ONLINE DRIVERS MEDIA

"No sun, no diabesity protection." The evidence is equivocal and the number of studies low, but there is evidence that this statement could be true.

Ok, its November and not exactly sunny in the Northern hemisphere, but if you look back at the months June-August, how much sun exposure did you actually get, this year? Hardly any? Well, thats bad news, because a recent review of the scant scientific evidence suggests that there is "a role of recreational sun exposure in reducing odds of T2DM incidence" (Shore-Lorenti. 2014).

In view of the fact that the contemporarily available evidence is not exactly comprehensive, you should yet consider the following overview of the potential effects and mechanism as a "work in progress".
As Shore-Lorenti et al. point out, the recent International Diabetes Federation (IDF) Diabetes Atlas (6th edition) describes a snapshot of the global diabetes burden in 2013 and projects this forward to the year 2035.1 Cur rently, an estimated 382 million global citizens have diabetes, costing around $1437 USD in 2013 for each person affected by the condition. Projections based on current trends predict that 592 million people will be living with diabetes by 2035; one in ten people will be affected, with an inordinate amount of fund ing required globally to treat diabetes and manage diabetic com plications ($627 billion USD in 2035).

And while scientists are feverishly searching for a solution for the diabesity epidemic, the ongoing research into the effectiveness of vitamin D supplementation in diabetes have yielded inconsistent results (Mitri. 2011). Against that background it appears almost negligent that only few scientists have yet taken a closer look at the factors that trigger vitamin D sufficiency or rather the global low vitamin D epidemia.

Lack of sun"low vitamin D" - thats not all!

Figure 1: Australians who use sunscreen chronically have 50% reduced vitamin D levels (Matsuoka. 1988)

A lack of sufficient (unprotected) sun exposure - previous studies have shown that chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin (Figure 1 | Matsuoka. 1988) - is one of the factors of which researchers speculate that it contributes to the development of vitamin D deficiency even in those of us who live in areas with a high annual sun-exposure.

Now, if restoring the 25-OHD (vitamin D) levels to normal does not work the anti-diabetic magic it is supposed to do and our D-levels are low due to insufficient sun-exposure, it appears only logical to assume that a lack sun-exposure and not a lack of vitamin D is one of the factors that contributes to the ever-increasing rates of diabesity - in conjunction with the usual subjects, obviously: The consumption of a junk-food diet and a lack of exercise, which is without doubt the #1 reason people in the Western Obesity Belt develop obesity, diabetes and the other characteristics of the metabolic syndrome.

Against that background its all the more surprising that evidence for an association between sun exposure and fasting serum glucose level is scarce.

"Typically, the lowest glucose levels occur during summer and levels peak in winter or early spring. One of these analyses [Shore-Lorenti et al. reviewed] went beyond simply observing trends in fasting glucose throughout the year: fasting plasma glucose was positively correlated with a measure of available sun and inversely correlated with temperature." (Shore-Lorenti. 2014)

The study, the researchers from the University of Melbourne have in mind was conducted by Suarez, L. & Barrett-Connor, E. in 1988, already.
If you look at the data Suaraez & Barret-Connor generated, you can see - even without their statistical sophisticated analysis - that there is a significant correlation between possible sun exposure (Figure 1, left) and the fasting plasma glucose levels (Figure 1, right).
Since physical activity may follow a similar circannual rhythm, its yet difficult to exclude that the effects Suarez & Barret-Connor observed were not corroborated (or corrupted?) by an increase in physical activity. However, Shore-Lorenti et al. believe that ...

"[...c]onsidering that the unadjusted analyses and three of four of the studies included in the best evidence synthesis (including the study adjusting for physical activity) are in agreement, it is possible that future research may confirm that sun exposure reduces fasting glucose" (Shore-Lorenti. 2014).

Shore-Lorenti et al. also point out that the highest level of evidence (moderate) for an association between sun exposure and T2DM outcomes in adults originates from the study by Lindqvist et al. (2010). In their paper, the researchers from the Karolinska University Hospital report a reduction in odds of developing T2DM given increased recreational (rather than occupational) sun exposure. 

