Creatine and Bicarbonate - A Worthwhile Combination: Supplements Exert Great Individual and Small Combined Effects on HIIT Performance Test in Nine Well-Trained Men

The results of a Wingate test cannot be translated 1:1 to any sports.

You will probably remember my article about the combination of creatine and bicarbonate. Mixing both is basically what the producers of "buffered creatine" supplements do. Albeit with amounts of bicarbonate that may affect the uptake of the latter and offer benefits if you have to load as fast as possible, but won't have individual performance effects (learn more).

Other studies I've likewise covered in the SuppVersity News in the past showed both significant as well as borderline significant and non-significant beneficial effects of combining creatine and bicarbonate for a performance enhancing double-whammy in trained individuals.

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

Bicarbonate Works for Most(!) Athletes

Against that background it is not surprising that a recent study by Griffen et al. (2015) found similarly ambiguous results. The study investigated the effects of creatine and sodium bicarbonate coingestion on mechanical power during repeated sprints. To this ends, nine well-trained men (age = 21.6 ± 0.9 yr, stature = 1.82 ± 0.05 m, body mass = 80.1 ± 12.8 kg) participated in a double-blind, placebo-controlled, counterbalanced, crossover study using six 10-s repeated Wingate tests.

Before each of the performance tests, the participants ingested either a placebo (0.5 g/kg of maltodextrin), 20 g/d of creatine monohydrate + placebo (Cre), 0.3 g/kg of sodium bicarbonate + placebo (Bi), or coingestion  (Cre + Bi) for 7 days, with a 7-day washout between conditions. Participants were randomized into two groups with a differential counterbalanced order. Creatine conditions were ordered first and last. The participants individual mechanical power output (W), total work (J) and fatigue index (W/s) were measured during each test and analyzed using the magnitude of differences between groups in relation to the smallest worthwhile change in performance.

Figure 1: Subject allocation.

Yes, the washout period could be a problem: With only nine participants you have to do crossover study, but in view of the results of previous studies (McKenna. 1999), which report washout times of 4 weeks, the scientists would have been on the safer side if they had planned for a washout of 28, not just 7 days. Now you may argue that not all subjects started "on" creatine, so that the residual effect could average out. The problem, however, is that the significance of the results of a study with only nine participants gets impaired with every subject who was in a creatine group before being randomly assigned to one of the placebo + X groups, so that the researchers would have had to order all the creatine conditions last, not one first and the other last, as it is depicted in Figure 1 and described in the full text of the study.

As the data in Figure 2 tells you, both, the creatine (effect size (ES) = 0.37–0.83) and sodium bicarbonate (ES = 0.22–0.46) supplementation, resulted in meaningful improvements of all three indices of mechanical power output compared to placebo. Now what we are really interested in, though, is what the combination of the two did...

• In general, the coingestion provided "small meaningful improvements on indices of mechanical power output (W)" (Griffen. 2015) 
• The previously mentioned advantage was yet only seen when comparing sodium bicarbonate (ES = 0.28–0.41) with the combination treatment; a similar beneficial effect was not seen compared to creatine alone

This does obviously mean that the addition of bicarbonate to creatine did not result in meaningful increases in power output in this particular exercise test.

Figure 2: The only relevant advantage of combining both creatine and bicarbonate was seen for the total work done (orange bars, see orange arrow); this however is also among the most relevant measures for real athletes (Griffin. 2015).

What it did do and that's what we actually take bicarbonate for is to "provided a small meaningful improvement in total work (J; ES = 0.24) compared with creatine" (Griffin. 2015) - or, in other words, anyone who does not just one, but several all-out sprints (and that's almost every athlete) will see a small but meaningful performance increase, one that may make the difference between victory and defeat (see Figure 1, orange bars).

The increase in PGC-1a expression you get if you do HIIT w/ sodium bicarbonate and the correspondingly increased stimulus for mitochondrial biogenenesis is a hitherto often overlooked benefit of "baking soda" supplementation | learn more

Disappointing? I would not say so, which significant improvements in response to both supplements and a potential "game changing" increase in the total work the subjects were able to perform on the cycle ergometer during the repeated Wingate tests, both supplements have proven their efficacy and the potential benefits of combining them. Benefits the Griffin et al rightly call "small", but "meaningful" in the conclusion to their recently published paper.

