If you have spent any time in the fitness arena, then you have surely heard about Branched Chain Amino Acids (BCAAs). Chances are you may have even been using them for some time. In the gym, people rave about the tremendous benefits of BCAA’s. They claim it can promote weight loss, enhance athletic performance and improve recovery. So is it all hype or is there any truth behind their popularity.  Let’s look at the research behind BCAA’s and draw our own conclusions.

So what are BCAA’s? BCAA’s are 3 of the nine essential amino acids in humans. They consist of leucine, isoleucine, and valine.  What makes them so unique is that they make up a very large portion of our muscles. In fact, they account for over one-third of the amino acids in muscle protein.  Out of the 3 BCAA’s, leucine is considered by many to be the most important.  Now before you go rushing for a bottle of BCAA’s, realize that you can get them from eating a nice balanced diet. High concentration of leucine can be found in foods such as beans, eggs, nuts, seeds, soy, whey and whole grains.  Isoleucine is also present in fish, dairy, meats, eggs, nuts and soy protein. Finally, valine can be found in meats, soy, dairy, and nuts.  Bottom line here is that a diet composed of lean meats, dairy products and nuts provides a good source of BCAA’s. Athletes may require supplementation to meet higher demands.

Now let’s turn our attention to the data and see what well designed research studies tell us.  In a small, randomized, double-blind, placebo controlled study, Matsumoto and colleagues looked at taking BCAA’s and their effects on muscle soreness and muscle damage. They measured plasma creatinine kinase (CK), lactate dehydrogenase (LDH) and granulocyte elastase (GEL). These are all markers elevated in muscle damage. The results were quite impressive. The people taking BCAA had a 21 percent reduction in plasma CK, a 6 percent reduction in LDH, and a 15 percent reduction in GEL. All of these reductions were statistically significant. A number of other well designed studies have shown similar results.

In a recent study, Sharp and Pearson took the role BCAA further by looking at testosterone and cortisol levels along with creatinine kinase levels. Using a randomized, placebo control design, they had participants perform high-intensity total-body resistance training. Their findings were in line with previous studies showing lower markers of inflammation (cortisol) and damage (CK). In addition, they also showed that athletes supplementing with BCAA group had significantly higher serum testosterone levels.

In terms of weight loss, there is some interesting data. A nice review by Devkota and Layman showed that supplementing with 2.5 grams of Leucine allows for increased fat loss during dieting while protecting lean muscle mass.  However, Cheng and colleagues showed that mice maintained on a leucine poor diet experienced greater fat loss.  Pedrosa and colleagues showed that supplementing with Leucine did not result in increased fat loss.  So the jury is still out on BCAA’s for weight loss.

The beneficial effects of BCAA’s extend far beyond those of muscle recovery for athletes. A review of 11 randomized studies showed that BCAA supplementation improved worsening of brain function (hepatic encephalopathy) seen in patients with liver damage. In addition, studies have also shown in rat models that BCAA supplementation promotes glucose uptake by cells. Finally, BCAA’s have been shown to stimulate appetite and improve nutrition status in both the elderly and patients on hemodialysis.

So there you have it, the scientific research supporting BCAA for muscle recovery. Go ahead and eat that chicken breast, the egg white omelet, or a variety of delicious foods high in BCAA’s. Your taste buds will be happy and your muscles will thank you.

References:

