1

Sports Nutrition

With Exercise Physiology andGeneral Studies with Practical Application

G. Douglas Andersen, DC, DACBSP, CCN www.andersEnchiro.com

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Lab Values During Cramping

• Twelve players in an NFL pre-season training camp who suffered exercise-associated muscle cramps (EAMC) received a blood test prior to IV fluid replacement.

• A second blood draw was done on each player following a subsequent practice when they did not cramp.

RESULTS• No difference in % of dehydration, hematocrit,

hemoglobin, lactate, or serum osmolality.

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Lab Values During Cramping continued

Electrolyte Cramping Not Cramping

Sodium 139.6 mmol/L 139.0 mmol/L

Potassium 4.65 mmol/L 4.88 mmol/L

Chloride 98.2 mmol/L 104.0 mmol/L

Authors conclude low blood chloride may have “reduced hyperpolarization of alpha motor neuron, allowing easier excitation.”

Bartolozzi, A.R., Godek S.F., Greene R., et al. Blood Electrolytes in NFL Players While Experiencing EAMC Compared to When They Are Not Cramping After Similar Practice Conditions. Med. Sci. Sports Exerc. 2007; 39(5): S15, A-573.

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Sodium Levels and Exercise-Associated Muscle Cramps

• Six NFL players with histories of exercise-associated muscle cramping (EAMC) were compared to 8 controls during the 2006 preseason training camp.

• Fluid intake, sweat loss, blood sodium, and sweat sodium were all tested.

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Sodium Levels and Exercise-Associated Muscle Cramps

continued

Substance Cramp Non-cramp

Fluid intake 3.0 L 2.1 L

Net dehydration 2.3 L 2.4 L

Sweat loss 5.9 L 4.8 L

% water vs. sports drink 81% 58%

Sweat Na 52.6 mmol/L 38.3 mmol/L

Acute Na balance -223 mmol -133 mmol

• Players with a history of cramping drank more fluid, lost more sweat, drank more water than sports drink, and lost more sodium compared to players without a cramping history.

Stofan J.R., Horswill, C.A., Lacambra, M., Torriscelli, T., Murray, R. Acute Change in Blood Sodium During

a Two-a-day Training in Professional Football Players. Med. Sci. Sports Exerc. 2007; 39(5): S15, A-572.

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No Association Between Sodium and Exercise-Associated Muscle

Cramping

• Nine players with a preseason history of cramping were compared to 9 noncramping controls.

• Players were matched for race, size, playing time.

Substance Cramp Hx Non-cramp Hx

Sweat Na 55.7 mmol/L 44.0 mmol/L

Sweat loss 4.25 L 4.07 L

Na loss in grams 5.7 gm 4.0 gm

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No Association Between Sodium and Exercise-Associated Muscle Cramping

continued

• Authors concluded there was no significant difference in sweat Na, gross sweat loss, total Na loss, fluid intake, or % dehydration between NFL players with EAMC history versus matched controls.

• The authors made a note of the large variability of Na loss, which ranged from 1.6 grams – 10.9 grams during a 2-hour preseason practice.

Greene R., Godek S.F., Burkholder A.R., Peduzzi C. Sweat Sodium and Total Sodium Losses in NFL Players with EAMC During Training Camp Versus Matched Noncrampers. Med. Sci. Sports Exerc. 2007; 39(5): S15, A-574.

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Caffeine Improves Bench Press Repetitions

• Study to determine how a caffeinated energy drink affected muscular endurance.

• Fifteen subjects (11 male and 4 female ~ 21 years) • Performance was compared using a caffeinated energy

drink 2 mg/kg BW versus an isoenergetic non-caffeinated placebo.

• Subjects were blinded, randomized, and were tested on bench-press repetitions and Wingate sprints on 2 occasions using either the caffeinated beverage or placebo.

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Caffeine Improves Bench Press Repetitions

continued

• Bench-press at 70% 1-RM was done for three sets to failure w/ 1-minute rest between sets.

• Wingate sprints were three 30-second sprints with 2-minute rest between bouts.

RESULTS

• Caffeine increased bench-press repetitions from 32 to 34 (rep total from all 3 sets).

• Caffeine had no effect on peak power or average power during Wingate sprints.

Candow D.G., Little J., Forbes S.C., et al. The Effect of Caffeinated Energy Drink on Muscle Endurance and Wingate Cycle Performance in Young Adults. Med. Sci. Sports Exerc. 2007; 39(5): S43, A-698.

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Caffeine Does Not Improve Bench Press Maximum

• Study was done to determine ergogenic potential during maximal strength testing.

• Twenty subjects were tested on 2 occasions using either 6 mg/kg/bw of caffeine or placebo.

• They abstained from caffeine for 2 days prior to the test and abstained from exercise for 24 hours prior to each test.

• Bench-press maximum was determined followed by rep’s (60% 1-RM) to failure.

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RESULTS• There was no difference in bench-press

maximum (averaged 260 vs. 258). • Number of repetitions were increased with

caffeine. • Authors concluded that caffeine does not have

an ergogenic effect for 1 rep maximum but may enhance endurance performance.

Caffeine Does Not Improve Bench Press Maximum

continued

Astorino T.A., Rohmann, R.L., Firth, K. Effect of Acute Caffeine Ingestion on One-Repetition Maximum Muscular Strength. Med. Sci. Sports Exerc. 2007; 39(5): S43, A-699.

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Effects of Caffeine on Simulated Four-Quarter Sporting Event

• Ten moderate caffeine users (6 males, 4 females) were tested on 4 occasions.

• Each test was four 22-minute quarters of shuttle running. • Subjects received 20 ounces of a flavored placebo, carbohydrate

sports drink, placebo plus 100 mg caffeine, or sports drink with 100 mg of caffeine prior to each test.

• During testing, the subjects drank 3.5 ml/kg/hr. {175 lb subject ~ 9oz/hr; ~14oz over 4 quarters}.

• Tests during the trial included 20-meter sprint, vertical jump, motor skill testing, rating of perceived exertion, psychomotor vigilance, mood profile, gross motor skill test, and force sensation.

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Caffeine and Four-Quarters RESULTS

• There were no differences in 20-meter sprint time, vertical jump, or gross motor skills between any of the treatments.

• Caffeine with and without carbohydrate significantly improved psychomotor vigilance at half-time.

• Carbohydrate with caffeine improved rating of perceived exertion, mood, and vigor.

• Systolic blood pressure was unchanged with every treatment except caffeine and carbohydrate.

• No difference was found in heart rate, core body temperature, plasma volume change, or hydration status between any of the 4 treatments.

• Conclusion: The authors concluded that the low-dose caffeine ingestion prior to and during team style exercise did not cause dehydration but did enhance mental function tasks.

