Advances. Fitness. Keeping Up An Active Life FREE VOLUME 4 ISSUE 8 RESEARCH-DRIVEN BOTANICAL INTEGRATIVE ORTHOMOLECULAR INNOVATIVE

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1 Advances I N O R T H O M O L E C U L A R R E S E A R C H VOLUME 4 ISSUE 8 Fitness Keeping Up An Active Life FREE RESEARCH-DRIVEN BOTANICAL INTEGRATIVE ORTHOMOLECULAR INNOVATIVE

2 All You Need is One 22 g Whey Protein 4 g Fibre 2.5 Billion Probiotics Advanced Multivitamin Get a full dose of nutrition with all the benefits of improved detoxification and immunity in just one scoop

3 4 18 Optimizing Physical Performance: The Science of Nutrient Supplementation Certain supplements can improve physical performance. Learn more about the benefits of whey protein, amino acids, astaxanthin, D-ribose and colostrum Weight Loss: The Importance of Balancing Blood Sugars Balancing the body s blood sugar level is critical for a healthy metabolism and for weight loss. Green coffee bean extract, resveratrol and green tea extract are all helpful in achieving healthy blood sugar levels Immunity for the Athlete: Supplements to Reduce Effects of Overtraining Intense exercise can reduce performance and immunity. Adequate rest and several supplements can help reduce the risk of immunosuppression due to overtraining. Move to the Beet of Nitric Oxide Nitric oxide is a super molecule that influences several factors related to athletic activity including: sleep, immunity, bone health and cardiovascular health. Curcumin: Cellular Protector and Performance Booster Curcumin offers several benefits for active people, including inflammation reduction and antioxidant protection among others. Essential Magnesium for Supporting an Active Body Magnesium plays many roles in the body, including involvement in energy production, immunity, bone health, heart rhythm, muscle and nerve function. Published in Canada by Advanced Orthomolecular Research Inc. Editor-in-Chief Jaime Thomas, BSc Marketing Consultant Katie Lemmon Research & Writing Dr. Colin O Brien, ND Dr. Paul Hrkal, ND Dr. Cameron McIntyre, ND Jaime Thomas, BSc Justine Florence, BSc Graphic Design/Art Production Neil Bromley Alvin Cha graphics@aor.ca Digital versions of this magazine and back issues are available online at Advances in Orthomolecular Research is distributed through integrative physicians, health care practitioners, and progressive health food retailers. The content of this magazine is provided for informational purposes only, and is not intended as medical advice for individuals, which can only be provided by a healthcare professional. Contents and design 2014 AOR. Any reproduction in whole or part and in print or electronic form without express permission is strictly forbidden. Permission to reproduce selected material may be granted by contacting the publisher. Volume 4 Issue 8 ADVANCED ORTHOMOLECULAR RESEARCH

4 Optimizing Physical Performance: The Science of Supplementation There are many different supplements marketed as performance enhancers in the world of sports nutrition. With athletes trying to find an edge, and opportunistic companies selling the latest fad ingredients, it is very difficult to discern what natural substances are supported by sound scientific evidence and which ones are the flavor of the month. The reality is that many of these natural products have little or no evidence supporting their effectiveness or safety. At worst, they may be adulterated with dangerous and banned substances. Despite the pit falls in the world of sports nutrition, good evidence is emerging to show that some nutrients can improve physical performance. This article will discuss the key evidence-based natural nutrients used to optimize performance and dispel common myths regarding sports supplementation. How Much Protein Do You Need Of all the nutrients and supplements used for sports performance enhancement, it s not difficult to argue that protein is most important. It provides essential amino acids that are the building blocks for muscle growth, recovery and repair. In order to optimize protein use, the first question most people have is: how much do I need? The goal is to consume enough protein to offset normal muscle breakdown and recycling as well as to stimulate growth and repair. Currently, the recommended dietary allowance (RDA) for protein in sedentary healthy adults is 0.8g per kg body weight per day. 1 While this may be adequate for most of the population, active people have higher demands on their muscular system and therefore require higher amounts of protein. The current scientific consensus is that endurance and strength athletes need g of protein per kilogram of body weight per day. 1 So the average 70kg male wanting to achieve 1.5g of protein intake per kg would need to consume 105g of protein a day. The biggest concern most people have is whether large amounts of protein may have a damaging effect on their kidneys. Despite this prevailing idea, there is very little evidence to support this concern. The only negative evidence linking large amounts of dietary protein having a detrimental effect on kidney function is from a few animal studies and in patients with kidney disease. 2 A number of 4 Advances

5 studies have shown that protein intake has no detrimental effect on kidney function and actually reduces the risk in hypertension, obesity and metabolic syndrome. 1 Drinking enough water is a safe practice to help protect the kidneys from damage due to consuming higher levels of protein. Using Protein Supplements With numerous sources of proteins becoming available on the market, another key question is: what type of protein is best for athletes? A full spectrum of all essential amino acids is required for muscle health. Animal sources provide a complete source of amino acids, whereas vegetable sources generally lack one or more. This is the reason animal sources such as whey or egg are traditionally considered superior to vegan proteins for building muscle. The precise protein digestibility corrected amino acid score (PDCAAS) is considered the gold standard measure of protein completeness and how well protein is digested. 3 Whey and egg protein consistently have the highest scores in most protein assessment measures, but certain vegan proteins such as soy, rice and pea also score well and are now being used by athletes for muscle growth and recovery. Current research supports whey as the gold standard for muscle building and recovery. 1,4 This not only applies to athletes, but also to the aging population which is susceptible to muscle loss. Due to the presence of growth factors, whey protein can prevent the loss of muscle mass and maintain strength in the elderly over and above the effect of simple amino acids. 5 In terms of timing, a common recommendation is to deliver amino acids to the muscle during and right after activity, when the ability of muscle to uptake and use amino acids is the highest. One widely accepted idea is that, after exercise a minute window exists where the body has an increased ability to utilize carbohydrates and protein. Recent evidence calls this theory into question and now suggests that overall nutrient intake throughout the day may be a better focus. 6 It is not recommended to eat a large meal before vigorous exercise because it can cause gastric upset, although a small carbohydrate and protein rich meal or smoothie minutes before exercise and within 60 minutes after is still a prudent idea to optimize amino acid delivery. 6 Whey protein has some distinct benefits compared to vegan proteins. Whey protein upregulates glutathione production, a powerful cellular antioxidant that prevents cancer formation, protects cells from free radical damage and increases elimination of harmful chemicals. 7 Vegan proteins do not increase glutathione to the same degree as whey since they have lower levels of the amino acid cysteine, a key glutathione building block. Whey also has higher levels of Branched Chain Amino Acids (BCAAs). These specific amino acids (leucine, isoleucine, and valine) stimulate muscle growth and maintenance. 8 They will be discussed in greater detail later in the article. Milk Intolerance, Allergies and Whey Protein Conversely, some people can have a food allergy or sensitivity to animal proteins such as egg, dairy (casein) and whey protein. This is not to be mistaken with lactose intolerance, which is an inability to digest lactose, a sugar found in dairy products. Dairy products, including whey protein, are common food allergens; if a person is sensitive to either the carbohydrate (lactose) component, the protein component, or cannot digest dairy fats properly, then it may promote inflammation and digestive irritation, which can hinder athletic performance and prevent nutrient absorption. 9 However, some people may tolerate different forms of whey protein over others and most whey proteins are very low in the fat Advances 5

6 Whey proteins Promote bone growth Muscle strength Protease inhibitors Wound healing Improved cognitive function Mood Anticancer Anti-oxidative Cholesterol lowering Immunoregulatory Anti-inflammatory Insulinotropic Anti-hypertensive Anti-microbial Glycomacropeptide-no phenylalanineprotein source for PKU patients component. Whey isolate has the nonprotein components (lactose) partially or totally removed to isolate the whey protein, meaning it contains a higher percentage of protein than concentrate and less carbohydrate calories. Whey protein concentrate contains a very small amount of carbohydrates (lactose) and fats in addition to protein. Whey hydrolysate contains both concentrates and isolates. These proteins have been further broken down for faster absorption and assimilation. Nutrition Myth Buster: Do amino acids boost growth hormone production? For many years, research has been focused on naturally stimulating human growth hormone (HGH) production since levels decline with age. Glycine is one amino acid that attracted special attention after 2 studies in the 1970 s found it increased growth hormone in prepubescent children. 8,9 However, these results were never replicated and the original studies used intravenous glycine. Therefore, oral supplementation most likely does not have any substantial impact on growth hormone levels. However, recent studies have shown that resting growth hormone responses increase with oral ingestion of L-arginine (with a dose range of 5-9g of arginine). Within this range there is a dose-dependent increase and higher doses are not well tolerated. Most studies using oral arginine have shown that arginine alone increases the resting growth hormone levels at least 100%, while exercise can increase growth hormone levels by %. The combination of oral arginine plus exercise attenuates the growth hormone response, however, and only increases growth hormone levels by around 200% compared to resting levels. 9 The following study adds to the evidence that that glutamine boosts growth hormone levels. In a randomized, double-blind, placebocontrolled trial of 42 healthy middleaged and elderly adults, the subjects consumed either a placebo or 5g of a nutritional supplement composed mainly of glutamine, glycine, and niacin. The supplement was ingested twice daily for three weeks. At baseline and at the study s end, the investigators analyzed the participants blood. Ingesting the supplement led to a 70% increase in serum growth hormone levels compared to placebo, leading the researchers to conclude that an oral mixture of glutamine, glycine, and niacin can enhance growth hormone secretion in healthy adults. 9 Branched Chain Amino Acids (BCAAs) and Muscle Growth BCAAs are specific amino acids that have the most significant role in stimulating protein synthesis since they upregulate enzymes that are responsible for muscle growth. 10 BCAA s make up about 25% of animal protein and occur in a 2:1:1 ratio (leucine: isoleucine: valine) in nature. High quality supplements should reflect this ratio. BCAA supplementation also prevents damage to muscle during exercise. One randomized, placebo controlled study found that those subjects that used BCAAs during and after strenuous exercise had less muscle soreness and faster recovery than those subjects that 6 Advances

7 Optimum Performance Guide Mitigates muscle damage Reduces lactic acid build up Increases energy Improves lean body weight Supports muscle building Best taken minutes before exercise or up to 60 minutes after Can be taken at any time Can be taken at any time Best taken in divided doses before and after exercise Take 2-4 hours before exercise Best taken in divided doses before and after exercise

