G. Douglas Andersen, DC, DACBSP, CCN

1. 2003 Research UpdateFor 2004 Symposium Sports NutritionWith Strength and ConditioningExercise Physiology andSpine/General Studies with Practical Application G. Douglas Andersen, DC, DACBSP, CCN

2. INFLUENCE OF DEHYDRATION AND REHYDRATION ON BASKETBALL FREE THROW ACCURACY Methods: 16 males performed four 90-minute sessions 1. Control – played cards 2. Basketball with no fluids 3. Basketball with water 4. Basketball with sports drink After 90 minutes subjects then shot 20 free throws Results: When players were dehydrated, free throw accuracy was 58%. When players were rehydrated with sports drink, accuracy was 71% Solera, A., Salazar, W. Influence of Dehydration and Rehydration on Basketball Free Throw Accuracy. Med. Sci. Sp. Ex. May 2003; 35(5): S29.

3. EFFECTS OF EXERCISE TRAINING INTENSITY AND AMOUNT ON VISCERAL, SUBCUTANEOUS AND TOTAL ABDOMINAL FAT: STRRIDE Methods: 111 overweight adults, ages 40-65, 8 month study Results: Activity Visceral Fat Change Abdominal Fat Change Body Weight Control +10% +4.7% +2.4 pounds Walk 12 mi/wk +3.3% +1.9% -2.9 pounds Jog 12 mi/wk -5.9% -3% -2.4 pounds Run 20 mi/wk -10% -8.9% -7.7 pounds Slentz, C.A., Duscha, B.D., Aiken, L.B., Jonhson, J.L., Ketchum, K.J., Tanner, C.J., Kelly, L.K., Houmard, J.A., Kraus, W.E. Effects of Exercise Training Intensity and Amount on Visceral, Subcutaneous and Total Abdominal Fat: Strride. Med. Sci. Sp. Ex. May 2003; 35(5): S34.

4. SWEAT AND SODIUM LOSSES IN NCAA DIVISION I FOOTBALL PLAYERS WITH A HISTORY OF WHOLE-BODY MUSCLE CRAMPING Methods: 10 Division I football players, 5 with a history of cramping Studied on a pre-season practice day, 2.5 hour AM and 2.5 hour PM practice in full gear Results: Never Cramp Cramp Fluid Intake 2.8 L 2.6 L Sweat Loss 3.5 L 4 L Sweat Na 2.4 gm 5.2 gm Net Loss 23 oz 46 oz Stofan, J.R., Zachwieja, J.J., Horswill, C.A., Lacambra, M., Murray, R., Eichner, E.R., Anderson, S. Sweat and Sodium Losses in NCAA Division I Football Players with a History of Whole-Body Muscle Cramping. Med. Sci. Sp. Ex. May 2003; 35(5): S48.

5. HYPONATREMIA AND SODIUM LOSS Methods: 111 marathoners from 4 races volunteered for pre- and post-race testing Results: Hyponatremics drank more fluid and lost more sodium in sweat. No differences between genders Chorley, J.N., Cianca, J.C., Divine, J.G., Hew, T. Hyponatremia and Sodium Loss. Med. Sci. Sp. Ex. May 2003; 35(5): S246. HYPONATREMIA AND ADVENTURE RACING • Methods: • Participants in an adventure race that ranged from 18 to 30 hours • Results: • Average weight loss 2% of body weight • 50% of participants were hyponatremic • Abbott, K.D., Nichols, J.F. Hyponatremia and Adventure Racing. Med. Sci. Sp. Ex. May 2003; 35(5): S246.

6. SNAPPING HIP SYNDROME TypeCausePresenting ComplaintExamTx External Posterior, proximal snapping lateral Patient lateral Soft tissue ITB or anterior to greater trochanter snapping side up mobilization, gluteous maximus Flex + extend hip modalities, rubs over greater keep leg neutral stretch ITB trochanter palpate Internal Iliopsoas tendon snapping ant./medial Patient supine Stretch and rubs over anterior to greater trochanter Flex, abduct & strengthen capsule or ilio- externally rotate hip. hip flexors. pectineal eminence As you return to Soft tissue neutral(Ext/add/ mobilization. int.rot.) palpate Intraartular Loose bodies, Deep snapping R/O Ext/int refer to ortho acetabular tear, X-ray, CT or MRI chronic subluxation or (in kids) dislocation Idjadi, J., Meislin, R., Symptomatic Snapping Hip. The Physician and Sports Medicine 32 (1) 2004; 25-31

