2 - Feb - 2008

AlanAragonsResearchReview,February,2008[BacktoContents] Page1
Copyright February 1st, 2008 by Alan Aragon

Home: www.alanaragon.com/researchreview
Correspondence: aarrsupport@gmail.com

2 Nutrient Timing, Part 2:
Pre- & During Exercise Carbohydrate & Protein

9 Carbohydrate-Protein Drinks Do Not Enhance Recovery
From Exercise-Induced Muscle Injury.
Green MS, et al. Int J Sport Nutr Exerc Metab. 2008
Feb;18(1):608-23. [IJ SNEM]
10 Effect of dietary protein content during recovery
from high-intensity cycling on subsequent
performance and markers of stress, inflammation,
and muscle damage in well-trained men.
Rowlands DS, et al. Appl Physiol Nutr Metab. 2008
Feb;33(1): 3951 [APNM]

11 Effects of a supplement designed to increase ATP
levels on muscle strength, power output, and
endurance.
Herda TJ , et al. J Int Soc Sports Nutr. 2008 J an 29;5(3)
[J ISSN]
12 One-year ad libitum consumption of diacylglycerol
oil as part of a regular diet results in modest weight
loss in comparison with consumption of a
triacylglycerol control oil in overweight Japanese
subjects.
J Am Diet Assoc. 2008 J an;108(1):57-66. [Medline]

13 Metabolic and performance effects of raisins versus
sports gel as pre-exercise feedings in cyclists.
Kern M, et al. J Strength Cond Res. 2007 Nov
1;21(4):1204-1207. [Medline]

14 Long-term effects of 2 energy-restricted diets
differing in glycemic load on dietary adherence,
body composition, and metabolism in CALERIE: a
1-y randomized controlled trial.
Das SK, et al. Am J Clin Nutr. 2007 Apr;85(4):1023-30.
[Medline]

15 Master Amino Acid Pattern (MAP) provides a sure
way to rebuild energy fitness life! [BodyHealth]


Nutrient Timing, Part 2:
Pre- & During Exercise Carbohydrate & Protein
By Alan Aragon

INTRODUCTION

The above boxed section was previously stated in last months
issue. Im carrying it over to the present issue because its
important to maintain that perspective as we go through what
amounts to an exercise in micro-management. Last month we
saw that when it comes to nutrient timing effects, fat generally is
a minor contributor. And in the case of endurance performance,
it can potentially be detrimental (particularly in the case of
MCT) taken pre- or during endurance training. In this issue,
well take a look at protein and carbohydrate together, since they
work interactively within the context of nutrient timing relative
to exercise.

Another thing that needs elucidating is that nutrient timing is of
little use to obese folks who just want to break into a normal
bodyfat range. For the latter population its all about maintaining
a calorie deficit, and re-opening that deficit when equilibrium is
reached. Nutrient timing has more measurable (and obviously
more acute) effects when its used for exercise performance than
when its used for altering body composition. This is especially
the case with endurance training which leads us back to the
fact that most nutrient timing research is focused on improving
endurance. As for the misunderstood & misguided practice of
slow and/or fasted training in attempt to hurry up fat loss, I go
into depth on both topics here and here. Assuming youve read
last months issue, it bears repeating that the vast majority of
nutrient timing research has centered on carbohydrate. Nutrient
timing for strength/power training, as well as protein timing in
general, is still preliminary and scarce, but well examine the
little there is.
PRE-EXERCISE

Although endurance training can refer to a wide range of modes
and intensities of exercise, lets define it for our purposes as any
continuous cardio-respiratory-focused activity that exceeds 60
minutes. The objectives of pre-exercise endurance nutrition are
to maintain sufficient levels of hydration, blood glucose, and
amino acids. The most measurable reasons behind these
objectives are to spare or reduce glycogen breakdown, prevent
muscle protein breakdown, and promote muscle protein
synthesis. The latter effects over time can result in beneficial
adaptations in both body composition and performance. These
same objectives apply to strength/power training, which well
define as activity involving intermittent sets of short-term near-
maximal efforts (and beyond) using external loads i.e., the
various incarnations of weight training. Ill interchange this with
resistance training, since this is the way its commonly stated
in the literature.
HIERARCHY OF IMPORTANCE (REITERATED)

When speaking of nutrition for improving body composition
or athletic performance, its crucial to realize theres an
underlying hierarchy of importance. At the top of the
hierarchy of effects is total amount of the macronutrients by
the end of the day. Below that and I mean distantly below
that is the precise timing of those nutrients. With very few
exceptions (i.e., the intermittent fasting crowd), athletes and
active individuals eat multiple times per day, to the tune of
at least four meals. Thus, the majority of their day is spent in
the postprandial (fed) rather than a post-absorptive (fasted)
state. The vast majority of nutrient timing studies have been
done on overnight-fasted subjects, which obviously limits
the applicability of the studies conclusions. Pre-exercise
(and/or during-exercise) nutrient intake often has a lingering
carry-over effect into the during- and post-exercise period.
Throughout the day, theres a constant overlap of meal
absorption. For this reason, nutrient timing is not a strategy
thats only effective if done with chronometer-like
precision.

Carbohydrate Loading Days Before Competition

Carbohydrate loading is a technique used to cause above-normal
glycogen storage, which is also referred to as glycogen
supercompensation. The classic carbohydrate loading model
involves 3-4 days of glycogen depletion (60-100g/day) coupled
with exhaustive exercise, followed by 3-4 days of carb-loading
(500-600g/day) and reducing training volume.
1
This has resulted
in performance enhancement by increasing time to exhaustion.
However, this protocol isnt free of adverse potential. A low
carbohydrate intake similar to the depletion phase was observed
to detrimentally impact mood in trained female endurance
athletes.
2
Interestingly, no alterations in mood were seen in men
undergoing a glycogen-depleting experiment that more closely
resembled a classic carb-loading protocol (except the low & high
carb phases were in reverse order).
3

To avoid the potential pitfalls of depletion phases, more linear
carbohydrate elevations have been investigated in various trials
(10-12.5g/kg, 1-7 days prior to testing), showing glycogen
supercompensation levels comparable to the classic model. Its
important to keep in mind that carb loading increases endurance
capacity, rather than exercise performance per se. In other
words, it can prolong the duration of exercise before fatigue hits,
but it cant necessarily reduce the amount of time it takes to
perform a given amount of work, nor can it reliably increase the
total work output within a given time period. For this reason,
carb-loading might not be a critical strategy for enhancing
endurance in competition lasting less than 90 minutes.
4,5
However, its still not all that simple. The effect of increased
glycogen on single bouts of high-intensity exercise is mixed, but
it can benefit performance in repeated/intermittent bouts of high-
intensity exercise.
6-8
It should be noted that a carbohydrate-
loaded state failed to increase endurance performance when
carbohydrate was ingested during training.
9

2-4 Hours Pre-Exercise

Although its somewhat arbitrary, Howley and Burke cited the
pre-exercise period (in the endurance context) as a 4-hour
window prior to training that can be further divided into 2 parts:

2-4 hours pre-exercise, and 30-60 minutes pre-exercise.
10
In
order to make the definition more literal, I would consider the
immediate pre-workout phase as a period extending right up
until the start of the exercise bout. Whether 60 minutes prior to
training can be considered immediate is almost a matter of
semantics, but Ive personally viewed a 30 minute window pre-
exercise as being more appropriate to the definition.

In any case, various trials have examined anywhere from 140-
330g carbohydrate taken 3-4 hours pre-exercise. This practice
has been shown to enhance endurance performance, presumably
by increasing muscle and liver glycogen levels. In a thorough
review, Hargreaves and colleagues recommend ingesting 200-
300g carbohydrate 3-4 hours pre-exercise in the event that
during-training carbs will be limited or nonexistent.
4
Take note
that in well-trained endurance athletes, as much as a few hours
delay might not make much difference in the effect of the pre-
exercise meal. For example, Flynn et al found no significant
difference in performance enhancement from a high-
carbohydrate meal ingested either 4 or 8 hours pre-exercise.
11

Finally, does the glycemic index (GI) of the pre-exercise meal
matter? In non-competitive subjects, the research results are
mixed, with no solid consensus in favor or against GI
manipulation in the pre-exercise meal. However, with the
exception of perhaps a single 1991 study,
12
several trials since
have shown that GI has no effect on endurance capacity in well-
trained subjects.
13-17

Within 60 Minutes Pre-exercise

Before diving in, its important to acknowledge the different
scenarios that end up dictating the protocol. Some folks train in
the morning, so a meal 2-4 hours prior is not possible. Generally,
the closer a meal is to the training bout, the easier it should be
designed to digest. Individual tolerance comes highly into play
here some trainees are sensitive to the presence of food
digesting during training, while others can train with a
substantial bolus in the gut. For those who train in the morning
almost immediately after waking, pre- and/or during-training
liquid nutrition becomes important.