8 took placebo. 11 In addition to supporting muscle growth, studies also show that BCAAs aid in the maintenance and production of glycogen, which is responsible for muscle energy and is a stored source of fuel during exercise. 11 They may also help to delay the onset of fatigue and maintain mental function in aerobic exercise, because BCAAs can compete with tryptophan (a calming amino acid) in the brain. 12 Some evidence also suggests that BCAAs maintain immune function in athletes. There is no substantial evidence that BCAAs improve performance, but they do improve recovery in both resistance and aerobic athletes. Due to their muscle protective mechanism and the fact that BCAA plasma levels peak about 30 minutes after ingestion, they should be supplemented before and after exercise in divided doses. Leucine, in particular, is the most studied of the three BCAAs since it signals the synthesis of protein and glycogen in the muscle (anabolism, or building), and it also appears to modulate the secretion of insulin or its actions on muscle cells. Glycogen is a quick energy supply for working muscles. Post-workout glycogen storage has traditionally been thought to be increased only by consuming a good amount of simple carbohydrates immediately post-exercise. Studies have gotten mixed results when examining the effect of combining protein or BCAAs with carbohydrates for elevated post-exercise glycogen synthesis. The more muscle glycogen stores can be increased, the more energy is available for the next exercise session, resulting in better performance. In terms of protein anabolism, the importance of leucine is demonstrated by the fact that when all amino acids are supplemented except leucine, protein synthesis decreases by 40%. The Amino Acid L-Carnitine L-carnitine is an amino acid that plays a central role in the breakdown of fatty acids and their subsequent transport into the mitochondria to be used in the production of cellular energy. 13 L-carnitine has been studied to address conditions such as angina, heart damage, peripheral vascular disease, diabetes, chronic fatigue syndrome, kidney failure and athletic performance. A number of studies using human subjects have found that L-carnitine supplementation reduces damage to muscle and decreases muscle soreness, especially after exhaustive exercise when oxygen is limited. 14 The primary mechanisms responsible for the positive results are the increase in energy formation in the mitochondria, the reduced build up of lactic acid and free radical damage to muscle cells. A new mechanism being explored is that L-carnitine improves blood flow in areas with poor oxygen levels, which can be beneficial for those doing intense exercise and for those with conditions such as diabetes or peripheral artery disease. 14 Despite the positive effects on muscle recovery, L-carnitine supplementation does not appear to improve performance markers such as strength and speed directly. 13 Some studies do show that oral carnitine reduces fat mass, increases muscle mass, and reduces fatigue, which may contribute to weight loss in some people. Additionally, disorders of fatty acid oxidation and metabolism typically are associated with primary and secondary forms of carnitine deficiency. 15 Nutrition Myth Buster: Does drinking coffee before a workout improve performance? Many people like to drink a coffee or another caffeinated beverage before their workout in the hopes it will boost their performance. Caffeine has been intensely studied as a potential sport performance aid. The summary of the research suggests it improves focus in intense and mentally demanding exercise. It also appears to reduce the use of muscle glycogen (an energy source) in endurance athletes. Additionally, it may help promote the recovery of glycogen after exhaustive exercise. 16 The evidence shows a moderate improvement in performance for endurance sports, but really does not apply to resistance athletes. It is important to note that most studies used dry caffeine extract and the same effects were not achieved when coffee was used in the trials. The typical doses 8 Advances

9 used were 3-6mg of caffeine per kg body weight (equal to approximately mg for an average 70kg male). As a reference, a typical medium (14 oz) coffee contains 140mg of caffeine. 16 In summary, drinking a coffee before an aerobic workout should be beneficial although the same cannot be said for resistance training. In terms of fat loss and increasing the metabolism, at least one study showed that caffeine/coffee stimulates the metabolic rate in both control and obese individuals; however, this was accompanied by greater oxidation of fat (use of fat as an energy store) in the control group only. 17 Other Nutrients That Improve Sports Performance Astaxanthin is a unique and powerful antioxidant that is being studied for a wide variety of conditions including eye fatigue, cardiovascular disease, and diabetes. 18 Astaxanthin appears to also improve muscle function after exercise since it may protect cells and mitochondria from free radical damage. It may also reduce lactic acid formation, which reduces muscle soreness, allowing athletes to perform exercise longer. 18 To support this theory, a number of studies in human subjects have shown astaxanthin supplementation improves both resistance and endurance performance. 19,20 One study supplemented athletes with 4mg of astaxanthin for 6 months leading to an improvement in the number of squats in just 3 months. 20 D-Ribose is a naturally occurring sugar that has been studied in heart failure, fibromylgia and exercise performance as a way to improve muscle energy production. A double blind, placebo-controlled trial looked at the effects of supplemental ribose on body composition and exercise performance in 20 male bodybuilders. They were given 10g/day of D-ribose for 4 weeks while on a strength training program. The results showed an improvement in the total work performed and in bench press strength. 21 More research is needed to confirm this effect, as a number of other studies have found that supplementation with D-ribose had no effect on exercise performance; although they used a lower dose (less than 3g. Colostrum is the first milk (before normal milk is produced) secreted by mammals when a baby is born that is very rich in immune and growth factors. Many athletes suffer from poor immunity as a result of intense training, making colostrum an attractive supplemental option. The evidence suggests that colostrum helps maintain intestinal barrier integrity, immune function, and reduces the chances of suffering upper respiratory tract infection symptoms in athletes undertaking heavy training. 22,23 The latest evidence suggests colostrum may improve lean body weight (compared to whey protein) and helps maintain testosterone levels during exercise. 24 Nutrition Myth Buster: Is creatine harmful or helpful? Creatine is one of the most studied sport performance supplements. Numerous studies have found it to be safe and beneficial for increasing high-intensity exercise capacity and lean body mass during training. 25,26,27 Supplementation studies with creatine have found that subjects experience a 10-15% improvement in strength and anaerobic performance, and increased muscle size gains. 26 Creatine provides the building blocks to produce a type of rapidly used energy called phosphocreatine which allows a person to train harder. Other emerging areas of research include looking at creatine in other diseases and injuries (i.e. Alzheimer s disease, muscular dystrophy, concussions, etc.) that could benefit from improved energy production. In summary, creatine can be used to improve strength, muscle size and reduce exercise fatigue. It s recommended for athletes who compete in short duration, high intensity sports like football, volleyball or weight lifting, but there is little benefit for endurance athletes such as runners or cyclists. What You Need To Know It is now well established that a balanced diet and appropriate supplementation can enhance sports performance. Protein is an essential dietary component, and whey protein in particular offers several health benefits. Branch chained amino acids are essential amino acids that improve recovery times from both resistance and aerobic activity, as does the amino acid L-carnitine. Other nutrients that improve sports performance include astaxanthin, D-ribose and colostrum. Advances 9

10 Weight Loss: The Importance of Balancing Blood Sugars Research has uncovered a multitude of factors that contribute to weight gain and the deposition of fat within the body (see Box 1). But at the core of many of these factors is the poor regulation of blood sugar levels. It is crucial to keep blood glucose relatively stable, avoiding the rollercoaster of sudden peaks and steep crashes. With such irregular patterns, your body actually craves more food and is less efficient at burning fat. 1 The end result is a larger waistline. Carbohydrates in our diet can drastically influence our blood sugar levels because they are digested and broken down into simple sugars like glucose. Once glucose is absorbed into the bloodstream, our body has a decision to make: how much sugar does it currently need? If our body requires energy immediately, then it will use the available sugar. However, if the amount needed is less than that in the bloodstream, the excess sugars will be stored as fat reserves. 2 At the same time, our body turns off its fat burning efforts and increases blood sugar levels to promote fat gain and prevent fat loss. Any time our body reaches peaks and valleys of blood sugar levels, hormones have to step in and perform an adjustment. Two hormones in particular are responsible for this balancing act: insulin and glucagon. The Roles of Insulin and Glucagon In a very basic sense, insulin is responsible for lowering blood sugar when it becomes too high (ie. after a large meal) by depositing the sugar into our cells for storage. Glucagon has the opposite effect. Its job is to release sugar from our cells into the blood and increase blood sugar when we have not eaten recently (See Figure 1 on page 12). This reciprocal relationship and balancing act is crucial for weight management. If excess insulin is constantly produced in response to excess glucose, we get increased fat accumulation. An even worse scenario occurs when too many spikes in sugar and insulin cause the body tissues to become unresponsive to the hormone. In this case, tissues cannot uptake glucose and your body is at risk of becoming insulin resistant (a key pathophysiological feature of Type 2 Diabetes Mellitus where sugars build up and damage organs). To keep insulin and glucagon working together in harmony, we need 10 Advances

11 to prevent high blood sugar spikes, which are largely mitigated by proper diet and exercise. The Glycemic Index Carbohydrate foods can be categorized based on how quickly they are broken down and absorbed into the bloodstream. Foods that create a rapid elevation of blood sugar are considered high glycemic index (GI) foods and those that generate a minimal response are categorized as low GI foods, (Glycemic Load [GL] is another common measurement that accounts for both GI and serving size). When it comes to weight loss, low GI foods increase satiety, reduce hunger levels, and decrease the amount of food eaten later in the day. 1 Carbohydrate foods with a low GI will generate much less insulin and allow our bodies more access to fatty acids to burn for fuel. Increased fat oxidation has been demonstrated during moderate exercise bouts. Better yet, research has also shown that resting energy expenditure is higher on a low GI diet when compared to a low fat diet. 1 This means that even when you re just sitting on the couch, your body is burning more energy if you eat lower GI foods. One study examining the effects of GI on weight loss in overweight adults found promising results after 12 weeks. The low GI diet was found to be almost twice as effective at lowering weight by 5% or more when compared to a high GI, low fat diet. 3 However, all research in this area is not so cut and dry. Other studies have found less significant results, demonstrating that weight management cannot be reduced to a single factor. 4 Now that we understand just how important blood sugar and insulin regulation is for weight management, let s take a look at a number of innovative nutrients that have been shown to help stabilize them. Green Coffee Bean Extract Green Coffee Bean Extract (GCBE) has been all the rage in the media over the past few years as a weight loss supplement, and with good reason. It Box 1. Is weight loss just about calories in and out? It is very well known that weight management is affected by excess caloric intake and insufficient exercise (essentially, consuming more energy than you re burning). Yet there are many people that are eating healthy and exercising without losing weight. This is because the body is not built so simply. Hormone imbalances resulting from chronic stress, poor sleeping patterns, nutrient deficiencies and chemical exposure can cause metabolic disturbance. Collectively, these dietary and lifestyle factors may lead to the dysregulation of hormones (such as glucagon and insulin) which can interfere with weight loss. contains chlorogenic acid, the active ingredient responsible for aiding weight loss (different than caffeine, known to generate a thermogenic or heat-producing effect). A 2012 study found that GCBE supplementation reduced weight by almost 18 pounds and body fat by 4.5% in human subjects over a 22-week period. 5 A large part of its success in weight loss hinges on the fact that the chlorogenic acid reduces the absorption of glucose, in turn leading to less of a spike in blood sugar after meals. One study found that glucose absorption in the small intestine of those consuming Svetol, a GCBE high in chlorogenic acid, was 6.9% less than control group subjects. 2 Subsequent research confirmed that chlorogenic acid reduces blood glucose and insulin responses after an oral glucose tolerance test (OGTT, a standardized test for measuring blood sugar regulation ability). 6 As a final bonus, GCBE has also been shown to induce weight loss by inhibiting an enzyme in the liver known as glucose-6-phosphatase (G6P). By blocking this enzyme, chlorogenic acid prevents the release of glucose from the liver and shifts the fuel burning efforts toward fatty acids. 7 All in all, GCBE utilizes a number of mechanisms to stabilize blood sugar and reduce body weight. Alpha-Lipoic Acid Alpha-lipoic Acid (ALA) is a shortchain fatty acid and vital antioxidant responsible for proper mitochondrial function. 8 It is one of the only antioxidants known to be both water and fat soluble, implying that it can exert its action in various tissues and parts of the cell. 9 Recent research has shown that ALA can improve cognitive function but it has also been examined for managing blood sugar, diabetic neuropathy and weight. ALA has been shown to increase glucose uptake into muscle cells, enhance insulin function and reduce insulin resistance. 9 One study found that it modestly reduced body weight after 20 weeks of supplementation. Over 20% of Advances 11