Chen S.C., Davis, J.M., Matthews E., Hebda S., et al. Effects of caffeinated sports drinks on physical/mental function during team sports exercise. Med. Sci. Sports Exerc. 2007; 39(5): S43, A-700.

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Caffeine’s Influence on Hydration in Women Using Birth Control

• Study to determine whether or not 365 mg of caffeine would affect hydration status in college-aged women during 2 phases of the menstrual cycle.

• Nineteen habitual caffeine users on oral contraceptives (~ 22yrs) were measured on 4 occasions following the consumption of 3 cans of caffeine-free soda or the consumption of 3 cans of soda with the addition of caffeine to total 365 mg.

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Caffeine’s Influence on Hydration in Women Using Birth Control

continued

• Subjects were measured on days 11 and 13 (follicular) and days 26 and 28 (luteal) after consuming either decaf-soda, or caffeinated soda.

RESULTS• Caffeine ingestion did not increase urine output,

or affect hydration status during either the follicular or luteal phase.

Shima, C., Dolgener, F., Lund, R., Finn, K. Influence of Caffeine on Hydration Status of College-Aged Females. Med. Sci. Sports Exerc. 2007; 39(5): S100, A-952.

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Caffeine’s Influence on Hydration During Tennis

• Ten experienced male tennis players participated in two 90-minute simulated matches.

• The simulated match was against a ball machine with skill tests done prior to and at 30, 60, and 90 minutes.

• Subjects consumed 32 ounces of a carbonated drink or a carbonated drink with 3 mg/kg/bw of caffeine.

• The skill testing included 15 ground strokes in 4 directions using backhand and forehand both cross court and up the line.

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Caffeine’s Influence on Hydration During Tennis

continued

• Players were monitored throughout the protocol and had blood samples collected prior to, and at 30 and 90 minutes (post match).

RESULTS

• There was no difference in urine volume, specific gravity, heart rate, rate of perceived exertion, or sweat rate, and hydration status between caffeine and non-caffeine trials.

• Caffeine improved the skill performance following the match (@ 90 minute test).

• The authors concluded caffeine may be of benefit during later stages of tennis match play with no dehydrating effects.

Strecker,E., Foster E.B., Taylor, K., et al. The Effect of Caffeine Ingestion on Tennis Skilled Performance and Hydration Status. Med. Sci. Sports Exerc. 2007; 39(5): S100, A-953.

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Caffeine’s Influence on Hydration During Cycling

• Test was performed to determine how caffeine affected fluid balance during exercise in warm, humid conditions (83 degrees with 60% relative humidity).

• Sixteen cyclists randomly participated in three trials using either 2-L of a placebo beverage (P), carbohydrate-electrolyte beverage (CE), or a carbohydrate-electrolyte beverage with 195 mg of caffeine (CEC) per L (380 mg total caffeine).

• Testing consisted of a 120-minute ride at 65 to 70% VO2 max followed by a 15-minute time trial.

• Tests were performed in random order. • Subjects were measured for relative dehydration (body weight loss),

sweat rate, urine output, plasma volume losses of serum electrolytes.

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Caffeine’s Influence on Hydration During Cycling-Results

• Caffeine did not affect any of the physiologic measurements following the 2-hour ride.

• During the 15-minute sprint, core body temp’s on CEC were than higher than P for all 15 minutes & higher than CE for the last 5 minutes.

• Serum osmolality during the time trial was as follows: CEC 7.9 mosmol/kg, CE 6.7 mosmol/kg, P 3.0 mosmol/kg.

• Time trial VO2 max was as follows: CEC 90%, CE 79% VO2, P 74.5%.

• Authors concluded CE + C improved performance, did not dehydrate, that the core temperature increase and mild fluid loss during the time trial (reflected via serum osmolality) was due to the greater intensity reflected in VO2 attained in TT.

Trilk, J.L., Millard-Stafford, M.L., Cureton, K.J., et al. Hydration During Exercise in Warm, Humid Conditions: Effect of a Caffeinated Sports Drink. Med. Sci. Sports Exerc. 2007; 39(5): S100, A-954.

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Caffeine and the Placebo Effect

• 14 competitive male cyclists (~ 43 yrs) who

averaged 300 mg of habitual caffeine intake participated in fourteen 40k trials over 14 weeks.

• Participants abstained from caffeine 24 hours before each trial.

• Trials 1, 2, 7, 8, 13, and 14 were baseline trials to establish effects of the test protocol.

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Caffeine and the Placebo Effectcontinued

Intervention

Trial Informed intervention

Actual Intervention

Power in watts

3, 4 Told caffeine Given caffeine 277

5, 6 Told no caffeine Given caffeine 279

9, 10 Told caffeine Given placebo 272

11, 12 Told no caffeine Given no caffeine 266

Ford, H.A., Beedie, C.J., Coleman, D.A. Pharmacological and Psychological Effects of Caffeine Ingestion in 40-KM Cycling Performance. Med. Sci. Sports Exerc. 2007; 40(1): 158-165.

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Betaine • Betaine is a methyl donor also known as

trimethylglycine (TMG). • TMG is the amino acid glycine with 3 methyl groups. • Methyl donors can transfer methyl groups from one

molecule to another (most commonly, a hydrogen atom is replaced by a methyl group).

• Betaine (TMG) is also considered an organic osmolyte.

• Organic osmolytes are substances that accumulate intracellularly to protect from osmotic injury and maintain hydration.

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Betaine for Strength and Power

• Twelve male subjects (~ 21 yrs) participated in two 14-day supplement periods concluding with 2 days of high-intensity/power resistance exercise challenge testing.

• Researchers compared placebo (8 ounces of Gatorade bid) versus the test supplement (8 ounces of Gatorade plus 1.25 grams of betaine bid).

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Betaine for Strength and Powercontinued

RESULTS• 2.5 grams of betaine for 14 days increased bench

press throw power 1779 W* compared to placebo 1535 W.

• Isometric bench press force was increased with betaine 2922 N** versus 2345 N placebo.

• Researchers concluded that betaine supplementation increased power and force in bench press. Vertical jump & squat force were unchanged.

*W = watt. Kinetic energy equal to 1/1000th horsepower. **N = newton. The amount of force required to move 1 kilogram 1 meter in 1 second of time.

Maresh, C.M., Sarrell, M.J., Kraemer, W.J., et al. The Effects of Betaine Supplementation on Strength and Power Performance. Med. Sci. Sports Exerc. 2007; 39(5): S101, A-957.

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Branched-Chain Amino Acids

• BCAAs are leucine, isoleucine, and valine. • BCAAs make up one-third of muscle protein. • BCAAs provide 90% of the nitrogen for glutamine

synthesis. • Studies on milligram amounts of BCAAs are

almost universally negative. • Studies using gram amounts of BCAAs are mixed

with increasing positives as doses inc.• Lean Beef, Chicken & Turkey breast contain ~1.4

gm/BCAA/oz (cooked)

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Branched-Chain Amino Acids, Muscle Damage, and Endurance Exercise

• Nine untrained male subjects performed three 90-minute cycling bouts at 55% VO2 max.

