Monday, April 29, 2013

Whey vs. Amino Acids by Jerry Brainum

Many older people suffer from a condition called sarcopenia, which literally means “loss of muscle.” When that happens, overall body frailty and weakness become common, limiting the quality of life for older people. Sarcopenia is caused by a number of mechanisms, such as diminished anabolic hormones, including growth hormone, IGF-1 and testosterone, as well as a lack of resistance exercise. Among the suggested treatments for preventing sarcopenia is increasing protein intake. The problem is that many older people get sufficient protein but have absorption problems, such as lower amounts of hydrochloric acid in the stomach, which is required for the initial breakdown of protein foods, and insufficient production of protein-digesting enzymes in the pancreas.

Studies show, however, that older people who take in easily digested protein, such as whey or amino acids, can overcome the protein deficit and may prevent sarcopenia by preserving muscle. Adding weight training makes the increased protein intake even more effective. The active ingredients in both whey and amino acid mixtures are presumed to be essential amino acids, which are so named because they can’t be synthesized in the body and must be obtained from food. Depending on which source you consult, either eight or nine amino acids are deemed essential in adult nutrition. The remaining aminos aren’t labeled “essential” not because they are unimportant but rather because the body can synthesize them. The anabolic effect of taking in essential amino acids is so potent that a mere six grams are enough to double the rate of protein synthesis. Of the essential amino acids, the branched-chain amino leucine is considered the most potent in that regard. Indeed, several studies have shown that leucine alone activates a number of reactions that form the basis of protein synthesis in the body.

One study compared intake of whey protein to essential aminos in older people who got 15 grams of each. The essential aminos more than doubled the protein balance compared to the whey intake, indicating that essential aminos are the active factors in the anabolic impact of protein. It’s as if essential amino acids are all older people need to correct protein problems.
In a new study1 15 people aged 60 to 85 were randomly assigned to take 1) 15 grams of whey protein, 2) 6.72 grams of EAA or 3) 7.57 grams of nonessential amino acids.1 In other words, the subjects got amino acids either as a whole protein source—whey—or as free amino acids, both essential and nonessential. Protein synthesis was measured by monitoring the activity of phenylalanine, an amino acid incorporated into muscle. The phenylalanine balance over a 3.5 hour period increased in the whey group but not in the essential or nonessential amino groups. How could that be, when previous studies showed that essential amino acids are superior to whey in causing anabolic effects in older people?

The answer lies in dosage. In the previous study 15 grams of essential amino acids were directly compared to 15 grams of whey. In the more recent study 15 grams of whey were compared to only 6.72 grams of essential aminos. Due to the blunted effects of protein metabolism in older people, it takes a greater amount of essential aminos, particularly leucine, to yield anabolic effects. Supplying large amounts of leucine can lead to protein synthesis in the elderly that is similar to that in younger people. Confusing the issue is that since whey contains 50 percent essential aminos, getting the same amount as straight essential aminos should have led to similar effects, yet the whey proved superior.

Whey, however, also contains other aminos involved in protein synthesis, such as cysteine, that may explain why the whey proved superior to essential aminos in the study. The whey also brought on a greater insulin response than the aminos, likely because the whey provided twice the level of aminos, some of which spur insulin release. The relevance here is that insulin potently helps along muscle protein synthesis only in the presence of a large amount of amino acids. The ones present in whey but not in the essential aminos mixture, such as arginine and aspartic acid, are potent partners in insulin release. The authors suggest that a combination of essential and nonessential aminos stimulates insulin. Thus, the study shows that whey exerts more potent muscle protein synthesis than free amino acids because it more potently stimulates insulin.

Leucine deficiency can be remedied with supplements, but a study revealed another way to deal with that problem.2 A negative by-product of aging is an increase in oxidative damage caused by decreased activity of built-in body antioxidants, such as superoxide dismutase, catalase and glutathione. Lack of antioxidant protection enables free radicals to wreak oxidative havoc in the body. That eventually results in a host of degenerative diseases related to the aging process. Oxidative damage can also interfere with the activity of body proteins, including protein-based hormones, such as insulin. A hallmark of out-of-control oxidation is increased tissue inflammation, which is the underlying cause of diseases linked to aging.

It turns out that oxidation-related inflammation is responsible for the lack of anabolic response to leucine in older people. In the new study, which lasted seven weeks, old rats with defective leucine metabolism were given a mixture of dietary antioxidants containing rutin (a common bioflavonoid found in fruit), vitamin E, vitamin A, zinc and selenium. The refractory leucine metabolism in the old rats was completely reversed, probably because of the antioxidant supplements. The effect was independent of leucine intake, meaning that it worked with normal leucine intake. Other studies have shown that antioxidant supplementation in older animals seems to help preserve muscle, and the effect on leucine metabolism may explain that frequently observed reaction.

It may be that in humans antioxidants work synergistically with increased and regular intake of protein to preserve muscle mass with the passing years.
1 Katsanos, C.S., et al. (2008). Whey protein ingestion in elderly persons results in greater muscle protein accrual than ingestion of its constituent essential amino acid content. Nut Res. 28:651-658.
2 Marzini, B., et al. (2008). Antioxidant supplementation restores defective leucine stimulation of protein synthesis in skeletal muscle from old rats. J Nutr. 138:2205-2211.

