Meaty News Choline Carnitine Bacteria Poop Make Red Meat Unhealthy Learn Why the Latest Revelations Are Neither New Nor Meat Specific And Still Made the News

Personally, I eat meat and will continue to do so, but the above is not meat. Thats junk, for which there is evidence that it precipitates heart disease (Micha. 2012).

Actually I did not really want to "blog" about the latest hypothesis on a mechanism by which red meat could give contribute to atherosclerosis and heart disease, but since its all over the news I feel inclined to provide you with some information to (a) find the happy medium between the scaremongering media hype and the similarly misplaced assessment that "we have been made to eat meat, so it cannot be bad for us" and (b) understand how science news are made.

I am not 100% sure which approach would be most appropriate, but I guess, it would be prudent to start the whole discussion by taking a peak at the actual paper, the publication, or rather the media coverage of which has sparked the whole turmoil.

Why does everybody and his mama talk about the study?

As a SuppVersity reader you probably belong to small number of people who actually care about scientific research. Being such a person myself, I know that people like us are hard-pressed to find anyone who will not answer questions like "have you heard about the latest results from the XYZ study" with a blank stare. So why on earth are there studies like the one Robert A Koeth et. al. just published (in fact the study is not even officially published, as of now its only an e-paper!) that spread faster than the Hollywood-caliber flu scenarios that are supposed to "encourage" you to get vaccinated? Personally I feel like there are a couple of factors coming together here:

• Familiarity & ostensible tangibility: The concept that red meat was bad for your heart is something everyone has heard about. You just have to add the words "bacteria poop" and even the average consumer of the Oz-show will feel like he/she knew all about the latest scientific evidence.

• Personal concernment: Whether we do, or dont eat meat, news like these concern all of us. The meat-eaters will question, whether they may be hurting their health and/or get upset about the "vegan propaganda", while the vegetarians and vegans will celebrate how smart they are not to eat meat and point with a finger at the dumb omnivores, who will soon be suffering the consequences of their "unsustainable and cruel" dietary habits ;-)

• The vegetarian / vegan lobby: Despite the fact that the "paleo movement" has gathered some momentum, vegetarianism and veganism still have a huge lobbying with sympathizers at many key positions of the society - esp. in the media business. With all "bad news about meat" being "good news for vegetarianism", it should be obvious that the "hurdle" a press release like the one Laura Ambro wrote for the Cleveland Clinic (read what all the "science mags" just copied and pasted here) does not have to pass a similarly high hurdle as the press release from the Michigan Diabetes Research and Training Center which does assert that lifting weights could help keep blood glucose levels under control (read it)

• The Nature factor: Before I started reading scientific papers on a regular basis I would have been impressed by the words "a recent article published in the prestigious journal Nature", these days I ignore statements like that. Good science will prevail, whether it is published in Nature or in an open journal like PLOS-1.

•  "Only bad news are good news" Lets be honest, we all know that bad news spread way more rapidly than good news. Imagine the study would have found that "no risk [increase of coronary arthery disease in type II diabetics] is seen with unprocessed meat consumption" (as a 2012 review of the evidence says; cf. Micha. 2012), who would have cared?
  

  "[...] the generally recognized tendency of the popular media to publish mostly negative aspects of news items is driven by the demand of their audience, rather than by inherent preferences of the media itself. To understand this, consider for a moment that there are two types of stories: positive stories or “good news” (and negative stories or “bad news”. Think of good news as stories about happy endings, in which people made the right choices. Bad news stories are about unhappy endings, in which people made the wrong choices. When consumers read good news stories, they can make similar choices to increase their incomes. When they read bad news stories, they can choose to avoid bad outcomes and the resulting income losses." (Swinnen. 2005)

  You see, according to science its your own fault that you are fooled by the media... and lets be honest, it in fact is. If people did not click on the "bad news" first, those would generate lower page impressions and ad revenues and the media would have to revise their policy.

Now these are five reasons that may explain why youve already heard about the study. There is yet at least another sixth reason thats missing from the list above - and that despite the fact that I already mentioned it in the introduction.

• The more publicity a study receives the more idiots like me will deem it necessary to blog about it, so that after bazillions of shares on Facebook (I got three on my Facebook, alone) and a couple of thousand blogposts, all the world knows exactly what the study is about (why are you laughing?)

In essence these would be 5 + 1 good reasons not to delve any deeper into the matter, but now that I am at it, I wont let you go without at least some additional rambling. 

Whats the main message of the article?

Apropos evidence: I wonder how the "choline is the bad guy hypothesis" thats at the heart (all puns intended) of the new "red meat causes heart disease" hypothesis is compatible with statements like "the long-term consumption of [dietary choline and betaine] have been shown to prevent CVD mortality by decreasing inflammation and other risk factors." (Rajaie. 2011) And why are they going after red meat specifically, if soy and particularly Miso have been shown to have similar effects on TMAO concentrations and - in human beings, by the way (Solanky. 2005). Plus: Isnt it surprising that the exact same (or almost the same) results have been reported by Wang et al. for phosphatidylcholine (best dietary source = soy lecithin!) and without the words "red meat" in the title in 2011 already and nobody cared? Just sayin...

Choline and choline-like/-based substances such as l-carnitine and phosphatidylcholine that are found at comparably high concentrations in (red) meat, eggs and all the other usual subjects are converted to trimethylamine by certain bacteria in your gut and metabolized to trimethylamine-N-oxide (TMAO) in your liver.

• Epidemiological evidence -- Concomitant elevations of serum l-increased risks for both prevalent cardiovascular disease (CVD) and incident major adverse cardiac events carnitine and TMAO levels.

• Experimental evidence --Tthe chronic administration of l-carnitine to rodents increased the incidence atherosclerosis. A process that was probably mediated by the reduction of reverse cholesterol transport from the arteries to the liver the scientists observed, when they kept their rodents on a carnitine, choline or TMAO supplemented chow. The extent to which the TMAO load explains variations in the risk of heart disease in rodent studieshas been estimated by Bennett et al. in another recently published study to be 11% (Bennett. 2013)

As mentioned before these are valid scientific findings that cannot be "discussed away" by stating that "we evolved to eat meat" or "thats just rodents, and I am no rodent!"

Which bacteria are to blame?

In view of the fact that scientists usually have a genuine interest in developing means to prevent (in this case) heart disease and not like the media and certain lobbyists to generate hype, acquire readers or rather advertisement consumers or reduce the consumption of meat, the most significant finding of the study at hand actually is that the use of a broad spectrum antibiotic does not only kill all bacteria, it also prevents the ill-health effects that come with the ingestion of large amounts of choline and l-carnitine (please mind my wording: "ill health effects of dietary choline and carnitine - not red meat).