7. PHYSICAL ACTIVITY AND CHILDREN In children ages 9 to 16, as total physical activity (TPA) increased, fasting insulin decreased1 TPA decreased between ages 9 and 161 In children ages 6 to 8, TPA declined with age.2 In children ages 7 to 10, TPA increase leads to increased bone mineral density, decreased blood pressure, decreased total cholesterol.3 In children ages 5 to 12, as TPA increased, bone mineral density increased.4 Children ages 8 to 9, were observed during recess on 4 consecutive days. As body mass index increased, activity decreased; that is, the heavier the child, the less active.5 1Hurtig Wennlöf, A., Yngve, A., Sjöström, M. Fasting Serum Insulin as Response to Total Physical Activity in Healthy Children. Med. Sci. Sp. Ex. May 2003; 35(5): S64. 2Economos, C.D., Shea, K., Socorso, E. Age, Gender and Weight Status Predict Objectively Measured Physical Activity Levels in Early Elementary School Children. Med. Sci. Sp. Ex. May 2003; 35(5): S63. 3Mjaavatn, P.E., Aa, K., Gundersen, U., Segberg, L., Bjørkelund, L.A. Physical Activity and Health-Related Variables in 6-9-Year-Old Norwegian Children. Med. Sci. Sp. Ex. May 2003; 35(5): S63. 4DiMarco, N.M., Greathouse, L.V., Essery, E.V., Kallio, A.K., Nichols, D.L., Sanborn, C.F. Bone and Connective Tissue. Med. Sci. Sp. Ex. May 2003; 35(5): S76. 5Foley, J.T., Yun, J.K. The Effect of Body Mass Index Level on Physical Activity During Recess. Med. Sci. Sp. Ex. May 2003; 35(5): S161.

8. CHILDHOOD ACTIVITY, BOYS VERSUS GIRLS Boys, ages 6 to 8, are more active than girls of the same age.1 Boys, ages 10 to 11, are more active than girls of the same age.2 Boys, ages 9 to 16, are more active than girls of the same age.3 1Economos, C.D., Shea, K., Socorso, E. Age, Gender and Weight Status Predict Objectively Measured Physical Activity Levels in Early Elementary School Children. Med. Sci. Sp. Ex. May 2003; 35(5): S63. 2Matsuzaka, A., Matsuzaka, K., Wilk, B., Bar-Or, O. Relationship Between Physical Activity and Aerobic Fitness in Children. Med. Sci. Sp. Ex. May 2003; 35(5): S64. 3 Hurtig Wennlöf, A., Yngve, A., Sjöström, M. Fasting Serum Insulin as Response to Total Physical Activity in Healthy Children. Med. Sci. Sp. Ex. May 2003; 35(5): S64.

9. CARDIOVASCULAR RISK Overweight adults who exercise have a stronger link to cardiovascular disease than adults who were unfit.1 Adults with better cardiovascular fitness have lower levels of C-reactive protein.2 Lower levels of fitness coupled with higher levels of abdominal fat lead to higher levels of insulin (even in 90-year-olds!)3 1Christou, D.D., Gates, P.E., Seals, D.R. Is Fatness or Fitness the Best Predictor of Cardiovascular Disease Risk Profile in Healthy Men? Med. Sci. Sp. Ex. May 2003; 35(5): S67. 2Reis, J.P., LaMonte, M.J., Ainsworth, B.E., Durstine, J.L. C-Reactive Protein and Cardiorespiratory Fitness in an Adult Population. Med. Sci. Sp. Ex. May 2003; 35(5): S68. 3Racette, S.B., Evans, E.M., Villareal, D.T., Holloszy, J.O. Fitness and Abdominal Fat Predict Insulin Action in Old Adults. Med. Sci. Sp. Ex. May 2003; 35(5): S68.

10. EFFECTS OF INCREASING FLUID MILK INTAKE ON BONE MINERAL DENSITY IN RESPONSE TO RESISTANCE TRAINING IN ADOLESCENT FEMALES Methods: Girls, ages 12 to 17, given 24 ounces of milk for 12 weeks, or 24 ounces of juice for 12 weeks. Results: Milk group gained bone mineral density, especially in the lumbar spine. Juice group did not gain BMD Gómez, A.L., Volek, J.S., Rubin, M R, French, D.N., Sharman, M.J., Ratamess, N.A., McGuigian, M.R., Scheett, T.P., Kraemer, W.J. Effects of Increasing Fluid Milk Intake on Bone Mineral Density in Response to Resistance Training in Adolescent Females. Med. Sci. Sp. Ex. May 2003; 35(5): S76

11. EFFECTS OF EXERCISE COMBINED WITH DIET ON BONE MASSAND BIOCHEMICAL BONE MARKERS DURING WEIGHT LOSS Methods: Women, ages 35 to 48, went on a weight-loss diet for 14 weeks. Results: In the non-exercise group, bone mineral density decreased. In the group that performed resistance exercise, i.e., weight lifting, bone mineral density loss was prevented. Nakata, Y., Ohkawara, K., Lee, D.J., Tanaka, K. Effects of Exercise Combined with Diet on Bone Mass and Biochemical Bone Markers During Weight Loss. Med. Sci. Sp. Ex. May 2003; 35(5): S80.

