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Carb Loading Update

Sports Nutrition Research Update 2009 with exercise physiology, strength conditioning & topics of interest in sports medicine G. DOUGLAS ANDERSEN DC DACBSP, CCN www.andersEnchiro.com. Carb Loading Update. CHO loading was first studied in the early 1960’s

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Carb Loading Update

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  1. Sports Nutrition Research Update 2009with exercise physiology, strength conditioning & topics of interest in sports medicineG. DOUGLAS ANDERSEN DCDACBSP, CCNwww.andersEnchiro.com

  2. Carb Loading Update CHO loading was first studied in the early 1960’s Vigorous exercise of 1-3 days followed by 3 days of rest accompanied simultaneous dietary manipulation of low and high carbohydrates. Various protocols had mixed results with some responding while others did not. The theory that super compensating glycogen stores would provide biochemical advantage Performance was not always improved and sometimes (loading CHO) it was harmful.

  3. Carb Loading UpdateEarly Problems • Marked dietary changes prior to competition were hard to follow • Major dietary changes often disrupt GI rhythm leading to gas, bloating and stool changes. • Exercise increases (to deplete glycogen) so close to competition altered established tapers. • Increased injuries from glycogen depleting exercise.

  4. In the 1980’s 3-4 days of exercise taper followed by 3 high CHO days made the process much more practical. Research then showed depletion exercise was not required to super-compensate contractile tissues and, once elevated, would remain so for 3-5 days provided calories were adequate & activity was low In a 2002 study, 1 day of inactivity with a high (10g/kg/bw) CHO intake of high glycemic index CHO’s elevated glycogen 90% with no additional benefit with 2 more days. Sedlock, D., The Latest Carbohydrate Loading: A Practical Approach. Cur. Sports Med. Reports 2008; 7(4) 209-13 4 Carb Loading Improvements

  5. Glycogen super-compensation can remain elevated for up to 5 days. For each gram of stored glycogen, 3-5 grams of water are stored. The type of CHO is less important than the amount of CHO. Events must be at least 90 minutes for any benefit. Sedlock, D., The Latest Carbohydrate Loading: A Practical Approach. Cur. Sports Med. Reports 2008; 7(4) 209-13 Carb Loading 2009 - Summary

  6. 10 Subjects consumed a CHO-protein drink on 3 occasions under 2 conditions (rest or exercise) with 3 types of protein. Protein types were Casein 100%, Whey 100% & Casein-Whey 85-15% Drinks all had 19 gm protein, 76 gm CHO & 2 gm fat. Measurements were taken at rest after 3 different drinks and after 60 minutes of exercise with 3 different drinks (6 weeks total) Results Protein type had no impact on post prandial A.A. concentration after rest or exercise. T.J. Smith, S.J.Montain, J.McClung, et. al Milk Protein Type Does Not Impact Plasma Amino Acid Concentration When Incorporated Into a High Carbohydrate Beverage. Med. Sci. Sports Excer. 2008; 40 (5) A-955 S101 Protein Uptake in High CHO Beverage

  7. Sport Drinks & Protein- Is it the Protein or Calories? • Adding small amounts of protein to CHO-Electrolyte (E) drinks is superior to traditional CHO-E drinks for cyclists. • In most trials the added protein means the comparison is not isocaloric. • 11 trained cyclists completed 4 rides to exhaustion in a double blind randomized fashion. • Every 15 minutes the subjects drank 250 ml. (8.45 oz.) of 1 of 4 drinks. • Placebo, 7.75% CHO-E 9.69% CHO-E 7.75% CHO 1.94% Protein. • Blood was drawn before, ~8 hours after and ~24 hours after each round of the trial. Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

