Take Control of Your Cortisol Levels - Use These 5x Stress-Modulating Diet, Lifestyle & Supplementation Rules Wisely

Always remember: You want to control cortisol, not eradicate it if you want to melt away your belly fat, beat your personal bests and feel just great!

As a SuppVersity reader, you belong to the chosen few who know that cortisol is not the villain as which it is stigmatized in the fitness industry (obviously to sell supplements | learn more). Rather than being "bad" or "good", cortisol, a glucocorticoid, i.e. a hormone that keeps your blood glucose stable, and potent anti-inflammatory agent, is more vital than any "vitamin" - in spite of not having the magic "vita" in its name.

Whether the effects of this vital adrenal hormone are going to be "bad" or "good" for you, depends mostly on whether it rises and falls according to its natural 24-h rhythm or is chronically low (often labeled adrenal insufficiency) or chronically high.

If you want to mess with your cortisol rhythm overtraining is exactly what you "need"!

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Now your diet alone will probably not suffice to induce one or the other state of chronically messed up cortisol (unless you eat (a) almost nothing while training like a maniac for weeks ⇉ low cortisol; or (b) too much of a typically Western diet ⇉ high cortisol). And yet, it is still a good idea to know more about the diet ⇆ cortisol interaction(s) to be able to maintain hormonal homeostasis, and the SuppVersity is obviously the right place to learn all about it.

Figure 1: Overview of the three areas of your physiology that are directly affected by the levels and rhythm of cortisol.

With the ever-increasing number of "functional" foods boasting of being able to modify health-relevant parameters, including your cortisol level and thus your ability to, through its
multipronged action, stabilize or mess with your blood levels of glucose, to stimulate your tissue's
regenerative processes and to inhibit inflammation in each and every organ of your body.

Figure 2: This is how cortisol is "made" in your body (Stachowicz. 2016). In theory, you can influence its concentration by modifying this cascade at any point.

As Stachowicz, et al. point out in a recent review of the literature they published in the peer-reviewed journal Eur Food Res Technol (Stachowicz. 2016), diet is obviously not the only factor that influences our cortisol levels. Of at least as much importance are "[f]actors like stressful work, personal problems, [and] intensive training" , which "can lead to long-term sustained, excessive concentration of this hormone, affecting formation of metabolic disorders such as insulin resistance, increased blood pressure, abnormal bone regeneration and collagen synthesis or calcium deficiency in the organism" (ibid.). Against that background, it is hardly surprising that various groups of the society try to modulate their cortisol levels in ways they consider healthy (again: low is not healthy!) by supplementing or eating / avoiding certain foods that contain nutrients which regulate steroid hormones homeostasis.

In the short term, e.g. strategic overreaching, your body can cope with the exercise induced release of cortisol, but when over-reaching becomes over-training you run the risk of plumetting into the deep dark valley of unsurmountable fatigue.

Excursion - Exercise and cortisol: Athletes experience substantial increases of cortisol and adrenaline during intense workouts. That's normal and even necessary to (a) keep your blood glucose levels stable and (b) train at high(est) intensities. In fact, studies have shown that in athletes with higher motivation and orientation on the success, levels of these hormones were higher than those of other players. As Stachowicz, et al. point out "[t]hey also generally achieve better results" (Obmiński. 2009). On the other hand, studies show that people who experience mental fatigue experience limited activity of pituitary gland and sympathetic nervous system - in other words low cortisol levels (or rather the absence of appropriate spikes in response to e.g. exercise and other stressors).

And that rightly so! After all, Stachowicz et al. (2016) rightly point out, a "balanced diet with optional supplementation is one of the important factors determining the high physical and mental capacity of organism" (ibid) - and this goes for everyone from the frail elderly over the hobby- and pro-athletes to the stressed manager or teacher, who are all "particularly exposed to abnormal secretion, metabolism and transport of hormones, including cortisol" (ibid.) - people who will probably know about the effects of chronic stress:

"It was shown that in stressful situations appetite for sweet and fat meals rises, probably because of their high rewarding character (Zellner. 2005). Consumption of meals induces [an] increase in cortisol level. This response is strongly marked in men than in women. Influence of kind of macronutrients in taken food on cortisol concentration was investigated in many [types of research], but the results are not clear" (Stachowicz. 2016). 

One of the best known (and most logical) effectors of cortisol production is the content and type of carbohydrates in your diet - especially if you're not a sedentary slob; after all, cortisol's main function as a glucocorticoid is to counter hypoglycemia.

• Rule #1 (esp. for easily fatigued athletes) - Eat enough (or no) carbs: Eat either no carbs at all (ketogenic diet) or enough carbs before, during and after training to prevent hypoglycemic conditions (click here to learn why this will also help to stay lean) and thus an abnormally high intra- and post-workout spike of hydrocortisone in blood while the consumption of liquids (studies show that this takes some carbs, i.e. 7% vs. just 1.5% in the intra-workout beverage | cf. Ihalainen, 2014 vs. Caris, 2014).
• Rule #2 - Don't believe everything the supplement industry claims: As Stachowicz et al. rightly point out, the impact of around training protein, glutamine, arginine or branched-chain amino acids (BCAA), on the other hand, "is not clear and requires testing on large groups of athletes of various disciplines" (Stachowicz. 2016).
  
