Complete Meals & GI (Non-)Sense, Glutamine & GLP-1, Low Thyroid & High Trigs, N-3 vs. N-6 Interactions, Optimal DHA Dosage in Kids W/ NAFLD, Selenium vs. Aluminum Toxicity

While this is not the exact combination of chicken breast, mashed potatoes and salad in the first one of today's news items, it's more than likely that the predicted GI (and thus probably what you would find if you looked it up in a table) overestimates the postprandial glucose response to this meal by ~50% and says absolutely nothing about the insulin response. It looks like complex meals and over-simplified theories, don't mix well, at all ;-)

78% that's the SuppVersity Figure of the Week and actually part of the additional information I provided on one of today's On Short Notice items. It's the increase in coronary heart disease risk women with subclinical hypothyroidism have compared to their peers with spot on TSH levels of 0.5-1.5mU/L (Asvold. 2013). In conjunction with other more or less recent studies, such as Mitchel's, Hsu's and Sahai's paper confirming the previously often talked about but not well-established 2-fold increase in congenital hypothyroidism from the early 1990s to the first years of the new millennium (Mitchel 2011), the predictive value of high TSH levels in the first trimester (early pregnancy hypothyroidism) for adverse pregnancy outcomes (Schneuer. 2013), the 30% risk increase in all-cause mortality in both women and men with subclinical hypothyroidism Tseng et al. reported in their paper earlier this year or the impairment of spatial working memory (Yin. 2013), Asvold's results only add to the evidence that the potential pitfalls of an increasingly prevalent metabolic dysfunction may have been ignored way too long.

• More GI lovin' - On the menu today: Mashed potaoes with chicken, rapeseed oil or both (Hätönen. 2011) - I thought a mini-follow-up on Friday's post on the GI would be nice, 'cause some of you have not without reason been complaining that not everyone would eat pure white bread, like my students do.
  
  

  

  Figure 1: The real (=measured) GI of a meal does differ significantly from the theoretical prediction. So, even if the concept was worth bothering, the GIs of complete meals simply wrong, if they are not measured (Hötönen. 2011).

  Moreover, the mere fact that the scientists from the Department of Lifestyles and Participation at the National Institute for Health and Welfare in Helsinki, Finland, found that the addition of chicken breast, rapeseed oil and a salad, individually and in combination, had the GI of a meal containing six mashed potatoes (this was the parameter that was held constant) induced more than twofold changes in GI, with the addition of chicken breast having the greatest deviation from the predicted value in this group of 11 (initially 12) healthy subjects, three men and nine women, aged 36.2 (SD 14.1) years with a BMI of 21.3 (SD 1.7) kg/m² and normal glucose tolerance (see figure 1).
  
  Now given the fact that most data on the GI of complete meals has never been measured, but is actually based on the same predictions the scientists used, it stands to reason that...
  

  [...] this highlights the problems encountered when predicting the GI values of mixed meals. The protein com-ponent of the mixed meal evoked the largest insulinaemic responses and markedly increased the II of the mixed meal containing protein. However, introducing fat into the meal decreased the effect of protein on the insulinaemic responses (Hätönen. 2011)

  So, this does not simply bust the idea that you could calculate the GI, it does likewise show you that people who are still overtly scared of insulin (which is hillarious as long as you are insulin sensitive) are doing he exact wrong thing, when they make food-choices based on GI: Whey protein would in that case be in as much a no-go as simply eating a chicken breast with your mashed potatoes would be, because other than what most people believe, it does increase the insulin spike and thus reduce the glycemic index by allowing your body to clear the glucose more efficiently from the circulation.
  
  Suggested reads: The red box in the "Whey is More Insulinogenic than White Bread" post on the partitioning effects of BCAAs and yesterday's Facebook post on the anti-Alzheimer's effects of insulin.

• 

  Suggested read: Amino Acids for Super Humans the purported ergogenic effects of l-glutamine

  30g of oral glutamine have similar effects on GLP-1 as 75g of glucose (Greenfield. 2008) - Still a follow up on the GI discussion, I think you may be interested in. If you are someone who follows the questionable practice of ingesting large boluses of glutamine in the futile believe that this would increase your gains or speed up recovery, you may be pleased to hear that only 30g of oral l-glutamine produced an increase in the "Fat Burning Satiety Hormone GLP-1" (read more on GLP-1) that's on a gram to gram basis more pronounced than in response to insulin (0.41pmol/L per gram glucose vs. 0.75pmol/L per gram of glutamine; in 8 healthy subjects).
  
  Before you go and buy tons of glutamine, you should however consider that GIP, the pro-insulinogenic peptide and glucagon (ramps up gluconeogenesis in the liver) were likewise increased by the ingestion of this bolus of glutamine. It is therefore no wonder that glutamine has never been shown to be a "fat burner". Nonetheless, a 1999 study by Bowtell et al. would suggest that it may come handy to replenish liver and muscle glycogen after a workout (8g alone did increase glucose storage after a workout to a similar degree as a 18.5% glucose polymer solution and additional 25% glucose storage mostly in the liver, when both were coingested; cf. Bowtell. 1999). And if you don't care about that - your gut integrity could also be a reason to consider supplementation in the vicinity of particular strenuous or length workouts (see "Shedding Some Light on the Leaky Gut <> Exercise Connection") 

• Practical relevance? Based on data from a 12-year longitudinal study, even women with subclinical hypothyroidism have 76% risk for coronary heart disease (p = 0.005), than women with spot on TSH levels of 0.5-1.5mU/L (Asvold. 2013). And even women well within in the "normal range" (TSH of 1.5-2.4mU/l) have a 41% higher risk of heart disease, although this is only borderline significant (p = 0.08). For men the TSH level alone had not predictive value. Spec. w/ regards to T3, there are also reports of increased incidence of ventricular disfuntion (Cassetti. 2009), increased cardiac death in CVD patients (Iervasi. 2003) and impaired recovery after a stroke (Alevizaki. 2007). We do yet have to be cautious, here as "low T3" syndrome could as well be the consequence of overall inflammation and the association does not tell us anything about what's the chicken and the egg.
  Low thyroid, high triglyceride (Hashimoto. 2013) -- If you are wondering why on earth your trigs won't come down, it may well be that it's the absence of sufficient amounts of thyroid hormone. I a soon-to-be-published paper in Endocrinology scientists from the Gunma University in Maebashi, Gunma, Japan, report that thyroid hormone regulates the expression of a Stearoyl-CoA desaturase-1 (SCD-1) which controls the production of trigs from carbohydrates.
  
  Surprisingly the 75% increase due to hypothyroidism and the 75% decrease in SCD-1 mRNA expression (both compared to a euthyroid state) the scientists observed in rodents in response to the administration of T3 were not mediated by receptor binding, but simply as a down-stream effect of direct modifications of the SCD-1 gene promoter between -124 and -92 bp by T3.
  
  On a related side note: It is actually the last mentioned mechanism which is the major new finding in the study at hand and not the fact that T3 can reduce the conversion of carbohydrates to triglicerides that is the actual news here. After all, the latter is something scientist should know, but obviously like to forget about ever since the late 1999s (Waters. 1997)

• Omega-6 intake and not low omega-3 intake is the problem (Liou. 2007) -- Another older study, but one I am posting in response to a discussion some of you are having about omega-3 (ALA) intake in the post about safflower oil and DHT, because I simply feel that it's necessary to shed some light  on the erroneous assumption that by simply upping your intake of omega-3s or fish oil intake you could get away without decreasing your omega-6 intake, which in and out of itself will already increase the amount of anti-inflammatory omega-3 fatty acids (supplementation of DHA can still be advisable, specifically if you are a vegetarian).
  