12 the participants taking high dose ALA reduced their weight by greater than 5%, an accomplishment met by half as many in the placebo group. 10 While this group of 228 subjects contained a mixture of those with and without diabetes, a recent study in schizophrenic patients without diabetes found significant weight loss effects. This suggests that ALA s weight reduction abilities may be due to a variety of mechanisms. 11 Note: ALA exists in two forms, R-lipoic acid and S-lipoic acid (SLA). Most alpha-lipoic acid supplements are a 50/50 mixture of the two. This is important to know because RLA is the biologically active form within the body and the supplemental form that must be used for blood sugar regulation and weight management. 9 For managing blood sugar, RLA should be taken 30 minutes before a meal in order to mirror the elevation of glucose. Green Tea Extract Green tea extract (GTE) has long been touted as a weight loss agent with a wide variety of health benefits. It contains a number of catechins responsible for such benefits, and epigallocatechin gallate (EGCG) is the most potent of the bunch. A 3-month study in obese individuals found that GTE positively affected body mass, waist circumference, LDL cholesterol and blood sugars. 12 On average, those taking the GTE reduced their waist size by 3cm and body mass index (BMI) by 1.5 points. 12 Another 3-month study examined the metabolic effects of GTE on 56 individuals with obesity-related high blood pressure. 13 GTE supplementation reduced blood pressure and significantly improved markers of insulin resistance, inflammation and oxidative stress. These three processes are all central not only to obesity, but also other chronic diseases such as cancer, cognitive dysfunction and cardiovascular disease. This speaks volumes for the wide application of GTE for general health. 13 Overall, a meta-analysis of 17 total studies determined that green tea consumption significantly reduces fasting glucose concentrations and Figure 1. Raises blood sugar Glycogen Liver Lowers blood sugar Stimulates glycogen breakdown Glucose Stimulates glycogen formation hemoglobin A1c levels (a measure of long-term blood sugar regulation). 14 Fasting insulin concentrations were improved as well. Given the totality of research and multifaceted mechanisms, it seems prudent to conclude that a high quality GTE is an effective adjunctive approach to balancing blood sugar levels, reducing weight and maintaining general health. Resveratrol Resveratrol is the polyphenolic ingredient found in grapes (and red wine) shown to turn on anti-aging genes that mimic caloric restriction. It High blood sugar Tissue Cells Glucagon Low blood sugar Insulin Stimulates glucose uptake from blood Promotes insulin release Promotes glucagon release is a potent antioxidant that improves insulin sensitivity and blood glucose measurements in those with impaired glucose tolerance, 15 but also has a unique influence on fat cells. New research has discovered that resveratrol decreases the size of fat cells in obese men and perhaps upregulates their breakdown. 16 This confirms previous test tube and animal research demonstrating increased fat breakdown and decreased fat synthesis. 17 The potential benefits of this antioxidant for sugar regulation and weight management appear to be just unfolding. What You Need to Know In order for the body to successfully lose weight and remain at a healthy weight, it is necessary for the body to be in balance. Having balanced blood sugar and hormone levels (primarily insulin and glucagon) are important for regulating metabolic activities and fat breakdown; instabilities in these levels makes losing weight and burning fat increasingly difficult. Research indicates that certain supplements can make weight loss easier to achieve such as green coffee bean extract, resveratrol, green tea extract and R-lipoic acid. These supplements help to stabilize blood sugar levels, reduce weight, and benefit overall health. 12 Advances

13 the Beet Revolution Beets are renowned for being one of the most beneficial vegetables because of their high nitrate content. AOR s NOx products effectively convert the nitrates found in vegetables like Beets and Spinach to Nitric Oxide in your body. Nitric Oxide isn t just for bodybuilders, it has important research-proven effects for heart health, stress, energy, bone health and immunity. Revolutionize your health with the power of Beets! Proudly Canadian ADVANCED ORTHOMOLECULAR RESEARCH

14 Immunity for the Athlete: Supplements to Reduce Effects of Overtraining It has long been known that exercise is a key component in a prescription for a healthy lifestyle. With respect to the athlete, the issue is not whether you are getting enough exercise, but rather how exercise can be potentially harmful when it relates to your immune health. As an athlete, understanding the relationship between exercise and infection is very important for long term success. The J Curve Many individuals who begin an exercise routine often note that their immune health is much stronger since becoming athletic. As the athlete progresses in their training, however, there often comes a time when too much of a good thing becomes detrimental to the immune system. In the research, this is often noted as the J curve (see Figure 1) of exercise as it relates to infection, particularly upper respiratory tract infections (URTI). 1 The model demonstrates that when an athlete engages in moderate exercise, the risk of infection decreases compared to someone who is sedentary. 1 However, with high-intensity exercise (e.g marathon training), the risk of infection may rise above average and athletes may become more prone to infection. Overtraining The J curve concept can also be explained by defining some phases of athletic training. Overreaching is a period of training where the athlete is pushed to their limits, forcing the body to adapt to new levels of stress. The athlete will become physically and mentally fatigued, and performance may worsen for a time, but after adequate rest, their performance is even better. 2,3,4 Overtraining occurs when an athlete is pushed to their limits without adequate rest, and performance degrades for 2 months or more. 3 Overtraining syndrome is usually characterized by a decline in performance, chronic fatigue, depressed mood, sleep issues, reduced appetite, increased incidence of illness such as colds and flu, and increased incidence of injury such as strains, sprains and stress fractures, and much more. 2,3,4 If not corrected, overtraining can lead to burnout or withdrawal from training for physical and mental health reasons. 3 Stress and the Immune System Overtraining syndrome has recently been recognized as a stress syndrome, paralleling the alarm, adaptation and exhaustion stages of stress or adrenal insufficiency. 2,5 In fact, overtraining often results from a combination of intense training, inadequate rest and other life stressors. 2,3,4 High levels of cortisol, the primary stress hormone, have been found in athletes experiencing overtraining. 4 When cortisol is high, the body enters a catabolic state where survival is the priority, not repair. Vigorous exercise training damages the muscle and results in oxidative stress and inflammation. This is a normal part of the process of adaptation. The body enters a hyper anti-inflammatory stage which is followed by immunosuppression partly due to cortisol (considered an anti-inflammatory hormone). 2 Here, the immune system is weakened for 3-72 hours, but this window of immunosuppression can be prolonged with repeated cycles of stress followed by inadequate rest and recovery time. 4 This leaves room for increased risk of infection and injury. When overtraining is severe enough and burnout is imminent, cortisol levels will 14 Advances

15 drop due to adrenal insufficiency and chronic fatigue, lethargy and apathy will set in, and illness and injury will be more prevalent. 3,5 Infection in Distance Runners Research led by Nieman and colleagues measured the incidence of URTI for marathon athletes training for a race. It was determined that runners training more than 96km/wk doubled their odds for illness compared with those training less than 32 km/wk. 6 In another study by led by Peters and Bateman, they looked at the incidence of URTI in 150 randomly selected runners who took part in a 56km race in South Africa and compared them to matched controls who did not run the race. Symptoms of URTI occurred in 33.3% of runners compared to 15.3% in controls during the 2 weeks after the race and were most common in those with the faster race times. 7 Thus, it appears both distance and speed are factors in relation to immune system susceptibility. Injury in Athletes A study on college athletes determined an association between overtraining and injury. 8 In this study, the average training regimen was 2-3 hours of moderate to intense training 4.5 days per week, and another 2-8 hours/week of light or leisure exercise. The athletes felt physically exhausted 25-33% of the time during competition season, and 17-20% of the time in the off-season. Half of the athletes reported chronic injuries. Clearly, proper periodization, tapering and balancing training against other life stressors are vital to both the health and the performance of the athlete. Supplements for Overtraining Now let s examine some potential supplement considerations to reduce the risk of infection due to overtraining and burnout. B complex: This is a group of eight essential vitamins including vitamins B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B12 (cobalamin), folate and biotin. Adequate intake of B vitamins is important for optimum Figure 1. Research Shows Athletes Have an Increased Risk of Respiratory Infections at High Levels of Exercise Intensity The J-Curve Risk of URTI Above Average Average Below Average Sedentary energy production and repair of muscle tissue. 18,19 B-vitamins are quickly used up by the body during periods of stress, especially vitamin B5 in the form of pantethine. Vitamin B6 directly supports immune cell production. Vitamins B1, B2, B3, B5, B6 and biotin are involved in energy production during exercise while folate and vitamin B12 are required for the production of red blood cells (carry oxygen), protein synthesis (builds muscle), and in tissue repair. 19,20 Vitamins B2, B6, B12 and folate are often found low in female athletes diets, especially those who are vegetarian or who suffer disordered eating patterns. 16 Magnesium: This mineral plays a variety of roles in cellular metabolism (of carbs, fats and proteins), regulates membrane stability and regulates neuromuscular, cardiovascular, immune and hormonal functions. 21,22 Magnesium deficiency impairs endurance performance by increasing oxygen requirements to complete submaximal exercise. Athletes in weight class (wrestling) and body conscious (gymnastics) sports have been reported to have inadequate dietary levels of magnesium. 21 Rhodiola is an herb known as an adaptogen. Adaptogens have the ability to help manage the effects of stress. Rhodiola has been shown to Moderate Exercise High Intensity Exercise Amount and Intensity of Exercise be very effective at modulating one of our stress hormones called cortisol. Under chronic stress or intense periods of exercise, cortisol remains elevated which causes impaired recovery for the athlete as well as lowered levels of sex hormones and a disrupted sleep cycle. For example, it is often noted that female athletes training at a high level will stop menstruating; this is a noted effect of elevated cortisol (although it can also occur due to low body fat). Additionally, a 2012 study showed that those athletes consuming Rhodiola before exercise displayed decreased heart rate, improved endurance and enhanced mood. 23 Ginseng: Another herb in the adaptogen class, ginseng has been used for centuries in traditional Asian cultures. Panax ginseng (aka Red, Korean or Asian ginseng) has many medicinal properties derived from its active constituents known as ginsenosides. It has shown to be of benefit for many stressors including heat, cold, trauma, sleep deprivation, infection and intense exercise. In one study performed by Ziemba and colleagues, fifteen soccer players averaging 19 years of age were placed into 2 groups, placebo and ginseng. They were then placed on a bicycle ergometer at various stages until exhaustion was reached. Along the way, they were measured on reaction time, Advances 15

