The Dangers of Sports Supplements - starteamsite.com · “The Dangers Of Sports Supplements” Dr. Steve Chaney 3 Introduction Sports supplements can be very beneficial. They can

The Dangers ofSports Supplements

Selections from https://healthtipsfromtheprofessor.com

Dr. Stephen G Chaney, PhD

© 2018, All rights reserved

“The Dangers Of Sports Supplements”

Dr. Steve Chaney https://healthtipsfromtheprofessor.com

About Dr. Steve Chaney has a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he ran an active research program and taught Human Metabolism and Nutrition to medical and dental students for 40 years. He is an educator who received the Excellence in Teaching Lifetime Achievement Award from the UNC School of Medicine Academy of Educators upon his retirement from the university in 2012. He is also a scientist who has published over 100 articles in peer reviewed scientific journals and 2 chapters on

human nutrition in one of the leading biochemistry textbooks for medical students. He is currently Editor-In-Chief of “Health Tips From The Professor” (https://healthtipsfromtheprofessor.com) and the bestselling author of “Slaying The Food Myths”. (https://slayingthefoodmyths.com). He is committed to helping people lead healthier lives, and keeps abreast of the latest scientific literature on holistic approaches to better health.

His mission is to cut through the hype and urban myths to provide you with the truth about how you can attain and maintain optimal health. He creates eBooks like this one because people like you need resources they can rely on for up-to-date, scientifically accurate health information without hype or bias. His goal is to provide you with accurate health information based on the latest clinical studies and to help you avoid both the more sensational and the negative claims in the media.


Dr. Steve Chaney 2 https://healthtipsfromtheprofessor.com

CONTENTS

Introduction 3 Use of Sports Supplements by Young Athletes 4

It’s A Jungle Out There 6

What Are They Thinking? 8

It’s Buyer Beware in the Sports Supplement Market 11

What You Don’t Know Could Kill You 15

Bad News For Sports Supplements 19

Barking Up The Wrong Tree 25

Choosing A Sports Supplement Company You Can Trust 28

The Good, The Bad, And The Ugly 29

Should Sports Protein Products Contain Sugar 34

What Should a Post-Workout Protein Shake Look Like? 37

Do Protein Needs Increase As We Age? 42

How Much Protein Do Athletes Need? 47



Introduction Sports supplements can be very beneficial. They can improve hydration, endurance, and recovery from exercise. And because they improve recovery times they can improve the gains in muscle mass, strength and endurance. In short they can help you maximize the benefits of your workouts.

The success of high performance athletes, such as Olympic athletes, often depends on a fraction of a second. These athletes rely on good diet and supplementation for peak performance. Knowledgeable athletes know to choose supplements that have been proven to be both safe and effective. Olympic athletes in particular are subject to more random drug screens than any other athletes. They absolutely have to rely on sports supplements that are pure, safe and effective. There are a number of reputable and well established sports supplement manufacturers who make high quality products—products that can be safely used by any athlete. Unfortunately, there is another segment to this market. Some athletes, particularly young men, are looking for a quick fix. They want to become an instant Mr. (or Mrs.) Atlas. They want to go from being a 150 pound weakling to the star of their high school football or basketball team—and they want to do it NOW! There is a shady side of the sports supplement industry that is only too happy to oblige. They often hype safe, but ineffective, ingredients as miracle substances that will fuel instant muscle mass. Even worse, some of them add dangerous or illegal ingredients to their sports supplements. They are focused only on their profits. They could care less about the health of their customers. They are a very small part—a few bad apples– of the sports supplement industry, but they do a lot of harm. This book is a collection of articles from past issues of Health Tips From the Professor. They are all based on published studies and/or FDA actions. They will help you identify some of the more dangerous sports nutrition products on the market. Finally, I will close by giving you some tips on how to find a reputable sports supplement manufacturer that you can trust with your health and the latest science on what the best sports supplements should look like.



Use of Sports Supplements By Young Athletes Guest Author: Dr. Pierre DuBois

October 31, 2013

In recent years, the use of sports supplements by young athletes has increased dramatically. The most commonly used sports supplements among teenagers of all ages were vitamins and minerals, though “ergogenic aids” are used by some teen athletes specifically to enhance performance. Among these performance-enhancing supplements are substances such as caffeine, creatine, ephedra and other stimulants, human growth hormone (HGH) and anabolic steroids. Of the vitamin and mineral supplements, multivitamins, vitamin C, calcium and iron were reported as being taken most

often. While the risks of taking vitamin supplements is relatively low, there is some concern that young athletes may then progress to taking more dangerous sub-stances under the impression that they are as harmless as vitamins and minerals. And while the risk of overdose with vitamins and minerals is low, it is not nonexis-tent, and some vitamins can be toxic when too much is taken (such as iron and vita-min A) or may interact with other vitamins or drugs.

Although many performance-enhancing supplements are advertised as being

safe – especially those made from natural compounds – a great number of them have not been tested by any regulatory agency, so their actual safety is not known. In addition, there are no formal guidelines for dosage in many cases, so there could be adverse side effects if too much is inadvertently taken.

The pressure to excel at sports is greater than ever, and there is increasing

competition to get into elite sports programs where they have a better chance of being discovered by professional sports scouts looking for the next big star. The possibility of fame and fortune can be a strong enticement to young athletes to try performance-enhancing supplements to give them an edge over their competition. And often it is their coach that suggests or encourages this practice.



According to studies done on high school athletes, they report taking supple-ments to not only enhance performance, but also to encourage growth and muscle development, prevent illness and reduce fatigue. Supplement use was greatest among athletes who practiced two or more different sports and those who were required to “bulk up”, such as wrestlers and weight lifters.

While the opinions of friends, teammates and coaches were a big influence on the decision of young football players to take supplements (particularly creatine), it was their parents who had the greatest amount of influence on their decision. So it is incredibly important for parents to be educated as to the benefits and drawbacks of each of these supplements for young athletes.

The Bottom Line:

There is tremendous pressure on teenage athletes to qualify for elite programs that will increase their chances of being selected for the top college teams and eventually getting onto professional teams. Because of that, the use of sports supplements by teenage athletes is commonplace.

Vitamin and mineral supplements are generally harmless unless taken in excessive amounts. Performance-enhancing sports supplements, on the other hand, are poorly regulated. Many are useless and others are potentially harmful. If you are the parent of a teen athlete, have a conversation with your child about

supplements. Don’t lecture, but involve them in the process of doing research. You may be surprised what you both find.

___________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. ___________________________________________________________________



It’s A Jungle Out There May 14, 2013

It's a jungle out there. You probably already know that there are some bad players in the food supplement industry. There are companies that make products that don't work, products that haven't been tested for safety and efficacy, products are contaminated, and even products that are dangerous. There are some companies that even make products that contain dangerous drugs – drugs that can kill you.

Are Dietary Supplements Safe?

A recent report (Harel et al, JAMA Internal Medicine, doi: 10.1001/jamaintermed.2013.379) states that between January of 2004 and December of 2012 there were 465 products that were subject to a class I recall by the FDA. A class I recall is for cases in which there is a reasonable probability that use of or exposure to a product will cause serious adverse health consequences or death. Now here's the scary part: 98% of those recalls were for dietary supplements. The worst offenders were sexual enhancement products (40%), bodybuilding products (31%) and weight loss products (27%). And these weren't all foreign-made products. 74% were manufactured in the United States. [Note: If you are good at math, you will have noticed that leaves 0% for recalls of all other dietary supplements].

The Bottom Line:

1) When you hear headlines about dietary supplements killing people, you should realize that the bad players are found in only 3 types of dietary

supplements – sexual enhancement products, bodybuilding products and weight loss products.



2) Just for perspective you should contrast any concerns about the safety of dietary supplements with:

- The more than 35,000 deaths/year from properly prescribed medications… and…

- The 8,000 deaths/year in US hospitals due to medication errors (Journal of General Internal Medicine, 25: 774-779, 2010)

3) When choosing supplements in that class use your common sense. Avoid those supplements promising magical gains in sexual prowess, increased

muscle mass or weight loss.

4) Stick with a supplement company you can trust – one that is committed to only making supplements of proven benefit, and never making supplements

that could cause any harm.



What Are They Thinking? February 21, 2012 The less reputable sports supplement manufacturers often add stimulants to their weight loss and bodybuilding products. Stimulants do raise metabolic rate so they help with weight loss. They have no effect on athletic performance, but the athletes often feel like they have more energy – so they are also popular in bodybuilding products.