Theoretically, a marked spike in blood glucose, followed by
hypoglycemia during exercise might hinder performance, but the
weight of the evidence doesnt support this concern. Two early
studies in the late 1970s showed immediate pre-exercise
carbohydrates potential to impair performance,
18,19
while all of
the subsequent research (totalling at least 9 studies) have shown
either no effect, or a performance increase.
4
Doses were
typically 1g/kg of bodyweight given 30-60 minutes pre-exercise.

Carbohydrate taken before and during high-volume resistance
training has been seen to preserve muscle glycogen.
20
This has
led some researchers to suggest that this tactic can maintain or
enhance resistance training performance. However, recent work
by Baty et al saw no performance enhancement from
approximately 1L of a protein (1.5%) and carbohydrate (6.2%)
solution whose ingested pre-, during-, and post-exercise.
21
Lack
of ergogenesis aside, this treatment reduced myoglobin and
creatine kinase levels, indicating an ability to suppress training-
induced muscle damage.
Similarly, Tipton et al saw 6g of essential amino acids (EAA)
plus 35g sucrose immediately before 45-50 minutes of resistance
training cause 262% more amino acid uptake than the same
treatment taken immediately afterward.
22
Performance was not
measured in this trial. In another trial led by Tipton, the protein-
synthetic effect of 20g whey taken either immediately pre- or
immediately post-exercise was compared.
23
Although no
significant differences in protein synthesis were seen, Tipton
suggested that a protein-synthetic increase would be seen in the
pre-exercise treatment if there were approximately double the
number of subjects. Its also likely that including carbohydrate
with the protein would likely cause more readily detectable
protein synthesis.

Cribb et al compared the effect of a carbohydrate-protein-
creatine supplement taken immediately pre- and post-resistance
training with the same supplementation taken at two points in
the day that were furthest away from the training bout.
24
The
dose was proportional to bodyweight (each of the 2 doses was
roughly 32g whey, 34g glucose, and 5.6g creatine). The
immediate pre-post group experienced greater gains in lean mass
and strength. To top it off, they also lost a slight amount of body
fat.

DURING EXERCISE

The objectives of during-exercise nutrition are the same as pre-
exercise nutrition to maintain hydration, blood glucose, and
amino acids. Once again, the goals are to reduce the breakdown
of glycogen and muscle protein, and promote muscle protein
synthesis. During training, special attention should be paid to
avoiding gastric distress and/or sensitivity to hypoglycemic dips
(dictated by individual tolerance). The aspects well examine are
the amount, type, and form of the substrates during training to
achieve these goals.

With a substantial body of research in support, during-training
carbohydrate has proven itself beneficial for endurance activity
that approaches or exceeds 2 hours.
25
Challenging the traditional
idea that carbohydrate during training only benefits prolonged
durations, an appreciable amount of research shows that it can
enhance higher intensity training lasting roughly an hour.
25-27

However, other trials have shown no effect, leaving this issue
incompletely resolved.
28-30

In Search of an Optimal Carbohydrate Dose

So the question then becomes, how much carbohydrate during
training is needed to optimize endurance performance? Before
speculating over a definitive answer, it might help to first discuss
carbohydrate oxidation rate. It was formerly believed that the
maximal rate of carbohydrate oxidation by muscle during
training was 1.2-1.3g/min when glucose and fructose were
ingested at a rate of 1.8g/min.
31
This is approximately 20-50%
greater than the oxidation rate of glucose alone. Glucose and
fructose have different transporters that can be utilized
simultaneously for faster availability to muscle. More recently,
an oxidation rate of 1.75g/min was seen as a result of ingesting a
1:1 proportion of glucose and fructose consumed at a rate of
2.4g/min.
32
In addition, a combination of glucose and sucrose, or

glucose and fructose, caused the least stomach upset during
training compared with glucose alone or glucose with
maltose.
33,34
Proportion of fructose in each trial was 33% and
25%, respectively. A widespread assumption is that a higher rate
of oxidation of ingested carbohydrate automatically equates to
greater work capacity. Although this is often implied in the
literature (and its also logical, since higher exogenous
carbohydrate use can prevent glycogen use), it hasnt been
proven. Let me quote a review by J eukendrup, one of the most
prolific researchers in the area of sports applications of
carbohydrate:
25

Although many studies (including our own) are based on this
assumption, the evidence for this is lacking. To our knowledge
no studies have demonstrated that ingesting larger amounts of
CHO that will result in higher exogenous CHO oxidation rates
will also enhance performance. Studies have shown effects of
CHO feeding even with relatively low rates of intake (as low as
16 g/h), but generally no greater improvements have been
observed with higher intake rates.

Despite the above explicit testimony that a larger amount of
carbohydrate hasnt been seen to increase performance,
J eukendrup goes on to say that the optimal amount is 60-70g/hr.
This level of intake results in maximal exogenous oxidation rates
without causing gastrointestinal problems. Exceeding the higher
end of this amount increases the risk of gastrointestinal upset
without any increase in carbohydrate use. At this point, I should
reiterate that this recommendation is exclusive to endurance
training. For strength/power athletes its safe to cut this
recommendation approximately in half, and ingest 20-35g/hr.
The wider range Ive provided accounts for differences in body
mass (little folks take the lower end, and large folks take the
upper end, medium-sized trainees can shoot somewhere in the
middle). Note that if the weight training bout is less than an
hour, and a pre-exercise meal or shake was ingested within half
an hour of training (or a large mixed meal within roughly 90
minutes before training), additional mid-training carbohydrate
will have little benefit, if any at all. The same goes for protein,
which well look at next.

Protein for Performance?

A relatively new area of research is the addition of protein to
sports drinks. Carbohydrate has a relatively consistent track
record for increasing endurance performance, but protein for this
purpose is still mixed and inconclusive. Some research has
shown additional protein to increase endurance capacity (time to
fatigue).
35,36
One recent study saw a carbohydrate-protein gel
increase endurance capacity better than a carbohydrate-only
gel.
37
However, 2 recent studies showed the failure of additional
protein to improve time trial performance.
38,39
Another study
compared a carb-only solution with an isocaloric amount of a
carb-protein-antioxidant supplement (which had 1.8% less
carbohydrate than the carb-only treatment) and found no
difference in time to fatigue.
40

So whats with all the discrepancies? The trials that found no
effect of additional protein used amounts of carbohydrate in line
with the amount required for maximal oxidation rate (60-
70g/hr). The trials that found an improvement with additional
protein used substantially less carbohydrate (37-47g/hr). This
indicates that additional protein is ergogenic only in the event
that carbohydrate intake is insufficient. Another way to look at it
is, above a certain threshold of carbohydrate intake during
training (roughly 60g/hr), additional protein doesnt enhance
performance. Of special note is that the trials showing a lack of
benefit from extra protein used a more applicable experimental
model to real-life competition. Whereas the other trials measured
time to exhaustion, these trials measured the time it took to
complete a fixed amount of work. In many competition
scenarios, and certainly all racing sports, those who complete the
course in the least amount of time are the winners as opposed
to those who can keep going for the longest distance past the
finish line.

