Sports and Anti-aging nutritional therapies

Nutritional Therapies and Anti-Aging Research James P. Meschino, DC, MS About the Columnist Other Articles

Sports Supplements That Actually Work

In the course of daily practice, many young and even older athletes ask about the value of certain supplements in regards to enhancing athletic performance, muscle and strength gains, explosive power, etc. Many supplements are more hype than science, as we all know; however, several supplements have impressive research to support their use as ergogenic aids. Sports supplements such as whey protein powder, sodium bicarbonate (or sodium citrate), creatine, L-glutamine and ornithine and arginine top the list of legitimate supplements for athletes to use in this regard.

Let's consider the synergistic effects of combining creatine, L-glutamine, ornithine and arginine to enhance athletic performance, accelerate strength, muscle and explosive power gains, and reduce risk of upper respiratory tract infections in athletes. Creatine supplementation is proven to increase strength, explosive performance, and lean mass in athletes. Creatine also preserves strength as athletes age, keeping them more functional. It has even been shown to improve strength and functionality in patients with multiple sclerosis and other neurodegenerative diseases, as well as in patients with chronic heart failure.

L-glutamine has been shown to decrease muscle catabolism during workouts and reduce the incidence of upper respiratory tract infections in athletes undergoing heavy training. L-glutamine is the primary fuel for many immune cells.

Supplementation with arginine and ornithine has been shown to boost release of growth hormone from the anterior pituitary gland, and thus accelerate lean mass development in young athletes and preserve lean mass in individuals over age 40, who typically show an age-related drop-off in growth hormone and insulin-like growth factor (IGF-1) blood concentrations.

Micronized Creatine Monohydrate

Creatine is an amino acid stored in muscle in the form of creatine phosphate. During explosive or intensive exercise, creatine phosphate is broken down by a specific enzyme to yield creatine plus phosphate plus free energy. The free energy released from the breakdown of creatine phosphate is used to regenerate ATP, which is the fuel that powers muscle contraction.^1-2

A number of studies have demonstrated that short-term creatine supplementation increases creatine phosphate stores in skeletal muscle by 10-40 percent.³ In combination with proper training, creatine supplementation leads to an increase in muscle mass, which is thought to occur from increased protein synthesis as the muscle lays down an increased number of contractile myofilaments (protein bands that contract and generate force). Increased muscular fluid retention may also participate in muscle volume gains with creatine use.^4-7

It also appears that creatine supplementation may allow athletes to train harder (due to increased available energy for muscle concentration), which promotes strength gains and increases muscle size due to hypertrophy (larger muscle fiber size).^2-3 Several studies have shown that creatine supplementation improves performance in repeated bouts of high-intensity strength work and repeated sprints, which are primary determinants and requirements for many sports.^8-18

In short, substantial evidence suggests creatine supplementation can increase lean body mass, muscular strength, and sprint power. As an anti-aging consideration, creatine supplementation has also been shown to help preserve strength as individuals age, and is used successfully as an adjunct in the management of various neuromuscular diseases and heart failure.^19-24

The established protocol for creatine supplementation used by athletes involves a loading dosage of 20-25 grams per day for the first 5-7 days. Typically, an athlete will mix a heaping teaspoon of creatine monohydrate crystals into a glass of juice to obtain about 5 grams of creatine. During the loading phase, the athlete does this on four or five occasions throughout the day to achieve an intake of 20-25 grams. After the loading phase is completed, the maintenance daily dosage is usually five to 10 grams per day.

Supplementation with creatine monohydrate (best absorbed in the micronized form) has been shown to be the preferred form of creatine supplementation, as it dissolves very well in a glass of juice (e.g., grape juice; no residue at bottom of glass) and is highly absorbable within the gut.