  

  

  Figure 2: Effect of 4 weeks of high (red) vs. 4 weeks of low (green) linoleic acid (n-6) intake on short and long-chain omega-3 plasma phospholipid content in healthy men (Liou. 2007)

  In 2007, already Liu et al. conducted a very interesting experiment in the course of which they fed healthy men diets with identical amounts of omega-3 fatty acids (1% of the total energy intake), but two different amounts of linoleic acid (omega-6) and found that the high omega-6 intake (10.1% vs. 3.8% of the total energy intake) alone decreased the total amount of EPA among the plasma phospholipids (the major long-chain omega-3 fatty acid in fish oil), not just the ratio of omega-3 to omega-6, in the blood of their 29-45 year-old subjects by more than 25% (see figure 2). The paradoxical effect on DHA, on the other hand, would warrant further investigation, and underlines how reliant we are - if anything on the intake of pure DHA, which dropped in consequence to the test diet, which was devoid of fatty fish, while the original diet of the non-vegetarian subjects had fish in it.
  
  In this context, I would also like to point out that DHA is exactly where real fish is far superior to fish oil caps, because it has a way more favorable EPA:DHA ratio than fish oil caps. Salmon fillets for example have - depending on the fatty acid source in the diet 8.5g : 13.8g, 4.4g : 7.8g and 1.5g : 2.9g (all values per 100g) when the feed contains fish oil, fish and rapeseed and fish + rapeseed and rapeseed, only.
  
  And while the ratios are similar regardless of the chow, the data from the Seierstad et al. clearly shows that the fatty acid content of the diets can induce almost 5-fold differences in terms of the total DHA content and the omega-3 to omega 6 ratio (fish oil diet: 6.5, fish oil + rapeseed: 1.7, rapeseed: 0.6) of salmon fillets (Seierstad. 2003). 

• It does not take much: 500mg DHA not more effective than 250mg  (Nobili. 2013) -- At least if it comes to its beneficial effects against liver steatosis in children  (mean age 11 years; BMI 26.6kg/m² and 24.4kg/m², in the low and high dose groups respectively with with NAFLD, the amount of DHA does not appear to be so important. According to the results of their 2-year registered controlled trial, both 250mg and 500mg of Docosahexaenoic acid lead to identical and profound reductions in the odds ratio of developing more severe steatosis during the study period.
  
  

  

  Figure 3: Odds ratio (comparing DHA supplement vs. placebo) of more severe vs. less severe liver steatosis determined every 6 months during the 24-month study period (Nobili. 2013)

  If you take a closer look at the data in figure 3, you will even have to concede that the lower dosage did a better job - while the mean odds ratios were only marginally lower in the 250mg DHA group, the extremely high standard deviations in the 500mg DHA would suggest that the 250mg dose appears to be more reliable. In this regard it may be interesting that the increase in serum DHA did mirror the dosages. With a 0.65% and 1.15% increase in DHA those were about 2x higher in the 20 boys and girls in the high dose group compared to the 20 kids in the control group who received a 290 mg linoleic acid germ oil supplement "placebo" (by the way, a monosaturated fatty acid placebo would have been more of a placebo than 290mg of omega-6)
  
  In view of the fact that the changes in triglycerides, ALT, HOMA-IR and BMI (which was not even different from the placebo group) were likewise identical, it does not appear as if anything that goes beyond the amount you will find in 2x cheap fish oil caps, or 10g even of the cheapest salmon fillet (see last paragraph of previous item) would be necessary to ellicit the anti-steatosis effect of fish oil - since those kids weight on average 55kg, an adult may want to add in another fish oil cap to get up to 360mg DHA per day or simply eat his fatty fish once or twice a week.

• Selenium ameliorates aluminum toxicity (Viezeliene. 2013) -- With the whole upheaval about the potential negative side effects of the aluminum in vaccines, the formerly overlooked yet well-known neurotoxic (Exley. 1992; Gupta. 2005), hepatotoxic (Abubakar. 2003; Perez. 2005) and nephrotoxic metal (Geyikoglu. 2013) has all of a sudden returned to the center of public interest.
  
  Therefore I thought that you will be interested in the results of a study that's going to be published in the next issue of the Journal of Trace Elements in Medicine and Biology - irrespective of whether you believe, like Tomljenovic and Shaw that
  

  "the possibility that vaccine benefits may have been overrated and the risk of potential adverse effects underestimated, has not been rigorously evaluated in the medical and scientific community"(Tomljenovic. 2011)

  After all, vaccines are not the only potential source of aluminum in our environment, so that the ameliorative effects (all values remained normal in the aluminum exposed group, while there were 30%, 55% and 42% increases in GSH in the animals who received only the selenium injection) the co-administration of supplemental selenium had on the GSH reductions in liver, kidney and brain of Balb/c mice weighing 20–25g who were exposed (by i.p. injection)to AlCl3 (25 mg Al(3+)/kg body mass) for 16h could be important, regardless of whether you do or don't intend to get vaccinated.
  
  

  

  There is more about selenium at the SuppVersity, for example on its pro-fertility effects, and its anti-corrosive effects in the brain.

  That said, the dosage requirements necessary to maintain healthy GSH levels are probably much lower than the hillarious (for a healthy individual) in the study at hand 1,250µg/kg body weight of sodium selenite (Na2SeO3). Considering the elemental selenium content in Na2SeO3, the latter would equal to ~3,650µg - unquestionably WAY too much (remember this was a one-time dosage that was specifically co-administered w/ the aluminum). Even the 'no observed adverse effect' level for a 70kg man of intake which is ~1000µg/d (Whanger. 1999) appears unnecessarily high, so that the consumption of a handful of brazil nuts once or twice a week and/or other high selenium foods such as tuna, cod, oysters, shrimp, but also eggs, meats, poultry, mushroom and onions on a regular should suffice to get what you need, to fortify yourself against the constant assault of heavy metals.
  
  What would be interesting, though, is a study into the effects of adding selenium to the "safe" aluminum in vaccines. I mean, you cannot seriously tell me that we could not afford doing that and if it reduced any toxicity issues, why not?

That's about it for today, I did not post all too many new facebook news as of yet (I mean, come on, it's Saturday ;-), but if you are into medicinal horror-stories, you will certainly like the story about the flesh eating killer fungus. If you prefer microbes over fungi, you are probably better off with the latest insights into the associations of certain gutbacteria with the incidence of stroke. And if you are more into other aspects of the digestive tract you may be interested in the effects of gastric emptying time on postprandial gylcemia and insulin release.

If none of those news is to your liking, I suggest you either wait for me to post something else (could be happening within the next hours at www.facebook.com/SuppVersity), or simply enjoy the weekend and come back tomorrow when you are rested for another (hopefully) enlightening SuppVersity post.