With that said, its tempting to write off protein during training
as unnecessary, but the critical facts of the matter are two-fold.
First off, protein doesnt appear to hinder performance compared
to carbohydrate alone at least within the context of these trials,
which set protein proportion at 20-25% of the solute. Secondly,
protein consumed during exercise has consistently shown a
greater suppressive effect than carbohydrate on training-induced
muscle catabolism.
35,36,40,41
Reduction of muscle damage can
lead to quicker recovery and ultimately better training
adaptations over time. For these reasons, its wise to make sure
youve consumed protein prior to, and/or during exercise
regardless of whether or not its consumption during may
improve performance. Note that only a small amount of essential
amino acids (6g EAA) plus 675mL of a 6% carbohydrate
solution (~40g CHO) taken during 60 minutes of resistance
training effectively suppressed markers of muscle protein
degradation.
41

Protein Dosage Speculations

Theres at least a couple of ways to approach the question of
how much protein might be optimal to ingest during training. A
convenient way is to formulate protein recommendations in
conjunction with the most commonly cited optimal during-
training carbohydrate intake recommendation is 30-60g/hr,
42

keeping in mind that others have cited 60-70g/hr.
25
As we just
reviewed in a series of trials,
35,37-40
with the exception of one of
them that set protein at 20% of the substrate mix,
36
a 25%
proportion of protein in the substrate mix has been seen to
suppress muscle protein breakdown. Importantly, this amount
did not hinder endurance performance. Therefore, an appropriate
protein intake during training is approximately 8-15g/hr, which
is 25% of the upper and lower ranges of carbohydrate intake
recommendations most commonly seen in research.

Another way to look at this question is by factoring in the
protein absorption rates seen in research. Bilsborough and Mann
recently compiled the results of trials examining the absorption
rates of various proteins.
43
Methodological limitations pervade
the data, but it at least gives us a ballpark idea. Whey isolate was
rated the second-fastest absorbed protein at 8-10g/hr, with an
amino acid mixture mimicking pork tenderloin topping the field
at 10g/hr (no lower range was listed). The latter treatment was
via intravenous infusion, so its application is particularly limited.

The investigators also cited other infusion data showing a peak
absorption rate equivalent to 12g/hr for an 80kg individual.
Proportionally, this turns out to be 0.15g/kg/hr. Using this figure,
a 60 kg (132 lb) individual would have 9g/hr, whereas a 100 kg
(220 lb) person would have 15g/hr. Interestingly enough, the two
methods produce very similar numbers.

An important thing to consider is that the protein absorption
measurements were taken in the resting/basal state rather than
the training or trained state. Depending on several factors, these
physiological states can have significantly higher rates of protein
turnover and thus a higher demand for protein. Yet another
factor to consider is that requirements based on bodyweight
assume that were talking about an acceptable or desired
maintenance bodyweight (also called ideal or target
bodyweight). Current weight only applies if the person happens
to be at their target bodyweight.

Since high-quality intact proteins (such as whey) are roughly
50% EAA, a case can be built for using a smaller amount of
isolated EAA, as much as 50% less than what you would use
with intact proteins. However, if the isolated EAA strategy is
chosen, be prepared to pay a minimum of twice as much for the
amount of whole protein that would give you an equivalent
amount of EAA. An additional consideration is that although
inessential amino acids dont directly trigger protein synthesis,
they can serve as precursors of nitrogenous compounds with
biologically important roles. The point is that they cant be
completely written off, and they may offer benefits beyond
whats been measured.

To reiterate an easily overlooked point, if the training bout lasts
less than 60 minutes, and a protein-containing pre-exercise meal
or shake was ingested within half an hour of training (or a full-
sized mixed meal within roughly 90 minutes before training),
additional protein during training will likely have negligible
benefit. Blood glucose and amino acid levels will already be in
the midst of absorption as a result of the pre-exercise mixed
meal. Remember that most trials use overnight-fasted subjects.

Fluid & Electrolyte Balance

Last but not least, we have fluid and electrolyte balance
considerations. Its fairly well-known that carbohydrate
concentrations in the range of 4-8% of the fluid solution (40-80g
per liter, or 10-20g per 8oz cup) optimizes the rate of fluid and
carbohydrate delivery to tissues.
42
As we saw in the previous
subsection, protein and carbohydrate in a 1:3 ratio (25% protein,
75% carbohydrate) has not hindered performance compared to
carbohydrate alone, as long as the overall solute concentration
doesnt exceed 4-8%. Whether research continues to show this
neutral-to-beneficial effect of a small amount of protein in the
mix remains to be seen.

In theory, fluid intake should correspond with sweating rate,
which will vary across training intensities, environmental
temperatures, and individual tolerances. The American College
of Sports Medicines former position stand recommended a
ballpark range of 0.6-1.2 liters of fluid per hour.
44
This was
publicly criticized by Noakes as being excessive.
45
Perhaps due
in part to this criticism, ACSMs latest position stand adopts
Noakes position that 0.4-0.8 liters per hour is a good starting
point from which to assess any further need for fluid intake.
46

Taken together, 0.5-1.0 liters per hour is a reasonable range for
most athletes. As a final wrinkle, sodium chloride (the chemical
equivalent of table salt) is released to a significant degree during
prolonged training. For events lasting over an hour, the
investigators recommend a sodium intake of 20-40mmol/liter
(460-920mg/liter). For events in excess of 2 hours, a
concentration of 30-50mmol/liter (690-1150mg/liter) doesnt
cause adverse effects, and protects endurance athletes from
hyponatremia.
47
In addition, salt stimulates thirst, increasing
voluntary consumption of fluid and thus increasing hydration.

As an example of products mirroring research, Gatorades
original Thirst Quencher formula is 457mg/liter, and their new
Endurance formula contains 832mg/liter. This formula is more
appropriate for athletes engaging in ultra-endurance competition,
while the original formula is suitable for bouts of training with
less extreme durations. Commercial formulas contain one or
more of the other electrolytes in sweat (potassium, calcium, and
magnesium). However, theres a lack of evidence of the
necessity of supplementing mid-training intake with anything
beyond sodium and chloride (easily accomplished by the salt in
the sports drinks), since losses of the other electrolytes are
miniscule and inconsequential.
42,47-49

SUMMARY PRINCIPLES & PRACTICAL APPLICATIONS

Hierarchy of Importance, Overview

At the top of the hierarchy of effects is total amount of the
macronutrients by the end of the day. Timing is secondary.
The vast majority of nutrient timing studies have been
done on overnight-fasted subjects, limiting the relevance of
the results.
Throughout the day, theres a constant overlap of meal
absorption, negating the need to spit hairs over the
precision of meal placement.
Most nutrient timing research is focused on carbohydrate
for improving endurance, but data on protein and
resistance training is mounting.
The objectives of both pre- and during-exercise nutrition
(especially in the endurance context) are to maintain
sufficient levels of hydration, blood glucose, and amino
acids.

Carbohydrate Loading Days Before Competition

The classic carbohydrate loading model consists of
approximately 3 days of a low carbohydrate intake (60-
100g/day) combined with exhaustive exercise, followed by
3 days of very high carbohydrate intake (500-600g/day)
and reducing training volume.
This causes glycogen supercompensation, where stores are
re-filled beyond their normal capacity.
Linear carbohydrate elevations have been investigated in
various trials (10-12.5g/kg, 1-7 days prior to testing),
showing similar effects on glycogen supercompensation.
Carbohydrate loading might not be necessary for
improving endurance in competition lasting less than 90
minutes.
Carbohydrate loading might not have additional
performance benefits if ample carbohydrate (~60g/hr) is
ingested during training.


2-4 Hours Pre-Exercise

140-330g carbohydrate taken 3-4 hours pre-exercise has
been shown to enhance endurance performance.
200-300g carbohydrate is recommended 3-4 hours pre-
exercise in the event that during-training carbs are limited
or nonexistent in endurance competition.
In non-competitive subjects, the research results are mixed
regarding glycemic index (GI) manipulation of the pre-
exercise meal.
The vast majority of research has shown that GI has no
effect on endurance capacity in well-trained subjects.
Even if you are a pre-competition endurance athlete whose
event exceeds 90 minutes, its not necessary to ingest a
huge pre-load (ie, 200-300g carbs) if you plan on doing the
smart thing, which is fueling yourself during competition.
Unless youre a pre-competition endurance athlete, this
meal typically ends up being whatever regular mixed meal
(whole food meal containing protein, carbohydrate, fat)
you have scheduled at the time.
This incidental nature of this meal is the main reason
theres no cool little grey application box.