12. ADDITION OF FAT TO POST-EXERCISE MEALS DOES NOT ALTER THE EXERCISE-INDUCED REDUCTION IN FASTING PLASMA TRIGLYCERIDES Methods: On 2 occasions men biked 90 minutes including 30 minutes of high intensity intervals, followed by a low or high fat dinner. Meal 1 – 12 gm of fat, Meal 2 – 165 gm of fat Carb content was the same. Pre exercise triglyceride .52 and .55 mm before LF and HF Next morning triglyceride .37 and .32 mm after LF and HF Conclusion: In this study, a high-fat meal (165 gm) did not alter the benefits of exercise induced triglyceride clearance. Kaufman, A.E., Fox, A.K., Horowitz, J.F. Addition of Fat to Post-Exercise Meals Does Not Alter the Exercise-Induced Reduction in Fasting Plasma Triglycerides. Med. Sci. Sp. Ex. May 2003; 35(5): S85.

13. EFFECTS OF EXERCISE INTENSITY ON POSTPRANDIAL LIPEMIA IN PATIENTS WITH HYPERTRIGLYCERIDEMIA Methods: Ten 40-year-old males were studied. Subjects jogged 1 hour at 40%, 60%, or 70% of maximum heart rate 12 hours before a meal containing 100 gm of fat was consumed. Results: From blood draws 2, 4, 6, 8, and 24 hours after eating. Triglyceride concentration mg/dl Control 369 40% jog 325 60% jog 316 70% jog 294 Zhang, J.Q., Ji, L.L., Fretwell, V., Nunez, L., Zhang, K.Y., Hart, C., Yao, W.X. Effects of Exercise Intensity on Postprandial Lipemia in Patients with Hypertriglyceridemia. Med. Sci. Sp. Ex. May 2003; 35(5): S87.

14. LOW CARBOHYDRATE DIET INDUCES WEIGHT LOSS AND CHANGES IN FUEL OXIDATION DURING EXERCISE IN OBESE ADULTS Methods: 13 obese young adults were put on a low-carbohydrate diet. Subjects were instructed what foods to avoid but were not instructed on quantities. The study was to test changes in fuel oxidation. Results: Low carb, high protein, high fat diet did increase fat oxidation during activity. Analysis of diet diaries revealed an unusual finding. Calories before the study were 2599, calories during the study were 1473. Komorowski, J.I., Schuler, G., Murrin, J., Farnoush, M., Doucet, E., Kerr, J. Low Carbohydrate Diet Induces Weight Loss and Changes in Fuel Oxidation During Exercise in Obese Adults. Med. Sci. Sp. Ex. May 2003; 35(5): S87.

15. DOSE OF EXERCISE TO PROMOTE LONG-TERM WEIGHT LOSS IN OVERWEIGHT ADULTS Methods: 184 obese women were in a 12-month program. Subjects were divided into 3 groups, all of which exercised 5 days a week. Groups were prescribed exercise ranging from 30 to 60 minutes a day. Results: No group completely met their requirements. The 60-minute group averaged 265/300 minutes per week. The 45-minute group averaged 173/225 per week. The 30-minute group averaged 113/150 per week. The 60-minute group lost 15%, the 45-minute group lost 10%, and the 30 minute group lost 7% bw. Jakicic, J.M., Gallagher, K.I., Ferguson, E., Marcus, B.H., Napoitano, M. Dose of Exercise To Promote Long-Term Weight Loss in Overweight Adults. Med. Sci. Sp. Ex. May 2003; 35(5): S106

16. EXERCISE HEMATOLOGY Study: 280 boys and girls, ages 16 to 19, were tested. 55% of the girls were iron deficient, 29% of the boys were iron deficient, and 3% of the entire group was anemic. Serum ferritin less than 16 mcg/dl was defined as iron deficient. Serum ferritin less than 20 mcg/dl was defined as probable iron deficient. Landahl, G., Börjesson, M., Rödjer, S. Exercise Hematology. Med. Sci. Sp. Ex. May 2003; 35(5): S126

17. PREVALENCE OF IRON DEFICIENCY AND ANEMIA IN TOP-LEVEL BASKETBALL PLAYERS Study: 103 teenage boys and girls and adults rated as top-level basketball players. Testing revealed iron deficiency in 15% of the males, 35% of the females. Anemia was present in 18% of the males, 38% of the females. Iron-deficient anemia (both) were present in 5% of males and 22% of females. Iron deficiency was defined as serum ferritin less than 20 mcg/dl. Anemia was defined as hemoglobin less than 14 gm/dl for boys and less than 12 gm/dl for girls. Constantini, N.W., Dubnov, G. Prevalance of Iron Deficiency and Anemia in Top-Level Basketball Players. Med. Sci. Sp. Ex. May 2003; 35(5): S126.