The fact that these benefits may not be as exorbitant as some of you may have hoped for does not imply that the combination of creatine and bicarbonate supplements is useless. In view of the overall small study size (low number of subjects even for a crossover study), the problem with the washout and the specificity of the exercise - who knows what the results in the gym or on a football field would have looked like, thus, future studies are warranted | Comment!

References:

• Barber, James J., et al. "Effects of combined creatine and sodium bicarbonate supplementation on repeated sprint performance in trained men." The Journal of Strength & Conditioning Research 27.1 (2013): 252-258.
• Griffen, C., et al. "Effects of Creatine and Sodium Bicarbonate Co-Ingestion on Multiple Indices of Mechanical Power Output During Repeated Wingate Tests in Trained Men." International Journal of Sport Nutrition and Exercise Metabolism, 2015, 25, 298-306.
• McKenna, Michael J., et al. "Creatine supplementation increases muscle total creatine but not maximal intermittent exercise performance." Journal of Applied Physiology 87.6 (1999): 2244-2252.

The "20 / 30 Principle" Sheds 15% Body Fat in 6 Months, Boosts Testosterone & Sexual Performance in Overweight Men. Plus: Six Signs You're Doing Too Much, Already.

One out of four men with newly diagnosed erectile dysfunction is under 40 (more)

You will probably remember the post about the increasing prevalence of erectile dysfunction in young(er) men on Facebook, the other day (learn more)!? As of now, one out of four patients who are newly diagnosed with erectile dysfunction are 40 years or younger. That's an alarming trend that certainly cannot be reversed by the use of adulterated OTC libido boosters with high amounts of pharmacological PDE-5 inhibitors that are not listed on the label (read more on the SuppVersity Facebook Wall and listen live to today's installment of the Science Round Up starting at 12PM EST!). With  30-40% of the overweight men not being able to achieve an erection of maintain it long enough to engage in sexual intercourse, it stands out of question that the root cause for the exploding numbers of impotent young men is diabesity.

Against that background it is only logical that Joan Khoo and his colleagues from the Department of Endocrinology at the Changi General Hospital, the Departments of Sports Medicine and Rehabilitative Services at the Changi General Hospital assumed that diet and exercise should be more than an alternative to drug interventions. The latter has in fact been established in numerous previous studies, already. In obese Australian men who lost an average of 10% of baseline weight from caloric restriction alone using meal replacements or a low-fat diet and in men after 2 years of weight loss using Mediterranean diet and exercise, for example, the test scores in the International Index of Erectile Function 5-item (IIEF-5) improved by ~20% (Khoo 2011; Esposito. 2004).

Exercise works, but how much exercise does it take?

What has been missing up to know is yet a study that would establish the amount of exercise that's necessary to boost the existing benefits of energy restriction. And guess what!? That's exactly what Khoo et al. set out to do - conduct a trial that would compare the effects of 24 weeks of ...

• low volume medium intensity exercise training (<150 minutes/week) and
• (relatively) high volume medium intensity exercise (>200m/w) training

on the body weight, waist circumference (WC), body composition, International Index of Erectile
Function 5-item (IIEF-5), International Prostate Symptom Scale (IPSS) (for LUTS), and 36-item Short Form Survey version 2 Instrument (SF-36) (for QoL) scores, plasma testosterone, sex-hormone binding globulin, glucose, insulin and lipids, and endothelial function (by Reactive Hyperaemia Index [RHI] using finger plethysmography) of 90 abdominally obese Asian men (BMI >27.5 kg/m²; WC>90 cm; mean age 43.6y), who ha not moved an inch all day long in the past years (average amount of "exercise" ~80 minutes/week).

Freedom of choice: Exercise when and where you want

The aerobic only *sigh* exercise program could be performed on whatever equipment / sportive activity the subject like - stationary cycling, treadmill, elliptical crosstraining, brisk walking, jogging, cycling, and swimming, all were eligible for 90–150 minutes/week - the subjects were free to chose and pick, but they had to record type and exercise duration and make sure that they would hit their target heart rates of 55–70% of their individual maximal heart rate (HR_max=220-age) on whatever they did.

