Supplement Review: "VolcaNO"

I figured it was time, yet again, for a supplement review, and today's pick certainly has a tall order to fill. VolcaNO, by Force Factor, supposedly does the following (Description from GNC.com):

"You’ve undoubtedly heard of L-citrulline, creatine, and agmatine, but you’ve likely never seen all three in a single pre-workout supplement. That’s because VolcaNO is one of the first of its kind- different from any formula ever developed. The unrelenting combination of red-hot muscle-building power ingredients is what sets VolcaNO apart from the competition.

As soon as you take VolcaNO, the rock-crushing blends get to work igniting the production of nitric oxide in your body. Like gasoline poured on a fire, L-citrulline is the primary catalyst for nitric oxide creation in VolcaNO. As your body produces more nitric oxide, your endurance will start to climb, and your strength and power will increase to help you blast through to your last rep. 

The second core ingredient in VolcaNO is CON-CRET®, a revolutionary form of creatine. Creatine delivers serious energy and power to help you get the results you want in the gym. It usually comes in bulky powders that require you to drink a lot of water right before your workout, but CON-CRET is ultra-concentrated, finally making it possible to get the strength, endurance, and muscle gains you’re craving, without that sloshy, bloated feeling.

Rounding out the formula agmatine, and for good reason. Naturally synthesized by your body, this super-ingredient is quickly becoming a key part of many weightlifters’ routines. 

The benefits of VolcaNO boil down to a simple equation: smart science plus cataclysmic ingredients equal an unbeatable transformation in the gym. VolcaNO sets a new standard for pre-workout supplements. When you feel the raw power ready to erupt inside you, you’ll understand why VolcaNO is the most intense nitric oxide booster you’ve ever tried." [1]

If that's not a lot of hype, then the sky isn't blue!

Seriously, though, VolcaNO's creators make a number of claims that only beg for skepticism. But let's not jump to any conclusions just let. As usual, we must let the research speak.

What Are These "Red-Hot Muscle-Building Power Ingredients?"

VocaNO contains the following: 

• arginine alpha-ketoglutarate (AAKG)
• L-Citrulline
• Agmatine Sulfate
• L-Norvaline
• Creatine HCl
• L-Methionine
• L-Glycine

I'll investigate each of these ingredients in order.

arginine alpha-ketoglutarate (AAKG) [2]

AAKG supposedly causes an increase in nitric oxide production, leading to increased vasodilation during weight training. In other words, it should result in you getting a better "pump" and improved blood flow while lifting weights. It should come as little surprise that better blood flow will result in the increased delivery of oxygen and other nutrients to your muscles. These benefits, however, are nothing but theoretical as of now. Little research actually exists that shows AAKG actually results in increased nitric oxide production, let alone increased vasodilation. One study by Willoughby et al. revealed that AAKG had no observable effects on heart rate, blood pressure, blood flow, nitric oxide metabolites, or asymmetric dimethyl arginine beyond what could be attributed to resistance training alone. It should be interesting to note that the body has self-regulatory feedback systems. When the body detects abnormally high levels of nitric oxide, it immediately begins a cascade of events whereby nitric oxide levels are reduced.

In short, AAKG is NOT "proven" to do much of anything. Any benefits are speculative at best.

L-Citrulline [3]

L-citrulline is an amino acid found naturally in food--particularly in watermelon. It is often used for Alzheimer's, dementia, fatigue, muscle weakness, sickle cell, erectile dysfunction, high blood pressure, diabetes, heart disease, bodybuilding, increased energy, and improved athletic performance--insufficient evidence exists to support its effectiveness with regards to any of the aforementioned. In terms of improved athletic performance specifically, some evidence actually reveals that L-citrulline leads to quicker exhaustion from exercise!

Agmatine Sulfate [4]

Agmatine is considered a neurotransmitter and neuromodulator. Evidence thus far reveals that it has potential to be used in the treatment of drug addiction and neuropathic pain. It may also protect the brain from toxins and strokes. Most of the research on agmatine has been done with animals, and what few human trials we do have reveal that agmatine may be effective when injected; however, there is insufficient evidence for its effectiveness as an oral supplement. 

Agmatine actually does not pair well with L-citrulline due to some neurological effects that result from their combination. Something else to keep in mind is the fact that agmatine may inhibit the production of nitric oxide--the very substance that VolcaNO is advertised to produce!

L-Norvaline [5]

L-norvaline is purported to inhibit the production of arginase (an arginine inhibiting enzyme). L-arginine is a precursor to nitric oxide, thus it is proposed that L-norvaline will lead to an uninhibited increase in nitric oxide; however, no evidence as of yet exists to suggest that this is in fact the case.

Creatine HCl [6]

Creatine hydrochloride is yet another "new and improved" form of creatine. However, like most permutations of good old creatine monohydrate, creatine hydrochloride is in fact no better than its monohydrate cousin. The chemical structure that distinguishes creatine hydrochloride from monohydrate is negated by stomach acid, which breaks creatine hydrochloride into the basic creatine molecule. On the plus side, creatine hydrochloride is more water soluble than creatine monohydrate (However, to be honest I've never had much issue mixing creatine monohydrate in liquid). On the negative side, creatine hydrochloride is more expensive per serving than creatine monohydrate.

Some of the purported benefits of creatine hydrochloride, such as no need for a loading phase, no water retention, etc. are backed up by little evidence. There is in fact no need to "load" creatine monohydrate. Moreover, water retention is in fact one of the positives of creatine--without water retention, creatine would not be effective.

L-Methionine [7]

L-methionine is an amino acid found naturally in meat, fish, and diary, and it plays an important role in several cell functions. It is possibly effective for preventing liver damage in the instance of acetaminophen overdose, but insufficient evidence exists to demonstrate its effectiveness at treating various other ailments.

L-Glycine [8]

L-glycine may work for treating schizophrenia, leg ulcers, and stroke. Little evidence, however, exists to suggest that it is effective at doing much else.

