Monday, November 7, 2016

Alternate Day Fasting: Does it Matter How You Time (Lunch / Dinner) & Distribute (1 or 3 Meals) Your Fasting Day Meals?

This & other studies show no increased binge eating risk on non-fasting days.
Yes, yes, ... I hear ya. Meal- and nutrient timing has been ridiculously overrated in the health and fitness community for years. To ignore a potential effect of when you eat completely, however, is about as stupid as the notion that your training was wasted if you don't get a 30-50g bolus of protein within the first 30 minutes of racking the weights.

In view of the far-reaching effects of our biological clock and its close interaction with food intake and nutrient availability, it is, after all, only logical to assume that food timing could have a significant effect on our metabolic health.
Learn more about fasting at the SuppVersity

Breakfast and Circadian Rhythm

"Lean Gains" Fast Works

Habits Determine Effects of Fasting

Fasting Works for Obese, Too!?

IF + Resistance Training = WIN

ADF Beats Ca-lorie Restriction
Previous research suggests that at least some of the benefits of intermittent or alternate day fasting are mediated by the interaction of the fasting / feeding cycle with our circadian rhythm. If that's indeed the case (and the evidence is quite convincing), it is not illusionary to assume that the timing of the meal(s) / feeding window on (intermittent) fasting days could affect the proven beneficial effects of these diet regimen, as well... I guess this or something like this was also what Kristin Hoddy told her thesis adviser, Krista A. Varady, before she started her research into the effects of "Meal Timing during Alternate Day Fasting". Research, the results of which have just been published by the University of Illinois at Chicago (Hoddy. 2016).

The trial itself consisted of a two-week lead-in followed by 8 weeks of alternate day fasting (ADF) - a basic template that identical for all subjects (BMI between 30 and 39.9 kg/m²; age between 25 and 65 years), the time at which the subjects were told to consume their only meal on the fasting day, however, differed for the three study groups the N = 74 subjects were randomly (stratified  based on sex, age, and BMI) assigned to:
  • in the ADF-L group, the subjects consumed their only meal at launch
  • in the ADF-D group, the subjects consumed their only meal at dinner, and
  • in the ADF-SM group, the ~500kcal were split into small meals throughout the day
All subjects consumed 25% of their baseline energy needs on a fast day (24 h), and ate ad libitum on each alternating feed day (24 h). The feed and fast days began at midnight each day. Subjects were asked to refrain from staying up until midnight on feed days, or getting up just after midnight following a fast day, to eat. Subjects were provided with meals on each fast day, and ate ad libitum at home on the feed day.
Table 1: The meals for the fast days were prepared for the subjects; here's the nutrient composition (Hoddy. 2016).
All ADF fast day meals were prepared in the metabolic kitchen of the Human Nutrition Research Center (HNRU) at the University of Illinois, Chicago (they were provided as a 3-day rotating menu, see Table 1). With the exception of energy-free beverages, tea, coffee, and sugar-free gum, no other 'foods' were allowed on the fasting day. On which the meals were consumed timed accordingly to the previously outlined scheme: ADF-L between 12.00 pm and 2.00 pm; ADF-D between 6.00 pm and 8.00 pm and ADF-SM group divided their fast day meal up into 3 mini meals that were consumed between 6.00 am and 8.00 am (~100kcal), between 12.00 pm and 2.00 pm (~300kcal), and between 6.00 pm and 8.00 pm (~100kcal).
Figure 1: Changes in body weight and body composition during the weight loss period (Hoddy. 2016).
And as you can see in Figure 1, the effect of timing differed for the changes in body composition, which were identical in all three groups, and the reduction in visceral body fat that was greater, albeit not statistically significantly greater in the ADF-D and ADF-SM groups.
Lean mass loss (positive values = lean mass lost) in ADF and "regular" sign. energy reduced (VLCD) diets according to a recent review by Alhamdan et al. (2016) - If you want to spare muscle tissue (and you should want that), intermittent fasting / ADF should clearly be your choice.
Intermittent fasting (ADF or lean-gains style) spares muscle as you're dieting: I have discussed the results of the first head-to-head comparison of a true alternate day fast vs. regular caloric restriction, only recently (read the article), but the respective study is not the only paper that discusses the efficacy of alternate day fasting and regular calorie restrictions. A recent systematic review and meta-analysis by Alhamdan et al. concludes (in line with what I've written in the previously referenced article] "that ADF is an efficacious dietary method, and may be superior to VLCD [very low-calorie diet] for some patients because of ease of compliance, greater fat mass loss and relative preservation of fat-free mass" (Alhamdan. 2016).
With visceral fat being one of the drivers of inflammation and the metabolic syndrome, it would thus seem as if eating only one meal and eating this meal between 12 pm and 2 pm was a bad idea if your goal was to improve your metabolic health. Other parameters Hoddy analyzed do yet not support this notion. In fact, not a single of the metabolic disease factors she tracked during the 10-week study showed significant inter-group differences.
Figure 2: Changes in metabolic disease factors over the course of the study (Hoddy. 2016).
If you scrutinize the data in Figure 2, you may argue that there are trends which appear to favor having only one meal and having it at dinner. And you're right. If we discard the statistical non-significance of the differences, the ADF-D regimen clearly had the most beneficial, while the ADF-L regimen had the smallest effects on glucose management. The differences, however, are far from reaching statistical significance (p = 0.87, p = 0.66, p = 0.68 for fasting blood glucose, insulin, and HOMA-IR, respectively) and the effects on blood lipids are devoid of any inter-group differences that are worth mentioning (statistically significant or not).
"Improvements in LDL particle size occurred in all of the groups. This was marked by an increase in the proportion of large LDL particles in all intervention groups, and a decrease in the proportion of small LDL particles in only the ADF-D and ADF-SM groups. This shift in LDL particle size represents a reduction of atherosclerotic risk."(Hoddy. 2016)
Overall, it does therefore probably not matter when you consume your ADF 'fast day meal', what will matter, however, is that you are able to stick to the rules, i.e. to not consume any other foods and based on my own intermittent fasting experience, that's going to be increasingly hard with both, the ADF-L and the ADF-SM regimen - corresponding data is unfortunately not available, because Hoddy et al. analyzed parameters such as the change in appetite hormones after weight loss only based on pooled ADF data.
True Alternate Day Fast Beats Classic Dieting: Max. Fat, Min. Muscle Loss, No 'Metabolic Damage' in 32 Wk Human Study - If you haven't read this recent SuppVersity article, yet, I highly suggest you do it now. It provides the first evidence from an RCT that indicates that intermittent fasting / ADF allows for easier and more efficient fat (not just weight) loss | read it
So, once again: Meal timing doesn't matter? Well, the three meal pattern appears to have the smallest effect on the subjects RMR and the all-calories-for-dinner pattern clearly had the most beneficial effects on glycemia... but the difference - and that's the case for all parameters the scientists measured - was statistically non-significant.