References:

• Abubakar  MG,  Taylor  A,  Ferns  GA.  Aluminium  administration  is  associated  with enhanced  hepatic  oxidant  stress  that  may  be  offset  by  dietary  vitamin  E  in  the rat. Int J Exp Pathol 2003;84:49–54.
• Asvold BO, Bjøro T, Platou C, Vatten LJ. Thyroid function and the risk of coronary heart disease: 12-year follow-up of the HUNT Study in Norway. Clin Endocrinol (Oxf). 2013 Dec;77(6):911-7.
• Bowtell JL, Gelly K, Jackman ML, Patel A, Simeoni M, Rennie MJ. Effect of oral glutamine on whole body carbohydrate storage during recovery from exhaustive exercise. J Appl Physiol. 1999 Jun;86(6):1770-7.
• Cassetti G, Pinelli M, Bindi M, Bianchi M, Castiglioni M. [Low T3 syndrome and left ventricular diastolic function]. G Ital Cardiol (Rome). 2009 Aug;10(8):553-7. 
• Exley  C,  Birchall  JD.  The  cellular  toxicity  of  aluminium.  J  Theor  Biol 1992;159:83–98.
• Geyikoglu  F,  Turkez  H,  Ozhan  Bakir  T,  Cicek  M.  The  genotoxic,  hepa- totoxic,  nephrotoxic,  haematotoxic  and  histopathological  effects  in  rats after aluminium chronic intoxication. Toxicol Ind Health 2013;15.
• Greenfield JR, Farooqi IS, Keogh JM, Henning E, Habib AM, Blackwood A, Reimann F, Holst JJ, Gribble FM. Oral glutamine increases circulating glucagon-like peptide 1, glucagon, and insulin concentrations in lean, obese, and type 2 diabetic subjects. Am J Clin Nutr. 2009 Jan;89(1):106-13.
• Gupta  VB,  Anitha  S,  Hegde  ML,  Zecca  L,  Garruto  RM,  Ravid  R,  et  al.  Alu- minium  in  Alzheimer’s  disease:  are  we  still  at  a  crossroad?  Cell  Mol  Life  Sci 2005;62:143–58.
• Hashimoto K, Ishida E, Miura A, Ozawa A, Shibusawa N, Satoh T, Okada S, Yamada M, Mori M. Human Stearoyl-CoA Desaturase 1 (SCD-1) Gene Expression Is Negatively Regulated by Thyroid Hormone without Direct Binding of Thyroid Hormone Receptor to the Gene Promoter. Endocrinology. 2013 Dec 7.
• Hätönen KA, Virtamo J, Eriksson JG, Sinkko HK, Sundvall JE, Valsta LM. Protein and fat modify the glycaemic and insulinaemic responses to a mashed potato-based meal. Br J Nutr. 2011 Jul;106(2):248-53. 
• Iervasi G, Pingitore A, Landi P, Raciti M, Ripoli A, Scarlattini M, L'Abbate A, Donato L. Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation. 2003 Feb 11;107(5):708-13.
• Liou YA, King DJ, Zibrik D, Innis SM. Decreasing linoleic acid with constant alpha-linolenic acid in dietary fats increases (n-3) eicosapentaenoic acid in plasma phospholipids in healthy men. J Nutr. 2007 Apr;137(4):945-52. 
• Mitchell ML, Hsu HW, Sahai I; Massachusetts Pediatric Endocrine Work Group. The increased incidence of congenital hypothyroidism: fact or fancy? Clin Endocrinol (Oxf). 2011 Dec;75(6):806-10.
• Perez  G,  Pregi  N,  Vittori  D,  Di  Risio  C,  Garbossa  G,  Nesse  A.  Aluminium  expo- sure  affects  transferrin-dependent  and  -independent  iron  uptake  by  K562  cells. Biochim  Biophys  Acta  2005;1745:124–30. 
• Schneuer FJ, Nassar N, Tasevski V, Morris JM, Roberts CL. Association and predictive accuracy of high TSH serum levels in first trimester and adverse pregnancy outcomes. J Clin Endocrinol Metab. 2013 Sep;97(9):3115-22.
• Seierstad SL, Seljeflot I, Johansen O, Hansen R, Haugen M, Rosenlund G, Frøyland L, Arnesen H. Dietary intake of differently fed salmon; the influence on markers of human atherosclerosis. Eur J Clin Invest. 2005 Jan;35(1):52-9.
• Waters KM, Miller CW, Ntambi JM. Localization of a negative thyroid hormone-response region in hepatic stearoyl-CoA desaturase gene 1. Biochem Biophys Res Commun. 1997 Apr 28;233(3):838-43. 
• Whanger P, Vendeland S, Park Y-C & Xia Y. Metabolism of sub-toxic levels of selenium in animals and humans. Annals of Clinical Laboratory Science. 1996;26, 99-113.

Science Round-Up Seconds: PGC-1 Alpha 4 Unlocks Muscle Growth, Alpha Lipoic Acid & Dietary N-6 Overload, Aspirin & Other NSAIDs Your Liver & Overall Mortality

Myotubes under the microscope - vehicle (top, normal size), clenbuterol (+100% protein content, middle), clenbuterol + PGC1a4 inhibition (+50% protein content, bottom)

Actually I would hope that you have by now already listened to yesterday's installment of the SuppVersity Science Round-Up. If you did, you are one of a group of highly privileged trainees who already knows why not all PGC1-alpha is created equal and how the alpha-4 isoform does appear to be the missing link between myostatin, on the one hand, and IGF-1 on the other. If you have already listened to the show, you may also have noticed that I was pretty excited about the publication of the Ruas paper (Ruas. 2013). Firstly this study has almost everything you could expect from cutting edge science: A in-vitro tudy to elucidate the basic mechanisms, an in-vivo rodent study involving both wild-type and genetically modified mice and - much to my own surprise - an in-vivo exercise part. And secondly, the results provides the missing link I personally have been looking for, when I wrote the Intermittent Thoughts on Building Muscle Series (click here for the summary and overview of the individual parts) - the link between IGF-1 and myostatin and the reason working out will always make you stronger and bigger and not bigger and weaker, as it is the case in the poor myostatin-knockout mice. Ah... I almost forgot: Third- and lastly, the fact that the researchers induced their hypertrophy effects in a specific part of their study by administering clenbuterol, which then did what I have likewise written about before (see "The Clenbuterol Myostatin Connection"), which is decreasing the expression of myostatin and thus producing skeletal muscle hypertrophy, yet as we now know not directly, but rather in consequence to its PGC-1 a4 promoting effects (+400%!) and the respective downstream effects on myostatin, which were non-existent, when the scentsts blocked PGC-1 a4 expresson (see images on the right)... 

I guess, you need to be somewhat geeky to find that exciting, but anyway. If you don't I'd still recommend you take a listen to the show - it's well worth it, even for totally normal exercise enthusiasts ;-)

And now for the actual seconds

Since the Ruas study appeared on my "radar" quasi in the last minute. We did not get to talk about several of the things I have announced and just to make sure you are not going to be disappointed, once you have gone through the following findings, I will address the acidity / alkalinity issue in a separate post in the future. It requires some more detailed elaborations - but the wait is going to be worth it ;-)

ALA rescues the liver from toxic N-6 overload

Actually this item would have fitted in pretty neatly with the things I explained about the different isoforms of PGC-1 alpha and how they appear to be regulated by diet / energy energy intake and expenditure via AMPK, on the one hand, and MAPKs, i.e. 'switches' that are triggered by stress, as the wear and tear of exercise, for example would be one. Now, we have already talked about the latter aspect, so that I guess I can get right to the not so novel, but still intriguing insights a  group of scientists from the Cerrahpaşa Medical Faculty Medical Biology Department at the Istanbul University  bring to the table as far as the former pathway is concerned (Kaya-Dagistanli. 2013).


In their 8-week experiment, Kaya-Dagistanli and her colleagues confirmed two things, of which I don't even know what would be the more important result:

Figure 1: Fibrosis and fatty degeneration scores in the control group (normal diet) and the high omega-6 group w/ and w/out ALA Kaya-Dagistanli. 2013)

1. The administration of a diet that contained 60% fat from safflower oil, 20% kcal carbohydrate and 20% kcal protein (51% of the fat from n-6, n-6:n-3 ratio of 15.4) did produce major changes not only in the GSH levels, a measure of the total antioxidant capacity in the livers of the 24 Wistar rats, the relatively short time span was even enough to increase the fibrosis and fatty degenration scores by ~10x (see figure 1) compared to the rodents on the low fat standard chow in the control group (only 12% fat total, 39.1% n-6, n-6 : n-3 ratio of 9.3).
2. The addition of 35 mg/kg DL-alpha lipoic acid (human equivalent: 5.7mg/kg; ~500mg/day) from week 4 to week 8 reduced both the negative effects of the omega-6 overload on GSH and the pathological degeneration of the liver, but could not fully restore it to normal levels.