• Beverages consumed in random fashion on each ride were as follows: placebo (P) flavored water, carbohydrate drink (CHO) 200 calories, BCAA drink (BCAA) 200 calories.

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Branched-Chain Amino Acids, Muscle Damage, and Endurance Exercise

continued

RESULTS• Creatine kinase (indicator of muscle damage)

was lower compared to placebo with CHO and BCAA at 24 and 48 hours post exercise.

• The rate of perceived exertion was lowest when BCAA drink was consumed.

• Conclusion: 50 grams of branched-chain amino acids attenuated muscle damage after a prolonged exercise in untrained individuals in a similar fashion as did 50 grams of carbohydrate ingestion.

Greer, B.K., Woodard, J., White, J., et al. Branched-Chain Amino Acid Supplementation Attenuates Indirect Indicators of Muscle Damage Post-Endurance Exercise. Med. Sci. Sports Exerc. 2007; 39(5):S82, A-872

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How Much Protein in a Sports Drink?

• It is well established that dilute carbohydrate drinks (6-8%) are superior to plain water for endurance.

• There is growing evidence that adding protein to a dilute carbohydrate drink will further improve performance.

• Optimal amounts of protein have yet to be established.

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Comparing Different Levels of Protein in a Sports Drinks

• Ten fit males participated in 3 simulated duathlons.

• 8k treadmill run @ 80% VO2 max plus 50k E-bike at 70% VO2 max plus treadmill run to exhaustion.

• Trials were separated by 7 to 14 days. • Test solutions were as follows: 1.5 L of 6%

carbohydrate drink, 1.5 L of 6% carbohydrate drink plus 1.2% protein, 1.5 L of 6% carbohydrate drink plus 2.4% protein.

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Comparing Different Levels of Protein in a Sports Drinks

continued

RESULTS

Beverage Time to Exhaustion (Minutes)

6% carbohydrate 13.0

6% carbohydrate plus 1.2% Pro 17.5

6% carbohydrate plus 2.4% Pro 14.2

Moore, R.W., Saunders, M.J., Pratt, C.A., et al. Improved Time to Exhaustion with Carbohydrate-Protein Hydrolysate Beverages. Med. Sci. Sports Exerc. 2007; 39(5): S89, A-904.

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Echinacea Raises EPO but not Erythropoietic Status

• 24 males (~ 25 yrs) divided into 2 groups of 8 grams echinacea purpurea daily or placebo for 4 weeks.

Serum EPO (mU/mL)

Day Echinacea Placebo

7 15.75 10.01

14 18.88 11.02

21 16.06 9.20

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Echinacea Raises EPO but not Erythropoietic Status

continued

• There were no statistically significant increases in hematocrit, hemoglobin, or red cell count despite the serum EPO increase.

• Conclusion: Echinacea significantly increased EPO, but concomitant increases reaching statistical and physiological significance in associated indices did not occur. The authors stated “…this raises doubt whether echinacea will enhance athletic performance or not.”

Whitehead, M.T. , Martin, T.D, Scheett, T.P., Webster, M.J., The Effect of Four Weeks of Echinacea Supplementation on Erythropoietin and Indices of Erythropoietic Status. Int. J Sports Nut Exerc Met 2007; 17(4) 378-390.

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Echinacea May Be Ergogenic

• The exercise testing data for the previous study was not available at the time of publication.

• VO2 max increased by 1.47 after 4 weeks of 8 grams of echinacea purpurea compared to placebo -0.13.

• The authors were surprised at the VO2 max improvement and suggested that the increased EPO may have affected VO2 max in a manner that has yet to be investigated (since red blood cell levels, hemoglobin, and hematocrit were unchanged).

Whitehead, M.T., Martin, T.D., Webster, M.J., Scheett, T.P. Improved Running Economy and

Maximal Oxygen Consumption after 4 Weeks of Oral Echinacea Supplementation. Med. Sci. Sports Exerc. 2007; 39(5): S90, A-90

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Topical Menthol and Blood Flow• Twelve subjects (~ 24 yrs) had brachial artery blood flow

measured by Doppler ultrasound before and after an application of a 3.5% menthol ointment to their forearms.

• Blood measurements began 5 minutes prior to and 1, 2, 3, 4, and 10 minutes following treatment with the ointment.

• Blood flow at 1 minute post treatment was decreased 43% and remained decreased at 23% when measured at the 10-minute measurement.

• Overall blood flow reduction averaged 30%, which the authors comment is similar to ice.

Hollis, B., Andres, J., Mattson, E., et al. Effects of Menthol on Skeletal Muscle Blood Flow. Med. Sci. Sports Exerc. 2007; 39(5): S20, A-595.

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Continuous Ultrasound versus Pulsed Ultrasound for Muscle Recovery

• Exercise-induced muscle damage leads to force loss and disruption of extracellular collagen matrix.

• 24 subjects performed an eccentric elbow flexor protocol to elicit delayed-onset muscle soreness (DOMS).

• Maximum isometric contraction was measured 3 days prior to and at 1, 2, 3, 4, and 7 days following the eccentric exercise protocol.

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Continuous Ultrasound (US) versus Pulsed Ultrasound for Muscle Recovery

continued

• Subjects were divided into 4 groups. – Group 1 – No exercise, no treatment (control).

– Group 2 – Eccentric exercise with no treatment.

– Group 3 – Eccentric exercise with pulsed US.

– Group 4 – Eccentric exercise with continuous US.

• Ultrasound treatments were applied for 5 minutes @ 0.8 W/cm2

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Continuous Ultrasound versus Pulsed Ultrasound for Muscle Recovery

RESULTS• The group that received the continuous US had

a full recovery of maximum isometric contraction by the 4th day.

• The exercise only and exercise plus pulsed US groups were still not fully recovered at 7 days although the pulsed US group had less pain more strength than the exercise-only group.

Penailillo, L., Plaza, P., Gurovich, A.N. Forced Recovery After Exercise-Induced Muscle Damage and its

Relationship with Muscle Extra-Cellular Collagen Matrix. Med. Sci. Sports Exerc. 2007; 39(5): S65, A-799.

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Traumeel Beats Diclofenac

• Diclofenac is a nonsteroidal anti-inflammatory also marketed under the name Voltaren and Mobidic, Arthrotec, and Zolterol.

• In Europe, it is available in a topical preparation over the counter and is used as a topical pain reliever.

• 252 Chilean Olympic athletes were recruited between December 2005 and September 2006 when they were seen for injuries.

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Traumeel Beats Diclofenaccontinued

• The athletes with nontraumatic tendon injuries received 1 of 3 topical ointments during their treatment. The caregivers were blinded as to what preparation they applied 4 times a day.