• -Matsumoto K, et al. Branched-chain amino acid supplementation attenuates muscle soreness, muscle damage and inflammation during an intensive training program. J Sports Med Phys Fitness. 2009 Dec;49(4):424-31.
• -Sharp CP, Pearson DR. Amino acid supplements and recovery from high-intensity resistance training. J Strength Cond Res. 2010 Apr;24(4):1125-30.
• -Glyn El, et al. Excess leucine intake enhances muscle anabolic signaling but not net protein anabolism in young men and women. J Nutr 2010 Nov;140(11):1970-6. Epub 2010 Sep 15.
• -Lee IJ, et al. Effect of Oral Supplementation with Branched-chain Amino Acid (BCAA) during Radiotherapy in Patients with Hepatocellular Carcinoma: A Double-Blind Randomized Study. Cancer Res Treat. 2011 Mar;43(1):24-31. Epub 2011 Mar 31.
• -Nishitani S, et al. Branched-chain amino acids improve glucose metabolism in rats with liver cirrhosis. Am J Physiol Gastrointest Liver Physiol 288:G1292-G1300, 2005.
• -Devkota S, Layman DK. (Commentary). Curr Opin Clin Nutr Met Care. 2010;13:403-407.
• -Pedrosa RG et al. Leucine supplementation favors liver protein status but does not reduce body fat in rats during 1 week of food restriction. Appl Physiol Nutr Metab. 2010 Apr;35(2):180-3.
• -Cheng Y, et al. Leucine deprivation decreases fat mass by stimulation of lipolysis in white adipose tissue and upregulation of uncoupling protein 1 (UCP1) in brown adipose tissue. Diabetes. 2010 Jan;59(1):17-25. Epub 2009 Oct 15.

This is a recipe for “Green Lemonade”. It contains good ingredients for weight loss and immunity. I recommend drinking 8-10 oz/ day if trying to lose weight. All the ingredients can be thrown into a juicer. For an added benefit, you can stir in some Chlorella and Spirulina powder to the drink.

one bunch of kale
one large cucumber
1-2 apples
one small container of blueberries
1/2″ chunk of ginger
juice of one lemon

1. Mississippi 33.8%
2. Alabama 31.6%
3. Tennessee 31.6%
4. West Virginia 31.3%
5. Louisiana 31.2%
6. Oklahoma 30.6%
7. Kentucky 30.5%
8. Arkansas 30.1%
9. South Carolina 29.9%
10. North Carolina 29.4%
11. Michigan 29.4%
12. Missouri 29.3%
13. Ohio 29.0%
14. Texas 29.0%
15. South Dakota 28.5%
16. Kansas 28.2%
17. Pennsylvania 28.1%
18. Georgia 28.1%
19. Indiana 28.1%
20. Delaware 27.9%
21. North Dakota 27.7%
22. Iowa 27.6%
23. Nebraska 27.3%
24. Alaska 26.9%
25. Wisconsin 26.9%
26. Illinois 26.6%
27. Maryland 26.6%
28. Washington 26.3%
29. Maine 25.8%
30. Arizona 25.8%
31. Nevada 25.6%
32. Virginia 25.5%
33. Minnesota 25.5%
34. New Mexico 25.5%
35. New Hampshire 25.4%
36. New York 25.1%
37. Florida 25.1%
38. Idaho 25.1%
39. Oregon 25.0%
40. Wyoming 25.0%
41. California 24.4%
42. ew Jersey 23.9%
43. Montana 23.5%
44. Utah 23.2%
45. Rhode Island 22.9%
46. Vermont 22.8%
47. Hawaii 22.6%
48. Massachusetts 21.7%
49. D.C. 21.5%
50. Connecticut 21.4%
51. Colorado 19.1%

It is interesting to see Mississippi top the list for the sixth year in the row.  In fact, according to Adds Marion Nestle, a Professor of Nutrition, at Food Studies and Public health at New York University, “States with highest obesity rates are in rural south where poverty especially rural poverty is a huge problem. The states with lowest rates are in areas with lots of outdoor recreation areas but also where the population is better educated and wealthier.”

So the question is what can we do curb this epidemic. The answer is a complex one but here is my take on it.