Figure 2: Leisure time sun exposure is associated with a significantly reduced risk (up to 50%!) of developing T2DM in Swedish adults (Lindqvist. 2010)

In subjects with a low BMI the beneficial effect of using the tanning bed and sunbathing is even more pronounced (-60% risk). In the obese, however, it is significantly reduced (-10%) compared to the average reductions you see in Figure 2.

The fact that only leisure time, but not occupational sun exposure was linked to a significant reduced risk of developing type II diabetes may, as Shore-Lorenti et al. point out be due ...

"[...] to the frequency of sun exposure (perhaps leading to tolerance), duration, intensity and site of exposure (sun protective clothing and behaviour differences between the two settings), or perhaps selection biases for such work (for example, fair-skinned people may avoid occupational sun exposure or a less healthy lifestyle may be associated with manual labour)."

Incidentally, a similar disparity between recreational and occupational sun exposure is well described for risk of developing melanoma (Chang. 2009).

A review by Chen et al. (2008) provides low-level evidence for an association between sun exposure and fasting insulin levels; fasting serum insulin was higher in summer than in winter. Overall, the results are yet inconclusive. A fact, Shore-Lorenti et al. ascribe to "the lack of adjustments made by the included study – particularly for BMI" (Shore-Lorenti. 2014)
Overall, we are thus left with the above overview (Table 1) as a conclusion of which the mere number of "unkown"s and "inconsistent"s tell you that we are not yet at the point to draw a water-proof conclusion.
References:

• Chang, Yu-mei, et al. "Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls." International journal of epidemiology (2009): dyp166. 
• Chen, Shui-Hu, et al. "Community-based study on summer-winter difference in insulin resistance in Kin-Chen, Kinmen, Taiwan." Journal of the Chinese Medical Association 71.12 (2008): 619-627.
• Lindqvist, Pelle G., Håkan Olsson, and Mona Landin-Olsson. "Are active sun exposure habits related to lowering risk of type 2 diabetes mellitus in women, a prospective cohort study?." Diabetes research and clinical practice 90.1 (2010): 109-114.
• Mitri, J., M. D. Muraru, and A. G. Pittas. "Vitamin D and type 2 diabetes: a systematic review." European Journal of Clinical Nutrition 65.9 (2011): 1005-1015.
• Nelemans, P. J., et al. "An addition to the controversy on sunlight exposure and melanoma risk: a meta-analytical approach." Journal of clinical epidemiology 48.11 (1995): 1331-1342.
• Shore?Lorenti, Catherine, et al. "Shining the Light on Sunshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus?related outcomes." Clinical endocrinology (2014).
• Suarez, L., and E. Barrett-Connor. "Seasonal variation in fasting plasma glucose levels in man." Diabetologia 22.4 (1982): 250-253. 

Green asparagus from the fridge and  from the market are not created equal - at least not when they finally end up on your plate after a short bath in hot water.

You just have to watch one of the consumer report shows on television to hear it: "Frozen veggies are way better than their reputation would suggest." Actually, here in Germany this sentence has been repeated to soften that Ive even heard people say theyd buy the frozen broccoli because it contained "more vitamins and the other good stuff, you know." And you know what? For some veggies like spinach, for example, this may actually be the case. For others, like broccoli or peas, the nutrient status of the frozen and the raw uncooked vegetable appears to be more or less identical (Favell. 1998). But thats something you cannot say for the green asparagus stems, zucchini and green beans in a recent study from the Università degli Studi di Parma in Italy.

I am not an asparagus expert and can still tell that the cell structure of the Transverse  sections boiled (C - from raw | D - from frozen) is profoundly messed up compared to the raw (A) and blanched (B) variety | legend: c = collenchyma; vp = vascular bundle; p = parenchyma; f = fissure.