Not just in view of the fact that ALA could not totally blunt the detrimental effects of the n-6 diet, but also in view of the fact that rodents on the regular diet did not see any benefits (remember: if you are not fat and metabolically deranged ALA ain't necessary, probably counterproductive; "Lean & Muscular W/ alpha lipoic acid?"), I personally gravitate towards (1), as far as the more significant finding is concerned. After all, it goes to show you that you simply have to the absolute (and relative?) amount of omega-6 fatty acids in your diets and can go without any such supplements as high dose fish oil and/or alpha lipoic acid. Bottom line: Don't bang your head against the wall and you won't need a helmet ;-)

NSAIDs liver cancer, chronic liver disease and other nasty ways to die

It's quite a happy coincidence that the December issue of the Journal of the National Cancer Institute held yet another intriguing study on the potentially beneficial health effects of the use of NSAIDs, which had been addressed in August already, when Jacobs et al. have gotten quite some public attention with their paper on aspirin use and the decrease in all-cause mortality (Jacobs. 2013). The novel paper that's based on prospective data on 300,504 men and women aged 50 to 71 years who had participated in National Institutes of Health-AARP Diet and Health Study and has been written by a group of scientist who actually work at the National Cancer Institute (Sahasrabuddhe . 2013), did not deal with a slightly different research question, i.e. does the use of aspirin and other NSAIDs offer protection against liver cancer (hepatocellular carcinoma) and death due to chronic liver disease, it also offers a slightly more sophisticated analysis of the (a) the frequency of NSAID use and potential interactions. Still, I decided to summarize the main findings of both, also in view of the fact that we are dealing  wih different cohorts (study subjects in the Jacobs paper were 100,139 men and women with no history of cancer in the Cancer Prevention Study II Nutrition Cohort).

Figure 2: Main results (hazard ratios) of two of the latest epidemiological studies into the effects of aspirin and other NSAIDs on liver cancer, death due to chronic liver disease (left) and aspirin alone on all cause mortality (right; data based on Sahasrabuddha. 2013 & Jacobs. 2013)

With the "demarcation lines" being present at 1.0 (meaning normalized risk) it is pretty easy to see that at least with respect to liver health and all-cause-mortality and solely based on epidemiological evidence, aspirin appears to be one of those "miracle drugs" everyone can benefit from. We have to be cautious however, when we compare everyone with ourselves, after all - and pretty much stands out of question - the protective effects of aspirin and the slightly less unambiguous and as far as hepatic cancer goes, even detrimental effects of other NSAIDs are mediated by...

• the modulation of inflammation via inhibition of the COX enzymatic pathways necessary for the synthesis of prostaglandins
• the ensuing decreases in epithelial proliferation and angiogenesis, as well as an
• increased apoptosis (regular cell death) and ameliorations in the inflammatory response and inflammatory cytokines via non-COX mediated pathways

Now, if you remember the previous study about ALA and how useful it can be if you are the kind of person who hammer his head... ah, I mean who still has not gotten the message that the formerly hailed omega-6 PUFAs from the "healthy corn and vegetable oils" are not a bit healthy, on the one hand, and how superfluous (if not detrimental) the same supplement is for someone who does not exhibit exuberant inflammation to begin with, this certainly does put the results into perspective.

---

Apropos perspective, I am not quite sure how you like the perspective that this is it, for today, but I would be pleased if you took that as an incentive to come back tomorrow and check out the next installment of SuppVersity On Short Notice and for the time being, I still have a couple of facebook news, I am sure you will enjoy:

• Scientists from the UK and New Zealand do pretty damn good job pimping the sales of low fat products - learn what the press release does not tell you (read more)
• German scientists find: Bisphenol A clogs calcium channels - don't know if you'd agree with them that the good news is that it appears to be reversible (read more)
• Grazing is for fat cows, only  - women who want to be lean better eat like a human, i.e. three square meals not more that's it - this will also help with blood triglyceride management (read more) 
• more, much more ;-) 

Any you know, facebook is a fast media, so expect more news to be posted even before the official next SuppVersity article will hit the main site ;-)

References:

• Jacobs EJ, Newton CC, Gapstur SM, Thun MJ. Daily aspirin use and cancer mortality in a large US cohort. J Natl Cancer Inst. 2013 Aug 22;104(16):1208-17.
• Kaya-Dagistanli F, Tanriverdi G, Altinok A, Ozyazgan S, Ozturk M. The effects of alpha lipoic acid on liver cells damages and apoptosis induced by polyunsaturated fatty acids. Food Chem Toxicol. 2013 Nov 28.
• Ruas et al. APGC-1aI soform Induced by Resistance Training Regulates Skeletal Muscle Hypertrophy. Cell, December 7, 2013; 151:1319–1331. 
• Sahasrabuddhe VV, Gunja MZ, Graubard BI, Trabert B, Schwartz LM, Park Y, Hollenbeck AR, Freedman ND, McGlynn KA. Nonsteroidal Anti-inflammatory Drug Use, Chronic Liver Disease, and Hepatocellular Carcinoma. J Natl Cancer Inst. 2013 Dec 5;104(23):1808-14.

High Dose Omega-3 for Fat Loss? With 90% Lower Body Fat EPA Takes The Lead, DHA Second, ALA Distant Third... in Rats on Cornstarch or High Fat + High Sugar Diets

For Neo in the Matrix (courtesy of Warner Bros.) the choice was comparably easy. He had only two pills! You, however got to chose between ALA, EPA, DHA and, believe it or not, taking no pill at all!

I guess, those of you who are curious about the whereabouts of "your's truly" Adelfo Cerame Jr. will be disappointed to hear that he is currently so overwhelmed with clients and other duties that we have decided to turn the weekly contest prep series into a bi-weekly one.

Since this was more or less a last-minute decision, I just picked the next best study from my "interesting finds" folder and ... it turns out to be one of your, yet certainly not my favorite topics: Omega-3 fatty acids! That I am still skeptic about the usefulness, let alone necessity of respective supplements, does yet not change mean that I am deliberately ignoring interesting research on the unquestionable beneficial effects they have on lazy couch-potatoes and respective rodent models.

ALA, EPA, DHA - different acronyms, different effects?

Speaking of rodents, the soon-to-be published study by Hemant Poudyal, Sunil K. Panchal, Leigh C. Ward and Lindsay Brown from the Universities of Queensland and Southern Queensland in Australia unquestionably belongs into this latter category of "interesting rodent research on the benefits omega-3 fatty acids" (Pudyal. 2013). In order to differentiate the effects of alpha linoleic acid (ALA), the short(er)-chain brother to the long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) people often falsely refer to as "fish oil" (while fish oil contains them, the average fish oil cap has ~40% EPA/DHA or 400mg in a 1g gel cap), the scientists assigned 96 male Wistar rats (9–10 weeks old) randomly to one out of 8 different diets containing

Carbohydrate, fat and protein content (rel. to total energy)

• corn starch,
• corn starch +1.1g/d ALA-rich chia oil,
• corn starch +0.7g/d EPA,
• corn starch +0.8g/d DHA, or
• high-carbohydrate, high-fat, 
• high carbohydrate, high-fat +0.7g/d ALA-rich chia oil 
• high-carbohydrate, high-fat +0.7g/d EPA oil and 
• high-carbohydrate, high-fat+0.6g/d DHA oil

The n-3 PUFA supplemented diets were prepared by adding 3% of the oil replacing an equivalent amount of water in the diet. n-3 PUFA supplemented diets were administered for 8 weeks starting 8 weeks after the initiation of the corn starch or high-carbohydrate, high-fat diet. The drinking water in all high-carbohydrate, high-fat fed groups was augmented with 25% fructose for the duration of the study.

