Hair Loss: Finasteride, Laser Light or Minoxidil - What Will Really Help Men & Women Regrow Lost Scalp Hair?

Men may be at a higher risk, but androge-netic hair loss is not a male exclusive.

Minoxidil, Finasteride, and low-level laser light therapy are Food and Drug Administration-approved/-cleared treatments for androgenetic alopecia, but do they actually work? That was one of the questions Areej Adil and Marshall Godwin tried to answer in a recent review; a systematic review and meta-analysis the scientists from the Memorial University of Newfoundland published in the Journal of the American Acadamy of Dermatology very recently and a paper of which its authors claim that I will clear up the confusion about the seemingly conflicting results of individual studies.

If your scalp is not your weak area, try these exercise to shed fat and gain muscle.

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Hula Hooping to Spot Reduce in the Midsection

For their paper, Adil and Godwin searched the usual suspect databases, i.e. PubMed, Embase, and Cochrane including all relevant articles that were published before or in December 2016, with no lower limit on the year. Included were only randomized controlled trials (RCT) of "good or fair quality based on the US Preventive Services Task Force quality assessment process" (Adil 2017). The initial search produced a list of 45 articles of which 22 were excluded.

The "Norwood-Hamilton" classification is used to qualify the degree and type of hair loss. IIIa-V is the type subjects in most studies in this meta-analysis had. If you have hair loss and want some hints that may help you identify the type and cause of losing hair, check out this free article in the American Family Physician.

Eventually, the scientists' insights into the efficacy of nonsurgical treatments of androgenetic alopecia in comparison to placebo for improving hair density, thickness, growth were thus based on 23 papers - and 24 interventions.

• 4 studies on minoxidil 5% in men
• 5 studies on minoxidil 2% in men
• 5 studies on minoxidil 2% in women
• 3 studies on low-level laser light (LLLLT)
• 4 studies on finasteride 

Based on this dataset Adil et al. conducted a separate meta-analysis for 5 groups of studies that tested the following hair loss treatments: low-level laser light therapy in men, 5% minoxidil in men, 2% minoxidil in men, 1 mg finasteride in men, and 2% minoxidil in women.

Women w/ increased hair shedding tend to have low ferritin and high folate levels (Rushton 2002).

Other forms of hair loss and treatments: I can only repeat that the results of Adil's & Marshall's study apply only to subjects with androgenetic alopecia, which is one of the most common forms of hair loss in men and can be observed increasingly often in women. Hair is usually lost in a well-defined pattern, beginning above the temples (you can see this early stage in Figure 1 cf. degrees I+II).

Accordingly, finasteride is only useful with androgenetic alopecia (in men or PCOS women). Minoxidil and low-level laser light therapy, which both seem to work by increasing scalp blood flow, on the other hand, may work for other forms of hair loss, too (e.g. due to metabolic disease).

Other common reasons for hair loss are caloric deprivation or deficiency of several components, such as proteins, minerals, essential fatty acids, and vitamins. If a nutrient deficiency is, in fact, the reason you're losing hair, supplements containing l-lysine and/or l-cysteine, biotin, B12, zinc, niacin, essential fatty acids or iron have some scientific back-up to help in deficiency or low-intake scenarios (Rushton 2002; Finner 2013). Overdoses of selenium or vitamin A, on the other hand, can easily trigger hair loss.

In addition to these well-known essentials of healthy hair growth, studies also suggest that taurine supplements can promote follicle cell survival - at least in vitro. Furthermore, evidence exists that carnitine can stimulate hair follicle cells and components derived from soybeans may also have an effect on hair growth through anti-inflammatory and estrogen-dependent mechanisms. None of these treatments, however, will achieve similar benefits as LLLLT or minoxidil outside of full-blown nutrient deficiencies (esp. in women, iron can work wonders though if they are sign. deficient). Insufficient evidence exists for the effects of topical caffeine or caffeine shampoos. While studies do confirm that caffeine will accumulate in the skin, "it must be borne in mind that penetration and accumulation cannot be equated with stimulation of the hair root" (Dressler 2017).

All treatments were superior to placebo (P < 00001) in the 5 meta-analyses. Other treatments were not included because the appropriate data were lacking.

Figure 2: The meta-analysis confirms the efficacy of each and every of the treatments (Adil 2017).

The meta-analysis main message is: these treatments actually work. Or, to say in the scientists' own words:  "all treatments were superior to placebo (P < 00001)" (Adil 2017). In that, it should be obvious that the majority of studies investigating treatments for androgenetic alopecia were done in men. However, with the ever-increasing number of women (both obese and normal-weight) suffering from PCOS, it is particularly interesting to see that the over-the-counter minoxidil solutions (for women those are usually dosed at "only" 2%) are similarly effective as the high(er)-dose treatments for men.