The Overall Verdict

There is little solid, peer reviewed evidence that suggests any of VolcaNO's ingredients will do what its manufacturers promise. Some of the ingredients are benign, while others actually cancel each other out. The effectiveness of nitric oxide producing supplements is still speculative. Thus far we only have some shining consumer reviews--however, the question of whether these reviews are representative of legitimate physiological effects or of psychological effects (aka, placebo) is still up in the air. 

The only possibly effective ingredient--in my book at least--would be the creatine hydrochloride, which for all intents and purposes is likely just as effective as creatine monohydrate. I think you would do well, however, to simply take creatine monohydrate. Most of the research to date on creatine has been done with creatine monohydrate, and said research has revealed little but effective results. Creatine monohydrate is also dirt-cheap compared to creatine hydrochloride.

Oh, and by the way, though creatine can be effective when taken pre-workout, research by Antonio J., and Ciccone V. demonstrates that creatine is way more effective when taken immediately post-workout [9].

Here's what I suggest you do. Skip the VolcaNO, and just take some caffeine pre-workout. Plenty of evidence suggests that caffeine effectively enhances workout performance (the same cannot be said for VolcaNO). 

Coffee is literally my answer for everything.

Controlled vs Uncontrolled Diets - Which Is Best?

A great debate of sorts has been brewing for quite some time--a debate regarding whether calories matter or food choice matters. When it comes to losing weight/maintaining a healthy weight, all sorts of people believe in all sorts of methodologies and philosophies. Continue reading to discover mine.

Context Matters

I've stated many, many times on this site that energy balance is the ultimate determinant of whether a person will gain, maintain, or lose body mass. Despite what many people purport, a low carbohydrate diet will not lead to weight-loss in the context of a caloric surplus; and neither will a low fat diet. Both the low carb camp and the low fat camp believe in mistaken understandings of how the body metabolizes incoming energy from food. The low carbers mistakenly think that when little to no carbohydrate are present in one's diet, insulin will hardly be produced, and since insulin causes fat storage, no fat will be stored in the context of a low carb diet. The logic here is absurd!

The body has various non-insulin dependent pathways by which it can store fat. Moreover, when you do consume carbohydrate, and thus have an insulin spike, that carbohydrate itself is less likely than whatever dietary fat you consumed with said carbohydrate to be stored as adipose tissue. Much to the low carbers chagrin, dietary fat is in fact the nutrient most easily stored as body fat.

This is not to say, however, that the low fat dieters are right. Yes, dietary fat does more often than not get stored as adipose tissue; but, whether or not said fat remains stored in the long term is a matter of energy balance. Energy balance is the key, and anyone who says otherwise better provide a comprehensive, intensive, and downright compelling case based upon quality scientific research if they wish to make claims to the contrary.

How Quality Food Choices Work

Certain diets, such as Atkins, Primal Blueprint, Vegan, etc., often have loyal followers for one very important reason: People have succeeded with these diets. While variations in macronutrient ratios abound with such diets--and thus the physiological effect of each varies--, these diets often lead to weight-loss because they restrict food choice in some way, thus curtailing the variety of foods one can eat, causing a spontaneous reduction in ad libitum calorie consumption.

This curtailment of variety is often bolstered by a simultaneous improvement in the quality of foods eaten. Fruits, veggies, whole cuts of meat, eggs, fish, plain potatoes, properly treated legumes and grains, etc. are far more filling and less hyper-rewarding than most foods that are typical of the standard American diet (SAD). By eliminating SAD foods from one's diet, and by replacing these foods with high quality fare, people often see drastic improvements in their health, in their body composition, and in their quality of life.

How "If It Fits Your Macros" (IIFYM) Works

IIFYM is a certain philosophical approach to dieting that entails unrestricted food choice, moderated by targeted macronutrient numbers and calories. So long as the foods you eat fall in line with the quantity of protein, carbohydrate, and fat you have allotted to you, you can virtually eat whatever food you want.

People often berate the IIFYM approach for being too laissez-faire in regards to food choice. These people's concerns are well founded. Many people who utilize this approach will often make some pretty questionable food choices, such as eating nothing but Big Macs, ice cream, and Lucky Charms. This is not to say, however, that this method does not lead to improvements in body composition.

As it should turn out, those who use IIFYM have provided thousands of anecdotal case studies that reveal that the quality/healthfulness of food choice has very little, if any effect upon short term changes in body mass. People using this method have shown us that, indeed, a diet composed of Big Macs, ice cream, and Lucky Charms can lead to a "beach-ready-body."

Finding a Balance

Uncontrolled food quantity can work for weight loss only when mediated by controlled food quality. Uncontrolled food quality can work for weight loss only when mediated by controlled food quantity. Both methods have their downsides and their upsides. With the former, you have to closely watch what you eat and make indulgences in SAD foods a rarity. With the latter, if you don't give at least some concern to the quality of the food you're eating, you could incur various nutritional deficiencies in the long term, despite looking incredibly lean and healthy.

In my opinion, both of these methods will work, but a hybrid of the two might work best. By controlling food quality, we can ensure that our long term health is taken care of. By controlling food quantity, and by using a targeted macros approach, we can ensure that our diet supports our performance and/or physique goals in the short term.

Pick Your Poison

Not everyone has the same goals, and not everyone has the same psychological response to food. Some people may find the incorporation of IIFYM a hindrance to the convenience of their lives. IIFYM may also lead to OCD behaviors in some individuals whereby they become obsessed with tracking their diet to absurd ends. For these people, monitoring their food choice will likely work best.

For others, the hybrid option may work very well. Once again, however, we must remain cautious of incurring OCD behavior. Moreover, we must be careful to avoid the development of orthorexia (a mental disorder entailing an unhealthy and extreme preoccupation with eating healthy foods). For people who may have a propensity to develop orthorexia, IIFYM may actually work best.