• First, increase education on the benefits of exercise starting with our children.
• Second, add and improve physical education back in schools. Too many school are cutting back on exercise due to budget deficiencies.
• Add exercise to the workplace. Given incentives to employees for working out. Have friendly competitions like 10,000 steps a day program where people walking the most steps get a small prize for their department
• Regulate marketing of junk foods to kids
• Educated physicians on importance of exercise and encourage them to bring it up to their patients on every visit.
• Create inexpensive group exercise programs in communities for different age groups.
• Teach people simple ways to eat better
• There are so many so-called experts out there who have an opinion on every idea but all I have to say is that we need change. Change begins with us so I leave you with this incredible quote from Mahatma Gandhi, “be the change you want to see in the world.”
• Do you have an idea on how to change the epidemic, let me know and I will add it to this list. Let’s start the fitness revolution!

After three months of monitoring, the researchers found that women in the milk group lost more body fat and gained more lean muscle then the control group drinking sugar-based energy drinks. So what is about milk that helped with the body composition change? Previous studies have already shown that calcium and whey protein can help with fat loss and both of these are found in milk.

Bottom line: Milk is a great source of calcium and protein and now there is one more reason to drink it. If you can’t drink milk, there are other sources of calcium such as tofu, soybeans, instant oats. Other protein sources include chicken breast, fish fillets, tuna, egg whites, soy milk, tofu, and nuts.

References:

Josse, A. American College of Sports Medicine, pp 1122-1128.

American Journal of Clinical Nutrition, Vol. 86, No. 2, 373-381, August 2007

Now here is the problem with this study, there were only 51 participants enrolled. More importantly, only 33 completed the study. 800cal/day is an extremely difficult diet to follow.

So bottom line…

Does DCT help with weight loss? Possibly by increasing metabolism.

Is it a miracle cure for weight loss? Definitely not.

Refernce:

Lee TY, Zerlin A, Thames G, et al. Effects of dihydrocapsiate on diet-induced thermogenesis following 4 weeks of very low calorie dieting. FASEB Journal. 2010(24).

Q: Does soy have antinutritional properties that can decrease the absorption of metals and other minerals.
First of all it is important to remember that soy has been used as a staple food in many regions for over 5000 years. That being said, there is some evidence to show that protease inhibitors found in soy can cause pancreatic hypertrophy/hyperplasia in experimental models (rats!). Lectins in soybeans can bind glycoprotein receptors on epithelial cells lining intestinal mucosa and interfere with absorption of certain nutrients. There may be slight increase in requirements of Vitamins A, B12, D, E. High levels of dietary trypsin inhibitors from soybeans can cause reductions in protein and amino acid digestibilities in rats and pigs. But the real question is does this matter. Well if you are an infant, elderly, or otherwise malnourished individual than the answer is yes. However, for healthy individuals, these antinutritional compounds will not significantly harm you.
References:
• Liener IE. Implications of antinutritional components in soybean foods. Department of Biochemistry, College of Biological Sciences, University of Minnesota, St. Paul 55108-1022.
• Gilani GS, Cockell KA, Sepehr E. Effects of antinutritional factors on protein digestibility and amino acid availability in foods. J AOAC Int. 2005 May-Jun;88(3):967-87.

Q: Is it true that soy protein’s naturally occurring phytoestrogens don’t prevent heart disease but cause a host of estrogen-related diseases?
A: Soy has not been proven to affect long-term cardiovascular outcomes such as heart attack or stroke. There are randomized control trials to show some effect on total cholesterol and LDL (bad cholesterol). However, according to the American Heart Association (2006): “No benefit is evident on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure”.
References:
• Cholesterol-lowering effect of plant sterols. Curr Atheroscler Rep. 2008 Dec;10(6):467-72.
• Soy Protein, Isoflavones, and Cardiovascular Health. Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1689.

Q: Does soy products cause goiters and other thyroid problems?
A: Data on soy reveals no adverse effect on thyroid function in adults. Some people confuse these studies with the ones that showed taking a thyroid hormone like synthroid with soy products can decrease the absorption of synthroid. This once again is not the same as saying soy causes hypothyroid.In children, soymilk can cause decrease in thyroid stimulating hormone. Also, infants fed soy milk may have slightly higher incidence of atopic eczema then fed breastmilk.
References:
• Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid 2006 Mar;16(3):249-58.
• Bell DS, Ovalle F. Use of soy protein supplement and resultant need for increased dose of levothyroxine. Endocr Pract. 2001 May-Jun;7(3):193-4.