"Discovery of a link between l-carnitine ingestion, gut microbiota metabolism and CVD risk has broad health-related implications. Our studies reveal a new pathway potentially linking dietary red meat ingestion with atherosclerosis pathogenesis. The role of gut microbiota in this pathway suggests new potential therapeutic targets for preventing CVD." (Koeth. 2013)

Against that background it is pretty intruiging that none of the articles I have read mentions that the scientists do already have preliminary evidence of who exactly those bad guys may be (only stat. sign. associations):

sign. associations with high TMAO concentrations 
• Tenericutes Mollicutes
• Tenericutes Mollicutes Anaeroplasmatales
• Tenericutes Mollicutes Anaeroplasmatales Anaeroplasmataceae

sign. associations with high TMA concentrations  >
• Bacteroidetes Bacteroidia Bacteroidales Prevotellaceae
• Bacteroidetes Bacteroidia Bacteroidales Prevotellaceae Unclassified
• Bacteroidetes Bacteroidia Bacteroidales Prevotellaceae Prevotella
• Deferribacteres Deferribacteres
• Deferribacteres Deferribacteres Deferribacterales
• Deferribacteres Deferribacteres Deferribacterales Deferribacteraceae

But things get even better there is more than a handful of potential "good guys" who appear to be associated with lower than average levels of TMAO in the blood on the scientists radar, already. Fostering the growth or directly supplementing with each of the following bacterial strains could thus mitigate if not nullify the ill health effects of carnitine & co. These potentially protective bacteria are bacteriodetes and firmicutes certain strains of protobacteria (* denotes statistical signficance)

If the connection of choline, meat & co and a certain enterotype is news to you, you can learn more about it in a previous post

• Bacteroidetes Bacteroidia
• Bacteroidia Bacteroidales
• Bacteroidales Porphyromonadaceae*

• Firmicutes Erysipelotrichi
• Erysipelotrichales
• Erysipelotrichales Erysipelotrichaceae

• Proteobacteria Betaproteobacteria
• Proteobacteria Deltaproteobacteria
• Deltaproteobacteria Desulfovibrionales

It is still preliminary to say, whether or not it would be a viable and more importantly practical strategy to constantly suppress the nutrient-dependent (see article referenced in the image above) rise in "bad bacteria" by using antibiotics or probiotics, but it would certainly be good to see the research zoning in on that instead of trying to find new explanations for epidemiologically non-sustainable claims such as "all red meat is bad for you".

A final word on the potential involvemend of the liver, bile and dietary fiber?

Another totally neglected yet potentially important factor, I personally feel would be worth investigating is the role of the liver. If you take a look at my slightly modified version of the proposed mechanism in Illustration 1 and remember my elaborations on the TMA => TMOA conversion in the liver, the brown metabolic "waste dump" certainly appears to be at an absolutely crucial position within the proposed etiology of TMAO-induced cardiovascular disease. 

Illustration 1: Modified sketch of the potential mechanism behind the pro-artherogenic effects of dietary carnitine and choline (adapted from Koeth. 2013)

I mean, what is the most common reason for heart disease? Meat consumption? No, if anything it is something that oftentimes correlates with the #1 reason, or I should say reasons for heart disease: the metabolic syndrome. You are very likely to give studies the abstracts of which include statements such as...

"The bile acid receptors farnesoid X receptor (FXR) and TGR5 both regulate lipid, glucose, and energy metabolism, rendering them potential pharmacological targets for MS therapy." (Porez. 2012)

"[Bile acid sequestrants] reduce atherosclerosis in Ldlr-deficient mice, coinciding with a switch from body cholesterol accumulation to cholesterol loss. RUN slightly modulated atherosclerotic lesion formation but the combination of BAS and RUN had no clear additive effects in this respect." (Maissner. 2013)

... a more thorough reading in the future. Especially in view of the fact that the -26% reduction in bile acids (Taurodeoxycholate, Tauroursodeoxycholate, Tauro-β-muricholate, Taurocholate) the scientists observed in the TMAO fed rodents suggest that the provision of bile acid sequestrants that promote the natural adaptation process and lower the intestinal cholesterol absorption even further could at least ameliorate the problem.

Moreover, the natural ability of dietary fiber to bind bile acids leads us back to things of which we already know that they are beneficial for the heart. Things that target both the gut microbiome and the absorption / excretion of cholesterol via bile... oats, for example! A 2010 study by Andersson et al. for example, shows quite conclusively that the bran of the fiber, protein, carb and fat laden powerfood will increase the faecal excretion of cholesterol and bile acids, lower blood lipids and reduce atherosclerotic lesion areas in the descending aorta (-77%) and aortic root (-33%) of LDR(-/-) mice, i.e. mice who lack the ability to "recycle" cholesterol due to the absence of the respective receptors on the liver.

---

You cannot handpick the several billion lodgers in your intestine, but you can attract the right ones by providing them with the foods they like. Contrary to the current probiotic hype, scientific evidence suggests the key to gut and metabolic health lies in the prebiotics you are stuffing down your piehole (learn more).

Bottom line: The main reason for mentioning the involvement of the liver and the potential role of the FXR (=bile acid receptor) in the etiology of the problem in the end of this post which got much longer than I had intended it to be is to point you to the hilarious over-generalizations that are taking place when the results and implications of studies like these are passed from one person to another before they finally end up at the "Mr. Joe Average Level" in the form of either Meat Kills! or The Vegan Lobby is at it again!

Whats lost in all the hysteria is the fact that the study at hand could in fact provide insights into the often-touted involvement of the gut microbiome in the etiology of all sorts of diseases... this, and not the "red meat is fill in whatever you like for you" debate, is what could actually help us to reduce the number of CVD related deaths on both an the large nation- and world-wide, as well as on a personal level.

Ah, and in the mean time, you probably dont have to be all too worried, as long as you eat a varied whole foods diet thats includes different sources of dietary fiber, vegetables and a rational amount of fruits, you can easily keep your gut microbiome in a state where real (=unprocessed meat) is not a problem.

References:

• Andersson KE, Svedberg KA, Lindholm MW, Oste R, Hellstrand P. Oats (Avena sativa) reduce atherogenesis in LDL-receptor-deficient mice. Atherosclerosis. 2010 Sep;212(1):93-9.
• Bennett BJ, de Aguiar Vallim TQ, Wang Z, Shih DM, Meng Y, Gregory J, Allayee H, Lee R, Graham M, Crooke R, Edwards PA, Hazen SL, Lusis AJ. Trimethylamine-N-oxide, a metabolite associated with atherosclerosis, exhibits complex genetic and dietary regulation. Cell Metab. 2013 Jan 8;17(1):49-60.
• Meissner M, Wolters H, de Boer RA, Havinga R, Boverhof R, Bloks VW, Kuipers F, Groen AK. Bile acid sequestration normalizes plasma cholesterol and reduces atherosclerosis in hypercholesterolemic mice. No additional effect of physical activity. Atherosclerosis. 2013 Feb 26.
• Micha R, Michas G, Mozaffarian D. Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes--an updated review of the evidence. Curr Atheroscler Rep. 2012 Dec;14(6):515-24.
• Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, Didonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013 Apr 7.
• Porez G, Prawitt J, Gross B, Staels B. Bile acid receptors as targets for the treatment of dyslipidemia and cardiovascular disease. J Lipid Res. 2012 Sep;53(9):1723-37.
• Rajaie S, Esmaillzadeh A. Dietary choline and betaine intakes and risk of cardiovascular diseases: review of epidemiological evidence. ARYA Atheroscler. 2011 Summer;7(2):78-86.
• Solanky KS, Bailey NJ, Beckwith-Hall BM, Bingham S, Davis A, Holmes E, Nicholson JK, Cassidy A. Biofluid 1H NMR-based metabonomic techniques in nutrition research - metabolic effects of dietary isoflavones in humans. J Nutr Biochem. 2005 Apr;16(4):236-44.
• Swinnen, J. F. M., McCluskey, J. and Francken, N. Food safety, the media, and the information market. Agricultural Economics. 2005; 32: 175–188.