• 59 M, 30 F received Traumeel S. • 60 M, 27 F received Diclofenac ointment. • 50 M, 26 F received neutral ointment. • Pain reduction was graded via the 10-point visual

analog scale (VAS).

• Echographic assessment of peritendinous diameter and edema was done by the same technician at the onset of injury and at day 21.

40

Traumeel Beats Diclofenaccontinued

Traumeel Diclofenac Neutral

Visual Analog Scale 5.2 points 3.6 points 1.4 points

Edema reduction* 88.2% 69.1% 25.6%

Days ** 20.3 24.6 30.6

* As measured by echograph day of onset versus day 21. ** Number of days needed to return to play.

Four athletes in the diclofenac group dropped out due to skin reactions. Authors conclude that Traumeel S is an efficacious and safe alternative to topical nonsteroidal anti-inflammatory cream in the treatment of tendon injuries in athletes.

Orizola, A.J,. Vargas, F. The Efficacy of Traumeel S Versus Diclofenac and Placebo Ointment in Tendinous Pain in Elite Athletes: A Randomized Control Trial. Med. Sci. Sports Exerc. 2007; 39(5): S79, A-858.

41

Heavy Training and URIs

• Upper respiratory illnesses (URI) are commonly encountered by elite athletes

• An association has been established between workload and susceptibility.

• URI incidence increases dramatically following competition or heavy training periods.

• Actual pathologic causes remain unclear because no studies have thoroughly isolated the etiology of infections.

42

Heavy Training, URI’s and Elite Athletes

• Researchers in Australia performed a prospective surveillance study over a 5-month period, following 83 subjects (19-34 yrs).

• The subjects were 32 elite triathletes, 31 recreational triathletes, and 20 non-exercising controls.

• When the subject had 2 or more of the following symptoms: Sore throat, runny nose, cough, sneezing, congestion, headache, fever, body ache for more than 24 hours, they contacted study personnel.

• Within 24-36 hours, the chief investigator presented and took throat samples, nasopharyngeal samples, saliva, and blood.

43

Heavy Training, URI’s & Elite Athletescontinued

• 17 subjects dropped out. (15 elite athletes, 1 recreational, and 2 controls.)

• 37 URIs were identified in 28 subjects over 5 months. • Breakdown was as follows:

– 16 elite athletes had 21 URI’s. – 6 recreational athletes had 7 URI’s. – 8 control’s had 9 URI’s.

• 7 subjects had more than 1 URI (5 elite, 1 recreational, 1 control).

• Only 30% had an identified pathogen. • Researchers questioned the practice of calling all upper

respiratory illness an infection.

Spence, L., Brown, W.J., Pyne, D.B., et al. Incidence, Etiology, and Symptomatology of Upper Respiratory Illness in Elite Athletes. Med. Sci. Sports Exerc. 2007; 39(4): 577-86.

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Quercetin Reduces URI in Athletes

• 40 male (~ 27 years) cyclists who rode at least 150 miles a week were recruited for a 5-week study.

• Subjects were divided into 2 groups of 20 and were given two 8-ounce packets of a powdered drink mix (Tang) twice daily.

• The experimental group’s powdered drink packets contained 500 mg of quercetin.

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Quercetin Reduces URI in Athletescontinued

• For 3 weeks, the athletes maintained normal diet and exercise and consumed the drinks twice daily.

• They then reported to the laboratory on 3 consecutive days for intensive 3-hour supervised rides.

• The 3-day test protocol exceeded the work that they would normally accomplish in 7 days.

• The subjects then continued to take the powdered drink 2 times daily for an additional 2 weeks.

46

Quercetin Reduces URI in Athletes

RESULTS• There were no differences between the groups

for blood lymphocytes, granulocytes, leukocytes, leukocyte subsets, and NK cell levels.

• Plasma cortisol, epinephrine, norepinephrine were unchanged between groups as was salivary IgA.

• The post study questionnaire regarding the intervention drink was answered exactly the same in both groups.

47

Quercetin Reduces URI in AthletesRESULTS

continued

• In both groups, 9/20 thought they were taking the quercetin, 4/20 thought they were taking the placebo & 7 subjects were unsure.

• At week 5, the researchers followed up with each subject and inquired if any had suffered an upper respiratory illness. (None of the participants were sick before the 3-day testing period.)

• 9/20 subjects consuming the placebo drink reported an illness vs only 1/20 in the quercetin users.

Neinan, D.C., Henson, D.A., Gross, S.J., et al. Quercetin Reduces Illness but not Immune Perturbations After Intensive Exercise. Med. Sci. Sports Exerc. 2007; 39(9): 1561-1569.

48

Nocebo Effect

• The nocebo effect is a negative placebo effect.• 42 team sport males (~20 yrs) from football, basketball,

soccer, rugby & field hockey were tested in 3-30 meter sprints (w/ 2 min rest) and separated into 2 groups.

• One group (positive belief) was given cornstarch capsules & were told they were taking a product proved to enhance endurance & repeated sprints.

• The other group (negative belief) got the same capsules but were told they helped endurance but harmed repeated sprints.

• 20 minutes later the separated groups repeated the 3-30m sprints

49Beedie, C.J., Coleman, D.A., Foad, A.J. Positive and Negative Placebo Effects Resulting from Deceptive Administration of an Ergogenic Aid Int J Sport Nutr Exerc Met 2007; 17(3) 259-269

50

Propolis

• The purpose of the study was to investigate the effect of 2 weeks of propolis supplementation had on exercise-induced oxidative stress at 110% of anaerobic threshold.

• Propolis is made by bees from mainly tree sap. • Propolis is rich in flavonoids. • Propolis has been used for thousands of years for

its antiseptic and antimicrobial properties. • There are unsupported claims that propolis is

ergogenic and that its use increases energy, stamina, endurance, and exercise performance.

51

Propoliscontinued

• 40 subjects (~ 45 yrs) took part in a 2-week study and were divided into 2 groups.

• Experimental group took 990 mg of propolis daily (3 capsules 3 times daily) for 2 weeks.

• The control group took 3 placebo capsules 3 times daily.

• Exercise testing prior to intervention established anaerobic threshold for all subjects.

52

Propolis

RESULTS• There was no change in exercise performance

between groups. • Laboratory measurements of malondialdehyde,

interleukin-6, tumor necrosis factor (TNF), and plasma total antioxidant status did not reach statistical significance between the groups.

• The authors stated there was a trend toward increase in plasma total antioxidant status and commented that propolis may help the antioxidant system even in high-intensity exercise.

Jin, Y.S., Lee, H.Y., Lee, H.J., et al. Effects of 2 Weeks of Propolis Supplementation on the Exercise-Induced Oxidative Stress by Exhaustive Exercise at the Level of 110% Anaerobic Threshold. Med. Sci. Sports Exerc. 2007; 39(5): S159, A-1222

53

Does Juice Plus Enhance Immunity?