All stimulants carry some risk. Even small amounts of caffeine can be problematic for some individuals, and many sports supplements contain massive amounts of caffeine. But, it is not caffeine containing sports products that are the most worrisome. It is the sports supplements containing amphetamine-like compounds that are particularly worrisome. These supplements can increase heart rate, increase blood pressure, cause arrhythmia, and they can kill people. If you have followed the weight loss and sports supplement industry over the years this should sound very familiar. Ephedra (also called ma huang) an analog of amphetamine, was first developed as a nasal decongestant. However, because it also had thermogenic and stimulant effects, it was widely used in weight loss and sports supplements. There was only one problem. It also cause high blood pressure, arrhythmia and death. After it killed a number of people, the FDA finally banned it in 2004.

The DMAA Scandal Shortly after ephedrine was banned in the United States manufacturers started adding DMAA to their weight loss and sports pre-workout supplements. DMAA is short for the chemical dimethylamylamine. It is also structurally very similar to amphetamine. DMAA was also originally developed as a nasal decongestant. However, it also has thermogenic and stimulant effects, which made it very desirable for weight loss supplements and sports supplements.



Because it is both a stimulant and an amphetamine analog, the World Anti-Doping Agency added DMAA to its prohibited list in 2010 and numerous elite athletes have been disqualified from competition for DMAA use since then. But that has not kept many other athletes from using DMAA supplements. And that is a concern because, just like ephedra, DMAA is not an innocuous substance. Reported side effects include headache, nausea and stroke. And now, just like with ephedrine, it appears that we can add death to the list of side ef-fects associated with DMAA usage.

After two US soldiers died following DMAA usage the US Army and Air Force Exchange Service stores ordered the removal of all products containing DMAA from their shelves. Dr. Michael Kilpatrick, deputy director of Force Health Protec-tion and Readiness Programs with the Of-fice of the Deputy Assistant Secretary of Defense for Force Health Protection and Readiness (don't you love

bureaucratic names!) was quoted as saying the products were pulled from the shelves because "We are concerned about reports of heat illness, kidney (and) liver damage, and sudden death in service members who reportedly used products containing DMAA."

What Are They Thinking? I might have considered this as just another sad example of a sports supplement industry that puts profits ahead of safety and athletes who are willing to take almost any risk to gain an edge. But then I read something in the February 17, 2012 issue of NUTRA ingredients-usa.com that made my blood boil. It turns out that while one major supplement retailer recalled all products containing DMAA from its stores on US military bases, it continued to sell those same products in all of its other stores. And their CEO was quoted as bragging that the DMAA saga had "no impact whatsoever" on their sales.



I don't know which was worse - that the retailer continued to sell the DMAA supplements or that people continued to buy them. What were they thinking?

The Scandal Worsens As you might expect, the deaths kept piling up. Several months later the FDA finally acted. It sent a warning letter to all US manufacturers of DMAA containing products asking them to stop using DMAA as an ingredient in their supplements. All of the companies agreed to stop using it except one. That company claimed that DMAA could be found in geranium, which is an approved herbal ingredient, so they continued to use it. And the retailer contin-ued to sell their DMAA containing products in all their nonmilitary stores. Finally, on April 11, 2013 the FDA issued a strongly worded warning about DMAA. The FDA warning said that by then there had been 86 reports of illnesses and deaths associated with supplements containing DMAA, and the preponderance of scientific evidence showed that DMAA was not a natural constituent of geranium.

The FDA said that they would take all possible means to get DMAA containing products off the market. A cynic might point out that the FDA did not act until the night before a high profile exposé on DMAA was scheduled to appear on NBC.

Finally, the manufactyrer threw in the towel and said that they would reformu-late their DMAA containing products. A cynic might suspect that they would just substitute yet another stimulant for DMAA.

And, what about the retailer? They said “It [DMAA] will be positioned out of stores, probably over the next five or six months as we sell existing inventory”. You don't need to be a cynic to interpret that statement.

It wasn’t until the FDA raided their warehouses and removed all remaining DMAA-containing products that the DMAA story was over.

So what's the bottom line for you? It is a jungle out there. Don't fall for the hype and fancy claims. Do your homework, and stick with a company you can trust.



It’s Buyer Beware in the Sports Supplement Market November 5, 2013

For many athletes it’s all about being bigger, faster, stronger. That’s what makes the fat burning sports supplements so appealing. If you believe the ads, they will burn fat, increase muscle mass and give you an energy boost. But, are fat burning sports supplements dangerous? Are they effective? What Are Fat Burning Sports Supplements? As I have discussed previously, most of the fat burning sports supplements contain metabolic

stimulants of some kind. That’s where the energy and fat burning claims come from. The stimulants range from clearly ineffective to downright dangerous.

Are Fat Burning Sports Supplements Effective?

Because sports supplements are considered to be foods rather than drugs, the FDA cannot require sport supplements manufacture to prove that their products are either safe or effective. As a consequence, most sports supplement manufacturers don’t conduct clinical trials to prove the effectiveness of their products. Their claims are based on animal studies and testimonials. In most cases there is no objective evidence that their supplements actually work.

Better Living Through Chemistry

Many sports supplement manufacturers are firm believers in the “better living through chemistry” motto. They start with an herbal ingredient that has stimulant properties. They synthesize what they think is the active ingredient. Perhaps they chemically modify it a bit…. ..and, Voila! They have a proprietary new sports supplement. They label it a fat burner, prepare their claims and they’re ready to go to market.



And, why bother testing it? Unless the product kills or seriously harms people, the FDA doesn’t step in and tell a manufacturer to take their product off the market.

And, if you think that the manufacturers and sellers of the product are looking after your best interests, think again. Perhaps the best analogy would be the “whack-a-mole” game you may have seen at your state or county fair. As soon as you whack one wooden mole back into it’s hole, another one pops up somewhere else. Unfortunately, the unscrupulous sports supplement manufacturers play the same game

with the FDA. As soon as the FDA banned ephedra, the manufacturers started adding DMAA to their products. As soon as DMAA was banned, they started looking around for other stimulants to add to their products. Here are two recent examples:

Case Study #1: Craze and DEPEA There is a developing story around a popular sports supplement called Craze. Why anyone would even consider using a supplement called Craze is beyond me, but that is another story. Researchers from the NSF, Harvard and the National Institute for Public Health in

the Netherlands recently published a paper claiming that Craze contained DEPEA, an amphetamine-like compound that is structurally related to DMAA. The manufacturers claimed that the researchers did the chemical analysis incorrectly and their product actually contained a close analog of DEPEA that is found in dendrobium orchids. (Again I’m not sure why that makes it OK. I don’t think people eat a lot of dendrobium orchids). Stay tuned. I’m sure this story will have some interesting twists before it’s finished.



Case Study #2: OxyElite Pro and Aegeline In case you thought that was an isolated case, a different sports supplement manufacturer has recently been involved in a second case that sounds all too familiar.

The FDA recently advised consumers to stop using a particular sports supplement after reports of 24 cases of acute non-viral hepatitis (a very rare disease) in

users of that sports supplement in Hawaii. Two of those patients required liver transplants, and one of them died.

In this case the manufacturer stopped domestic distribution of the product, but argued that the product is safe. They claimed that counterfeit versions of

Of the product were being sold in the US market.

On October 11, 2013 the FDA sent a warning letter to the manufacturer stating that the active ingredient, aegeline, was not a lawful dietary ingredient. The manufacturer replied that it was a natural constituent of the citrus fruit tree Bael. (I’m not sure why that makes it safe. I don’t know about you, but I don’t eat a lot of Bael fruit either.)

As of a few days ago England, Denmark, Spain, Australia & New Zealand have warned consumers in those countries not to use that sports supplement.

It’s too early to tell how this story is going to turn out, but my money is with the FDA.

The Bottom Line

1) In the sports nutrition industry, it is buyer beware. There are lots of rogue manufacturers out there who care more for their bottom line than your well being. Do your homework and search for reputable companies with a long track record of product quality and ethical standards. There are some out there. 2) Ignore the outlandish claims, no matter how appealing. Once again, stick with established companies with a track record of product integrity. In addition, only use sports supplements that are backed by clinical studies showing that they are both safe and effective.



The Bottom Line 3) Be particularly cautious about sports supplements that claim to burn fat or give

you energy. They generally contain metabolic stimulants, and often those stimulants are poorly characterized. Most have not been proven to be effective,

and some have the potential to do more harm than good. 4) Fat burning supplements are often cross marketed as weight loss supplements.