Based on the Latest Evidence Who Would Benefit From Even more Vitamin D Plus How Much Vitamin D Do I Need To Achieve Optimal Levels Keep Them Steady

Injecting large doses of vitamin D is unnecessary to get into the normal range and everything way above 35ng/ml could be doing more harm than good.

Its not as hot as its use to be, but the token "vitamin" will still produce mostly studies dealing with "vitamin D", when you type it into the search field of PubMed or any other medical database search. Against that background, its almost pathetic that "information regarding the associations between vitamin D and inflammatory markers in the general population is sparse" (Hannemann. 2014) - we know the non-classical effects of vitamin D on the innate and adaptive immunity for 30 years and still, at least for Germany only few studies assessed the relation between vitamin D and chronic inflammation in a way that would allow us to answer the question I posed in the title of todays SuppVersity article.

You can learn more about vitamin D at the SuppVersity

Vitamin D Builds Muscle

Leucine, Insulin & Vitamin D

Vit. D Speeds Up Recovery

Overlooked D-Sources

Vitamin D For Athletes!

Vitamin D Helps Store Fat

In their latest paper in the peer-revied scientific journal Metabolism, Liesa Mellenthin, Henri Wallaschofski, Anne Grotevendt, Henry Völzke, Matthias Nauck, and Anke Hannemann from the University of Greifwald present the corresponding data. Data from 2723 men and women aged 25-88
years who were part of the first follow-up of the Study of Health in Pomerania.

Figure 1: Vitamin D status of the 2723 men and women in the Study of Health in Pomerania (Mellenthin. 2014)

As you can see in Figure 1 the number of Germans with low vitamin D levels is significant. The number of subjects in the target range of >30ng/ml 25OHD, on the other hand, was comparatively low.

The selected few are at a disadvantage

Interestingly, those "selected few" who are "in the zone", were  not the ones with the lowest levels of hs-CRP, the contemporary standard marker of whole body inflammation.

Vitamin D status	Hs-CRP	Fibrinogen	White blood cell count
			Smoker	Non-smoker
Deficiency (n = 322)	1.40 (0.88-2.22)	Reference	Reference	Reference
Insufficiency (n = 1301)	1.27 (0.91-1.78)	0.75 (0.51-1.09)	0.92 (0.52-1.61)	0.69 (0.39-1.22)
Sufficiency (n = 744)	Reference	0.69 (0.44-1.06)	0.59 (0.29-1.17)	0.79 (0.43-1.45)
Target Range (n = 356)	1.18 (0.72-1.95)	0.50 (0.28-0.91)	0.57 (0.24-1.35)	0.51 (0.24-1.11)
Table 1: Odds ratios (OR) and 95% confidence intervals (CI) from multivariable logistic regression models for the association between vitamin D status with increased inflammatory biomarker concentrations (≥90 th percentile)

Whether the lower white blood cell counts above the target range are desirable may depend on whether youre suffering from an auto-immune disease. In general, they are yet another reason to keep the in mind that Mellenthin et al. are not the first to observe a non-linear, U-shaped dose-response relationship for the beneficial health effects of vitamin D.

There are exceptions to all "rules" - except from one: Testing makes sense, because low levels of 24OHD are far worse than high ones! Whether or not 25OHD levels way beyond the sufficiency range of 30ng/ml (75mmol/l) will promote or impair your health will depend on many factors. Autoimmune diseases, as mentioned before, may be one. In view of the fact that most 99% of the reported benefits were observed in subjects with insufficient, if not deficient pre- (at the beginning of the experiment) vitamin D levels, even these alleged benefits are in no way certain. I mean, look at the data in Figure 2 (right). Even in otherwise healthy people its way better to have slightly high D levels than extremely low ones. In the end, the best way to make sure you are doing fine is to test: As long as you hover in the 28-40ng/ml range yearlong, there is nothing to freak out about.

In this case this was a reduction in overall inflammation. In previous studies similar U-shaped, non-linear dose-response relationships were observed for

• Did you know? Seasonal variation in serum 25(OH)D is between 10 and 20 nmol/L. Sunscreen use decreases, but does not abolish, vitamin D production in the skin. A high dietary calcium intake has a vitamin D-sparing effect, because it increases the half-life of 25(OH)D. A combination of sunlight exposure, nutrition, food fortification, and supplements is desirable to obtain sufficient vitamin D status in the population of most countries throughout the year (Lips. 2014).
  pre-hospital vitamin D status and mortality in a recent paper in the Journal of Clinical Endocrinology & Metabolism (Amerin. 2014),
• serum 25‐Hydroxyvitamin D and fracture risk in older men in the Prospective Population Based CHAMP Study (Bleicher. 2014),
• the maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study (Weisse. 2013)
• the population-wide cancer risk (White. 2013)
• the duration of hospital stays after cardiac surgery (Zittermann. 2013), 
• the association between vitamin D & mortality and morbidity based on data for 1 282 822 Clalit Health Services members aged >45 between July 2007 and December 2011 (Dror. 2013)

I could extent this list endlessly, but I honestly have better things to do, so lets stick to that and say: The notion that "more vitamin D" equals better health is obviously more than questionable. 

Figure 2: 25OHD levels and survival (left) and calculated risk for (right) of increased mortality in 1 282 822 Clalit Health Services members aged >45 between July 2007 and December 2011 (Dror. 2013)

Needless to say you are better off in the high 25OHD region (Figure 2, right >28-32), but if your goal is to avoid dying within the next 60 months, the previously cited study by Dror is only one of many references that would suggest that you are better of in the happy medium.

Studies like Close et al. (2013) leave little doubt that it does not take tons of vitamin D to get lowish levels back into the normal range - in fact, taking too much, in this case 40,000 IU per week, will take you into a 25OHD range, where the benefits are starting to diminish. Still, even here youre better off than youd be with "officially low" 25OHD levels of <25ng/ml.

Bottom line: Vitamin D does not break the "more is not more"-rule of medical sciences. Instead of thriving to bring your vitamin D levels up into the hilarious D-council levels, youd do yourself or rather your overall health a favor if you  hovered around in the normal zone.

This does not mean that you should try to avoid being deficient at all costs. So, how much do you need? Well, assuming that most of you are young(er) and active, you can follow the same protocol as the young healthy men in a 6-week trial by Close et al. whose previously low levels jumped up to >30 ng/ml was only 20 000 IU per week (for older subjects and/or subjects with (pre-)diabetes / other chronic disease with inflammatory component, twice the dosage may be necessary; cf.  Davidson. 2014).

A means to ensure sufficiency for the misers who are to cheap to test, would thus be taking 5,000IU every day for 1 month and a maintenance dose of 1,000IU/day or 10,000IU once per week to maintain optimal levels (Is it better to take your D and other fat soluble vitamins w/ fat? learn more) .