In the corresponding experiment, the Italian researchers bought Green asparagus stems (Asparagus officinalis L., var. Grande), zucchini (Cucurbita pepo L., va Quine) and green beans (Phaseolus vulgaris L., var. Giamaica) from a local producer and processed them within 24 hours from harvesting. For each of the veggies four samples were prepared: Raw/uncooked  (R), raw/boiled  (B), blanched (BL) and industrially frozen/boiled (FB)

The raw (ten kilograms of each vegetable), blanched (five kilograms of each vegetable) and industrially frozen  samples  (five  kilograms  of  each  vegetable) had been transported were  transported  to  the  University of  Parma laboratories  under  adequate  refrigerated conditions to avoid the exuberant nutrient loss that occurs upon inadequately slow (re-)freezing.
If you "freeze" your veggies in the freezer compartment of your fridge, this will make the cells blast, so that even before they are cooked, and the nutrients flow out. It is generally assume that the latter would not happen, if the veggies are shock-frosted.

Figure 1: Total antioxidant capacity of green asparagus, zucchini and green beans raw, blanched, boiled and frozen and boiled (Paciulli. 2014); as the data tells you frozen veggies with similar  icy grease on them like you see on the right may not really be a better source of antioxidants than fresh veggies from the farmers or even the supermarket.

If we look at the data in Figure 1, though, it would appear that the cells may have "cracked" already so that they are more susceptible to the subsequent heat assault and the frozen + boiled samples end up having consistently lower total antioxidant (Figure 2) and feric acid reducing capacity than their raw + boiled counterparts.

For a similar reason (nutrient retention), the blanched samples have been cooled immediately after blanching in an ice-water bath for 3 min before they have been transported to the laboratories, where their analysis shows that only the Zucchini lost a small, but significant amount of their total antioxidant activity.
References:

• Paciulli, Maria, et al. "Impact of the industrial freezing process on selected vegetables Part I. Structure, texture and antioxidant capacity." Food Research International (2014).

This image of heavy sled pulls was taken during one of the strongmen training sessions in the study at hand - for the full protocol see Table 1 (Winwood. 2014)

Brad Schoenfelds recent study on the differential effects of 3x10 vs. 7x3 rep x set resistance training regimen (reread corresponding SuppVersity Article) took much of the wind óut of the sails of the proponents of classic hypertrophy training (3-4 sets of 8-12 reps) as the one and only training method for anyone thriving for maximal muscle gains.

An even more recent study by Paul Winwood et al. thats about to be published in the upcoming issue of the #1 journal for everything strength training, i.e. the Journal of Strength and Conditioning Research, does not just support the findings of Schoenfeld et al. it claims "that short term strongman training programs are as effective as traditional resistance training programs in improving aspects of body composition, muscular function and performance." (Winwood. 2014)
Next to the fact that the two protocols in the study at hand were neither volume-matched nor based on the same exercises, there is yet another highly significant difference between the study at hand and the aforementioned powerlifting vs. classic resistance training study by Schoenfeld et al. the conclusion of the Winwood study is only "statistically correct". From a practical point of view, on the other hand, the body composition part of it is total bullshit.

If you take a look at the actual "body composition" data, even a blind man sees that the strongman protocol that consisted seven weeks /two obligatory training sessions per week) of the resistance training protocols outlined in Table 1 and two facultative, non-supervised and recorded sessions of prehabilition exercises, as well as two cardiovascular training sessions per week.

Table 1: Outline of the training protocols; * indicates that the exercise is performed explosively (Winwood. 2014)

The first thing you should realize after taking a look at the "traditional" protocol is that its traditional, but not the protocol you would traditionally use if your main goal was to build muscle. The number of repetitions is too low there is no individual training for the arms - both of which are characteristics most hypertrophy regimens share.
This alone wouldnt be that bad, if the conclusion that both training regimen had identical effects on the body composition of the subjects wasnt simply flawed.

Figure 1: Changes in body composition and strength (Winwood. 2014)

Ok, the differences may not be statistically significant, but if one regimen, i.e. the "traditional" training improves, while the strongman training compromises the body composition of young men, I would be very hesitant to state that "strongman training programs are as effective as traditional resistance training programs in improving aspects of body composition" (Winwood. 2014).

If the trend the researchers must obviously have overlooked (or ignored) continues, the guys in the "traditional group" will soon look like ripped mens fitness cover models, while the guys in the strongmen group will develop a pot belly. Not exactly what anyone could want. Even if you dont care about being jacked, looking at the effects on body fat, the "traditional" strength training protocol would also classify as the healthier training regimen.
Reference:

• Winwood, PW, et al. "Strongman  versus  traditional  resistance  training  effects  on  muscular  function  and  performance." Journal of Strength and Conditioning Research (2014). Publish Ahead of Print. DOI: 10.1519/JSC.0000000000000629

Its not just about more protein its about significantly more protein and - possibly - also about whey!