16 mental alertness and mental acuity. The study concluded ginseng does improve psychomotor performance and reaction time during exercise without affecting exercise capacity. 24 Phosphatidylserine (PS): A naturally occurring compound of an amino acid (serine) bound to a phospholipid, PS is required for the functioning of all cells and is found in highest concentrations in the membranes of cells with high metabolic activity such as the brain, heart, liver and skeletal muscle. 25 While previous research focused on the role of PS on the brain in relation to cognitive support and cognitive decline prevention, recent research has examined its role in athletics. A 1990 study examined the effects of PS on cortisol levels during exercise and demonstrated a blunting of cortisol when vigorous exercise was performed. 26 This is a real positive because as previously noted, chronically elevated cortisol levels disrupt many systems in the body. The next phase of the study looked at the long term effects of PS supplementation on post exercise cortisol following strenuous resistance training. The results showed not only a continued blunting of cortisol, but also a lower level of perceived muscle soreness post-exercise, a real win-win. 27 Colostrum, also known as the first milk, makes up the first few meals of newborn mammals. It is produced in the breasts of the mother for several days after birth, followed eventually by regular milk. It provides the newborn with the necessary immune factors to fight infection, such as immunoglobulins, leukocytes, cytokines, lactoferrin and polyproline-rich peptides (PRP) so that the newborn can survive its first few days of life as well as prepare the immune system for lifelong protection. With direct application to athletics, one study looked at the effects of colostrum on immune variables in highly trained cyclists and concluded that colostrum balances immune parameters during normal training as well as after an acute period of intense exercise. This may have contributed to the trend toward reduced upper respiratory tract illness in this group. 28 The following checklist may help athletes who are preparing for an event to help reduce their risk of illness and infection. Eating a well-balanced, clean diet will help to maintain proper vitamin and mineral levels during training and race day. 9 Keep life stresses to a minimum by establishing healthy ways to cope with stress; mental stress has been shown to increase the risk of infection. 10 Avoid overtraining (training beyond what the body can recover from or adjust to) as this has been shown to increase risk of infection. 11,12 Avoid rapid weight loss (e.g. more than 1% of body weight per week) as it has been linked to decreased immunity, especially T cell (immune cell) suppression. 13 Avoid putting hands to eyes and/or nose (primary route of virus entry into body) before important race events. 14 Obtain adequate sleep on a regular schedule. Sleep disruption has been linked to suppressed immunity. 15 Using carbohydrate beverages (such as healthy drinks including coconut water or natural electrolyte replacers) during and after heavy training or long race events may lower the impact of stress hormones on the immune system. 16,17 Pelargonium sedoides: A member of the geranium family of plants, this South African herbal has been used traditionally to treat issues of respiratory illness of both viral and bacterial origin. Its roots contain active chemical compounds known as phenols and coumarins which have shown immune boosting and antimicrobial effects. One of Pelargonium s key features is its ability to help prevent the adherence of bacteria to the respiratory mucosa, thus minimizing colonization and infection. 29 As upper respiratory infection is a common occurrence and complaint among athletes, this herbal may be worth considering especially after a bout of intense training. Balancing it All Out As with many things, too much of a good thing can be bad. The same applies to exercise and athletics as it pertains to the immune system. It is important for the athlete to listen to their body cues when it comes to timing for rest and repair. Emphasis needs to be on the management of external stressors outside of training, appropriate sleep and diet. In addition, some key supplements may allow the athlete to rise even higher in their athletic pursuits as a result of their immune system being nourished. What You Need to Know Maintaining a high level of athletic performance and staying healthy in general all have related common factors. It is important to have a healthy diet and avoid excessive stress. However, supplements can help to fortify the body and prevent some of the pitfalls of overtraining including illness, injury and burnout. Certain vitamins, minerals, adaptogens and herbs are key supplements for supporting the body as an active person. Magnesium and B-vitamins are essential maintenance therapy for athletes. Herbal adaptogens such as Rhodiola and Asian ginseng can help prevent burnout and bolster the body against stress. Phosphatidylserine can help reduce cortisol levels. Colostrum directly supports the immune system and, along with Pelargonium sedoides, decreases the risk of upper respiratory tract infections among athletes. 16 Advances

17 Manage Your Training Burnout burnout can affect anyone from the high performance athlete to the regular gym goer. By making use of a few carefully chosen supplements you can reduce the impact burnout can have on your training schedule. Replenishes B vitamins depleted by increased stress Prevents post exercise muscle soreness Prevents magnesium deficiency which can impair muscle function Reduces risk of upper respiratory tract infections Improves reaction time and boosts exercise capacity Relieves colds and cold symptoms faster Supports muscle repair and recovery Increase endurance Improves muscle function Improves energy production Supports immune function Reduces recovery time

18 Move to the Beet of Nitric Oxide Often, the smallest, simplest molecules have the greatest importance. Nitric oxide (NO) is made up of one atom of nitrogen and one atom of oxygen. It is one of the most important molecules able to influence metabolic activities and have diverse effects throughout the body. Previously, it was thought that the main pathway by which NO was produced in the body was from the amino acid arginine, which is what made arginine such an attractive workout supplement for gym-goers, athletes and even heart patients. However, scientists now understand that NO is produced even more effectively through the consumption of nitrates and nitrites found in foods such as beets, spinach, lettuce, bok choy, celery and so many of the healthiest vegetables in the world. In fact, researchers think that higher NO production through increased nitrate and nitrite consumption may be in large part responsible for the health benefits attributed to diets such as the Mediterranean diet and the DASH diet (the Dietary Approaches to Stop Hypertension) which exceeds the acceptable daily intake for nitrate set by the World Health Organization by 550%. 1 Vegetarian diets and the newer trend of a vegan diet are also known to produce lower blood pressures and hence better cardiovascular function and exercise endurance. 2 The Age Factor NO production in the body decreases after the age of 30, and blood vessel production of NO is almost totally compromised between the ages of ,4,5 But the ability of the blood vessels to respond to NO doesn t change. So while dietary nitrate and nitrite consumption can benefit younger, recreationally active people during exercise and at rest (in fact, most of the athletic performance studies have used healthy male subjects in their 20s, and most have found benefits), it may hold even greater benefits for middleaged and elderly people. In fact, a small study noted that older adults around the age of 70 did not even actually absorb nitrate from nitrate-rich foods but did so from nitrate supplements, making supplementing with nitrates even more important as you age Advances

19 Exercise and Your NO Levels If you exercise, then you are already doing one of the best things you can to protect yourself against the agerelated decline in NO production in your blood vessels and against arterial stiffness. 3 But exercise also increases the responsiveness of the blood vessels to NO! A study on healthy older adults aged years found that the blood vessels of those who exercised, burning the equivalent of calories to walking 1 hour a day, were almost 10% more responsive to nitroglycerin (an NO source given orally) than those who were less active. 7 NO and Your Fitness Levels NO helps regulate many different functions in the body including sleep, immunity, bone health, multiple aspects of cardiovascular health such as the blood pressure, blood clotting, cholesterol, and more. Of course, all of these influence health and fitness. But more specifically, NO can benefit exercise capacity, fitness and athletic performance in several interlinked ways. NO has come to be known as the endothelial-derived relaxation factor. What this means is that NO is produced by cells lining the blood vessels, and it signals the blood vessels to relax or widen. This reduces blood pressure and improves blood flow. As a result, more oxygen and nutrients get delivered to the muscles and the heart, allowing them to function better at the same exercise intensity. This is called improving your VO 2, or the amount of oxygen you need to use at a given exercise intensity, and is one of the main goals and outcomes of endurance training. The fitter an endurance athlete is, the harder and longer they can work with less oxygen at a given exercise intensity. The presence of NO seems to increase energy production efficiency. Supplementing with a nitrate source causes muscles to use less energy during contractions, do more work, and delay fatigue during exercise. Supplemental nitrates have also been shown to allow mitochondria to produce more energy more efficiently by enhancing their function. 8 This is especially important Dose-Dependent Effects of Nitrate on Exercise and What It Means For You Effect: Peak changes resulting from nitrate supplementation occurred 2-3 hours after consumption. Conclusion: Take your nitrate supplement about 2 hours before engaging in minutes of exercise. If you re a long distance runner or cyclist, take your supplement 0-60 minutes before exercising and during. If your supplement is in a lozenge form, take it minutes before exercise as well as during exercise for longer events. Effect: A dose of 260 mg of nitrate had almost no effect on exercise, similar to the placebo. This is the same maximum daily intake recommended by Health Canada. Conclusion: While the daily recommended amount of nitrate in Canada will still offer health benefits, you will probably need more if you want the performance benefits. Effect: An acute dose of 1040 mg of nitrate improved oxygen consumption efficiency by 3% compared to a dose of 520 mg of nitrate at 1.7% during moderate exercise. However, supplementing with around 500 mg of nitrate over 3-6 days may improve oxygen consumption by up to 7%. Conclusion: During moderate, steady state or long-distance exercise, the more nitrate you take, the better you will perform. However, supplementing with a lower dose for several days before might work even better. Effect: The 520 mg dose of nitrate delayed the time to fatigue by 14% while the higher dose of 1040 mg only delayed it by 12%. Conclusion: An acute, moderate dose of nitrate is sufficient to delay fatigue during shorter bursts of high-intensity exercise. for people with disorders related to mitochondrial dysfunction and during aging since mitochondrial damage accumulates with age and is thought to be related to a host of common agerelated diseases (including vascular dysfunction or hypertension. Beetroot Juice Studies Most beetroot juice studies have been done on cycling, walking and running, and with the exception of some elite, highly trained athletes, they have all found improved performance. 9,10 A clinical study compared the effects of beetroot juice versus a placebo on exercise in recreationally active men between 20 and 40 years of age. 11 During moderate exercise, the beetroot juice group had lower oxygen consumption in both the lungs and the muscles, and during intense exercise their fatigue was delayed over the placebo group. A second similar study was done on healthy men and women around years of age. It showed that VO 2 was 4% lower after 2.5 hours of steady state exercise after just 5 days of supplementation, with this effect lasting until the end of the study which was 15 days long. 12 Just to be sure that the authors were correct in assuming that the nitrate in the beetroot juice was responsible for these benefits, a study compared the effects of nitrate-rich beetroot juice against nitrate-depleted beetroot juice on exercise. 13 They were right: the nitrate-rich beetroot juice lowered blood pressure, improved performance at all exercise intensities (both walking and hard running), and delayed fatigue during intense exercise after just 6 days of supplementing while the nitratedepleted beet juice did not. Finally, a similar group of authors decided to see Advances 19