Reference:

• Amrein, Karin, et al. "Evidence for a U-shaped relationship between pre-hospital vitamin D status and mortality: a cohort study." The Journal of Clinical Endocrinology & Metabolism (2014).
• Bleicher, Kerrin, et al. "U‐Shaped Association Between Serum 25‐Hydroxyvitamin D and Fracture Risk in Older Men: Results from the Prospective Population Based CHAMP Study." Journal of Bone and Mineral Research (2014).
• Close, Graeme L., et al. "The effects of vitamin D3 supplementation on serum total 25 [OH] D concentration and physical performance: a randomised dose–response study." British journal of sports medicine 47.11 (2013): 692-696. 
• Davidson, Mayer B., et al. "High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D." Diabetes Care 36.2 (2013): 260-266.
• Dror, Yosef, et al. "Vitamin D levels for preventing acute coronary syndrome and mortality: evidence of a nonlinear association." The Journal of Clinical Endocrinology & Metabolism 98.5 (2013): 2160-2167.
• Mellenthin, Liesa, et al. "Association Between Serum Vitamin D Concentrations and Inflammatory Markers in the General Adult Population." Metabolism (2014).
• Lips P, van Schoor NM, de Jongh RT. "Diet, sun, and lifestyle as determinants of vitamin D status." Ann N Y Acad Sci. (2014).
• Weisse, K., et al. "Maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study." Allergy 68.2 (2013): 220-228.
• White, John H. "Vitamin D and human health: more than just bone." Nature Reviews Endocrinology 9.10 (2013): 623-623.
• Zittermann, Armin, et al. "Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery." European heart journal 34.18 (2013): 1358-1364.

BRIEF IDEA ABOUT PILES (Hemorrhoids)

What is piles ?

Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.

Depending upon the situation there are two types of piles.

1) External piles. 2) Internal piles.

1) External piles:-

This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.

2) Internal piles:-

It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.

Some times internal and external piles occure in same individual.

Factors responsible for piles:--

1) This is a familial disease.

2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.

3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.

4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.

5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.

6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.

Signs and symptoms of piles:--

1) Pain:-

Pain is common in external piles which will be worse while straining at stool.

2) Bleeding:-

Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.

3) Protruding mass:-

In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.

4) In some cases there will be discharge of mucus with itching around the anal orifice.

Complications of piles:--

1,Infection: The infection can spread to deep veins resulting in septicaemia.
2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.
3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.
4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.
5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

Treatment of piles:--

Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.

1) The thrombosed external pile is excised under local anaesthesia.

2) Sclerosant injection therapy can reduce the size of piles.

3) Rubber band ligation around the neck of piles is useful in some cases.

4) Cryosurgery is very effective.

5) Anal dilatation can reduce constipation and pain.

6) Haemorrhoidectomy is the surgical removal of piles.


How to prevent piles?

1) Eat plenty of fruits and vegetables.

2) Take fibrous food.

3) Avoid excess intake of meat,prawns,crabs ect.

4) Keep a regular timing for food.

6) Drink sufficient quantity of water.

7) Keep a regularity in bowel habits.

8) Take treatment for constipation.

BDNF Driven Athletic Brain Optimization For Wise Guys Better Hard Than Long But Always Without Interruptions

Believe it or not, a "smart" brain is not necessarily a healthy brain. Nevertheless, if Einstein had worked out regularly and lived a couple of years (better decades ;-) longer, he may have had a change to figure out the missing link between his Theory of Relativity and the Quantum Theory ;-)

"Workout for your brain!" If you were a member of the club of sedentary couch-potato, you would probably be thinking of Dr. Kawashima or similar IQ games on one of your beloved gaming devices. As a diligent student of the SuppVersity and life-long follower of physical culture, you will yet be aware that the imperative "Work out for your brain!" has to be understood quite literally. After all, there have been dozens of studies to show how exercise benefits the brain of young and old, sick and healthy, lean and obese individuals.

In this context scientists often measure a peptide that goes by the name brain-derived neurotrophic factor, or short BDNF, which has been recognized as an important tropic hormone in the regulation
of neuron morphology and survival. With exercise being one of the stimuli that triggers its production BDNF it is not surprising that working out has been shown to improve cellular development and growth, exert beneficial effects on mood regulation, and cognitive functions such as learning and memory - all of these things are after all influenced by this important hormone.

Low circulating BDNF levels, on the other hand, have been associated with a widerange of neuropsychiatric disorders including depression (Karege. 2002), bipolar disorder (Cunha. 2006), schizophrenia (Zhang. 2007) and neurodegenerative diseases (Yu. 2008). And despite the fact that a definitive causal relationship between low BDNF levels and the said pathologies has yet not been established, researchers are confirmed that elevated BDNF levels can lead to improved brain health.

So if exercise is good, how much is optimal?

As mentioned before, we do already know that chronic exercise training - endurance exercise in particular - will promote the production of this important neurologically active peptide, what we do not know, however, are the dosage and intensity that would yield "optimal" effects... well, I should say we did not know that until a group of researchers from the Department of Psychology, Neuroscience Program, and the Department of Health Promotion and Human Performance at the Weber State University in Odgen gave us a first glimpse on what this "optimal" dose / intensity ratio may look like.

In their latest paper Matthew T. Schmolesky, David L. Webb and Rodney A. Hansen report the results of a study involving 45 healthy human adult males aged 18-25, who were assigned to one out of six exercise conditions that varied in both, intensity (80% or 60% of heart rate reserve, or control) and duration (20 or 40 min). To elucidate whether circadian or other effects would influence the response to the long and short vigorous and moderate intensity exercise, three subjects were excluded to serve as a sedentary control.

Figure 1: Changes in s-BDNF levels relative to baseline (Schmolesky. 2013)

If you discard the inter-group differences and focus on the effect size in general, first, you will notice that any type of aerobic exercise will result in significant increases in BDNF levels (30% on average). Once you look closer, it does yet become apparent that there is a non-significant tendency for higher changes in BDNF levels with higher intensities and longer durations.

For the study at hand this implies that the Vig40 trial, in the course of which the subjects cycled for 40 min at an intensity of 80% of their maximal heart rate, yielded the greatest total increase in BDNF. If you do yet take a look at the non-significant difference to the Vig20 trial, the additional 25% increase in BDNF is paid for with an additional 20 minutes on the cycle ergometer. Now taking into account that this was still more effective than the high dose bout (40min) of moderate intensity exercise, the 20 min of vigorous exercise provide the most BDNF-bang for your bucks and should thus be considered the "optimal" training regimen to promote your brain health.

---

Exercise specific news: "Bigger, Stronger, Faster: CoQ10 for Brain & Muscle. The Optimal HIIT Regimen for Fun & Fat Loss - 8s at 100% 60s Idling! Protein Power From Oats? Plus: Rest Times, Clusters, Form & Hypertrophy Training" (read more)

"Hold on thats not optimal"... Ok, you are right, it is not just questionable, but in fact highly unlikely that the scientists actually found these 20 minutes of vigorous activity are actually the non-plus-ultra among the unlimited number of potentially BDNF-boosting exercise regimen.

In fact, the existing bias towards higher intensities and shorter durations. Yet while this would suggest that high intensity interval training could be the true "optimum" in terms of BDNF-boosting exercise. There are as of now no human studies to support this notion and a previously published study in which the researchers tested the effects of exercise on the regeneration of axons in injured peripheral nerves clearly suggests that the BDNF response to interval training is inferior to its continuous counterpart (Wood. 2012).

Whether these results are applicable to human beings and / or whether the 5x2min intervals the rodents in the Wood study were exposed to may have been "too much of a good thing", will yet have to be elucidated in future trials.