  What has been shown to work is tryptophan, which is a precursor of serotonin, that will effectively ameliorate the cortisol level increase, during and after workouts, but its potential side effects (esp. performance decrements) have not been well-studied, yet. The same must be said of phosphatidylserine and phosphatidic acid, which have been shown to (a) normalize the stress reactivity of hypothalamus-pituaryadrenal-axis in chronically stressed men and to reduce the cortisol response to exercise in a sponsored trial in which it was administered at dosages of 400 mg/day for 6 weeks - the total number of studies to support PS as a useful supplement for anyone from manager to athlete and from elderly to toddler, however is low; oftentimes, there's sponsorship involved and long-term studies or studies that would evaluate the effect of cortisol control on the adaptational response to exercise are missing.
• Rule #3 - Don't overrate its benefits but get enough protein (1.6-2.2 g/kg per day): As explained in rule #2, there's no evidence that simply adding more protein to your diet is going to help you control cortisol. In fact, eating too much protein and too little fat and carbs may chronically elevate the glucocorticoid, because it has to keep the production of glucose from amino acids in the liver, i.e. gluconeogenesis, working. That adequate protein intakes are necessary, on the other hand, is a logical consequence of the role of serine, taurine, and other amino acids play in the control of the balance and optimal function of your hypothalamus-pituitary-adrenal-axis.
• Rule #4 - Optimize your sleep by sleep hygiene and (optional) supplements: By optimizing your sleep you can restore a normal and healthy circadian rhythm and thus battle what makes cortisol a problem for so many in our society directly. How's that? Well, as previously highlighted, it's not the cortisol spikes you experience in the AM and during and after workouts, but chronically elevated (or depleted) levels of cortisol and spikes that occur untimely (e.g. the "2AM wake-up call", when your cortisol rises way too early and you cannot sleep longer than until 1-3 AM).
  

  

  Figure 3: Optimal sleep, melatonin and cortisol patterns are mutually dependent in health and disease - if you mess up one with the way you behave / live and/or supplements you mess up all (Glickman. 2010).

  Next to using earplugs, a blindfold (or curtains to make sure light doesn't disturb your sleep), reducing your (blue) light exposure in the evening, and using a non-stressing alarm to tell you that it's time to go to bed, a sleep tracker to access whether your intervention is successful, your circadian rhythm restoration program may involve: (1) no caffeine, coffee, or other stimulants in the 6h window before bed (some people will have to extend this window even further); (2) GABA at doses of 100-500mg before bed (don't take more or you may faint); if you cannot tolerate GABA, try taurine, instead, it will also enter the brain and act on the GABA receptor (Song. 2003); (3) melatonin at dosages you will have to figure out yourself (start with 1-3mg and ramp up until you sleep well and wake up refreshed, not groggy, which is usually a side effect of taking (a) too much or (b) the by no means recommendable time-released melatonin preparations).  
• Rule #5 - Strategically supplement with... In contrast to the previous rules, rule #5 is "optional" or facilitative. There's mixed evidence for some vitamins, namely vitamin C (500-1000 mg), vitamin E (400 IU+), vitamin D (>2,000 IU), as well as high doses of vitamin B1, B2, and niacin, which are involved in metabolism and production of cortisol, can lower the glucocorticoid response to exercise. 

  

  Figure 4: Sign. associations between PWO hormone levels and lean mass, as well as fiber size, increases (West. 2012) - they exist, but the largest and best study to investigate them clearly shows: It's cortisol that predicts lean mass gains (left) and GH that predicts the growth of individual fibers. High post-workout testosterone, however, predicts ... nothing (learn more) .

  At least for the former (vitamin C and vitamin E), however, it has also been shown that it will impair the exercise-induced adaptational processes, i.e. improved conditioning, muscle strength, and size when taken chronically. No wonder, if you think about the previously outlined beneficial effects of your body's most potent anti-inflammatory homrone, cortisol, (see Figure 4, too) on the regenerative process after workouts.
  
  The beneficial effects of a natural (controlled) cortisol response to exercise are something you should also keep in mind when using magnesium supplements which have been shown to blunt the cortisol increase to physical exercise in Golf et al. (1984) 32 years ago. Since newer studies were not generally able to confirm Golf's findings, though, I wouldn't be too afraid of (or rely too much on) magnesium's ability to lower your cortisol levels in non-(mg)-deficiency situations. That's particularly true in view of the fact that Cinar et al. saw a sign. increase in cortisol in response to a similar combination of magnesium supplementation (10 mg/kg b.w.) and physical activity in 2008. Stachowicz, et al. are thus right to point out that "[t]he impact of magnesium supplementation on cortisol levels in athletes is not clear and needs further investigation" (Stachowicz. 2016).
  

  

  Figure 5: While we do have evidence that boron will have opposing effects (vs. magnesium or the previously mentioned vitamins on cortisol), the existing evidence is far from being conclusive (Naghii. 2011).

  The same must be said of the cortisol modulating effects of a former star on the bodybuilding supplement sky that has been largely forgotten today: boron. While Naghii et al. (2011) confirmed relatively recently that a daily morning use of preparation containing 11.6 mg of boron, just after 1 week, results in increase in cortisol and free testosterone, dihydrotestosterone (DHT) and vitamin D while decreasing estradiol levels, we are far from being able to call boron a proven ergogenic - also because its long-term benefits appeared to be zero in most exercise-related long-term studies with relevant outcome parameters (not hormones, but gainz in performance, size or strength). The same must be said of fish oil, which has been shown to reduce perceived stress, green tea (EGCG), which is supposed to inhibit the activity of 11β-hydroxysteroid dehydrogenase type 1 that converts cortisone to cortisol, and betaine with one study backing its anti-cortisol effect in trained individuals (Apicella. 2013).
  
  Long-term data assessing its safety, and potential detrimental effects on testosterone is also lacking on the effectiveness of licorice, one of the few supplements of which we have reliable evidence that it affects (increases) cortisol. 

Cardio - Only significantly "too much" can hurt your circadian cortisol rhythm, but if it does, it trigger muscle loss, fatique and (in a caloric surplus) even fat gain | learn more.