L-Glutamine

L-glutamine is the most abundant amino acid in the bloodstream and the body. Glutamine is also a main anti-catabolic agent in muscle, which when supplemented, may help preserve muscle tissue (preventing its breakdown) during and after exercise. The heavier one trains, the greater the stress on muscle and the greater the breakdown (catabolism) of muscle mass, as the muscles release glutamine into the bloodstream.²⁵

During and following exercise or trauma, large amounts of alanine and glutamine are released from muscle. In turn, alanine and glutamine travel through the bloodstream to the liver where they can be used to form glucose and glycogen. Glutamine supplementation has been shown to maintain muscle mass in catabolic patients.²⁶ Thus, athletes often supplement with L-glutamine (1,000-2,000 mg per day) to decrease muscle breakdown during training.³⁰

Glutamine supplementation in endurance athletes has been shown to reduce the incidence of infections in this population, members of which are known to have their immune system suppressed by excess training of this nature. A double-blind, placebo-controlled study showed that glutamine supplementation at a dose of 5 grams, taken after the end of exercise in 151 endurance athletes, resulted in a significantly lower incidence of infections (19 percent) compared to the placebo group (51 percent) during the study period.²⁷

It has been suggested that the immune system suppression associated with endurance exercise may be due in part to reduction in glutamine that results from intensive training. Another study, using the same protocol, demonstrated that 81 percent of athletes taking glutamine had no subsequent infection during the study period compared to 49 percent in the placebo group.²⁸

Arginine and Ornithine

Arginine and ornithine are amino acids that have been shown to increase the release of growth hormone (growth hormone secretagogues) when supplemented at a dose of 500 mg each, twice per day, five times per week. These initial studies were performed on young athletes. Acting as growth hormone secretagogues, these two amino acids increase growth hormone release, which, in turn, increases synthesis and release of insulin-like growth factor-1 (IGF-1) from the liver. It is IGF-1 that exerts the anabolic and other physiological effects attributed to growth hormone on the tissues of the body.

As we age, growth hormone and IGF-1 levels decline, facilitating breakdown of lean mass and bone mass. Supplementation with arginine and supplementation with arginine and ornithine can help reverse this trend, elevating and preserving IGF-1 levels. This has important anti-aging effects on the musculoskeletal system. If the individual is performing resistance training and consuming adequate protein, then arginine and ornithine supplementation can help enhance lean mass and strength gains, even in older individuals. This helps to keep individuals more functional as they age, elevates their metabolism, and helps to reduce body fat.

L-arginine is also converted to nitric oxide, which dilates blood vessels and feeds muscles additional nutrients and oxygen. This effect has also been shown to enhance athletic performance.^29-30

Natural Performance Enhancement

Supplementation with a product that combines creatine monohydrate (ideally micronized creatine), L-glutamine, and arginine and ornithine at scientifically proven dosages, provides athletes young and old with legitimate ergogenic and anti-aging effects in regards to enhanced muscle, lean mass, strength and explosive power gains, and immune system support. Stirred into a glass of juice (4-6 ounces) on an empty stomach between meals, these nutrients have proven performance effects in young and older athletes. They can help preservefunctional ability as individuals age (more strength and lean mass in older subjects) and should also be used in the adjunctive management of many neurodegenerative conditions. The same is true for heart-failure patients, who can use this strategy under the supervision and monitoring of their physician or medical specialist.

