Advances IN ORTHOMOLECULAR RESEARCH VOLUME 4 ISSUE 8 Advances FitnessIN ORTHOMOLECULAR RESEARCH Keeping Up AnAdvances Active Life IN ORTHOMOLECULAR RESEARCH

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Get a full dose of nutrition with all the benefits of improved detoxification and immunity in just one scoop Optimizing Physical Move to the Beet of 4 Performance: The 18 Nitric Oxide Science of Nutrient Nitric oxide is a ‘super Supplementation molecule’ that influences Certain supplements several factors related to can improve physical athletic activity including: performance. Learn more sleep, immunity, bone about the benefits of whey health and cardiovascular protein, amino acids, health. astaxanthin, D-ribose and colostrum.

Weight Loss: The Curcumin: Cellular 10 Importance of 22 Protector and Balancing Blood Sugars Performance Booster Balancing the body’s blood Curcumin offers several sugar level is critical for a benefits for active people, healthy metabolism and for including inflammation weight loss. Green coffee reduction and antioxidant bean extract, resveratrol protection among others. and green tea extract are all helpful in achieving healthy blood sugar levels.

Immunity for the Essential Magnesium 14 Athlete: Supplements 26 for Supporting an to Reduce Effects of Active Body Overtraining Magnesium plays many Intense exercise can roles in the body, including reduce performance and involvement in energy immunity. Adequate rest production, immunity, and several supplements bone health, heart rhythm, can help reduce the risk of muscle and nerve function. immunosuppression due to overtraining.

Published in Canada by Advances in Orthomolecular Research Advanced Orthomolecular Research Inc. is distributed through integrative physicians, health care practitioners, and progressive health food retailers. Editor-in-Chief Jaime Thomas, BSc The content of this magazine is provided for informational purposes only, and is not intended as medical advice for Marketing Consultant individuals, which can only be provided by a healthcare Katie Lemmon professional. Contents and design © 2014 AOR. Any reproduction in whole or part and in print or electronic Research & Writing form without express permission is strictly forbidden. Dr. Colin O’Brien, ND Permission to reproduce selected material may be Dr. Paul Hrkal, ND granted by contacting the publisher. Dr. Cameron McIntyre, ND Jaime Thomas, BSc Justine Florence, BSc

Graphic Design/Art Production Volume 4 Issue 8 Neil Bromley Alvin Cha email: [email protected]

Digital versions of this magazine and back issues are available online at www.AOR.ca ADVANCED ORTHOMOLECULAR RESEARCH sedentary healthy adults is 0.8g per kg Optimizing Physical Performance: body weight per day.1 While this may be adequate for most of the population, The Science of Supplementation active people have higher demands on their muscular system and therefore There are many different supplements discuss the key evidence-based natural require higher amounts of protein. marketed as performance enhancers nutrients used to optimize performance The current scientific consensus is that in the world of sports nutrition. With and dispel common myths regarding endurance and strength athletes need athletes trying to find an edge, and sports supplementation. 1.4-2.0g of protein per kilogram of opportunistic companies selling the How Much Protein Do You Need body weight per day.1 So the average latest fad ingredients, it is very difficult Of all the nutrients and supplements 70kg male wanting to achieve 1.5g of to discern what natural substances used for sports performance protein intake per kg would need to are supported by sound scientific enhancement, it’s not difficult to argue consume 105g of protein a day. evidence and which ones are the that protein is most important. It The biggest concern most people flavor of the month. The reality is that provides essential amino acids that are have is whether large amounts of many of these “natural” products have the building blocks for muscle growth, protein may have a damaging effect on little or no evidence supporting their recovery and repair. In order to optimize their kidneys. Despite this prevailing effectiveness or safety. At worst, they protein use, the first question most idea, there is very little evidence to may be adulterated with dangerous people have is: how much do I need? support this concern. The only negative and banned substances. Despite the pit The goal is to consume enough protein evidence linking large amounts of falls in the world of sports nutrition, to offset normal muscle breakdown and dietary protein having a detrimental good evidence is emerging to show recycling as well as to stimulate growth effect on kidney function is from a that some nutrients can improve and repair. Currently, the recommended few animal studies and in patients physical performance. This article will dietary allowance (RDA) for protein in with kidney disease.2 A number of