Figure 1: Absolute (body composition) and relative changes (lipids, sex hormones & erectile function); after 6 months on the diet + low vs. high volume exercise regiment;LUTS = lower urinary tract symptoms; IIEF-5 = International Index of Erectile Function 5-item questionnaire; IPSS = International Prostate Symptom Scale; SF-36 PCS and MCS = 36-item Short Form Survey version 2 Instrument Physical Component Summary and Mental Component Summary scores (Khoo. 2013)

In combination with the obligatory reduction in energy intake (-400kcal/day; ~15-20% of their baseline intake) both groups made significant progress. In comparison to the -4.7kg of body fat the guys in the "high volume" group (I use the quationmarks to emphasize that I would not consider ~30min of exercise/day exorbitantly high, considering the fact that the this was cycling, walking or swimming at a relatively moderate intensity) lost in the course of the 6-months intervention, the -1.1kg of total fat mass the guys in the low volume group dropped do yet look pretty pathetic.


"Doing more" for total & free testostosterone!?

What are signs that you are already doing too much ?

• constant fatigue that does not disappear, when you take a day off and get enough sleep (too much volume)
• inability to fall asleep (too much high intensity work)
• inability to sleep through (too much volume)
• getting up to pee every 1-2h (too much volume, too few carbs vs. too much protein)
• the 4am wake-up call = inability to sleep through (see above, fasting in the evening)
• no fat loss despite caloric deficit (eating too little + high training volume)
• losing muscle, not fat (too much volume, too much medium intensity cardio)
• low sex hormones / drive, low thyroid function, high rT3 (too much volume, too much protein, too little fat & carbs, not eating enough)

If you want more insights, you can find them in the Athletes Triad Series.

If we take a look at a couple of other parameters the scientists evaluated, you will notice a clear dose-response relationship. Much contrary to the participants in the Rosenklide study, I wrote about in 2012, which had a much higher training volume and intensity, doing more did - within this narrow relatively low volume moderate intensity regimen - did thus really yield superior results. Even more, the dose-response relationship is almost linear: 2x more exercise, 2x more weight loss, 2x more fat loss, 2x greater reduction in insulin, 2x greater reduction in blood glucose.

For testosterone (>2x more) and free testosterone (almost 5x more), the benefits were even more pronounced and the difference between the ratio of fat and lean mass lost 6.7 for the high vs. 5.5 for the low volume group are certainly not to be scoffed at, either.

Still, we just have to go back to the counterproductive effects Rosenkilde et al. observed in their study (go back and learn more), to see that the 30 minutes of exercise per day are probably not the end of the flagpole, but a very happy medium beyond which previously untrained individuals, and experienced trainees who work out at a correspondingly higher intensity level, could hit a wall and spiral down into the abyss of chronic overtraining - especially when exercise habits like that are combined with a diet that does not only induce an energy deficit of 20% but does at the same time make it particularly hard for the body to use the energy it gets... yep, I am talking about the notorious high protein, low carb, low fat diets the scaremongerism on both sides of the low-carb vs. low-fat divide have made so popular (learn more).

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Bottom line: Diabesity, erectile dysfunction and hypogonadism? The solution to this triad is there! It's not complicated, but it requires commitment, it requires discipline and it will cut your daily screen time by 30 min... if you or your overweight friends don't feel that this is worth it, let them waste their money and risk their health by jumping from one "quick fix" solution and diet (e-)book to the other. If not, write the numbers "20/30 x 6" on a DinA4 sheet and pin that to your or your friends' fridge to remind yourself or them that it takes a caloric reduction of 20% + 30min of moderate intensity exercise and the stubbornness to adhere to that protocol for 6 months day in day out (I guess 90% compliance would even be enough) to take a huge step on your way towards normalizing your body composition, glucose and lipid metabolism and endocrine and erectile function... and on a last note: I bet this works for overweight women with PCOs, as well.

References:

• Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, D’Armiento M, Giugliano D. Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA 2004;291:2978–84.
• Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, Worthley MI, Lange K, Wittert GA. Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med 2011;8:2868– 75.

Training for Size & Strength - Does the Rest Matter? Study Finds 7-9% Greater Increase in Muscle Size With Decreasing Rest Periods.

Image 1: If you want to build Arnold-esque arms you better not sit around too long in-between your sets.

