maximal strength of m. quadriceps femoris." Isokinet Exerc Sci 10 (2002): 203-9. 
• Hortobágyi, Tibor, Jean Lambert, and Kevin Scott. "Incomplete muscle activation after training with electromyostimulation." Canadian journal of applied physiology 23.3 (1998): 261-270. 
• Maffiuletti NA, Cometti G, Amiridis IG, et al. "The effects of electromyostimulation training and basket practice on muscle strength and jumping ability. Int J Sports Med 21 (2000): 437-
  43. 
• Malatesta D, Cattaneo F, Dugnani S, et al. "Effects of electromyostimulation training and volley practice on jumping abilities." J Strength Cond Res 17 (2003): 573-9.
• Herrero JA, Izquierdo M, Maffiuletti N, et al. "Electromyostimu lation and plyometric training effects on jumping and sprint time." Int J Sports Med 27 (2006): 533-9.
• Paillard, Thierry, et al. "Effects of two types of neuromuscular electrical stimulation training on vertical jump performance." The Journal of Strength & Conditioning Research 22.4 (2008): 1273-1278.
• Pichon F, Chatard JC, Martin A, et al. "Electrical stimulation and swimming performance." Med Sci Sports Exerc 27 (1995): 1671-6.
• Venable MP, Collins MA, O’Bryant HS, et al. "Effect of supplemental electrical stimulation on the development of strength, vertical jump performance and power." J Appl Sport Sci Res 5 (1991): 139-43

Taking vitamin D pills on their own may be less effective than taking them with a meal containing 30% of the calories from fat - at least for older men & women and high doses of vitamin D3

This is science. Only 6 months ago, I wrote in an article about the effects of fat on the absorption and bioavailability of fat soluble vitamins that vitamin D would be the fat soluble vitamin with the lowest dependence on the co-administration of fat. Rather than the amount, it appeared as if the change in plasma 25OHD (nanograms per milliliter) during vitamin D supplementation was rather associated with the types of fat, i.e. MUFA = increased absorption vs. PUFA = decreased absorption (Niramitmahapanya. 2011).

Now, half a year later, it appears as if another, previously overlooked variables would force me to reformulate previous recommendations: Age and dosage!
In contrast to previous studies, Bess Dawson- Hughes and colleagues investigated the influence of fat on the absorption of vitamin D3 in older, not young men and women. In that, inclusion criteria for the study were

• no use of not more than 400 IU vitamin D or 1,000 mg calcium per day,
• serum 25(OH)D level in the range 20 to 29.5 ng/mL (49.9 to 73.6 nmol/L),and
• a body mass index in the range 20 to 29.5 (normal weight)

Subjects with kidney problems, hypercalcemia, general issues with malabsorption, Crohn’s disease, disorders of bone metabolism, kidney stones, cancer and those who were using proton pump in hibitors, lipid-lowering medications, fish oil, or flaxseed oil, hormones, osteoporosis medications, or high-dose thiazide diuretic therapy were equally excluded as those subjects who attended tanning salons, regularly.
This was yet not the only difference. Next to the subjects age, the amount of vitamin D3 in the capsules the subjects received differed, as well. While previous studies that reported little to no effect of fat on the absorption of vitamin D3 used small(er) amounts of vitamin D, like 1,000, 2,000 or 5,000 IU per serving, Dawson-Hughes et al. used a single serving of 50,000 IU(!) and thus more than 10x higher dosages than previous studies.

Figure 1: Composition of the test breakfast, lunch, and dinner meals, expressed as % of total energy the 50 healthy older adults consumed in the study at hand (Dawson-Hughes. 2014)

Alongside said vitamin D3 super-dose all 50 subjects ingested one out of three randomly selected meals that were either fat free or contained 30% of the total calories in form of dietary fat - albeit at two different PUFA:MUFA ratios (see Figure 1)

"[The m]eals were provided by the metabolic kitchen and consisted of real food. For example, breakfast consisted of egg whites flavored with small amounts of onion and tomato, fruit, toast, and cranberry juice. The groups were balanced for energy by adjusting the amount of sugar in the cranberry juice (diet or regular juice or a mixture of the two). Protein and fiber were balanced across all groups. MUFA:PUFA was manipulated by adding varying amounts of MUFA (olive oil) and PUFA (corn oil) to achieve a ratio of 1:4 in the low and 4:1 in the high MUFA:PUFA diets. The boxed lunch and the dinner provided to the study subjects on the test day had fat/protein/carbohydrate content similar to that of the test breakfast meals.

Importantly, the subjects were required to (a) eat all of the food provided and (b) refrain from pigging out on anything that was not on the menu for the study day.

Figure 2: Serum vitamin D3 levels in subjects after consuming fat-free or -containing meals (Dawson-Hughes. 2014)

What the scientists found, when they analyzed the vitamin D response of the subjects depending on (a) the fat content and (b) the type of the fat, Dawson-Hughes et al. found:

• In analyses of vitamin D absorption at baseline and the three follow-up time points, there was a significant interaction of fat-free vs fat-containing meal group with time (P < 0.001). As shown in [figure 2], there was no significant difference in plasma vitamin D-3 levels at baseline, but the fat-containing meal group had significantly higher plasma vitamin D-3 concentrations than the fat-free meal group at each time point thereafter.
  
  At 12 hours, the fat-containing vs fat-free meal mean difference in plasma D-3 concentration was 26.9 ng/mL (95% CI 9.6 to 44.1 ng/mL) (69.9 nmol/L). Differences at the other time points were for 10 hours, 30.5 ng/mL (95% CI 14.4 to 46.7 ng/mL) (79.3 nmol/L) and for 14 hours, 21.3 ng/mL (95% CI 4.6 to 37.9 ng/mL) (55.4 nmol/L).