Just to make sure: Yes, I know the study I am about to discuss in todays SuppVersity article is a rodent study - a rodent study by researchers from the University College Cork and the University College Dublin (Mc Allan. 2014).  And yes, I know that you aint no fury little mouse or rat...

... but I do also know that the beneficial metabolic effects of high protein intakes appear to be even more, not less pronounced in human beings and will thus not mention 500x that the assumption that wed see similar benefits in men and women would obviously require experimental confirmation... alright?

Now that we are clear, dear non-dams and non-bucks...

... you are probably already drooling at the sought of reading yet another "high protein is good for you" study. Dont worry I am not going keep you on the tenderhooks longer than absolutely necessary. What is necessary, though is a very brief summary of the study design, which was designed to elucidate the effects macronutrient quality and composition on energy balance and the gut microbia - probably two of the hottest topics in todays discussions on the health and fitness bulletin boards of this world.
As the Irish researcher point out, their goal was to investigate how changes to protein quality (casein versus whey protein isolate; WPI) and the protein to carbohydrate (P/C) ratio within a high fat diet (HFD) impacts on the aforementioned parameters. The questions the experiment was supposed to answer were thus:

• Protein Quality ? Would adding whey protein on top of an obesogenic high fat rodent diet yield to a different weight and microbiota response than casein protein?
• Protein Quantity ? Would diets with 20%, 30% or 40% of the total energy intake from protein have different effects on body weight and microbiota in the rodents?

In view of the fact that casein is the standard protein in many of the high fat diets that are used in experiments like this, the study would thus also be able to give us an idea of whether or not the use of the slow-releasing IGF-1 boosting dairy protein contributes to the obesogenic effects.

As it turned out, the analysis of issues related to question #2, i.e. "Would diets with 20%, 30% or 40% of the total energy intake from protein have different effects on body weight and microbiota in the rodents?" did produce the more intriguing results, though.

Figure 1: Weight gain, fat and lean mass, as well as energy intake and respiratory exchange ratio (RER) after 21-weeks on diets with different amounts of whey protein in them (McAllan. 2014),

If you take a look at the data in Figure 1, its easy to see that (a) in comparison to casein (data from casein experiment not shown, because it was not discussed in detail | maybe there will be a follow up paper!?), WPI at a similar energy content normalised energy intake, increased lean mass and caused a trend towards a reduction in fat mass (P= 0.08). You may find that surprising, but its actually been known for quite some time now that whey buffers many of the ill-health effects of high fat diets in rodents.

Figure 2: Adipose tissue mRNA expression of selected genes (McAllan. 2014)

Although the addition of whey protein did not alter the oxygen consumption or locomotor activity, it was able to ...

• reduce the plasma leptin and liver triacylglycerold levels, and...
• attenuate the reduction in adipose FASN mRNA 

in HFD-fed mice (compared to what the researchers observed in rodents on the casein chow). Moreover, a high throughput sequence-based analysis of faecal microbial populations revealed that the

"[...]microbiota in the HFD-20% WPI group clustering closely with HFD controls, although WPI specifically increased Lactobacillaceae/Lactobacillus and decreased Clostridiaceae / Clostridiumin HFD-fed mice." (McAllan. 2014)

To understand the potential implications of these changes we will have to take a closer look at the recent evidence linking Clostridiaceae and Lactobacillaceae to the diabesity epidemic:

• Lactobacillus reuteri has anti-breast-cancer effects as well  (Lakritz. 2014).