Ultimately, you must take personal responsibility for assessing what method will work best for you. Remember, the best diet in the world is the one that you will follow.

A New Study Suggests 2 Meals/Day Is Best for Weight-loss in Diabetics: Let's Have a Look-See

The question of "what is the optimal meal frequency for weight-loss?" seems to never go away. Most of the evidence regarding the specific effects of high vs low meal frequency is inconclusive. Therefore when I came across the below study that seemed to indicate that meal frequency might very well play a critical role in helping people lose fat, I was understandably skeptical. Thus far, all we can really say with any amount of tentative certainty is that (1) neither a high nor low meal frequency effect diet induced thermogenesis, total energy expenditure, or resting metabolic rate, and (2) neither a high nor low meal frequency yield favorable changes in body composition in sedentary populations [1]. In regards to meal timing, some evidence suggest that being consistent/regular about when you eat--independent of meal frequency--may improve fasting lipid and postprandial insulin profiles and may have beneficial effects on thermogenesis [2]. Being haphazard about your meal timing, however, can have not-so-pretty effects, resulting in lower postprandial energy expenditure thus leading to increased fat mass, independent of increased calorie consumption [3].

Study: Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study [4]

At first glance, this study seems promising. It has the makings of a truly influential bit of research. Upon further inspection, however, the actual data collected by the authors rather underwhelmed me. But before I go all pessimistic on you, let's break down what the researchers/authors of this study did.

Study Design

The authors used a "randomized cross-over study design." Participants were randomly assigned, via a computer algorithm, to 1 of 2 groups: One group consumed six meals/day (A6) (breakfast, lunch, diner, and 3 snacks) while the other group ate two (B2) (breakfast and lunch). Half way through the trial, the meal frequencies of the groups were switched. 54 people (all diabetic with BMIs between 27-50; ages ranged form 30-70) participated in the study. Seven of these participants dropped out before the study concluded--nevertheless, the results of these seven were included in the authors' analysis. The trial lasted 12 weeks.

Diet Composition

Each person participating in the study was fed a controlled diet wherewith all participants would be in a daily caloric deficit of about 500 calories. 50-55% of the participants' calories came from carbohydrate, 20-25% came from protein, and 30% came from fat. Half of all participants were picked at random to have their food pre-prepared for the duration of the trial. The other half had to prepare their own meals, keeping these meals consistent with the dietary guidelines set by the researchers.

Results

The authors' data showed that both the A6 and B2 regimens resulted in weight-loss; though the B2 regimen resulted in a greater amount (-3.7 kg for B2 vs 2.3 kg for A6). B2 also resulted in a greater loss of hepatic fat content (liver fat) (-.04% vs -.03%). Fasting plasma glucose and C-peptide levels decreased more with B2 (fasting plasma glucose actually increased with A6--not a good sign). Both groups saw an improvement in oral glucose insulin sensitivity; though, guess what?: B2 yielded a better improvement.

Considerations

Critique of Diet

• The participants of this study were diabetics. It therefore makes no sense to me why the researchers assigned them to a diet wherein 50-55% of their calories were derived from carbohydrate! The fact that this diet was carb-rich may have influenced the data. A high carb, six meals/day regimen is not inherently a diabetics best friend. 
• Diabetes results in impaired carbohydrate metabolism, and exposing those with this condition to frequent feedings of carbohydrate would obviously yield not-so-superior results. It makes sense, then, why the two meals/day regimen yielded marginally better results than the six meals/day regimen. Yes, those eating two meals/day had higher levels of carbohydrate to contend with when they did eat, but they also had less frequent feedings of carbohydrate overall. In my book, chronic stressors will more often cause problems than will acute stressors.
• While half of the subjects had their meals pre-prepared, the other half were responsible for their own meals. It is therefore hard to say whether or not this half adhered faithfully to the diet parameters.
• I would like to see what would happen if this study was conducted again; though with a lower carbohydrate protocol.

Critique of the Results

• Aside from the fact that the six meals/day regimen resulted in slightly worsened fasting insulin, both regimens resulted in weight loss, decreased hepatic fat content, and increased oral glucose insulin sensitivity. 
• Calories matter--even for diabetics--however, I think those with diabetes, because of their damaged metabolic condition, ought to pay close attention to the frequency and timing of carbohydrate consumption.
• Once again, the macrocomposition of the diet may have influenced the results of this study.
• The authors more rightly might have concluded that, in the context of a high carbohydrate hypocaloric diet, diabetics can better handle two large (and less frequent) carbohydrate feedings/day than they can handle six smaller (and more frequent) carbohydrate feedings/day.

Conclusion

The results from this study certainly are intriguing, however these results may reflect something entirely different from what the authors conclude. Meal frequency per se may not be the real factor that diabetics ought to take into the most consideration. Rather, the frequency of insulin spikes may be the more pertinent issue that those with diabetes need to consider. I'm merely speculating, but I think this is an hypothesis worthy of future investigation. 

What You Can Survive Does Not Reflect What You Can Achieve

"What we [are] capable of surviving doesn't automatically equate to what we as a species are capable of achieving in terms of optimal health."

- Alan Aragon

Humans are opportunists, we're omnivores, we're pretty darn scrappy. As evinced by the wide variety of ecosystems, diets, and lifestyles within which the human species has managed to call home, we can generally infer that the task of trying to uncover the bare-bones makeup of the optimal human diet is a daunting one at best. What sort of foods are humans most adapted to eating? What ratio of macronutrients should we incorporate into our diet so as to best mimic the dietary habits of our ancestors? Anthropological and archaeological data abound, yes, but ultimately, we must rely upon best-guesses and conjecture regarding the distant past in order to come to practical conclusions which we can apply in the present, and in the future. While I agree with many of the tenants of the paleolithic/ancestral diet, the reality is that we can never know what foods our ancestors truly ate; unless, of course, new scientific tools are created which can allows to see into the past. Until such a time arises, educated guesses and the following question are all we have: What does it look like to achieve optimal health vs to survive?