• Vitamin D-3 levels at 12 hours after the dose were 116.0 3 ng/mL (301.5 nmol/L) in the low MUFA:PUFA group and 104.2 ng/mL (270.8 nmol/L) in the high MUFA: PUFA group.
  
  Potential covariates, body mass index, total body fat mass, and screening plasma 25(OH)D level were not associated with vitamin D absorption and neither modified the effect of fat on vitamin D absorption.

As the researchers point out, "[t]here were no serious adverse events during the study" and "[c]ompliance with the vitamin D supplement was 100%" (Dawson-Hughes. 2014). So, non of these obvious, but undesirable confounding factors could explain the observed differences between (a) the non-fat vs. fat-meals and (b) the influence of the PUFA:MUFA ratio.
References:

• Dawson-Hughes, Bess, et al. "Dietary Fat Increases Vitamin D-3 Absorption." Journal of the Academy of Nutrition and Dietetics (2014).
• Niramitmahapanya, Sathit, Susan S. Harris, and Bess Dawson-Hughes. "Type of dietary fat is associated with the 25-hydroxyvitamin D3 increment in response to vitamin D supplementation." The Journal of Clinical Endocrinology & Metabolism 96.10 (2011): 3170-3174. 
• Wortsman, Jacobo, et al. "Decreased bioavailability of vitamin D in obesity." The American journal of clinical nutrition 72.3 (2000): 690-693.

Todays SuppVersity News will provide you with "confirmation" rather than "innovation", I suppose

With my recent article on the non-existance of protein-related osteoporosis (read more) and the short news post about the unique satiating effects of protein snacks (read more), theres been quite some protein lovin here at the SuppVersity as of late. Usually, I would try to avoid having yet another "protein article" in the same week, but for the most recent study on "Dietary Protein Distribution", I will make an exception and I bet, you wont mind! Why? Well, what about what follows the "Dietary Protein Distribution" in the title of said paper?

"...Influences 24-h Muscle Protein Synthesis in Healthy Adults"

By now, you may feel reminded of a recent review by Alan Aragon and Brad Schoenfeld (Aragon. 2013), the results of which (learn more) are not refuted by the results of the study at hand.
What the study does tell us, is simple: "The consumption of a moderate amount of protein at each meal stimulated 24-h muscle protein synthesis more effectively than skewing protein intake toward the evening meal." (Mamerow. 2014)

In other words: Dont cram all your protein into one meal!

I guess in view of past articles on related topics (e.g. "2x40g, 4x20g or 8x10g of Whey? Which Feeding Strategy Yields the Greatest Net Protein Retention?" | read more; or "Protein Timing Reloaded: A Reminder on the Importance of Repeated 20g Pulses for Optimal Protein Synthesis" | read more), this insight is not really going to surprise you.

Figure 1: Fractional protein synthesis at breakfast (left), when the difference was most pronounced (+30%) and rel. calculated 24h fractional protein synthesis (right) with EVEN vs. SKEWED protein distribution (Mamerow. 2014)

What may surprise you, though is the simple fact that this study, which was a joint venture of scienfitsts from the Division of Rehabilitation Sciences at the Department of Nutrition and Metabolism, and Department of Internal Medicine at the University of Texas Medical Branch and the Department of Food Science and Human Nutrition at the University of Illinois at Urbana (Mamerow. 2014) is the first study to conclusively show that spreading a relatively high protein intake (1.2g/kg body weight) across the day is superior to the large steak the average intermittent faster may be washing down with a triple protein shake in the evening.

With an average age of 37 years the 8 healthy, normal-weight adult men and women who participated in the study at hand were neither rodents, nor elderly individuals, and - contrary to what you may expect if you look at the italicized names of the Institutions the scientists who were involved in this study are working at - they were not in need of rehabilitation after an injury - they were average Joes (n = 5) and Janes (n= 3).

This is not about rodents, elderly people or injured athletes

As you can see in the overview in Table 1, the subjects consumed three square meals, i.e. breakfast, lunch and dinner in the course of the 7-day study period. The previous reference to intermittent fasting is thus obsolete - eating a minimal amount of protein in the morning and at noon is after all very different from eating nothing at all. 

Table 1: Seven-day mean energy and macronutrient intake in healthy adults consuming diets with an EVEN or SKEW protein distribution (Mamerow. 2014)

As the scientists point out, the total 24-h protein, carbohydrate, and fat consumption in the SKEW and EVEN conditions was not different.

"Both diets exceeded the RDA for protein [0.8 g/(kg d)] by ~50%. The SKEW diet met the RDA for protein during the evening meal alone. In all versions of the EVEN and SKEW menus used in this study, the animal-to-vegetable protein ratio was ~2:1." (Mamerow. 2014)

By using a 7-d crossover feeding design with a 30-d washout period, the scientists were thus able to measure the influence of protein timing, on the changes in muscle protein synthesis.

The latter was measured thrice, i.e. after each of the three meals, and used to calculate the twenty-four-hour mixed muscle protein fractional synthesis rates on days 1 and 7 after the ingestion of EVEN-ly or SKEW-edly distributed protein diets.
Reference:

• Aragon, Alan Albert, and Brad Jon Schoenfeld. "Nutrient timing revisited: is there a post-exercise anabolic window?." Journal of the International Society of Sports Nutrition 10.1 (2013): 5.
• Mamerow, Madonna M., et al. "Dietary Protein Distribution Positively Influences 24-h Muscle Protein Synthesis in Healthy Adults". J. Nutr. January 29, 2014 jn.113.185280 [ahead of print].