References:

• Cunha AB, Frey BN, Andreazza AC, Goi JD, Rosa AR, Gonçalves CA, Santin A, Kapczinski F. Serum brain-derived neurotrophic factor is decreased in bipolar disorder during depressive and manic episodes. Neurosci Lett. 2006 May 8;398(3):215-9.
• Karege F, Perret G, Bondolfi G, Schwald M, Bertschy G, Aubry JM. Decreased serum brain-derived neurotrophic factor levels in major depressed patients. Psychiatry Res. 2002 Mar 15;109(2):143-8.
• Schmolesky MT, Webb DL, Hansen RA. The Effects of Aerobic Exercise Intensity and Duration on Levels of Brain Derived Neurotrophic Factor in Healthy Men. Journal of Sports Science and Medicine. 2013. 12 [epub ahead of print]
• Wood K, Wilhelm JC, Sabatier MJ, Liu K, Gu J, English AW. Sex differences in the effectiveness of treadmill training in enhancing axon regeneration in injured peripheral nerves. Dev Neurobiol. 2012 May;72(5):688-98.
• Yu H, Zhang Z, Shi Y, Bai F, Xie C, Qian Y, Yuan Y, Deng L. Association study of the decreased serum BDNF concentrations in amnestic mild cognitive impairment and the Val66Met polymorphism in Chinese Han. J Clin Psychiatry. 2008 Jul;69(7):1104-11.
• Zhang XY, Tan YL, Zhou DF, Cao LY, Wu GY, Xu Q, Shen Y, Haile CN, Kosten TA, Kosten TR. Serum BDNF levels and weight gain in schizophrenic patients on long-term treatment with antipsychotics. J Psychiatr Res. 2007 Dec;41(12):997-1004.

Regular Skin care Beautiful glowing youthful skin in just four steps

Getting a beautiful bright skin is easy, girls can do that by getting a nice facial from a nice parlor. But right after two three days it get back to that boring dead dull look... why??? because girls forget the main task n that is maintenance, so dont rush in to getting beautiful in few min (not to forget that will cost you a lot) in stead look for something that can be done on regular basis in order to maintain your looks.
I have some very simple steps for you that you can easily do regularly at home and will feel the difference every time you do it.





Step#1 Cleansing:

Cleansing is a very important step is regular skin care. It help removing make-up, dead skin cells, oil, dirt and other impurities from facial skin. Cleansing unclog pores and prevent skin conditions such as acne.
There are many products available in market commonly for face cleansing such as soap, lotions, milks, foaming mousses, oils, wipes, motorized brushes etc Facial cleansers are getting more and more popular for cleansing face over the old methods of using soap.

Dermatologists suggests that using a liquid cleanser to remove dirt is considered to be a better alternative to bar soap or another form of skin cleanser not specifically formulated for the face because bar soap has a high pH (9 to 10) where as skins natural pH is 5.5 which means that soap can change the balance present in the skin to favor the overgrowth of some types of bacteria, increasing acne. Bar cleansers in general, soap or not, have thickeners that allow them to assume a bar shape can clog pores again resulting acne. Most important thing is bar soap on the face can remove natural oils from the skin which helps in retaining water. This causes the facial glands to overproduce oil, a condition known as reactive seborrhoea, which will lead to clogged pores.


In order to prevent these facial problems cleansers with proper moisturizers are suggested. People with dry skin try to skin cleansing process considering the fact that it might dry out their skin. But if you find a good cleanser this problem can be solved.


Keep following points in mind before getting a new cleanser:

• Get a nice cleanser according to your skin tone.
• Choose the one which leaves your skin normal after wash i.e. neither dry nor oily.
• Avoid soap , it dry out most of the skin.
• Choose creamy cleanser (like Cetaphil cleanser, dove or ponds) for dry skin.
• Cerave Hydrating skin cleanser is a fragrance free milky formula for extra dry skin.
• Use extra gentle cleansers (like Boscia Purifying cleansing gel or DHC deep cleansing oil) if you have sensitive skin.
• Get clean cleanser (like Malachite Cleansing Gelle or Clean n Clear)  for oily skin.

Natural Cleanser:

• Milk and yogurt are the best natural cleansers for every skin type.
• Mix honey with milk for dry skin.
• Mix salt with a little warm milk for oily skin.

Note: In the morning just use pleasant warm water to splash face. Avoid hot or cold water as both cause broken skin.


Step#2 Remove dead skin:


Do u know that your skin naturally shed thousands of cells per minute? but sometimes even that’s not enough so you should do that artificially in order to keep your skin looking younger, this process is known as exfoliation process.

For normal and oily skin exfoliation process should be performed twice a week.  For sensitive and dry skin either skip this and use toner instead or if needed remove dead skin with extra gentle scrub.

How to exfoliate facial skin:

• There are many ways to exfoliate your skin such as exfoliating soup, scrub or tools like gloves, face brush, cleansing pouch, facial cloths etc.
• To remove dead skin use pleasant warm water to wet skin and then apply your choice of scrub.
• Use your scrub or exfoliating tool to rub gently in circular motion.
• Rinse off your face thoroughly and move to the next step.

Step#3 Apply toner:

Many people don’t believe in applying toner, because exfoliation process do the job, but exfoliation cant be done on regular basic where as soft toner can be applied daily. It removes extra oil and dirt.

You can get one according to your skin. Apply and feel the difference.

Step#4 Moisturize Skin:

Moisturizing  is a very important step toward building up a healthy skin. It encourages dead cell shading process as well as balances the water contents of skin making it look more smooth. Every skin type need proper moisturizing  as we all know even the most oily skins are susceptible to dryness and water loss.

A huge number of moisturizers are available in market for every skin type in the form of creams and lotions. Try some of the product keeping in mind your own skin type. (read my article "How to know your own skin type").

Normal and oily skin should be moisturized twice a day where as if you have dry skin, you should moisturize your skin more often specially when your skin is getting tight.

Don’t over do moisturizing process else it will clog pores.

Natural Moisturizers: includes jojoba oil, almond oil, coconut oil or olive oil.




The most important thing is treat your skin like its most expensive piece of art that you own.... give it some extra time... only your efforts can do that... dont depend on beauticians for that because you know your skin batter...


Good Luck

Menopause Symptoms – Free Android Application from KRM Apps

For those who already extended use of the Android smart phone beyond the basic phone abilities and actively operate it for references and information, the new application, outlining main symptoms of menopause, might be handy. There are many signs and indicators of menopause, and having your mobile reference always with you may help you to deal with questionable and unclear situations.

It is understandable, that there is no need to have any fear or anxiety about menopause, because it is as much a natural process as puberty and it happens to every woman. However, for many, that is sign of aging and loss of femininity. Such rejection and lack of acceptance might lead to severe psychological problems, including major depression.

Having the menopause symptoms manual will help you recognizing the characteristic symptoms of menopause, when it is approaching, and getting ready for transformation physically and emotionally. That may also ease some suspicion that your health problems represent signs of the incoming serious illnesses.

This application contains the following information:

1) What Is Menopause?
2) The Best Ways to Deal with Menopause.
3) Interact With Other Women And Get Tips And Help.
4) Video Instructions on Menopause Symptoms.
5) and More...

Getting through the menopause completely naturally is all about having the strength to fight back against the inevitable setbacks and occasional hardships that you will almost inevitably have to put up with from time to time. 

Screenshots:

Cost: Free

Google Play Website: https://play.google.com/store/apps/details?id=com.a11083730445264f2ff8310e7a.a52274419a

Power Up With Bands Inexpensive Rubber Gear Doubles Explosiveness of Professional Athletes and Will Have Similar Effects on the Bench Press of Regular Gymrats

Is "bench from the trench" all bro-science and you better bench with bands - additional bands, of course?