They are just as dangerous for dieters as they are for athletes. 5) Don’t assume that just because the ingredients supposedly come from a natural

source (Bael trees or dendrobium orchids, for example) they are safe. __________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. __________________________________________________________________



What You Don’t Know Could Kill You November 11, 2014

There are a few bad apples in every barrel, and the supplement industry is no different, especially when it comes to sports nutrition and weight loss products. In previous “Health Tips From the Professor I have exposed some of the more dangerous sports nutrition and weight loss products on the market at the time. For example, I have reported on the dangers of weight loss and

sports nutrition products containing the amphetamine-like compounds DMAA and DEPA. The DMAA story was a real scandal. Not only did sports nutrition products containing DMAA kill people, but the FDA actually had to raid the warehouses of a major nutrition retailer to force them to stop selling it. You might ask why would supplement manufacturers even make products like that? The bottom line is that some companies are far more interested in their profit margin than they are in the safety of their customers. Amphetamine-like ingredients burn off calories and give athletes an artificial energy boost. Those results sell products. The fact that those same ingredients also kill people is of little concern to unscrupulous manufactures. In fact, as soon as one amphetamine-like ingredient is banned, they just reformulate by adding another amphetamine-like ingredient to their product.

Another Sports Supplement To Avoid The unscrupulous manufacturers are at it again. A recent paper by a group of scientists in the United States and the Netherlands (Cohen et al., Drug Testing and Analysis, 2014: DOI 10.1002/dta.1735) reported that DMBA, another amphetamine-like ingredient that is a close analog of DMAA, was found in at least 12 products marketed to improve athletic performance, increase weight loss and enhance brain function.



DMBA (1,3-dimethylbutylamine) is a synthetic compound that has never been tested for safety in humans, something that the FDA is supposed to require for every new dietary ingredient added to a supplement. Because DMBA is chemically similar to DMAA (1,3-dimethylamylamine), the scientists conducting the study suspected that manufacturers may have started adding it to their products when DMAA was banned. The scientists surveyed the listed ingredients on all supplements distributed in the United States for any ingredient name that might be a synonym for DMBA. They identified 14 supplements that fit that criteria and analyzed them for the presence of DMBA. 12 tested positive for DMBA. The authors of the study stressed that DMBA is a synthetic pharmaceutical ingredient, has the potential to cause the same health risks as DMAA, and has never been tested in humans. They stated: “Given the potential risks of untested pharmacologic stimulants, we strongly recommend that manufacturers immediately recall all DMBA in dietary supplements…The FDA and other regulatory bodies should, without delay, warn consumers about the presence of DMBA in [certain] dietary supplements.” The Council for Responsible Nutrition, an industry group, sent a letter to the FDA on September 12th urging regulatory action…noting that it has a similar chemical structure to the banned ingredient [DMAA] and that none of those selling it have filed required “new dietary ingredient” paperwork with the FDA to substantiate its safety.” The FDA has yet to respond. This story is all too familiar. The unscrupulous manufacturers won’t remove unsafe ingredients until they are forced to, and the FDA is far too slow to act. Often the FDA doesn’t act until the product actually kills people, as was the case for products containing DMAA.



Label Deception If you are like me, you are probably outraged that manufacturers would even consider selling products like these. But the story only gets worse. None of the labels actually list DMBA as an ingredient. That’s probably because DMBA looks enough like DMAA that intelligent consumers might be scared off. Instead, they list the ingredient as AMP citrate. They can do that because they are using AMP to stand for 4-amino-2-methylpentane. But that is not the common usage for AMP.

To any biochemist, and probably most high school biology students, AMP stands for 5’-adenosylmonophosphate – a normal and harmless cellular metabolite. Citrate is also a normal cellular metabolite. In short, the manufacturers are purposely masquerading a synthetic and potentially dangerous stimulant under a pseudonym that looks like naturally occurring cellular metabolites. That is shameful!

Lack of Quality Control But wait, it gets even worse. The scientists analyzed 14 products that had AMP citrate on the label and the amount of DMBA ranged from 0 to 120 mg. Apparently these manufacturers have no quality control process either. That is a huge concern because this ingredient has never been tested for safety in humans. We have no idea how much it takes to harm people!

What Can You Do? Every time you read something like this, you might be tempted to avoid all sports nutrition and weight loss supplements. However, you should realize that unsafe products like these represent a very small part of the industry. You just need to be an informed consumer so that you can avoid products like that. For example:



Be skeptical of flamboyant claims. For example, some of the claims made by the products listed in this article are “The ultimate stimulant experience”, “Fat

incinerator”, “Rapid energy surge”. When you see claims like that you should run in the other direction.

Research your manufacturer. Only choose companies with a long track record of integrity and product quality.

Insist on published clinical studies showing that the product is both safe and effective.

The Bottom Line

1) A recent report identified a number of sports nutrition and weight loss products containing the amphetamine-like ingredient DMBA. This is a synthetic com-pound that closely resembles DMAA, a stimulant that was recently banned by the FDA.

2) Because DMBA is potentially dangerous and has never been tested for safety in humans both the authors of this report and the Council for Responsible

Nutrition have recommended that the FDA issue a recall of products containing this ingredient. To date the FDA has not acted.

3) You cannot identify products containing this dangerous ingredient by searching for DMBA on the label. That is because the manufacturers selling these products have chosen to use the harmless sounding pseudonym AMP citrate on their

ingredient list rather than DMBA.

4) The amount of DMBA in products listing AMP citrate on their label ranged from 0 to 120 mg. That means you have no idea how much DMBA you are getting from the label. Even worse, because this ingredient has never been tested in

humans we have no idea how much is safe.

5) Unscrupulous manufacturers who put untested and potentially dangerous ingredients in their supplements represent only a tiny fraction of the industry, but reports like this emphasize the importance of being an informed consumer.



Bad News For Sports Supplements May 12, 2015

“Pump up your muscles”, “Explode your muscles”, “”Blast your fat”, “Annihilate your fat”, “Ramp up your energy”: The claims leap off the page of the ads for many sports and weight loss supplements. The easiest way to ramp up your energy and annihilate your fat is to put amphetamines or other illegal stimulants in the supplement. The easiest way to pump up your muscles is to put steroids in the supplement. Unfortunately, there are always a few unscrupulous companies that are only too willing to do just that.

Well, the chickens have come home to roost. It’s been a bad few weeks for the sports supplement industry. It seems like every time you turned around there was another article about a sports supplement making fraudulent claims, containing illegal ingredients, or actually harming people. It makes you wonder whether you should just completely avoid sports supplements all together. That would be unfortunate because sports supplements can help with hydration, endurance and recovery. They can help you maximize the benefits of your exercise program. Furthermore, there are a lot of reputable sports supplement companies out there. The problem is that there are a few “bad apples” in the industry, and the FDA is not really doing its job to protect the American consumer from their deceptive and dangerous products. Even worse, when the FDA acts, major retail nutrition stores often drag their feet at actually removing the products from their shelves, and unscrupulous manufacturers just switch to another equally dangerous stimulant. It is, therefore, important for those of us who are nutrition educators to warn consumers like you about the dangerous products that are in the marketplace. The FDA will eventually act, but you need to know about those products now!



Amphetamine and amphetamine-like substances are popular in sports nutrition and weight loss products because they increase energy levels and speed up metabolism. Unfortunately, they also cause high blood pressure, arrhythmia, heart attacks and death.

Bad News For Sports Supplements Another Sports Supplement Containing a Form of Amphetamine Yet another amphetamine-like analog of DMAA called beta-methylphenethylamine (BMPEA) has appeared in the sports nutrition marketplace. It is an isomer of amphetamine that was first synthesized in the 1930’s. Because it is an analog of amphetamine, BMPEA is classified as a banned substance by the World Anti-Doping Agency. Unfortunately, its story is all too familiar. The FDA first reported the presence of pharmacological doses of BMPEA in 43% of sports and weight loss supplements containing the herbal ingredient Acacia rigidula in 2012. The manufacturers claimed that the BMPEA in their products came from the Acacia rigidula even though there was no scientific evidence that it had ever been successfully extracted from Acacia rigidula. BMPEA causes high blood pressure in animals and has never been tested for safety or efficacy in humans. Its close analog, DMAA, caused scores of deaths before the FDA finally banned it. However, the FDA did not warn consumers that supplements with the ingredient Acacia rigidula might contain BMPEA and might, therefore, be dangerous. A group led by Dr. Pieter Cohen of Harvard University (Cohen et al, Drug Testing and Analysis, DOI: 10.1002/dta.1793, 2015) recently decided to analyze sports and weight loss supplements containing Acacia rigidula to see whether some compa-nies had voluntarily removed DMPEA from their products over the last two years. One might hope that at least some of those companies might have been more motivated by protecting the health of their customers than by profit.