"Short rest periods to burn fat, medium rest periods to build muscle and long rest periods to build strength" - it's actually pretty likely that one of your trainers, gym buddies or fatherly mentors told you something along those lines in the past. In view of the results of a soon to be published international study by Brazilian researchers from the State University of Campinas and the Federal University of Rio de Janeiro and their American colleagues from the Eastern Illinois University, the University of Memphis and the Colorado College (Souza-Junior. 2011), this is probably the next item on list of widely accepted bodybuilding myths that have a spark of truth to them... at least for recreational strength trainees who use some creatine monohydrate to promote their strength and mass gains.

Learn more about muscle builder & fat shredder training at the SuppVersity

Optimizing Rest for Size and Strength Gains

When Rodents Squat, We Can Learn A Lot!

Farmer's Walk or Squat? Is Strong- men T. For You?

Full ROM ➯ Full Gains - Form Counts!

Battle the Rope to Get Ripped & Strong

Up Your Squat by 25% With Sodium Bicarbonate

For their study, the results of which are going to be published in the next issue of the Journal of the International Society of Sports Nutrition, Tacito P. Souza-Junior and his colleagues recruited 22 "recreationally trained" men with a minimum of one year resistance training experience at a frequency of 4 sessions a week, who were randomly assigned to one out of two exercise protocols, which differed only in the time the subjects were allowed to rest in-between sets (cf. figure 1).

Figure 1: Identical training protocol for all subjects participating in the study (compiled based on information from Souza-Junior. 2011)

The only difference between the groups was that half of the subjects trained with a constant rest time of 2 minutes between sets over the whole 8 weeks (CI group), while the remaining subjects had to decrease their rest times from week to week (DI group) according to the scheme illustrated in figure 2. The training sessions were supervised and the subjects were " verbally encouraged to perform all sets to voluntary exhaustion". Considering the overall workload and the training frequency, this were probably pretty hard weeks for the 22 trainees.

Figure 2: The rest times decreased according to a standardized protocol by 15 sec each week.

In addition all subjects, who btw. did not follow a standardized diet, consumed the proven creatine + maltodextrin mix (7 day loading phase with 20g/day creatine + 20g maltodextrin followed by a maintenance dose of 5g creatine + 5g maltodextrin taken immediately post workout) that has been used in numerous studies before.

Figure 3: 1RM performance (in kg) for bench press and barbell squat before and after the 8-week training period in subjects with constant and decreasing rest periods (data adapted from Souza-Junior. 2011).

Now, if the initially stated "wisdom" held true, then the 11 subjects with constant rest periods should either have gained more muscle (if you consider 2 minutes a "medium" rest period) or built more strength (if you would say that 2 minutes belong to the realm of "long" rest periods) - yet figures 3 and 4 seem to indicate that neither of that was the case.

Figure 4: Muscle CSA (in cm²) of arm and tigh muscles before and after the 8-week training period (data adapted from Souza-Junior. 2011).

If we have do yet a closer look at the effect sizes, there is yet a notable advantage of the DI protocol in terms of the measured increases in muscle CSA with +14% and +19% in arm and tigh CSA in the constant rest interval group (CI) and +21% and +28% in the decreasing rest interval (DI) group.

SuppVersity Classic: Full ROM = More Growth, More Strength, More Structural Changes & More Sustainable Gains & Fat Loss - Insights from Realistic 8 Weeks Leg Training + 4 Weeks Detraining | more

There is a spark of truth to every myth To give you an idea of how significant - and I am talking about "posing significance" not statistical significance here - this is, I have calculated the respective increases in arm- and tigh-circumference, which would differ by 0.4cm and 0.7cm, respectively. Not really outstanding, but nevertheless an important finding of which the researchers say that it lends support to the notion that

decreasing [rest] interval[s] seems to be more efficient than constant interval to produces [sic!] hypertrophic responses.

It has yet to be stated that the 11 subjects in the decreasing rest interval group paid dearly for this increase in muscular hypertrophy, as their "exercise performance" as measured by the total workload per session decreased profoundly from week 1 to week 8: -35% total volume for barbell squats and -30% for bench presses.

The subjects who used constant rest periods, on the other hand, increased their total volume by +20% for squats and by +30% for bench presses. That being said, all powerlifters out there better stick to their constantly (long) rest periods if they do not want to compromise their game.