4 Advances 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 not recommended to eat a large meal valine) stimulate muscle growth and research supports whey as the gold before vigorous exercise because it can maintenance.8 They will be discussed in standard for muscle building and cause gastric upset, although a small greater detail later in the article. recovery.1,4 This not only applies to carbohydrate and protein rich meal or Milk Intolerance, Allergies and Whey athletes, but also to the aging population smoothie 60-90 minutes before exercise Protein which is susceptible to muscle loss. and within 60 minutes after is still a Conversely, some people can have Due to the presence of growth factors, prudent idea to optimize amino acid a food allergy or sensitivity to animal whey protein can prevent the loss of delivery.6 proteins such as egg, dairy (casein) and muscle mass and maintain strength in Whey protein has some distinct whey protein. This is not to be mistaken the elderly over and above the effect of benefits compared to vegan proteins. with lactose intolerance, which is an simple amino acids.5 Whey protein upregulates glutathione inability to digest lactose, a sugar found In terms of timing, a common production, a powerful cellular in dairy products. Dairy products, recommendation is to deliver amino antioxidant that prevents cancer including whey protein, are common acids to the muscle during and right formation, protects cells from food allergens; if a person is sensitive after activity, when the ability of muscle free radical damage and increases to either the carbohydrate (lactose) to uptake and use amino acids is the elimination of harmful chemicals.7 component, the protein component, highest. One widely accepted idea Vegan proteins do not increase or cannot digest dairy fats properly, is that, after exercise a 60-90 minute glutathione to the same degree as then it may promote inflammation and window exists where the body has an whey since they have lower levels digestive irritation, which can hinder increased ability to utilize carbohydrates of the amino acid cysteine, a key athletic performance and prevent and protein. Recent evidence calls this glutathione building block. Whey also nutrient absorption.9 However, some theory into question and now suggests has higher levels of Branched Chain people may tolerate different forms that overall nutrient intake throughout Amino Acids (BCAAs). These specific of whey protein over others and most the day may be a better focus.6 It is amino acids (leucine, isoleucine, and whey proteins are very low in the fat

Advances 5 Whey proteins

Wound healing Promote bone growth Improved Muscle strength cognitive function

Protease inhibitors Mood

Anticancer

Anti-oxidative Cholesterol lowering

Anti-hypertensive Immunoregulatory Anti-microbial Anti-in ammatory Insulinotropic Glycomacropeptide-no phenylalanine- protein source for PKU patients

component. Whey isolate has the non- have any substantial impact on growth twice daily for three weeks. At baseline protein components (lactose) partially hormone levels. However, recent and at the study’s end, the investigators or totally removed to “isolate” the whey studies have shown that resting growth analyzed the participants’ blood. protein, meaning it contains a higher hormone responses increase with oral Ingesting the supplement led to a 70% percentage of protein than concentrate ingestion of L-arginine (with a dose increase in serum growth hormone and less carbohydrate calories. Whey range of 5-9g of arginine). Within this levels compared to placebo, leading protein concentrate contains a very range there is a dose-dependent increase the researchers to conclude that an small amount of carbohydrates (lactose) and higher doses are not well tolerated. oral mixture of glutamine, glycine, and and fats in addition to protein. Whey Most studies using oral arginine have niacin can enhance growth hormone hydrolysate contains both concentrates shown that arginine alone increases secretion in healthy adults.9 and isolates. These proteins have the resting growth hormone levels at Branched Chain Amino Acids been further broken down for faster least 100%, while exercise can increase (BCAAs) and Muscle Growth absorption and assimilation. growth hormone levels by 300-500%. BCAAs are specific amino acids Nutrition Myth Buster: Do amino The combination of oral arginine plus that have the most significant role in acids boost growth hormone exercise attenuates the growth hormone stimulating protein synthesis since they production? response, however, and only increases upregulate enzymes that are responsible For many years, research has been growth hormone levels by around 200% for muscle growth.10 BCAA’s make up focused on naturally stimulating compared to resting levels.9 about 25% of animal protein and occur human growth hormone (HGH) The following study adds to in a 2:1:1 ratio (leucine: isoleucine: production since levels decline with the evidence that that glutamine valine) in nature. High quality age. Glycine is one amino acid that boosts growth hormone levels. In a supplements should reflect this ratio. attracted special attention after 2 studies randomized, double-blind, placebo- BCAA supplementation also prevents in the 1970’s found it increased growth controlled trial of 42 healthy middle- damage to muscle during exercise. One hormone in prepubescent children.8,9 aged and elderly adults, the subjects randomized, placebo controlled study However, these results were never consumed either a placebo or 5g of found that those subjects that used replicated and the original studies used a nutritional supplement composed BCAAs during and after strenuous intravenous glycine. Therefore, oral mainly of glutamine, glycine, and exercise had less muscle soreness and supplementation most likely does not niacin. The supplement was ingested faster recovery than those subjects that