Within 60 Minutes Pre-exercise Principles

Individual schedules sometimes must dictate this area of
nutrient timing sometimes theres no option for a meal 2-
4 hours before training.
Although a spike in blood glucose followed by
hypoglycemia during exercise can occur as a result of
having a high-carbohydrate meal within an hour of
training, research on the whole does not warrant any
performance concerns.
Low-to-moderate volume resistance training bouts may not
depleting enough to derive performance benefits from pre-
exercise carbohydrate.
As little as 6g EAA + 35g sucrose immediately pre-
exercise has been observed to promote protein synthesis
more effectively than the same treatment immediately after
exercise.
As for having isolated amino acids (EAA and BCAA are
the most popular), let me reiterate that whey contains about
50% EAA, half of which is BCAA. To top things off, whey
contains compounds that exert pro-immune, antioxidant,
and antibacterial effects. These compounds are absent in
isolated amino acid supplements. A detailed review of the
therapeutic potential of whey can be found here.
Positioning macronutrients immediately surrounding
training (as opposed to deferring them from either side) has
resulted in superior strength and body composition
changes.
In private practice, clients have the choice of having one of
two immediate pre-exercise meals (I wish the following
could be more succinct, but here it goes):

WITHIN 60 MINUTES PRE-EXERCISE APPLICATION

Consume either one of the following choices:

a) A solid meal consisting of protein and carbohydrate
set at (0.25g/lb) target bodyweight for each of the
two macronutrients, ingested 60-120 minutes pre-
exercise. For example, a 160 lb person would have
40g carbs plus 40g protein. Tolerance for pre-exercise
fat is an individual matter best left to personal trial. In
my observations with clientele, any amount of fat
within moderation here generally doesnt hinder
exercise performance. Youd have to really go out of
your way not to mention overshoot your target for
total fat intake for the day in order to cause any real
performance detriments at this point. Dont obsess
over specific subtypes of food (i.e., chicken versus
steak, rice versus pasta, apples versus oranges, etc);
just stick to your personal preferences.

b) A shake at any point within 30 minutes pre-
exercise, or an easily digested meal within any
point 60 min pre-ex. Same dose as choice (a).
stick to your personal food preferences. Individuals
who train immediately after waking might need to
minimize digestion and mix up a shake consisting of
whey protein powder and a carb source. Sucrose (table
sugar) will do just fine, although some may want to
nitpick and combine dextrose or maltodextrin with
sucrose in an even proportion (this will set fructose at
25% of the mix).

Technically, if you finish a whey/carb shake near the start
of training, its fine for it to be roughly an even mix of
carbohydrate and protein in the robust amounts suggested
above. However, this is not an optimal mid-training mix
for endurance athletes; it has too high a proportion of
protein. Those who are headed straight for a prolonged
training bout (meeting or exceeding 2 hours of
endurance exercise) immediately after waking will benefit
by starting on their during-exercise fuel, which has a
different composition than the above-discussed pre-
exercise meal format, to be outlined next.

During Exercise Principles

The objectives of during-exercise nutrition are the same as
pre-exercise nutrition to maintain hydration, blood
glucose, and amino acids.
Its generally agreed that carbohydrate during training can
benefit endurance exercise approaching or exceeding 2
hours.
Although an appreciable amount of research shows that
during-training carbohydrate can enhance higher intensity
training lasting roughly an hour, other trials have shown no
effect, leaving this issue incompletely resolved.
Along with a higher oxidation rate (potentially a good
thing for sparing glycogen), less gastrointestinal upset is
reported when fructose is included in a mix of
carbohydrate as opposed to glucose or fructose alone.
Adding protein to carbohydrate during training
(approximately 1 part protein, 3-4 parts carbohydrate) has
shown mixed results in the literature. It appears to offer
some benefit when carbohydrate isnt ingested in ample
amounts (~60g/hr).
The trials showing a lack of benefit from extra protein used
a more applicable experimental model to real-life
competition.
Protein (as well as protein plus carbohydrate) consumed
during exercise has consistently shown a greater
suppressive effect than carbohydrate alone on training-
induced muscle catabolism.
Sodium chloride (the chemical equivalent of table salt) is
lost from the body to a significant degree during training
that exceeds 2 hours.
It bears repeating that during-training carbohydrate,
protein, and electrolyte concerns are practically nil for
most trainees whose exercise bouts do not meet or exceed
60 minutes as long as proper pre-exercise nutrition is in
place.


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DURING EXERCISE APPLICATION

Carbohydrate intake recommendations for endurance
training are split between a conservative side (30-
60g/hr) and liberal side (60-70g/hr). The lower range
will suit less intense endurance work.
Either sucrose or a 1:1 ratio of glucose and sucrose
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Carbohydrate-Protein Drinks Do Not Enhance
Recovery From Exercise-Induced Muscle Injury

Green MS, et al. Int J Sport Nutr Exerc Metab. 2008
Feb;18(1):608-23. [IJ SNEM]

PURPOSE: To examine the effects of carbohydrate (CHO),
carbohydrate-protein (CHO+PRO), or placebo (PLA) beverages
on recovery from novel eccentric exercise. METHODS: Female
subjects (age = 18-35 yrs) performed 30 min of downhill
treadmill running (12% grade, 8.0 mph), then consumed a
CHO, CHO+PRO, or PLA beverage immediately, 30, and 60
min post-exercise. CHO and CHO+PRO groups consumed
1.2g/kg/hr CHO, with the CHO+PRO group consuming an
additional 0.3g/kg/hr PRO. The PLA group received a
noncaloric beverage. Maximal isometric quadriceps strength
(QUAD), lower extremity muscle soreness (SOR), and serum
creatine kinase (CK) were assessed pre-injury (PRE) and
immediately and 1, 2, and 3 days post-injury. RESULTS: There
was no effect of treatment on recovery of QUAD, SOR, or CK.
In all groups, QUAD was reduced compared with PRE by
20.6%, 17.2%, and 11.3% immediately, 1, and 2 days post-
injury, respectively. SOR peaked at 2 days post-injury, and
serum CK peaked 1 day post-injury. CONCLUSIONS:
consuming a CHO+PRO or CHO beverage immediately after
novel eccentric exercise failed to enhance recovery of exercise-
induced muscle injury differently than what was observed with a
PLA drink. SPONSORSHIP: Not listed.

Study Strengths

The subjects in each treatment group were evenly matched in
average height, weight, and bodyfat percent. The testing was
done under non-fasted conditions, which more closely mirrors
real life versus previous research which tested subjects in a
glycogen-depleted state minus a pre-exercise meal. Too bad the
pre-exercise meal wasnt controlled, but Ill get to that. Another
methodological strength was the use of dual-energy X-ray
absorptiometry (DEXA) to measure body composition.

Study Limitations

Sample size (6 subjects per treatment group) was small. A low-
to-moderate level (1-5 hours per week) of habitual aerobic
exercise was one of the participant criteria, potentially limiting
the results to the novice or casual trainee. This population is
likely much more susceptible to muscle damage than highly
trained athletes. But those are minor/common limitations
compared to this studys complete disregard for dietary control
outside of the testing period. Subjects arrived at the lab 2-3
hours after finishing a meal which was not controlled, let alone
standardized. As a matter of fact, diet was not controlled nor
accounted for throughout the length of the study. The lack of
dietary control is difficult to reconcile, especially since the
effects under investigation were contingent upon the interaction
between diet and training variables. Finally, this was an acute-
effect trial, tracking the outcomes over a period of days rather
than weeks.
Comment/Application

This is perhaps the second study to ever investigate the effect of
a protein-carbohydrate beverage taken solely after injury-
inducing exercise. The only other trial was by Wojcik et al, who
compared a protein-carbohydrate milk-based beverage with a
carb-only beverage. Fasted subjects were taken to glycogen
depletion using eccentric quadriceps contractions. There were no
significant differences in muscle protein breakdown as indicated
by 3-methylhistidine release. Creatine kinase levels (an indicator
of muscle catabolism) were lower in the protein-carb group, but
not to a degree of statistical significance. Although the general
lack of effect was shared by both studies, the present trial was
perhaps more broadly applicable because the exercise protocol
was less extreme, and the subjects werent fasted.