How much hair can you expect to regrow?

For women Adil et al. (2017) report an average increase in hair growth amounted to 112.41 hairs/cm² in response to 2% minoxidil (vs. placebo). For men, the treatments that showed a mean difference in hair count listed from highest to lowest for men are

• finasteride 1 mg daily - 18.37 hairs/cm²,
• low-level laser light therapy (LLLLT) - 17.66 hairs/cm², 
• 5% minoxidil twice daily - 14.94 hairs/cm², 
• 2% minoxidil twice daily - 8.11 hairs/cm², and
• platelet rich plasma injections (3 months post) - 27.6 hairs/cm² (see bottom line)

In view of its - in some cases - extreme systemic (side) effects and considering the fact that it was the only treatment in which the scientists observed a significant heterogeneity (I² = 91%; P < 0.001 | note: I² statistic describes the percentage of variation across studies that is not due to chance), I would clearly recommend you stay away from finasteride until you've tried all the other venues.

Addendum: Using platelet-rich plasma as a "one-time" treatment alternative

Figure 3: Scalp of 29-year old at baseline (left) and 3 months (right) after treatment w/ PRP (Gkini 2014).

Studies investigating the effects of platelet-rich plasma injections, such as Gkini et al. (2014), found significant increases in hair growth after only three treatment sessions that were performed with an interval of 21 days. The unfortunate truth, however, is that, after a peak at 3 months (see photo on the right for a visual of the results in a 29-year old man | +27.6 hairs/cm²), the hair density started declining again and a single "booster session" after 6 months alone only slowed that decline, it didn't reverse it. Accordingly, it would seem as if you'd have to undergo the procedure thrice a year to get optimal results.

Speaking of which: Other studies confirm the observations Gkini et al. made, reporting an average increase of 28.37 hairs/cm² (45.9 hairs/cm², 12.3 hairs/cm² and 27.7 hairs/cm² in Gentile 2015; Kang 2009 and Cervelli 2014, respectively).

Quite impressive, but, with an average cost of $300-$500 per session, i.e. $900-$1500 for a single treatment, not exactly cheap (make sure the PRP for the is produced from your blood according to a standardized procedure - Gentile et al. for example combined PRP they extracted using the Cascade-Selphyl-Esforax system and PRP extracted according to the P.R.L. Platelet Rich Lipotransfert system).

Don't make a mistake: Unless it's an ultra-sophisticated device with a broad range of frequencies and emitters you cannot use the same low-level-laser-light therapy device for performance enhancement and hair growth.

What to do if you're losing/have already lost hair? At least if your hair loss is a result of being genetically predisposed to androgen-induced hair loss, there's hope: all four treatment options Adil and Gowin analyzed in their latest systematic review are scientifically backed.

With that being said, the low-level laser light therapy has the best risk-benefit, while the 5% (in men) and 2% (in women) have the best cost-benefit-side effect ratio... at least in the short run. In the long run, it may be more economical to invest $250+ in a home LLLLT-device (Leavitt et al. (2009), for example, used a cheap HAIRMAX Laser Comb and found sign. effects compared to a sham device after 26 wks).

Speaking of the costs: If you choose minoxidil, you can save up to 50% if you avoid the highly advertised "R*****" and buy a cheap generic form of minoxidil 5%. Also: keep in mind that all treatments will have to be used/applied regularly: With finasteride and minoxidil being taken/used every day and low-level laser light therapy 2-3 times per week | Comment on Facebook!

References:

• Adil, Areej, and Marshall Godwin. "The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis." Journal of the American Academy of Dermatology (2017).
• Cervelli, V., et al. "The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: clinical and histomorphometric evaluation." BioMed research international 2014 (2014).
• Dressler, Corinna, et al. "Efficacy of topical caffeine in male androgenetic alopecia." JDDG: Journal der Deutschen Dermatologischen Gesellschaft 15.7 (2017): 734-741.
• Finner, Andreas M. "Nutrition and hair: deficiencies and supplements." Dermatologic clinics 31.1 (2013): 167-172.
• Gentile, Pietro, et al. "The effect of platelet‐rich plasma in hair regrowth: a randomized placebo‐controlled trial." Stem cells translational medicine 4.11 (2015): 1317-1323.
• Gkini, Maria-Angeliki, et al. "Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period." Journal of cutaneous and aesthetic surgery 7.4 (2014): 213.
• Kang, J‐S., et al. "The effect of CD34+ cell‐containing autologous platelet‐rich plasma injection on pattern hair loss: a preliminary study." Journal of the European Academy of Dermatology and Venereology 28.1 (2014): 72-79.
• Leavitt, Matt, et al. "HairMax LaserComb® laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial." Clinical drug investigation 29.5 (2009): 283.
• Rushton, D. H. "Nutritional factors and hair loss." Clinical and experimental dermatology 27.5 (2002): 396-404.