©,2013 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited.

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Friday, April 12, 2013

Women, Weights and Waistlines by Jerry Brainum

Creeping obesity affects both sexes, with youthful, slim waistlines morphing into potbellies by the time most people are in their 40s. While men have obvious potbellies, women tend to store more fat in their upper thighs, hips and buttocks, so the effect of midsection fat is more subtle. In women, a roll of fat around the middle spills over their pants to create a muffin-top effect. Various studies show that American women, aged 25 to 44, gain an average of 0.5 to 1 kilogram (2.2 pounds) of fat each year.

While such fat is undesirable from an aesthetic viewpoint, when it’s around the waist, it has a far more ominous portent because it’s a sign of deep-lying, or visceral, bodyfat. Fat in the abdominal area is closely linked to various degenerative diseases, such as insulin resistance, diabetes, high blood pressure and cardiovascular disease. The good news is that it’s the first fat to go if you stick with a judicious program of exercise and diet.

Several studies have shown that the body preferentially burns visceral fat during aerobic exercise. Emerging studies show that you can get the same effect from weight training. A recent study illustrates the point. In it, 164 overweight women, aged 25 to 44, were divided into two groups. The first group weight-trained twice a week for two years. The other group received brochures suggesting that they do aerobic exercise at least 30 minutes daily.

At the end of the two-year study the women in the weight-training group had lost 4 percent of their bodyfat, while those in the brochure group had lost none—they must have read about exercise rather than doing it. Those in the weight group also gained less abdominal fat than the other group—7 percent vs. the 21 percent gain in the brochure group.

Based on those results, the authors suggest that young women who participate in a weight-training program can expect to gain less bodyfat, especially abdominal fat, as the years go by. There are obvious benefits in appearance, as well as less obvious but more important benefits in health and longevity. Women should be aware that while aerobics is great for aiding bodyfat loss, it does little to improve body shape. You get that only from weight training. The best program includes both aerobics and weight training.

As for the “muffins,” they’re best left in the oven or in the care of the Pillsbury doughboy—who, come to think of it, could stand to lose a little bodyfat himself.

Schmitz, K.H., et al. (2007). Strength training and adiposity in premenopausal women: Strong, Healthy, and Empowered study. Am J Clin Nutr. 86:566-72.

©,2013, Jerry Brainum.Any reprinting in any type of media, including electronic and foreign is expressly prohibited.