Profound anti-obesity effects of EPA and DHA

Over the course of the 8-week supplementation period the researchers took daily measurements of body weight, food and water intakes. They performed two oral glucose (OGTT) and insulin tolerance tests (ITT) before and after the 16 weeks trial and measured the body composition by Dual-energy X-ray absorptiometric (DXA).

Figure 1: Body composition, lipid profile, glucose management (left to right) in rodents after 8 weeks on chia seed oil (ALA), EPA and DHA supplemented diets (date expressed relative to cornstarch non-supplemented control; calculated based on Poudyal. 2013)

If you take a look at my plot of the data, you may be surprised about the significance of the results. While it has to be said that even the "normal" control diet was not exactly what I would deem healthy (even for a rodent), it is nevertheless astonishing how pronounced the anti-obesity effects actually were.

Downstream benefits on organ health, ...

Figure 2: Contrary to what we have seen in previous studies (see TTA+fish oil), the high doses of the different omega-3s (HED ~20-30g!) had no effect negative effects on either the transaminase (ALT, AST), lactate dehydrogenase (LDH), alkaline phosphatease (ALP) or bilirubin values or the histology (histologies of hepatcytes not shown) of the liver of the rodents (data based on Poudyal. 2013)

Compared to the effects of the high doses of long-chain omega-3s the ALA treatment had a comparatively low impact on the adiposity. This could partly be a result of the fact that the omega-3 fatty acid metabolism in skeletal muscle and adipose tissue appears to be specific. While EPA and DHA
accumulated readily in these organs, when they were directly supplemented, the provision of ALA did not increase the contents of long-chain omega-3 fatty acids in either body fat or skeletal muscle tissue.

On the other hand, all omega-3 fatty acids showed beneficial effects on heart and liver the function of which had already been compromised by the 8 weeks on the extreme high carbohydrate or high sugar + high fat diet (reduced cardiac fibrosis, hepatic steatosis and inflammation in both the heart and the liver). In that, both, both, the improvements in body composition, as well as organ health, were more pronounced in the low-fat diet compared to the high-carbohydrate, high-fat diet.

... but negative effects on glucose management

Against that background it is actually surprising that none of the omega-3 fatty acids actually did what they are often hailed for: Neither ALA, nor EPA or DHA did improve the profoundly reduced glucose tolerance of the carb-o-holic rodents. On the contrary,...

"[...] EPA and DHA supplementation increased basal blood glucose concentrations, decreased intestinal glucose absorption and maintained the blood glucose concentrations for two hours after glucose loading with normal insulin sensitivity." (Poudyal. 2013)

Interestingly, this effect was probably brought about by yet another unexpected effect the high dose (human equivalent ~20-30g) omega-3 treatment had on the sympathetic nervous system:

"These effects were accompanied by increases in sympathetic activation seen as increased heart rate and cardiac output, increased force of left ventricular contraction and increased vascular responses to noradrenaline and sodium nitroprusside as observed with the hypothalamus–pituitary– adrenal axis response to stress and low blood glucose concentrations " (Poudyal. 2013; my emphasis)

As Poudyal et al. point out, this could also explain the profound weight loss effect in the cornstarch groups, and the "relatively smaller but significant changes in [high fat + high sugar] rats that still have an abundance of fructose and fat to meet the energy requirements."

From rodents to humans, from humans to...  fishmen?

The latest on the usefulness of omega-3 supplementation for active individuals and athletes: One of the most recent reviews of the issue states: "[O]nly a few studies have evaluated the impact of omega-3 PUFA supplementation on exercise performance. It has been suggested that the ingestion of DHA of approximately 1-2 g per day, at a ratio of EPA to DHA of 2:1, may be beneficial in counteracting exercise-induced inflammation and for the overall health of an athlete. However, the human data is inconclusive as to whether omega-3 PUFA supplementation, at this dosage, is effective in attenuating the inflammatory and immunomodulatory response to exercise, and improve exercise performance." (Micleborough. 2013; my emphasis)

These (at least for me novel) effects of very high doses of EPA and DHA on the sympathetic nervous system as well as the modulatory effects of the baseline diet are certainly things to keep in mind. This is particularly true in view of the latest epidemiological data which suggests that the consumption of comparatively minuscule amounts of fish oil has a population (and thus probably diet-)dependent effect on diabetes risk  (Wallin. 2013), with

• 17% increased risk of type-2 diabetes per 0.30 g per day increment in long-chain n-3 fatty acids in US residents, and
• -2% reduced risk of type-2 diabetes per 0.30 g per day increment in long-chain n-3 fatty acids in Europeans

The same goes for the U-shaped dose-response curve, Crochemore observed in one of the most recent controlled trials in the course of which a low dose (1.5 g/d) fish oil supplement improved the body composition and fatty acid metabolism of 41 women (60.64 ± 7.82 years) with high blood pressure and diabetes mellitus, while only 1g more, i.e. 2.5g/day, did not simply yield less pronounced decreases in body mass and waist circumference, the "high" dose fish oil supplement also reduced the already highly compromised insulin sensitivity of subjects even further (Crochemore. 2013).

EPA & DHA can come to the rescue, but a healthy diet would render supplements obsolete

If I did not know that fish oil was an invention of the 1990s, I would speculate that the "fishman" in the 1954 horror blockbuster The Creature from the Black Lagoon (Universal Pictures) was a "fish oil fat loss supplementation experiment gone wrong" ;-) Or joke aside - you don't seriously consider popping 70 fish oil caps a day to get the human equivalent of the ~1g of EPA or DHA the rodents in the study consumed, do you?

Regardless of the "optimal dosage", we should not lose sight of the influence and importance of the basal diet, when we evaluate the effects of DHA and EPA on body composition, lipid metabolism and not the least glucose management. It is, for example, very unlikely that we would see anywhere similarly pronounced effects in humans who are following a whole-foods based, "paleo-esque" diet without tons of cornstarch in it (control group), or plain sugar (and 17% additional fructose) that are on top of that hilariously protein-deficient (5%-6% is - if anything - enough not to die).

If you chose grass-fed over regular butter / dairy (makes sense only for high fat dairy), eat fish once or twice a week and replace the grain-based oils in your diet with coconut and olive oil, anything that goes beyond the occasional one or two fish oil caps will probably do more harm than good. And let's be honest, you don't really believe that you would get rid of the blubber that may still be covering your abs by copying the supplementation protocol of the study at hand and taking 70 fish oil caps every day to get your 20-30g of EPA and DHA, do you?

References:

• Crochemore IC, Souza AF, de Souza AC, Rosado EL. ω-3 polyunsaturated fatty acid supplementation does not influence body composition, insulin resistance, and lipemia in women with type 2 diabetes and obesity. Nutr Clin Pract. 2013 Aug;27(4):553-60.
• Mickleborough TD. Omega-3 Polyunsaturated Fatty Acids in Physical Performance Optimization. Int J Sport Nutr Exerc Metab. 2013 Sep 4.
• Poudyal H, Panchal SK, Ward LC, Brown L. Effects of ALA, EPA and DHA in high-carbohydrate, high-fat diet-induced metabolic syndrome in rats. J Nutr Biochem. 2013 Sep 28. pii: S0955-2863(12)00207-0. .
• Wallin A, Di Giuseppe D, Orsini N, Patel PS, Forouhi NG, Wolk A. Fish consumption, dietary long-chain n-3 fatty acids, and risk of type 2 diabetes: systematic review and meta-analysis of prospective studies. Diabetes Care. 2013 Apr;35(4):918-29.