Reductive Stress: An Argument Against Anti-Oxidants for Athletes & Everyone Else? Plus: AGE-Reduced Diets for Health & Weight Loss & Iron For Women in the Military

It's sort of funny that the mental fatigue is reduced, but the physical performance stagnates w/ iron supplementation.

You will probably already have seen the results of the latest study from the Norwegian School of Sport Sciences which provides additional evidence that "vitamin C and E supplementation interfere[s] with exercise-induced signalling in muscle cells after a session of strength training, by reducing the phosphorylation of p70S6K and mitogen activated protein kinases (MAPKs: p38 and ERK1/2)", two proteins with significant effect on the exercise induced increase in protein synthesis and corresponding increases in the overall adaptation to exercise, and "have the potential to adversely affect cellular adaptations to exercise in healthy individuals." (Paulsen. 2014).

To put this results into perspective I will briefly recap the main message of a corresponding review of the "sense and non-sense" of antioxidant supplementation in athletes from the University of Florida  to kick off today's installment of the Short News that will then turn towards the beneficial health and anti-obesity effects of AGE-reduced diets and the need for iron supplementation in physically active women.

Read more short news at the SuppVersity

Exercise Research Uptake Nov '14 1/2

Exercise Research Uptake Nov '14 2/2

Weight Loss Supplements Exposed

Exercise Supplementation Quickie

Skipping Break- fast & More to Control Weight

HIIT, Caffeine & Other Success Boosters

• Antioxidant supplementation in athletes, sense or non-sense? The bottom-line of the latest review of the literature appears to be clear: Non-sense! Why? Well, according to Powers & Sollanek (2014)...
• Regular bouts of endurance exercise will increase the endogenous antioxidant enzymes in the trained skeletal muscles. In view of the fact that this translates to an improved ability to protect against exercise-induced oxidative stress in skeletal muscles, supplements appear to be less useful for athletes than they are for sedentary individuals, anyways. 

• 

  Figure 1: . Illustration of the relationship between radicals (i.e., oxidants) and antioxidants in the determination of redox balance (i.e., balance between oxidants and antioxidants). Note that an increase in radicals or antioxidants results in a disturbance in redox balance. Figure from Powers & Sollanek (2014), redrawn from Powers et al. (2004)

  While there is consistent evidence of the beneficial health effects of an increased fruits and vegetables consumption, foods have two major advantages over vitamin supplements: (1) they contain a plethory of compounds with antioxidant activity, which differ in their cellular locations and radical scavenging capacity and will thus act synergistically; and (2) the amount of antioxidants is small enough to assume that ther is a limited risk of an antioxidant "overdose" and consequent i.e. "reductive stress" (see Figure 1) by consuming a diet rich in both fruits and vegetables.
• In contrast to fruits and vegetables, the ingestion of megadoses of antioxidant via dietary supplements (e.g., vitamin E) can increase the risk of toxicity and the associated possibility of negative health consequences.
Accordingly, the authors of the review conclude that "consuming megadoses of antioxidants via supplements is not recommended" (Powers. 2014).


• An AGE restricted diet reduces serum AGE and indices of body fat, study shows. In a 12 week randomized, controlled study scientists from the Universidad Guanajuato observed that the consumption of an AGE-reduced diet alone and in conjunction with exercise lead to a decrease in serum advanced glycation end product (AGE) levels and body fat - the addition of exercise provided additional benefits and lead to significant reductions in blood lipid levels.
  

  

  Figure 2: Changes in weight, waist, fasting blood glucose and blood lipids after 12 weeks on AGE reduced diet, exercise and exercise + AGE reduced diet (Macías-Cervantes. 2014)

  What is difficult to tell, though, is whether the reduction in body fat is a result of reduced AGE-levels in the diet and corresponding reductions in the blood of the participants or simply a consequence of eating a healthier diet - I mean, food products that are high in AGE are characteristic of the modern Western junk-food diet. It is thus also not surprising that the low AGE diet was both ~50% lower in AGEs and 26% lower in energy.
   
• Iron supplementation improves indicators of iron status and emotional fatigue in female offiers-in-training, study shows. Researchers who are working for the US military have recently been able to show that the exercise-induced decrease in iron-status in female officers during military training can be ameliorated by supplements with 18mg of iron that were consumed on a daily basis over the course of the 13-week study (Boot. 2014).
  