J ust by reading the title and the abstract of the study, its
possible that some might jump to the conclusion that post-
exercise protein-carbohydrate solutions are useless. However,
its critical to remember that post-exercise recovery drinks are
designed to complement (and potentially synergize with) the
other meals. In the case of inflicting eccentric contraction-
induced muscle damage, inadequate pre- and/or during-training
nutrition followed by a recovery drink is sort of like jumping
into a pool with J aws, then putting a band-aid over the shark
bites. Preventive nutrition would have served as the shark cage
upon entering the water. Granted, shark bites are a little more
severe than elevated creatine kinase levels, but you get the point.

Speaking of more appropriate nutrient timing protocols, other
investigations have examined the effects of protein-carbohydrate
solutions given pre- and/or during exercise, with some of these
studies lasting several weeks. The results unanimously support
the use of a protein-carbohydrate mix for suppressing markers of
muscle damage. For example, a relatively recent trial by
Saunders et al compared a carbohydrate-only beverage with a
carb-matched beverage containing additional protein (an extra
20%) drank during and after exercise. The latter treatment
enabled subjects to cycle 29% longer to fatigue at 75% VO
2
max
and 40% longer at 85% VO
2
max compared to the carb-only
group. Despite the substantially greater workload done by the
carb-protein group, it had 6x lower creatine kinase output than
the carb-only group, indicating significantly less muscle damage.
Heres a quote from the discussion section of the present trial:

Although these studies did not seek to specifically cause
exercise-induced muscle injury, the activities performed by the
participants are likely candidates for its induction. Thus, it is
possible that chronic use of carbohydrate-protein beverages will
enhance the recovery from repeated bouts of exercise-induced
muscle injury.

The moral of the story is that if youre involved with activity
that contains a high volume of repeated bouts of eccentric
contractions (such as downhill running), special attention must
be paid to nailing your pre- and if necessary, during-exercise
nutrition, not just post-exercise. Heres a link back to the
opening article if you need a refresher on how to accomplish
this.


Effect of dietary protein content during recovery from
high-intensity cycling on subsequent performance and
markers of stress, inflammation, and muscle damage in
well-trained men.

Rowlands DS, et al. Appl Physiol Nutr Metab. 2008 Feb;33(1):
3951 [APNM]

PURPOSE: To determine the effect of post-exercise dietary
protein content imposed over a high-carbohydrate background
on subsequent performance. METHODS: Using a crossover
design, 12 cyclists completed 3 high-intensity rides over 4 days.
Day 1 comprised 2.5 h intervals, followed by repeat-sprint
performance tests on days 2 (15 h post) and 4 (60 h post),
interspersed with a rest day. During 4 h recovery on days 1 and
2, cyclists ingested either 1.4g/kg/hr carbohydrate, 0.7g/kg/hr
protein and 0.26g/kg/hr fat (protein-enriched) or 2.1g/kg/hr
carbohydrate, 0.1g/kg/hr protein, and equal fat (control). At
other times, cyclists ingested a standardized high-carbohydrate
diet. Anabolism was assessed via nitrogen balance, stress and
inflammation via cortisol and cytokines, skeletal-muscle
membrane disruption via creatine kinase (CK), and oxidative
stress via malonyl dealdehyde (MDA). RESULTS: Sprint mean
power was not different on day 2, but on day 4 it was 4.1%
higher in the protein-enriched condition. CK was reduced by
26% but other effects were inconclusive. Overnight nitrogen
balance was positive in the protein-enriched condition on day 1,
but negative in the control. CONCLUSION: A nutritive effect
of post-exercise protein content was not detectable short-term
(15 hrs), but a delayed performance benefit (60 hrs) was
observed. SPONSORSHIP: The researchers of this study
funded it themselves.

Study Strengths

Trained endurance endurance cyclists were used, which
eliminates the possibility of results coming from the newbie
effect. The latter is generally responsible for suppressing
potential differences between groups due to an indiscriminately
high level of responsiveness that novices have to any given
protocol. Subjects recorded their training and diet daily in lab-
provided journals. Dietary intake was standardized throughout
the trial to contain 8-10g of carbohydrate per kg of fat-free mass,
and reality-based feeding patterns were mimicked. On day 1,
subjects underwent a glycogen depletion protocol 4 hours after a
1pm meal. On day 2 and 4, where the subjects arrived at the lab
first thing in the morning, a normal training day was simulated
by consuming a small standardized high-carbohydrate meal
before the repeated sprint tests. Speaking of which, instead of
using a fixed load time-to-exhaustion model of testing, the
measurement of a maximal effort over repeated sprints more
accurately reflected the intermittent high-intensity bouts of many
types of sport, including endurance cycling competition.

Study imitations

I use the skinfold method in my private practice, so it feels a
little strange to be criticizing studies that use the same method.
However, I make it perfectly clear to my clients that theyre used
because 1) I can choose which specific sites to assess; 2) Theyre
reliable enough at measuring change in skinfold thickness,
regardless of how closely the caliper-determined bodyfat percent
estimate relates to what the clients actual bodyfat percent might
be. Im very clear with my clients that the only way to determine
bodyfat percent with the highest degree of accuracy is dissection
which has obvious side effects. This brings me to my point that
Id rather see either hydrodensitiometry or DEXA used in
research where much of the outcomes hinge upon as accurate an
assessment of body composition as possible. In the case of the
present study, many of the calculations and feeding dosages
were based on the subjects fat-free mass, which ultimately falls
back on the accuracy (or lack of accuracy) of the body comp
assessment method.

Nitrogen balance as a tool for measuring anabolism has its fair
share of limitations. This study measured urinary nitrogen
losses, but only estimated other nitrogen losses through sweat,
feces, and other means. Unfortunately, there will always be a
built-in degree of possibility for under- and over-estimation of
nitrogen losses due to factors such as denitrification by colonic
bacteria, and further urea losses from skin and expired ammonia.
For these reasons, it would have helped to use another method in
tandem for cross-checking purposes, such as a metabolic tracer
to determine muscle protein balance.

Comment/Application

The most important finding of this study was that it took
roughly 2 and a half days for any performance effect to become
evident. The fact that a performance benefit happened at all in
the protein-enriched group was notable, since the control group
consumed 1.2g/kg/day (50% above the RDI). This is within the
range of protein intake recommended for athletes, which is 1.2-
1.7g/kg/day (see the review by Tipton and Wolfe). And still, it
wasnt enough to prevent the control group from falling into
negative nitrogen balance. The protein-enriched group consumed
an average of 1.9g/kg/day, and this not only preserved nitrogen
balance, but it imparted an eventual performance enhancement,
as well as a reduction of creatine kinase (a marker of muscle
breakdown) on day 4.

According to the authors calculations, a 50mg/kg net loss of fat
free mass occurred in the control group on day 1. This translates
to 54g of protein lost over the 4 day trial, as opposed to a gain of
95g in the protein-enriched group. An extra 13.5g protein per
day, which is the equivalent of 2 ounces of meat, or about 2/3
the typical sized scoop of protein powder would have been
sufficient for preserving protein balance.

The results may all boil down to the protein enriched
treatment (contributing to a total of 1.9g/kg/day) merely
enabling a protein intake within range of what athletes
habitually ingest without any special effort. Illustrating my
point, the authors point to a study of the macronutrient intake of
top-level cyclists on the 3-week tour who consumed protein at
about 3g/kg, which was 14.5% of total intake of 5600 kcal. In
future research it would be interesting to see if pre and/or post-
exercise protein enrichment leading to a total intake substantially
above 1.9g/kg would cause any further increase in performance
or suppressive effects on markers of muscle breakdown.


Effects of a supplement designed to increase ATP levels
on muscle strength, power output, and endurance.