• 40 members of a Special Forces unit were divided into 2 groups and took either 3 Juice Plus pills twice daily or a placebo for 7 months.

• Blood samples and exercise testing (79% VO2 max to exhaustion) was done at baseline in months 1, 2, 4, and 7.

54

Does Juice Plus Enhance Immunity?

RESULTS• TNF-alpha increased significantly in both groups* at month

2 due to a documented upper respiratory infection. • The Juice Plus group had decreasing TNF-alpha and

carbonyl protein (CP) levels at months 4 and 7. • The placebo group’s TNF-alpha and carbonyl protein

levels remained unchanged at months 4 and 7. • The authors concluded the ability of Juice Plus to reduce

TNF and CP indicated it reduced immune system activation (therefore enhancing immunity).

• *The authors did not explain why the J.P. group caught the same URI and got just as sick as the Placebo group did.

55

Juice Plus – Analysis Fruit & Vegetable Juice dried extracts

Nutrient Fruit Pill* Veggie Pill** Folic Acid 50mcg 150mcg Vitamin C 75mg 25mg Vitamin E 20 IU 20 IUCarotenoids 833 IU 833 IUBioflavonoids 50mg 50mg*apple, orange, cranberry, acerola cherry, pineapple, peach, pawpaw

**carrot, barley, parsley, beet, broccoli, cabbage, spinach, tomato, kale

Samman, S., Sivarajah, G., Man, JC., et al. A Mixed Fruit & Vegetable Concentrate Increases Plasma Antioxidant Vitamins & Folate & Lowers Homocysteine in Men. J Nutr 2003: 133(7) 2188-93

56

Creatine Mechanism of Action Review

• Creatine increases ATP resynthesis during high-intensity exercise, which in turn increases muscular performance.

• Via creatine supplementation, phosphocreatine pools increase, allowing the phosphagen system to participate in more reactions before depletion.

• Phosphocreatine increases (via creatine supplementation) the transfer rate of high-energy phosphates between the mitochondria and cytosol, which are used to drive the reactions for the synthesis of contractile protein.

57

Creatine Mechanism of Action Review

continued

• Creatine supplementation appears to increase the intramuscular concentration of satellite cells and myonuclei, which in turn enhances muscular strength and hypertrophy.

• Creatine supplementation appears to up-regulate transcriptional changes in muscle-gene expression involving contractile protein synthesis in response to progressive resistance exercise.

58

Protein, Carbohydrate and Creatine (PCC) vs. Protein & Carbohydrate (PC)

vs. Protein only (P)

• 31 males (~ 26 years) with an average of 4 years of weight training who have been working out on average 4 times per week for the previous 6 months were recruited.

• None of the subjects had ever used anabolic steroids.

• All of the subjects had abstained from any type of ergogenic aid for the previous 3 months.

59

PCC vs. PC vs. Pcontinued

• The subjects began the investigation with a 3-week pretrial exercise routine to eliminate any muscular improvements due to neurological adaptation from different exercises.

• After 12 weeks, all subjects then underwent baseline testing, which allowed the researchers to form 3 groups matched for strength in the test exercises (bench press, pull-downs, and squats).

• Workout: 10 weeks of high-intensity workouts with one-on-one supervision.

• The program was based on compound exercises with free weights designed to increase strength and mass.

60

PCC vs. PC vs. Pcontinued

• Weeks 1 and 2 followed a 10-repitition routine; weeks 3 to 6 with 6 to 8 repetitions; weeks 7 to 10 with 4 to 6 repetitions.

• The 3 groups were assigned to consume 1 of 3 supplements.

• Each group took the supplement midmorning, post workout or mid afternoon, and before bed.

• The supplement amount was based on g/kg of body weight.

• For an 80-kg subject, this equated to protein (P) 120 grams divided into 3 doses, which provided 103 g of protein, 5 g of carbohydrate, 1 g of fat, and 447 calories.

61

Protein, Carbohydrate & Creatine vs. Protein & Carbohydrate vs. Protein

continued

80-kg SubjectProtein (P) 120 grams

Protein carbohydrate 120-g dose (PC)

Protein-Carbohydrate-Creatine (PCC) 120-g dose

Protein 103 52 g 48 g

Carbohydrate 5 59 g 53 g

Fat 1 0.5 g 0.5 g

Calories 447 449 409

Creatine 0 0 8 g

62

63

64

Protein, Carbohydrate & Creatine vs. Protein & Carbohydrate vs. Protein-Only

continued

Weight Gain in lbsGroup Total Mass Lean Mass Body Fat (Pre,

Post)

P +9.28 +10.78 17.2% – 13.6%

PC +14.96 +9.02 15.1% – 15.9%

PCC +15.6 +15.18 16.3% – 14.1%

Exercise Improvements in lbsGroup Squat Bench Pull-Down

P +55.4 +24.86 +26.62

PC +50.8 +19.80 +26.62

PCC +76.3 +49.28 +41.14

Cribb, P.J., Williams, A.D., Hayes, A. A Creatine-Protein-Carbohydrate Supplement Enhances Responses to Resistance Training. Med. Sci. Sports Exerc. 2007; 39(11): 1960-1968.

65

Creatine and Kidney Function

• 14 males (18-35 yrs) were randomized into 2 groups.

• Subjects took either 10 grams of creatine per day or a placebo for 90 consecutive days.

• Both groups participated in a moderate aerobic workout 3 days a week for 40 minutes.

• Neither group did any other exercise including weight training of any form.

66

Creatine and Kidney Function

RESULTS• There was no difference in renal function between

those who took 70 grams of creatine per week for 12 weeks and those who did not.

• Both groups showed a reduction in oxidative stress and an improvement in glomerular filtration rate.

• The authors commented that moderate aerobic training appeared to improve renal function irregardless of whether high-dose creatine was used or not.

Gualano, B., Novaes, R.B., Coelho, D.F., et al. High-Dose Long-Term Creatine Supplementation Deteriorate Renal Function in Males Submitted to Exercise Training? Med. Sci. Sports Exerc. 2007; 39(5): S44, A-705.

67

Vibration Training #1

Effects of Whole-Body Vibration on 40-Meter Sprint Times

Conclusion: Vibration training did not produce

any statistically significant findings in the 14 subjects.

The authors commented that “perhaps whole body vibration training would benefit sprints greater than 40 meters.”

1. Guggenheimer, J.D., Tveden, R., Reyes, G.F., et al. Effects of Whole-Body Vibration Exposure on 40-Meter Sprint Times. Med. Sci. Sports Exerc. 2007; 39(5): S209, A-1424.