Surviving

Many in the paleo movement like to assert that the diets of our ancestors, prior to the creation of agriculture, represent the panacea of optimal human health. To their benefit, there does exist fossil evidence which suggests that hunter-gather societies exhibited greater health, strength, stature, bone density, dental health, lifespan and vitality, than the agrarian societies which proceeded them (1). Moreover, ethnographic data from modern-day non-Westernized, non-industrialized hunter-gather societies reveals than many of these groups which still subsist upon traditional foods (wild game, fish, fruits, tubers, roots, vegetables) are notably free of most all Western diseases of affluence--i.e., diabetes, obesity, heart disease, hypertension, etc. (2). Staples of the Western diet, particularly the American diet, such as breads, industrial seed oils, flower products, "Franken-meats," and factory produced hyper-rewarding foods are also absent from the diets of these groups.

But what of this? These groups are noticeably healthier than most Americans, but we in America actually have longer lifespans. We must of course consider the fact that our longer lifespans are more or less a product better medical services. If we suffer from diabetes, we have insulin shots. If we break a bone, we have topnotch medical professionals who can take care of us. In hunter-gather societies, no such medical services are widely nor readily available. A broken leg, which is something we in America usually consider a recoverable ailment, could represent a permanently crippling injury for a non-industrialized person.

What we see in this distinction is a notable example how the unavoidable balancing act of cost-reward can play out. The technological advances which we have experienced within Western society have arisen much in part because of the efficiency with which modern industry has revolutionized our method of calorie acquisition. Industrial food production has freed many people within our society from the time-consuming need to hunt and gather their food. People can freely follow intellectual pursuits. Music, science, theology, philosophy, technology, all of these things would have been impossibilities without the advent of agriculture. Moreover, the more recent advent of industrialized agriculture has made such pursuits all the more possible. Are not such innovations achievements? Haven't we gone beyond the need to merely survive?

Achievement is, however, relative. While we humans have made great technological advances, do these advances reflect an improvement in our condition? Sedentary lifestyles are the norm, and the fact that such a lifestyle is the norm reveals how truly affluent we have become. Our hunter-gather ancestors were true specimens of strength, power, and endurance. They were of a caliber that would rival that of our most skilled Olympic athletes (3). But, their prowess resulted from necessity. By all accounts, most of us today are physically unimpressive--I don't mean unimpressive in terms of aesthetics solely, but unimpressive in terms of our health.

Our bodies reflect the environment in which they've been placed. An environment in which 9-5 desk jobs reign supreme, congested traffic is the norm, late-night TV beckons, and fast food sustains, molds its inhabitants with such habits which are most naturally suited to allow for efficient survival in said environment. Our ancestors lived in an environment much different from ours. Theirs was one of intense physical bursts, ours is one of chronic mental endurance. Theirs was filled with times of scarcity and times of abundance, ours is filled with never-ending overabundance. Theirs necessitated strength, power, and flexibility, ours necessitates physical therapy, surgery, and pills. Yes, we have achieved much with the advent of mass industry, but we have lost much as well.

Achieving

The best course of action, in my opinion, is to recover what we've lost (our strength, power, endurance, health, vitality) all the while preserving what we've gained (civilization). Simply put, we need to eat more whole foods and traditionally prepared foods, we need to get off our butts, we need to lift progressively heavier objects, we need to sprint, we need to go to sleep at a decent hour, and we need to stop being chronically stressed out by the trivial minutia which invariably crops up in our lives. All of these things represent actionable practices which will in no way, shape, or form endanger our "Progress"--whether Progress is any such real thing which we have achieved/are achieving is a long, though interesting philosophical debate which I don't care to go into at the moment. When we start enacting these practices, we will create for ourselves a new environment, and we will be molded by it and thus inculcated with new habits which will allow us to effortlessly and efficiently survive in it. But, we will not have reached "achievement."

We will have truly experienced achievement when we have made this abundant and vitalized life a reality for everyone. We do not put ourselves on the path to achievement when we set about living healthful lives in the midst of our affluence. Rather, we put ourselves on the path to achievement (Progress) when we recognize that while we are dying from being overfed, millions are dying from starvation. This is the great irony of the health crisis in America. We eat a lot of "bad" food, but the not-so-fortunate eat a lot of no food. We will have "achieved" the greatest good when we stop thinking about our "right" to health and, rather, start considering and acting upon our responsibility to help the unhealthy (whether they are overfed or underfed).

Calories vs Macros--How Do People Really Get Fat?

The fitness industry is overflowing with hyped up conjecture regarding the mechanism of fat gain. Some blame carbs, others blame fat, and still others blame calories. There are even those who claim that our food choices are what truly bear the full responsibility for fat gain. What gives?! Are we really so much in the dark about what's going on inside our bodies that we can't arrive at any meaningful consensus about the physiology and psychology of obesity?

Money Talking

It doesn't require a stretch of the imagination to suggest that the sea of confusion flooding the media and bookshelves everywhere has at its source money, money, money! Back in 2012, nearly $20 billion were made in revenue for the weight-loss industry (1). People everywhere seem to be capitalizing on the money flow; and herein lies the crux of the confusion. Often times (but not always) bestselling authors and fitness gurus are more interested in helping themselves to your checkbook than in helping you. Don't get me wrong, there are some people out there who legitimately want to help, but there are way, way more people whose desires are not so benevolent. 

The malevolent know that shiny new products sell. They know that consumers need to feel like they're being let in on a "secret"; and a powerful secret at that; one which no one in the mainstream yet knows of, and one which will make (insert desire here) become a reality.

Given the above, I think the real reason for all of the mass confusion about which foods, exercises, and lifestyle practices lead to health appears clear. People in the fitness industry are trying to outmaneuver--out secret--their competition. And many of these same people are making bank in the process.