Eventually, it would thus seem as if it all came back to the tried and proven principle according to which "the best diet is always the diet you can adhere to" and adherence is actually a huge strength of intermittent fasting diets (Varady. 2011; Klempel. 2013); most people find it much easier to achieve a decent caloric deficit with these diets compared to the classic calorie restriction... no wonder, a recent study (Catenacci, et al. | discussed here) showed better results with ADF vs. classic calorie restriction | Comment!
References:
  • Alhamdan, B. A., et al. "Alternate‐day versus daily energy restriction diets: which is more effective for weight loss? A systematic review and meta‐analysis." Obesity Science & Practice 2.3 (2016): 293-302.
  • Catenacci, Victoria A., et al. "A randomized pilot study comparing zero‐calorie alternate‐day fasting to daily caloric restriction in adults with obesity." Obesity 24.9 (2016): 1874-1883.
  • Hoddy, Kristin. Meal Timing during Alternate Day Fasting: Effect on Body Weight and Cardiovascular Disease Risk. Diss. University of Illinois at Chicago, 2016.
  • Klempel, Monica C., Cynthia M. Kroeger, and Krista A. Varady. "Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet." Metabolism 62.1 (2013): 137-143.
  • Varady, Kristina A. "Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss?." obesity reviews 12.7 (2011): e593-e601.

Saturday, November 5, 2016

40 vs. 70g of Food Protein per Meal? No Ceiling Effect for Improvement(s) in Net Protein Balance (+65% w/ 70 vs. 40g)

This study does almost everything right and yet, it still needs a follow-up study to address the question whether the results would be the same for fast(er) digesting proteins such as whey protein where 'more', i.e. ever-increasing boluses of protein, could actually increase the amount of protein that is being fed into gluconeogenesis, bros.
You've read it here, you've read it elsewhere: Simply doubling your protein intake ain't going to double your gains. That's true and the latest data from the Center for Translational Research in Aging and Longevity at the University of Arkansas for Medical Sciences ain't going to change that.

The questionable, if not incorrect overemphasis on postprandial (meaning right after you ingested a protein shake) and/or post-exercise and -prandial (meaning after the protein shake you consumed right after a resistance training workout) skeletal muscle protein synthesis of the vast majority of studies that investigate the effects of different doses of protein on acute protein kinetics has, however, given rise to the intrinsically flawed idea that any extra protein (in excess of 20-40g of high EAA protein, depending on the study you look at | the younger the subjects, the less appears necessary) would be wasted.
High-protein diets are much safer than pseudo-experts say, but there are things to consider...

Practical Protein Oxidation 101

5x More Than the FDA Allows!

More Protein ≠ More Satiety

Satiety: Casein > Whey? Wrong!

Protein Timing DOES Matter!

High Protein not a Health Threat
In the experiment for their latest paper, Kim, Schutzler, Schrader, Spencer, Azhar, Ferrando and Wolfe went one step further. In a previous study in older subjects (discussed at the SuppVersity News a year ago | read it), the authors have already proven the ...
Read my article about the previous study.
"potential importance of suppression of protein breakdown in response to dietary [meaning intake from food] intake of meals containing two levels of protein totaling either 0.8 or 1.5 g protein/kg/day...