Its been a while since weve had a "simple" workout study here. With all the hypoxia or hyberbaric oxygen training shenanigan, it really seems as if there wouldnt be any simple and practicable ways to improve your training outcomes. Luckily, not all researchers focus on elite athletes who train in high-tech facilities with all sorts of performance enhancing gear.

David García-López, Sonsoles Hernández-Sánchez, Esperanza Martín, Pedro J. Marín, Fernando Zarzosa and Azael J. Herrero belong to this group of "low tech researchers" and their gear is a simple elastic band.

Youre kiddin me, right? Elastic bands?

I know rubber is not exactly what many of the bros consider "gear", but if you look at the astonishing results the researchers from the Laboratory of Physiology at the European University Miguel de Cervantes observed in their study, you may realize that "coolness" is a miserable guide, when it comes to exercise selection - in bros, pros, and noobs, by the way!

Figure 1: Acute changes in velocity and acceleration, when bench press is performed with / without additional bands; data expressed relative to inter-group means (García-López. 2014)

You want to know how I know that? Well, many of the bros are noobs when it comes to their actual training performance. So, if we are dealing with a study with 8 rugby players and 8 recreationally-trained subjects, we covered them all: Athletes, bros + noobs. And if the said study assigned the participants to two different experimental conditions in a cross-over design with

• regular training
• training with additional bands

says that the addition of elastic bands "significantly increased the range of concentric movement in which the barbell is accelerated and that this increase was significantly in higher in the "pros" (35%) compared to the "noobs" (13%), this tells you that using exercise bands may be especially beneficial for advanced trainees - exactly those people who usually laugh, when someone only mentions the green, red and blue bands.

Aint got enough for today? Try this SuppVersity highly suggested read ➲ "Bicarbonate For Strength Athletes: 25g of Baking Soda Up Your Squat (+27%) and Bench Press (+6%) Within 60 Minutes" | read more

Bottom line: If we take into consideration that one of the major downfalls of the regular bench press is that it involves a certain amount of momentum, even if it is performed with picture perfect form. It is certain that adding a pair of elastic bands to your gym-tools will increase the time under tension. It is likely that this will help to increase your overall power and it is not impossible that it is going to to support your gains.

To make definitive statements about any of these "likely" and "possible" consequences of the regular use of additional bands during the bench press, we would yet need a 6-12 week trial the Spanish scientists would first have to finance - and lets be honest: Do you think the elastic band industry has the funds to do that ;-)

References:

• García-López, D. et al. "Free-weight augmentation with elastic bands improves bench-press kinematics in professional rugby players". Journal of Strength and Conditioning Research. Jan 2014 [publish ahead of print]

Tricks to Keep Eyes Healthy

Many are ignoring the treatments and eye health. Often you suddenly realize that there is something wrong with your eyes. Heres what you need to be aware of. Take a look at some of these tips. Here you will find information on how to maintain the health of your eyes.

1. Get your eyes tested annually to an ophthalmologist

Eye conditions can always change. This is because the eye always accept new things every day. Environmental conditions then affect the state and health of your eyes.

You can not tell by examining their own eye health. It takes a special tool to see eye health. The best advice for you is always checked by an eye doctor regularly once a year. You do not want your eyes hurt right?

2. Purchase the best quality contact lenses

Choosing a contact lens takes precision. Do not just brand names, or select an affordable price only. Choose the best for your eyes.

Contact lenses direct contact with the eye, so it should be more careful choosing contact lenses than ordinary glasses. Choose the best color that suits your eyes. But still do not ignore the quality.

3. Always use UV glasses under the hot sun

The sun is not only wicked on your skin. Eye also should not be exposed to direct light. That if you really love your eyes. Because UV radiation will give a bad effect on the eyes.

Try using anti-UV sunglasses that protect your eyes from direct sunlight. Especially if you are doing activities outdoors. Just choose glasses that fit with the fashion trends. Healthy eyes, but still be stylish.

4. Consumption of supplements or foods are good for the eyes

Want healthy eyes do not forget that the consumption of foods or supplements containing vitamin A, C, E, Folic Acid, Selenium and Zinc. All the food and supplements can inhibit aging factors that also affect the performance of the eye.

5. Set your lights when reading or working at the computer

Your lights affect the health of your eyes. Attain your lights to suit your eye comfort while reading or working at the computer.

Dark conditions and dimly lit very bad for you. Accelerate eye damage. Too light is also not good, because it makes a quick glare and eye fatigue. Therefore just set your light, not too dark or bright. Are important enough to help you see the best condition.

6. Give adequate rest time for your eyes

Your eyes need a rest, like your other limbs. So when you sleep, use a light sleeper. Or just turn off your lights. It would be better if your eyes are already tired of a day in the dark condition. Will make your eyes more relaxed and fresh the next morning.

7. Change your contact lenses fit the recommended time

Each contact lenses have a lifetime. Avoid using too long. Loose if you do not need it, or when you are relaxing at home.

Usage time is normally 12 hours a day. The rest do not force your eyes to work too hard with contact lenses. And do not forget, check its expiration date. Do not be force to use it, because there are time limits specified usage. Change new every month.

8. Be diligent cleaning your contact lenses

Dust and other particles will stick on contact lenses, therefore, must be diligent to clean it with a special fluid. To guard sanitation.

Prevent Cancer with Magic Nutrition Basics of the Ocean

One of the natural resources owned by Indonesian ocean are seaweed. Seaweeds are sea plants or algae multicellular algae species, which do not have roots, stems, and leaves, with diverse forms, ranging from a round shape, flat, tube or branched.

Seaweed has been known worldwide since the 16th century and became a source of food for the Aztecs and Mesoamericans that time.

Seaweed is a 100 percent natural source of nutrients that have various health benefits for those who eat them. Here are some health benefits that can be obtained by diligent eating grass miracle is:

Improve Endurance Body

Research suggests that seaweed can be a stimulant in the healing process of cancer through its ability to increase endurance. Seaweed works by increasing the production of antibodies, cytokines, (infection fighting proteins), and other cells that improve immunity to infection and helps heal chronic diseases such as cancer.

Controlling Weight Gain

Seaweed is a food rich in fat and dietary fiber. As we know that in addition to digestion, fiber also can make the stomach full longer, so you can avoid eating glutton who could gain weight. Suitable to be consumed as a snack for those who are dieting.

Salt substitute

British researchers tested the seaweed granules as a flavor enhancer that can replace salt in snacks and other processed food products. Reducing salt intake can reduce the risk of high blood pressure, heart attacks to strokes.

Prevent Anemia

Research also proves that, seaweed spiriluna can also stabilize the number of red blood cells, white blood cells and hemoglobin. In addition, the seaweed used for reducing the side effects of inhibition of the production of cells producing blood cells. Research shows that seaweed increases hematopoiesis, ie, the formation of red blood cells. It is believed to be due to the high iron content in it.

Overcoming Allergies

Seaweed also can resist correcting allergies by preventing the release of histamine or substance that causes allergy symptoms such as nasal congestion and watery eyes.

Prevent Cancer

Research Harvard School of Public Health in America revealed that premenopausal women in Japan were three times less likely to develop breast cancer than American women. This is due to the diet of Japanese women are always adding seaweed in their diet.