18. THE RELATION BETWEEN TRUNK STRENGTH MEASURES AND LUMBAR DISC DEFORMATION DURING STOOP TYPE LIFTING Methods: 12 50-year-old males under lateral video fluoroscopy lifted No load 4 times a minute for 15 minutes A 25-pound milk crate 4 times a minute for 15 minutes Subjects were also measured for strength of trunk flexion and extension via a dynamometer and abdominal endurance by the number of curl-ups performed in 60 seconds. Results: Subjects with greater abdominal strength showed less shear deformation when the trunk was flexed with a load. Subjects with greater abdominal endurance show less shear deformation when the trunk was erect. Subjects with greater spinal erector muscle strength showed less shear deformation when the trunk was erect. DeBeliso, M.A., O’Shea, J.P., Harris, C., Adams, K.J. The Relation Between Trunk Strength Measures and Lumbar Disc Deformation During Stoop Type Lifting. Med. Sci. Sp. Ex. May 2003; 35(5): S134.

19. THE EFFECT OF AN ACUTE DOSAGE OF AN ANTIOXIDANT MIXTURE UPON FATIGUE DURING INTERMITTENT WORK Study: 25,000 IU beta carotene, 400 IU vitamin E, 500 mg vitamin C taken in a single dose did not improve work capacity. Guillory, I., Nelson, A.G., Glickman, E. The Effect of an Acute Dosage of an Antioxidant Mixture Upon Fatigue During Intermittent Work. Med. Sci. Sp. Ex. May 2003; 35(5): S145.

20. EFFECT OF VITAMIN C SUPPLEMENTATION ON IMMUNE PARAMETERS FOLLOWING INTERMITTENT SHUTTLE RUNNING Methods: 7 days of 800 mg of vitamin C or placebo followed by a vigorous shuttle run. Results: No differences in immune or inflammatory response (equally increased in both groups). Hurst, T.L., Bailey, D.M., Williams, C., Powell, J.R. Effect of Vitamin C Supplementation on Immune Parameters Following Intermittent Shuttle Running. Med. Sci. Sp. Ex. May 2003; 35(5): S156.

21. ANTIOXIDANTS DO NOT ATTENUATE THE RISE IN LIPID HYDROPEROXIDES OBSERVED AT 4300 M ELEVATION Methods: 3 weeks of 10,000 IU beta carotene, 200 IU vitamin E, 250 mg vitamin C, 50 mcg selenium, and 15 mg of zinc. Results: Did not prevent an increase in lipid peroxidation at high elevation compared to placebo. Friedlander, A.L., Subudhi, A.W., Hagobian, T.A., Jacobs, K.A., Fattor, J.A., Stone, K.S., Rock, P.B., Muza, S.R., Fulco, C.S., Hoffman, A.R., Cymerman, A. Antioxidants Do Not Attenuate the Rise in Lipid Hydroperoxides Observed at 4300 M Elevation. Med. Sci. Sp. Ex. May 2003; 35(5): S163.

22. ANTIOXIDANT SUPPLEMENTATION DOES NOT REDUCE INCIDENCE OR SEVERITY OF ACUTE MOUNTAIN SICKNESS AT 4300 M Methods: 3 weeks of 10,000 IU beta carotene, 200 IU vitamin E, 250 mg vitamin C, 50 mcg selenium, and 15 mg of zinc. Results: Did not reduce incidence of acute mountain sickness. Jacobs, K.A., Muza, S.R., Pidgeon, S., Hagobian, T.A., Subudhi, A.W., Stone, K.S., Fattor, J.A., Fulco, C.S., Rock, P.B., Cymerman, A., Friedlander, A.L. Antioxidant Supplementation Does Not Reduce Incidence or Severity of Acute Mountain Sickness at 4300 M. Med. Sci. Sp. Ex. May 2003; 35(5): S164.

23. ANTIOXIDANT SUPPLEMENTATION HAS NO EFFECT ON MUSCLE DAMAGE FOLLOWING AN ULTRAMARATHON RUN Methods: 400 IU vitamin E and 1000 mg vitamin C 6 weeks prior to and 1 week after a 31-mile run. Results: No effect on plasma markers of muscle damage. Mastaloudis, A., Widrick, J., Traber, M.G. Antioxidant Supplementation Has No Effect on Muscle Damage Following an Ultramarathon Run. Med. Sci. Sp. Ex. May 2003; 35(5): S197.

24. DIETARY ANTIOXIDANT SUPPLEMENTATION DOES NOT AFFECT CYTOKINE RESPONSE TO ECCENTRIC EXERCISE Methods: 400 mg vitamin C, 800 IU vitamin E for 29 days prior to and 6 days after a 20 minute eccentric cycle exercise designed to damage muscles Results: Plasma creatine kinase increased 11 fold placebo, 3 fold antioxidant. All other markers including IL/TNF/mRNA were unchanged. Condlin, M.L., Kellogg, M.D., Young, A.J. Dietary Antioxidant Supplementation Does Not Affect Cytokine Response to Eccentric Exercise. Med. Sci. Sp. Ex. May 2003; 35(5): S156.