68

Vibration Training #2

The Effects of Six Weeks Periodized Resistance Training With or Without Whole-Body Vibration

Conclusion: Whole-body vibration training for 13 subjects for 6 weeks did not improve 1 rep max on the Smith machine squat beyond resistance training alone done by 11 subjects. Vibration frequency and amplitude “appeared to be too intense for most subjects”.

Lamont, H.S., Bemben, M.G., Bemben, D.A., et al. The Effects of Six Weeks Periodized Resistance Training With or Without Whole-Body Vibration. Med. Sci. Sports Exerc. 2007; 39(5): S296, A-1787.

69

Vibration Training #3

Effect of Whole-Body Vibration on Three Maximum Repetition Sets of Push-Ups – Pilot Study

Results: in the 7 subjects, no statistically significant difference between the number of reps in 3 sets of maximum push-ups with high-frequency vibration, low-frequency vibration, or no vibration. A slight trend favoring vibration was present.

Terra, B., Teixeria, R.T., Leite, B.M., et al. Effect of Whole-Body Vibration on Three Maximum Repetition Sets of Push-Ups – Pilot Study. Med. Sci. Sports Exerc. 2007; 39(5): S297, A-1790.

70

Vibration Training #4

A Comparison of Strength Gains Between Exercises Utilizing the Power Plate Versus Free Weights

Conclusion: Subjects in both groups saw increases in upper body strength.

Statistically significant differences between pre and post testing were only seen in the free weight group and not the power plate (vibration) group.

Boland, B., Barfield, W.R. A Comparison of Strength Gains Between Exercises Utilizing the Power Plate Versus Free Weights. Med. Sci. Sports Exerc. 2007; 39(5): S298, A-1796.

71

Vibration Training #5

Acute Effects of Whole-Body Vibration on Vertical Jump Performance and Related

Muscle Activity

Conclusion: Jump height and electrical activity of muscles showed no significant differences between the 30 participants.

Skidmore, E., Stoutenberg, M., Webb, V., et al. Acute Effects of Whole-Body Vibration on Vertical Jump Performance and Related Muscle Activity. Med. Sci. Sports Exerc. 2007; 39(5): S300, A-1802.

72

Vibration Training #6

3-RM Bench Press Responses to Upper Body Vibration Exposure

Conclusion: Upper body vibration had no effect on 3-RM bench press when exposed either prior to or during exercise and does not augment acute maximal strength in the 13 young men (~20 yrs) studied.

Reyes, G.F., Silvers, W.M., Dolny, D.G. 3-RM Bench Press Responses to Upper Body Vibration Exposure. Med. Sci. Sports Exerc. 2007; 39(5): S304, A-1823.

73

Energy Patches

• Companies who market energy patches claim that organic nanoscale biomolecular substances resonate at frequencies similar to human cells.

• The frequencies emitted from the patches are claimed to activate electron flow in the body, which in turn attracts calcium influx to contractile tissues allowing greater recruitment of muscle fibers and a stronger contraction.

74

Energy Patchescontinued

• The manufacturers of the product in this study cite unpublished data that shows 99% of users experienced improvements in strength of at least 10%.

• 41 collegiate football players were tested to establish a baseline and then divided into 2 groups, one of which wore the energy patch and the other a placebo patch and were retested.

• 7 days later, the tests were repeated with the subjects using the opposite patches.

75

Energy Patches

RESULTS• There were no differences between the energy patches

and placebo patches in maximum bench press repetitions, vertical jump, grip strength, total work, average peak torque.

• There were increases between the energy patch group and placebo group for power and peak torque.

• The authors stated that inconsistency in the overall results “demanded further studies to determine the reliability in improvement of performance in the presence of energy patches.”

Jacobson, B.H., Kolb, T., Smith, D., et al. Effect of Liquid Crystal Semi-Conductor Energy Patches on Strength and Endurance in Collegiate Football Players. Med. Sci. Sports Exerc. 2007; 39(5): S299, A-1798.

76

Panax Ginseng• 30 male college students consented for a double-blind, placebo-

controlled randomized trial. • They were divided into 2 groups and for 60 days took either a

standardized panax ginseng extract equivalent to 2 grams of ginseng root or a sugar placebo.

• The authors described the dose as “the upper end of clinically recommended levels.”

• 12 out of 15 in the ginseng group and 13 out of 15 in the placebo group completed the study.

RESULTS• Pre/post examinations showed that ginseng had no effect on heart

rate, stroke volume, or blood pressure. • Exercise testing revealed ginseng had no effect on cardiac output

at rest, submaximal, or peak exercise.

Engels, H.J., Lohcham, N.S., Elmore, N.S. Effects of Panax Ginseng on Rest, Exercise, and Post-Exercise Recovery Hemodynamics in Healthy College Males. Med. Sci. Sports Exerc. 2007; 39(5): S360, A-2055.

77

Korean Red Ginseng

• 18 male college students were divided into 2 groups.

• 7 days prior to and 3 days following a test designed to elicit muscle injury, the subjects took 3 servings a day (7 grams) of red ginseng or placebo.

• The eccentric test was a 6-km downhill treadmill run at a 14-degree slope.

• Venous blood was drawn prior to exercise, immediately post exercise, and at hours 1, 24, 48, and 72 following exercise.

78

Korean Red Ginsengcontinued

RESULTS• Creatine kinase (enzyme indicative of muscle

damage) was elevated in both groups immediately following exercise, 1 hour, and 24 hours.

• Creatine kinase levels were lower in the red ginseng group at 48 hour and 72 hours compared to placebo.

Kwak, H.E., Kim, Y.C., et al. Effects of Red Ginseng Intake on Muscle Injury Due to Eccentric Exercise. Med. Sci. Sports Exerc. 2007; 39(5): S361, A-2056.

79

NotoginsengAKA Pseudoginseng or Tienchi Ginseng

• Purpose of the study was to test 4 weeks of various doses of notoginseng on its effect on blood glucose, insulin, and glycosylated hemoglobin A1c, and postprandial glycemia.

• 30 sedate, overweight (BMI ~29) adults (~50 years), 24 F and 6 M.

• Subjects were divided into 3 groups and for 4 weeks took either 3 grams of notoginseng daily, 2 grams of notoginseng daily, or a placebo.

• Neither 3 grams of notoginseng or 2 grams of notoginseng had any effect on reducing fasting and postprandial glucose, insulin, or hemoglobin A1c.

Campbell, K.E., Caudill, M.A., Spalding, T.W., et al. Four Weeks of Panax Notoginseng Supplementation has No Effect on Blood Glucose on Non-Diabetic Adults. Med. Sci. Sports Exerc. 2007; 39(5): S361, A-2057.

80

Static Stretching Inhibits Sprint Speed• 20 elite female collegiate soccer players were randomly

assigned to either a static stretch or no stretch group following a standard warm-up that preceded two 30-meter sprints.

• 2 days later, the groups reversed their assigned pre-sprint protocol.