  

  Figure 3: Changes in selected markers of fatigue in iron vs. placebo supplemented women (Booth. 2014)

  As you can see in Figure 3 the provision of extra iron did not just blunt the decrease in serum ferritin in the ADFA students who participated in around 20 hours of classes (mainly lectures) and 2–7 hours of organized physical training (PT) per week, it did also have a significant effect on the emotional fatigue (-4.2 to -0.6 95% CI, P = 0.04).
  
  What is somewhat surprising, though, is that the effects on physical fatigue parameters were neither significant, nor positive.

Bottom line: There are new studies on the effects of food and supplements on our health on a daily basis. Things that we believe to be true today may be falsified tomorrow and agents that may be good for some people (like iron for athletes) and potentially bad for others are rather the rule than the exception.

D-aspartic acid: When study cherry picking turns a useless supplement into a mega-seller | learn more

Accordingly, it's important to look beyond the ostensibly obvious results like "low AGE diets promote fat and weight loss". While this may be true, even the cursory analysis of the study results in today's SuppVersity short news indicates that the obvious conclusion that reducing AGEs would mechanistically reduce body fat is probably flawed. Rather than that people who avoid high AGE foods will necessary avoid foods with high energy density, consume less energy and lose weight in response to a reduction in energy intake - not in response to the reduced intake of AGEs. Problems like these are why it is important to look beyond the conclusions in the abstracts and / or come back to the SuppVersity regularly for short and in-depth analyses of the latest studies | Comment on Facebook.

References:

• Booth, Christine K., Julia E. Carins, and Iain K. Robertson. "Randomised double-blind, placebo-controlled trial of iron supplementation attenuates fatigue and declining iron stores for female officers-in-training." RegisteR Now! 22.3 (2014).
• Paulsen, G., et al. "Vitamin C and E supplementation alters protein signalling after a strength training session, but not muscle growth during 10 weeks of training." The Journal of Physiology (2014). 
• Powers, Scott K., et al. "Dietary antioxidants and exercise." Journal of sports sciences 22.1 (2004): 81-94.
• Powers & Sollanek. "Endurance Exercise And Antioxidant Supplementation: Sense Or Nonsense?-Part 1." Sports Science Exchange 27.137 (2014): 1-4.

Low Fat Toddler, High Fat Adult?! Intra-Workout Carbs More 'Anabolic' Than Protein!? Iron Prevents Gastric Cancer & Insulin Resistance?! Plus: A Sixpack of Kettlebell Studies

If you want to know exactly how your neighbors or rather your county did, check out the CDC's brand new County Data Interactive Atlas (may take some time to load), select your state and click on your county. Unfortunately, it's not exactly likely that you will be pleasantly surprised after all, places with rates below 6.5% (white on the map) have become rare, while those with 11.2% or more are becoming the norm.

"100%" - In words: One hundred percent, that's the SuppVersity figure of the week and at the same time the rate at which the prevalence of diagnosed diabetes in 14 of the US states grew faster in the years between 1995 and 2000 than previous estimates had predicted. The CDC has published this figure along with more information and the link to their brand new County Data Interactive Atlas in their weekly report on November 15, 2012. The Top 5 offenders on the list that's attached to the report are (1) Oklahoma (226 percent), (2) Kentucky (158 percent), (3) Georgia (145 percent), (4) Alabama (140 percent), and (5) Washington (135 percent).

No reason to worry, though, my American friends! According to their own assessment, the CDC and its partners are working on "a variety of initiatives to prevent type 2 diabetes and to reduce complications in those already diagnosed."... you see,all is going to be good! Your well-meaning government is taking care of the problem ;-)

I guess that's enough sarcasm and useless statistics for the day. Let's get down to some serious On Short Notice business, now. And what would be more obvious than to start with something that's probably still not on the radar of the CDC or any its smart partners over at the NIH who are still promoting a high carb + low fat diet to people who can hardly tolerate the amount of carbohydrates in a TicTac. What I am talking about? The predispositioning effects of a fat-deficient toddler diet...

• Fat loving toddlers grow up to be leaner adults (Rolland-Cachera. 2012) -- To determine whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years, a group of researchers from the University of Paris analyzed data from 73 subjects, who had been part of a two-decade-long prospective study (ELANCE, Etude Longitudinale Alimentation Nutrition Croissance des Enfants).
  
  
  Associations of specific factors that increase the risk of being obese in the kindergarten as based on another study that's also been published ahead of print in the online version of Obesity (Flores. 2012):
  

  • born to an obese mother + 240% risk
  • gestational diabetes and gestational diabetes + 190%
  • drinking tea or coffee between meals before bedtime at 2 years old +230% and drinking sugary beverages at kindergarten age at least weekly + 130%
  • Latino or multiracial + 130% race ethnicity
  • ever-attending center-based daycare -70%
  • eating fruit at least weekly at kindergarten age -70
  • maternal history of a prior newborn birth weight greater than or equal to 4000g -90%

  If you do have or plan to have kids, you should maybe make a mental note on some of these.
  The kids, now all young adults had been examined twice, at the age of 10 months and with 2 years. During the recent followup, the  body weight, height, subscapular and triceps skinfold thicknesses, fat mass (FM), fat-free mass (FFM) and serum leptin concentration of the young adults (now twenty years of age) were recorded in order to identify associations between early nutrition and adult body weight.
  