Not a chance! Dr. Cohen and his colleagues tested 21 products containing Acacia rigidula and found that 11 of them (52%) contained BMPEA – some in amounts as high as 94 mg/serving. Dr. Cohen was quoted as saying “More than two years after the FDA’s discovery [of BMPEA in sports supplements], the FDA has yet to warn consumers about the presence of an amphetamine isomer in supplements. This is really about the FDA and why the FDA is not enforcing the law. This is a great example of how the FDA could so easily move now and not wait like it did with DMAA, wait until strokes and heart attacks had become front page news.” After Dr. Cohen’s article became front page news several Senators called on the FDA to ban BMPEA. A week later the FDA finally caved in and announced that BMPEA was not a legal ingredient and that any products listing it on the label must be withdrawn from market. A skeptic might note that this was a full two years after the FDA discovered the existence of products containing BMPEA. Even worse, the FDA’s announcement only covered products with BMPEA on the label. It did not cover BMPEA-containing products listing only Acacia rigidula on the label – which made up most of the BMPEA-containing products identified by Dr. Cohen and his col-leagues. As the old saying goes, the FDA action was “a day late and a dollar short”. Sports Supplements Containing Steroids A week later the FDA issued a warning to consumers to stop using a product call Tri-Methyl Extreme because of reports of serious liver damage in people using it. The product contained the anabolic steroids methyl-stenbolone (a non-methylated pro-hormone) and epistane. There are two important take home lessons from this incident. 1) The product actually claimed that it contained anabolic

steroids. Anabolic steroids are known to cause liver damage, heart attack and stroke, testicular cancer, infertility and mood disorders. It is hard to imagine why

anyone would use a product that claimed to contain anabolic steroids. Unfortunately, some people are willing

to do almost anything that will increase muscle mass and strength.



2) The FDA often only acts once a product has either seriously injured or actually killed people. I tend to agree with Dr. Cohen that it would be far preferable for the FDA to be proactive and warn consumers about products that have the

potential to do harm. Sports Supplements That Cause Cancer

As if that weren’t bad enough, at about the same time a paper was published reporting that use of muscle-building supplements by young men may increase their risk of testicular cancer by up to 177% (Li et al, British Journal of Cancer, DOI: 10.1038/bjc.2015.26).

The incidence of testicular germ cell cancer in men 15-39 years old has increased 1.6-fold between 1975 and 2011. The reason for that increase is not known, but the authors of British Journal of Cancer article noted that the use of performance-enhancing supplements in that group has also increased dramatically during the same time period.

A previous study of testicular cancer patients reported that a high percentage of them (~20%) had used performance-enhancing supplements, but no control group was included in that study. Thus, the authors of this study set out to carefully match testicular cancer patients with healthy men of the same age and demographics – something we scientists call a case-control study.

The study compared 356 testicular cancer patients age 18-55 from Connecticut and Massachusetts with 513 controls that were matched by age, race, education, tobacco and alcohol use, exercise level, injury to testes or groin, and family history of testicular cancer. The results were pretty scary.

1) Use of muscle building supplements increased the risk of testicular cancer by 65% compared to men who never used that kind of supplement.

2) For men who started using muscle building supplements before they were 25, the risk of developing testicular cancer increased to 121%.

3) For men who used muscle building supplements for more than 3 years, the risk increased to 156%.

4) For men who used more than 2 types of muscle building supplements, the risk increased to a whopping 177%. That’s almost double.



This study did not identify the actual ingredients that caused the increased testicular cancer risk, but with so many of the muscle-building supplements on the market containing dangerous and/or illegal ingredients it is perhaps not surprising that they might increase cancer risk. After all, this demographic (young males) is the group most likely to choose the “Monster Muscle Builder” products rather the less glamorous, but safer, sports supplements. Sports Supplements That Mislead

At the same time that we were hearing about sports supplements with dangerous and illegal ingredients and sports supplements that may cause cancer, the Advertising Standards Authority (the British equivalent of the FTC) accused a British sports supplement company of making false and misleading ingredient claims. That’s a polite way of saying they were lying! In particular, they disallowed claims that:

CLA (conjugated linoleic acid) builds lean muscle and attacks fat stores, promotes fat loss, improves mood and focus and boosts energy.

Acetyl-L-Carnitine aids weight loss, burns fat, boosts energy, improves mental performance, and improves focus.

There were more claims they disallowed, but I included those two because you’ve probably seen similar claims for those ingredients on this side of the Atlantic. Those claims are just as bogus in the United States as they are in England.

The Bottom Line

There are a few bad apples in every barrel, and the sports supplement industry is no exception. Over one two-week period lately we have learned:

1) Over 50% of sports nutrition products labeled as containing an innocuous sounding herbal ingredient were actually found to contain an amphetamine

isomer called BMPEA that has been banned by the World Anti-doping Agency. After years of dragging its feet, the FDA finally banned some of the products containing BMPEA, but left many others on the market. As the old saying goes, the FDA was “a day late and a dollar short”.



2) Even though they are extremely dangerous, new sports supplements with anabolic steroids keep popping up online. Once again, the FDA has had to warn

consumers not to use a new muscle building supplement containing steroids because several people using that supplement suffered severe liver damage. 3) A study reported that young men who use muscle building supplements may increase their risk of testicular cancer by up to 177%, most likely because of the

dangerous ingredients in many of those supplements.

4) The British equivalent of our FTC has told a British sports supplement manufacturer that it must stop making false and misleading claims about ingredients like CLA and acetyl-L-carnitine. That is noteworthy because some sports supplement companies in the US make very similar claims for the same ingredients. ___________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. ___________________________________________________________________



Barking Up The Wrong Tree April 3, 2012

I recently came across a somewhat disturbing report on supplements containing yohimbe bark published by two scientists at the USDA Agricultural Research headquarters in Beltsville, Maryland (Sun & Chen, Journal of Pharmaceutical and Biomedical Analysis, 61: 142-149, 2011). They analyzed 18 different yohimbe bark dietary supplements for yohimbine, the active ingredient. Of the 18 supplements they analyzed only one had the amount

of yohimbine claimed on the label. Two supplements contained significantly more yohimbine than stated on the label, while the rest contained 0-50% of what was stated on the label. This is a particularly disturbing because yohimbine has a very narrow therapeutic index - which is just a fancy way of saying that the difference between an effective dose and a toxic dose is very small. And yohimbine can be quite toxic! Side effects include gastrointestinal upset and vomiting, anxiety, panic attacks, hallucinations, irregular and rapid heartbeats, high blood pressure, kidney failure and heart attack. In fact, the FDA has recently classified yohimbe supplements as "potentially unsafe". This classification means that the FDA considers the side ef-fects to be potentially life threatening and is just one step short of an outright ban of the supplement.

What Are The Uses of Yohimbe Bark? With all this background I was actually surprised that there were people still selling and using yohimbe bark supplements. So I decided to go online and research the subject a bit more.



I started with PubMed, the National Library of Medicine web site for searching peer-reviewed scientific journals. I didn't find any recent articles supporting the efficacy of yohimbe, but I found lots of articles on its toxicity. One article surveyed Poison Control Centers in 2006 and found that yohimbe supplements accounted for 18% of food and supplement related calls (Heller et al, J Med Toxicol, 4: 84-92, 2008). The only foods generating more calls were the ones containing caffeine because of overuse of all the “monster” energy drinks by teens and young adults. Then I Googled yohimbe. But I skipped over the marketing sites and "muscle madness" sites and went straight to reputable sites like WebMD and the NIH web site. It turns out that the only approved use of yohimbine is for erectile dysfunction. It is actually pure yohimbine hydrochloride, not yohimbe bark, that is approved for that use, and it is only available with a prescription. It's also not very widely used for that purpose because it is much less effective than the popular brands on the market. You know the ones I mean. One of them rhymes with Niagara and the other rhymes with Alice.