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Friday, April 5, 2013

Steroid Side Effects— Recent Research by Jerry Brainum

    Much of the medical literature on anabolic steroid use in sports and bodybuilding isn’t relevant. Studies often involved dosages that bear no resemblance to what was used by real-world athletes. Conservative study designs were based on medical ethics, in that no one really knew the possible health effects of using amounts that far exceeded what’s commonly prescribed for therapeutic purposes. That explains the claims that anabolic steroids don’t build muscle. Of course they don’t—when the dose is one tablet a day of Dianabol.
    The end of the controversy about the role of anabolic steroids in developing muscular size and strength came with the 1996 publication of a study in the New England Journal of Medicine. It clearly showed that 600 milligrams of weekly testosterone injections boosted muscular gains, especially when combined with weight training. That, of course, came as no surprise to anyone in the bodybuilding world. It did, however, change the opinions of medical professionals, who were forced to accept the indisputable fact that steroids work when used in significant amounts.
    While doctors no longer deny that steroids aid muscular growth, they still warn of significant health risks linked to the use of steroids—especially in light of the extreme amounts commonly used by athletes. While the average man produces about nine milligrams of testosterone daily, many athletes inject themselves with more than 1,000 milligrams a week. Surely there’s a price to pay for such pharmaceutical extravagance—or is there?
    Scientists are constrained by medical ethics to limit the doses of steroids that they administer to subjects in their studies. Thus, the latest trend among researchers who investigate the health and performance effects of anabolic steroids is the “observational” study. The researchers don’t supply any drugs but observe subjects who use their own. The subjects permit the researchers to monitor them via various medical tests. It gives a more accurate view of the impact of athletic doses of anabolic steroids and other drugs.
    A recent observational study published by a group of Italian researchers provided an interesting overview of the long-term effects of anabolic steroids because it featured 20 male bodybuilders who’d never previously used them. It lasted two years and involved extensive physical evaluations of the subjects every six months. The bodybuilders provided their own drugs, which included injectable and oral steroids as well as other drugs commonly used in athletic and bodybuilding circles—clenbuterol; Cytodren; Nolvadex; human chorionic gonadotropin, a.k.a. hCG; thyroid; insulin and aromatase-blockers. On the average, 10 drugs were used during a cycle.
     At the start of the study the bodybuilders received counseling about possible risks and side effects linked to steroid use. That caused two of the men to immediately withdraw from the experiment. Subsequently, seven other men withdrew for various reasons, some involving adverse mental effects such as aggression and depression, sexual dysfunction, family problems and inability to attend scheduled medical exams. The subjects all ate a high-protein diet and increased their protein intake after starting the drugs. They also used such nutritional supplements as creatine and amino acids.
    Gynecomastia, or male breast development, occurred in five subjects, producing notable pain in two. Only one subject showed “clinical relevance”—presumably he needed surgery to correct the gyno. Measures of estrogen, the usual cause of gyno, increased in the subjects—not surprising, as many anabolic steroids are converted into estrogen—but it was considered clinically insignificant because the measures varied among the subjects.
   A common side effect of long-term steroid use is shrinkage of the testicles. Sure enough, 16 of the 20 subjects experienced that. A semen analysis after two years showed a drop in sperm count and fertility but no reduction in sperm motility or shape, both of which can also adversely affect fertility. Two of the bodybuilders showed no sperm production, while another two had counts not consistent with fertility. Many bodybuilders use hCG to prevent those effects, but only eight of the 20 subjects used hCG.
    The bodybuilders also experienced an increase in insulin sensitivity, along with a drop in plasma glucose and insulin. While some studies have found that anabolic steroids produce insulin resistance, that didn’t prove true here.The authors think that’s because of the added muscle and decreased bodyfat, a combination proven to boost insulin sensitivity. Oral steroids lower high-density lipoprotein,a protective cholesterol carrier in the blood, and in this study there was an average drop of 26 percent in the subjects.
    Free T3, or active thyroid hormone, and TSH, which stimulates thyroid hormone release, were both elevated, but thyroid levels remained within normal limits. A surprising finding was a drop in plasma insulinlike growth factor 1. IGF-1 usually rises when testosterone does. The authors speculate that the suppression of gonad function induced by the anabolic steroids may also have suppressed the IGF-1. Gonadotropin often drops during steroid use, as in this study. The suppression of luteinizing hormone by higher estrogen levels is thought to be mainly responsible for the loss of testicle size. Interestingly, even the bodybuilders in the study who used HCG and Nolvadex, both of which help prevent estrogen rise and luteinizing hormone suppression, still showed gonadotropin suppression. The good news is that no changes in prostate gland volume or size occurred in any of the bodybuilders.
    Liver enzymes, which offer a picture of liver function, are frequently affected by high doses of oral steroids. That points to liver inflammation and possibly liver damage. Most cases of liver impairment as a result of anabolic steroid use reported in the medical literature involve hospitalized patients on long-term anabolic steroid therapy. Complicating the picture is the fact that some liver enzymes increase in those engaged in the kind of exercise that causes muscle damage, such as typical bodybuilding workouts. The same enzymes found in the liver also show up in muscle and are released into the blood when muscles are damaged.
    At the beginning of the study the bodybuilders had liver enzymes at the higher range of normal, likely because of their training. Most of those values remained steady during the two years of the study, although the liver enzymes in two of the bodybuilders doubled, which was thought to be related to their use of oral steroids. Despite that, their enzymes were still considered in the normal range. Ultrasounds revealed no adverse structural changes in the liver or any evidence of incipient tumors. Most of the bodybuilders had slightly enlarged livers and more liver fat than usual at the start of the study, but that was attributed to long-term high-protein intake and wasn’t considered pathological. The authors suggest that reports of liver toxicity induced by anabolic steroids are probably overestimated.
     Testosterone and anabolic steroids increase the production of red blood cells by stimulating EPO, a hormone made in the kidneys that facilitates red cell production. In this study the bodybuilders had increased hemoglobin—the protein in red blood cells—but the hematocrit, or density of red cells, remained within normal limits. What’s called humoral immunity, or immune factors in the body, represented by B cells, wasn’t affected. Cellular immunity, which among other things protects against viral infections and tumor formation, was decreased by steroids but remained within normal range.
    The heart, as a muscle, enlarges with stimulation just as skeletal muscle does, and the left ventricle is its primary pumping chamber. Past studies have indicated adverse changes in the heart, such as an increase in left-ventricular-wall thickness and mass. That particular change, often called “athlete’s heart,” is also a by-product of exercise. Some research has found that steroids interfere with the diastolic phase, or the filling of the heart with blood, which can dangerously disturb normal heart rhythm. Examinations of heart tissue have revealed microscopic damage and scar-tissue formation. Many such changes, however, depend on length of use and dose, with those using high doses for longer periods being more susceptible to heart damage. In this study echocardiograms of the bodybuilders’ hearts revealed no structural abnormalities.
By and large, the adverse effects of anabolic steroid use revert to normal when drug use stops. That explains why you rarely hear about bodybuilders and athletes dropping dead from steroids. There are, however, exceptions. Genetics may make large doses of steroids particularly dangerous for some people, and it’s difficult to predict precisely who is susceptible. That’s one reason it’s absolutely essential for anyone either using steroids or contemplating it to undergo regular medical evaluation.

Bonetti, A., et al. Side effects of anabolic androgenic steroid abuse. Int J Sports Med.2008;29:679-97.

©,2013 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited.

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