Q: Does soy cause rather than prevent cancer?
A: This is a tough question. There are plenty of trials showing protective effects of soy in tumor growth (in animal models ONLY) and case control studies showing populations with high soy intake having low cancer rates. HOWEVER, there is no evidence to state soy treats cancer! In fact, there is some data saying that in the short term certain soy isoflavone like genistein can have a stimulatory effect on breast cancer cells. Therefore I CANNOT recommend soy for any patient who either currently has cancer or has had cancer in the past. However, I do recommend soy and soy-based products as part of a balanced lifestyle for healthy, cancer free patients.
References:
• Gallo D, Zannoni GF, De Stefano I, et al. Soy phytochemicals decrease nonsmall cell lung cancer growth in female athymic mice. J Nutr. 2008 Jul;138(7):1360-4.
• Do phytoestrogens reduce the risk of breast cancer and breast cancer recurrence? What clinicians need to know. Eur J Cancer 2008 Sep;44(13):1799-806. Epub 2008 Jul 7.
• Soy isoflavones and their bone protective effects. Inflammopharmacology. 2008 Oct;16(5):213-5.

• Haagen-Dazs Sticky Toffee Pudding => 1/2 cup = 300 calories
  • Activity needed: 55 minutes of golf, carrying clubs
• Haagen-Dazs Fat-Free Raspberry Sorbet => 1/2 cup = 120 calories
  • Activity needed: 22 minutes of golf, carrying clubs
• Plain bagel=> 1 bagel = 320 alories
  • Activity needed: 88 minutes of ballroom dancing
• Regular cream cheese => 1 tablespoon = 45 calories
  • Activity Needed: 37 minutes of sitting, watching TV
• Lay’s Classic potato chips => 1 oz. = 150 calories
  • Activity needed: 16 minutes of running at 5mph
• McDonald’s Caesar salad, no dressing => Full salad = 90 calories
  • Activity needed: 20 minutes walking at 3.5mph
• Newman’s Own Creamy Caesar Dressing => 2 tablespoon = 170 calories
  • Activity needed: 37 minutes at walking
• Dunkin Donuts corn muffin => 1 muffin = 510 calories
  • 70 minutes of shoveling snow
• Celery, medium stalk => 1 celery = 10 calories
  • 9 minutes of sleeping

Looking at the above list, a couple of things really stand out. For an average 160lb male, 20 minutes of walking at 3.5mph ONLY burns 90 calories. Thus, after a brief 30 minute walking session, you have only burned 135 calories. That’s not much if you are working towards losing weight. Remember, you need a 3500 calorie deficit to lose 1lb. Likewise, running at 5mph for 30 minutes burns only about 280 calories. That’s not even enough to burn off the bagel you had in the morning. So remember, the amount and type of food you eat is extremely important when it comes to losing weight and getting healthy.

Reference:
Website: http://www.consumerreports.org/health/healthy-living/diet-nutrition/diets-dieting/snacks/overview/work-off-a-snack-ov.htm; Accessed Jan 2009.

Okay so let’s start with the worst offenders:

1. Golden Crisps (Kellogg’s): Each serving contains more sugar than a Dunkin’ Donuts glazed doughnut. 15 grams of sugar to be exact.