Lean & Muscular With Alpha Lipoic Acid? You Could Be Just as Lean, But More Muscular W/out "Nutrient Repartitioner"!

Image 1: Lean enough? Ever thought it may be better to stop taking your ALA, now?

I know what you are probably thinking right now: "Not yet another rodent study on the insulin sensitizing effects of alpha lipoic acid!" And in fact, you would be totally right if the results of this very study, which is going to be published in the next issue of the European Journal of Nutrition could not just save you a lot of money but also propel, or rather restore your lean mass gains. After all, the real-world implications of the differential effects of alpha lipoic acid supplementation Prieto-Hontoria et al. observed in lean vs. obese rodents would suggest that your expensive "nutrient repartitioner" may repartitions the energy away from your muscles and thus impair your gains. Put simply: Alpha lipoic acid keeps you lean, yeah... lean, but probably undermuscled!


Now you are listening, right? 

Well, let's see what the Spanish researchers did, then. Basically Prieto-Hontoria and his colleagues repeated an experiment many other researchers have conducted before. They took a bunch of young male Wistar rats and fed them a...

• regular diet with a macronutrient ratio of 20/67/13 (protein, carbs, fats)
• regular diet + 0.25g racemic alpha lipoic acid per 100g chow
• high fat diet with a macronutrient ration of 20/20/60 (protein, carbs, fats)
• high fat diet + 0.25g racemic alpha lipoic acid per 100g chow

And while the existence of a ALA control group on a normal diet alone would be a very welcome twist on your average "lipoic acid helps vs. diet induced insulin resistance / obesity"-study, the existence of two pair-fed groups

• regular diet, pair-fed receiving the same amount of chow as the regular diet + ALA group consumed voluntarily, but without the ALA content
• high fat diet, pair-fed receiving the same amount of chow as the high fat + ALA group consumed voluntarily, but without the ALA content

Allows for unique conclusions in terms of which effects are actually ALA-mediated and which ones are nothing but a side-effect of the anorexic (=appetite / food intake reducing) effects of alpha lipoic acid.

What's good for obese pre-diabetics on the standard American diet ...

Body weight and food intake were recorded every 2–3 days. And blood glucose, insulin, HOMA-IR, white adipose tissue mass, body total body weight gain, serum adiponectin levels and AMPK levels in white and brown adipose tissue, as well as skeletal muscle were determine at the end of the 8-week experimental period.

Figure 1: Effects of 8 weeks of supplemental alpha lipoic acid on body composition of rodents on different diets; active treatment vs. control (left) and active treatment, pair-fed (with active treatment) and control (right; data based on Prieto-Hontoria. 2013)

If you take a look at the left graph in figure 1 you see, what you probably would have expected. The rodents in the ALA groups (ad-libitum fed) gained significantly less body weight and had significantly less body fat than their peers, regardless of which diet they were on. Ok, the "lean mass" (here simply the difference between total and fat mass and thus not necessarily 100% identical to muscle mass - the rodents in the ALA groups could for example also have lower bone or organ weights) is lower, but alas, at least they are lean! And you are right, lean they are, but their pair-fed peers in the regular diet group, who received the exact same amount of food, but without any supplemental alpha lipoic acid, were exactly as lean, but made significantly greater gains (cf. figure 1, right)!

... can be detrimental for healthy, lean individuals whose ideal body image is not just skinny!

Figure 2: AMPK expression in white & brown fat and muscle (top, based on Prieto-Honta. 2013), and implications (bottom)

Now that we know about beneficial effects for SAD dieters and the detrimental effects for physical culturists, it's about time to take a look why on earth this happens and the answer - as counter-intuitive as that may sound, is via downregulation of AMPK (click here to read my dissertation on the "mTOR <> AMPK Seesaw ") - yes, you heard me right. As it turns out the "beneficial" effects of ALA on 5' adenosine monophosphate-activated protein kinase activity are tissue- and downstream effects diet-specific. Therefore, the detrimental effects of the decreased skeletal muscle and brown adipose tissue AMPK activity are outweighed by the increase in white adipose tissue AMPK activity, the researchers observed in ALA supplemented rodents from both groups, was outweighed by the increase in white adipose tissue AMPK activity (and increases in adiponectin, see figure 2) only in the high fat diet group. The rodents who received the normal chow, on the other hand, achieved a much more favorable body composition by simply mimicking (obviously through pair-feeding and not voluntarily) the ALA induced (small) reduction in food intake.

"Hold on, what's all that AMPK b*s* about? Where's the connection to being lean & muscular?"

The downregulation of BAT AMPK activity, on the other hand, is as the analysis of the role of AMPK in cold thermogenesis by Mulligan et al. suggests, is a clear downside of ALA (Mulligan. 2007) and could in fact be related to its previously reported negative effects on thyroid metabolism, respectively the conversion of the "inactive prohormone" T4 to the metabolically active T3 (Segermann. 1991). Likewise, the reduction of skeletal muscle AMPK is not a benefit as the data in figure 1 clearly shows that the bro-scientific claims about muscle loss due to increased skeletal muscle AMPK activity don't hold. Something that should actually be obvious, in view of the role AMPK plays skeletal muscle glucose uptake, glycogen and ATP regulation (Kurth-Kraczek. 1999; Musi. 2002), and mitochondrial biogenesis (Hardie. 2010).

Figure 3: Insulin, HOMA-IR, adiponectin and adiponectin relative to white adipose tissue weight in control, pair-fed (same food intake as ALA, but no supplement) and ALA supplemented rodents after 8 weeks (based on Prieto-Hontoria. 2013)

Still, due to the profound increases (total and relative to fat weight) in adiponectin (cf. figure 3), a fat-derived hormonal with well-established insulin-sensitizing and anti-obesity effects (Yamauchi. 2001; Shehzad. 2013), which showed a statistically significant correlation (after correction for adiposity) with the HOMA index, a recognized marker of insulin resistance, and its preventive effects against diet induced obesity, alpha lipoic acid should remain among the recommended supplements for obese, insulin resistant or diabetic subjects.

Is alpha lipoic acid for you? If you are lean, this study says "NO"!

Image 2: If you are the fat endo at the bottom, ALA could be for you. If you are the guy on the left, mild cutting and bulking w/out ALA is for your. And if you are on the right, you better spend your money on protein, creatine, BC/EAAs.

Its merit for lean physically active people, who consume a energetically appropriate whole-foods diet and strive to build a lean and muscular, not just a skinny physique, its usefulness is yet somewhat questionable. After all, the pair-fed animals had an equally low amount of body fat as their peers on ALA, but statistically significant more lean body mass; and I personally don't believe that it is a realistic assumption that these effects could be countered by simply eating more without having negative effects on the total amount of body fat you would accumulate on this heavy-duty bulk.

Your best bet would to try and "exercise away" the negative effects on  skeletal muscle AMPK expression, but let's be honest: Would you rather wear a helmet instead of simply stopping to hammer your head against the wall? You would, ha? In that case you are beyond help, I guess... go ahead then and do what works for your obese neighbor.