Physiology Talking*

The reality of fat gain is multifaceted. Broadly speaking, however, a caloric surplus is ad rem a major culprit in the obesity epidemic. However, having an informed understanding of the underlying physiological mechanisms of fat accumulation can go a long way in upping the performance of your BS-detector.

Hierarchy of Fuel Oxidation

Calories are not just calories but are rather composed of various macronutrients: fat, carbohydrate, protein, and alcohol. Each of these macronutrients is metabolized in a way unique from the others, especially as regards storage and relative thermic response (RTR).

• Alcohol
• Storage - There is no storage mechanism for alcohol. It is a toxin, and it must be immediately eliminated once ingested. It therefore takes first precedence above all other macronutrients regarding its disposal. The body will preferentially oxidize (burn as fuel) alcohol and thus suppress the oxidation of all other macronutrients (especially fat) as long as alcohol remains in the system.
• RTR - Highest of all macronutrients in order to ensure the alcohol is quickly and efficiently oxidized.
• Protein
• Storage - There is no formal storage mechanism for protein; though there is a circulating pool (reserve) of amino acids in the blood. Though there are physiological pathways by which protein can be converted into fat, the conversion efficiency is only 66%; whereas its efficiency in contributing to the synthesis of new muscle tissue is is 86%. Protein can also, via de novo gluconeogenesis, be converted into glucose. These metabolic conversions rarely occur under normal circumstances however.
• RTR - Very high due to the necessity of removing and excreting the nitrogen component of excess protein in order to preserve proper acid-base balance and prevent excessive ammonia concentrations.
• Carbohydrate
• Storage - Ingested carbohydrate is preferentially stored (up to 300-500g total) as glycogen in the muscles, liver, and to a small extent in the kidneys. Because carbohydrate storage is limited, and since blood glucose levels must be maintained within a narrow margin, carbohydrate is preferentially oxidized following ingestion; the result being the suppression of fat oxidation. Despite popular belief, carbohydrate is rarely converted into fat under normal circumstances. You would have to consume calories from carbohydrate in excess of your daily energy needs in order for de novo lipogenesis to occur. If someone's daily energy expenditure was 2,500 calories, said person would have to consume more than 625g of carbohydrate for an extended period of time before any noticeable fat gain would occur. The efficiency of its conversion into adipose tissue is 80%, and its glycogen storage efficiency is 90%.
• RTR - High to ensure that dietary carbohydrate is successfully oxidized in the event that there is no room for it in muscle, liver, or kidney tissue.
• Fat
• Storage - Fat can only be stored as fat. There are no physiological pathways for its conversion into anything other than fat. Though fatty acids can be stored in muscle tissue, fat is primarily stored as adipose tissue in virtually unlimited amounts. As a result, the need for fat's oxidation is minimized; hence this is why all other macronutrients will take oxidative precedence over fat in the context of a mixed meal. Dietary fat is converted into adipose tissue with an efficiency of 96%. It cannot be converted into non-adipose tissue.
• RTR - Low because there is little metabolic cost involved in fat storage. 

Dietary Fat on Trial

Based on the above hierarchy of fuel oxidation, dietary fat looks pretty incriminated. Out of all the marcronutrients, it is the most likely to be stored as body fat in the context of a caloric surplus; and, admittedly, there are several other incriminating factors we have yet to discuss.

• High metabolic efficiency - As discussed above, the RTR of dietary fat is quite low. There is no strong physiological need to oxidize fat when other macronutrients are present. Thus, fat seems, by its very nature, designed for easy storage so that the body can more readily oxidize protein, carbohydrate, and alcohol.
• High energy density - 1g of dietary fat equals about 9 calories, whereas 1g of of carbohydrate equals about 4 calories, and 1g of protein equals about 4 calories (though protein may arguably equate to 3 when one considers its high thermic effect). Because it is so calorie dense, dietary fat is often indicted as being the primary agent of inadvertent over-consumption of calories. 
• Low satiety - Dietary fat is notable for its negligible impact of satiation following consumption. Have you ever opened a new jar of peanut butter only to find it half empty quicker than Porky Pig could say "aequeosalinocalcalinoceraceoaluminosocupreovitriolic"? Though fat does effect satiety once it reaches the duodenum (the upper portion of the small intestine), this effect is often not fast enough so as to prevent rapid over-consumption.

Dietary Fat Acquitted

There are, however, a number of factors which demonstrate that dietary fat cannot hold full responsibility for the accumulation of fat. 

• The Laws of Physics - Regardless of the macrocomposition of one's diet, an energy surplus is a surplus, a deficit is a deficit, and an equilibrium is an equilibrium. One cannot gain, lose, or maintain one's total body mass unless one's energy intake-expenditure ratio is such that it corresponds to a loss, maintenance, or gain of body mass. Though dietary fat is preferentially stored as body fat when other macronutrients are present, the question of whether or not it stays stored as body fat is a matter of energy balance.
• Health Benefits - A growing body evidence suggests that various types of fatty acids have protective properties. Monounsaturated fatty acids can lower total cholesterol, triacylglycerol, and LDL, while raising HDL. Polyunsaturated fatty acids (n-6 and n-3) are essential fatty acids which play an integral role in maintaining bodily health. They cannot be manufactured by the body and thus must be obtained from exogenous sources.
• Inconclusiveness of Research - Despite the efforts of many researchers, there is as of yet no conclusive evidence indicting dietary fat as the cause of obesity.

If anything, the biggest factors worth blaming as regards obesity are a sedentary lifestyle coupled with poor food choices.

Psychology Talking

The food reward hypothesis seems to me the most relevant model for explaining the seemingly spontaneous increase in the average calorie consumption of everyday Americans (2). Moreover, research suggests that this increase in total calories is related to proportionate increases in carbohydrate, protein, and fat consumption (3). No one macronutrient is at fault; rather, the increased availability, reward value, and calorie density of our food seems more to blame. In my opinion (based on personal observation and what I've read), any diet which eliminates or abates the availability, reward value, or calorie density of foods will likely prove effective for fat loss; not for physiological reasons per se, but for psychological ones.