• Stretching was basic static stretches to the hamstrings, quadriceps, and calves.

RESULTS

• In both groups, stretching before sprinting reduced acceleration and maximum velocity and increased overall 30-meter times.

Sayers, A., Caputo, J.L., Farley, S.J., et al. The Effect of Static Stretching on Phases of Sprint Performance in Elite Soccer Players. Med. Sci. Sports Exerc. 2007; 39(5): S212, A-1440.

81

The Effect of Stretching on Muscle Oxygen

• The influence of muscle position on oxygen saturation was investigated.

• Five subjects had near-infrared spectroscopy probes placed in their calves during 3 different exercise positions.

• Oxygen saturation values were monitored with ischemia and reperfusion.

• The subjects performed a 5-second maximal contraction followed by a 55-second rest interval for three 10-minute periods under different positions.

• The calf contractions were performed in a neutral position, a shortened position, and a stretched position.

82

The Effect of Stretching on Muscle Oxygencontinued

Oxygen Saturation %

Calf Position

At Rest In Position Start Exercise

End Exercise

Shortened 66.3 77.2 77.5 79.0

Neutral 71.3 71.5 69.5 75.3

Stretched 70.0 51.6 40.3 51.2

• This study was to determine how muscle position influences muscle oxygen saturation.

• Reduced oxygen saturation in muscles could explain why stretching appears to cause strength loss when performed prior to an event.

McPherson A.K., King J.M., Elder C.P., et al. The Influence of Muscle Length on Muscle Oxygen Saturation.

Med. Sci. Sports Exerc. 2007; 39(5): S430, A-2342.

83

Sodium Bicarbonate is the Best Buffer

• Energy from continuous high-intensity activity causes intramuscular acidity, which leads to fatigue.

• Ingestion of sodium bicarbonate (NaHCO3) has been shown to improve performance in single-bout high-intensity exercise.

• Research supports NaHCO3’s superiority over other common buffers such as sodium citrate and sodium lactate.1

84

Sodium Bicarbonate is the Best Buffer

continued

• In a recent trial of 16 runners, who participated in a round-robin protocol, time to exhaustion on a treadmill sprint comparing NaHCO3 with Na lactate, Na citrate, and placebo was as follows:

Time to Exhaustion

Buffer Time

Bicarbonate 82.3 seconds

Lactate 80.2 seconds

Citrate 78.2 seconds

Placebo 77.4 seconds

1 Van Montfoort, M.C.E., Van Dieren, L., Hopkins, W.G., et al. Effects of Ingestion of Bicarbonate, Citrate, Lactate, and Chloride on Sprint Running. Med. Sci. Sports Exerc. 2004; 36(7): 1239-1243.

85

Sodium Bicarbonate is Ergogenic for Swim Sprint

• 9 elite male swimmers volunteered for a randomized counterbalanced double-blind crossover study. 2

• On 3 occasions, subjects swam a 200-meter freestyle race.

• The races were as follows: one control, one with 300-mg/kg/bw NaCHO3 at 90-60 minutes before racing, and a placebo supplement (calcium carbonate) 200 mg/kg/bw.

86

Sodium Bicarbonate is Ergogenic for Swim Sprint

continued

• NaHCO3 and calcium carbonate were provided in gelcap form.

RESULTS

• Note: 300 mg/kg/bw = 24 grams for an 80-kg athlete. (One level tablespoon of NaHCO3 = 12.7 grams.)

Treatment Minutes Seconds

Control 1:53.7 +/- 3.8

Placebo 1:54.0 +/- 3.6

NaHCO3 1:52.2 +/- 4.7

2 Peyrebrune, M.C., Lindh, A., Ingham, S., Folland, J. Sodium Bicarbonate Supplementation Improves 200 m Freestyle Performance in Elite Male Swimmers. Med. Sci. Sports Exerc. 2007; 39(5): S218, A-1462.

87

Comparison of Nutritional Intakes Between Overtrained and Normal-Trained Athletes

• Overtraining is a symptom complex that includes decreased performance, reduced sleep quality, malaise, depression-like symptoms, increased rate of injury, prolonged injury recovery, with lesser symptoms such as muscle heaviness, feeling “flat,” “stale,” “always tired,” and increased rates of illness, infection, and allergic response.

• 33 club athletes (~ 30 yrs) were divided into 2 groups based on the presence or absence of signs and symptoms of overtraining.

88

Comparison of Nutritional Intakes Between Overtrained and Normal-Trained Athletes

continued

• Average hours spent training were 17.5 per week in overtrained athletes and 11.5 in normal-trained athletes.

• All subjects completed a detailed questionnaire on diet and exercise habits, which were then computer analyzed.

RESULTS• Per kg/bw, there were no differences between groups

for total protein, carbohydrate, fat, calorie, and micronutrient intake.

• When dietary intakes were divided by number of hours spent training, athletes categorized as overtrained had a statistically significant reduction in protein, carbohydrate, fat, and total calories.

van Rensburg, D.J. Differences in Nutritional Intake Between Overtrained and Non-Overtrained Athletes. Med. Sci. Sports Exerc. 2007; 39(5): S246, A-1579.

89

Comparing ADL’s of Obesity-Prone vs. Obesity-Resistant after Overfeeding

• Weight gain over time is accomplished by consistent activity deficiency coupled with excessive energy consumption.

• Biochemical individuality and genetics also contribute to what is described as individuals who are either obesity-prone or obesity-resistance.

• 34 adults – 14 obesity-prone plus 20 obesity-resistant – (~ 30 yrs) were studied.

90

Obesity-Prone vs. Obesity Resistantcontinued

• The subjects wore pedometers for 7 days prior to intervention in order to establish daily activity averages & had normal calories determined.

• During each 6-day intervention, the subjects wore pedometers all day.

• Intervention was as follows: 3 days of controlled supervised over-feeding (OF) at 40% extra calories was followed by 3 days of uncontrolled, free-feeding while still using the pedometer.

• Following a 3-day washout, there were 3 days of controlled supervised normal feeding (NF) followed by 3 uncontrolled free-feeding days with the pedometer.

91

Obesity-Prone vs. Obesity ResistantRESULTS

• Obesity-prone individuals showed no difference in physical activity between the 6-day OF/free-feed period versus the 6-day NF/free-feed period.

• Obesity-resistant individuals demonstrated an increase in pedometer readings to 8370 during the OF/free-feed period compared to 7335 during the NF/free-feed period.

• Evaluation of controlled periods only (3 days OF versus 3 days NF) revealed that the obesity-prone individuals reduced pedometer readings by an average of 773 per day.

CONCLUSION• Obesity-resistant individuals respond to brief periods of over-feeding

by increasing activities of daily living. • Conversely, obesity-prone individuals responded to the over-feeding

protocol by reducing their activities.