What Are They Thinking? Yohimbe bark supplements are still widely used by athletes as a stimulant and to reduce body fat. And they are used by some for their supposed aphrodisiac and hal-lucinogenic effects. It turns out that the hallucinogenic effects are the only ones that are actually proven. There's no good clinical evidence for the other reported uses of yohimbe containing supplements. Interestingly, the USDA study was criticized by an industry spokesperson who said that the study "...was unscientific and betrays a lack of understanding of natural products chemistry". He went on to say "It is established in the scientific literature that there can be a range from 7 to 115 mg yohimbine per gram of yohimbe bark. There is no doubt that the amount of this alkaloid in the yohimbe plant...varies from sample to sample."



I could only shake my head in disbelief. That sounded to me a whole lot more like a reason not to use the yohimbe bark supplements than a reason to use them. My question is: Why anyone would sell - and why would anyone use - a supplement with no proven efficacy, significant risk of toxicity, and with widely varying amounts of the active ingredient from batch to batch? As I said previously in another expose: "What are they thinking?"

___________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. ___________________________________________________________________



Choosing a Sports Supplement Company You Can Trust May 12, 2015

By now you are probably convinced that you should never use a sports supplement product again. That would be unfortunate because good sports supplements properly used can improve hydration, endurance, recovery and the results you obtain from your exercise program. The question is which sports nutrition products can you trust? Here are some simple guidelines to help you choose a trustworthy sports supplement company.

1) Avoid the hyped claims. If the supplement makes claims like “Get ripped fast”, “Intense Energy”. “Extreme Energy”, “Eviscerate fat”, “Makes fat cells self-destruct” or “boosts testosterone”, you should run the other direction.

2) Ignore testimonials. The placebo effect is close to 50% for things like energy, and if an athlete “thinks” they have more energy every time they work out, they will get stronger.

3) Look for published clinical studies showing that the product is safe and effective. Those clinical studies should be published in peer-reviewed scientific journals. If the company just cites their own “studies” or “white papers”, ignore them. They may look impressive, but they have not been peer reviewed. You have no idea whether they are accurate.

4) I could tell you to look for rigorous quality control standards, but every company claims they have excellent quality controls. Instead I will tell you to look for sup-plements that are used by medal winning Olympic athletes. Why Olympic ath-letes? That is because Olympic athletes are more rigorously drug tested than any other athlete. They absolutely cannot afford to have any stimulants, steroids or other banned substances in their body at any time. They need products that are pure, safe and effective.

5) Finally, avoid products with artificial ingredients. While the risks associated with artificial sweeteners, artificial flavors and artificial colors are not as great as the risks associated with stimulants and steroids, they are still ingredients to be avoided. They provide no real benefits, and we simply do not know the long term health consequences of artificial ingredients.



The Good, The Bad, And The Ugly March 22, 2013

In previous issues of “Health Tips From the Professor” I have focused on the bad players in the sports supplement market. I have shared the horror stories of sports supplements that contain dangerous stimulants or steroids. I’ve told you about sports supplements that have killed people. I have probably convinced you never to go near a sports supplement again. Perhaps it is time to put things into perspective. There are ingredients in sports supplements that actual

work—ingredients that provide clinically proven benefits. In this issue of “Health Tips From the Professor” I am going to take the ingredients you often find in sports supplements and divide them into the good (ingredients that provide clinically proven benefits), the bad (ingredients that are probably harmless, but provide no real benefit), and the ugly (ingredients that are dangerous and may even kill you).

The Ugly

Let’s start with the ugly—those ingredients that are dan-gerous and may even kill you. I’ve already warned you about the dangers of steroids and amphetamines. Based on my years of cancer research I would also add growth hormone, testosterone and pro-hormones such as DHEA that can be converted to testosterone and estrogen to the list of ingredients to avoid. Most of the amino acids and herbal ingredients that are advertised as increasing the levels of these hormones don’t actually work, but if they did, they would be on my list as well.

I realize that those supplements are very appealing if you are trying to maximize muscle mass or if you are over 50 and just aren’t feeling like yourself anymore



(your younger self, of course). After all, the TV ads are constantly telling you that if you have low energy, your sex life is lagging, and your muscles are turning into flab, you must have “low T”. A testosterone cream or pill will solve all your problems. The online ads for human growth hormone convey a similar message. What these ads and some misguided doctors are missing is that there is a very good reason why growth hormone, estrogen and testosterone levels decrease as we get older. That is because we accumulate precancerous cells as we age. These hormones stimulate those precancerous cells to become cancer cells and stimulate cancer cells to grow. It is common knowledge that estrogen can cause breast cancer, and testosterone can cause testicular cancer. The effects of human growth hormone are more subtle, but equally scary. Is it really worth it to achieve better muscle gain at the expense of increased risk of cancer?

The Bad

Next, let’s consider the bad—those ingredients that are probably of no real value. In most cases, these are ingredients that may have some benefit for muscle function under exceptional circumstances. The problem is that unscrupulous companies extrapolate those results to imply that the ingredient will provide the same benefit to healthy individuals who are simply trying to improve their workouts.

Generally, this extrapolation is based on little or no evidence. In fact, companies often ignore evidence showing that those ingredients are of no value in healthy individuals. Let’s look at some examples: Ribose: Some studies have suggested that ribose may help protect heart muscle in patients with advanced heart disease. However, multiple clinical studies have shown that ribose provides no exercise benefit for healthy individuals (Int J Sport Nutr Exerc Metab, 13: 76-86, 2003; J Strength Condit Res, 17: 47-52, 2003; Int J Sports Nutr Exerc Metab, 15: 653-664, 2005). Inosine: Inosine may provide some benefit to patients with spinal chord injuries, but clinical studies show that it has no benefit for healthy individuals (Med Sci Sports Exerc, 1996; Int. J Sport Nutr, 1999).



Carnitine: Carnitine appears to be beneficial in patients with carnitine-deficiency diseases, muscle wasting diseases and congestive heart failure. However, once again multiple clinical studies show that it has no benefit with respect to exercise performance in healthy individuals. Arginine and Citrulline: Arginine and citrulline may be of benefit for patients with pulmonary hypertension, but are of limited benefit with respect to exercise performance in healthy individuals. The story with arginine and citrulline is actually quite interesting. They appear to offer modest exercise performance benefits to untrained individuals, but offer little or no exercise benefits to highly trained individuals (J Appl Physiol Nutr Metab, 37: 115-126, 2012; Sports Med, 42: 99-117, 2012; Med Sport Sci, 59: 18-28, 2012). There is a biochemical rationale for this seemingly contradictory paradox. Arginine and citrulline both increase levels of nitric oxide, which relaxes blood vessels and improves blood flow to the muscles. This is important for an untrained individual, because blood flow to the muscle can be limiting for intense exercise. However, training over a period of months causes an increase in blood supply to the muscle and improves the efficiency of oxygen utilization by the muscle. Simply put, with training the muscles become better adapted to high intensity exercise, and the ef-fects of arginine and citrulline on blood flow are no longer needed. The bottom line is that if you are just starting an intense exercise program, arginine and/or citrulline may provide some benefit, but if you’ve been training for more than a month or two, you might as well save your money. HMB: Beta-hydroxyl beta-metylbutyrate (HMB) is a minor metabolite of leucine (which I will discuss in a minute). If you believed the advertising, you would think that it was much more effective than leucine at enhancing exercise performance. In fact, there have been more than 30 clinical studies evaluating its effectiveness, and they are evenly split. About 50% show a positive benefit on exercise performance, while the other 50% show no benefit. Once again it appears to be the untrained individuals who benefit the most (Nutr Metab, 5: doi: 10.1186/1743-7075-5-1, 2008; J Strength Condit Res, 33: 836-846, 2009), although there is not an obvious biochemical rationale for this observation. In addition, some reports suggest that excessive use of HMB can result in mental confusion and memory loss, so this is an ingredient I would avoid.



Caffeine: Caffeine is on the borderline between “bad” and “good” ingredients. It is hard to be too negative about a substance that millions of Americans consume every day in their coffee, tea, sodas and energy drinks. I do consider it to be the safest stimulant in the sports supplement market. Unfortunately, it is also the most abused stimulant in the sports supplement market. It is responsible for more hospital admissions than any other sports supplement. That is because many energy drinks on the market today have up to 200-300 mg of caffeine per serving, and some people don’t stop with one serving. If you choose to use a sports supplement containing caffeine, I would not exceed the 60-90 mg level that you would find in a cup of tea or coffee, and I don’t recommend caffeinated sports supplements for youth athletes.