More than just mere reward value is a play here, however. There is a very real difference between the psychological response I have toward prime rib than the response I have toward Doritos. I like both, but I'm more likely to want to eat more Doritos after I've already eaten enough to satisfy my physical need for calories. This issue of liking vs wanting represents a very important yet subtle nuance in our understanding of the physiological and psychological factors which influence our desire to eat in reference to our need to eat. I like steak, but I rarely want to eat any after I've had a big meal. I like Pringles, and I always want to eat some, even after a big meal. What is it about these two foods which causes each to elicit different behavioral responses?

The complexities of food reward are, well, complex. While I must confess ignorance in regards to the finer points of the hypothesis, I do know that "junk food" is, in many respects, "engineered" to be more than just likable. Food scientists and researchers, who are quite aware of the behavioral impact which various combinations of tastes, textures, smells, and colors of foods have on humans, do a great deal of experimental work for major food corporations. They have the secret of how to make consumers constantly want their products down to a science.

Me Talking

If you asked me, I would say the main cause of obesity in America, and in Western societies, is a general decline in active lifestyles, a general increase in calorie consumption, a general increase in chronic stress, and a general decline in sleep duration and quality. I could add more factors to this list, but I think you get the picture. I think you can also understand now why the money driven fitness industry does little to disseminate the "truth" about how people really get fat. The causes are, more or less, no-brainers (yes, they are complex, but they aren't shocking). The solution, too, is a no-brainer. No-brainers, however, don't rake in the dough!

* Source: Aragon, Alan. Girth Control: The Science of Fat Loss and Muscle Gain.

Why I Have a Problem with Vegetarianism - Part VI: Vegan Diets by Default Require Supplementation

It's been a long while since I wrote Part V of my "Why I Have a Problem with Vegetarianism" series. But, I'm back at it today. For today's post, I plan to take a step away from critiquing the lofty claims made by Campbell in his book The China Study. In all honesty, I probably should have avoided, from the very beginning, digging into and hashing out the scientifically biased/flat out unscientific nature of Campbell's work, since so many other authors/people with better pedigrees than me have done a much more thorough critique than I would ever care to offer. Let's be honest, most people are concerned with practical implications and big-picture ideas; not the minutia bantered about by talking heads with nothing better to do than argue about whether omega-3s from Atlantic salmon are better than omega-3s from Pacific salmon (or other such nonsense). Therefore, the goal I have in mind for this post is to offer you with a comprehensive and concise picture of why I think being a vegetarian (barring religious/moral convictions) for purely health related concerns is misguided.

Vegetarianism Is Premised upon the Wrong Assumptions

Often times, many vegetarians, and non-vegetarians alike, premise the healthfulness of a meat-free diet (or lean-meat-only diet in the case of non-vegetarians) upon the notion that saturated fat and dietary cholesterol are "unhealthy." In reality, there isn't conclusive evidence to suggest that we ought to be fearful of these nutrients.

A meta-analysis conducted by Chowdhury et al. conducted earlier this year revealed that "Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats" (1). After examining 32 observational studies of ingested fatty acids, 17 observational studies of fatty acid bio-markers, and 27 randomized controlled trials, the authors essentially concluded that we don't know much of anything about how the fatty acid profile of our foods effects us. Regarding saturated fat specifically, the authors were not able to find any association between saturated fat consumption and disease.

Turning to cholesterol, much of the hype regarding its status as a health taboo is based on a blatant misunderstanding of how the human biology works. Dr. Uffe Ravnskov, an independent medical researcher, lays out the following nine common myths regarding cholesterol (2). 

1. "Cholesterol is not a deadly poison, but a substance vital to the cells of all mammals. There are no such things as good or bad cholesterol, but mental stress, physical activity and change of body weight may influence the level of blood cholesterol. A high cholesterol is not dangerous by itself, but may reflect an unhealthy condition, or it may be totally innocent."
2. "A high blood cholesterol is said to promote atherosclerosis and thus also coronary heart disease. But many studies have shown that people whose blood cholesterol is low become just as atherosclerotic as people whose cholesterol is high."
3. "Your body produces three to four times more cholesterol than you eat. The production of cholesterol increases when you eat little cholesterol and decreases when you eat much. This explains why the "prudent" diet cannot lower cholesterol more than on average a few per cent."
4. "There is no evidence that too much animal fat and cholesterol in the diet promotes atherosclerosis or heart attacks. For instance, more than twenty studies have shown that people who have had a heart attack haven't eaten more fat of any kind than other people, and degree of atherosclerosis at autopsy is unrelated with the diet."
5. "The only effective way to lower cholesterol is with drugs, but neither heart mortality or total mortality have been improved with drugs the effect of which is cholesterol-lowering only. On the contrary, these drugs are dangerous to your health and may shorten your life."
6. "The new cholesterol-lowering drugs, the statins, do prevent cardio-vascular disease, but this is due to other mechanisms than cholesterol-lowering. Unfortunately, they also stimulate cancer in rodents, disturb the functions of the muscles, the heart and the brain and pregnant women taking statins may give birth to children with malformations more severe than those seen after thalidomide."
7. "Many of these facts have been presented in scientific journals and books for decades but are rarely told to the public by the proponents of the diet-heart idea."
8. "The reason why laymen, doctors and most scientists have been misled is because opposing and disagreeing results are systematically ignored or misquoted in the scientific press."
9. "People with high cholesterol live the longest."

A Vegetarian Diet Is a Slippery Slope

In a 2009 article written for The American Journal of Clinical Nutrition entitled "Health Effects of Vegan Diets," Winston J. Craig reveals that vegans may be at an increased risk for suffering from deficiencies in "vitamins B-12 and D, calcium, and long-chain n–3 (omega-3) fatty acids...[and] In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals" (3).