References

1. Kreider RB. Creatine, the next ergogenic supplement? Sportscience Training and Technology. Internet Society for Sports Science.
2. Kreider RB. Creatine supplement: analysis of ergogenic value, medical safety, and concerns. Journal of Exercise Physiology (online), 1998;1(1).
3. Bramberger M. "The Magic Potion." Sports Illus, 1998;88(16):58-65.
4. Bessman SP, Savabi F. The Role of the Phosphocreatine Energy Shuttle in Exercise and Muscle Hypertrophy. In: Taylor AW, Gollnick PD, Green HJ (eds.). International Series on Sport Sciences: Biochemistry of Exercise VII. Champaign, IL, Human Kinetics, 1988;19:167-178.
5. Ingwall JS. Creatine and the control of muscle-specific protein synthesis in cardiac and skeletal muscle. Circ Res, 1976;38(5 suppl 1):I115-I123.
6. Sipila I, Rapola J, Simell O, et al. Supplementary creatine as a treatment for gyrate atrophy of the choroid and retina. N Engl J Med, 1981;304(5):867-870.
7. Almada A, Kreider R, Ferreira M, et al. Effects of calcium-HMB supplementation with or without creatine during training on strength and sprint capacity. FASEB J, 1997;11:A374.
8. Earnest CP, Snell PG, Rodriguez R et al. The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand, 1995;153(2):207-209.
9. Burke LM, Pyne DB, Telford RD. Effect or oral creatine supplementation on single-effort sprint performance in elite swimmers. Int J Sports Nutr1996;6(3):222-223.
10. Dawson B, Cutler M, Moody A, et al. Effects of oral creatine loading on single and repeated maximal short sprints. Aust J Sci Med Sports, 1995;27(3):56-61.
11. Redondo DR, Dowling EA, Graham BL, et al. The effect of oral creatine monohydrate supplementation on running velocity. Int J Sports Nutr,1996;6(3):213-221.
12. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc, 1998;30(1):73-82.
13. Poortmans JR, Auquier H, Renaut V, et al. A effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol,1997;76(6):566-567.
14. Mazzini L, Balzarini C, Colombo R, Mora G, Pastore I, De Ambrogio R, Caligari M. Effects of creatine supplementation on exercise performance and muscular strength in amyotrophic lateral sclerosis: preliminary results. J Neurol Sci, 2001 Oct 15;191(1-2):139-44.
15. Persky AM, Brazeau GA. Clinical pharmacology of the dietary supplement creatine monohydrate. Pharmacol Rev, 2001 Jun;53(2):161-76.
16. Stout JR, Eckerson JM, May E, Coulter C, Bradley-Popovich GE. Effects of resistance exercise and creatine supplementation on myasthenia gravis: a case study. Med Sci Sports Exerc, 2001 Jun;33(6):869-72.
17. Witte KK, Clark AL, Cleland JG. Chronic heart failure and micronutrients. J Am Coll Cardiol, 2001 Jun 1;37(7):1765-74.
18. "A Leg to Stand On." Better Nutrition, May 2002;64(5):20.
19. Chrusch MJ, Chilibeck PD, Chad KE, Davison KS, Burke DG. Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc, 2001 Dec;33(12):2111-7.
20. Gotshalk LA, Volek JS, Staron RS, Denegar CR, Hagerman FC, Kraemer WJ. Creatine supplementation improves muscular performance in older men. Med Sci Sports Exerc, 2002 Mar;34(3):537-43.
21. Gordon A, Hultman E, Kaijser L, et al. Creatine supplementation in chronic heart failure increases skeletal muscle creatine phosphate and muscle performance. Cardiovasc Res, Sep 1995;30(3):413-8.
22. Andrews R, Greenhaff P, Curtis S, et al. The effect of dietary creatine supplementation on skeletal muscle metabolism in congestive heart failure.Eur Heart J, Apr 1998;19(4):617-22.
23. Healthnotes, Inc., 2001. www.healthnotes.com
24. Walter MC, Lochmueller H, Reilich P, et al. Creatine monohydrate in muscular dystrophies: a double-blind, placebo-controlled clinical study. Neurology,2000;54:1848-50.
25. Roth E, et al. Glutamine: an anabolic effector. J Parent Ent Nutr,1990;14:1305-65.
26. Lacey JM, Wilmore DW. Is glutamine a conditionally essential amino acid?Nutr Rev, 1990;48:297-309.
27. Castell LM, Poortmans JR, Newsholme EA. Does glutamine have a role in reducing infections in athletes? Eur J Appl Physiol Occup Physiol,1996;23:488-90.

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Sugar can hijack the same brain region that is hijacked by drug abuse. Dr. Shawnie, Tulsa chiropractor

Consumption of a meal that has a high glycemic index (GI) appears to stimulate key brain regions related to craving and reward, a finding that supports the controversial hypothesis of food addiction, new research suggests.

Investigators from Boston Children's Hospital in Massachusetts found that compared with consumption of a low-GI meal, a meal high in refined carbohydrates decreased plasma glucose, increased hunger, and selectively stimulated brain regions 4 hours after eating — a critical time point that influences eating behavior at the next meal.