Note (I know someone is going to ask this): If anyone can show me peer-reviewed in-vivo data that confirms the constantly made claim that the physiological effects (not the petri-dish or XYZ-essay effects) of R-ALA are superior, not just on a gram-per-gram base, but qualitatively, tho those of the cheap and obviously less profitable racemic ALA (= natural mix of R- and S-ALA), I would be inclined to answer the question "wouldn't taking R-ALA maybe make a difference".

References:

• Hardie DG. Energy sensing by the AMP-activated protein kinase and its effects on muscle metabolism. Proc Nutr Soc. 2011 Feb;70(1):92-9. Epub 2010 Nov 11.
• Kurth-Kraczek EJ, Hirshman MF, Goodyear LJ, Winder WW. 5' AMP-activated protein kinase activation causes GLUT4 translocation in skeletal muscle. Diabetes. 1999 Aug;48(8):1667-71.
• Mulligan JD, Gonzalez AA, Stewart AM, Carey HV, Saupe KW. Upregulation of AMPK during cold exposure occurs via distinct mechanisms in brown and white adipose tissue of the mouse. J Physiol. 2007 Apr 15;580(Pt. 2):677-84.
• Musi N, Hirshman MF, Nygren J, Svanfeldt M, Bavenholm P, Rooyackers O, Zhou G, Williamson JM, Ljunqvist O, Efendic S, Moller DE, Thorell A, Goodyear LJ. Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes. 2002 Jul;51(7):2074-81. 
• Prieto-Hontoria PL, Pérez-Matute P, Fernández-Galilea M, Martínez JA, Moreno-Aliaga MJ. Effects of lipoic acid on AMPK and adiponectin in adipose tissue of low- and high-fat-fed rats. Eur J Nutr. 2013 Jun 5. [Epub ahead of print]
• Segermann J, Hotze A, Ulrich H, Rao GS. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels. Arzneimittelforschung. 1991 Dec;41(12):1294-8.
• Shehzad A, Iqbal W, Shehzad O, Lee YS. Adiponectin: regulation of its production and its role in human diseases. Hormones (Athens). 2013 Jan-Mar;11(1):8-20. 
• Yamauchi T, Kamon J, Waki H, Terauchi Y, Kubota N, Hara K, Mori Y, Ide T, Murakami K, Tsuboyama-Kasaoka N, Ezaki O, Akanuma Y, Gavrilova O, Vinson C, Reitman ML, Kagechika H, Shudo K, Yoda M, Nakano Y, Tobe K, Nagai R, Kimura S, Tomita M, Froguel P, Kadowaki T. The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med. 2001 Aug;7(8):941-6.

Science Round-Up Seconds: DHA, Algae Oil, Fish Protein, Insulin Sensitivity, Fat Loss & Muscle Gain. Plus: Night Shifts & BPA = Pro-Carcinogenic From Breast to Prostate

It's somewhat ironic that Nurse's are one of the three high risk groups for breast cancer, because they work night shifts to help others. Who the other two groups are? Female military personnel and flight attendants on international flights.

If you did already listen to yesterday's installment of the Science Round-Up, you should actually be able to connect the dots between both, the first and second course of today's installment of the Science Round-Up Seconds, and the studies on the effects of DHA on fatty acid metabolism, as well as the fallacies of insufficient, interrupted, or irregular sleep Carl and I have been addressing, yesterday.

If all that does not ring a bell, I suspect you missed the show and have not had a chance to listen to the podcast (as usual the Science Round-Up starts in the 2nd hour of the show), yet. In this unfortunate case, I'd suggest you do at least start downloading the file while you take the first bite of today's two course menu ;-)

More things fishy from proteins with funky names to DHA and fish protein

Pollachius virens (Photo: Tino Strauss) is king, when it comes to the n:3/n:6 ratio, but with <1% of fat you will still be hard pressed to get tons of omega-3s from eating pollock... but is more really better, let alone necessary? Learn how to make the right fish choices here.

(Lane. 2013; Vikøren. 2013) -- Actually I wanted to title this one "Some Things Fishy", but then I remembered that there is already a SuppVersity post with this title, one I am still not able to make head or fin... ah, pardon tail of, by the way, because it clearly suggest that the consumption of oxidized fish oil is not a problem. Be that as it may, these are the SuppVersity Science Round Up Seconds, so the "more" does not refer to the said SuppVersity post on oxidized fish oil, but rather to the 70x* increase in the expression of a protein called Angiopoietin-like 4, which controls the availability of fatty acids for fuel I mentioned during the podcast (*the differential response for DHA was elucidated in a separate study on isolated rat hepatic cells, the general effect was however observed in a human trial, where all tested fatty acids, not just DHA, produced 11-12x ANGPTL-4 increases).

In view of the more of less undisputed benefits of having reasonable amounts of DHA (400mg) in your diet, it would obviously be nice if we could increase our intake of this relatively scarce omega-3 fatty acid in our diet, without having to resort  to fish and fish oil caps. A recently published overview of vegetarian dietary sources of omega-3 fatty acids by Katie Lane and her colleagues does however confirm what you've heard both Carl and me say on previous episodes of the SuppVersity Science Round Up, already.

The conversion of alpha linolic acid (ALA, the short-chain version of omega-3) from nuts (walnut) and seeds (flaxseed, echium) to DHA is literally zero. 

According to he researchers' review of the literature, only the ingestion of oils that were derived from micro-algae provide some, albeit preliminary evidence to support their usefulness as dietary source of DHA. The number of studies is yet relatively limited and "further research is necessary to evaluate optimal doses" (Lane. 2013) of respective supplements and/or food additives for "functional foods" (how I hate this word)

Micro-algae oils are not fish, though, and thus you would once more be missing out on the unique synergy only real foods have to offer: The fish proteins!

If you are not one of the many new visitors who have found their way to the SuppVersity only recently, the keyword "fish protein" should actually ring a bell... exactly! That's the stuff that has previously been shown to have astonishingly pronounced effects on glucose metabolism. Effect that have initially been observed in rodent studies and are not being replicated in human trials. Trials such as the one by Vikøren and his colleagues from the University of Bergen who report in their latest paper that was February issue of the British Journal of Nutrition that the provision of 3 g/d of a cabbed fish protein supplements for the first 4 weeks and 6 g/d for the last 4 weeks of a 2 months placebo controlled intervention study effectively and significantly

• 

  Table 1: Amino acid composition of fish, whey and casein protein (Hall. 2003; Vikøren. 2013)

  lowered the values of fasting glucose
• 2 h postprandial glucose and glucose-area under the curve,

• increased the important early insulin and 
• decreased the detrimental late insulin response to glucose ingestion 

• reduced the amount of  LDL-cholesterol (P< 0·05) and

• led to increases in lean (+0.8%) and decreases in fat mass  (-1.6%)

compared to the calorie-free placebo. Pretty impressive results, right? That's particularly true in view of the fact that neither the food intake nor the physical activity levels changed in the course of the 8-week intervention period.

What's that: Fish protein + fish oil? (Almost) whole fish, right!

Fish happens to be a way better source of taurine than the sperm of this Belgian Blue. There is in fact so little taurine bull sperm that it is "supplemented" with this amino acid in order to keep it fresh and stable and have it survive refrigeration. Apropos, you do remember that taurine can boost testosterone levels up to 250% - at least in rodents?

The obvious question therefore is: How does that work? The scientists don't provide a satisfactory explanation and to be honest, I have nothing more than a couple of half-assed hypotheses either. My best bet, and I am suggesting that despite the fact that a recent post of mine was entitled "Don't Judge a Protein By Its Amino Acid Content", would in fact be the amino acid content. If you take a look at table 1 it is obvious that the cod protein the scientists used in the study contained one amino acid you as a SuppVersity reader should by now be familiar with and neither whey, nor casein or any of the other standard proteins has to offer: Taurine!