Sharp, T.A., Horton, T.J., Kealey, E., et al. Effects of Short-Term Overfeeding on Physical Activity in Obesity-Prone and Obesity-Resistant Adults. Med. Sci. Sports Exerc. 2007; 39(5): S385, A-2157.

92

Soft vs. Firm Running Shoe Midsoles

• 5 runners performed two 1.5-mile runs in running shoes with midsoles that could be adjusted firm or soft.

• The 1.5-mile run covered 8 different surfaces. • Subjects wore portable data loggers, which

were used to record ground impacts. • The soft midsole reduced impacts on every

surface compared to the firm midsole.

93

Soft vs. Firm Midsolescontinued

*The amount of shock reduction in soft midsoles versus hard measured @ 512Hz with effect size in grams between firm midsoles on various surfaces.

Differences in Shock Reduction on Various Surfaces

Surface Soft Midsole Shock Reduction*

Asphalt 1.19

Cement 1.02

Dirt 0.59

Grass 0.76

Gravel 0.73

Sand 0.98

Wood bridge 0.71

Woodchips 0.28

Sealine, B.J., Meardon, S.A., Edwards, W.B., Derrick, T.R. Midsole Cushioning During Running on Various Surfaces. Med. Sci. Sports Exerc. 2007; 39(5): S155, A-1206.

94

Aerobic Exercise & Brain Function In Kids

• 36 7 yr olds and 36 10 yr olds were dividedinto groups of 18.

• 36 (18 age 7 and 18 age 10) watched 30 min. of TV• 36 (18 age 7 & 36 age 10) did 30 min. aerobic activity.• Groups were then given cognitive function test

RESULTS• Both 7 & 10 yr olds exercised prior to the testing responded

faster to visual detection tasks, and much better to cognitive decisions making tasks than the TV watchers.

St. Louis-Deschenes, M. Ellemberg, D. Improvement of Sensori-Motor and Cognitive Function in Children Following Acute Physical Exercise Med Sci Sport Exerc. 2007; 39 (5) 5163 A-1238

95

Aerobic Exercise and Brain Function In Older Adults

• 26 Sedentary (62-88 yr) adults were divided into an exercise or non-exercise groups following, cognitive processing speed tests.

• Exercise groups walked 60 min twice weekly for 12 weeks and then both groups were retested

RESULTS• Cognitive processing speed was improved in the aerobic

exercise groups and unchanged in the non-exercising group.

Kamijo, K. Nishih, Sakai, T. et al of an Aerobic Exercise Program on Cognitive Processing in Older Adults Med Sci Sport Exerc 2007; 39 (5) S 163 A-1240

96

Anaerobic Exercise and Brain Function In Older Adults

• 62 Sedentary males and 65-75 prescreened for mental or physical health issues were divided into 3 groups.

• 23 Controls• 19 Moderate intensity exercise (50% 1 rep max-weight

training 3 times a week for 24 weeks.• 20 High intensity, exercise (80% 1 rep max weight training

60 min 3 times a week for 24 weeks.• Neuropsychological Tests strength and body fat tests were

done pre and post interventions

97

Anaerobic Exercise and Brain Function In Older Adults

continued

RESULTS• Compared to controls, both exercise groups improved equally in short & long term memory and attention.• Both exercise groups mood profiles and quality of life scores

improved compared to controls with the moderate intensity group showing greater improvement than the high intensity group.

• Both exercise groups made strength gains in upper and lower body compared to controls with the high intensity group clearly superior to the moderate intensity group and the only group to gain lean mass during the trial.

Cassilhas, R. Viana, V.A.R., Grassmann, V. et al The Impact of Resistance Exercise on The Cognitive Function of The Elderly Med Sci Sport Exerc. 2007; 39 (8) 1401-1407

98

Percentage of Participants Using Medications

Drug Women Men

Anti-Diabetic 2.8% 7.4%

Anti-Hypertensive 14.3% 29.0%

LDL-Cholesterol 7.3% 21.5%

A cross sectional analysis of over 32,00 female and 8,000 male walkers in the National Walkers Health Study was done to investigate walking influence on blood sugar, blood pressure and blood lipids

Walking is Healthy

99

Results• Weekly Walking Distance was associated with declines

in the odds for anti-diabetic, anti-hypertensive and LDL Cholesterol medications for both sexes.

• Walking Speed was the strongest predictor of reduced medication use in both sexes for diabetes, hypertension or high cholesterol. The effect was independent of both total distance and body mass index.

• Longest Single Walk as the longest walk increased from 4k to 10k of the odds of medication use for all 3 conditions in both sexes decreased even when adjusted for total weekly distance.

Williams, P.I. Reduced Diabetic, Hypertensive, and Cholestrol Medication Use with Walking. Med Sci Sport Exerc. 2008; 40 (3) 43-443

100

Nutrient Partitioning and Protein• 22 males (~ 23 yrs) with > 6 months endurance training

VO2 max > 53 spent 12 days in a research dormitory• Days 1-4 all subjects followed normal diets and workouts• Days 5-12 divided in to 3 groups and began 7 days of

additional exercise of 1000 calories• Neutral Energy group (NE) - 1g/kg/bw protein and were

fed 1000 extra calories• Low Energy group (LE) – 1g/kg/bw protein with normal

diet• Low Energy Protein group (LEP) – 1.75g/kg/bw protein

with normal diet

101

Nutrient Partitioning and Proteincontinued

After 7 days Neutral Energy Low Energy LE Hi Pro

Body Weight -2.0 -5.3 -5.9

Lean Mass -1.3 -3.5 -2.9

Fat Mass -0.4 -2.0 -2.9

Body Fat % -0.2 -0.9 -1.2

Pikosky, M.A., Smith, T.J., Grediagin, A. et al Increased Protein Maintains Nitrogen Balance during Exercise – Induced Energy Deficit Med Sci Sport Exer 2008; 40(3) 505-512

Changes in Pounds

102

A Pilot Study of the Relationship of Breast Size and Clinical Measures of Cardiovascular Disease

Risk.

Med Sci Sports Exerc 2007; 39(5) S231, A-1519

103

The six authors obtained approval by the

Institutional Board for Human Subjects @ Eastern Washington

University

104

Only 1 of 6 authors carried a Y-chromosome

Christopher Domes

Wendy Repovich

Carlye Hill

Mary Eash

Debra Notrica

Janet Peterson

105

This Study analyzed anthropometric data, blood tests, lifestyle questionnaires, personal & family history’s of 75 women (19-67 yrs) free of silicon, saline, soybean, or gel like material.

106

The researchers found a positive relationship between chest size, cup size, and cardiovascular disease risk. In most cases, simple visual inspection will identify afflicted patients. Since these anomalies are difficult to conceal, disrobing is not necessary.

107

This study did not evaluate intervention of any type. Therefore, it is premature to recommend manual therapy for high risk patients.