[More specifically, they] found that at both levels of dietary protein [i.e. 0.8 or 1.5 g protein/kg/day from food] whole body net protein balance became positive in the fed state compared with the fasted state, mainly due to reductions in protein breakdown" (Kim. 2015) 
This novel focus on the response to (a) food proteins and (b) the important net protein balance differentiates the study at hand, as well as the previously quoted preceding study from the rest of the pack which focused entirely on the response of muscle (often to various forms of protein supplements, instead of foods) and may thus (a) underestimate the total anabolic response to feeding and (b) give the false impression that it takes protein supplements to maximize the postprandial/postworkout protein anabolic response... to cut a long story short, Kim et al. are completely right to say that it is thus only...
"[...] reasonable to examine whole body effects of exercise in the context of quantifying the anabolic response to different levels of dietary protein [as they did it in their latest study in which they] have quantified protein kinetics (protein synthesis (PS), breakdown (PB), and net balance (NB)) at the whole body level before and throughout the response to two levels of protein intake in mixed meals with or without prior resistance exercise in healthy young adults, [hypothesizing] that 1) the whole body net anabolic response (NB) would be greater with intake of 70 g protein, compared with 40 g protein in mixed meals; and 2) the whole body net anabolic response to either level of dietary protein in mixed meals would be greater following resistance exercise" (Kim. 2016).
To test this hypothesis, the scientists recruited twenty-three healthy subjects [18–40 yr] who didn't suffer from diabetes, or any other active malignancy within the past 6 mo, didn't have gastrointestinal bypass surgery, a chronic inflammatory disease, low hematocrit or hemoglobin concentration, low platelets, concomitant use of corticosteroids, any unstable medical conditions, and who already performed resistance exercise more than once per week.
Table 1: Subject characteristic (before the experiment | Kim. 2016)
We are thus dealing with previously trained, albeit not exactly jacked young subjects (see Table 1 for detailes subject characteristics) who may be considered representative of 'the average gymgoer' who were randomly assigned to the resistance exercise group (X) or the resting group (R).
"The resistance exercise bout consisted of 3 sets of 10 repetitions of bench press, lateralis pull-down, leg press, and leg extension each at 80% of 1 repetition maximum (1 RM, the maximum weight that can be lifted for 1 repetition). Each set was completed within 30 s. The rest interval between sets was <2 min, and the entire exercise bout was completed in ∼45–50 min" (note: the subjects trained only on day 4 | my emphasis in Kim. 2016).
To standardize the subject's dietary intake(s) the meals for both, the medium and high protein groups were provided for both, the 3-day run-in period (intended to be dietary normalization period) before the metabolic study and the metabolic study on day 4.
This is not the end of the 30g of protein per meal rule: Why's that? Well, first of all the scientists measured total body protein turnover. It is thus not possible to say how much of the 65% decrease in protein breakdown was muscle specific (some people will argue the answer is zero). In addition to that, the study at hand provides evidence only for the acute effects of a single large high protein meal. The chronic effect could be different or less pronounced - especially if this meal is consumed as part of a diet that is already high in protein.
The protein source of choice was, just as in the previously cited study in older individuals (Kim. 2015) 85% lean ground beef from a local grocery that was formed into patties weighing 113.4 g (4 oz) or 283.5 g (10 oz) of the beef (pre-cooked/raw).
Table 2: Macronutrients of 3-day run-in on day 1–3 and metabolic infusion study on day 4; Values are expressed as means SE. Each subject consumed his or her respective interventional foods based on their sex; n number of subjects. X, exercise group; R, resting group; MP, low protein; HP, higher protein; M, male; F, female; CHO, carbohydrate (Kim. 2016)
Subjects were asked to record time of meal consumption and percentage of meal consumption and to photograph the meal before and after consumption, as well as to return all unused or empty meal/supplement packaging on the morning of the fourth day when they reported to the lab for the metabolic study (only subjects who achieved a minimum compliance of 80% consumption of meals progressed to the metabolic study).
Timing may matter albeit only for trained individuals, it seem.
Remember: For trained individuals timing may matter - While the evidence for nutrient and protein timing may be skinny (Kerksick. 2008; Aragon 2013; Schoenfeld. 2013), it's not as if there was no data suggesting that you want to put a special emphasis on consuming adequate amounts of high quality [=high essential amino acid (EAA)] protein such as whey (or dairy in general), meat, eggs, fish, soy or pea protein in the vicinity of your workouts.

Needless to say that this does not imply that you "wasted" your time whenever you fail to get your protein shake or high protein meal in within X minutes after your workout! 
By the means of phenylalanine as a tracer amino acids, the subjects' individual whole body protein kinetics were calculated based on the determinations of the rate of appearance (Ra) into the plasma of phenylalanine and tyrosine and the fractional Ra of endogenous tyrosine converted from phenylalanine as in the previous study (18). The analysis of this data yielded the following results (Kim. 2016): (a) Exercise did not significantly affect protein kinetics and blood chemistry, the feeding, however, (b) resulted in a positive net protein balance (NB) at both levels of protein intake, but...
  • Figure 1: Changes in rates of whole body protein net balance (NB), synthesis (PS), and breakdown (PB) from the fasted state in response to meal containing 40 g (MP) or 70 g (HP) of dietary protein with prior resistance exercise (X) or time-matched resting (R | Kim. 2016).
    the net protein balance (NB) was  65% greater in response to the meal containing HP vs. MP (i.e. 40g vs. 70g of protein; P < 0.00001) - irrespective of exercise, 
  • the greater NB with HP was achieved primarily through a 66% greater reduction in protein breakdown (PB) and to a lesser extent stimulation of protein synthesis (for all, P < 0.0001), and 
  • the HP resulted in greater plasma essential amino acid responses (P < 0.01) vs. MP, with no differences in insulin and glucose responses - likewise without sign. differences in the exercise (X-MP and X-HP) vs .the resting (R-MP and R-HP, respectively, in Figure 1) condition. 
As the scientists point out in the conclusion of their study, the ingestion of an increased amount of protein in form of a whole protein (in this case lean beef) will thus significantly improve the whole body net protein balance in the rested and trained state in healthy, young male and female subjects - mostly due to a previously often overlooked reduction in protein breakdown.
Bottom line: The study addresses an important question that had been left open in the previously discussed study in older subjects, i.e. 'Is the beneficial effect of increased protein intakes an age-specific phenomenon?' - with the answer being 'no, it isn't' and the study providing further evidence of the benefit of extra protein in both a sedentary and resistance training context, the study at hand provides further incentive to 'super-size" your average per meal protein intake to achieve total protein intakes way beyond the USDA recommendation of only 0.8g/kg body weight.

