Sports Nutrition Research Update 2007 With Exercise Physiology and General Studies with Practical Application G. Douglas

1. Sports Nutrition Research Update2007 With Exercise Physiology andGeneral Studies with Practical Application G. Douglas Andersen, DC, DACBSP, CCN www.andersEnchiro.com

2. Nutrient Timing Study • 17 males, aged 18-28 with 1 to 5 years of lifting experience. • No past or current steroid history. • No supplements in 3 months prior to study. • 8 weeks prior to trial, started 4d/wk study workout.

3. Nutrient Timing Study Continued • Diets analyzed 8-12 weeks prior and during the 10 week experiment. • Normal food patterns were established prior to and confirmed throughout. • Whole body scans, muscle biopsies and 1 rep max at the beginning and end. • Every workout done with personal trainers blinded to groups.

4. Nutrient Timing Study Supplements • Protein, carbohydrates, and creatine monhydrate drink – 2 times daily on workout days. • Dosed by percent of body weight. For 80kg (175lb) – 270 calories - 32gm. Protein, 34.4gm. Carbs, & 5.6gm. Creatine. • 1 group doses AM and PM on workout days. • 1 group doses Pre and Post workout days. • Both groups had the same workouts and supplements on same days, at different times.

5. Nutrient Timing Study Results • Pre/Post vs. AM/PM – PP had greater gains in strength, lean mass and muscle hypertrophy than AMPM.* • Pre/Post vs AM/PM – PP had higher muscle Glycogen, total Creatine, and Phosphocreatine. *Measured as contractile protein accural + Type Ila & Type IIx fiber cross-sectional area.

6. Nutrient Timing Study Conclusion • Both groups had no dietary restrictions so they could eat before and after workouts. • Both groups had an established high protein diets, (2gmkgbwd) took the same % of additional protein, yet pre/post had greater contractile protein accrual. • Both groups took the same carb and creatine percent, yet pre/post had higher glycogen and creatine levels. • ONLY DIFFERENCE WAS THE TIME OF DAY THAT THEY TOOK THE SUPPLEMENTS. Cribb, P.J, Hayes, A., Effects of Supplement Timing and Resistance – Exercise on Skeletal Muscle Hypertrophy. Med.Sci.. Sp. Ex. 2006; 38, (.11) 1918-26

7. Whey Protein vs. Casein • 13 resistance trained males (~26.5yrs) divided into teo groups for 10 week double-blind study • 3 day a week freeweight-based, compound exercise, high intensity supervised workouts were followed by both groups • Subjects supplemented with either whey or casein protein at 1.5gm/kg/bw/d divided into four 0.4gm/kg/bw doses • Products were ingested with breakfast, lunch, dinner, and following workouts. • Diets were unchanged (pre vs. during)

8. Whey Protein vs. CaseinContinued Average strength (kg) Exercise Whey (n=6) Casein (n=7) Squat Pre 80.2 71.0 Post 155.5 123.2 Bench Pre 84.0 87.0 Post 132.0 105.5 Pull-down Pre 84.0 72.0 Post 106.8 92.7 Cribb, P.J., Williams, A.D., et. al. The Effect of Whey Isolate and Resisitance Training on Strength, Body Composition and Plasma Glutamine. Int.J.Sp.Nutr.Metab. 2006: (16) 494-509

9. Whey Protein vs. Soy Protein • 27 subjects ~23yrs (18f, 6m) not exercising prior to the study • Double-blind divided into 3 groups for the 6 week trial • Each group (6f, 2m) lifted weights 3x/wk for 3 weeks prior to experiment to familiarize and condition • Workout was supervised and followed in 3 on- 1 off pattern for 6 weeks • Supplements: whey protein, soy protein or maltodextrin. Amount: 1.2gmkgbwd taken in three .4gmkg doses (~28gm x 3) Time: 30 min. before, 30 min. following workouts and at bedtime.