So what's the verdict? Get your ducks in a row by following rules #1-4. If you still feel (or even better have evidence from multiple cortisol swap tests in 24h) that you cortisol rhythm is messed up (see Figure 3 for what you should look out), try using supplements like magnesium, green tea or b-vitamins to lower and boron or licorice to increase it strategically.

Needless to say that the latter will require proper timing with the supplements that lower cortisol being taken at times when you want cortisol to decrease (PM) and supplements that increase the glucocorticoid being taken at times when you want it to increase.

Why the timing? If you'd read the whole article and not just the bottom line you wouldn't be asking that, because you'd should know by now that you want a natural cycle of peaks and troughs, not chronically high or low levels (don't use supplements that block your body's ability to activate / deactivate cortisone <> cortisol completely, unless you've good medical reasons, to) of this important adrenal glucoregulatory + anti-inflammatory hormone  | Comment!

References:

• Caris, Aline V., et al. "Carbohydrate and glutamine supplementation modulates the Th1/Th2 balance after exercise performed at a simulated altitude of 4500 m." Nutrition 30.11 (2014): 1331-1336.
• Cinar, Vedat, et al. "Adrenocorticotropic hormone and cortisol levels in athletes and sedentary subjects at rest and exhaustion: effects of magnesium supplementation." Biological trace element research 121.3 (2008): 215-220.
• Glickman, Gena. "Circadian rhythms and sleep in children with autism." Neuroscience & Biobehavioral Reviews 34.5 (2010): 755-768.
• Golf, S. W., et al. "Plasma aldosterone, cortisol and electrolyte concentrations in physical exercise after magnesium supplementation." Clinical Chemistry and Laboratory Medicine 22.11 (1984): 717-722.
• Hellhammer, Juliane, et al. "A soy-based phosphatidylserine/phosphatidic acid complex (PAS) normalizes the stress reactivity of hypothalamus-pituitary-adrenal-axis in chronically stressed male subjects: a randomized, placebo-controlled study." Lipids in health and disease 13.1 (2014): 1.
• Ihalainen, Johanna K., et al. "Effects of Carbohydrate Ingestion on Acute Leukocyte, Cortisol, and Interleukin-6 Response in High-Intensity Long-Distance Running." The Journal of Strength & Conditioning Research 28.10 (2014): 2786-2792.
• Naghii, Mohammad Reza, et al. "Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines." Journal of Trace Elements in Medicine and Biology 25.1 (2011): 54-58.
• Obmiński, Zbigniew. "Pre-And Post-Start Hormone Levels In Blood As An Indicator Of Psycho-Physiological Load With Junior Judo Competitors." Polish Journal of Sport & Tourism 16.3 (2009).
• Stachowicz, Marta, and Anna Lebiedzińska. "The effect of diet components on the level of cortisol." European Food Research and Technology (2016): 1-9.
• Song, Zhilin, and Glenn I. Hatton. "Taurine and the control of basal hormone release from rat neurohypophysis." Experimental neurology 183.2 (2003): 330-337.
• Zellner, Debra A., et al. "Food selection changes under stress." Physiology & Behavior 87.4 (2006): 789-793.

Excessive Cardio & Testosterone: The free T / Cortisol Ratio Revisited | Plus: Why Even a 72% Decrease in fT/C May be Less Significant for Your Gains Than You Thought It'd Be

Cardio - Only "too much" can hurt you.

Let me get this straight: this is not an anti-cardio article. There's not just little, there's rather absolutely no doubt that a sane amount of endurance training is nothing but healthy for us, but done in excess, especially "running has been demonstrated to provide a large physiological stress to the body, resulting in large neuroendocrine system responses" (Anderson. 2016) - more specifically, running to exhaustion will have the hypothalamic–pituitary–adrenal (HPA) axis overproduce the glucocorticoid hormone, cortisol, which in turn appears to suppress the production of testosterone.

Now, cortisol - you've learned that in previous articles - is not the villain as which it is portrait by companies that are trying to sell you useless and potentially counter-productive "cortisol blockers". Rather than ruining your results, normal amount of cortisol will aid in substrate mobilization (including the use of body fat during your workouts) and can even improve your running performance.

You can learn more about overtraining and checking your training status at the SuppVersity

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Surprised? Well, I guess you will be likewise surprised to hear that the well-established connection between high cortisol and low testosterone levels that are characteristic of overtraining is likewise not as black-and-white as you may have heard. In 2005, for example, Brownlee et al. were able to show that the significant decline in total testosterone in response to exercise goes hand in hand with a disassociation of testosterone and its binding globulin SHBG that triggers an increase in free and thus bio-active testosterone levels - an increase that correlates with the exercise-induced increase in cortisol (as Brownlee et al. point out this is probably due to "an adrenal cortex contribution of fT or disassociation of fT from sex hormone binding globulin" | Brownlee. 2005).

Figure 1: Free testosterone and cortisol in young mend during recovery from 60-90min intense exercise (Brownlee. 2005).

In that, it is important to acknowledge that this finding of which the scientists rightly say that it "would seem to support the notion that the observed testosterone reductions following certain forms of physical exercise could be related to cortisol elevations in response to that exercise" does not "indicate a cause and effect relationship" (Brownlee. 2005).

What are the limitations of the study at hand? Next to a too limited (to fully grasp the time-course of the fT / cortisol response after exercise) number of blood draws and the small sample size that did not suffice to confirm the significance of the 24- and 24-h post hormonal changes (this would have required N = 16 subjects), the study at hand shares a general limitation with other studies: it fails to expand its analysis beyond the regular fT : cortisol ratio and into the realm of additional neuroendocrine biomarkers (e.g., prolactin, growth hormone, catecholamines), of which Anderson et al. (2016) rightly point out that they me of particularly importance in women and could vary and eventually determine the fitness-related differences in the hormone response we see in trained vs. untrained athletes.