Yet despite the fact that taurine has the potential to boost testosterone levels, increases insulin sensitivity and has in fact been shown to actively reduce body weight in a 2003 human study by Zhang et al. (Zhang. 2003), I am not sold on the idea that the relatively minor total quantity of taurine in the already low amount of fish protein (I mean 8g?) is the only reason for the non-negligible health benefits the scientists observed in their 10 male and 10 female participants (BMI 31-37kg/m²). Maybe it's another of those funky di-peptides you've read about in the context of the nutrient repartitioning effect of whey protein hydrolysate, only lately.

Regardless of what exactly it may be that facilitated the improvements in blood glucose management and the minor, but significant improvements in body composition, the health benefits you can derive from the consumption of cod protein make the notion of fish oil, let alone micro-algae oil supplementation appear even more retarded, when eating fish once or twice a week offers a way more natural and unquestionably more tasty solution to satisfy your DHA requirement.

Night shifts and breast, BPA and prostate cancer

There are two clockworks operating parallel in your body. The one in the brain has to be hacked by light exposure (learn more about "Sunlight a la Carte"), the one in your liver and other peripheral organs, on the other hand, can be (re-)set by specific feeding strategies, like Intermittent Fasting (learn more)

I simply assume that you have by now downloaded and listened to the podcast and are thus aware of what I said about the importance of rythmicity (if you did not really get the notion, I suggest you read up on the posts in the SuppVersity Circadian Rhythm Series to get a better grasp of the different clocks that are ticking in your body ;-) Exactly this kind of rhythmicity is continuously disturbed when you are either switching back and forth from day- to night-shifts or work the night-shift continuously and dare having a social life that's simply not compatible with sleeping all day and waking all night.

That the life of a nurse, for example takes it's toll on your health and precipitates not just the development of breast cancer (+36% after 30 years of rotating night shifts; Schernhammer. 2001), but colorectal cacers (+35% after 15 years of rotating night shifts; Schernhammer. 2003) and endometrial cancer (+47% after 20+ years and even +109% in obese women; Viswanathan. 2007), as well, has been debated ever since the early years of the 21st century.

With the recent publication of two meta-analyses the debate probably will not be over; and that despite the fact that even the less unsettling analysis by Kamdar et al. reports increases in breast cancer risk of +21% for women "with ever night-shift work exposure" (Kamdar. 2013).

"Subgroup analyses suggested that flight attendants with international or overnight work exposure and nurses working night-shifts long-term were at increased risk of breast cancer." (my emphases in Kamdar. 2013)

While the Kamdar study also included observational data, this 2nd meta-analysis, which was likewise published less than a week ago, included only case-control and cohort-studies yielding risk increases of +32% and +8%, respectively (Jia. 2013). Somethin else thatg may be worth mentioning is the fact that both, the studies the scientists ranked as "high quality" research, as well as the only existing study involving female military personnel observed even higher risk increases of +40%.

Despite methodological differences and slightly different outcomes of the two meta-analyses, both research groups do reach very similar conclusions stating that the evidence is still "weak", but does "support previous reports that night-shift work is associated with increased breast cancer risk" (Kamar. 2013) and that "large-scale epidemiological studies are needed" (Jia. 2013).

From breasts to prostates ;-)

Figure 1: Effects of 4-days of BPA injections at different dosages on systemic hormone levels (Castro. 2013)

I know the subheading sounds somewhat gross, but there are certain parallels. For one, there is the same need for large-scale epidemiological studies on the connection between BPA exposure and the development and malignancy of prostate cancer as it is the case with breast cancer and night shifts. On the other hand, BPS of which a recent study was now able to show that it messes with the aromatase and 5-alpha reductase activity in the prostate and can thus precipitate prostate cancer even in adulthood (Castro. 2013), is unquestionably relevant for the development of breast cancer, as well.

What's more, the reductions in 5α-R1 and 5α-R2 Castro et al. observed in their previously healthy, adult rodents after only 4-days of BPA injections at doses of 25, 50, 300, or 600 µg/kg per day and the concommitant increase in the expression of the third isoform of 5-α reductase (5α-R3) does not only precipitate cancerous growth, it's also a recently proposed as a biomarker of cancer malignancy. In conjunction with the quasi-reversal of hormones (see figure 1), the results of this study, which happens to be the first one to demonstrate such profound detrimental effects on mature mammals, should remind us of the fact gestation and early childhood are not the only time-points in our lives, we have to beware of endocrine disruptors.

---

That's it for the Seconds and in case you are missing the information about fruits and vegetables, I will serve those tomorrow as part of the as of in fact short, but way more numerous "Short News". In case you are still hungry for more, I suggest you make take a slight detour to the SuppVersity Facebook Wall before you you sally into the weekend. There are a couple of appetizers waiting for you there:

• 

  "Does the Usefulness of Vitamin E Supplementation Depend on Your Activity Level?" While the marathon runners in the facebook study took only 50IU, 400IU is what most supplements have to offer as a minimum. Is that too much, for you? Do athletes need more? What about the hormetic response to exercise - it it even hormetic? (learn more)

  EGCG is an "anti-folate" - You still don't have to worry, nature has made sure that those who value the synergy of whole foods, or in this case drinks, won't be harmed (read more)
• LOW(!) doses of vitamin C & E (125mg & 50IU) don't diminish the benefits of exercise - On the contrary, in marathon runners that's enough to blunt the neutrophil damage (read more)
• Smart Kids = Lean Adults  - General intelligence as assessed in childhood has a significant and direct effect on adult obesity risk (read more)
• Valine, vanadium and oxygenated water - All useless for athletes. That's at least what the latest installment of the "A–Z of nutritional supplements" says (read more)

When you are done with those, it's about to start news fasting, for a couple of hours until tomorrow's morning news (for you probably today's late evening news) will be published on Facebook. Have a great "Post-Valentine's Day", everyone - I just  hope your spouses were happy with their presents ;-)


References:

• Castro B, Sánchez P, Torres JM, Preda O, Del Moral RG, Ortega E. Bisphenol A Exposure during Adulthood Alters Expression of Aromatase and 5α-Reductase Isozymes in Rat Prostate. PLoS One. 2013;8(2):e55905.
• Hall WL, Millward DJ, Long SJ, Morgan LM. Casein and whey exert different effects on plasma amino acid profiles, gastrointestinal hormone secretion and appetite. Br J Nutr. 2003 Feb;89(2):239-48.
• Jia Y, Lu Y, Wu K, Lin Q, Shen W, Zhu M, Huang S, Chen J. Does night work increase the risk of breast cancer? A systematic review and meta-analysis of epidemiological studies. Cancer Epidemiol. 2013 Feb 8.
• Kamdar BB, Tergas AI, Mateen FJ, Bhayani NH, Oh J. Night-shift work and risk of breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2013 Feb 12. 
• Lane K et al. Bioavailability and potential uses of vegetarian sources of omega-3 fatty acids: a review of the literature. Critical Reviews in Food and Science Nutrition. February 2013 [Epub ahead of print].
• Schernhammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ, Kawachi I, Colditz GA. Rotating night shifts and risk of breast cancer in women participating in the nurses' health study. J Natl Cancer Inst. 2001 Oct 17;93(20):1563-8. 
• Schernhammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ, Kawachi I, Fuchs CS, Colditz GA. Night-shift work and risk of colorectal cancer in the nurses' health study. J Natl Cancer Inst. 2003 Jun 4;95(11):825-8. 
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