Accelerate Wound Healing

Vitamin C in seaweed containing antioxidants such as vitamin A, also maintain strong bones, teeth, gums, skin health and also helps to heal injuries, and strengthen blood vessels.

Prevent osteophorosis

Research claims that seaweed contains calcium 5x greater than milk. With such a large calcium content, the seaweed can prevent bone loss, helping the growth of bones and teeth, maintain healthy nails, hair, and increase metabolism in the body.

Exercise Threesome 40g of Galactose 17 More Stamina Than W Same Amount of Glucose ☆ Faster Sprints W Psychological Tricks ☆ 10 Lower Insulin W Exercise

A neat threesome, anyone?

A threesome is always quite entertaining, especially, when its one that can help you (a) increase your stamina, (b) boost your sprint performance, and (c) decrease your fasting insulin levels by 10%. Ok, I have to admit it will probably not suffice if you only read the following paragraph, but buying 40g of galactose, playing a couple of psycho-games on yourself and the adherence to the regular exercise program you are already performing anyway (right!?) is something you will probably manage to do, as well.

• 40g galactose before a workout will increase your stamina (OHara. 2014) -- Basically that is already the main finding of a recent study by John P. OHara et al... well, aside from the fact that the same dose of glucose didnt produce similar benefits - but lets tackle one thing after the other...
  
  The researchers evaluated the effects of the pre-exercise (30 minutes) ingestion of galactose (Gal) or glucose (Glu) on endurance capacity, as well as glycaemic and insulinaemic responses.
  
  To this ends 10 trained male cyclists completed three randomised high-intensity cycling endurance tests. Thirty minutes prior to each trial cyclists ingested 1 litre of either
  
  • 40g of glucose,
  • 40g of galactose, or
  • 40g of a placebo
  in a double blind manner. The protocol comprised: 20 minutes of progressive incremental exercise (70% to 85% maximal power output (Wmax)); 10x90 second bouts at 90% Wmax, separated by 180 seconds at 55% Wmax; 90% Wmax until exhaustion.
  
  Blood samples were drawn throughout the protocol. As the headline already told you the times to exhaustion were longer with glactose (68.7+/-10.2 minutes, P=0.005), interestingly that was true for both the placebo (63.9+/-16.2 minutes) and the glucose (58.5+/-24.9 minutes) trial.
  
  In view of the anti-lipolytic effects of high insulin, its probably also worth mentioning that the ingestion of 40g of performance-increasing galactose supplement did (at least from a statistical perspective) not increase the participants insulin levels, at all.

• 

  SuppVersity HIGHLY Suggested Read: " Brocebo? Add 10kg to Your Bench in Days with Sugar-Based "Anabolic Steroids". Old Study Shows, Many "Natural Anabolics" Could Work Solely via Placebo Effects" | read more

  Psyching yourself up will boost your sprint performance (Sarra. 2014) -- A soon-to-be-published study in the Journal of Strength and Conditioning Research that investigated the effect of "psyching-up" (PU) strategies, in this case preparatory arousal and imagery strategies, would improve the performance of 16 male sprinters (age 20.6 +/- 1.3 years, body mass 77.5 +/- 7.1 kg, height 180.8 +/- 5.6 cm).
  
  If we sprint forward to the results, well see that the imagery and preparatory arousal strategies did in fact contribute to performance increases in the short-distance sprints (from 0 to 10-m). The imagery strategy also increased the performance in the 30-m sprints.
  
  And you know what? These "psyching-up" strategies work even if you dont buy a useless supplement take it before your workout and ignite the "placebo afterburner"
• Work out to decrease your fasting insulin levels by 10% (Conn. 2014) -- In spite of the fact that we all believe we knew that regular exercise will have beneficial effects on  insulin sensitivity, there is very little comprehensive data on the average effect size.
  
  A recent meta-analysis from the University of Missouri provides just that: A "Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults", which reveals what the subheading to this item in todays exercise news-quickie already told you: The average participant in one of the 78 papers that were included in the analysis showed statistically lower fasting insulin levels (6.9mU/L) than the control subjects (7.9 mU/L).

Bottom line: If you are already working out regularly, you may want to try to psyche you up, while youre guzzling a galactose drink before your next workout and let me know what happened, after you tore down the gym... if you are not, I mean, not working out, on the other hand, the decrease in insulin you can achieve with a minimal amount of physical activity should be reason enough to get your ass off the couch... and no, I am not talking about walking to the fridge to get another bottle of coke and some ice-cream to satisfy your sweet tongue ;-)

Reference:

• Conn V. S. et al. "Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults." J Prim Care Community Health. (2014) Jan 27. [Epub ahead of print]
• Hammoudi-Nassib, S. et al. "Effects of psyching-up on sprint performance". Journal of Strength & Conditioning Research. January 28, 2014 [accepted manuscript].
• OHara, J.P. et al. "The Effect of Pre-exercise Galactose and Glucose Ingestion on High-Intensity Endurance Cycling". Journal of Strength & Conditioning Research. January 28, 2014 [accepted manuscript].

Trying to Build Strength Periodized Training Yields 30 34 77 Increases in Bench Press Squat and Deadlift Performance in Elite ! Powerlifters over 16 Weeks

With the huge success of Crossfit more and more women are "hitting the weights"

Almost 80% increase in deadlift performance in "elite powerlifters" with 7 ± 3 yrs of training experience and a mean age of 34 ± 5 yrs and a mean body mass of 94.4 ± 16.7 kg? Thats catching your attention, right? Now, what would you say that there was no magic supplement involved and that the periodization routine the researchers prescribed to their 9 male study participants is far from being revolutionary?

Youre still interested to learn more? Even if I tell you that the baseline lifts dont look very elite, rather average, though? Lets see, then, what the subjects had to do during their three weekly 120min training sessions.

Want to get stronger? Dont take creatine? Huge mistake! Learn why at the SuppVersity

Creatine Doubles Ur GainZ!

Creatine, DHT & Broscience

Creatine Better After Workout

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Build Ur Own Buffered Creatine

As the graphical overview in Figure 1 shows, the subjects trained in four mesocycles, each of them lasting for four weeks (although the fulltext does not mention this, I assume that the subjects did all three exercises in all sessions - how else would you spend 120 training minutes?).

Figure 1: Overview of the study protocol and assessment points 1-5 (Allegretti. 2014)

Well, if we are honest, this is not 100% exact. The last of the four mesocycles was actually further devided into two 2-week and one 1-week microcycles... but I guess, its best you check out the details in Table 1 for yourself.

Table 1. Periodization of 4 Powerlifting Training Mesocycles. Explanation of the acronyms: MESO: mesocycle; MICRO: microcycle; No. SER: number of sets; No. REP: number of repetitions; ID: rest interval; RM%: percentage of 1 repetition maximum; CT: Workload (the product of sets x reps)

I am not sure how familiar you are with classic powerlifting programs, but I personally wouldnt call the above scheme "revolutionary". What I would do, though, is call the results it produced over the course of the 16-week study period "damn impressive!".

Figure 2: Strength development from one assessment (AS) to the other (Allegretti. 2014)

Overall the researchers recorded highly significant strength increases of 31.7kg, 45.0kg and 101.7kg in the three major powerlifting exercises, the bench press, the squat and the deadlift, respectively.