What it does do, however, is tell us that we cannot restrict post-workout hormone essays to cortisol and total testosterone - unfortunately, the many currently available studies do just that... and what's more: they also fail to "assess the time course required for the neuroendocrine system to return to a resting homeostatic state" (Anderson. 2016) - even though

"[s]uch information is potentially vital to the coach and athlete in establishing timeline guidance forthe number of rest days necessary after strenuous exercise, such as might occur in a competition" (Anderson. 2016).

It is thus only logical that Travis Anderson and colleagues conducted a study to assess
the dynamics (!) of cortisol and testosterone concentration during recovery, following an exhaustive exercise bout. A study the results of which gain significance to the researchers' choice of subjects.

Table 1: Subject characteristics - Certainly not a bad thing to use elite athletes instead of noobs (Anderson. 2016).

12 elite endurance runners who reported to the laboratory on seven separate occasions each time being required to adhere to the preassessment guidelines, which included being 2.5 h fasted, abstaining from strenuous activity, alcohol and sexual activity for 24 h, and abstaining from caffeine consumption for 12 h.

Table 2: Exhaustive exercise session (X ± SD) | VO 2 oxygen uptake, HR heart rate, RPE rate of perceived exertion, VT ventilatory threshold (Anderson. 2016).

Following a 7-day wash-out period, participants took part in a standardized exhaustive exercise test -- a prolonged exercise run on the treadmill until volitional fatigue, running at 100 % +/-3% (see Table 3) of their pre-determined ventilatory threshold (VT | ventilatory threshold refers to the point during exercise at which ventilation starts to increase at a faster rate than VO2, the VT thus reflects the levels of anaerobiosis and lactate accumulation).

Complete exhaustion is key to the ill effects of "cardio"
.
To ensure "a truly fatiguing exercise session", strong "verbal encouragement" was given to subjects towards the end of the exercise session (the RPE levels in Table 2 indicate that this worked - the subjects, elite athletes or not, were truly exhausted) after which the subjects completed a ~5 min cool down, prior to a post-exercise blood sample being taken (+0 h).

Figure 2: Free testosterone (left, top), cortisol (left, bottom) and fT:cortisol ratio (right | Anderson. 2016).

Subjects reported back to the laboratory at the same time of day 24 (+24 h), 48 (+48 h), and 72 (+72 h) hours after the exhaustive exercise bout, where blood samples were again drawn. Subjects
were asked to maintain a similar diet and activity level compared to the pre-EES period during this 72 h of recovery, and the latter involved only activities of daily living and no exercise training. The analysis of these samples revealed the following results:

• free testosterone - as far as fT is concerned the researchers observed a significant decrease in fT following EES compared to pre-EES time points (−48 to 0 h; p = 0.053 to p = 0.001) that persisted for up to +48 h into recovery, before returning to baseline (pre-EES) levels at +72 h,
• cortisol - the scientists' REPANOVA and post hoc analysis revealed increases and decreases in C following EES compared to pre-EES. At +0 h, C was increased (p < 0.001) and decreased at +24 h (p < 0.002) before returning to baseline (pre-EES) levels,
• free testosterone : cortisol ratio - the analysis of the ratio of the two measured hormones revealed significant differences with post hoc analysis showing fT:C was significantly decreased at +0 h (0.167 ± 0.084) relative to all other time points (p < 0.005), interestingly enough, it took only 24h for the fT:C to return to pre-EES, with no significant differences between +48 h or +72 h compared to any pre-EES values,

With the increase in cortisol being - as preciously hinted at and discussed at length in "All About Cortisol" | read it) - indicative of an increased use of alternative (=non-glucose) substrates, it is not surprising that the intense exercise session, despite being conducted out of the "fat burning zone", did not affect the subjects' glucose concentrations at any measurement time. How's that significant? Well, previously, scientists have speculated that the reduction in testosterone and increase in cortisol could be a stress response to hypoglycemia (=low blood glucose levels). With the study at hand demonstrating stable blood glucose levels, this hypothesis must be refuted. 

Figure 3: Changes in testosterone (top) and T/C values (bottom) of Rugby players during the rest day (black bars), during the competition day (grey bars) and during the postcompetitive recovery period at 8 am and 8 pm (white bars | Elloumi. 2003)

Could HIIT actually increase your testosterone levels in the long(er) run? One interesting artifact the researchers found when reviewing the existing literature on the effects of exercise on (free) testosterone was the sign. increase in testosterone Elloumi et al. observed in the 6 days after an intense rugby match. What speaks against this theory, however, is the fact that Morville et al. have observed a similar increase in T in response to a 100km run in a 1979 study.

Against that background, Anderson's assumption that high-intensity, intermittent nature exercise would elevate, not lower the levels of testosterone during recovery, despite being in line with research in Wrestlers (Passelergue. 1999), appears to be questionable and I would recommend not to try to use high intensity interval (HIIT) training (of all) as a means of increasing your testosterone levels.

As Anderson et al. point out, the results of the study at hand also conflict with previous research suggesting significantly shorter recovery times for the fT:cortisol ratio, namely 38 h and 24h in Rugby and soccer players (after matches | Cunniffe et al. 2010; Ispirlidis et al. 2008).

Eventually, the study at hand therefore supports the previously voiced hypothesis that there may be a mechanistic link between increased cortisol and decreased testosterone levels - a mechanism that has been confirmed for orally ingested cortisol, which resulted in testosterone suppression without changes in follicle-stimulating hormone or luteinizing hormone as early as in 1976 (Doerr. 1976).
Overall, the existing evidence can thus be said to suggests that glucocorticoids will directly suppress steroidogenesis at the level of the Leydig cells, where LH and will no longer do its testosterone production triggering magic when your testes are bathing in cortisol - how the previously discussed increases in free testosterone fit in here, however, requires further research.