10. Whey Protein vs. Soy ProteinContinued Whey Soy Placebo Squat (kg) +26.7 +23.7 +14.1 Bench (kg) +8.2 +7.6 +4.0 Urinary (3-mh*) 24% 30% 42% Lean mass (kg) 2.5 1.7 0.3 *Urinary 3 methyl histidine (umol/kg lean tissue mass) an indicator of protein catabolism • Protein increased strength and lean mass vs. isocaloric placebo with no difference between whey and soy Candow, D.G., Burke, N.C., et. al. Effect of Whey and Soy Protein Supplementation Combined with Resistance Training in Young Adults. Int.J.Sp.Nutr>Metab. 2006: (16) 233-244

11. HMB, KIC and DOM’S • Beta hydroxy beta methylbutyrate (HMB) with ketoisocaproic acid (KIC) • HMB and KIC have been used to reduce muscle damage and speed recovery following resistance exercise. • 8 males (~ 23 years) in a randomized crossover design who were unaccustomed to eccentric exercise • 3 gm/d HMB plus 0.3 gm/d KIC or placebo for 14 days • On day 15 eccentric exercise was performed (dosing was continued through day 17)

12. HMB, KIC and DOM’S Continued Results: There were no changes in delayed onset muscle soreness, range of motion, plasma, creatinine kinase activity, peak isometric torque, or peak isokinetic torque. Conclusion: HMB and KIC were not effective in reducing the signs or Symptoms of eccentrically induced muscle soreness. Hewitt, J., Nunan, D., et al. HMB and KIC Supplementation Does Not Reduce Signs and Symptoms of Exercise Induced Muscle Damage. Med Sci Sp Ex. 2006;38(5)S401:A2233.

13. Iron Levels and Mental Acuity in Women • 149 women (age 18-35) were tested for both iron levels and cognitive function in preparation for the study Results before intervention • Subjects Iron levels: 42 were normal, 73 were low, 34 were deficient • Cognitive Tasks: As iron declines so did task accuracy • Processing Speed: Lower iron = slower processing

14. Iron Levels and Mental Acuity in WomenContinued • Subjects were divided into 2 groups, either • 160 mg/d ferrous sulfate providing 60 mg of elemental iron • Placebo • Following 4 months of daily dosing the women were retested Results Following Intervention • Elevated serum ferritin levels were associated with improved cognitive performance • Elevated hemoglobin levels were associated with faster processing speed Murray-Kolb, L.E., Beard, J.L. Iron Treatment normalizes Cognitive Functioning in Young Women. Am J Clin Nutr. 2007;85(3):778-787.

15. Cherry Juice and DOM’s • 14 males (22 yrs) randomized placebo cross over study • 12 oz fresh cherry juice 2x / day or placebo for 8 days. 16 days later procedure was repeated with opposite drink. Results • In the 4 days following the exercise, mean strength loss was 22% for placebo and 4% for cherry juice group. • There was also less muscle soreness in the cherry juice group Connolly, D McHugh, M. Padilla-Zakour, o. “The efficiency of tart cherry juice blend in preventing the symptoms of muscle damage” Br J Sports Med 2006; 6-21-06, pre print Epub

16. Echinacea Raises EPO But Not Erythropoietic Status • 24 M (~ 25 yr) divided into 2 groups - 8 gm daily of echinacea purpurea or placebo Results: Serum EPO (mU/mL) Day Echinacea Placebo 7 15.75 10.01 14 18.88 11.02 21 16.06 9.20 There were no statistically significant increases in hematocrit, hemoglobin, or red cell count despite positive trends. Conclusion: • Echinacea significantly increased EPO but concomitant increases reaching statistical and physiological significance in associated indices did not occur. • Therefore, this raises doubt to use echinacea to increase endogenous EPO for purposes of enhanced athletic performance Whitehead, MT The Effect of Four Weeks of Echinacea Supplementation on Erythropoietin and Indices of Erythropoietic Status Med Sci Sp Ex. 2006; 38(5)S407:A2256.