20 what the optimal dose of nitrate was that would have these effects. 14 Their findings were very interesting (on page 19), but ultimately they found that while a dose of juice containing 1040 mg of nitrate increased the efficiency of oxygen usage during moderate exercise more than 520 mg of nitrate did, there was no extra benefit in taking the higher dose for delaying fatigue. A recent study even showed that athletes in intermittent interval type sports could benefit from nitrate supplements. 15 Young men involved in recreational team sports underwent a test meant to simulate short bursts of intense activity with brief breaks in between like in hockey, soccer and other such sports. Just 30 hours of supplementing with a nitrate-rich beet juice improved test performance by over 4%. Based on other findings, the authors suggest that the improvements were due to increased NO levels, better glucose use and better muscle contractility. People with arterial or cardiovascular diseases are no exception. Studies have shown that people with peripheral arterial disease get the same benefits from beetroot juice during exercise as mentioned above. 16 AOR s Stamina Shot has been designed to provide the Canadian recommended daily intake equivalent of nitrate from potassium nitrate in one small bottle, supplemented with nitrate-containing beetroot juice and a touch of magnesium for additional muscle function benefits. Stamina Shot is coloured naturally by the beet juice and with red raspberry juice, and contains vitamin C and green tea extract as part of AOR s proprietary NOx 3,2,1 Technology to enhance the conversion of nitrate to active NO. Whether you are in sports, working out, dealing with cardiovascular issues or are middle-aged, just 1-2 bottles of Stamina Shot can provide you the boost you need. Supplemental Nitrate Studies Since nitrate is the active component in beet juice, some studies have used sodium nitrate as a direct supplement and have found similar benefits as those using nitrate-rich beet juice. If beet juice is not your thing, you can opt for a nitrate supplement, such as AOR s NOx Boost or EnergyNOx. NOx Boost lozenges capitalize on two important facts: that nitrate is converted into nitrite and then into NO in the body, but more importantly, that this conversion occurs much faster when nitrate is dissolved in the mouth than when swallowed. NOx Boost lozenges contain all the ingredients to ensure that this conversion occurs effectively. They are naturally sweetened with natural low glycemic sweeteners, coloured and flavoured naturally with berry and beet extracts, and contain a small amount of vitamin C to complete AOR s NOx 3,2,1 Technology requirements. So for the quick preworkout or mid-workout boost, NOx Boost provides a tasty way to replenish your NO levels and boost 20 Advances

21 your performance. Since NO also increases circulation and the delivery of blood, oxygen and nutrients to the muscles, NO could potentially be a vital addition to a post-workout supplement regimen or snack to make sure your muscles are getting the most nutrients possible for growth and repair. Combining Nitrate with Other Supplements If you are looking for a sports nutrition supplement that enhances performance in more ways than one, then EnergyNOx is for you. Of AOR s NOx series products, EnergyNOx is the most tailored toward increasing athletic performance. EnergyNOx combines Asian ginseng (Panax ginseng) with potassium nitrate. Not only do you get the benefits of increased NO levels, Panax ginseng enhances physical and mental performance under stress, supports blood sugar balance, reduces fatigue and blood lactic acid levels, making it the ideal sports nutrition supplement. Panax ginseng has been documented to help with physical stress as well as mental stress. It has been shown to help improve cognitive skills such as better focus, calmness and reduced mental fatigue in situations requiring a greater cognitive load or those causing mental stress. 17 This is important for athletes in competition or during difficult drills, since mental stamina is just as important as physical stamina. Studies have found that Panax ginseng can help improve exercise capacity. 18 In one study, 1350 mg per day of a Panax ginseng supplement taken over 30 days improved time to exhaustion, and lowered blood pressure and required oxygen intake during endurance exercise. Panax ginseng also has ergogenic properties in facilitating recovery from exhaustive exercise, reducing exercise-induced muscle damage and inflammatory responses and supporting muscle repair. 18,19,20 Panax ginseng has also been shown to help regulate blood sugar, possibly by improving insulin sensitivity and improving glucose usage by the body. 17,21 In COPD patients, all measures of lung function as well as maximal exercise capacity were increased when Panax ginseng was administered for 3 months with no side effects whatsoever. 22 In a mouse and in vitro study investigating the effects of Panax ginseng on nitric oxide production by blood vessels, the ginseng was found to protect the blood vessels, increase their responsiveness and improve impaired vascular function by increasing nitric oxide signaling. 23 These findings make Asian ginseng a suitable supplement for the elderly, those with compromised exercise capacity or those with blood vessel or lung disorders as well as athletes who want to be on top of their game. It s easy to see why nitric oxide is so popular in research and in the media recently. Not only is consuming adequate nitrates and nitrites through a healthy diet important for producing nitric oxide, but other nutrients that support NO s production and function in the body may be very useful for the young and old alike. Boosting NO activity is of prime importance for health and fitness, and AOR makes it easy to do, wherever you re at in life. What You Need to Know Due to their ability to produce nitric oxide (NO) in the body, nitrate-rich beet juice or isolated nitrate supplements have been shown to improve physical performance and delay fatigue by reducing the body s oxygen requirements, improving the body s energy production and usage and enhancing mitochondrial function, particularly in recreational athletes, people who are trying to become more active and in older adults. Cyclists, runners, walkers and those involved in intermittent high-intensity activities/sports have been shown to perform better after consuming nitrates. Middle-aged people, the elderly and those with compromised exercise capacities due to lung or cardiovascular complications can greatly benefit from nitric oxide-enhancing supplements. AOR offers several revolutionary products that capitalize on the fitness-boosting effects of NO each in different ways: Stamina Shot, a small but potent beet juice and magnesium drink; NOx Boost, a tasty lozenge for a fasteracting NO boost; and EnergyNOx, encapsulated Asian ginseng and nitrate to boost physical performance and mental performance during exercise, regulate blood sugar and support exercise recovery. Since exercise also increases the body s responsiveness to NO supplements, the two go hand in hand. Advances 21

22 Curcumin: Cellular Protector and Performance Booster Curcumin is widely used and well recognized as a highly valued component of the turmeric root. Used extensively in India for cooking and medicinal purposes, it boasts many health promoting chemicals and has been the subject of intense research over the last few years. It is now well established that curcumin protects against inflammatory disease, diabetes, prostate cancer, Alzheimer s and heart disease, among other health issues. 1 More recently, the health promoting properties of curcumin have been further investigated to determine how they affect exercise performance. Curcumin is not only a potent antioxidant that helps to protect cells when they are under stress, but it also has the ability to protect and strengthen the cardiovascular system and to boost exercise performance, specifically by improving endothelial function and improving muscle recovery time. 2,3 What Happens to the Body During Intense Exercise Exercise can provide several health benefits to the body, but it can also cause stress to the cells comprising muscle and other tissues. The muscles that allow one to move, and the muscle tissue that allows the heart to pump blood through the body are all vulnerable to damage from various sources, one being exercise. However, we also know that exercise is vital for these tissues in order to strengthen them and to allow them to continue to perform their intended functions. Therefore, regular cardiovascular exercise is important and beneficial overall. As the heart rate increases during exercise, the level of oxygen in the blood is improved and natural painkillers called endorphins are increased in the body. However, if the body is pushed into cardiovascular exercise for too long a duration it can enter into a catabolic state in which tissues start to break down; excess stress hormone (cortisol) is produced which contributes to this catabolic process of tissue breakdown. Microscopic tears can occur in the muscle fibers making healing a slower process if overtraining is continued. The risk of injury is also increased when overtraining occurs. 4 In terms of the heart, studies on marathon runners show that the right ventricle of the heart is more susceptible to damage when overexertion occurs. Overtraining leaves the immune system in a weakened state and taxes the body s organs. So the question might be asked, what can be done to protect the body s cells and tissues during exercise? Supporting the body with antioxidants such as curcumin is known to have several benefits for protecting against the damaging aspects of exercise. Numerous research studies have investigated the various beneficial effects of curcumin in relation to physical exercise. 22 Advances

23 Improving Vascular Endothelial Function with Curcumin Vascular endothelial function, which refers to the functioning of the inner lining of the blood vessels, declines with age and is associated with an increased risk of cardiovascular disease. The vascular endothelium is a multifunctional organ system composed of metabolically active and physiologically responsive component cells that carefully regulate blood flow according to metabolic conditions. Lifestyle modification, particularly aerobic exercise and dietary adjustment, has a positive effect on vascular aging. A new study from the University of Tsukuba investigated the effects of curcumin in 32 post-menopausal women divided into one of three groups. 4 The first group was the control group, the second group took part in an aerobic training schedule, and the third group was given a curcumin supplement on a daily basis. The curcumin used in the study was highly bioavailable (with up to 300 times increased bioavailability compared to raw turmeric) and in colloidal nanoparticle form, given at a daily dosage of 25 mg. The study duration was for eight weeks. Over the course of the study, the results demonstrated that blood vessel dilation increased equally and to a notable extent in the exercise and the curcumin group. No changes were apparent in the control group. These results indicated that curcumin ingestion and aerobic exercise training can increase flow-mediated dilation in postmenopausal women, suggesting that both can potentially improve the age-related decline in endothelial function and therefore improve exercise performance. 4 Reducing Exercise-Induced Oxidative Stress Oxidative stress occurs on an ongoing basis as the body comes into contact with oxygen. It occurs as a result of necessary body functions such as eating, breathing and moving. Caloric restriction reduces oxidative stress and promotes longevity by reducing the number of reactions that occur in the body as a result of the digestive process. During digestion, the molecules from food become oxidized; they lose an electron and become unstable. If they are not neutralized or cleaned up by the body, they cause damage to other cells. This form of stress causes us to age faster and to feel the pains of aging and of overtraining. Reducing oxidative stress is paramount for improving athletic performance, recovery time and overall health. Eating healthfully, reducing stress and supplementing appropriately can all help to reduce the level of oxidative stress the body is under. Curcumin has been demonstrated to significantly reduce oxidative stress within the body, with some of the research focusing on curcumin s beneficial role in cadioprotection. Another study investigated the effects of curcumin supplementation on exercise-induced oxidative stress in humans. Ten male participants were asked to take part in three phases of the study in random order. They were a part of any of the following groupings that took a treatment before or after exercise: 1) placebo (control), 2) single (curcumin only before exercise) and 3) double (curcumin before and immediately after exercise). Each participant received oral administration of 90 mg of curcumin or the placebo 2 hours before exercise and immediately after exercise. Blood samples that were taken pre and post exercise indicated that curcumin increased blood antioxidant capacity and can reduce exercise-induced oxidative stress. 5 Curcumin also raises glutathione levels in the body; glutathione is the body s chief antioxidant. Studies to learn more about the effects of curcumin in the body after exercise have been conducted in humans and animals. 2,5 Intensive exercise such as downhill running can cause muscle fibre damage, inflammation and delayed onset muscle soreness (DOMS). Curcumin reduces exerciserelated inflammation and improves running performance recovery in mice, according to a recent study. 2 The animals received either curcumin or placebo and were assigned to run either uphill or downhill on a Advances 23