One important last finding I would like to discuss before wrapping it up is the (also previously observed | Kraemer. 2009) time-lag between the decline in cortisol and the recovery of testosterone levels. In fact, previous studies in athletes indicate that cortisol will be depressed during recovery. Now, acutely, this may be considered what Cunnife et al. (2010) call a "rebound anabolic stimulus" stimulus during recovery - in the long run, however, a suppressed diurnal cortisol rhythm is one of the hallmark features of overtraining that contributes to its ill effects on both overall well-being and physical performance.

Bottom line: No, cardio is not the devil and cortisol is not always bad for you. In fact, the almost oscillating nature of the individual hormone recovery dynamics in the 48 h postexercise, prior to returning to pre-exercise values clearly supports "the hypothesis that a negative relationship only exists between these hormones when cortisol is significantly elevated (>160 % of baseline values) | Brownlee et al. 2005)" (Anderson. 2016) - with the rapid clearance of cortisol from the bloodstream during the recovery period rendering its effects void within only 24 h of recovery from an exhaustive exercise bout.

Figure 4: Correlations between acute GH, free testosterone, IGF-1 and cortisol responses (area under the curve—AUC) and gains in lean body mass (n = 56). Cortisol AUC was correlated with LBM (r = 0.29, P = 0.03 | West. 2010).

Furthermore, we should not forget that the assumption that the fT or total T to cortisol ratio was a reliable marker of anabolic / catabolic state in the hours and days after a workout is, much in contrast to what the average bro-article on bodybuilding websites would suggest, not backed by science. Rather than that, studies such as may favorite large-scale + long-term resistance training study by West et al. (2009 / 2012) indicate that (a) the transient increases in endogenous purportedly anabolic hormones do not enhance fed-state anabolic signalling or MPS following resistance exercise (West. 2009) and (b) the post-exercise increase in the allegedly catabolic hormone cortisol even correlates with the extent of the 12-week skeletal muscle hypertrophy response to resistance training in 56 young men.

It should be obvious that this does not mean that you should aim to chronically elevate your cortisol levels, but I'd hope that the profound decline in testosterone in response to exhaustive (cardio) exercise is not the only information you take away from today's SuppVersity article. After all, the full recovery of fT within only 24h is of equal if not greater importance when it comes to the allegedly negative effects of sane amounts of cardio training on hormonal parameters of which we assume, but don't know that they determine our training success | Comment!

References:

• Anderson, Travis, Amy R. Lane, and Anthony C. Hackney. "Cortisol and testosterone dynamics following exhaustive endurance exercise." European journal of applied physiology (2016): 1-7.
• Cunniffe, Brian, et al. "Time course of changes in immuneoendocrine markers following an international rugby game." European Journal of Applied Physiology 108.1 (2010): 113-122.
• Doerr, P., and K. M. Pirke. "Cortisol-induced suppression of plasma testosterone in normal adult males." Acta Endocrinologica 80.1 Suppla (1975): S55-S55.
• Elloumi, M., et al. "Behaviour of saliva cortisol [C], testosterone [T] and the T/C ratio during a rugby match and during the post-competition recovery days." European journal of applied physiology 90.1-2 (2003): 23-28.
• Ispirlidis, Ioannis, et al. "Time-course of changes in inflammatory and performance responses following a soccer game." Clinical Journal of Sport Medicine 18.5 (2008): 423-431.
• Kraemer, William J., et al. "Recovery from a national collegiate athletic association division I football game: muscle damage and hormonal status." The Journal of Strength & Conditioning Research 23.1 (2009): 2-10.
• Passelergue, P., and G. Lac. "Saliva cortisol, testosterone and T/C ratio variations during a wrestling competition and during the post-competitive recovery period." International Journal of Sports Medicine 20.02 (1999): 109-113.
• West, Daniel WD, et al. "Resistance exercise‐induced increases in putative anabolic hormones do not enhance muscle protein synthesis or intracellular signalling in young men." The Journal of physiology 587.21 (2009): 5239-5247.
• West, Daniel WD, and Stuart M. Phillips. "Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training." European journal of applied physiology 112.7 (2012): 2693-2702.

HMB for Every, Not Just Strength Athletes? Lower Body Fat, Improved VO2, Muscle, Testosterone in 2x12 Week Study

Lean muscle for athletes? HMB could help, irrespective of exercise type - by increasing strength, lean mass and VO2. In the study at hand, all three increased and that is / was in highly trained athletes.

You've read all articles about HMB at the SuppVersity? In that case you will be aware that HMB has hitherto been perceived rather as a strength / bodybuilding than an endurance supplement. Against that background it may come as a surprise that researchers from the Poznán University of Life Sciences in Poland chose to study the effects of HMB on the aerobic capacity (Burkalec-Michalski. 2016), instead of the usual study outcome, the subjects' strength. Is that a bad thing? Not at all!

After all, there are  more sports that require optimal aerobic performance than sports that require (only) optimal strength performance. It thus makes perfect sense that Krzysztof Durkalec-Michalski and Jan Jeszka chose aerobic performance as their primary, but not only study outcome.

Learn more about the potential beneficial effects of HMB at the SuppVersity:

HMB For Fat Loss?

Hica & HMB in Yogurt

More on HMB Free Acid

Breakthrough HMB Science

HMB + Whey = Useless?!

HMB Hampers Fat Loss?

Don't worry, though! With the body composition (unfortunately only BIA data) as second outcome measure, the results the scientists derived in an experiment that involved 58 male athletes aged 22 ± 6 years, with body weight of 82.9 ± 12.3 kg and height of 181 ± 7 cm, practicing wrestling (n = 12), judo (n = 10), Brazilian jiu-jitsu (n = 14), karate (n = 6), and rowing (n = 16) are still interesting and relevant for those of you who don't care that their aerobic conditioning forces them to take the elevator.