"We think we have shown for the first time that refined carbohydrates' biological effects can provoke, independent of calories and tastiness, symptoms related to addiction in susceptible people — those who are overweight or obese," said the study's principal investigator, David Ludwig, MD, from Boston Children's Hospital.

Dr. Ludwig, director of the hospital's New Balance Foundation Obesity Prevention Center, told Medscape Medical News that his team's preliminary findings support "the notion of food addiction [which] is very controversial because, unlike drugs of addiction, we have to eat to survive."

Craving Carbs

He said the randomized, blinded, crossover study in 12 overweight or obese men had several strengths over previous studies whose findings also suggested that certain tasty foods might be addictive.

"Prior studies, best described as observational, tended to compare vastly different foods, such as cheesecake and boiled vegetables," he said.

In the new study, participants aged 18 to 35 years consumed, in a randomized order on test days 2 to 8 weeks apart, 2 test milkshakes that had similar ingredients, calories (500 kcal), appearance, taste, and smell.

Participants were not aware which was the low-GI meal (37%) with slow-acting carbohydrate and which was the high-GI meal (84%) with fast-acting carbohydrate, and they reported no preference for either meal.

Additionally, the investigators monitored participants 4 hours after the meal, when the individuals likely would be considering what to eat at their next meal. At that time, participants underwent a final blood glucose test and neuroimaging, and rated their hunger levels.

After eating the high-GI meal, participants initially had a surge in blood glucose level that was 2.4-fold higher than after the low-GI meal, followed by a crash in blood glucose at 4 hours, the authors reported. They also reported excessive hunger 4 hours after the high-GI meal, Dr. Ludwig said.

Table. Effect of Low- vs High-Glycemic Index Meal on Patient Outcomes 4 Hours Later (n = 12)

Outcome (mean ± standard error)	Low Glycemic Index	High Glycemic Index	P-Value
Hunger rating, change from baseline, cm	-0.01 ± 0.92	1.65 ± 0.79	.04
Venous plasma blood glucose, mmol/L	5.30 ± 0.16	4.70 ± 0.14	.005

 

The investigators looked directly at participants' cerebral blood flow, as a measure of resting brain activity, using arterial spin labeling functional magnetic resonance imaging (fMRI), which allowed them to examine persistent effects of test meals.

Results showed an 8.2% relative difference in cerebral blood flow between the high- and low-GI meals at 4 hours (mean difference, 4.4 ± 0.56 mL ∙ 100 g⁻¹ ∙ min⁻¹).

After correction for the prespecified anatomic regions of interest, Dr. Ludwig said that the difference was strongly significant (P = .0006), with "less than 1 in 1000 likelihood that the results were due to chance."

"Every single subject showed intense activation in the nucleus accumbens, the area of the brain related to addiction," he said.

The results show that highly processed carbohydrates, such as white bread, potatoes, and concentrated sugar, "alter brain activity in ways that make us crave them even more," he said.

Clear Take-Home Message

Dr. Ludwig stated that the study must be repeated in larger numbers of persons, in a more diverse population, and before and after weight gain. Yet he said that the initial results send a clear take-home message: "Avoiding highly processed carbohydrates could help overweight people avoid overeating."

Mark Gold, MD, a longtime researcher in the area of food and addiction, from the McKnight Brain Institute of the University of Florida (UF), Gainesville, said it is important that clinical research tests the food addiction hypothesis first generated by laboratory researchers.

Asked by Medscape Medical News to comment on the findings, Dr. Gold, who was not involved with the study, said that the brain imaging test the researchers used "is exceptional and provides additional strong evidence that manufactured foods, sugar, and fats can interact with the brain and systems that [also] are hijacked by drugs of abuse."

"Hedonic overeating...makes more sense with clinical research like this," Dr. Gold, who is professor and chair of psychiatry at UF College of Medicine, concluded.

This study was funded by the National Institutes of Health and the National Center for Research Resources, Bethesda, Maryland; the Pediatric Endocrine Society, McLean, Virginia; the Endocrine Fellows Foundation, Washington, DC; and the New Balance Foundation, Boston, Massachusetts. Dr. Ludwig and Dr. Gold have reported no relevant financial relationships.

Am J Clin Nutr. Published online June 26, 2013. Abstract