2. Honey Smacks (Kellogg’s): This one was no better. It had 14 grams of sugar per ¾ cup serving.

3. Apple Jacks (Kellogg’s) had 12 grams of sugar, 1 gram of fiber, and 135mg of sodium per 1 cup serving.

4. Froot Loops (Kellogg’s) had 12 grams of sugar, 1 gram of fiber, and 135mg of sodium per 1 cup serving.

5. Corn Pops (Kellogg’s) had 12 grams of sugar, 1 gram of fiber, and 135mg of sodium per 1 cup serving

6. Captain Crunch (Quaker Oats) had 12 grams of sugar, 1 gram of fiber and 200mg of sodium per ¾ cup serving

7. Captain Crunch’s Peanut Butter Crunch (Quaker Oats) had 9 grams of sugar, 1 gram of fiber, 200mg of sodium per ¾ cup serving

Now there is something very interesting in the above list. 5 out of the 7 cereals are made by Kellogg’s. In response to this report, Kellogg’s released the statement that the company had recently reformulated five of its cereals (Froot Loops, Corn Pops, Rice Krispies, Cocoa Krispies, and Apple Jacks) to make them healthier choices. However, Consumer Reports article states that even with this reformulation, the five cereals would still score poorly in nutrition rating compared to the other choices.

Before we decide to give up cereal forever, there is some good news. 4 of the 27 tested cereals were labeled as “Very Good” breakfast choices due to their low sugar (< 9 grams) and sodium (<210 mg) content. In addition, all 4 cereals had greater than 2 grams of fiber. Alright, drum roll please.

1. Cheerios (General Mills) had ONLY 1 gram of sugar, 3 grams of fiber and 190mg of sodium. This also happened to be my favorite in college.

2. Kix (General Mills) had 3 grams of sugar, 3 grams of fiber, and 210 mg of sodium.

3. Life (Quaker Oats) had 6 grams of sugar, 2 grams of fiber, and 160mg of sodium.

4. Honey Nut Cheerios (General Mills) had 9 grams of sugar, 2 grams of fiber, and 190 mg of sodium.

The bottom line behind this article is that you do have some healthy choices when it comes to cereal for both you and your children. So the next time you are in the grocery store, put the Kellogg’s cereal down and reach for some good old plain Cheerios. Your heart will thank you for it!

To answer this question, let’s turn to most comprehensive evidence we have available so far.  In a recent meta-analysis, the Cochrane group looked at a total of 67 trials with 232,550 total participants.  Included were forty-seven trials with 180,938 participants that had a low risk of bias (adequate randomization, blinding and follow-up), twenty-one trials with 164,439 healthy participants, and forty-six trials with 68,111 participants with various diseases (gastrointestinal, cardiovascular, neurologic, ocular, dermatologic, rheumatoid renal, endocrinologic or other).

The results of these trials showed no beneficial effects on mortality (RR = 1.02; 95% CI, 0.99-1.06).  In fact, the trials with low risk of bias showed significantly INCREASED mortality (RR= 1.05; 95% CI, 1.02 to 1.08) in the participants taking antioxidants.  When the different antioxidants were assessed separately, INCREASED mortality was seen with Vitamin A (RR = 1.16; 95% CI, 1.10-1.24), beta-carotene (RR = 1.07; 95% CI, 1.02 to 1.11) and Vitamin E (RR = 1.04, 95% CI 1.01 to 1.07), and no detrimental effect with selenium (RR = 0.91; 95% CI, 0.76 to 1.09) or Vitamin C (RR = 1.06; 95% CI  0.94 to 1.20).  However, please review my other post about how Vitamin C is NOT effective for the common cold.

The bottom line is that the authors found NO evidence to support the use of antioxidants. In fact there was some evidence that excess intake of Vitamin A, E and beta-carotene may increase your chances of dying.  The current guidelines from the American Heart Association and U.S. Preventive Service Task Force are to eat a diet high in fruits and vegetables as a natural source of antioxidants.  There is no recommendation for adding supplements to your diet.  So please stop spending your money on unnecessary and potentially harmful supplements and just stick to a balanced diet. Your body will thank you for it.

References:

• Kris-Etherton PM, Lichtenstein AH, Howard BV, Steinberg D, Witztum JL, for the Nutrition Committee of the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Antioxidant vitamin supplements and cardiovascular disease. Circulation. 2004;110(5):637-641.
• Website: http://www.cochrane.org/reviews/en/ab007176.html; accessed 12/08