17. Chromium PicolinateFat Loss and Muscle Gain • 86 F (19-50 yr) divided into 3 groups: Group 1 – 200 mcg of chromium picolinate Group 2 – Picolinate capsules Group 3 – Placebo capsules • Subjects ate the same low-calorie diets (3 meals + 1 snack were delivered daily) • Trial period was 90 days

18. Chromium Picolinate Fat Loss and Muscle Gain Continued Results: Cr pic pic placebo Body Fat (%) -2.1 -2.0 -2.0 Lean Mass (%) +1.1 +1.2 +1.2 Conclusion: No difference between chromium picolinate and placebo regarding fat loss or muscle gain in women who consumed the same low-calorie diet while maintaining their pretrial activity levels. Lukaski, H.C., Penland, J.G. No Effect of Chromium Picolinate Supplementation on Body Weight/Composition of Women Fed Controlled Diets. Med Sci Sp Ex. 2006;38(5)S126:1122

19. Quercetin and Endurance • A flavanoid found in onions, kale, apples and broccoli • Typical US diet contains ~107mg/d • Estimated intake of persons with the highest intake of fruits and vegetables (90th percentile) ~225mg/d • Quercetin is a powerful antioxidant (much stronger than vitamin C) with high levels anticarcinogenic activity and other properties including protection of proteins, DNA and regulation of gene expression • Studies on antioxidants and exercise are mixed with a trend toward reducing muscle damage but seldom showing improved performance.

20. Quercetin and EnduranceContinued • 12 elite cyclists were recruited for a double-blind in season study and had at least 1 race during the two 6 week legs of the trial • 11 completed both legs that consisted of baseline week 3, 6, crossover and week 12 – 30km (18.6 miles) time trials on an exercise bike • Subjects drank 2/srv/d for 6 weeks of a product which contained 150mg of vitamin C, 50mg of vitamin E, 300mg of green tea extract, 45mg caffeine, and small amounts of B, B2, B6, and B12 per serving. The same formula with 300mg of quercetin per serving was also consumed 2x/d 6 wks. • No changes were made to subjects diets, training or racing schedules throughout the 12 week study.

21. Quercetin and EnduranceContinued Results Baseline 6 wks/sup 6 wks/sup+Q 30k time (min/sec) 52:18 51:31 50:42 Final 5K (min/sec)7:44 7:37 7:29 Speed (km/hr) 32.24 34.76 35.24 Power (watts) 277 293 303 • No change in heart rate, VO2 max or perceived exertion • Quercetin improved 30km time ~3.1% and final 5k ~2% Macrae, H., Meffered, K. Dietary Antioxidant Supplementation Combined with Qeurcetin Improves Cycling Time Trial Performance. Int.J.Sp.Nutr.Ex. Metab. 2006: (16) 405-419.

22. Testosterone, Ergogenesis and Detection • 18 M (~ 25 yr) consented to a double-blind trial • Subjects were match-paired for bench press, leg press, and 10 second cycle sprints • Random assignments of testosterone enanthate 3.5 mg/kg/bw or saline via IM injection once weekly for 6 weeks • 280 mg of testosterone per week for an 80 kg (176 pound) subject

23. Testosterone, Ergogenesis and Detection Continued • All subjects were tested at baseline, week 3, and week 6 • Week 3: single repetition bench press increased 9% in testosterone group, no change in placebo group; cycle speed increased in testosterone group • Week 6: bench press increased 15% in testosterone group, no change placebo; body mass increased 7% in testosterone group, no change placebo.

24. Testosterone, Ergogenesis and Detection Continued Laboratory Results: T/E ratio of 4:1 from urine is currently the level used to screen for anabolic steroid use. • 9/9 in testosterone group had improved performance • The T/E range in the 9 subjects was 2:1 to 37:1 • 4/9 in testosterone group had T/E ratio below 4:1 Conclusion: 4 of 9 subjects used testosterone for 6 weeks, yet did not test above the allowable limit. Deakin, G., Rogerson, S., et al. Performance Enhancement and Urinary Detection After Short-Term Testosterone Enanthate Use. Med Sci Sp Ex. 2006;38(5)S405:A2249.