25. ARE MEN’S PERCEPTIONS OF A DESIRABLE BODY IMAGE RELATED TO THE ACTUAL PREFERENCES OF WOMEN? Methods: 206 college males and females were shown 16 male figures of varying body types. Results: The males perceived their current body to be less muscular than they would like. The body males thought females would prefer was more muscular. The most desirable male body picked by the women was less muscular than the males thought they would pick. Women knew that men thought they preferred a more muscular physique. Downing, A.J., Giuliano, T.A., Smith, J.C. Are Men’s Perceptions of a Desirable Body Image Related to the Actual Preferences of Women? Med. Sci. Sp. Ex. May 2003; 35(5): S140.

26. THE EFFECTS OF ECHINACEA ON THE MUCOSAL IMMUNE RESPONSE AND UPPER RESPIRATORY TRACT INFECTIONS Methods: 32 adults, ages 19 to 46. A series of intense wingate tests known to decrease mucosal immunity were given (decreased mucosal immunity increases rate of upper respiratory tract infection). Results: 4 weeks of echinacea or placebo revealed no change in the percentage of the number of upper respiratory tract infections caught by each group. There was a significant difference in disease length – 1.7 days for echinacea, 5.4 days for placebo. Hall, H.L., Fahlman, M.M., Engels, H.J. The Effects of Echinacea on the Mucosal Immune Response and Upper Respiratory Tract Infections. Med. Sci. Sp. Ex. May 2003; 35(5): S156.

27. DOSE-EFFECT RESPONSE OF 80 WEEKS OF RESISTANCE TRAINING ON MUSCLE STRENGTH AND MUSCLE MASS OF OLDER MEN AND WOMEN Methods: 46 men and women, ages 60 to 70, in an 80-week exercise program performed either 2 or 3 times per week, were divided into 4 groups. 2 high intensity – weight lifting (80% of 1 repetition max, 8 repetitions to failure). 2 low intensity – weight lifting (40% of 1 repetition max, 16 repetitions). Results: Gains were as follows: Muscle mass and strength gains were the greatest in high intensity 3 times a week, followed by high intensity 2 times a week, low intensity 3 times a week, and low intensity 2 times a week. Conclusion: High intensity twice a week is more beneficial than low intensity 3 times a week. Bemben, M.G., Bemben, D.A. Dose-Effect Response of 80 Weeks of Resistance Training on Muscle Strength and Muscle Mass of Older Men and Women. Med. Sci. Sp. Ex. May 2003; 35(5): S171.

28. EFFECTS OF RED PEPPER INTAKE ON MUSCLE OXYGEN CONSUMPTION IN HUMANS Methods: 1 gm of dried, powdered, red hot pepper increased metabolic rate for 2-1/2 hours. Results: The red pepper group had a 10% increase in pulmonary oxygen uptake and a 15% increase in muscle oxygen consumption. Ueda, C., Hamaoka, T., Murase, N., Sako, T., Murakami, M., Kime, R., Homma, T., Nagasawa, T., Kitahara, A., Ichimura, S., Motobe, M., Nakagawa, N., Katsumura, T. Effects of Red Pepper Intake on Muscle Oxygen Consumption in Humans. Med. Sci. Sp. Ex. May 2003; 35(5): S248.

29. ACUTE EFFECTS OF TRANS-10,CIS-12 CONJUGATED LINOLEIC ACID CONSUMPTION ON FUEL USE An acute (4.8 gm) dose of conjugated linoleic acid (CLA) 80 minutes before exercise was given to 13 participants. Results: CLA was absorbed in 8/13 subjects. CLA did not affect resting metabolic rate, exercise metabolic rate, or fuel source indicators (glucose, glycerol, lipolysis). Conclusion: Animal studies that show acute ingestion raises metabolic rate and fat oxidation. This was not seen in humans. Shute, M., Rankin, J.W., Herbein, J. Acute Effects of Trans-10,Cis-12 Conjugated Linoleic Acid Consumption on Fuel Use. Med. Sci. Sp. Ex. May 2003; 35(5): S248

30. THE EFFECTS OF ACUTE CITRUS AURENTIUM INGESTION ON ENERGY EXPENDITURE IN MILDLY OBESE SUBJECTS 24 subjects mean age 25 - mean BMI 26.5 3 doses on day 1 + am dose day 2 tested pre/post Results: Day 1 Day 2 Calorie Expenditure CA 1.18 kcal/min 1.26 kcal/min placebo 1.26 kcal/min 1.24 kcal/min Oxygen update CA 230 mL/min 250 mL/min placebo 250 mL/min 250 mL/min CA (Synephrine) increased calorie expenditure 8% Seifert, J.G., Burke, E.R., Devonish, J., Nelson, A., Bacharach, D.W. The Effects of Acute Citrus Aurentium Ingestion on Energy Expenditure in Mildly Obese Subjects. Med. Sci. Sp. Ex. May 2003; 35(5): S248.