24 treadmill for 2.5 hours. Two to three days later, they were placed on a treadmill and allowed to run to fatigue, with time to fatigue recorded. In a second experiment, voluntary running on an activity wheel was monitored in another subset of animals, while a third experiment analyzed muscle tissue for inflammatory cytokines after the forced running exercises in additional mice. The research team found that downhill running increased inflammatory cytokines, decreased voluntary activity, and shortened the animals run time to fatigue. 2 However, curcumin was able to offset these effects. The results of the study clearly demonstrate that curcumin is able to reduce inflammation and offset some of the performance deficits associated with exercise-induced muscle damage. Inflammation and Muscle Damage Due to Exercise It is well understood that intense exercise can cause inflammation and muscle damage depending on the duration, intensity and mode of exercise. Some experimental evidence drawn from animal models of inflammation has suggested that curcumin can provide a similar anti-inflammatory effect to that of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, Celebrex or Vioxx. 7 However, curcumin is free from the negative side effects that are associated with these drugs, such as cardiovascular complications and gastrointestinal effects. Curcumin is able to attenuate inflammation by targeting several factors including growth regulators, cell signalling molecules and transcription factors, proteins that regulate the flow of genetic information in the cells. 8 Inflammation is a condition that involves uncontrolled activated immune responses. Numerous studies have suggested that curcumin is able to modulate the immune response and play an important role in the treatment of inflammation and metabolic diseases. Results from both in-vitro and in-vivo studies have provided strong evidence towards the therapeutic potential of curcumin. This research has also identified multiple biological targets and intricate mechanisms of action that characterize curcumin as a potent drug for numerous ailments. Curcumin can modulate the functional influence of immune cells and the related crosstalk during inflammation to improve immune status against diseases. As a potent antioxidant and powerful anti-inflammatory, curcumin has several mechanisms of action in the body that help to improve physical performance and improve health in general. Studies have demonstrated that curcumin is able to modulate the immune system, put out the fires of inflammation, and decrease muscle soreness for improved recovery time. It acts to improve endothelial function to the same extent that an aerobic exercise regimen can. Both animal and human studies have highlighted numerous benefits of curcumin and future research will likely identify others. AOR is proud to be the exclusive Canadian provider of Longvida curcumin, a highly bioavailable form of curcumin with over 100-fold bioavailability increases when compared to other forms of curcumin. Longvida curcumin is the only curcumin that yields free curcumin in the blood. This means that it is able to cross the bloodbrain barrier for maximum effectiveness. AOR s Longvida curcumin containing products include: CurcuVIVA, CurcuMIND, Curcumin Active, Inflammation Relief and Fem Ease. What You Need to Know Curcumin is a powerful cellular protector that can have very beneficial and positive exercise performance effects in people who are active. This well-known and potent natural antioxidant ingredient derived from the turmeric root is able to reduce and prevent inflammation and also provide a performance boost by modulating the immune system, decreasing muscle soreness to improve recovery time, and also by enhancing endothelial function in the same manner as exercise does. Curcumin is a safe and effective exercise recovery enhancer, and it even produces some of the same cardiovascular benefits as aerobic exercise itself. 24 Advances

25 Curcumin and Exercise Performance Antioxidant Vigorous physical activity increases the body s production of free radicals Improves Endothelial Function Maintaining the integrity of your vascular system improves exercise performance and muscle recovery time. Proper vascular function is important for adequate blood flow during exercise and recovery. Inflammation Alleviating muscle soreness and inflammation can help speed up your recovery time. Longvida Curcumin is an optimized curcumin developed by researchers at UCLA. Longvida is the only curcumin on the market that allows free-form, active curcumin to effectively reach the tissues that need it. Longvida Curcumin is a clinically proven and highly bioavailable form of curcumin; the only one that yields free curcumin in the blood. Curcumin Active provides the highest dose of curcumin, CurcuViva is for general use, and CurcuMind supports cognitive health. For those who struggle with joint pain as well as exercise induced inflammation, Inflammation Relief provides a range of ingredients to target your pain Not just for women, Fem Ease provides an effective formula to target muscle cramping and pain Curcumin is exclusive to AOR in Canada.

26 Essential Magnesium for Supporting an Active Body As one of the most important nutrients in the diet, magnesium offers several health enhancing benefits. The body uses magnesium for essential cellular functions such as producing energy, maintaining normal functioning of the nerves and muscles, heart rhythm, immunity and bone health. More than 300 biological processes occurring in the body require magnesium. Thankfully, magnesium is relatively easy to obtain through a healthful diet. However, for some people magnesium absorption may be impaired for a number of reasons such as depleted soils, having intestinal disorders like Crohn s disease or colitis, and/or as a result of taking certain types of medications. A deficiency in this valuable mineral will eventually cause health problems; correcting any underlying deficiency can also help to improve existing health conditions including headaches, chronic pain, osteoporosis, diabetes, cardiovascular disease and fibromyalgia. Numerous studies have reported improvements in the symptoms of these ailments when a person s magnesium levels are restored to an optimal level. Magnesium is also extremely valuable for improving fitness performance and helping active individuals feel their best. Magnesium for Improving Exercise Performance Research demonstrates that having even a marginal magnesium deficiency is detrimental to achieving peak exercise performance, and a deficiency exacerbates the negative consequences of oxidative stress due to strenuous exercise. Exercise can also cause excessive magnesium loss through sweating and urination. 1 Research has indicated that many people are deficient in magnesium due to low consumption. 1 The recommended daily intake of magnesium for adult males is 420 mg/day and 320 mg/day for adult females. 2 Athletes that are participating in sports that require weight control are particularly at risk for having magnesium deficiency and more recently, magnesium has been recognized as having a beneficial effect on athletic performance. Magnesium is able to improve metabolic efficiency, relax muscles and reduce soreness, and is necessary for proper bone development, sleep and mood balance, all of which are factors that not only 26 Advances

27 affect general health but also physical fitness and performance. Magnesium Research in Athletes In one study, magnesium was shown to improve the physical performance of volleyball players. 3 Twenty-five professional male volleyball players took part in a four week study and were randomly assigned to a control or experimental group. The men had normal baseline magnesium levels at the start of the study. After four weeks of taking additional magnesium oxide at 350 mg per day, the athletes all showed impressive improvements in their jump abilities, on average being able to jump 3 cm higher. These results are exciting, and future research in this area will likely explore how athletes performing in other sports are affected from supplemental magnesium. Another study conducted over a three month period investigated the effects of magnesium deficiency on exercise performance in women. 4 Ten women took part in the study which investigated the effects of magnesium on cycling performance. In months 1 and 3, the women adhered to a magnesiumdeficient diet of 112 mg per day and a magnesium supplement of 200 mg per day to reach the Recommended Dietary Allowance per day. In the second month, the women stopped taking the supplement to intentionally result in a magnesium-deficient diet. At the end of each month, the women were asked to cycle at increasing intensity until they reached 80% of their maximum heart rate, at which time they were subjected to a battery of tests. The results showed when magnesium was deficient at the time of the cycling test during the workout in month 2, their metabolic efficiency was reduced as both heart rate and oxygen intake increased, indicators that the body was working much harder to perform the same task. Animal studies have also demonstrated that magnesium enhances exercise performance. The results of a study using two different groups of mice investigated magnesium s effect on fitness performance in mice given supplemental magnesium and mice with normal magnesium levels. 5 Results indicated that the muscle, blood, and brain glucose levels immediately increased during exercise, and then gradually decreased to near basal levels in the recovery periods of each groups. These glucose levels were significantly enhanced to approximately two-fold in the magnesium group. Lactate levels in the muscle, blood, and brain significantly increased in both groups during exercise, and brain lactate levels in the magnesium group were further elevated than those in the control group during exercise. Lactate is metabolized by neurons in the brain as a source of fuel. Lactate levels significantly decreased after exercise in both groups. Overall, magnesium enhanced glucose availability in the muscles and in the central nervous system, and increased lactate clearance in the muscle during exercise. Lactate clearance from the muscles is important for preventing muscle pain. Magnesium for Strong and Resilient Bones in Athletes Having strong bones is important for athletes. It is well known that magnesium is essential for proper bone development and that physical activity is also crucial for bone mineralization. Accelerated bone mass loss has been observed in subjects with low magnesium intake. One study proved this point by studying eighteen elite swimmers and assessing their bone mass density (BMD), lean soft tissue, and nutrient intake. Statistical analysis demonstrated a significant association between lean soft tissue and BMD. 6 When magnesium intake was included in the analysis, it was found to be a significant, independent predictor of BMD. When the analysis was adjusted for energy, vitamin D, calcium, and phosphorus intake, magnesium remained a significant predictor of BMD. Choosing a Magnesium Form That Supports an Active Lifestyle As with many minerals, supplemental magnesium is found in various forms. Calcium and magnesium may be combined with another stabilizing molecule to form what is called a chelate. The molecules that are formed from Advances 27

28 Type of Magnesium Magnesium Malate Magnesium Aspartate Magnesium Orotate Magnesium Glycinate Conditions Benefited By Magnesium Supplementation Fibromyalgia Related Pain Chronic Fatigue Low Energy Level Poor Endurance Physical Strain (ie. from athletic activities) Low Energy Level Sore Muscles Chronic Fatigue Cardiac Disorders (ie. cardiomyopathy) Exercise Induced Heart Pain Muscle tension Calming Stress Chronic pain these combinations have a significant impact on how well magnesium is absorbed and utilized in the body. The following forms of magnesium may be most suitable for athletes and active individuals. Magnesium Aspartate: This form has higher bioavailability compared to oxide and citrate. There were some promising clinical trials conducted in the 1960s that found a combination of magnesium and potassium aspartates had a positive effect on fatigue, and they reduced muscle hyperexcitability. 7 Physiologically this makes sense since both magnesium and aspartic acid are critical players in cellular energy production which is important for everyone whether an athlete or not. This form is not as commonly used but has been used for chronic fatigue syndrome. Magnesium Glycinate: Glycine is a well-known calming amino acid. This combination has good bioavailability and does not have a laxative effect since glycine is actively transported through the intestinal wall. Due to the calming and relaxing effect of both glycine and magnesium, this combination has been used successfully for chronic pain and muscle hypertonicity. 8 Easing muscle tension is important for athletes that rely on their muscle power for optimal performance. Muscle hypertonicity can also occur as a result of stress from emotional or physical origin. Whether muscular hypertonicity arises from physical or emotional causes, the result is the same: lactic acid build-up and joint compression, both of which can impede physical performance and cause muscle pain. Magnesium Malate: This less wellknown combination has been studied for use in fibromyalgia. Since malate is a substrate in the cellular energy cycle, it can help improve ATP production. There is some preliminary evidence that it may reduce muscle pain and tender points in fibromyalgia patients. 9 This form of magnesium may help to reduce muscle pain as a result of muscle taxation during athletic activity. Magnesium Orotate: This is another relatively unknown chelate combination containing orotic acid. This form has good bioavailability and has been studied specifically for heart health. Orotates can penetrate cell membranes, enabling the effective delivery of the magnesium ion to the innermost layers of the cellular mitochondria and nucleus. Orotates themselves increase the formation of RNA and DNA which can help heart cells repair and therefore improve function. This combination has been shown to improve heart failure, symptoms of angina and exercise performance in clinical trials. 10,11 In a double-blind randomized study, 23 competitive triathletes competing in an event consisting of a 500-meter swim, a 20-km bicycle race, and a 5-km run were studied after 4-week supplementation with placebo or 17 mmol/day of magnesium orotate. Results of the study demonstrated that the swimming, cycling, and running times decreased in the magnesium orotate group compared with the controls. Serum glucose concentration increased 87% during the test in the control group and 118% in the magnesium orotate group, while serum insulin increased 39% in the controls and decreased 65% in the magnesiumorotate group. The magnesium orotate group had a higher venous oxygen pressure than the control group and lower blood leukocyte counts and cortisol levels. Magnesium orotate was able to boost athletic performance and decrease stress in the triathletes. 12 Other Forms of Magnesium Magnesium L-threonate: This form of magnesium has recently been studied to improve memory, brain function and ease mental stress. One preliminary study in animals found that it significantly enhanced both shortterm and long-term memory, boosting scores by 15% for short-term memory and 54% for long-term memory compared to magnesium citrate Advances