25. Creatine Use & Free Radicals • 29 M (~ 17 yr) divided into 3 groups: creatine 10, placebo 10, control 9 • 32 days of either creatine or placebo supplementation while undergoing a resistance training program • Pre and post testing included oxidative stress, total antioxidant status, uric acid, and bench press maximum Results: • Bench press increase averaged 10 kg (22 lb) in creatine group compared to placebo or control • Total antioxidant status decreased in creatine group 1.11 vs 0.6 mmol/l in placebo Conclusion: • Strength gains caused by creatine may tax antioxidant system by enhancing the ability to perform work thus exceeding reserves Conte, M., Percario, S., et al. Increase of Free Radical Production in Athletes Undergone Creatine Supplementation and Resistance Training. Med Sci Sp Ex. 2006;38(5)S405:A2250

26. Amino Acid Muscle Uptake • 9 seniors (5 F, 4 M; ~ 68 years) ingested 7gm of essential amino acids • 10 seniors (3 F, 7 M; ~ 67 years) ingested 15gm of whey protein which also contained 7gm of essential amino acids. • Phenylalanine was measured before and 3.5 hours following ingestion via leg muscle biopsy and femoral arteriovenous blood draw

27. Amino Acid Muscle UptakeContinued *Blood **Biopsy The whole whey protein increased protein synthesis more than it’s essential amino acid content. Probably caused by greater insulin response to ingestion. Katsanos, C.S., Paddon-Jones, D., Zhang, X., et al. Muscle Protein Synthesis in the Elderly Following Ingestion of Whey Protein or its Corresponding Essential Amino Acid Content. Med Sci Sp Ex. 2006;38(5)S112:A1061.

28. Intramuscular Buffering with Beta-Alanine • Carnosine is a dipeptide synthesized from Histidine and Beta-Alanine • Beta-Alanine is the rate-limiting substrate in Carnosine synthesis • Beta-alanine ingestion will increase muscle Carnosine levels • 20 subjects (~ 25 years) took 2 weeks of Beta-Alanine or placebo • Dosed at 1.6 gm with ~ 50 gm carbohydrate 4x/d (6.4gm total) • Muscle endurance was measured by the time subjects could maintain an isometric leg extension

29. Intramuscular Buffering with Beta-AlanineContinued Results: Isometric Endurance Time Researchers concluded the 11.4% increase in isometric endurance was consistent with an increased intramuscular buffering capacity supporting their previous work that pH can limit exercise performance. Harris, R.C., Hill, C.A., Sale, C., et al. Effect of 14 Days Beta-Alanine Supplementation on Isometric Endurance of the Knee Extensors. Med Sci Sp Ex. 2006;38(5)S125:1119.

30. Taurine and Endurance • Taurine is the second most abundant free amino acid in muscle • A common ingredient in energy drinks, made from cysteine • Best understood for its role in bile formation • Possesses antioxidant, hypotensive, detoxifying capabilities • May slow the breakdown of hyaluronic acid • Small studies show improved energy in congestive heart failure patients

31. Taurine and EnduranceContinued • 11 (~ 28 years) triathletes and cyclists did 3 separate trials • 90 minute submaximal ride (65% VO2) followed by a time trial • Subjects ingested each drink in random order: Crystal Light™ placebo, CL with 2000 mg taurine added, CL placebo #2 – researchers falsely stated taurine was added (it was not). Results: No difference in time trial, 02 consumption, or CO2 production Rutherford, J., Stellingwerff, T., Spriet, L.L. The Effect of Acute Taurine Ingestion on Endurance Performance in Well Trained Cyclists. Med Sci Sp Ex. 2006;38(5)S127:A1124.