  8. INGREDIANT COMPARISON OF EXPERIMENTAL DRINKS Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

  9. Time to Fatigue with each Beverage Treatment Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

  10. Plasma Creatine Kinase Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

  11. Serum Myoglobin Concentration Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

  12. Cystine and Theanine 15 Subjects (mean age 23) with 4-5 years of resistance training @ 3x/week enrolled in a 2 week experiment. Divided into 2 groups and took either 700 mg Cystine + 280 mg theanine or placebo after dinner. Week one subjects continued with normal workout. Week two subjects doubled their workout (6 days) Blood was drawn at beginning and end of each week. Results Natural killer cell activity decreased 30% in placebo group following high intensity, high frequency resistance exercise with no decrease in C/T groups. Kawada, S., Kobayashi, K., Ohtani, M., Fukusaki, C. Protective Effects of Cystineand Theanine Supplementatio On Immune System In High-Intensity Resistance Training. Med. Sci. Sports Exerc. 2008; 40(5) A-2204 S402

  13. Beta Glucagon & URI’s • A Class of Soluble fibers found in plants especially oats and barley best known for modest cholesterol reduction. • Promoted to prevent upper respiratory infections following strenuous endurance exercise. • 36 male cyclists were randomized into 2 groups under double blind conditions • Subjects took either 5.6 grams of Beta Glucagon (N=19) or placebo (N=17) for 17 days the last 3 of which were intense 3 hour rides. • Pre and Post blood tests were done on all subjects.

  14. Beta Glucagon for URI’sRESULTS • Natural Killer Cell activity, lymphatic proliferation various interleukin and plasma cytokines did not differ pre-post between groups. • URI incidence was 9/19 for Beta Glucagon and 6/17 for placebo • The URI rate 47% in Beta Glucagon and 35% in placebo groups did not statistically differ according to the authors. Neiman, DC, Hensen, DA, McMahon, M et al. Beta Glucagon Immune Function and Upper Respiratory Tract Infections in Athletes. Med. Sci. Sports Exerc. 2008;40(8) 1463-71 New study: B-G lowers total + low density cholesterol & tri’s but not HDL’s Bandayl, L. Dietary Soluble Fiber may be Beneficial for Adults w & w/out Hypercholesterolemia. Ann. Int. Med. 2009 (7) 157-63

  15. Quercetin A flavonoid found in onions, kale, apples and broccoli Typical US diet contains ~107mg/d Estimated intake of persons with the highest intake of fruits and vegetables (90th percentile) ~225 mg/d Quercetin is a powerful antioxidant (much stronger than vitamin C) with high levels anti-carcinogenic activity and other properties including protection of proteins, DNA and regulation of gene expression 1000 mg/d 3 wks prior to exhaustive endurance exercise reduced URI’s post exercise challenge fm 9/20 to 1/20. 15

  16. Quercetin Increases Power and Endurance • 12 fit college age students tested in double blind fashion. • Baseline fitness on exercise bike was established. • Took 500 mg Quercetin 2x/day for 7 days or placebo • Measured lab test ride then protocol was repeated so all subjects were tested with both treatments. • Quercetin (1000mg/day) x 7 days increased maximum aerobic power 3.9% and time to exhaustion by 13.2%. S.C. Chen, J.M. Davis, C. Carlsted et.al Effects of Quercetin Feedings on Maximal Oxygen Consumption and Fatigue During Prolonged Exercise .Med. Sci. Sports Excer. 2008; 40 (5) A-1250 S165

  17. Beta-Alanine • Beta-alanine is the only natural occurring AA in beta form • It is the rate limiting molecule for Carnosine synthesis • Carnosine is a dipeptide which buffers hydrogen ions. Muscles contain most of the bodies carnosine • Ample carnosine allows muscles to buffer hydrogen ions produced during contraction. • The more hydrogen we buffer, the more work we can do before the ‘burn’ stops us. • Carnosine (also composed of histidine) is not absorbed well and is best elevated by increasing Beta-alanine which is absorbed well and, because of the Beta group is not incorporated into other proteins. 17