The subjects were asked to complete dietary records every second week to ensure that they did not change their dietary habits during the two 12-week supplementation periods during which the subjects alternately consumed HMB or a placebo supplement (for 12 weeks each with 10 days wash-out inbetween).

"The experiments were conducted using a preparation of calcium salt of β-hydroxy-β- methylbutyric acid, produced by Olimp Laboratories. A single capsule contained 1250 mg Ca-HMB, which corresponds to 1000 mg β-hydroxy-β-methylbutyrate. The producer also prepared a placebo preparation containing maltodextrin. The tested group of athletes was administered 3 capsules of the assigned preparation a day, in 3 doses as follows: upon waking, immediately after training, and before sleep. On nontraining days, the participants were instructed to consume one serving with each of three separate meals throughout the day" (Burkalec-Michalski. 2016 | my emphasis).

As you will remember based on previous SuppVersity articles, the HMB dose of 3g per day (in 3x1g doses) is what previous studies have shown to trigger significant improvements in performance and body composition in even shorter times-spans (Nissen. 1996; Lamboley. 2007; Wilson. 2008; Portal. 2011; Zanchi. 2011).

Ca-HMB or free acid? There is no doubt that this is another study to put a questionmark behind the necessity of buying the expensive free acid gel of HMB. More than 90% of the previous (mostly promising) HMB studies have been conducted with calcium HMB consumed either once or, as in this case, thrice a day. In contrast to the functionality of Ca-HMB, however, the increased speed of absorption scientists have observed for the free acid form of HMB has yet to be proven to have practical relevance.

In conjunction with the previously not mentioned blood draws, the weighing and BIA measurements, as well as the ergometer tests that were performed at the beginning and end each of the 12-week study periods clearly support the scientists conclusion that...

"[t]he results indicate that supplying HMB promotes advantageous changes in body composition and stimulates an increase in aerobic capacity, while seeming not to significantly affect the levels of the analyzed blood markers" (Burkalec-Michalski. 2016).

Here, the scientists refer to the observed beneficial effects on fat-free mass (+0.2 kg HMB vs. -1.0 kg PLA, P = 0.021), with a simultaneous reduction of fat mass (-0.8 kg HMB vs. +0.8 kg PLA, P < 0.001), as well as the augmented increases in maximal oxygen uptake (VO2max: +0.102 L·min-1 HMB vs. -0.063 L·min-1 PLA, P = 0.013), time to reach ventilatory threshold (TVT: +1.0 min HMB vs. -0.4 min PLA, P < 0.0001), and the threshold load and heart rate at ventilatory threshold (WVT: +20 WHMB vs. -7 WPLA, P = 0.001 // HRVT: +8 bpm HMB vs. -1 bpm PLA, P < 0.0001).

Figure 1: HMB supplementation lead to sign. improvements in body composition (BIA | Burkalec-Michalski. 2016)

If and to which extent these effects were related to statistically significant increase in testosterone levels (P = 0.047), which, in contrast to the increase in cortisol, occurred only in the HMB group, is difficult to say (see Figure 1).

Figure 2: Changes in testosterone and cortisol during the treatment phase; * p < 0.05 (Burkalec-Michalski. 2016).

In view of the fact that the testosterone to cortisol ratio did not differ significantly in the two groups, it is yet very unlikely that the hormonal changes played a decisive role in terms of the previously discussed study outcomes.

As you can see, the study at hand confirmed that HMB is not a "strength supplement"; increases in VO2max, the ventilatory threshold and even the maximal wattage in trained athletes are an argument in favor of Ca-HMB for every, not just endurance athletes. I mean, who wouldn't want to get faster, stronger, and in better shape.

Bottom line: Even though the supplement company that produced the HMB product that was used in the study is explicitly mentioned in the methodology section of the paper, the authors report "no conflicts of interest with this work". It does therefore appear unwarranted to question the results based on potential bias. What you should question, though, is your own interpretation of the results. The use of HMB did, after all, not provide a steroid-like advantage to the athletes.

What's even more relevant than the effect sizes, though, is the fact that the benefits occurred in the absence of protein supplementation. If we assume that the differences persist and that similar effects would be observed if HMB is consumed on top of three whey protein shakes per day, though, the study at hand provides one of the most convincing arguments in favor of a supplement that is close to being unpalatable (buy caps, boys & girls ;-) | Comment!

References:

• Durkalec-Michalski, Krzysztof, and Jan Jeszka. "The Effect Of Hmb On Aerobic Capacity And Body Composition In Trained Athletes." The Journal of Strength & Conditioning Research (2016).
• Lamboley, Cédric RH, Donald Royer, and Isabelle J. Dionne. "Effects of beta-hydroxy-beta-methylbutyrate on aerobic-performance components and body composition in college students." International journal of sport nutrition and exercise metabolism 17.1 (2007): 56.
• Nissen, S., et al. "Effect of leucine metabolite β-hydroxy-β-methylbutyrate on muscle metabolism during resistance-exercise training." Journal of Applied Physiology 81.5 (1996): 2095-2104.
• Portal, Shawn, et al. "The effect of HMB supplementation on body composition, fitness, hormonal and inflammatory mediators in elite adolescent volleyball players: a prospective randomized, double-blind, placebo-controlled study." European journal of applied physiology 111.9 (2011): 2261-2269.
• Wilson, Gabriel J., Jacob M. Wilson, and Anssi H. Manninen. "Effects of beta-hydroxy-beta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: A review." Nutrition & metabolism 5.1 (2008): 1.
• Zanchi, Nelo Eidy, et al. "HMB supplementation: clinical and athletic performance-related effects and mechanisms of action." Amino acids 40.4 (2011): 1015-1025.