  The adjusted linear regression models Rolland-Cachera and colleagues used to analyze the data actually showed a couple of significant associations, the first one of which, i.e. the fact thatan increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness (β=6.4%, P=0.002) and higher FFM (0.50 kg, 0.06–0.95, P=0.03) at 20 years, seems to stand in line with the hilarious calories-in-vs-calories-out hypothesis. However, these associations could also be related to the fact that early nutrition will program our satiety response, so that those programmed to be "good eaters" by a less nurturing diet in their earliest childhood will remain "good eaters", even when they switch to the energy-laden standard American diet.
  
  Against that background, the second significant association the researchers observed, i.e. the fact that an increase by 1% energy from fat at 2 years was associated with lower subscapular skinfold thickness (−2.3% SF, −4.41 to −0.18, P=0.03), lower FM (−0.31 kg, −0.60 to −0.01, P=0.04) and lower serum leptin concentration (−0.21 μg l−1, −0.39 to −0.03, P=0.02) at 20 years appears to be even more important. After all, it looks like the Rolland-Cachera et al. had found the first relatively convincing evidence (not proof, yet) for the negative metabolic effect of early low fat diets in human beings:
  

  "Low-fat intake in early life was negatively associated with body fat (particularly at the trunk site) and serum leptin concentration at 20 years, suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages. These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity." (Rolland-Cachera. 2012)

  Now let's just hope that scientists are actually tackling these "new directions" and - more importantly - that the respective results are recognized by the public and incorporated into the "dietary guidelines".
• Study suggests: If you could chose only one, your intraworkout nutrition should be a carbohydrate not a protein supplement (Kazemzadeh. 2012) -- This is at least the authors' own interpretation of the results of a recent study that was conducted by three researchers from the Azad University and the Teheran University in Iran.
  
  

  

  Figure 1: Changes in hormone levels from pre to post exercise (Kazemzadeh. 2012). If you focus solely on statistical significance you can be likewise mislead as, when you don't even check whether you findings are significant at all.

  According to the statistically significant part of the hormonal response of the 18-25-year-old subjects (university students who selected physical training course, but had no prior training experience), the consumption of an intra-workout supplement containing either 10 ml/kg of a 6% glucose solution was in fact "less catabolic" than during the same strength training routine with a 0.2 g/kg protein shake (PRO group) as an intra-workout supplement. On paper that's certainly true: The increased insulin response "enhances removal of amino acids and synthesis of proteins after the resistance exercise, on the one hand, and decreases the activity of proteolytic enzymes" (Kazemzadeh. 2012) and the non-existant increase in cortisol is in fact what scientists have long heralded as the goto indicators of anabolism.
  
  
  Note: Just as most of these studies the participants did not consume breakfast before the resistance exercise session, which comprised six selected exercises: The bench press, biceps curl with barbell, side stretch, leg press, knee stretch, knee bending. If the study had been conducted after a regular breakfast ~2-3h before the workout, the study could have yielded totally different effects with respect to both, the blunted insulin, as well as the increased cortisol response. On the other hand, the GH spike in the protein group would most certainly have been lower as well. After all, the latter is - as you may have read in the SuppVersity Facebook News earlier today - basically only a means by which your body taps into its fat reservoirs to satisfy his acute energy demands and not strictly a way to protect lean mass (Gahete. 2012).
  I do still have serious doubts about the real-world significance of the temporary blunt in cortisol. After all, the immediate post-workout response is, in contrary to sustained elevations of cortisol levels for hours or days after a workout, associated with an increase, not a decrease in skeletal muscle hypertrophy (West. 2012) and in essence nothing else, but a physiological adaptation that's necessary to maintain stable blood glucose levels during strenuous workouts and sooth the early burst of inflammation after a workout. Moreover, despite being only borderline significant, only the protein shake did increase growth hormone (p=0.057), testosterone (p=0.52) and IGF-1 (p=0.51) levels during the workout.
  