The Good Finally, it is time to talk about the good—those sports supplement ingredients that actually do provide a proven benefit . Creatine: Creatine is another ingredient that is on the border between bad and good. I nudged it to the good side because of its benefits, although modest,

are well established, but creatine is not for everyone. Creatine phosphate is an en-ergy store in the muscle that can be very rapidly utilized for energy production. It can fuel the muscle for only 1-2 seconds, so it is best utilized for rapid bursts of energy. Creatine supplementation can increase muscle stores of creatine phosphate by 20-40%. The mathematicians among you may have sharpened your pencils and figured out that creatine supplementation can fuel the muscle for an additional 0.2 to 0.8 seconds. That can be the difference between winning or losing if you are a competitive sprinter. It also modestly improves high power performance which, if repeated over and over, can give greater long term strength gain. However, it is of no value to an endurance athlete, and its cost-benefit ratio is doubtful if you are not an elite athlete. Creatine does have a dark side as well. At high doses it can lead to dehydration and muscle cramping, so adequate hydration is absolutely essential if you choose to use creatine. It is also a sports supplement that I do not recommend for youth athletes.



Leucine: The branched chain amino acids leucine, isoleucine and valine have been used in sports supplements for a long time, and their value in improving muscle mass and exercise performance is well established. The original biochemical rationale for the beneficial effects of the branched chain amino acids was based on the observation that they were preferentially used as fuel by muscle during high intensity exercise. However, recent research has singled out leucine as the most important member of the trio when it comes to enhancing the increase in muscle mass associated with exercise. It turns out that leucine is the only amino acid that activates the mTor pathway which, among other things, specifically stimulates the muscle to create new muscle fibrils. That is a fancy way of saying that leucine stimulates an increase in muscle mass which, of course, leads to greater strength and endurance. I will talk more about leucine in subsequent chapters in this ebook. _________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. _________________________________________________________________



Should Sports Protein Products Contain Sugar? If you believe many of the self-appointed “gurus” in the sports supplement market, sugar of any kind has no place in a sports protein product. This is actually not true, but it has been repeated over and over so many times that many people believe that it is true. It has become what I call an “urban nutrition myth”. I love to debunk the myths and misinformation on nutrition that abound on the internet. That is why I created my weekly blog

“Health Tips From The Professor”. I wanted to create a source of health information that people could trust. It is easy to understand how that myth about sugar in sports protein products was created. After all, we already know that we consume way too much sugar in this country, and it seems intuitive that we don’t really need sugar in a protein product. Right? Actually that is an incorrect statement.

The Truth About Sugar Let me start by setting the record strait with respect to sugar. I’ll just give you a brief synopsis here, but you can find complete details along with the references in my book “Slaying The Food Myths” (https://slayingthefoodmyths.com). 1) There are no sugar heroes and there are no sugar villains. Honey and agave nectar are no healthier than table sugar, high fructose corn syrup or fructose. 2) The problem lies in the total amount of sugar we consume and the foods that we consume it in. 3) When we consume sugars in sodas, juices and highly refined foods they enter the bloodstream rapidly and cause a sudden spike in blood sugar levels. The technical term for this is they have a high glycemic index. If you actually read the clinical studies, it is sugar consumed in this form that is linked to obesity, diabetes, heart disease and inflammation.



4) When we consume the same sugars in foods that contain protein, fiber and a touch of fat they enter the bloodstream much more slowly and have a low glycemic index. Sugars consumed in this form play their intended role in metabolism and do not appear to be harmful. Simply put, high fructose corn syrup in sodas is problematic, but the same amount and kinds of sugars in fruits or a protein supplement is perfectly healthy for most people.

The Truth About Protein Supplements

Again, I’ll just give you a brief synopsis here, but you can find complete details along with the references in my video “The Truth About Protein”, which you will find on the video resource page of https://healthtipsfromtheprofessor.com. 1) We actually need sugar for optimal utilization of protein. That is because our brains and several other organs are absolutely dependent on blood sugar as a source of energy. Therefore, if we don’t consume sugars (or carbohydrates

that can rapidly be broken down to sugars) along with the protein, our cells will convert a portion of the protein we eat to sugar to keep our brains alive. Simply put, without sugar the protein will not be optimally utilized by your body, and it turns out that the optimal ratio of sugar to protein is 1:1. This is a concept called “protein sparing” that biochemists have known about for years, but for some reason is not understood by many protein supplement manufacturers. 2) The flip side of this coin is that protein supplement manufacturers need something to make their protein shakes palatable. In addition, most of the other ingredients (amino acids, citrulline, carnitine, etc.) aren’t very tasty, which makes their challenge even more difficult. Once they have made the decision (based on faulty information) not to add sugar to their protein shake, most sports supplement companies simply use artificial sweeteners (and sometimes artificial flavors) because they are cheap and inexpensive. My recommendation is to avoid those products. There are still unresolved concerns around all of the artificial sweeteners. We simply do not know their long term safety. A better approach that some companies are using is to add the natural, non caloric sweetener stevia. It is not possible to rely 100% on stevia for sweetness because it has a distinct aftertaste that some people don’t like. However, the addition of stevia to a protein shake



usually allows the manufacturer to keep the ratio of natural sugars to protein in the 1:1 range and still have a shake with acceptable taste. 3) If you are trying to maximize the recovery process an even higher ratio of carbohydrate to protein is optimal. That is because insulin is the master hormone that drives the recovery process. It stimulates uptake of blood glucose into muscle cells and conversion of that glucose into the glycogen stores that the muscle will use during the next round of exercise. It also stimulates uptake of amino acids into muscle cells and the incorporation of those amino acids into new protein to repair muscle protein that was damaged during exercise and build new muscle protein so that the muscle will be larger and stronger for the next round of exercise. In short, you don’t need steroids, growth hormone or “magic” ingredients (that don’t really work) to increase muscle mass and strength following exercise. You just need to maximize the body’s natural insulin response. A large body of research indicates that the optimal carbohydrate to protein ratio to achieve this is in the range of 2.5:1 to 4:1 (J Appl Physiol, 72: 1854-1859, 1992; J Appl Physiol, 76: 839-845, 1994; J Appl Physiol, 93: 1337-1344, 2002; J Strength Cond Res, 17: 12-19, 2003; J Appl Physiol, 104: 1029-1096, 2008; J Strength Condit Res., 24: 2577-2866, 2010). ___________________________________________________________________ If you would like to receive scientifically accurate nutrition updates each week—updates you can trust and use, subscribe to “Health Tips From the Professor” by going to https://healthtipsfromtheprofessor.com today. ___________________________________________________________________



What Should a Post-Workout Protein Shake Look Like? January 39, 2014

If you work out on a regular basis and read any of the “muscle magazines”, you’ve seen the ads. “Explode Your Muscles.” “Double Your Gains.” They all claim to have the perfect post-workout protein shake, backed by science. They all sound so tempting, but you know that some of them have to be scams. I told you about some of the sports supplements

to avoid in previous “Health Tips From the Professor”. In this issue, I’m going to ask “What does the perfect post-workout protein shake look like?” For years athletes have been using protein beverages containing branched chain amino acids after their workouts to maximize muscle gain and recovery. There is some good science behind that practice, but the major questions were unanswered. Nobody really knew: How much protein is optimal?

What kind of protein is optimal?

What amount of branched chain amino acids is optimal?

Are some branched chain amino acids more important than others?

Does the optimal amount of branched chain amino acids depend on the amount of protein? As a consequence, after workout protein supplements were all over the map in terms of protein source, protein amount, branched amino acid amount and type of branched chain amino acids. Fortunately, recent research has clarified many of these questions.



How Much and What Kind of Protein Do You Need?

Recent research has shown that the optimal protein intake for maximizing muscle gain post workout is 15-20 gm for young adults (Katsanos et al, Am J Clin Nutr 82: 1065-1073, 2005; Moore et al, Am J Clin Nutr, 89: 161-168, 2009) and 20-25 gm for older adults (Symons et al, Am J Clin Nutr 86: 451 456, 2007).

More protein isn’t necessarily better. The effect of protein intake on post work-out muscle gain maxes out at around 25 gm for young adults and 30 gm for older adults (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009).

Whey protein is the best choice for enhancing muscle gain immediately after a

workout. Other protein sources (soy, casein, chicken) are better choices for sustaining muscle gain over the next few hours.

Does Leucine Stimulate Muscle Growth? It turns out that leucine is the only branched chain amino acid that actually stimulates muscle protein synthesis (Am J Physiol Endocrinol Metab 291: E381- E387, 2006). And protein is what gives muscles their strength and their bulk.

Recent research has shown that 2-3 gm of leucine (2 gm for young adults; 3 gm

for older adults) is sufficient to maximize post workout muscle gain if protein levels are adequate (Am J Physiol Endocrinol Metab 291: E381-E387, 2006).