  18. Beta Alanine with Resistance Exercise • Double Blind trial with resistance trained subjects • 4 weeks of 4.8 grams of Beta Alanine or placebo. • 6 sets of 12 reps of squats with blood draws at baseline, after exercise and 30 minutes after exercise. • Protocol was repeated for 4 weeks with a second test. • Results: 4 weeks of B.A. increased reps by 22%. No changes in growth hormone, testosterone or cortisol levels. J.R. Hoffman, N.A. Ratamess et. al Effects of B-Alanine Supplementation on the Acute Hormonal Response to Resistance Exercise. Med. Sci. Sports Exerc. 2008;40 (5) A-1253 S166

  19. Caffeine Regular use can build intolerance and dependency. Addicts will suffer from withdrawal headaches + brain fog, fatigue. Side effects may include insomnia, nervousness, elevated heartbeat, and headaches. Caffeine is not a diuretic. (under 600mg) Some report better results and improvement during an athletic event when they have abstained for 48 hours. 19

  20. CaffeineContinued Increases time to exhaustion in both endurance exercise and in shorter, higher intensity activities Studies are negative for events lasting under 1 minute Can improve concentration Can increase speed of reaction (i.e., a shorter time to react) Increases strength of contraction Improves ventilation in asthmatics A vasoconstrictor, it can relieve headaches 20

  21. Caffeine • Mobilization of free fatty acids – it blocks enzymes that breakdown C-AMP • Higher C-AMP increases lipolysis allowing preservation of glycogen • Reduction of potassium gradient run down • Stimulation of CNS motor control • Increase neurotransmitter release • Increase motor unit firing rates • Translocation of calcium to a more favorable membrane position for excitation – contraction coupling in skeletal muscle • Binds to adenosine receptors which prevents adenosine from causing drowsiness thus improving alertness. Stewart, G.R., Hopkins, W.G., Cook, C., Caims, S.P. Multiple Effects of Caffeine on Simulated High-Intensity Team-Sport Performance. Med Sci Sp Ex. 2005; 37 (12): 1998-2005 Kalmar, J.M. The Influence of Caffeine on Voluntary Muscle Activation Med Sci Exerc. 2005;37(12) : 2113-19

  22. Caffeine Improves Sprint Times 21 males (age 18-21) participated in a double blind trial preceded by establishing a baseline. Subjects took 5 mg/kg/bw caffeine or placebo 1 hour prior to sprint testing. Test was 12 sprints of 30 meters with a 35 second break after each run and repeated 4-5 days later with the opposite treatment.

  23. Caffeine Improves Sprint Times RESULTS • 20/21 had their fastest sprint time with caffeine. • 9/21 were able to ID which trial they took caffeine. • There was a placebo effect, with mean times faster than baseline. (But slower than caffeine) • Caffeine’s effect decreased in later stages (6-12) Glaister, M., Howatson,G., Abraham, C.S., et al. Caffeine Supplementation and Multiple Sprint Running Preformance. Med.Sci. Sports Exerc. 2008;40(10) 1835-40

  24. CAFFEINE IMPROVES SPRINT TIMES Glaister, M., Howatson,G., Abraham, C.S., et al. Caffeine Supplementation and Multiple Sprint Running Preformance. Med.Sci. Sports Exerc. 2008;40(10) 1835-40

  25. 7 males volunteered for a 2-trial double blind study. Interval cycling to exhaustion followed by low CHO dinner. Next morning ride to fatigue then consume either 4 gm CHO/kg bodyweight or 4gm/kg/bw of CHO + 8mg/kg/bw of caffeine. Drinks were consumed over 4 hour period. For a 175 pound person, the treatment was 70 grams of CHO per hour or 70gm/CHO/hr + 140 mg caffeine per hour. Caffeine and Glycogen Replenishment Hawley, J., Pedersen, D., Lessard, S. et al. High Rates of Muscle Glycogen Resynthesis After Exhaustive Exercise When Carbohydrate Is Co-Ingested With Caffeine. Med. Sci. Sports Exerc. 2008; 40(5) A-669 S36