32. Branch Chain Amino Acids and Fatigue • Central fatigue hypothesis contends that a high tryptophan to BCAA ratio can contribute to fatigue • 8 untrained men (30-48 yr) were tested on 2 occasions • An exercise bike ride of 4 hours (or until exhaustion) at 50% VO2 max was performed and repeated 1 month later • 8 gm of branch chain amino acids in 1 liter of fluid or a zero calorie placebo beverage was consumed throughout the ride

33. Branch Chain Amino Acids and FatigueContinued • Plasma BCAA concentration increased when BCAAs were ingested • Free tryptophan to BCAA ratio was reduced • There was no change in exercise time • Subjective fatigue was lower with BCAAs than placebo Yoshida, M., Tanaka, H., et al. Effects of BCAA Supplementation on Plasma Amino Acids and Subjective Fatigue and Muscle Soreness During Low-Intensity Prolonged Exercise. Med Sci Sp Ex. 2006;38(5)S404:A2246

36. Vitamin C and EIA • 8 subjects with exercise-induced asthma (EIA) consented to this trial • 1500 mg of vitamin C or placebo was taken for 2 weeks • Following a one-week washout, protocol was repeated with the opposite treatment • Procedure: pre and post-exercise pulmonary function was evaluated, pre and post-exercise urine samples were assayed for proinflammatory chemicals, and pre- and post-exercise exhaled breath nitric oxide was measured

37. Vitamin C and EIAContinued Results: Test Vitamin C Placebo Post exercise nitric oxide (ppb) 23.7 34.1 Post ex. leukotriene (ng/mmol/cr) 5.3 11.1 Post ex. prostaglandin F2 (ng/mmol/cr) 8.5 13.0 Post ex. hydrogen peroxide (mmol/L) 5.6 12.6 Conclusion: In this trial vitamin C reduces severity of exercise-induced asthma Tecklenburg, S., Stager, J.M., et al. Ascorbic Acid Supplementation Reduces Severity of Exercise-Induced Asthma. Med Sci Sp Ex. 2006;38(5)S382:2158.

38. Variability Of Sweat NA and Fluid LossEndurance Athletes • 132 subjects (84 M, 48 F) ~ 39.5 years of age • Exercise bike for 30 min at 70-75% of max heart rate • Sweat rate was calculated by weighing before and after the workout • Sodium loss was calculated by a chemical analysis of absorbent patches worn on the forearm and scapula

39. Variability Of Sweat NA and Fluid LossEndurance AthletesContinued Results: • Sweat rate was 1.4 ± 0.5 l/hr • Fluid coefficient of variation (CV) was approximately 34% • Sweat sodium was 66.6 ± 40.7 mEq/hr (~ 1400 mg ± 900 mg) • Sodium CV was 61% Pahnke, M.D., Trinity, J.D., Coyle, E.F. Large Interindividual Variability in Sweat Sodium Loss in Well-Trained Endurance Athletes. Med Sci Sp Ex. 2006;38(5)S218:A1509.

40. Variability Of Sweat NA and Fluid LossProfessional Hockey PlayersGame vs Practice • 10 NHL players were weighed before and after a pre-season practice and a pre-season game • On both occasions they wore absorbent patches in order to calculate sodium losses Results: • Total sweat losses in players were greater during the game: 3.71 ± 0.9 than in practice, 2.6 ± 0.6 • Total sodium losses were greater during the game: 252 ± 104 vs 168 ± 118 mmol (1 mmol/na = 23 mg/na) Conclusion: • Professional ice hockey players experience greater sweat and sodium losses during games compared to practices. • Sodium replacement may be necessary due to high sodium losses. Comment: This study should be replicated with a larger sample size. Godek, S.F., Godek, J., McCrossin, J., Bartolozzi, A. Sweat and Sodium Losses in Professional Ice Hockey Players During a Pre-Season Practice and Game.

41. Sodium Loading • 8 endurance trained males, (~36 yrs) double-blind trial • High vs. Low sodium beverage prior to a run to exhaustion @ 70% VO2 max in 90 degree heat with 50% relative humidity • Repeated 2 weeks later with opposite treatment • 65 minutes prior to the run, subjects drank 25 oz. in equal portions (3.5 oz. every 9 minutes) • High sodium 164mmol Na/L • Low sodium 10mmol Na/L

42. Sodium LoadingContinued Times in minutes Subject Hi Na Low Na_____ 1 49.1 47.0 2 82.2 47.0 3 85.2 59.8 4 136.3 125.9 5 59.0 48.8 6 59.3 38.3 7 70.0 53.2 8 37.4 38.4 High Na increased plasma volume, decreased perceived exertion and improved exercise capacity in the heat in 7/8 subjects. Sims, S.T, Vliet, L., et. al. Sodium Loading Aids Fluid Blance and Reduces Physiological Strain of Trained Men Exercising in the Het. Med.Sci.Sp.Ex. 2007; 39 (1) 123-130