Unanswered Questions About Optimizing Muscle Gain Post-Workout Do the other branched chain amino acids play a supporting role, or is leucine

alone sufficient to drive post-workout muscle gain?

Can leucine still help maximize post-workout muscle gain if protein intake is inadequate? If so, how much leucine is needed?

Does Leucine Enhancement Improve Low Protein Shakes? A recent study (Churchward-Venne et al, Am J Clin Nutr, 99: 276-286, 2014) seems



to answer those two questions. The authors compared the effect of 5 protein-amino acid combinations on muscle protein synthesis in 40 young men (~21 years old) following unilateral knee-extensor resistance exercise. The protein shakes contained: 25 gm of whey protein, which naturally contains 3 gm of leucine (high protein, moderate leucine) 6.25 gm of whey protein, which naturally contains 0.76 gm of leucine (low protein, low leucine)

6.25 gm of whey protein with 3 gm of leucine (low protein, moderate leucine)

6.25 gm of whey protein with 5 gm of leucine (low protein, high leucine)

6.25 gm of whey protein with 5 gm of leucine + added isoleucine and valine (the other branched chain amino acids). (low protein, branched chain amino acids).

The results were clear cut: The high protein shake (25 gm of protein) was far superior to the low protein

shake (6.25 gm of protein) at enhancing post workout protein synthesis. This is consistent with numerous other published clinical reports.

Adding 3 gm of leucine to the low protein shake had no effect on post-workout

protein synthesis, but 5 gm of added leucine made the low protein shake just as effective as the high protein shake at supporting post-workout protein synthesis. In short, leucine can improve the effectiveness of a low protein shake, but you need more leucine than if you chose the high protein shake to begin with.

Adding extra branched chain amino acids actually suppressed the effectiveness

of leucine at enhancing post-workout protein synthesis. These data suggest:

Leucine probably is the major amino acid responsible for the muscle gain reported in many of the previous studies with branched chain amino

acids.



If the other branched chain amino acids play a supporting role in the muscle gain, the quantities that occur naturally in the protein are probably enough. Adding more may actually reduce the effectiveness of leucine at stimulating muscle gain.

While this is a single study, it is consistent with numerous other recent clinical studies. It simply helps clarify how much leucine is needed and whether leucine can increase the effectiveness of a low protein supplement. It also clarifies the role of branched chain amino acids. While this study focused on protein synthesis, numerous other studies have shown that optimizing post-workout protein and leucine intake results in greater muscle gain (for example, Westcott et al., Fitness Management, May 2008)

The Bottom Line

Research on post-workout nutrition to optimize muscle gain from the workouts has come a long way in recent years. It is now actually possible to make rational choices about the best protein supplements and foods to support your workouts.

If you are a young adult (17-30), you should aim for 15-20 gm of protein and about 2 gm of leucine after your workout.

If you are an older adult (50+), you should aim for 20-25 gm of protein and 3 gm of leucine after your workout.

If you are in between you are on your own. Studies haven’t yet been done in your age group, but it’s reasonable to assume that you should aim for somewhere between the extremes.

If you are getting the recommended amounts of whey protein, the leucine level will also be optimal. If you are using other protein sources you may want to choose ones with added leucine. The research cited above shows that you can make a low protein supplement

effective by adding lots of leucine, but that’s going to require artificial flavors and sweeteners to cover up the taste of that much leucine. I would recommend choosing one that provided adequate protein to begin with.



While the research in this area is still somewhat fluid, I would avoid protein sup-plements with added branched chain amino acids other than leucine. If the paper I cited above is correct, you probably get all of the other branched chain amino acids you need from your protein and adding more may actually interfere with the effect of leucine on muscle gain.

I’d pretty much forget all the other “magic ingredients” in post-workout supplements. If you’re a novice, there is some evidence that arginine, citrulline and beta-hydroxyl beta-methylbutyrate (HMB) may be of benefit, but if you have been working out for more than 6 months, the evidence is mixed at best. As for the rest, the clinical studies are all over the map. There’s no convincing evidence that they work.

Whey protein is the best choice for enhancing muscle gain immediately after your workout. Soy and casein are better choices for sustaining muscle gain over the next few hours. If you’re looking at meat protein, chicken is a particularly good choice. Four ounces of chicken will provide the protein and leucine you need to sustain muscle gain for several hours.



Do Protein Needs Increase As We Age? February 10, 2015

In previous “Health Tips From the Professor” I have covered the optimal amount of protein following workouts. In this issue of “Health Tips From the Professor” I will review the latest information about protein needs as we age. To put this in perspective, many Americans suffer from sarcopenia (loss of muscle mass) as they age Starting at age 50 we lose1-2% of muscle mass and 1.5% of muscle strength each year. Over age 65 this increases to 3% loss of strength/year. That’s a 30% loss by age 75 and a 60% loss by age 85! Some of you may be saying "So what? I wasn't planning on

being a champion weight lifter in my golden years." The "So what" is that loss of muscle mass leads to loss of mobility, a tendency to fall (which often leads to debili-tating bone fractures) and a lower metabolic rate - which leads to obesity and all of the illnesses that go along with obesity.

How Can We Prevent Loss of Muscle Mass As We Age? Fortunately, sarcopenia is not an inevitable consequence of aging. There are things that we can do to prevent it. The most important thing that we can do to prevent muscle loss as we age is to exercise - and I'm talking about resistance (weight) training, not just aerobic exercise.

But we also need to look at our protein intake and our leucine intake. Protein is important because our muscle fibers are made of protein. Leucine is an essential amino acid. It is important because it stimulates the muscle's ability to make new protein. Leucine and insulin act synergistically to stimulate muscle protein synthesis after exercise. I have covered the evidence behind leucine’s importance in maintaining and building muscle mass in a previous chapter”.



Do Our Protein Needs Increase As We Age? Interestingly, our protein needs actually increase as we age. For example, Campbell et al (Journal of Gerontology: Medical Sciences 56A: M373-M380, 2001) showed several years ago that RDA levels of protein were not sufficient to maintain muscle mass in both men & women aged 55 to 77 years old. The RDA for protein is currently set at 0.8 g of protein/kg of body weight/day for all adults (56 grams of protein/day for men and 46 grams of protein/day for

women). However, an international team of experts recently recommended setting the protein allowance at 1.0 to 1.2 grams of protein/kg of body weight/day for adults over 65. That would correspond to 70-84 grams/day for men over 65 and 58-69 grams/day for women over 65. Dr. Jose Antonio, head of the International Society of Sports Nutrition, recently said “It is about time that clinicians realized that consuming protein above the RDA is needed to ameliorate the loss of muscle protein with age. Adhering to the RDA for protein would be like white water rafting without a paddle. It’s just plain dumb.”

When Should We Eat Our Protein?

When we consume protein is also important. Forget that continental breakfast, salad for lunch and protein-rich dinner. As we age we increasingly need high quality protein at every meal.

In one study, young adults (average age = 31), experienced increased muscle protein synthesis when they consumed as little as 15 grams of protein at a meal, but older adults (average age = 68) experienced no increase in muscle protein synthesis in response to the same low protein meal (Katsanos et al, Am J Clin Nutr 82: 1065-1073).

However, when the amount of protein in a meal was increased to 30 grams (equivalent to a 4 oz piece of chicken or beef) both younger and older adults were able to use that protein to build muscle (Symons et al, Am J Clin Nutr 86: 451-456, 2007).



But, 30 grams seems to be about optimal. Protein intakes above 30 grams in a sin-gle meal resulted in no further increase in muscle protein synthesis (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009), which means you can't hope to get all of the muscle building benefits of protein in a single meal.

As a consequence of these studies most experts recommend that we "golden agers" aim for 20 to 30 grams of high quality protein with every meal.

How Much Leucine Do We Need? The story with leucine is similar. 1.7 grams of leucine was not sufficient to increase muscle protein synthesis following exercise in older adults, while 2.7 grams was sufficient (Katsanos et al, Am J Physiol Endocrinol Metab 291: E381-E387, 2006). So the experts recommend that older adults get 3 grams of leucine in our diet following workouts to maximize the effect of the workout.

And, of course, if we want to maximize the effects of resistance training, both the protein and leucine need to be consumed after we exercise, not before (Fujita et al, J Appl Physiol 106: 1730-1736, 2009).