  This does not necessarily refute the benefits of carbohydrate supplementation during a workout, but if you insist on maximizing gains (not necessarily all lean I would guess) at all costs, it may be wise to consume a slow digesting protein + some fiber-laden carbs like oats 1-2h before a workout, to sip a light carbohydrate + BCCA drink intra- and wash everything down with another shake w/ whey protein and one or two bananas afterwards instead of just drinking some sugar water while you are lifting.
• Iron is a negative predictor of gastric cancer in humans and lowered hemoglobin and hematocrit levels induce insulin in rodents (Cook. 2012; Davis. 2012) -- While the alpha-tocopherol, beta-carotene cancer prevention study was a failure (at least with respect to the expected benefits of the anti-oxidants), there are still a couple of interesting side-findings.
  
  

  

   Meat-Ology: The Link Between Red Meat, Cooking Techniques & Prostate Cancer

  One of these side-findings pertains to the touted effects of increased iron intake on the etiology of gastric cancer, which is simply not existent. According to Cook et al. there were statistically significant negative associations for ferritin in the 2nd, 3rd quartile (-33% risk and -48% risk, respectively) and a borderline significant risk reduction of -31% for overall gastric cancer in the highest quartile (>241 ng/ml) and statistically nonsignificant decreases in gastric cancer risk for total iron, transferrin saturation and total dietary iron intake per 1,000kcal/day in the 2nd-4th quartiles of the respective serum parameters.
  
  That said, subsequent adjustments for H. pylori and then gastric atrophy did not materially affect a majority of the estimates ...
  

      "[...] the only exception was that the relationship  between ferritin and GNCC [Gastric noncardia cancer] was attenuated  There was little evidence for direct associations between iron metrics and H. pylori seropositivity or gastric atrophy (low pepsinogen I)—only serum ferritin appeared to share a relationship with these variables, and this relationship was stronger between ferritin and gastric atrophy." (Cook. 2012)

  So if "red meat is bad for you" it is probably not the iron content of the meat that is responsible for the observed associations of gastric cancer and high red meat intake in some previous studies (cf. WCR Fund. 2011).
  
  And with respect to its effect on glucose metabolism, a recent rodent study has just shown that a reduction in hemoglobin and hematocrit due to a lack of dietary iron does actually impair, not improve glucose management in otherwise healthy rodents fed an iron-deficient diet:
  

  

  Figure 2: Blood glucose, insulin and triglyceride on iron sufficient / deficient high sugar (AIN-76) or high starch (AIN-93) died (Davis. 2012)

  "Hemoglobin and hematocrit were significantly reduced in both ID groups compared to the C  and PF groups. Similarly, animals in the both ID groups exhibited elevated steady-state levels of blood glucose and insulin [...]
  
  [Moreover, hepetic]epatic gene expression analyses revealed a ~4-  and 3-fold increase in the expression of glucokinase and pyruvate dehydrogenase kinase-4 mRNA, respectively, in the ID group on either diet compared to their respective PF [pairfed on iron sufficient diets] counterparts" (Davis. 2012)

  The accompanying negative effects on triglycerides and fatty acid synthesis and storage Davis et al. observed were yet exclusive to the animals who received a high succrose iron-deficient diet.
• Vitamin C, D & E in health not disease - Only alpha-tocopherol shows negative correlation with markers of inflammation (Garcia-Bailo. 2012)-- A very recent study that has been conducted by researchers from the University of Toronto and the University of Guelph did not find any relation between the novel and the old savior of the human race, i.e. vitamin D and C, respectively and expression of inflammatory cytokines.
  
  

  

  Suggested read: "Are Vitamin Supplements Bad For Me (1/2)? The wrong Vitamin E Supplements Increase Cancer Risk."

  Plain Vitamin E in its alpha-tocopherol form, which has almost been written off after the selenium + E (and E only) cancer trials, on the other hand, showed statistically significant correlations with interferon-gamma and RANTES, a pro-inflammatory cytokine that is also known as CCL5 and the acronym for "egulated and normal T cell expressed and secreted" plays an important role in various immune processes, such as recruitment of leukocytes to sites of inflammation and mediating T cell and monocyte traffic. In view of the fact that this cytokine has also been shown to increase angiogenesis and is generally elevated in several inflammatory conditions, including atherosclerosis, these results would suggest that keeping an eye on your E-levels is about as, if not more important for young healthy individuals than vitamin C and D.
  
  If you also consider the fact that IL-1RA (by the way not necessarily inflammatory), interferon gamma, IP-10, PDGF-bb and RANTES were the only out of 27 cytokines the researchers initially measured with high enough concentrations to be detect accurately in the 1007 subjects with a BMI of ~23 and a weekly activity level of ~7Met, these results do also provide substantial evidence that it would probably be worth spending more money on studies that investigate  what it is that makes normal people healthy, instead of spending bazillions of dollars into the 1001st study on how people with XYZ (pt your favorite disease here) have low vitamin D levels *yawn*.