Latest Study Shows that a 3.3 g/kg High-Protein Diet is Safe -- And Yes, This Means it Doesn't Hurt Your Kidney or Liver | more
What the study does not do, however, is to address the question whether that's the same for fast-absorbing (more anabolic) whey protein, where both, the protein anabolic response (i.e. acute postprandial protein synthesis) as well as the postprandial protein breakdown could still show a ceiling effect in both, young and older individuals. Until this interaction with protein quality / the type of protein will not have been investigated, it still appears to make sense to aim for a higher per meal (and thus total) protein intake - after all, Antonio et al. (2016) have only recently shown that the often-cited potential detrimental effects on your health simply don't exist | Comment on Facebook!
References:
  • Antonio J, Ellerbroek A, Silver T, et al. A high protein diet has no harmful effects: a one-year crossover study in resistance-trained males. J Nutr Metab. 2016.
  • Aragon, Alan Albert, and Brad Jon Schoenfeld. "Nutrient timing revisited: is there a post-exercise anabolic window?." Journal of the international society of sports nutrition 10.1 (2013): 1.
  • Kerksick, Chad, et al. "International Society of Sports Nutrition position stand: nutrient timing." Journal of the International Society of Sports Nutrition 5.1 (2008): 1.
  • Kim, Il-Young, et al. "Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults." American Journal of Physiology-Endocrinology and Metabolism 308.1 (2015): E21-E28.
  • Kim, Il-Young, et al. "The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults." American Journal of Physiology-Endocrinology and Metabolism 310.1 (2016): E73-E80.
  • Schoenfeld, Brad Jon, Alan Albert Aragon, and James W. Krieger. "The effect of protein timing on muscle strength and hypertrophy: a meta-analysis." Journal of the International Society of Sports Nutrition 10.1 (2013): 1.

Thursday, November 3, 2016

TeaCrine®, Tribulus, Cordyceps, ALA, Sesamin, Fish Oil & More - The Latest Supplement Science (November 2016)

Many currently available supplements lack sufficient scientific backup.
It has been a while since I published the last supplement science update - the recent release of the latest edition of the Journal of Dietary Supplements reminded me of that. In issue 1 of volume 14 of this journal that "addresses important issues that meet a broad range of interests from researchers, regulators, marketers, educators, and healthcare professionals" (Aims & Scope according to the publisher) you will find studies on (you already know that from the headline) "TeaCrine®, Tribulus, Guarana, ALA, Sesamin, Fish Oil & More", studies the design and results of which I will briefly summarize for you in the following paragraphs:
Read about rather exercise-related studies at the SuppVersity

Tri- or Multi-Set Training for Body Recomp.?

Aug '15 Ex.Res. Upd.: Nitrate, Glycogen, and ...

Pre-Exhaustion Exhausts Your Growth Potential

Full ROM ➯ Full Gains - Form Counts!

BFR-Preconditio- ning Useless for Weights?

Study Indicates Cut the Volume Make the Gains!
  • TeaCrine® performs again: New data on safety, dosing and time course of effects (Ziegenfuss. 2016) -- You've read about theacrine (not to be confused with l-theanine although both are naturally occurring in tea) in previous SuppVersity articles. It's a purported cognitive and physical performance enhancer and its patented variety, which is extracted from Camellia assamica variety kucha tea, is now part of many pre-workout formulas.

    In their latest study, Ziegenfuss et al. (2016) who generated most of the currently available TeaCrine® (TC) research examined the "subjective dose–response, daily changes in cognitive and psychometric parameters, and changes in gas exchange and vital signs" (Ziegenfuss. 2016).  As the authors point out, these particular study outcomes "were chosen to better ascertain the previously reported animal and human outcomes involving theacrine administration" (ibid.).
    Figure 1: Relative changes (calculated based on arithmetic mean of 95% confidence interval) in self-reported fatigue, focus, and willingness to exercise in the chronic administration trial (Ziegenfuss. 2016).
    The study had two parts: Part 1 (chronic administration) was a randomized, open-label, dose–response investigation in nine healthy participants  (3F, 6M) who consumed either 400 mg TC per day or 200 mg TC per day and recorded the subjective changes in cognitive, psychometric, and exercise attributes using 150-mm anchored visual analog scale (VAS) before, and 1, 4, and 6 hours after ingestion every day for 7 consecutive days.