  certain types of clostridiaceae are characteristic for obesity prone animals; their transplanation to normal mice will make them similarly vurnerable to the obesogenic effects of HFDs (Duca. 2014); similar differences, i.e. higher levels of clostridiaceae in obese individuals, have been observed in human studies, as well (Ferrer. 2013)
• lactobacilli, above all those of the reuteri type, have recently been used in several studies for their anti-obesogenic (Million. 2013a, b), anti-autoimmune (Forsberg. 2013), anti-caries (Stensson. 2013), anti-helicobacter plyori (Francavilla. 2013), pro-vitamin-D (Jones. 2013), and a whole host of other beneficial effects; for other types of lacutobacilli researchers have observed that they exert similar anti-obesity effects that may be mediated by the intestinal productino of the anti-obesity isomer of CLA, i.e. trans?10, cis?12?conjugated linoleic acid (Lee. 2007)

If we look at the previously listed metabolic effects, these changes in the make-up of the gut microbiome obviously correspond with the remarkable health improvements that occured in the whey-fed rodents.

High protein, low carb - What does it do?

Table 1: Plasma amino acid levels (mmol/L); blue bars to the right indicate sign. inter-group difference (McAllan. 2014)

Contrary to what youd expect based on appetite increasing effects researchers ascribe to high protein diets (Weigle. 2005), the increase in protein-to-carbohydrate ratio (P/C) did not lead to measurable reductions in energy intake, but ....

"[...]the highest ratio [40% of the total energy intake from protein] reduced HFD-induced weight gain, fat mass and plasma triacylglycerol, non-esterified fatty acids, glucose and leptin levels, while it increased lean mass and oxygen consumption." (McAllan. 2014)

As the scientists point out, similar effects were observed on adipose mRNA expression, where the highest ratio of protein to carbohydrates reduced HFD-associated expression of UCP-2 (a protein that has the fat stores eat themselves up), the inflammatory marker TNF-alpha and CD68 a gylcoprotein that messes with LDL cholesterol.

On the other hand, the (really) high protein diet increased the diet-associated expression of the b3-adrenergic recepto (b3-AR), lipoprotein lipase, a water soluble enzyme that hydrolyzes triglycerides in lipoproteins, such as those found in chylomicrons and very low-density lipoproteins (VLDL), as well as the expression of insulin receptors and the glucose transporters GLUT4 - all of which should be old acquaintances of loyal SuppVersity readers.

References: 

• Duca, Frank A., et al. "Replication of obesity and associated signaling pathways through transfer of microbiota from obese prone rat." Diabetes (2014): DB_131526.
• Forsberg, Anna, et al. "Pre?and post?natal Lactobacillus reuteri supplementation decreases allergen responsiveness in infancy." Clinical & Experimental Allergy 43.4 (2013): 434-442.
• Jones, Mitchell L., Christopher J. Martoni, and Satya Prakash. "Oral Supplementation With Probiotic L. reuteri NCIMB 30242 Increases Mean Circulating 25-Hydroxyvitamin D: A Post Hoc Analysis of a Randomized Controlled Trial." The Journal of Clinical Endocrinology & Metabolism 98.7 (2013): 2944-2951.
• Lakritz, Jessica R., et al. "Beneficial bacteria stimulate host immune cells to counteract dietary and genetic predisposition to mammary cancer in mice." International Journal of Cancer (2014).
• Lee, K., et al. "Antiobesity effect of trans?10, cis?12?conjugated linoleic acid?producing Lactobacillus plantarum PL62 on diet?induced obese mice." Journal of applied microbiology 103.4 (2007): 1140-1146.
• McAllan, Liam, et al. "Protein Quality and the Protein to Carbohydrate Ratio within a High Fat Diet Influences Energy Balance and the Gut Microbiota In C57BL/6J Mice." PLOS ONE 9.2 (2014): e88904.
• Million, M., et al. "Correlation between body mass index and gut concentrations of Lactobacillus reuteri, Bifidobacterium animalis, Methanobrevibacter smithii and Escherichia coli." International Journal of Obesity (2013a).
• Million, Matthieu, and Didier Raoult. "The role of the manipulation of the gut microbiota in obesity." Current infectious disease reports 15.1 (2013b): 25-30.
• Stensson, Malin, et al. "Oral Administration of Lactobacillus reuteri during the First Year of Life Reduces Caries Prevalence in the Primary Dentition at 9 Years of Age." Caries research 48.2 (2013): 111-117.
• Weigle, David S., et al. "A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations." The American journal of clinical nutrition 82.1 (2005): 41-48.