Herda TJ , et al. J Int Soc Sports Nutr. 2008 Jan 29;5(3) [J ISSN]

PURPOSE: To examined the acute effects of a nutritional
supplement intended to improve adenosine triphosphate (ATP)
concentrations on vertical jump height, isometric strength of the
leg extensors, leg extension endurance, and forearm flexion
endurance. METHODS: Twenty-four healthy men (mean age =
23yrs) completed a familiarization trial plus 2 randomly-ordered
experimental trials separated by a 7-day washout period.
Participants the supplemental treatment (TR; 625 mg of
adenylpyrophosphoric acid and calcium pyruvate, 350.8 mg of
cordyceps sinensis extract and yohimbine hydrochloride) or
placebo (PL; 980 mg of microcrystalline cellulose) 1 hour prior
to the following tests: countermovement vertical jump (CVJ ),
forearm flexion repetitions to exhaustion, isometric maximal
voluntary contractions (MVCs) of the leg extensors, and a 50-
repetition maximal concentric isokinetic leg extension endurance
test. RESULTS: There were no differences between the TR and
PL trials for CVJ height, isometric MVC peak torque, maximal
concentric isokinetic peak torque, percent decline during the leg
extension endurance tests, or repetitions to exhaustion during the
forearm flexion endurance tests. CONCLUSION: No
improvements occurred as a result of ingesting this supplement.
Future studies should examine whether chronic supplementation
or a loading period is necessary to observe any ergogenic effects.
SPONSORSHIP: Not listed.

Study Strengths

At an average age of 23, it seems the appropriate age
demographic was tested (young, impressionable). Ive actually
come across peer-reviewed supplement research that was single-
blind, so Ive come to appreciate, or at least have an eye out for
double-blinding in this area of research. Another study strength
was its crossover, meaning that experimental and control groups
swapped spots after a 7-day washout period, and all the
subjects all got to be tested with the supplement. 7 days was a
sufficient period for eliminating any residual effects of the
supplement or the performance tests.

Study Limitations

The authors noted that because the supplement didnt improve
performance, its possible that it simply did not increase ATP
availability to the body. This could have been a result of the
compound getting inactivated by the digestion process. But since
no blood tests or biopsies were done to assess ATP levels,
theres no way to know for sure whether it was an issue of
availability, or an issue of ATPs ineffectiveness within the
context of the supplement.

Comment/Application

Google searches bring up the darndest things. The J ust Jump
TM

mat was used to measure vertical jumping ability in this trial.
The odd thing about the apparatus is that you have to land with
your legs relatively straight so as not to alter the measurement of
how much flight time you achieved. Heres a video of the
apparatus in use. Notice the urban slang congratulation banter
after the jump, it kind of makes the clip. Since the company
distributing the supplement was listed in the study (5-TETRA by
Epic Nutrition), Google came in handy again. Here are some of
the claims on the front page of the companys website, all of
which the present study invalidated:

5-TETRA is the ideal pre-workout supplement for increased Strength
and Endurance.

Immediate Performance Increase
Increase ATP Levels
Accelerate Recovery
Im not sure what sort of politics if any may have been
involved with the proceedings of the study, but the
ineffectiveness of 5-TETRA was exposed handily. I mention
politics because at least one of the authors of this trial (J effrey
Stout), as well as J ose Antonio, the co-founder of the journal in
which this trial was published, are both heavily involved in the
development and marketing of various supplements. Either Epic
Nutrition was not on their affiliate list, or the authors were
simply were doing their job as scientists for the interest and
protection of the consuming public. Ill stay optimistic towards
the latter. I own the book Sports Supplements by Antonio &
Stout, and its a very thorough, well-done, although currently
out-dated text.

5-TETRA is a mix of ingredients with sketchy track records, so
its lack of ergogenic effect was not too surprising. A 14-day
study by J ordan et al examined the effect of an oral ATP
supplement on anaerobic power and strength. The lower dose of
ATP (150mg) was ineffective for all parameters tested, while the
higher dose (225mg) failed at significantly improving all
parameters except for modestly increasing total lifting volume.

As listed in the present trial, 5-TETRA contains 625mg of a mix
of adenylpyrophosphoric acid and calcium pyruvate. Since no
proportions were listed, anything is possible here. Adding to the
history of calcium pyruvate supplementations marginal
effectiveness, a relatively recent trial showed its failure to
significantly alter body composition or improve exercise
capacity. Furthermore, the supplement actually inhibited the
HDL-raising effect of exercise. Lastly, the product has 350.8 mg
of cordyceps sinensis extract and yohimbine hydrochloride, and
again, no specific amount of each is listed. Cordyceps sinensis
is a larva-bound fungus used in traditional Chinese medicine for
a number of purposes, including the increase of physical
stamina. Unfortunately for those attempting to market it as an
endurance agent, it has failed in the peer-reviewed literature for
this purpose, both in combination with other compounds, and by
itself. Yohimbine has been touted for its ability to increase
lipolysis and thus reduce bodyfat, but research has been hit and
miss. The latest yohimbine trial showed some fat loss
effectiveness in elite soccer players, but no performance benefit
was seen. Yohimbine supplementation has some promise for fat
loss, especially if you train in a fasted state - which isnt
conducive to increasing strength or endurance.
One-year ad libitum consumption of diacylglycerol oil
as part of a regular diet results in modest weight loss in
comparison with consumption of a triacylglycerol
control oil in overweight Japanese subjects.

J Am Diet Assoc. 2008 J an;108(1):57-66. [Medline]

PURPOSE: To investigate the effect of 1-year ad libitum
consumption of diacylglycerol oil on body weight and serum
triglyceride. METHODS: In a 1-year double-blind, placebo-
controlled parallel trial with clinic visits at month 0, 3, 6, 9, and
12, a total of 312 J apanese men (174) and women (138) aged 22-
73 years, with body mass index (BMI) >/=25 and/or fasting
serum triglyceride level >/=150 mg/dL (1.70 mmol/L) were
randomly assigned to the diacylglycerol (DAG) or
triacylglycerol (TAG) group. Participants substituted their usual
cooking oil with the test oils. RESULTS: Body weight
decreased significantly in the DAG group. Changes in body
weight and body mass index during the study period differed
between the two groups by 0.87 kg and 0.32 kg, respectively.
Participants with higher initial BMI or greater percentage of total
fat intake as diacylglycerol had greater reductions in body
weight. Serum triglyceride levels decreased significantly in
individuals with hypertriglyceridemia, but did not differ between
groups. CONCLUSION: Modest body weight reduction was
observed after 1-year ad libitum consumption of DAG oil as part
of a regular diet in comparison to that of triacylglycerol oil.
SPONSORSHIP: Kao Corporation, Tokyo, J apan.

Study Strengths

Perhaps the most obvious strengths here are the 12-month study
duration and the large number of subjects (312). But, these
elements also raise the sensors up for what commercial entity
might be able to fund a trial of this length more on that in a
minute. At each visit, a registered dietitian reviewed diet records
and verified their accuracy by interviewing the participants. Diet
records were analyzed by food and nutrition professionals who
were specifically trained in nutritional assessment using
computer software. Subjects were encouraged to maintain their
usual eating habits and physical activity.

Study Limitations

Research, like life, is full of irony. This study undoubtedly must
have cost a small fortune, yet a very crude method was
employed for body composition analysis 2-site caliper
readings. Hydrodensitiometry or dual-energy X-ray
absorptiometry (DEXA) would have been much more
appropriate. Judging fro the accompanying news article excerpt,
the study sponsor certainly could have afforded such methods.
Although physical activity was accounted for via questionnaire,
its always ideal if subjects are administered a structured
exercise program that involves resistance training. Admittedly,
the proper execution of a formal training protocol would be cost-
prohibitive with a trial this size and length. Although diet
records were reported to a dietitian, only 3 arbitrary consecutive
days (not weekends excluded) were recorded and submitted with
each quarterly visit. Another critical limitation was the burden of
oil dose accuracy being placed on the participants, who self-
reported their intake. No clinical biomarkers were used to
quantify changes in blood or tissue levels of the test oils.

Comment/Application

DAG-rich oil is the result of an esterification process where soy
and canola oil are subjected to an enzyme which acts upon the 1
and 3 positions of the glycerol molecule. The result is a product
sold under the trade name Enova. The thing that irks me about
this trial is that despite its dichotomous results, its conclusion
will be used as an advertising headline. Heres a bit of
background on the studys funding source straight from Kao
Corporations website, in a news article entitled ADM Forms
Joint Venture to Produce Fat-Fighting Oil:

Kao is focusing on the expansion of its business globally, as well as
its health-related products. "This alliance with ADM will facilitate the
rapid global expansion of DAG oil," said Takuya Goto, President of
Kao.

Kao has more than 22,000 employees worldwide and net sales of
approximately $7.9 billion.