• 

  Check out the Website of the Reigning Canadian Kettlebell Biathlon Champion, Ameer Rosic for some workout videos

  A sixpack of kettlebell studies to remind trainers and trainees, alike, that there are more things you can lift than just dumbbells and barbells (various authors) -- I have never gotten hooked to kettlebells myself and would never agree to exchange my barbells and dumbbells for the finest set of kettlebells for more than one week, but if you take a look at some of the studies that have been published in the past 12 months or so, there is sufficient evidence to suggest that the incorporation of kettlebell workouts into your routine, as a means to provide new muscular and metabolic stimuli, could yield highly beneficial results:
  

  Kettlebell swings restore and enhance back health and function (McGill. 2012) On the basis of electromyography, ground reaction forces (GRFs), and 3D kinematic data the researchers determined that kettlebell swings create a "hip-hinge squat pattern characterized by rapid muscle activation-relaxation cycles of substantial magnitudes (∼50% of a maximal voluntary contraction [MVC] for the low back extensors and 80% MVC for the gluteal muscles with a 16-kg kettlebell) resulting in about 3,200 N of low back compression." The way the swings activate the abs and the unique loading patterns of the posterior shear of the L4 vertebra on L5, which is opposite in polarity to a traditional lift could make it a valuable tool in re- and prehab.	Kettlebell swing training improves maximal and explosive strength (Lake 2012) 21 healthy men  were randomly assigned to either a kettlebell (KB) or jump squat (JS) training twice a week. The KB group performed 12-minute bouts of KB exercise (12 rounds of 30-second exercise, 30-second rest with 12 kg if lower than 70 kg or 16 kg if higher 70 kg). The JS group performed at least 4 sets of 3 JS with the load that maximized peak power—Training volume was altered to accommodate different training loads and ranged from 4 sets of 3 with the heaviest load (60% 1RM) to 8 sets of 6 with the lightest load (0% 1RM). The increase in maximum strength of 9.8%, as well as explosive strength (+19.8%) were identical in both groups
  Kettlebell training has "has potential for improving some components of MetS in middle-aged women." (Moreno. 2011): While the changes the author of the thesis observed in response to 10 weeks twice weekly kettlebell training did not reach statistically significance (probably due to the low subject size of N=6 physically inactive women, mean age (mean age 48.8y, BMI 31.8) the trends in " fasting glucose and body fat were encouraging and suggest that kettlebell training has potential for improving some components of MetS in middle-aged women."	Kettle bell workouts can decrease blood pressure (Douglass. 2012): Eight resistance trained pre-hypertensive and HTN males saw statistically and more importantly clinically significant declines in blood pressure (to normal levels!) in the course of a randomized cross-over designed study which included 12 minutes of continuous two-handed swings (THS), three sets of a 6 exercise circuit (CIR), and a resting control (CON).
  Kettlebell training can improve strength, power and and endurance (Mannocia. 2012):  23 subjects (age 18-72 years) were required to perform a10-week kettlebell training program that took place in a group setting two times per week. Post hoc pairwise comparisons of assessments barbell clean and jerk, barbell bench press, maximal vertical jump, and 450 back extensions performance revealed significant time x group interaction and a main effect (p < 0.05) for the bench press, a trend toward a time x group interaction and a significant main effect for clean and jerk. These observations suggest "that kettlebells may be an effective alternative tool to improve performance in weight- and powerlifting".	10 min of treadmill running may burn more more energy, than a short 10-min kettlebell drill, but pro-anabolic & strength edurance effects speak in favor of 'the bells' (McGill. 2012): Only those who still believe in santa... ah, I mean the calories in vs. out theory of weight loss, will probably care, whether they are burning 12.5 or 17.1kcal/min and therefore this "advantage" would hardly be important even if the participants had not been sprinting part of their 10min on the treadmill just to make sure to achieve the prescriped (identical) rates of perceived exertion. And as usual, there is no reason, why you could not switch back and forth from one "drill" to another.

That's it once more for this week's installment of pretty longish short news. I hope you liked one or another and will see you tomorrow for some more information on the latest and greatest from the world of exercise and nutrition sciences. And just in case you have not seen those already, I guess there are a handful of news on facebook you may be interested in:

• 

  If you just skip the hookers and the transdermal cocaine and take a regular bath, this may speed up your regeneration and propel your gains - if timepoint and temperature are spot on!