    Part 2 (acute administration) had a different design, with 15 healthy subjects (7F, 8M)
    participating in a randomized, double-blind, placebo-controlled, crossover investigation in which all participants ingested a single 200 mg dose of TC or Placebo (PLA).
    Just like in part 1 (results see Figure 1), VAS questionnaires were used to detect subjective changes in various aspects of physical and mental energy along with changes in gas exchange and hemodynamic parameters before, and 1, 2, and 3 hours after acute ingestion.

    What the scientists found was a similar increase in energy, focus, and concentration with both dosages of theacrine. Interestingly enough, the subjects' willingness to exercise, anxiety, motivation to train and libido increased only in the low-dose group receiving 200mg/d for 7 days while it was unchanged in the higher-dose group who took 400 mg of the supplement on a daily basis.
    Figure 2: Graphical summary of the most important take-home messages of the study at hand.
    Now this, i.e. the U-shaped dose-response curve (cf. Figure 1) is yet only one of three important insights into how you should supplement with this natural purine molecule: It can be derived from (a) Ziegenfuss' et al.'s acute administration study that you (A) don't have to take theacrine chronically for a week (or longer) before you see beneficial effects. On the other hand, the results from the long(er)-term study show (B) no habitation effect, i.e. the dreaded decrease in efficacy you see with other stimulants such as caffeine.

    Speaking of which, since theacrine does not have any of caffeine's (mild) adverse side effects such as increased heart rate or changes in systemic hemodynamics (more safety data can be found in Hayward. 2015), theacrine could, in fact, make a good adjunct to caffeine in pre-workout supplements or fat loss adjuvants. To award teacrine the "SuppVersity seal of ergogenic approval", it would yet be nice to see independent research on the combination of the two, i.e. caffeine and theacrine - research that would prove that theacrine does, indeed, add meaningfully to the benefits of caffeine when it's co-consumed with the world's favorite stimulant. For l-theanine there's some such evidence, as you've learned earlier this year at the SuppVersity, for theacrine, on the other hand, the one study that investigated the potential nootropic effects of this combination found only subjective, yet no objective benefits (Kuhman. 2015).
  • Tribulus disappoints again: No beneficial effects in men with unexplained infertility (Roach. 2016) -- With their latest study, researchers from the Cairo University in Egypt add to the confusion over the efficacy of tribulus terrestris supplements. Unlike the others of other recent studies, Roaiah, et al. didn't find any measurable benefits in the 30–50-year-old patients with unexplained infertility who participated in their three-months study.
    Figure 3: The relatively low dose of regular tribulus powder didn't have a measurable effect on the hormone levels of the infertile men in the 3-months study at hand (Roaiah. 2016).
    The authors, themselves, attribute the different study outcomes primarily to differences in the dosage regimen with studies yielding positive results using twice the amount that was used in the study at hand (meaning 1,500 mg/day instead of 750 mg/day in three divided doses). Personally, however, I would suspect that the type of the supplement [raw powder vs. saponin extract as it was used in Wilk, et al. (2016)] may better explain the sign. inter-study differences. If that's indeed the case it wouldn't make sense to pick up the next best TT supplement at your local GNC and hope for results. Rather than that, it would be wise for studies to finally settle if it's the product quality and, more specifically, the saponin content and composition that makes all the difference.
  • Cordyceps (militaris) surprises again: Study finds performance benefits during high-intensity exercise tests w/ chronic supplementation (Hirsch. 2016) -- Cordyceps is not just the third purported ergogenic in today's installment of the SuppVersity Supplement Research Update, it's also one of those supplements where we simply don't have enough evidence to be sure that it's worth the significant amount of money you have to pay for a monthly supply of 4g/day of this peculiar mushroom.