31. REPEATED EXERCISE PERFORMANCE AND CAFFEINE INGESTION Methods: 9 male caffeine users were tested on 4 occasions. Testing consisted of morning workout (80% VO2max ride to exhaustion) followed by a second bout 5 hours later. Results: AM caffeine PM caffeine AM Times PM Times 5 mg/kg/bw 2.5 mg/kg/bw 24.9 minutes 21.5 minutes 0 mg/kg/bw 0 mg/kg/bw 18.0 minutes 18.3 minutes 5 mg/kg/bw 0 mg/kg/bw 21.8 minutes 21.0 minutes 0 mg/kg/bw 5 mg/kg/bw 17.7 minutes 22.4 minutes A single morning dose of caffeine has a carryover effect in exhaustive exercise 5 hours later. Bell, D.G., McLellan, T.M. Repeated Exercise Performance and Caffeine Ingestion. Med. Sci. Sp. Ex. May 2003; 35(5): S267

32. THE EFFECTS OF OXYGENATED WATER ON HEART RATE AND ARTERIAL SATURATION RESPONSES DURING HYPOXIA Methods: 20 subjects given 20 oz of oxygenated water or placebo water following an induced hypoxia. Results: There was no difference in heart rate or oxygen saturation between 2 types of water. Porcari, J.P., Witt, L., Foster, C., Aiuppa, T., Doberstein, S. The Effects of Oxygenated Water on Heart Rate and Arterial Saturation Responses During Hypoxia. Med. Sci. Sp. Ex. May 2003; 35(5): S269.

33. THE EFFECTS OF HMB SUPPLEMENTATION ON INDICES OF EXERCISE-INDUCED MUSCLE DAMAGE IN MAN Methods: 14 days of 3 gm of HMB or placebo followed by a single bout of 3 sets of 10 repetitions of eccentric arm curls designed to provoke muscle damage. Results: HMB had reduced DOMs 24 hours post exercise. HMB had lower levels of plasma creatine kinase activity. Van Someren, K.A., Edwards, A.J., Howatson, G. The Effects of HMB Supplementation on Indices of Exercise-Induced Muscle Damage in Man. Med. Sci. Sp. Ex. May 2003; 35(5): S270.

34. EFFECTS OF ORAL D- RIBOSE SUPPLEMENTATION ON ANAEROBIC CAPACITY AND SELECTED METABOLIC MARKERS IN HEALTHY MALES 19 trained males Pre and post supplementation Wingate sprint (30sec) tests separated by 3 minute recovery Placebo or Ribose 10gr/d for 5 days Ribose did not alter peak power, average power, torque, fatigue index, lactate, ammonia, glucose, uric acid or anaerobic exercise capacity. Kreider, R.B., Melton, C., et al Effects or Oral D-Ribose Supplementation on Anaerobic capacity and Selected Metabolic Markers in Healthy Males. International Journal of Sport Nutrition and Exercise Metabolism, 2003, 13, 76-86

35. REHYDRATION WITH FLUIDS CONTAINING BETAINE: RUNNING PERFORMANCE AND METABOLISM IN A 31°C ENVIRONMENT Betaine at 5 gm per liter when added to sports drink improved sprint time to exhaustion following 75 minutes of running in 88° weather. This improvement was not seen with a placebo beverage, or a placebo beverage and betaine. It was a greater improvement than 6% carbohydrate – electrolyte drink Conclusion: Betaine added to a carbohydrate electrolyte drink may be synergistic. Armstrong, L.E., Roti, M.W., Hatch, H.L., Sutherland, J.W., Mahood, N.V., Clements, J.M., Seen, A.D., Fiala, K.A., Craig, S.A.S., Casa, D.J., Maresh, C.M. Med. Sci. Sp. Ex. May 2003; 35(5): S311.

36. INFLUENCE OF PRE-EXERCISE CARBOHYDRATE MEALS ON A 21-KM RUN Methods: 8 endurance-trained male runners, averaging 33 years of age, in a random, crossover study. Testing was performed on 2 occasions with a meal, 2 hours prior to testing, that provided 15% protein, 65% carbohydrate, and 20% fat, totaling approximately 580 calories. One meal contained high glycemic index carbohydrates (77), the other low glycemic index carbohydrates (37). Protein and fat sources were unchanged. Results: All 8 improved their time in a 21K (12.5 mile) run following the low glycemic index meal. Average improvement was 98 minutes versus 101 minutes. Low glycemic index also increased fat oxidation 17.9% and decreased carbohydrate oxidation 9.5%. Wong, S.H., Lok, A., Morris, J. Influence of Pre-exercise Carbohydrate Meals on a 21-KM Run. Med. Sci. Sp. Ex. May 2003; 35(5): S298.