29 BEET the Odds! AOR s Stamina Shot combines beetroot juice and magnesium with NOx 3,2,1 Technology to convert dietary nitrates to Nitric Oxide in your body, enhancing your muscle function and giving you the boost you didn t know your body needs and craves. Stamina Colada: 1 Stamina Shot + 2 oz Coconut Water + 6 oz Unsweetened Pineapple Juice Proudly Canadian ADVANCED ORTHOMOLECULAR RESEARCH

30 Based on this preliminary study, it appears that magnesium L-threonate is a highly absorbable form of magnesium that may potentially improve brain function, which is important for athletes under mental stress. Magnesium Oxide: Often used in milk of magnesia products since this form has a strong laxative effect. Even though this combination contains a large proportion of magnesium compared to the oxide molecule, it has poor bioavailability and readily causes loose stools; therefore it is considered the least optimal form to use as a supplement. Magnesium Sulfate: This form is often used as an intravenous preparation but it is not used in oral formulations. Since it does have some absorbability through the skin, it is also found in Epsom bath salts. Magnesium Citrate: A commonly used form that has good bioavailability compared to oxide. It is also very rapidly absorbed in the digestive tract but does have a stool loosening effect. 14 This form is found in many supplements and remains a solid option for delivering magnesium into the body. Magnesium Taurate: Both magnesium and the amino acid taurine share the ability to improve cardiac function; each has a potentiating effect on insulin sensitivity and also a calming effect on neuromuscular excitability. The actions of both have striking similarities when it comes to cardiovascular health. They both have blood pressure reducing effects, stabilize nerve cells, improve the contraction of the heart muscle and have an antithrombotic effect. 15 Additionally, low levels of vitamin B6 have been shown to further deplete both magnesium and taurine. Magnesium Pidolate (or picolinate): This form of magnesium has generated interest because it is very inexpensive and can easily be made into a liquid supplement. There really have not been any substantial research trials supporting its specific health benefits. The down side of this form is that the pidolate molecule does not have any additional health benefits. Magnesium Ascorbate: Magnesium ascorbate is a buffered (non-acidic) form of vitamin C that will not contribute to gastric irritation in acidsensitive persons. Magnesium ascorbate is synthesized from a combination of ascorbic acid and magnesium to form magnesium ascorbate. Magnesium ascorbate delivers antioxidant protection since it provides magnesium in combination with vitamin C. Concluding Thoughts on Magnesium Magnesium is essential for the body in order to maintain good health and is certainly beneficial for athletes. In supplement form it is known to have an excellent safety profile and can be very beneficial for improving certain health conditions. It is important to understand which form of magnesium will be best suited to address your health needs. A combination product such as AOR s Advanced Magnesium Complex combines 4 valuable forms of magnesium to meet your body s magnesium needs. This formula has been formulated with the optimal dosages and forms of magnesium (including magnesium aspartate, magnesium ascorbate, magnesium malate and magnesium glycinate) to ensure maximum effectiveness. What You Need to Know Magnesium is an essential ingredient in your diet and helps your body to perform numerous functions from nerve control to detoxification to muscle relaxation. Those who take part in exercise and strenuous physical activities will require more magnesium than a sedentary person. Magnesium supplements are available in several different forms. Depending upon your own personal health needs and digestive ability, one form may be better than another and offer specific benefits. A combination magnesium product such as AOR s Advanced Magnesium Complex will cover all of your bases and ensure you are obtaining the many benefits that a magnesium supplement can provide to your body. 30 Advances

31 References Article #1 Optimizing Physical Performance: The Science of Nutrient Supplementation 1. Campbell et al. International Society of Sports Nutrition position stand: protein and exercise. Journal of the International Society of Sports Nutrition 2007, 4:8. 2. Martin WF et al. Dietary protein intake and renal function. Nutr Metab (Lond) 2005, 2: Hoffman and Falvo. Protein Which Is Best? Journal of Sports Science and Medicine (2004) 3, Hulmi et al. Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein. Nutrition & Metabolism 2010, 7: Katsanos et al. Whey protein ingestion in elderly persons results in greater muscle protein accrual than ingestion of its constituent essential amino acid content. Nutr Res Oct;28(10): Aragon AA and Schoenfeld BJ. Nutrient timing revisited: is there a post-exercise anabolic window? J Int Soc Sports Nutr Jan 29;10(1):5. 7. Middleton N et al. Whole blood and mononuclear cell glutathione response to dietary whey protein supplementation in sedentary and trained male human subjects. Int J Food Sci Nutr Mar;55(2): Kanaley JA. Curr Opin Clin Nutr Metab Care Jan;11(1):50-4. Growth hormone, arginine and exercise. 9. Arwert LI, Deijen JB, Drent ML. Effects of an oral mixture containing glycine, glutamine and niacin on memory, GH and IGF-I secretion in middle-aged and elderly subjects. Nutr Neurosci Oct;6(5): Howatson et al. Exercise-induced muscle damage is reduced in resistance-trained males by branched chain amino acids: a randomized, double-blind, placebo controlled study. J Int Soc Sports Nutr May 8;9(1): Blomstrand E et al. Influence of ingesting a solution of branched-chain amino acids on plasma and muscle concentrations of amino acids during prolonged submaximal exercise. Nutrition 1996, 12(7-8): Blomstrand E: A role for branched-chain amino acids in reducing central fatigue. J Nutr 2006, 136(2):544S-547S 13. Goldstein et al. International society of sports nutrition position stand: caffeine and performance. Journal of the International Society of Sports Nutrition 2010, 7: Huang A and Owen K. Role of supplementary L-carnitine in exercise and exercise recovery. Med Sport Sci. 2012;59: Ho JY et al. l-carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middleaged men and women. Metabolism Aug;59(8): Wutzke KD1, Lorenz H. The effect of l-carnitine on fat oxidation, protein turnover, and body composition in slightly overweight subjects. Metabolism Aug;53(8): Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jéquier E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. Am J Clin Nutr May;33(5): Hoppel C. Am J Kidney Dis Apr;41(4 Suppl 4):S4-12. The role of carnitine in normal and altered fatty acid metabolism. 19. Kidd P. Astaxanthin, cell membrane nutrient with diverse clinical benefits and anti-aging potential. Altern Med Rev Dec;16(4): Djordjevic et al. Effect of astaxanthin supplementation on muscle damage and oxidative stress markers in elite young soccer players. J Sports Med Phys Fitness Aug;52(4): Malmsten CL and Lignell A. Dietary supplemen- tation with astaxanthin-rich algal meal improves strength endurance a double blind placebo controlled study on male students. Carotenoid Sci 2008;13: Gammermen DV and Falk D. The effects of four weeks of ribose supplementation on body composition and exercise performance in healthy, young, male recreational bodybuilders: a double-blind, placebo-controlled trial. Current Therapeutic Research (8): Shing CM et al. Bovine colostrum supplementation and exercise performance: potential mechanisms. Sports Med. 2009;39(12): Davison G. Bovine colostrum and immune function after exercise. Med Sport Sci. 2012;59:62-9. doi: / Epub 2012 Oct Shing CM et al. A pilot study: bovine colostrum supplementation and hormonal and autonomic responses to competitive cycling. J Sports Med Phys Fitness Oct;53(5): Buford et al. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr Aug 30;4: Lugaresi R et al. Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a highprotein diet? J Int Soc Sports Nutr May 16;10(1):26. Additional Sources Mero A: Leucine supplementation and intensive training. Sports Med 1999, 27(6): Grant EC. Food allergies and migraine. Lancet May 5;1(8123): Popa M and Florea I. Biomedicine. Growth hormone release by glycine injected intravenously in 22 healthy sexually immature children. Biomedicine, 1975 Apr 30;23(4): Kasai K et al. Stimulatory effect of glycine on human growth hormone secretion. Metabolism Feb;27(2): Article #2 Weight Loss: The importance of Balancing Blood Sugars 1. Brand-Miller J et al. Dietary glycemic index: a review. J Am Coll Nutr 2009; 28(4):446S-449S. Advances 31

32 2. Thom E. Effect of Chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used longterm in overweight and obese people. Journal of International Medical Research 2007; 35: McMillan-Price J et al. Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial. Arch Intern Med 2006; 166: Esfahani A et al. The application of the glycemic index and glycemic load in weight loss: A review of the clinical evidence. IUBMB Life 2011; 63(1): Vinson JA et al. Randomized, double-blind, placebo-controlled, linear dose, crossover study to evaluate the efficacy and safety of a green coffee bean extract in overweight subjects. Diabetes, Metabolic Syndrome and Obesity: targets and Therapy 2012; 5: van Dijk AE et al. Acute effects of decaffeinated coffee and the major coffee components chlorogenic acid and trigonelline on glucose tolerance. Diabetes Care 2009; 32(6): Henry-Vitrac C et al. Contribution of chlorogenic acids to the inhibition of hepatic glucose-6-phosphatase activity in vitro by Svetol, a standardized decaffeinated green coffee extract. J Agric Food Chem 2010; 58: Liu Jiankang. The effects and mechanisms of mitochondrial nutrients a-lipoic acid on improving age-associated mitochondrial dysfunction: an overview. Neurochem Res 2008; 33: Singh U and Jialal I. Alpha-lipoic acid supplementation and diabetes. Nutrition Reviews 2008; 66(11): Koh et al. Effects of Alpha-lipoic acid on body weight in obese subjects. Am J Med 2011; 124(1):85e1-e Ratliff JC et al. An open-label pilot trial of alpha-lipoic acid for weight loss in patients with schizophrenia without diabetes. Clin Schizophr Relat Psychoses. 2013; Mar 7: Suliburska J et al. Effects of green tea supplementation on elements, total antioxidants, lipids, and glucose values in the serum of obese patients. Biol Trace Elem Res Dec;149(3): Bogdanski P et al. Green tea extract reduces blood pressure, inflammatory biomarkers, and oxidative stress and improves parameters associated with insulin resistance in obese, hypertensive patients. Nutr Res. 2012; 32(6): Liu K et al. Effect of green tea on glucose control and insulin sensitivity: a meta-analysis of 17 randomized control trials. Am J Clin Nutr 2013; 98: Crandall JP et al. Pilot study of resveratrol in older adults with impaired glucose tolerance. J Gerontol A Biol Sci Med Sci. 2012; 67(12): Konings E et al. The effects of 30 days resveratrol supplementation on adipose tissue morphology and gene expression patterns in obese men. Int J Obes (Lond) Baile CA et al. Effect of resveratrol on fat mobilization. Ann N Y Acad Sci. 2011; 1215: Foster-Powell K et al. International tables of glycemic index and glycemic load values: American Journal of Clinical Nutrition 2002; 62:5 56. Article #3 Immunity for the Athlete: Supplements to Reduce the Effects of Overtraining 1. Nieman DC. Risk of Upper Respiratory Tract Infection in Athletes: An Epidemiologic and Immunologic Perspective. Journal of Athletic Training Oct. 2. Smith, LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med. Sci. Sports Exerc Vol. 32, No. 2, pp DiFiori JP et al. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med Feb;48(4): Hackney, AC. Clinical management of immunosuppression in sportsmen-women: recommendations for sports medicine physicians and physiotherapists. 5. Brooks K, Carter J. Overtraining, Exercise, and Adrenal Insufficiency. J Nov Physiother Feb 16;3(125). 6. Nieman DC et al. Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness. 1990;30: Peters EM and Bateman ED. Ultramarathon running and upper respiratory tract infections: an epidemiological survey. S Afr Med J.1983; 64: Vetter RE, Symonds ML. 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Carbohydrate supplementation affects blood granulocyte and monocyte trafficking but not function after 2.5 h of running. Am J Clin Nutr. 1997; 66: Nehlsen-Cannarella SL et al. Carbohydrate and cytokine response to 2.5 h of running. J Appl Physiol. 1997; 82: Woolf K et al. B-vitamins and exercise: does exercise alter requirements? Int J Sport Nutr Exerc Metab. 2006; 16: Institute of Medicine. Dietary Reference Intakes for B vitamins. Wash (DC): National Academies Press; Advances