    With the data in Figure 1 and the fact that it is now offered in bulk at prices that would allow you to get a one-month supply for less than $15, cordyceps may be a candidate for your "next supplement to test-drive"-list.
    Figure 4: Phase II changes in performance measures (A) maximal oxygen consumption (VO2max), (B) ventilatory threshold (VT), and (C) time to exhaustion (TTE) presented as 95% confidence intervals (Mean ± (1.96 × SEM)) | ∗indicates a significant improvement, as determined by 95% CI (Hirsch. 2016).
    You should be aware, though, that it took Hirsch et al. the analysis of 95% confidence intervals and thus some statistical shenanigan to be able to report significant improvements in total time to exhaustion (TTE) after one (+28.1 s) and three weeks (+69.8 s) and three weeks before the small, but measurable increases in VO2max (+4.8 ml/kg/min) and ventilatory threshold (+0.7 l/min) surfaced. If cordyceps does indeed work it is thus, just like creatine, whey and other better-proven ergogenics, a thing that has to be consumed chronically - unlike caffeine and its stimulating cousins' (including theacrine, see above) whose immediate effects are probably the reason why they are so popular.
While it is no longer a popular fat burner ingredient sesamin may be an anti-inflammatory, blood glucose management improving adjunct to the supplement regimen of any type II diabetic according to a new human study (Mohammad. 2016).
What else have we got? Alright, with the three most interesting studies being discussed in detail we can turn to the noteworthy, but not exactly super-interesting studies on guarana, ALA, carnitine, magnesium and fish oil. And no, we're not talking about stacking them. Rather than that, the latest research from scientists all around the world suggests that there are (A) no benefits of 2x50mg /day of guarana in neck cancer patients during chemotherapy (Martins. 20016), (B) potential benefits of carnitine and alpha lipoic acid (ALA) may prevent the onset of diet-induced type II diabetes in humans just like they did in a recent rodent study (Abdelkarem. 2016), (C) significant benefits of sesamin (you may remember this oil from various OTC fat burners) as an anti-inflammatory T2DM supplement (see Figure to the right) and (D) small but significant reductions in muscle soreness in response to resistance training after one week on 6g of fish vs. soybean oil (Tinsley. 2016) | Comment!
References:
  • Abdelkarem, Hala M., Laila H. Fadda, and Abeer AG Hassan. "Potential Intervention of α-Lipoic Acid and Carnitine on Insulin Sensitivity and Anti-Inflammatory Cytokines Levels in Fructose-Fed Rats, a Model of Metabolic Syndrome." Journal of Dietary Supplements (2016): 1-11.
  • Habowski, S. M., et al. "The effects of Teacrine TM, a nature-identical purine alkaloid, on subjective measures of cognitive function, psychometric and hemodynamic indices in healthy humans: a randomized, double-blinded crossover pilot trial." Journal of the International Society of Sports Nutrition 11.1 (2014): 1.
  • Hayward, Sara, et al. "Safety of Teacrine®, a Non-Habituating, Naturally-Occurring Purine Alkaloid Over Eight Weeks of Continuous Use." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P59.
  • Hirsch, Katie R., et al. "Cordyceps militaris Improves Tolerance to High-Intensity Exercise After Acute and Chronic Supplementation." Journal of Dietary Supplements (2016): 1-13.
  • Kuhman, Daniel J., Keanan J. Joyner, and Richard J. Bloomer. "Cognitive performance and mood following ingestion of a theacrine-containing dietary supplement, caffeine, or placebo by young men and women." Nutrients 7.11 (2015): 9618-9632.
  • Martins, Suelen Patrícia dos Santos, Cynthia Lemos Ferreira, and Auro del Giglio. "Placebo-Controlled, Double-Blind, Randomized Study of a Dry Guarana Extract in Patients with Head and Neck Tumors Undergoing Chemoradiotherapy: Effects on Fatigue and Quality of Life." Journal of Dietary Supplements (2016): 1-10.
  • Mohammad Shahi, Majid, et al. "Effect of Sesamin Supplementation on Glycemic Status, Inflammatory Markers, and Adiponectin Levels in Patients with Type 2 Diabetes Mellitus." Journal of Dietary Supplements (2016): 1-12.
  • Roaiah, Mohamed Farid, et al. "Prospective analysis on the effect of botanical medicine (Tribulus terrestris) on Serum testosterone level and semen parameters in males with unexplained infertility." Journal of Dietary Supplements (2016): 1-7.
  • Tinsley, Grant M., et al. "Effects of Fish Oil Supplementation on Postresistance Exercise Muscle Soreness." Journal of dietary supplements (2016): 1-12.
  • Wilk, Michał, et al. "Endocrine Responses to Phys^ical Training and Tribulus Terrestris Supplememtation in Middle-Age Men." Central European Journal of Sport Sciences and Medicine 13.1 (2016): 65-71.
  • Ziegenfuss, Tim N., et al. "A Two-Part Approach to Examine the Effects of Theacrine (TeaCrine®) Supplementation on Oxygen Consumption, Hemodynamic Responses, and Subjective Measures of Cognitive and Psychometric Parameters." Journal of dietary supplements (2016): 1-15.

Tuesday, November 1, 2016

Choosing & Processing Foods for Satiety: The Science 101 for Regular Consumers and Food Industry Insiders

Don't worry, this is no article about "Frankenfood" like salami bananas, ...
According to the drugs.com definition, a "designer food" is "a dietary supplements or foodstuffs containing nutrients and various combinations of vitamins, minerals, and other substances considered by some to offer clinically significant benefit, often without adequate scientific proof of efficacy." If you don't want your designer foods (or your self-prepared foods and meals) to fall into the latter category of products without adequate scientific proof of efficacy, this article is for you, because it summarizes the science on an often overlooked quality of food: its structure, and the effect the latter will have on your and/or customers' satiety.
Learn more about the satiety effects of foods, supplements and exercise

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More Protein Doesn't Always More Satiety

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Tryptophan, the Satiety Amino Acid?