Tapering is a must for professional athletes before an event like the Olympic games - learn how to do it in a previous SuppVersity article.

Bottom line: Assuming that strength (not size - that may need a higher volume and lower rest times) is your main goal, you may want to spend the next four months doing exactly what Table 1 tells you to do.

Assuming that youre eating clean (and enough), it would be a real stroke of bad luck if you didnt increase all your major lifts... well, a stroke of bad luck or the inability to recognize that the real "strength explosion" occurs only, when you are reducing volume and intensity of at the end of mesocycle four and the subsequent ignorance towards the worth of layoff phases and weeks of well-deserved rest.

Reference: 

• Astorino, Todd, et al. "Effect of 16 Weeks of Periodized Resistance Training on Strength Gains of Powerlifting Athletes." Journal of Exercise Physiologyonline 17.3 (2014).

Human Study Links High Meal Frequency to Higher Weight Gain and Accumulation of Liver Fat Are Our Sugary Fatty Snacks the Reason We Are Sick Obese

The "average Westerner" is fat. Thats for sure, but is it actually possible that it is the often recommended increase in meal frequency which is to blame for that?

A soon-to-be-published published study from the Academic Medical Centre Amsterdam sheds a whole new light on the role chocolate bars, potato ships, coke and even "healthy" *rofl* fruit juices may play in the etiology of the obesity epidemic (Thanks to reductions in life expectancy and fertility the US prevalence of overweight, obesity, and extreme obesity will plateau at about 28%, 32%, and 9% in 2030; cf. Thomas. 2013)

In a one of a kind human study, the researchers assigned 36 lean, initially healthy men to a 40% hypercaloric diet that was meant to emulate the contemporary food intake of US kids who get ~ 27% of their daily energy intake from high fat and high fat + high sugar snacks.

You can learn more about meal frequency at the SuppVersity

Grazin Bad For the Obese!

Breakfast Keeps You Lean?!

Frequent Protein Consumption

Myth: Few Meals More Bodyfat

8 Meals = Stable, But High Insulin

Int. Fasting & Exercise

Instead of randomly adding a bunch of Snickers bars, Twinkies and DingDongs to the subjects diets, the researchers from the Department of Endocrinology & Metabolism had their subjects consume their "snacks" either with their three main meals, or as a true snack, 2h thereafter:

• Nutridrink Compact ® liquid meal with nutritive value of 240 kcal/100 ml (16% protein, 49% carbohydrates (mainly maltose and poly- saccharides), 35% fat (mainly unsaturated)).
  

  The high-sugar liquids were commercial soft drinks sweetened w/ 50% glucose and 50% fructose and had 43.3 kcal/100 ml.
  HFHS-size group: high-fat-high-sugar (HFHS) diet using Nutridrink Compact ®three times a day, consumed together with the three daily main meals. 
• HFHS-frequency group: high-fat-high-sugar (HFHS) diet using Nutridrink Compact ® three times a day, consumed two to three hours after each meal.
• HS-size group: high-sugar (HS) diet using commercially available sucrose-sweetened beverages three times a day, consumed together with the three daily main meals. 
• HS-frequency group: high-sugar (HS) diet using commercially available sucrose
  sweetened beverages three times a day, consumed two to three hours after each meal.

As you can see in Figure 1, this methodological twist produced quite astonishing results. Results of which the headline of todays SuppVersity article already revealed that they clearly suggest that " that snacking, a common feature in the Western diet, independently contributes to hepatic steatosis and obesity" (Koopmann. 2014).

Figure 1: Changes in body composition and resting energy expenditure on hypercaloric diets with different snacks & meal frequencies (Koopmann. 2014)

What I personally find pretty intriguing is are the intra-group differences in the "sweet beverage group" (high sugar, three meal) which appear to correspond with a phenomenon I hear you, my dear readers complain about pretty often. The complaints about that anonymous extremely lean friend of yours who drinks coke all day and appears to live on bonbons, popcorn and Gatorade and how unfair it is that you cant do just that... but I am digressing.

Eating too much and eating too frequently

In the end, the real news is obviously not that there are purported genetic outliers, but rather that these people are often not at a genetic advantage. In 99% of the cases I know in person, I had to realize that these guys and gals have a funny way of "intermittent fasting". Contrary to the average obese person complaining about his or her "genetic disadvantage", these folks still know the meaning of satiety and mix days with exorbitant energy over-consumption with days on which they skip breakfast, have a snickers for lunch and a regular dinner. Thats certainly not healthy, but it keeps them lean and misleads bystanders and even close friends to assume that they were at a "genetic disadvantage", when the latter is in fact rather the result of eating too much and eating too frequently.

Figure 2: The increases in intra-abdominal fat, visceral fat, subcutaneous fat and intrahepatic fat were significant only in the "Snackers", i.e. those subjects who consumed their high fat + high sugar or high sugar "snacks" in-between meals, but not  in those who simply added them on top of one of their three regular meals (Koopmann. 2014)

I guess before youve have had a look at Figure 2 you may (rightfully) have been asking yourself what all that has go to do with the study at hand. Afterwards, however, you should realize that my previous ramblings were actually not so far off the intriguing insight that " snacking, a common feature in the Western diet, independently contributes to hepatic steatosis and obesity" (Koopmann. 2014) - or, to put it differently: If you combine eating much with eating frequently you blow up like a balloon (or the average Westerner - you decide which image you prefer).

Question: Is this true for protein snacks, as well? In the context of a hypercaloric diet with 40% more energy than you need, the answer is YES! We do in fact have the evidence from human studies: Protein is obesogenic! It may be "less effective" than the nasty combination of sugars and fats used in the study at hand, but if you simply add three 50g whey protein shakes on top of your regular 2,000kcal diet, this will provide a 25% increase in energy in- take and corresponding weight gain. Some of the latter will be muscle - but the chances that you wont accumulate some body fat as well are lower than the allegedly over- estimated increase in cancer risk from chronic mTOR (over-) activation (Zoncu. 2011).

Bottom line: In conjunction with a chronically hypercaloric diet as in the obese, yet not with an "intermittent fasting" + satiety guided snacking regimen as in the purported "genetic outliers" high fat and high sugar snacking does in fact promote the accumulation of unhealthy body and liver fat.

If, on the other hand, the overall energy intake does not exceed the energy demands, chronically. Its a mere question of thermodynamics that the amount of stored energy will not increase. And thats true regardless of the macronutrient composition (the latter will have direct and indirect consequences on the energy expenditure and intake, respectively, though).

Practically speaking the results of the study at hand do thus support the often-cited contribution of chronic anabolism aka diet-induced increases in insulin, IGF-1 and mTOR and put a huge questionmark behind the still often-heard recommendation to consume many small instead of three larger meals, if your goal is to maintain a healthy body fat level. Unlike you belong to the lucky few whose energy thermostat is still intact - the previously referenced "purported genetic outliers" - its easier, safer and healthier not to snack in the hours between your main meals.

References:

• Koopmann, et al. "Hypercaloric diets with increased meal frequency, but not meal size, increase intrahepatic triglycerides: A randomized controlled trial." Hepatology (2014). Accepted Article.
• Thomas, Diana M., et al. "Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends." Obesity (2013).
• Zoncu, Roberto, Alejo Efeyan, and David M. Sabatini. "mTOR: from growth signal integration to cancer, diabetes and ageing." Nature reviews Molecular cell biology 12.1 (2011): 21-35.