Where Do We Get the Protein and Leucine We Need? So, where do we get the amount of protein and leucine that we are looking for? If you want to get them from food alone, 4 oz servings of meat are a good starting place - with chicken being the best (35 grams of protein and 2.7 grams of leucine). If you are looking at vegetarian sources, soy is your best choice. An 1 oz serving of soy protein provides 23 grams of protein and 2 grams of leucine. Dairy, eggs and other vegetable foods are much lower in leucine, protein or both. Unfortunately, I keep running into seniors who are fully convinced that broccoli and leafy greens will meet their protein needs. I fully understand the rationale for choosing vegetarian protein sources. However, you need a bit more protein than broccoli and leafy greens provide if you are going to meet your protein needs in your golden years



For example, a 1.5 cup serving of broccoli provides only 4.2 grams of protein and a miserly 0.36 grams of leucine. You would have to eat a lot of broccoli to meet your target of 20-30 grams of protein and 2.7 grams of leucine with each meal. I’m not saying that you can’t get enough protein and leucine to maintain muscle mass on a vegetarian diet. However, I am saying you will need to plan that diet very carefully. So, if you want to know what the old professor does, here it is: I work out almost every day. On the days when I work out in the morning I rely on a protein shake immediately after the workout to meet my protein and leucine goals. On the days when I train at the gym in the late afternoon, I rely on 4 oz of chicken or fish with dinner to meet those goals. Those of you who know me know that I will never be featured in muscle magazine, but at least I'm gaining muscle mass - not losing it.

The Bottom Line 1) As we age many Americans suffer from sarcopenia (loss of muscle mass). The

loss of muscle mass leads to loss of mobility, a tendency to fall (and break things) and a lower metabolic rate - which leads to obesity and all of the

illnesses that go along with obesity. 2) The most important thing that we can do to prevent muscle loss as we age is to

exercise - especially resistance (weight) training exercise - at least 30 minutes every day. It is also important to make sure that we are getting adequate intake of protein and the essential amino acid leucine.

3) Our protein needs increase as we age. Recent studies suggest that the RDA levels of protein are not sufficient to maintain muscle mass in people over the

age of 55. Many experts recommend that those of us in our golden years consume the amount of protein in grams that is equivalent to half our body

weight in pounds every day.



4) Recent studies show that it is important to spread the protein out through the day rather than consume one protein rich meal at the end of the day. If we are over 50 we should be aiming at 20-30 grams of protein per meal. However, more than 30 grams of protein at a single serving appears to provide no additional benefit.

5) Seniors also appear to need more leucine in each meal than younger adults if

they wish to preserve muscle mass. Young adults need only around 1.7 grams of leucine per serving to stimulate muscle protein synthesis, while mature adults may need as much as 2.7 grams per serving.

6) Well-designed protein shakes and 4 ounces of lean meats are the easiest way for

seniors to meet their protein and leucine needs. Vegetarian diets can provide the protein and leucine needed to maintain muscle mass in seniors, but those diets need to be very well planned. Broccoli and leafy greens just don’t make the grade if you are serious about preserving muscle mass.



How Much Protein Do Athletes Need? August 29, 2017

There is so much conflicting information about how much protein we should be getting. Some experts say we are eating too much. Others say we are eating too little. Some experts say we should just eat fruits and vegetables. Others say we should load up on meat. Some experts say athletes need more protein. Others say they get plenty of protein in the standard American

diet. No wonder you are confused! Because of all the conflicting advice, I thought it would be worthwhile to share with you the International Society of Sports Nutrition Position Statement on protein and exercise (R. Jagr et al, Journal of the International Society of Sports Nutrition 14:20, 2017. DOI: 10.1186/s12970-017-0177-8)

How Much Protein Do Athletes Need? Before summarizing the International Society of Sports Nutrition (ISSN) recommen-dations, I should start by pointing out that these recommendations are focused on the effect of protein on exercise performance. They are also focused more on high performance athletes than on those of us who are just trying to stay fit. Here are the ISSN recommendations:

#1: “An acute exercise stimulus, particularly resistance exercise, and protein ingestion both stimulate muscle protein synthesis and are synergistic”. In simple English, exercise and protein work synergistically to help you increase muscle mass. #2: “For building and maintaining muscle mass…, an overall daily protein intake in the range of 0.6 – 0.9

gm/pound body weight/day is sufficient for most exercising individuals”. This is 1.7-2.5 times the RDA for sedentary individuals, and is more appropriate for elite athletes than for your average weekend warrior or fitness enthusiast.



They make the point that protein alone is sufficient for increasing muscle mass following resistance training. However, they also say that addition of carbohydrate to a protein supplement improves muscle glycogen recovery and reduces post-workout muscle soreness. I also prefer some carbohydrate with a protein supplement because of a phenome-non called “protein sparing”. In the absence of carbohydrate, some of the ingested protein is converted to glucose to restore blood glucose levels and muscle glycogen stores. If you include carbohydrate with the protein, the carbohydrate will be used to restore blood glucose & glycogen, and all the protein can be used to increase muscle mass. #3: “There is novel evidence that suggests higher protein intake (>1.36 gm/pound body weight/day) may promote loss of fat mass in resistance-trained individuals”. This recommendation is primarily for body builders. #4: “Optimal protein intake per serving…depends on age and [the intensity of] re-cent resistance exercise. General recommendations are…a dose of 20-40g”. As I discussed previously, older people require less protein following exercise than younger people. As for intensity of exercise, most of us engage in moderate Intensity exercise and should aim for the lower dose recommended by the ISSN. The higher dose is more appropriate for elite athletes engaged in high intensity training.

#5: “Acute protein doses should strive to contain 700-3,000 mg of leucine…in addition to a balanced array of the essential amino acids”. As I noted previously, older people also need more leucine than younger people. It is worth noting that in their position statement,

the ISSN did not recommend any of the other ingredients that you often find in those “Mega Muscle” protein supplements. #6: “These protein doses should be evenly distributed, every 3-4 h, across the day”. If you consume too much protein at one time, the excess will not be used for building muscle.



#7: “The optimal time period during which to ingest protein is likely a matter of individual tolerance…However, the anabolic effect of exercise is long-lasting (at least 24 h), but likely diminishes with increasing time post-exercise”. While the anabolic effect of exercise lasts for 24 hours or more, the maximum anabolic effect occurs during the first 2-4 hours after exercise. This is why a post-workout supplement is generally recommended immediately following a workout. Because there is a limit to how much protein can be consumed at any one time, additional protein should be consumed at regular intervals over the next 24 hours (recommendation #6).

#8: “While it is possible for physically active individuals to obtain their daily protein requirements through the consumption of whole foods, supplementation is a practical way of ensuring intake of adequate protein quality and quantity, while minimizing caloric intake”. #9: “Rapidly digested proteins that contain high propor-tions of essential amino acids and adequate leucine are most effective in stimulating muscle protein synthesis”.

This recommendation is most appropriate for protein(s) ingested during the acute 2-4 hour anabolic phase immediately after exercise. During the remaining 24 hours of the anabolic phase, it is more important to maintain a constant amino acid concentration in the bloodstream. For this reason, I generally recommend more slowly digested proteins, such as soy or meat, between 4 and 24 hours after exercise. #10: “Different types and quality of protein can affect amino acid bioavailability following protein supplementation”. Simply put, there are a lot of “junk” protein supplements out there. Look for a manufacturer with a reputation for integrity and for product quality. #11: “Athletes should consider focusing on whole food sources of protein that contain all the essential amino acids”. Simply put, you should avoid supplements that contain only a few selected amino acids. Instead, choose supplements that provide whole protein from natural sources. Leucine, for example, is very beneficial when added to a whole protein supplement containing all the essential amino ac-ids, but leucine by itself would be of little value.



#12: “Endurance athletes should focus on achieving adequate carbohydrate intake to promote optimal performance; the addition of protein may help offset muscle damage and promote recovery”. In short, endurance athletes benefit from a combination of carbohydrate and protein, but carbohydrate is of primary importance. #13: “Pre-sleep casein intake (30-40 g) provides increases in overnight muscle protein synthesis and metabolic rate without decreasing the

overnight fat breakdown”. The definitive studies on this have been fairly recent. This recommendation is most appropriate for elite athletes who are primarily interested in increasing muscle mass. For the rest of us, calorie considerations would outweigh the small increment in muscle mass we could gain overnight.

Documents

The Dangers of Sports Supplements - starteamsite.com · “The Dangers Of Sports Supplements” Dr. Steve Chaney 3 Introduction Sports supplements can be very beneficial. They can