43. Heat Impairs Exercise - Marathons • Results of 7 annual marathons (# of yrs) – Boston (36), New York (29), Twin Cities (22), Duluth (23), Richmond (6), Hartford (12), and Vancouver (10) were analyzed for times and temperatures by both gender and fitness level. Findings: Times were slower as temperatures increased. Men, women, elites, and recreational runners were all affected in a linear fashion. Slower runners had greater sensitivity to heat than elites. 1Ely, M R., Cheuvront, S.N., Roberts, W.O., Montain, S.J. Impact of Weather on Marathon Running Performance. Med Sci Sp Ex. 2007;39(3)487-501.

44. Heat Impairs Exercise - Squash • Squash players either 1) rested or 2) rested in cool water for 60 min prior to intervention • Intervention consisted of a simulated 60 min match followed by skill tests in 82° weather Results: • Compared to rest only, the rest with whole body precooling players had lower core temps, greater heat storage, and lower heart rates throughout the workout • Athletes who were precooled also had increased target accuracy and reduced errors in the skill tests which followed the 60 minute simulated match Sherman, R. Batterham, A. Influence of Pre-Cooling on Skill Performance During Intermittent Exercise in the Heat. Med Sci Sp Ex. 2006;38(5)S58:A824.

45. Patient Impression of Exercise Exertion • 88 subjects age 27-30 (50 male, 38 female) were exercise tested (based on 85% age-adjusted heart rate) and then questioned about their effort • 47% overestimated, 34% underestimated, 19% were accurate when asked how hard they worked during the test. • Gender breakdown revealed: 53% F, 42% M over-estimated, 18% F, 46% M underestimated Comment: Apparent unsuccessful office-designed programs need on-field observational confirmation. Matthews III, M.L., Aaron, D.J., Jekal, Y., et al. Comparison of Predicted vs. Actual Rating of Perceived Exertion (RPE) for a Submaximal Exercise Test. Med Sci Sp Ex. 2006;38(5)S79:A917

46. Effects of Dehydration on Basketball • 8 elite males (17-22 yr) basketball players were tested on 5 occasions • In random order the tests performed were at 1%, 2%, 3%, and 4% dehydration and euhydrated • Compared to the euhydrated state, as the subjects’ fluid deficit increased, sprinting speed and shooting accuracy decreased in a linear fashion

47. Effects of Dehydration on BasketballContinued Baker, L.B., Doherty, K.A., Chow, M., Kenney, W.L. Progressive Dehydration Causes a Progressive Decline in Basketball Performance in 17-22-Year-Old Men. Med Sci Sp Ex. 2006;38(5)S177:A1341.

48. 15 boys (12-15) played basketball 2¼ hours on 3 occasions The 3 trials were double blind and consisted of drills to simulate a 4 quarter game Each subject played: Dehydrated 2% Euhydrated with Gatorade Euhydrated with a flavored placebo Basketball, Fluids, and Performance

49. Basketball, Fluids, and PerformanceContinued Results: *15 feet around the world, and free throws **Suicide sprints times (seconds) ***10 width of court sprints (seconds) Dougherty, K.A., Baker, L.B., Chow, M., et al. Two Percent Dehydration Impairs and Six Percent Carbohydrate Drink Improves Boys Basketball Skills. Med Sci Sp Ex. 2006;38(9):1650-1658.

50. Added Protein to CHO Drink Aids Fluid Retention • 13 endurance trained subjects (5f, 8m) ~24 yrs cycled in 3 counter-balanced, blinded tests • Subjects rode to dehydration (-2.5% bw) at 80% max heart rate in 77 degree heat. • Fluid was replaced (+2.5% bw) during 20 minutes following ride • Recovery was monitored for 3 hours • Beverages were 6% CHO, 6% CHO+1.5% PRO, or flavored water.