37. EFFECT OF MODERATE AND HIGH INTENSITY AEROBIC EXERCISE ON BODY COMPOSITION IN OVERWEIGHT MEN Methods: 16 overweight males in the military, ages 18 to 33 years, were trained for 14 weeks. All meals were consumed on the base. Training protocol was as follows: 3 times a week for 5 weeks a 3K run (1.8 miles), followed by 3 times a week for 9 weeks a 4K run (2.4 miles). One group ran with high intensity (75-90% max heart rate), the other group with medium intensity (60-70% max heart rate). Results: High intensity group lost 4.91% body fat. Medium intensity group lost 1.4% body fat. Marra, C.C., Bottaro, M.M., Oliveira, R.J., Novacs, J.S. Effect of Moderate and High Intensity Aerobic Exercise on Body Composition in Overweight Men. Med. Sci. Sp. Ex. May 2003; 35(5): S308.

38. THE EFFECT OF HIGH INTENSITY RESISTANCE TRAINING ON BODY COMPOSITION AMONG COLLEGIATE FOOTBALL PLAYERS Methods: 40 Division I college football players were divided into 2 groups. Over 10 weeks subjects used 2 exercise protocols: 1 set to failure 6-10 RM, versus 3 sets to fatigue 6-10 RM. Results: The 1-set high intensity group reduced body fat by 1.5%. The 3-set medium intensity group reduced body fat by 0.45%. Fincher, G.E. The Effect of High Intensity Resistance Training on Body Composition Among Collegiate Football Players. Med. Sci. Sp. Ex. May 2003; 35(5): S324.

39. INDUCTION OF LOW T3 SYNDROME IN FEMALE SWIMMERS DURING A COMPETITIVE SEASON Methods: 10 sub-elite adolescent female swimmers were evaluated during a 12-week period. Swimmers were divided into improved an unimproved groups.Results: Testing revealed that the group that did not improve had signs of low T3 syndrome. VanHeest, J.L., Mahoney, C.E., Cappaert, J.M., Hill, K.W., DeSouza, M.J., Rodgers, C.D. Induction of Low T3 Syndrome in Female Swimmers During a Competitive Season. Med. Sci. Sp. Ex. May 2003; 35(5): S330.

40. THE EFFECTS OF CREATINE ON CAST IMMOBILIZATION INDUCED MUSCLE ATROPHY AND DETRAINING Methods: Subjects were given 20 gm of creatine,(5gm-4x/d for 7 days), or a placebo while 1 arm was in a cast. The study was then repeated with the opposite arm in a cast. Upon removal results were: When subjects’ arms were in a cast and they consumed creatine, 0.17% lean mass was lost on the casted arms. Placebo beverage losses for the casted arms were 4.0%. Single repetition strength was reduced 29% with placebo and 6% with creatine. Maximum number of repetitions was reduced 46% with placebo and 5% with creatine. Johnston, A.W., Burke, D.G., MacNeil, L.G. The Effects of Creatine on Cast Immobilization Induced Muscle Atrophy and Detraining. Med. Sci. Sp. Ex. May 2003; 35(5): S401.

41. OXYGENATED WATER AND ATHLETIC PERFORMANCE Methods: 5 brands of oxygenated water plus tap water were analyzed for their oxygen content. Results: Brands: 1 2 3 4 5 Tap Water mL O2 per 355 mL (12 oz) 8.9 33.7 37.3 42.6 80.2 8.9 Hampson, N.B., Pollock, N.W., Piantadosi, C.A. Oxygenated Water and Athletic Performance. JAMA.2003; 290(18): 2408-9.

42. OXYGENATED WATER AND ATHLETIC PERFORMANCE   Air contains 20.9% oxygen. Normal human breath contains 500 mL of air. .209 x 500 = 104.5 mL O2 – average single breath “Given that hemoglobin is already nearly saturated with oxygen during air breathing, and that only a small amount of additional oxygen can be dissolved in plasma, it is not surprising that oxygenated water did not improve maximal exercise performance.” Hampson et al Hampson, N.B., Pollock, N.W., Piantadosi, C.A. Oxygenated Water and Athletic Performance. JAMA.2003; 290(18): 2408-9.

43. DOES REJECTION HURT? FMRI STUDY OF SOCIAL EXCLUSION Methods: 13 subjects from UCLA underwent MRI brain scans on 3 different occasions. 1 – as bystanders 2 – as participants in a virtual video game 3 – as a participant in a video game where systematic exclusion resulted in a sense of social rejection Results: As social isolation increased, so did blood flow to the anterior cingulate cortex. This is very similar to the blood flow pattern found in physical pain. Social and physical pain share common neuroanatomical brain blood flow patterns. Eisenberger, N.I. Does Rejection Hurt? fMRI Study of Social Exclusion. Science. 2003; 302: 290-2.