ADM has over 23,000 employees, 368 processing plants, and net
sales for the fiscal year ending J une 30, 2000 of $18.6 billion.
Is any real excitement warranted? Is this a break-through fat-
fighting oil as its been marketed?

It should go without saying that a high degree of caution must
always be used when interpreting study results. While its true
that a statistically significant degree of weight and fat loss was
seen in the diacylglycerol group compared to the triacylglycerol
group, the actual differences were very small in fact they were
downright negligible. The participant subgroup whose BMI was
at or greater than 30 lost an average of 1.5 kg (3.3 lbs) more than
the triacylglycerol group over the course of a year. Thats a
little over a quarter-pound per month, good grief. Those with a
BMI of 25-30 lost 0.5 kg (2.2) more than the triacylglycerol
group during this 12 month trial. This gives a whole new
meaning to the word modest in the title of this study. Subjects
in the highest BMI bracket actually experienced an increase in
both waist circumference (0.9cm) and triceps skinfold thickness
(1.9mm). This finding was conveniently ignored in the
discussion section of this study. In addition to being marketed as
a weight loss aid, DAG is also hyped as an agent for
significantly improving blood triacylglycerol levels. In the
present trial, this was not the case.

Applying the present study to the big picture, its clear that
substituting one type of cooking oil in your diet for another
special engineered oil isnt likely to fulfill any fat loss
promises. But in the end, the main problem is that consumers as
well as unknowing professionals will be taken by the headlines
of the peer-reviewed research, and accept it as valid without
question. This is a perfect example of how critical analysis cant
automatically stop at the lay literature. Scientific literature often
hides under the veil of legitimacy, skates by unchecked, and gets
leveraged for the benefit of the corporations funding the studies.
Imagine using research showing virtually undetectable weight
loss to market premium-priced cooking oil... Now, thats slick.


Metabolic and performance effects of raisins versus
sports gel as pre-exercise feedings in cyclists.

Kern M, et al. J Strength Cond Res. 2007 Nov 1;21(4):1204-
1207. [Medline]

PURPOSE: To examine potential differences in metabolism and
cycling performance after consumption of raisins vs. a high
glycemic commercial sports gel. METHODS: Eight endurance-
trained male and female (even split) cyclists, mean age =30 yrs,
completed 2 trials in random order. Subjects consumed
carbohydrate at 1g/kg bodyweight from either raisins or sports
gel (Clif Shot) 45 minutes prior to cycling at 70% VO
2
max.
After 45 minutes of submaximal exercise, subjects completed a
15-minute performance trial. Blood was collected prior to
starting, and at the 45th minute of exercise, to measure glucose,
insulin, lactate, free fatty acids (FFAs), triglycerides, and beta-
hydroxybutyrate (BHB). RESULTS: Performance was not
different between the raisin and gel trials. Pre-exercise, glucose
and other substrates did not differ between trials; however,
insulin was 44.2% higher for the gel vs. raisin treatment. After
45 minutes of exercise, insulin decreased to similar levels in
both trials. FFAs increased significantly during the raisin trial.
CONCLUSION: Inconsequential metabolic differences and no
difference in performance were detected. Raisins appear to be a
cost-effective pre-exercise carbohydrate in comparison to sports
gel for short-term exercise bouts. SPONSORSHIP: A grant
from the California Raisin Marketing Board.

Study Strengths

There is an inherent practicality in the core concept of this study.
If all it takes is a measly bunch of raisins for an ergogenic effect,
and it costs about 40% less per gram of carbohydrate compared
to sports gel, then its a win-win. But can this be possible? Can
Mother Nature keep up with the tireless work of the sports
supplement engineers? If you took the time to read the abstract,
apparently, she can at least within the context of the present
protocol. Aside from practical allure, a decent host of metabolic
parameters were assessed in addition to the most important one
exercise performance. Consistent with an emerging trend in
performance testing, instead of using a constant-load, time-to-
exhaustion model of testing, the measurement of a maximal
effort over fixed amount of time more closely reflects the nature
of sports competition. Using in-season trained cyclists
including triathletes and duathletes gave this trial relevance to
the population that might care most about the small details that
might make a difference under highly competitive conditions.

Study Limitations

In my opinion, the investigators wasted their energy by
clamoring over the glycemic index (GI) differences of the two
carbohydrate sources. Better resources could have been put to
use by carrying the study through a longer duration instead of
leaving it at a single performance bout. Had the trial been
prolonged for several weeks, not only performance, but changes
in body composition, glucose, and lipid metabolism could be
assessed as well.

Comment/Application

To reiterate a point I made in the opening article, rebound
hypoglycaemia during training is an unsubstantiated concern
regarding carbohydrate intake within 60 minutes prior to
training. With the exception of 2 studies done in the 1970s, at
least 9 studies since then have shown either no effect, or a
performance increase as a result of ingesting a wide range of
carbohydrate types at 1g/kg of bodyweight ingested 30-60
minutes pre-exercise. Trained endurance athletes for the most
part are unaffected by GI manipulations in general, regardless of
the timing of a meal prior to exercise. Any potential effect that
GI might have diminishes even further if the training bout is
relatively short (equal to or less than 60 minutes), such as the
protocol used in this study. For those reasons, all of the GI
business was largely irrelevant to the context of this trial.

An unexpected occurrence was a lack of difference between pre-
and post-exercise serum glucose levels. Since lower-GI foods
tend to evoke a lower insulin response, a more sustained level of
glucose was expected during the outset of exercise compared to
the gel treatment, which was expected to cause a more dramatic
spike and dip. This was not the case. Lower blood lactate levels
post-exercise were also expected of the raisin trial, since this
would concur with less carbohydrate oxidation and greater fat
oxidation. This didnt happen either, perhaps the exercise
duration was too short to give those phenomena a chance to
become detectable. Since pre-exercise insulin levels were
significantly higher in the gel group than the raisin group, the
suppression of lipolysis and decreased FFA levels were
expected. Nevertheless, a greater reliance on FFAs sparing the
oxidation of carbohydrate could potentially increase
performance, but again, this was not seen in this short-term bout.
However, remember that trained subjects have been observed to
be impervious to GI manipulations, even in prolonged training
bouts.

On to the nitty-gritty. Performance was not significantly
different between the raisins or Clif Shot gel. The authors
speculate that if a lower GI really was a potential performance
factor, this possibility was diminished by the subjects carrying
sufficient levels of glycogen prior to testing. However, they do
diligently note that GI still might not have made any difference
regardless, as seen in a trial by Febbraio et al.

So, granted that the California Raisin Marketing Board doesnt
soon get one-upped by the many sports gel companies, a green
light can be given to stick with the cheapest, most convenient
carbohydrate source that youre gastrically comfortable with
and of course suits your taste buds. As long as the training bout
is less than 2 hours, it isnt likely that youd need any of the
extra ingredients typical of gels (sodium & potassium). As done
in this and other studies, a 1g/kg dose of carbohydrate was
ingested 45 minutes pre-exercise. This is equivalent to about 2-3
small boxes of raisins, or 3-4 packets of sports gel. Both are
equally effective, the raisins cost 40% less, but unlike most
cutting-edge ergogenic aids, you actually have to chew them.

Long-term effects of 2 energy-restricted diets differing
in glycemic load on dietary adherence, body
composition, and metabolism in CALERIE: a 1-y
randomized controlled trial.

Das SK, et al. Am J Clin Nutr. 2007 Apr;85(4):1023-30.
[Medline]

PURPOSE: To examine the effects of 2 macronutrient patterns
with different glycemic loads on adherence to calorie restriction
(CR), weight and fat loss, and related variables. METHODS: A
randomized controlled trial (RCT) of diets with a high glycemic
load (Hg) or a low glycemic load (LG) at 30% CR was
conducted in 34 healthy overweight adults with a mean age of 35
and BMI of 27.6. All food was provided for 6 months in
controlled diets, and subjects self-administered the plans for 6
additional months. Outcomes included energy intake measured
by doubly labeled water, body weight and fatness, hunger,
satiety, and resting metabolic rate. RESULTS: All groups
consumed significantly less energy during CR than at baseline.
Changes in energy intake, body weight, body fat, and resting
metabolic rate did not differ between groups. Both groups ate
more energy than provided. Percentage weight change at 12 mo
was -8.04% in the HG group and -7.81% in the LG group. There
was no effect of dietary composition on hunger, satiety, or
satisfaction with the amount and type of provided food during
CR. CONCLUSION: These findings provide more detailed
evidence that diets differing substantially in glycemic load
induce comparable long-term weight loss. SPONSORSHIP: A
grant coordinated by the National Institutes of Health.