An article published earlier this year for PloS One entitled "Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study" suggests "that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life" (4). Many of these issues may in large part be due to the nutrient deficiencies mentioned above by Craig.

Common Deficiencies

Vitamin B-12

• Research by Herrman W. et al. suggests that B-12 Deficiency is most prevalent among vegans (83%), followed by vegetarians (68%), all the while only 5% of omnivores were deficient (5).
• Some common side effects of B-12 deficiency include: weakness, tiredness, light-headedness, rapid heart beat, rapid breathing, pale skin, sore tongue, easy bruising and bleeding, bleeding gums, upset stomach, weight loss, diarrhea, and constipation (6).
• Louwman M.W. et al. found that B-12 deficiency led to impaired cognitive function in adolescents (7).
• Despite what many many vegans/vegetarians may think, supposed plant-based sources of B-12 (such as seaweed, algae, fermented soy, and spirulina) actually contain an analogous B-12, the effect of which blocks the absorption of animal-based sources of B-12 (8 & 9).

Calcium

• While many plant foods contain copious amounts of calcium, the absorption of said calcium is often inefficient due to the inhibiting effects of oxalate and phytate found in plant-foods (10).
• The bio-availability of calcium from plant sources (aside from a few obscure ones) falls far behind that of a good ol' glass of milk (11).

Iron

• Vegetarians/Vegans tend to have lower iron stores than omnivores (12).
• Due to the high levels of phytates in vegan diets, the iron present in the diet may be insufficiently absorbed (13).

Zinc

• As in the case of iron, zinc, too, can be absorbed insufficiently in the context of a vegetarian diet (14).

EPA and DHA

• Vegans often rely on ALA as a source for their omega-3s. ALA, however, is not immediately usable by the body, and it must be converted from ALA to EPA and DHA; a process which is incredibly inefficient (15).
• This conversion process requires nutrients such as iron and zinc in order to take place (16); and as we've already discussed, vegans are already at risk for being dificient in these nutrients.

Vitamins A and D

• These are fat soluble vitamins which are found mainly in animal-based sources of food such as eggs, dairy, seafood, and organ meats. Some types of mushroom have vitamin D, but these varieties are not numerous, nor commonly eaten (17).
• Vegetarians and vegans are often far more deficient in vitamin D than are omnivores (18).
• Many people have a misconception that vitamin A is found in plant sources, like carrots. In reality, these plant sources contain beta-carotene, which is a precursor to vitamin A. Not only is the process of conversion inefficient, but dietary fat is required for this process to truly take effect; and vegans and vegetarians are notorious for their abstention from fat (19).

Creatine, Carnitine, and Carnosine

• These nutrients are well known and well accepted as athletic enhancing supplements (and not in the illegal sense!). Unfortunately for the vegan, these can only be found in sufficient quantities in meats; though small amounts of carnitine can be found in avocados, peanuts, wheat, and soy (20).

Two Strategies to Combat These Problems

1. Become OCD about your supplementation. If you are absolutely hellbent on sticking to your guns and avoiding meat at all costs, you have no other option than this.
2. Eat meat!

Thus concludes my 6 part rant. Adieu.

I'll take the no-supplements route!

Understanding "Stubborn" Fat

How often have you seen some late-night infomercial touting the mind blowing benefits of this crazy-punishing abs workout that will be sure to burn away your belly fat? Is there even any scientific validity to the claim that you can "spot-reduce" fat? Is there a such a thing as "stubborn" fat? Keep reading to find out...

What is Spot-Reduction?

Spot-reduction is premised on the notion that targeted fat loss is physiologically possible. Ever hear a friend say that they're doing abs work to burn their belly fat? Have you seen anyone trying to lose some tush-cushion by doing glute exercises? These people are trying to spot-reduce fat. Is such a thing even possible?

I used to think that spot-reduction was totally absurd. I had always heard, and thus believed, that it was impossible to experience "targeted" fat loss. When you lose fat, you lose it all over; you can't target this or that area on your body. Right?

Well, as it turns out, some research does suggest that spot-reduction is indeed possible. Dr. Bente Stallnecht published an article in the American Journal of Physiology, Endocrinology and Metabolism in 2007 which revealed that one can in fact experience localized fat burning when you exercise a given body part (1). Before you get too excited, though, let me tell you that the statistical significance of this targeted fat oxidation was nowhere near practical significance. Yes, you can spot-reduce fat, but the meaningfulness of this spot-reduction in real world terms would unavoidably disappoint you (this is probably the reason why so many people give up on those 500 crunches-a-day routines they so hope will turn their keg into a six-pack).

What is Stubborn Fat?

Now that I've just crushed all of your most cherished dreams of targeted fat loss, let me tell that there are things that you can do to eliminate "stubborn" fat. But, before I offer you a prescription, let me tell a little about what stubborn fat actually is.

The first thing to keep in mind is that stubborn fat is physiologically different from not-so-stubborn fat. Fat cells have primarily two receptors (well there are more, but I'm keeping things simple) which regulate the release and storage of fat. These receptors are called alpha and beta-receptors; the former of which hinder fat release, the latter of which un-hinder its release. Stubborn fat cells have a higher ratio of alpha to beta-receptors than do not-so-stubborn fat cells.

Catecholamines (epinephrine and norepinephrine) bind to these receptors and send signals through them in order to regulate the release of fat. Once fat has been released (a process called lipolysis), the fat must then be taken to another cell in order to be burned (a process called lipid oxidation). Since stubborn fat cells are less likely to permit lipolysis, the fat stored in these cells is more likely to stick around.