44. A META-ANALYSIS TO DETERMINE THE DOSE RESPONSE FOR STRENGTH DEVELOPMENT Methods: 140 studies with a total of 1433 subjects analyzed. Results Optimal Loads – maximum strength gains attained: Untrained subjects, 60% of 1-rep maximum. Trained subjects, 80% of 1-rep maximum. Frequency – maximum gains attained (muscle group): Untrained subjects, 3 times per week. Trained subjects, 2 times per week. Rhea, M.R., Alvar, B.A, Burkett, L.N., Ball, S.D. A Meta-Analysis to Determine the Dose Response for Strength Development. Med. Sci. Sp. Ex. 2003; 35(3): 456-64.

45. EFFECTS OF GINSENG ON SECRETORY IGA, PERFORMANCE, AND RECOVERY FROM INTERVAL EXERCISE Methods: 400 mg a day of a standardized ginseng concentrate equivalent to 2000 mg of Panax ginseng powder or placebo was consumed for 8 weeks. Results: Ginseng did not enhance immune response, exercise performance, or heart rate recovery following repeated bouts of exhaustive exercise. Engels, H.J., Falman, M.M., Wirth, J.C. Effects of Ginseng on Secretory IgA, Performance, and Recovery from Interval Exercise. Med. Sci. Sp. Ex. April 2003; 35(4): 690-6.

46. EFFECT OF ALPHA LIPOIC ACID COMBINED WITH CREATINE MONOHYDRATE ON HUMAN SKELETAL MUSCLE CREATINE AND PHOSPHAGEN CONCENTRATION Methods: Experienced weight lifters with higher than normal levels of creatine who eat red meat on a regular basis were tested following 3 protocols. Creatine 5 gm, 4 times a day for 5 days Creatine 5 gm plus 25 gm of sucrose, 4 times a day for 5 days Creatine 5 gm plus 25 gm of sucrose plus 250 mg of alpha lipoic acid, 4 times a day for 5 days Results: When lipoic acid was added to loading regimen, there was a significant increase in intramuscular phosphocreatine and total creatine compared to creatine and creatine with a small amount of sugar in trained participants who consumed red meat. Burke, D.G, Chilibeck, P.D., Parise, G., et al. Effect of Alpha Lipoic Acid Combined with Creatine Monohydrate on Human Skeletal Muscle Creatine and Phosphagen Concentration. Int. J Sport Nutr. Ex. Meta. 2003; 13(3): 294-302.

47. EFFECTS OF A CARBOHYDRATE-PROTEIN SUPPLEMENT ON ENDURANCE PERFORMANCE DURING EXERCISE OF VARYING INTENSITY Methods: 12 trained cyclists on 3 separate occasions rode 3 hours of variable intensity followed by an 85% VO2 max sprint to exhaustion. Results: Sprint to exhaustion times: Placebo beverage – 13 minutes Carbohydrate beverage (7.75% CHO) – 20 minutes Carbohydrate-protein beverage (7.75% CHO-1.94% protein) – 27 minutes Carbohydrate versus placebo: Endurance improved in 10 of 12 subjects with carbohydrate Carbohydrate-protein versus carbohydrate: Endurance improved in 10 of 12 subjects with protein Ivy, J.L., Res, P.T., Sprague, R.C., Widzer, M.O. Effects of a Carbohydrate-Protein Supplement on Endurance Performance During Exercise of Varying Intensity. Int. J Sport Nutr. Ex. Meta. 2003; 13(3): 382-95.

48. Vitamin D and Adolescents Methods: 307 teens - mean age 15 were tested Results: 40% insufficient 24% deficiency breaks down as follows: 35% of Blacks; 22% of Latinos; 17% of Asians; 6% Whites Summer levels are 20% higher than Winter and Spring 0/307 had excessive Vitamin D levels MacReady, N. Many Teens May Not Get Enough Vitamin D, Family Practice News, January 1 2004; P77

49. New Side Effect of Iron Deficiency Restless Legs Syndrome Study: Women who complain of hair loss when compared to normal controls had much lower mean Ferritin levels. Kantor, J., Cotsarelis, G. Decreased Serum Ferritin Is Associated With Alopecia in Women, J Invest Dermatol, November 2003; 121(5) :P985-988 • 21/22 patients with normal serum iron had resolution after Fe supplementation • When serum ferritin is at 15 or below 50 mcg/dl, a high percent respond to Fe. Earley, C.J. Restless Legs Syndrome. New England Journal of Medicine 348 (21) 2003; 2103-9

50. Vitamin B-12 and Seniors 24% deficient over 60; 32% deficient over 70; 37% deficient over 80 B-12 in food is protein bound. GI inflammation and atrophy can not break the protein bonds. Vitamins that are not protein bound are absorbed. RX- Oral deficiency replacement 100-500 mcg/day (RDA 2mcg/day) to insure enough gets absorbed. Consider referral for IM delivering. Zoler, MC. B12 Deficiency Can Escape Detection, Family Practice News, January 1 2004, P25