Always Hungry? What's Triggering Your Craving?
In a recent review, Campbell et al. have aptly illustrated how both the product and the way(s) costumers eat it affect the individual satiety (see Figure 1).
Figure 1: Satiety is more complex than calories in vs. calories out - In fact, it's hardly about calories at all.
Allegedly, the separate roles of the initial food structure, structural transformations, oral processing,
and dynamic sensory perception in satiation (makes you stop eating) and satiety (reduces your incentive to have another meal | see blue box) have not been fully established, but hey: you've got to start somewhere when designing functional (satiating and satiety promoting) foods is #1 on your private or professional agenda. So here's what we know:
  • food structure and texture contribute to satiation and satiety,
  • time required for oral processing has been shown to influence satiation/satiety,
If we were able to integrate the interaction of food structure, texture, and oral processing on satiation/satiety this may help us to produce more satiating foods and thus help people lose weight. So how can we do that?  Vliet, van Aken, de Jongh, & Hamer (2009) classified foods as fitting into broad categories of:
  1. fluids - fluids flow and have minimal or no yield stress (e.g. beverages like sodas or milk); 
  2. semi-solids - semisolids are fluid-like, have a high yield stress, and deform or break without fracturing into pieces (e.g., pudding, yogurt, and bananas); 
  3. soft solids - soft solids fracture into pieces but without sound (e.g., cooked egg white, some cheese and processed meats); and 
  4. hard solids - hard solids fracture into pieces and emit sound during fracture (e.g., crackers, toast, nuts, apples, and carrots). 
Needless to say that these overall physical properties are (a) a result of the foods individual food structure and can (b) be modified to a certain degree and thus affect an individual food's satiety effect by either natural (e.g. fermentation, mixing, etc.) or artificial (e.g. enzymatic treatments, adding thickening agents, etc.) means.

But isn't that overrating the importance of texture?

Not really... After all, you must take into consideration that the texture of your foods will influence their satiating effect and your satiety (after the meal) by at least mechanisms, i.e.
  • oral processing parameters which are directly influenced, as well as adjusted to accommodate changes in food texture throughout the chewing sequence and ...
  • texture perception, which will influence your expectations of satiety, which - despite being a highly dynamic process that correlates with oral processing (chewing, etc.) will eventually have significant effects on the satiating and satiety effects of the foods you eat.
By turning a protein shake into a pudding with xanthan, for example, you will "force" yourself or your customers to consume the shake like a pudding: with a spoon. In addition, the mouthfeel of a pudding will leave them with the expectation that the product is more satiating than a watery whey protein shake - an expectation that usually turns into a self-fulfilling prophecy.
Table 1: Overview of the results of Campbell's review (2016); studies accompanied by a plus symbol (+) indicate that at least one measured marker of satiation/satiety was affected by texture
As Campbell et al. point out in their previously cited review, this has been shown in multiple study. Agrawal et al. (1998), for example, were one of the first to demonstrate the dependence of oral processing and thus your eating speed on intrinsic properties of food texture:
"Using a selection of cheeses, nuts, and carrots, the authors established a clear dependence of breakdown rate and activity of closing muscles on mechanical parameters – in this case, toughness and modulus of elasticity. More recent studies have expanded on this concept by utilizing a wider variety of foods varying in texture from fluids to soft and hard solids (Forde et al., 2013; Viskaal-van Dongen, Kok, & de Graaf, 2011). Though the foods were not characterized structurally, both Forde et al. (2013) and Viskaal-van Dongen et al. (2011) found significant differences in eating rates, ranging between 4 g/min for crisp foods such as rice cakes or tortilla chips, 100 g/min for soft cooked vegetables, and 650 g/min for thin beverages such as juice or soda. The total number of chews necessary to process 50 g samples ranged from 27 to 488 chews for mashed potatoes and tortilla chips, respectively while total oral processing time ranged from 27 s for canned tomatoes to 350 s for tortilla chips" (Cambell. 2016).
Now, I am probably not telling you something new, when I inform you that science shows that faster eating rates are associated with increased food intake. Thus the "real-world, real-food approach" (Campbell. 2016) indicates that foods requiring limited oral processing actions, such as liquids, semisolids, and soft, cooked solids, may be more easily over-consumed than hard or chewy solids, such as crackers, chips, or certain meats.
With its satiety-promoting effects soluble fiber will reduce the number of meals and prolong the intervals between meals on an ad-libitum diet. It will, however, not affect the satiating effect of an individual meal; meaning: if you are a binge eater whose extra body  fat is "acquired" from super-size meals, it's not going to get you lean.
Did you know that there's a difference between satiety and satiation? Satiety is what determines when and whether you're going to eat. Satiation is what tells your body that you can stop eating now.

Why would you care? Well, the answer can be found in a recent study on soluble fiber intakes, for example. While the latter will increase your satiety and thus reduce your meal frequency and the number of meals you will be consuming on an ad-libitum (eat when and how much you want), it won't affect your satiation. Practically speaking this means: Increasing the soluble fiber content of your diet is not going to magically prevent obesogenic binges - and, when all is said and done, 3x2000 kcal are as fattening as 6x1000kcal.
That doesn't sound so indisputable any longer, right? I mean we know that chips are not exactly more satiating than, say, chicken breasts. In this context, it is important to understand that pertinent studies measure eating rate by weight (g/min) rather than by total calorie intake (calories/minute). In our example, the chicken breast will yield higher eating speeds indicating that a higher amount (as in weight) of the product is being consumed per minute, but for a given amount of food, the caloric content of the chicken breasts is usually still significantly lower than that of potato chips, which is yet another example of the fact that you have to consider all variables (in this case, first and foremost texture, eating speed and relative energy density) and their interaction to predict the satiety and satiating effects of a meal.

But there's more to it than the difference between hard, soft and liquid. Even if you don't go beyond the structure (e.g. looking at the protein content of foods), modifying the microstructure with gelling protein-polysaccharides or reducing the creaminess by cutting down on fat will sign. affect the chewing rate and thus - at least theoretically - make foods more or less satiating.