Cardio After Weights! Doing Resistance Before Endurance Training Has More Beneficial Effects on Leptin, Cortisol, Testosterone and Body Composition in Young Men

I can almost guarantee that the results of this study are not sex-specific. Ladies, pick up the weights fater you hit the treadmill, stairmaster, elliptical or other torture instrument you like to use!

It has been a while since the last study on exercise order (cardio or weights first) has been published. Now, scientists from the University of Kurdistan have conducted another study to investigate the effects of intrasession sequencing of concurrent resistance and endurance training on the serum leptin, testosterone, cortisol responses and body composition in obese men.

And don't worry, we are not talking about useless acute-phase data that shows no correlation with either strength or muscle gains, or fat loss (West. 2012). Sheikholeslami-Vatani and colleagues conducted an eight-week study on thirty obese young male students without continuous exercise history (age: 23.2±1.4 year, BMI: 31.8±1.6 kg/m²).

You can learn more about the optimal exercise order at the SuppVersity

Before, After or In-Between?

Exercise Order and Leptin Levels

Cardio First for Anabolism?

Large Muscle Groups First?

Combine Cardio & Strength, Right

Exercise Order Reloaded

The subjects were randomly divided into three groups: concurrent resistance-endurance (CRE, n = 10) group, concurrent endurance-resistance (CER, n = 10) group and control (C, n = 10) group (no training program). The concurrent training groups (CER and CRE) trained three times a week on alternate days for 8 weeks. The training itself consisted of which consisted of ...

"running with 70—75% of maximal heart rate (HRmax) for 10 minutes which gradually increased to 80% HRmax for 21.5 minutes [plus] resistance training consisted of 3 sets of 8 repetitions at 80% of 1 repetition maximum (1RM) in 5 resistance exercises (leg extensions, lying leg curl, triceps pushdown, bench press and lateral pull down)" (Sheikholeslami-Vatani. 2015). 

In-between the endurance and resistance (or vice versa) training parts of the workouts, the subjects rested for 5 minutes. Blood sampling and skin-fold measurements to asses the body composition was conducted 48 hours before the start of the course and again 48 hours after the last training session (learn why waiting longer for the body comp test may have been better, but no study does that).

Figure 1: Relative changes in hormone levels (left) and absolute and relative changes in body fat fat free mass and body fat % (right) after 8 weeks of doing nothing (C) or doing cardio (CER) or weights (CRE) first (Sheikholeslami-Vatani. 2015).

I've plotted the most important results in Figure 1a & b. So, let's take a look: The first thing that everyone should see is that both workout regimen had relevant health and physique effects:

• 

  Similar gains w/ weights vs. cardio first in trained men | more.

  normalization of leptin levels (health)
• slight increases in testosterone (health)
• increases in cortisol (which are benign | learn why)
• significant reductions in body fat (health + physique)
• increases in fat free mass (health and physique)

In that, the resistance training first (CER) group came off slightly better in all tested study outcomes. Statistical significant inter-group differences, however, were observed only in comparison to the control group. In view of the fact that the body fat (total and %) improvement reached statistical significance compared to control only in the endurance first, group, yet not in the strength first group, one may still argue that the difference between cardio first (CER) and weights first (CRE) was "almost significant" ;-)

Weights or Cardio? What's the Best Visceral Fat Burner + How Often, Long and Intense Do You Have to Train | Learn more!

So, weights first is the way to go? Well, I assume I should write that doing both on separate days and thus doing having 5-6 workout days per week may have even more pronounced effects on the body composition of obese young men. In the end, though, I have no evidence to prove that doing the same amount of cardio on a separate day would actually have yielded greater improvements in body composition. Against that background and in view of the fact that three workouts per week is everything that fits into the busy schedules of the average trainee, we are left with the confirmation that (a) doing (intense) cardio and weights in one session feasible and effective when the goal are health and physique improvements and that (b) if you or your clients combine both, you better start with the weights, not the cardio part | Comment!

References:

• Sheikholeslami-Vatani, D., et al. "The effect of concurrent training order on hormonal responses and body composition in obese men." Science & Sports (2015).
• West, Daniel WD, and Stuart M. Phillips. "Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training." European journal of applied physiology 112.7 (2012): 2693-2702.

Low Grade Metabolic Acidosis May Eat Away Your Bones and Blow Up Your Belly Via Empowering Glucocorticoids!

The way we eat and live is not just obesogenic it is also acidogenic... or is the former just a consequence of the latter? 

I've written about the nasty effects of low grade metabolic acidosis which include calcium loss and brittle bones, nitrogen / protein loss and decreased protein synthesis, impaired growth hormone and IGF-1 production and more in a 2013 SuppVersity Science Round-Up (read it).

For you, as a SuppVersity veteran who's read this and related articles, it should thus not be surprising that scientists from the German Aerospace Center in Cologne were now able to establish a new, mechanistic link between the "long-term ingestion of habitually acidifying western diets may constitute an independent risk factor for bone degradation and cardiometabolic diseases" (Buehlmeier. 2015).

As Judith Buehlmeier and her colleagues point out, we have long been aware of the ill effects of low-grade metabolic acidosis (LGMA), as induced by high dietary acid load or sodium chloride (NaCl) intake and a lack of alkaline foods and nutrients in the average Western diet. What has hitherto not been fully elucidated is the underlying mechanisms, which is not as simple as the dissolving tooth in a glass of coke would suggest.