33 20. Driskell J. Summary: Vitamins and trace elements in sports nutrition. Sports Nutr. 2006: p Lukaski HC. Vitamin and mineral status: effects on physical performance. Nutrition. 2004;20: Institute of Medicine. Dietary intakes for Calcium, Phosphorus, Magneium, Vitamin D and Fluoride. Wash (DC): The National Academies Press; Noreen EE et al. The Effects of an acute dose of Rhodiola Rosea on Endurance Exercise Performance. Journal of Strength and Conditioning. 2012, May Ziemba AW et al. Ginseng treatment improves psychomotor performance at rest and during graded exercise in young athletes. Int J Sport Nutr. 1999; 9: Biophys Acta-Biomembr 1984; 793: Eur J Clin Pharmacol. 1992; 42; Biol Sport 1998; 15: Shing CM et al. Effects of bovine colostrum supplementation on immune variables in highly trained cyclists. J Appl Physiol.2007; 102: Additional Sources Bachert C et al. Treatment of acute rhinosinusitis with the preparation from Pelargonium sedoides EPs 7630: a randomized, double-blind, placebo-controlled trial. Rhinology Mar; 47(1):51-8. Article #4 Move to the Beet of Nitric Oxide 1. Hord NG et al. Food sources of nitrates and nitrites: the physiologic context for potential health benefits. Am J Clin Nutr Jul;90(1): Pettersen BJ et al. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr Oct;15(10): Golbidi S & Laher I. Exercise and the aging endothelium. J Diabetes Res. 2013;2013: Lauer T et al. Age-dependent endothelial dysfunction is associated with failure to increase plasma nitrite in response to exercise. Basic Res Cardiol May;103(3): Taddei S et al. Age-related reduction of NO availability and oxidative stress in humans. Hypertension Aug;38(2): Miller GD et al. Plasma nitrate and nitrite are increased by a high-nitrate supplement but not by high-nitrate foods in older adults. Nutr Res Mar;32(3): Nguyen PK et al. Physical activity in older subjects is associated with increased coronary vasodilation: the ADVANCE study. JACC Cardiovasc Imaging Jun;4(6): Larsen FJ et al. Dietary inorganic nitrate improves mitochondrial efficiency in humans. Cell Metab Feb 2;13(2): Hoon MW et al. The effect of nitrate supplementation on exercise performance in healthy individuals: a systematic review and metaanalysis. Int J Sport Nutr Exerc Metab Oct;23(5): Bescós R et al. The effect of nitric-oxide-related supplements on human performance. Sports Med Feb 1;42(2): Bailey SJ et al. Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans. J Appl Physiol (1985) Oct;107(4): Vanhatalo A et al. Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. Am J Physiol Regul Integr Comp Physiol Oct;299(4):R Lansley KE et al. Dietary nitrate supplementation reduces the O2 cost of walking and running: a placebo-controlled study. J Appl Physiol (1985) Mar;110(3): Wylie LJ et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985) Aug 1;115(3): Wylie LJ et al. Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. Eur J Appl Physiol Jul;113(7): Kenjale AA et al. Dietary nitrate supplementation enhances exercise performance in peripheral arterial disease. J Appl Physiol (1985) Jun;110(6): Reay JL et al. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol Jul;19(4): Liang MT et al. Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res Feb;19(1): Jung HL et al. Effects of Panax ginseng supplementation on muscle damage and inflammation after uphill treadmill running in humans. Am J Chin Med. 2011;39(3): Kim SH et al. Effects of Panax ginseng extract on exercise-induced oxidative stress. J Sports Med Phys Fitness Jun;45(2): Liang MT et al. Effects of Panax notoginseng (Chinese ginseng) and acute exercise on postprandial glycemia in non-diabetic adults. J Complement Integr Med Jan 4; Gross D et al. Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Arch Chest Dis Oct- Dec;57(5-6): Shin W et al. Korean red ginseng inhibits arginase and contributes to endothelium dependent vasorelaxation through endothelial nitric oxide synthase coupling. J Ginseng Res Mar;37(1): Advances 33

34 Article #5 Curcumin: Cellular Protector and Performance Booster 1. Anand P et al. Biological activities of curcumin and its analogues (Congeners) made by man and Mother Nature. Biochem Pharmacol Dec 1;76(11): Davis JM et al. Curcumin effects on inflammation and performance recovery following eccentric eccentric, in mechanics, device for changing rotary to back-and-forth motion. A disk is mounted off center on a shaft. One flat, open, circular end of a rod fits around the edge of the disk; the other end is usually attached to a block that slides in a slot. exercise-induced muscle damage. Am J Physiol Regul Integr Comp Physiol Jun;292(6):R Akazawa N et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutrition research, N Kawanishi et al. Curcumin attenuates oxidative stress following downhill running-induced muscle damage. Biochem Biophys Res Commun Nov 22;441(3): Takahashi M et al. Effects of Curcumin Supplementation on Exercise-Induced Oxidative Stress in Humans. Int J Sports Med Oct Sugawara J et al. Effect of endurance exercise training and curcumin intake on central arterial hemodynamics in postmenopausal women: pilot study. American Journal of Hypertension (Impact Factor: 3.67). 03/2012; 25(6): Nandal S et al. Curcumin potentiates the anti-inflammatory activity of cyclooxygenase inhibitors in the cotton pellet granuloma pouch model. Methods Find Exp Clin Pharmacol Mar;31(2): Wing-Hin L et al. Neuropharmacol. Curcumin and its Derivatives: Their Application in Neuropharmacology and Neuroscience in the 21st Century. Jul 2013; 11(4): Additional Sources Srivastava G and Mehta JL. Currying the heart: curcumin and cardioprotection. J Cardiovasc Pharmacol Ther Mar;14(1):22-7. Clutterbuck AL et al. Curcumin reduces prostaglandin E2, matrix metalloproteinase-3 and proteoglycan release in the secretome of interleukin 1β-treated articular cartilage Jul 4 [revised 2013 Aug 20];2:147. Jones T et al. (2009) Effects of Fenugreek, Cinnamon, & Curcumin on Post Workout Inflammatory Response, International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 1, Article 18. Article #6 Essential Magnesium for Supporting an Active Body 1. Elin RJ. Magnesium: the fifth but forgotten electrolyte. Am J Clin Pathol Nov;102(5): Health Canada Website: accessed March, Setaro L et al. Magnesium status and the physical performance of volleyball players: effects of magnesium supplementation. J Sports Sci Sep Henry C. Lukaski and Forrest H. Nielsen. Dietary Magnesium Depletion Affects Metabolic Responses during Submaximal Exercise in Postmenopausal Women1,2 J Nutr 132: (2002). 5. Chen HY et al. Magnesium enhances exercise performance via increasing glucose availability in the blood, muscle, and brain during exercise Jan 20;9(1):e Matias CN et al. Magnesium intake mediates the association between bone mineral density and lean soft tissue in elite swimmers. Magnes Res Jul-Sep;25(3): Nagle FJ et al. The mitigation of physical fatigue with Spartase. FAA Office of Aviation Medicine Reports. Rep Civ Aeromed Res Inst US Jul;26: Lamontagne C et al. (2012) Rapid Resolution of Chronic Back Pain with Magnesium Glycinate in a Pediatric Patient. J Pain Relief 1: Abraham GE, Flechas JD. Management of Fibromyalgia: Rationale for the Use of Magnesium and Malic Acid. 10. Stepura OB et al. Orotic acid as a metabolic agent. Vestn Ross Akad Med Nauk. 2002; (2): Geiss KR et al. Effects of magnesium orotate on exercise tolerance in patients with coronary heart disease. Cardiovasc Drugs Ther Sep; 12 Suppl 2: Golf SW et al.on the significance of magnesium in extreme physical stress. Cardiovasc Drugs Ther Sep;12 Suppl 2: Coudray C et al: Study of magnesium bioavailability from ten organic and inorganic Mg salts in Mg- depleted rats using a stable isotope approach. Magnes Res 2005;18: Slutsky I et al. Enhancement of learning and memory by elevating brain magnesium. Neuron Jan 28;65(2): McCarty MF. Complementary Vascular-Protective Actions of Magnesium and Taurine: A Rationale for Magnesium Taurate. Medical Hypotheses (1996) Additional Sources Chen HY et al. Magnes Res Jul-Sep;25(3): doi: /mrh Magnesium Enhances Exercise Performance via Increasing Glucose Availability in the Blood, Muscle, and Brain during Exercise. Abraham GE and Flechas JD. Management of Fibromyalgia: Rationale for the Use of Magnesium and Malic Acid. Journal of Nutritional Medicine (1992) 3, Advances

35 Enhance Your Performance with NOx Nitric Oxide improves exercise performance by making the body s energy production more efficient, increasing exercise capacity and improving blood flow Increases athletic performance by pairing the benefits of ginseng with NOx 3,2,1 technology Reduces lactic acid levels Improves physical and mental stamina Increases endurance Best used before exercise A convenient shot combining the power of NOx 3,2,1 with beetroot juice and magnesium Supports muscle function and exercise capacity Consume 1-2 bottles before or during exercise Faster acting with unique lozenge delivery system Great taste and naturally sweetened Can be used before, during or after to enhance your athletic performance

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