Stubborn Fat and Insulin Sensitivity

Another thing about stubborn fat to keep in mind is its relatively high level of insulin sensitivity/low level of insulin resistance. When insulin interacts with a fat cell, it causes a down-regulation of hormone sensitive lipase (HSL), a fat releasing enzyme, and it causes an up-regulation of lipoprotein lipase (LPL), a fat storing enzyme. An insulin resistant fat cell will be less likely to store fat, and, conversely, it will be more apt to release fat. On the other hand, an insulin sensitive fat cell will be more likely to store fat, and it will be less apt to release fat. Thus, as I need not further explain, insulin is not exactly your best buddy when it comes to burning off stubborn fat.

Stubborn Fat, Thyroid Function, and Estrogen

One of the functions of the thyroid gland is to ramp up the activity of fat cell beta-receptors; thus permitting the release of stored fat. A malfunctioning thyroid, therefore, can be a very real hindrance when one is trying to burn off stubborn fat. 

Estrogen, too, can be a source of trouble. Estrogen up-regulates the activity of alpha-receptors, causing fat cells to more readily undergo lipogenesis (fat storage). Thus, high levels of estrogen can be an obstacle to fat burning (probably a reason why intravenous testosterone/steroids can allow bodybuilders to eat a ton of food, all the while putting on slabs of muscle with little accompanying fat). This issue with high levels of estrogen can be of particular concern for women during the late follicular phase and the early luteal phase of their cycle, since estrogen is particularly high during this time.

Stubborn Fat, Blood Flow, and Heat

Stubborn fat also has this rather unfortunate characteristic of getting less blood flow than not-so-stubborn fat. Alpha-receptors seem to have a negative impact on blood flow. What's unfortunate about this situation is that (1) since low-blood-flow areas of adipose tissue have a greater number of alpha-receptors, lipolysis is less likely to occur, and (2) since there's less blood flow to this adipose tissue, what fat does get released via lipolysis is less likely to be oxidized, therefore meaning that this released fat's fate will be lipogenesis; therefore meaning "bummer." 

Stubborn fat is also located in areas which are farther from your core, thus meaning that these areas are harder to heat up. Love handles, for example, are relatively far the center of your body mass, therefore making them a common place on the body where fat is not easily lost.

How to Eliminate Stubborn Fat

While I hope all of the above information hasn't left you in a hopeless state of self-loathing, you at least, now, have some validation that stubborn fat is actually a real thing. But, what to do with this information? Now that we've identified the enemy and his allies, its time to plan our attack.

Step #1 - Fixing your diet.

Though stubborn fat is indeed stubborn, it still gets burned off just like not-so-stubborn fat. The only difference is that stubborn fat just gets burned off much more slowly. When you put yourself in a caloric deficit, your body draws upon its fat stores from everywhere in your body, including from your stubborn fat. However, since the stubborn fat (which lies in noticeably unwanted places) gets burned at a slower rate, the illusion is created that these problem areas have somehow become worse. In reality, your stubborn areas did not in fact get bigger, they've just become more pronounced because you've more quickly burned off your not-so-stubborn fat.

Thus, my recommendation to you is this: since stubborn fat is burned at a relatively slow rate, you need to slow down your diet--i.e., you need to either use a smaller calorie deficit, or you need to cycle your diet, using a moderate calorie deficit on certain days of the week (preferably on non-workout days), while eating maintenance (+) calories on others (preferably on the days you workout). I personally would encourage you to utilize the cyclical approach because it will help to prevent metabolic adaptation.

Step #2 - Using the right supplements.

I know, I know! I just published a post where I kinda' sorta' bashed on supplements. But, keep in mind that I also said that supplements can help, so long as you've gotten everything else in line. The following supplements may speed up the fat burning process, if you're dieting intelligently, training intelligently, and living healthfully overall.

• Caffeine (think coffee!)
• Green Tea Extract
• Coleus Forskohlii
• Yohimbine HCL 
• Synephrine
• Berberine

Most of the above are best utilized in a fasted state (not to be confused with merely having an empty stomach). As per any discourse on dieting/supplementation advice, make sure to get clearance from a medical professional before you decide to implement any of my advice.

Conclusion

It's big-picture time:

1. Spot-reduction is a waste of time.
2. Stubborn fat is a real thing.
3. The way to get rid of stubborn is essentially the same as that employed to get rid of not-so-stubborn fat. The only difference is that you'll need to either lessen the degree to which your using a caloric deficit or you'll need to cycle your diet.
4. So long as you have all your ducks in row, there are some supplements which may help to make the process of losing stubborn fat more efficient.

A Brief Debrief on Supplements

Miracle pills, fat loss accelerators, testosterone boosters, supplements. I can't tell you how often I've read a riveting article on some game-changing pill or powder; the contents of which are "guaranteed" to be effective, "or your money back." All too often, however, these supplements turn out to be nothing more than a flashy farce.

Something which I've found to be uncannily true in life is the following: the greatest hope lies in the light, the greatest fear lies in the dark, and the greatest truth lies in the twilight. You could apply this phrase to anything in life really, and in terms of supplements, this phrase means that the truth about supplements usually lies at the mean on a spectrum between miracle and disaster. Some people (cough...Dr. Oz...cough!) like to peddle the latest life enhancing product as if it's God's gift to humanity. Others like to spout curses, and claim that the latest supplement to hit the shelves is literally the demonic in capsule form.


In reality, however, most supplements--based on my experience, the experience of countless others, and actual scientific research--are either neutral or minimally to moderately beneficial. They're usually neutral if you don't have your lifestyle and habits and check, and they're usually minimally to moderately beneficial if you've already gotten all your bases covered (i.e.-your diet, your activity, your sleep, your stress levels, etc.).

The only people (usually) who have any business looking into any kind of performance/health enhancing supplement are the people (usually) who already are doing everything, or mostly everything right in the gym, in the kitchen, in bed (I don't mean what you think I mean!), and in life generally.

As you think on what I've said above, consider this as well: healthy is not about that one thing you do or eat; healthy is about everything you do and eat and everything you don't do and don't eat.

Supplements can be helpful additions to your daily regimen, but they can never replace smart dieting and lifestyle habits.