  26. GLYCOGEN LEVELS* *measured by muscle biopsy Caffeine and Glycogen Replenishmentcontinued Hawley, J., Pedersen, D., Lessard, S. et al. High Rates of Muscle Glycogen Resynthesis After Exhaustive Exercise When Carbohydrate Is Co-Ingested With Caffeine. Med. Sci. Sports Exerc. 2008; 40(5) A-669 S36

  27. Exercise Frequency and Workload 30 Obese women 25-38 years old were divided into 2 groups: 8 weeks of 75 minute exercise 2x/week 8 weeks of 30 minute exercise 5x/week Both groups exercised at 90-95% lactate threshold (typical untrained individuals reach LT@60% VO2 max) RESULTS No difference between groups in fitness improvement, insulin resistance or reduction in waist circumference. CONCLUSION Total time per week at a similar intensity yields similar benefit regardless of frequency. Manthou, E., Gill, J., Malkova, D. Impact of Exercise Programs With Different Frequency On Physical And Metabolic Characteristics In Overweight Women. Med. Sci. Sports Exerc. 2008; 40(5) A-875 S83

  28. Intense Resistance Exercise Can Lower Post-Prandial Blood Lipids 10 males (ages 21-30) performed 3 two day trials. Day 1 was one of three routines; no exercise, moderate exercise, or intense exercise followed by a 50-35-15 (%CPF) meal @ 5 cal/kg bodyweight Day 2 was identical in all 3 trials. 15.5 hours after exercise (or rest) subjects returned for morning meal 25-11-64 (%CPF) meal @ 20 cal/kg bodyweight. Venous samples were taken before and 3 hours after the meal.

  29. Intense Resistance Exercise Can Lower Post-Prandial Blood Lipidscontinued Moderate resistance exercise was 3 sets of 16 reps of 10 exercises @ weight of 50% of 8 rep max. Intense resistance exercise was 3 sets of 8 reps of 10 exercises @ a weight of 100% of 8 rep max. Meals for 70 kg (154lb) subject averaged 350 calories post-exercise and 1400 calories the next morning. RESULTS High intensity R.E. the day before lowered post-prandial lipids following high calorie, high fat breakfast. Moderate intensity of equal work had no effect on post-prandial lipids. Singhal, A., Trilk, J., Jenkins, N., et al. Effect of Intensity of Resistance Exercise on Postprandial Lipemia. Med. Sci. Sports Exerc. 2008; 40(5) A-757 S56

  30. Exercise Dependence • Exercise dependence is defined as 3 or more of the following: -Tolerance -Symptoms of Withdrawal -More exercise than intended -Inability to reduce exercise -Excessive time spent exercising -Conflict with other activities -Exercising despite contraindications Bartholomew, J., Hodgkinson, M., Exercise Motivation and Dependence: A Cluster Analysis of Endurance Athletes. Med. Sci. Sports Exerc. 2008; 40(5) A-1424 S209

  31. Korean Red Ginseng 8 male students were divided into 2 groups. Ginseng group took 7 grams of Korean Red Ginseng extract 3x/day for 7 days in 6 oz. liquid. Placebo group followed same protocol. On the 8th day subjects did two 45 minute uphill treadmill runs with 5 minute rest break. Blood was drawn immediately pre-post exercise and @ 30 min, 1,2,3,24,48, 72 hours and 10 days following exercise. Interleukin, creatine kinase and cortisol were determined (3 factors at 8 times = 24 data points.) 31

  32. Korean Red Ginseng results • Interleukin-6 was reduced @2 hour test in Ginseng group .22 pg/ml vs .26 pg/ml in placebo. • Creatine kinase activity was lower in the ginseng group @ 72 hour test. 223 IU/L vs 263 IU/L in placebo. • Cortisol response @ 72 hours was lower in ginseng 13.6 vs 18.7 ug/dl in placebo • There were no significant differences in any other factors over the 8 measurements taken. • 3/24 data points showed benefit. Park, S., Jung, H.L., Hong, S. et al. Effects of Red Ginseng Intake on Interleukin-6 (IL-6) and Cortisol Responses after High-Intensity Exercise. Med. Sci. Sports Exerc. 2008; 40(5) A-2329 S432