You can learn more about bicarbonate and pH-buffers at the SuppVersity

The Hazards of Acidosis

Build Bigger Legs W/ Bicarbonate

HIIT it Hard W/ NaCHO3

Creatine + BA = Perfect Match

Bicarb Buffers Creatine

Alkalosis Boosts Muscle Activity

In their latest study, the researchers from the German Aerospace Center in Cologne and their colleagues from the Universities of Bonn and Heidelberg do now present the first convincing evidence that the previously cited catabolic / anti-anabolic effects of chronic low-grade acidosis (LGMA) are triggered by interactions of the acid–base balance with the metabolism of glucocorticoids (GC). In said, study, the researchers "aimed to investigate GC activity/metabolism under alkaline supplementation and NaCl-induced LGMA" in eight young, healthy, normal-weight men who participated in two crossover designed interventional studies.

Figure 1: Correcting a diet-induced low grade metabolic acidosis with K-bicarbonate reduces the nitrogen loss of 750mg - 1000mg per day (per 60kg BW) in post- menopausal women in a prev. study (Frassetto. 1997)

• In Study A, two 10-day high NaCl diet (32 g/d) periods were conducted, one supplemented with 90 mmol KHCO3/day.
   
• In Study B, participants received a high and a low NaCl diet (31 vs. 3 g/day), each for 14 days. During low NaCl, the diet was moderately acidified by replacement of a bicarbonate-rich mineral water (consumed during high NaCl) with a non-alkalizing drinking water. 

In repeatedly collected 24-h urine samples, potentially bioactive GCs (urinary-free cortisol / free cortisone), as well as tetrahydrocortisol (THF), 5a-THF, and tetrahydrocortisone (THE), were analyzed.

Even Low Grade Acidosis Will Increase Your Diabetes Risk | learn more!

Beware! It does not take much to mess you up! A quantitative analysis of the data from the study at hand shows that even increases of dietary acid loads in the magnitude of only 30 mEq/d, which drive the renal net acid excretion into a range that is commonly seen in people on the standard Western diet (60–70 mEq/d), suffice to affect glucocorticoid activity in ways that may ruin your bone, heart and muscle health. In that, the main offenders are grains, not meats. Grains contribute an estimated 38% to the net acid load of the avg. Westerner (Sebastian. 2002).

A brief glimpse at the glucocorticoid levels in the urine of the subjects (see Figure 2) shows that with supplementation of 90 mmol KHCO3, the marker of total adrenal GC secretion dropped (p = 0.047) and potentially bioactive-free GCs were reduced (p = 0.003).

Figure 2: aily adrenal cortisol secretion as indexed by the sum of excretion rates of the 3 major urinary glucocorticoid (GC) metabolites tetrahydrocortisol, 5a-tetrahydrocortisol, and tetrahydrocortisone (THF + aTHF + THE) as well as excretions of potentially bioactive-free GCs (UFF + UFE | Buehlmeier. 2015)

This is particularly interesting if we also take into account that in Study B, the GC secretion and potentially bioactivefree GCs did not exhibit the expected fall with NaCl-reduction as net acid excretion was raised by 30 mEq/d. In conjunction study A + B do thus underline the important role of alkalizing agents like bicarbonate or potassium - irrespective of the total intake of NaCl, of which the study at hand confirms that it is part of the problem. Its ill effects, however, appear to be mediated mainly, if not exclusively, via the acidifying effects of chloride.

Bottom line: As the authors point out, their study is the first to provide convincing evidence that the ill effects of chronic low-grade metabolic acidosis are mediated via enhanced glucocorticoid activity and secretion. In that, the pro-acidic effects of NaCl, as well as the lack of alkalizing foods and nutrients in the Western diet are the main motors of dietary induced glucocorticoid elevations.

Inactivity amplifies the ill effect of glucocorticoids on muscle loss by up to 213% (Ferrando. 1999).

These elevations are - in spite of being still in the physiological range - significant enough to compromise bone quality (Bedford. 2010; Shi. 2015), cardiometabolic health & diabetes (Prodam. 2013; Qi, 2007), and protein turnover (Frassetto. 1997 | see Figure 1; Buehlmeier. 2012), and appear to be particularly unfavorable under conditions of physical inactivity (Ferrando. 1999 | see Figure on the right). Reason enough for the authors to conclude that "[a]ccordingly, higher dietary acid loads may, in the long run, constitute an independent GC-driven musculoskeletal and cardiometabolic risk factor related with western dietary habits" (Buehlmeier. 2015) | Comment!

References:

• Bedford, Jennifer L., and Susan I. Barr. "The relationship between 24-h urinary cortisol and bone in healthy young women." International journal of behavioral medicine 17.3 (2010): 207-215.
• Buehlmeier, Judith, et al. "Alkaline salts to counteract bone resorption and protein wasting induced by high salt intake: results of a randomized controlled trial." The Journal of Clinical Endocrinology & Metabolism 97.12 (2012): 4789-4797.
• Ferrando, Arny A., et al. "Inactivity Amplifies the Catabolic Response of Skeletal Muscle to Cortisol 1." The Journal Of Clinical Endocrinology & Metabolism 84.10 (1999): 3515-3521.
• Frassetto, L., R. Curtis Morris Jr, and A. Sebastian. "Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women." The Journal of Clinical Endocrinology & Metabolism 82.1 (1997): 254-259.
• Qi, Dake, and Brian Rodrigues. "Glucocorticoids produce whole body insulin resistance with changes in cardiac metabolism." American Journal of Physiology-Endocrinology and Metabolism 292.3 (2007): E654-E667.
• Prodam, Flavia, et al. "High-end normal adrenocorticotropic hormone and cortisol levels are associated with specific cardiovascular risk factors in pediatric obesity: a cross-sectional study." BMC medicine 11.1 (2013): 44.
• Sebastian, Anthony, et al. "Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors." The American journal of clinical nutrition 76.6 (2002): 1308-1316.
• Shi, Lijie, et al. "Higher glucocorticoid secretion in the physiological range is associated with lower bone strength at the proximal radius in healthy children: importance of protein intake adjustment." Journal of Bone and Mineral Research 30.2 (2015): 240-248.