So far so bad, because it's all theory!

I am not sure if you've tried low-fat cheese; but if you have, you will have notice that it chews and, unfortunately, tastes like cardboard and is thus hardly more satiating than regular cheese. To actually make reliable predictions about the satiating and satiety effect of various foods, it does, therefore, take real-world studies the design of which usually look as described by Campbell et al., recently:
" Measurements of satiation and satiety typically fall into three categories: subjective panelist ratings, physiological measurements, and ad libitum intake. Subjective panelist ratings of hunger and fullness, often in the form of a 100 mm visual analog scale (VAS), represent the most direct and simplistic measurement of hunger and fullness. These ratings are often corroborated by offering an ad libitum snack or meal and measuring how many calories the panelist consumes following consumption of a test food. One can also measure physiological biomarkers associated with metabolism, satiation, and satiety, including glucose, insulin, ghrelin, leptin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and gastric inhibitory peptide (de Graaf et al., 2004). Other physiological measurements include diet induced thermogenesis (Crovetti, Porrini, Santangelo, & Tesolin, 1997; Westerterp-Plantenga, Rolland, Wilson & Westerterp, 1999) and gastric emptying time (Blundell et al. 2010). While quantification of biomarkers provides an unbiased, physiological response, healthy panelists often exhibit wide ranges of biomarker concentrations and this biological variation can complicate interpretation of results. Combinations of the above measurements are more commonly utilized to account for biological and psychological variability" (Campbell. 2016).
From these studies, scientists have learned a lot. Not all of it was surprising. After all, we all have some knowledge of what is satiating and what is not. It is thus not a surprise that...
  • protein is the most satiating macronutrient, carbohydrates come in as a distant second and fats are really trailing behind;
Table 2: Dietary fibre content of foods in commonly served portions (Slavin .1987).
  • non-digestible carbohydrates are satiating, too  -  fiber (see Table 2) and resistant starches both fall into this category and are (rightly so) on the list of 'best-known satiety promoters'
That the satiating effect of protein is more or less independent of whether it is fast- or slow-digesting, on the other hand (see my recent article on whey and casein | read it), is something only a few people know. The same goes for the advantages of fiber with a high intrinsic viscosity – such as pectin, β-glucan, psyllium, guar gum, and alginate, which have been shown to have superior effects on individual's energy intake(s). Likewise on the list of often-overlooked satiety factors are...
  • polyphenolic compounds - these plant molecules have been shown to form high affinity, non-covalent bonds with both food proteins and digestive enzyme, will thus slow digestion and nutrient absorption... and thus up the satiety effect of the product and/or limit the nutrient uptake from the foods (e.g. tannins in cocoa, fruits, tea, cinnamon, and peanuts have been shown to be 'carb blockers')
Figure 3: Even for high protein foods, turning a solid into a liquid significantly compromises its satiety effect as measured by the dietary energy consumed after an isocaloric protein preload in 40 obese & lean subjects (Mourao. 2016).
  • grinding or homogenizing food - while solidifying is a tried and proven method to make a food more satiating, grinding, pureeing, homogenizing and co will decrease the satiety effects of foods such as a chunky fruit yogurt, chicken, etc. that will be less satiating when you puréed it and/or created a pie of it
  • increasing food volume - that's not by switching from chocolate to zucchini; rather than that it's about turning a soup-like food into a foam and/or simply using water to add volume
Figure 4: Mean overall intake at a breakfast test meal (±SEM) in grams (a) and kilocalories (b) that was served after a preload with 2mm (filled) or 50 mm (open bars). * represents significance at P < 0.05 (Lett. 2016).
  • modifying the lipid droplet size - emulsion with smaller droplets are more satiating than those with large(r) fat droplets (Lett. 2016)
Can xanthan reduce the glycemic response to "sweet treats" like this? Learn more in this SuppVersity Classic.
Ok, we know relatively little, but... the little we know leaves no question that satiety is not just about macros. After all, calories count and the amount of energy you will consume depends on more parameters than "your macros".

With that being said, the addition of fiber is already used extensively in the food industry. What is hardly noticed by consumers and producers alike, however, is that simply adding volume by stirring air / adding water (in)to a product will likewise add to the satiating effect of a given food; the same goes for water. In fact, up to now producers add air (e.g. ice-cream) and water (e.g. to ham) mostly to make the production cheaper. That this has satiating side effects, on the other hand, is rarely used on purpose | Comment!
References: 
  • Campbell, Caroline L., Ty B. Wagoner, and E. Allen Foegeding. "Designing foods for satiety: The roles of food structure and oral processing in satiation and satiety." Food Structure (2016).
  • Lett, Aaron M., Jennifer E. Norton, and Martin R. Yeomans. "Emulsion oil droplet size significantly affects satiety: A pre-ingestive approach." Appetite 96 (2016): 18-24.
  • Mourao, D. M., et al. "Effects of food form on appetite and energy intake in lean and obese young adults." International journal of obesity 31.11 (2007): 1688-1695.
  • Slavin, Joanne L. "Dietary fiber: classification, chemical analyses, and food sources." Journal of the American Dietetic Association 87.9 (1987): 1164-1171.