  33. Energy Patch Science Claims Organic nanoscale biomolecular antennas are imbedded in a matched pair of patches. They are placed on the skin in two locations. The patches emit a frequency that resonates in unison with intracellular biomolecules. These biorhythms are able to signal metabolic pathways causing a shift of substrate to fat utilization by activation of Beta-oxidation. This enables greater ability to use fat for fuel thus spares glycogen. Smith, D., Jacobson,B., Fedick, J. et. Al. The Effect of Energy Patches on Graded Exercise Test Performance in College Male Cross-Country Runners. Med. Sci. Sports Exerc. 2008; 40(5) A-2269 S418 33

  34. Energy Patch Experiment - Males 14 collegiate cross country males were measured in the laboratory. Oxygen consumption, respiratory exchange ratio, rate of perceived exertion, heart rate and time to exhaustion were measured in a baseline test, with energy patches and with placebo patches. Results There were no differences between placebo and active patches in any of the measured variables. This included no change in fat utilization. Smith, D., Jacobson,B., Fedick, J. et. Al. The Effect of Energy Patches on Graded Exercise Test Performance in College Male Cross-Country Runners. Med. Sci. Sports Exerc. 2008; 40(5) A-2269 S418 34

  35. Energy Patch Experiments – Females • 17 women (ages 18-43) were divided into 2 groups. • Body mass, body fat %, oxygen consumption and respiratory exchange ratio were determined. • Every other day for 2 weeks energy patches or placebo were worn in different areas (ankle, knee, shoulder, wrist). • Diet and exercise diaries were kept. Results Energy patches had no effect on any of the monitored factors. Witt, J., Wooten, N.D. Effect of LifewaveTM Patches on Fat Metabolism in Moderately Active Women. Med. Sci. Sports Exerc. 2008; 40(5) A-1894 S326

  36. Passive Stretching and Golf Driver 15 Male Competitive golfers underwent 2 trials 1. Dynamic warm-up with golf clubs 2. Same warm-up plus 20 minute total-body passive stretching After warm-up subjects hit 10 balls at full velocity with their drivers. RESULTS – EFFECTS of STRETCHING Accuracy decreased 31% Distance dropped 5.6% Ball Contact lost 16.3% Club speed slowed 4.2% Gergley, J., Austin, S. Acute Effects of Passive Static Stretching During Warm-up on Driver Clubhead Speed, Distance, Accuracy, and Consistent Ball Contact in Young Male competitive Golfers. Med. Sci. Sports Exerc. 2008; 40(5) A-2263 S417

  37. Drink Temperature During Exercise 8 males (ages 18-29) completed 2 trials in a random fashion separated by 1-2 weeks. Food and activity 48 hours prior to testing were identical. Subjects rode exercise bike in a chamber with a temperature of 95 degrees and relative humidity of 60%. Every 10 minutes they drank 100 ml (~3.5 oz) of orange flavored water (sugar free). The beverage temperature was either 4˚C or 37˚C (39˚F or 98.6˚F)

  38. Drink Temperature During ExerciseResults • Average time to exhaustion with cold water 63:48 • Average time to exhaustion with hot water 52:00 • Cold drinks extended time to exhaustion during exercise in the heat by 23%. Lee, J.K.W., Shirreffs,S.M., Maughan, R.J. Cold Drink Ingestion Improves Exercise Endurance Capacity in the Heat. Med Sc Sport Exerc. 2008;40(8) 1637-44

  39. Athletic Cramping Exercise associated muscle cramps (EAMC) is an umbrella term that describes any cramp sustained during a workout, practice, training or competition. Ask a health professional ‘what causes EAMC?’ and most likely a debate will ensue. Ask a grocer ‘What color is fruit?’ and he will reply ‘What kind of fruit?’