O

perational Definition of Glycemic Index (GI)
GI is a measure of ability of a fixed amount (50g) of, or
available (non-fiber) carbohydrate within a food source
(regardless of portion size) to raise blood sugar over a 3-hour
period. The area under the response curve is calculated, and
bam, theres the GI. Multiple factors can alter GI and challenge
its relevance especially in the big picture, as the present trial
demonstrates. For more detail on the inherent confounders of GI,
efer to this r article.

O

perational Definition of Daily Glycemic Load (GL)
The daily GL in this trial was calculated as: [daily GI x the
days total available carbohydrate in grams/1000 kcal]. J ust as
above, the amount of available carbohydrate for each food was
calculated as total grams of carbohydrate minus total dietary
fiber.

S

tudy Strengths
This is a monster of a trial. By that, Im not referring to the
number of participants (even though that was appreciable).
Nearly everything was tightly controlled, and this was a major
undertaking considering that a high degree of micro-
management of the subjects occurred for 12 months. The
strength of this trial that distinctly separates it from others is its
rigorous control of the subjects dietary intake. All food for the
first 6 months was provided by the lab. Even during the 2nd 6
months of the trial, high measures of control were imposed.
Subjects worked with a dietitian to develop an individualized plan
that included menus, recipes, portion sizes, and food lists that were
consistent with their diets. Food scales were provided to control
portions, and the subjects even attended a grocery store tour and a
cooking class. The study was independently monitored for
overall compliance and data accuracy by an external clinical trial
monitor. Baseline weight-maintenance energy requirements were
measured by doubly labeled water, which involves determining the
turnover of two isotopes in order to arrive at the amount of CO
2

produced, and from that, energy expenditure can be calculated
(theres decent tutorial on DLW on page 281).

When snooping for dietary design flaws, I immediately check for
protein insufficiency in at least one of the groups this was not the
case here. Both treatments provided adequate protein. Another
common limitation is the absence of an exercise program, but then
again, that limitation tends to be specific to the readership of this
research review. For the sedentary folks who make up the majority
of the industrialized world, the absence of a structured training
protocol might actually be more applicable. A limitation common
with larger, longer trials especially ones involving caloric
restriction is dropout (attrition). This trial retained 85% of its
starting participants, so dropout was not a major issue, nor was
sample size.

Study Limitations

This is going to be a stretch, since this is one of the most tightly
controlled, meticulously executed RCTs Ive ever come across. So,
in the spirit of groping for study limitations, I have a minor issue
with the choice of instrumentation for body composition analysis:
air displacement plethysmography (ADP), which goes by the trade
name Bod Pod. In my quest to pick a bone with ADP, I found
several studies implying that its on par with the validity and
reliability of DEXA and hydrodensitiometry. However, breaking
research found that variations in clothing tightness cause significant
error in ADP readings, a factor that can either alleviate or worsen
the error depending on the individuals degree of excess
bodyweight. Obese folks in spandex experienced the greatest error.
T-shirt and shorts, or scrubs would be best for this population. If the
initial phase of the present trial could be re-done, this data would
serve as an important guide to properly matching clothing fit and
bodyweight in order to minimize error.

Comment/Application

The high-GL diet was 60%C, 20%P, 20%F, with high-GI carb
sources. The low-GL diet was 40%C, 30%P, 30%F, with low-GI
carb sources. Popular media trends would lead most to predict the
folly of the high-GL diet without hesitation. But, not only was there
no difference in hunger, satiety, fat loss, and weight loss there was
actually a beginning of a trend toward weight re-gain in the low-GL
group. To quote the authors, Taken together, these findings suggest
that reduced energy intake may be somewhat harder to sustain with
the LG group in the long term. The authors go on to conclude that,
the present results suggest that a broad range of healthy diets
can successfully promote weight loss. On this point I agree, but I
would also add that in my observations, caloric deficits offer a lot of
leeway more leeway than caloric surpluses for muscle gain. The
subjects in this trial were in a 30% caloric deficit, so fudging
carbohydrate and fat one way or the other wouldnt make much
difference as long as protein is adequate.


Master Amino Acid Pattern (MAP) provides a sure way
to rebuild energy fitness life! [BodyHealth]

A competitive triathlete client of mine asked me to check this
article out and give him my two cents. Well, I might as well
spread the wealth. On their About Us page, BodyHealth is
anonymous. There are no faces to associate with the company.
No founder, no president, no staff listing, nothing. Yet, they
claim to have started in March of 2000, marketing supplements
o doctors. Heres what appears to be their core cause: t

Okay, sounds noble and medical enough. Its obvious that this is
simply a supplement sales operation, but lets take a look at
some of the elements that may have led my new (at the time)
client to ask me to have a look... For starters, theres the
champion triathlete endorsing the product with a manufactured-
sounding testimonial with the products name in bold. The
product in question is MAP, formerly called Biobuilde. Its
nothing more and nothing less than an essential amino acid
(EAA) supplement, but the guys at BodyHealth have found a
brilliant way to market it as a sports panacea to the lay public.

Their campaign? Simple, keep the professional triathlete
testimonials in place, and make all other protein sources appear
completely useless. Make sure to blind the consumer with
scientific jargon such as net nitrogen utilization (NNU), then
emphasize that all-important acronym NNU. Because you see,
MAP has the highest NNU of anything on the planet, which
means that virtually none of it gets wasted, unlike other amino
acid sources in your diet wrapped up in this dreadful complex
called food which renders it... Toxic Nitrogen Waste. Heres
the chart that gave me an instant education in the art of BULL:

J ust think, that right there is the pinnacle of someones graphic
design career... Okay, enough poking fun, this is serious
business. Without even pondering the claims that are misleading
to the point of blasphemy, I look for the price of this EAA
supplement. I cant find it. I keep looking, give up, do a Google
search. Its not a red flag or anything when prices of a product
arent even listed on the site. There was an option to register my
email address, and I think I would have gotten access to the
prices, but I didnt have the energy that day. Anyway, the search
turned up a few sources that listed prices in the neighborhood of
55 bucks plus shipping for (get ready for this) 120 tabs, each tab
is a gram. This amounts to a little over a quarter of a pound of
EAA, for about 60 bucks when you count shipping.

I explained to my client that for 60 bucks, you can go wild and
get 5 lb of whey isolate. That translates to 2270 grams of
protein, half of which is EAA 1135 grams. So when you
compare 120g EAA from BodyHealth for the price of 1135g
EAA from whey (nevermind the other 1135g protein in & other
goodies) you begin to realize why I wanted to share this little
story.
Our mission is to educate doctors and the public with the correct
know-how and products to improve the body's condition, and to
provide them with the products needed to do that.

Indeed, I eventually called BodyHealth and asked them for some
research backing up their claims. The sales rep sounded like an
honest, hard working, warm-hearted person, so I sort of feel like
Im taking advantage of this situation. Damn that conscience of
mine. To my surprise, she sent me at least a couple of studies
that supposedly support their Master Amino Acid Pattern
EAA product. Ill have them laid out for you next month, gotta
do it right and keep an open mind. They might be on to
something.

In addition to reviewing the current and past-yet-juicy studies,
Ill wrap up the theory and practice of protein and carbohydrate
timing with post-exercise nutrition. In the mean time, Ill be
endlessly navigating my way through the waxy maze of info.

Im open to suggestions, comments, questions, and civil debate
(letters to the editor). Send your correspondence to
aarrsupport@gmail.com. Until next month, enjoy the Feb love.

In some instances, statistically significant

results may not be
clinically important and, conversely, statistically

insignificant
results do not completely rule out the possibility

of clinically
important effects.
Chan KBY, et al. 2001

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AlanAragonsResearchReview,February,2008[BacktoContents] Page1

Copyright February 1st, 2008 by Alan Aragon

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