  Transdermal 'cocaine' in "bath salt" - 3,4-methylenedioxypyrovalerone (MDPV) in OTC "bath salt" is 10x more potent than cocaine and unquestionably hazardous
• The anti-cancer effect of 'active vitamin B6' - High levels of pyridoxal 5'-phosphate, the active form of vitamin B6 appear to have protective effects against breast cancer... or is it exactly the other way around?
• Bisphenol A is a local fat synthesizer - Study shows how Bisphenol A increases obesity: it ramps up the local cortisol production in adipose tissue and thus 'helps' you stash away more body fat

As usual there is more on facebook and further news to come, but I guess you got other things to do on a Saturday than reading SuppVersity posts all day ;-)

References:

• Cook MB, Kamangar F, Weinstein SJ, Albanes D, Virtamo J, Taylor PR, Abnet CC, Wood RJ, Petty G, Cross AJ, Dawsey SM. Iron in relation to gastric cancer in the alpha-tocopherol, Beta-carotene cancer prevention study. Cancer Epidemiol Biomarkers Prev. 2012 Nov;21(11):2033-42. 
• Davis MR, Hester KK, Shawron KM, Lucas EA, Smith BJ, Clarke SL. Comparisons of the iron deficient metabolic response in rats fed either an AIN-76 or AIN-93 based diet. Nutr Metab (Lond). 2012 Oct 30;9(1):95.
• Douglass, MJ. The blood pressure response of two popular kettlebell routines. M.S. thesis in  Kinesiology (Exercise Science). California State University, Sacramento, 2012.
• Flores G, Lin H. Factors predicting severe childhood obesity in kindergarteners. Int J Obes (Lond). 2012 Nov 13.
• Gahete MD, Córdoba-Chacón J, Luque RM, Kineman RD. The Rise in Growth Hormone during Starvation Does Not Serve to Maintain Glucose Levels or Lean Mass but Is Required for Appropriate Adipose Tissue Response in Female Mice. Endocrinology. 2012 Nov 13.
• García-Bailo B, Roke K, Mutch DM, El-Sohemy A, Badawi A.Association between circulating ascorbic acid, alpha-tocopherol, 25-hydroxyvitamin D, and plasma cytokine concentrations in young adults: a cross-sectional study. Nutrition & Metabolism 2012, 9:102. 
• Hulsey CR, Soto DT, Koch AJ, Mayhew JL. Comparison of kettlebell swings and treadmill running at equivalent rating of perceived exertion values. J Strength Cond Res. 2012 May;26(5):1203-7.
• Kazemzadeh Y, Gaeini A, Abasrashid N. Comparison of the Effect of Consuming Carbohydrate or Protein during Exercise on Hormonal Response. Zahedan Journal of Research in Medical Sciences. 2013; 15(2): 90-93. 
• Lake JP, Lauder MA. Kettlebell swing training improves maximal and explosive strength. J Strength Cond Res. 2012 Aug;26(8):2228-33.
• Moreno KIK. Effects of kettlebell training on metabolic syndrome in women. M.A. Thesis, San Jose State University, 2011, 138 pages.
• McGill SM, Marshall LW. Kettlebell swing, snatch, and bottoms-up carry: back
  and hip muscle activation, motion, and low back loads. J Strength Cond Res. 2012
  Jan;26(1):16-27. 
• Manocchia P, Spierer DK, Lufkin AK, Minichiello J, Castro J. Transference of kettlebell training to strength, power and endurance. J Strength Cond Res. 2012 May 3.
• Rolland-Cachera MF, Maillot M, Deheeger M, Souberbielle JC, Péneau S, Hercberg S. Association of nutrition in early life with body fat and serum leptin at adult age. Int J Obes (Lond). 2012 Nov 13.
• WorldCancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity and the prevention of cancer: a global perspective. Washington, DC: AICR; 2007.
• West DW, Phillips SM. Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training. Eur J Appl Physiol. 2012 Jul;112(7):2693-702. 

Low Iron Still an Issue in Professional Athletes

Despite the fact that most of you are probably weekend-warriors or recreational athletes, I suspect that some of you expose their bodies to similar stressors as professional athletes do. Therefore, I assume you'd be interested in a recent study coming from German scientists (Reinke. 2011) who found that "although recuperation seems to allow a certain recovery of iron storage, particularly in athletes with initially low ferritin levels, this retrieval was insufficient to fully normalise reduced iron levels."

The scientists had previously examined the iron metabolism in 20 elite rowing athletes and 10 professional soccer players at the end of a competitive season, after recuperation and during pre-season training and found:

At the end of season, 27% of all athletes had absolute ID [iron deficiency] and 70% showed functional ID. Absolute iron depletion was not generally restored after recuperation and observed at all time points in 14% of the athletes. Although athletes with initially low ferritin levels showed a slight increase during recuperation (p < 0.09), these increases remained within borderline levels. Furthermore, 10% showed borderline haemoglobin levels, suggestive of mild anaemia, as defined by the World Health Organisation.

While I would not suggest supplementing with iron without due reason, this study should remind you to have your levels checked, at least once a year in order to intervene before you actually feel the negative effects of low iron and anemia.