  40. Types of Cramps and Treatment Eichner E.R. Heat Cramps in Sports. Curr. Sports Med. Rep. 2008;7(4)178-9 Eichner E.R. Stitch in the Side: Causes Workup Solutions. Curr Sports Med. Rep. 2006; 5(5) 289-92

  41. New England Journal of Medicine. March 19, 2009 Reisenauer, C. Solomayer, E. Pelvic-Organ Prolapse and Uterine Inversion NEJM. 2008; 360 (12) 1238

  42. Fruits in Cure-All JuicesAcai From a palm tree in the Amazon Purple/black berries the size of a grape 12-15 vit’s/min’s; 15-20 amino & fatty acids High anthocyanin content (class of flavonoids known for red/purple/blue pigment & anti oxidant properties Claims of highest ORAC score (but can’t quench hydroxyl radical) Tastes like unsweetened dark chocolate

  43. Fruits in Cure-All JuicesGoji Berries from a vine-like bush in Tibet, western China and Mongolia. AKA Wolfberry, it is the size of a raspberry; when dried looks like red/orange raisin Has bitter/sour taste 17 vit’s/mins, 18 amino acids, 5 fatty acids Goji is a rich source of 5 carotenoids & vitamin C (50 mg/oz) Some claim Goji has highest ORAC score

  44. Fruits in Cure-All JuicesNoni Fruit from a South Pacific evergreen tree Pale yellow, oval w/ bumpy skin ~ 2” long When ripe, has a foul smell Taste is bitter; juice is dark brown Grape & other juices are added to commercial products ~ 20 vitamins & minerals Over 120 phytochemicals

  45. Fruits in Cure-All JuicesMangosteen A fruit from an Asian evergreen tree A thick dark purple skin with juicy white tangerine sized wedges in the center Tastes like a grape/strawberry mix Low in vitamins & minerals Has 40 of the known 200 xanthones which are anti oxidants in the polyphenol family Mangosteen marketers also claim it has the highest ORAC score.

  46. Fruits in Cure-All JuicesIndian Gooseberry From a tree native to foothills of India AKA Amalaki Fruit is cherry sized, lime green, w/ 6 furrows Low in most vitamins and minerals - except Very high in vitamin C (125-475mg/oz) Does contain Quercetin Fibrous w/ bitter/sour taste (often dipped in salt when consumed in India.) Some say ORAC score doubles Acai

  47. Fruits in Cure-All juicesOranges Grown on trees, named after it’s color 17 vitamins and minerals 18 amino acids 20 carotenoids Over 150 phytochemicals A medium orange has ~ 100mg vitamin C, 75 mg calcium, 325 mg potassium, 3 gm fiber and 12.5 mg omega 3 fatty acids Taste is delicious

  48. Sodium Levels and Exercise-Associated Muscle Cramps in 14 NFL Players (6 cramp hx. – 8 n/c) Stofan J.R., Horswill, C.A., Lacambra, M., Torriscelli, T., Murray, R. Acute Change in Blood Sodium During a Two-a-day Training in Professional Football Players. Med. Sci. Sports Exerc. 2007; 39(5): S15, A-572. Players with a history of cramping lost more sweat, drank less sports drink, and lost more sodium compared to players without a cramping history. 49

  49. Sodium Loading 8 endurance trained males, (~36 yrs) double-blind trial. High vs. Low sodium beverage prior to a run to exhaustion @ 70% VO2 max in 90 degree heat with 50% relative humidity. Repeated 2 weeks later with opposite treatment. 65 minutes prior to the run, subjects drank 25 oz. in equal portions (3.5 oz. every 9 minutes) High sodium 164mmol Na/L Low sodium 10mmol Na/L 50

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