6 Advances Optimum Performance Guide

Mitigates muscle Reduces lactic Increases Improves lean Supports damage acid build up energy body weight muscle building

Best taken 60-90 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 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 took placebo.11 In addition to supporting is a quick energy supply for working contribute to weight loss in some people. muscle growth, studies also show muscles. Post-workout glycogen Additionally, disorders of fatty acid that BCAAs aid in the maintenance storage has traditionally been thought oxidation and metabolism typically are and production of glycogen, which is to be increased only by consuming a associated with primary and secondary responsible for muscle energy and is a good amount of simple carbohydrates forms of carnitine deficiency.15 stored source of fuel during exercise.11 immediately post-exercise. Studies have Nutrition Myth Buster: Does They may also help to delay the onset of gotten mixed results when examining drinking coffee before a workout fatigue and maintain mental function the effect of combining protein or improve performance? in aerobic exercise, because BCAAs can BCAAs with carbohydrates for elevated Many people like to drink a coffee compete with tryptophan (a calming post-exercise glycogen synthesis. The or another caffeinated beverage before amino acid) in the brain.12 Some more muscle glycogen stores can be their workout in the hopes it will boost evidence also suggests that BCAAs increased, the more energy is available their performance. Caffeine has been maintain immune function in athletes. for the next exercise session, resulting intensely studied as a potential sport There is no substantial evidence that in better performance. In terms of performance aid. The summary of the BCAAs improve performance, but protein anabolism, the importance of research suggests it improves focus they do improve recovery in both leucine is demonstrated by the fact that in intense and mentally demanding resistance and aerobic athletes. Due to when all amino acids are supplemented exercise. It also appears to reduce their muscle protective mechanism and except leucine, protein synthesis the use of muscle glycogen (an the fact that BCAA plasma levels peak decreases by 40%. energy source) in endurance athletes. about 30 minutes after ingestion, they The Amino Acid L-Carnitine Additionally, it may help promote the should be supplemented before and L-carnitine is an amino acid that recovery of glycogen after exhaustive after exercise in divided doses. plays a central role in the breakdown exercise.16 The evidence shows a Leucine, in particular, is the most of fatty acids and their subsequent moderate improvement in performance studied of the three BCAAs since it transport into the mitochondria to for endurance sports, but really does signals the synthesis of protein and be used in the production of cellular not apply to resistance athletes. It is glycogen in the muscle (anabolism, energy.13 L-carnitine has been studied important to note that most studies or building), and it also appears to to address conditions such as angina, used dry caffeine extract and the same modulate the secretion of insulin or heart damage, peripheral vascular effects were not achieved when coffee its actions on muscle cells. Glycogen disease, diabetes, chronic fatigue was used in the trials. The typical doses

8 Advances used were 3-6mg of caffeine per kg body weight (equal to approximately 210-420mg 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 had no effect on exercise performance; be safe and beneficial for increasing wide variety of conditions including although they used a lower dose (less high-intensity exercise capacity and eye fatigue, cardiovascular disease, than 3g. lean body mass during training.25,26,27 and diabetes.18 Astaxanthin appears Colostrum is the first milk (before Supplementation studies with creatine to also improve muscle function after normal milk is produced) secreted have found that subjects experience a exercise since it may protect cells and by mammals when a baby is born 10-15% improvement in strength and mitochondria from free radical damage. that is very rich in immune and anaerobic performance, and increased It may also reduce lactic acid formation, growth factors. Many athletes suffer muscle size gains.26 Creatine provides which reduces muscle soreness, allowing from poor immunity as a result of the building blocks to produce a athletes to perform exercise longer.18 intense training, making colostrum type of rapidly used energy called To support this theory, a number an attractive supplemental option. The phosphocreatine which allows a of studies in human subjects have evidence suggests that colostrum helps person to train harder. Other emerging shown astaxanthin supplementation maintain intestinal barrier integrity, areas of research include looking at improves both resistance and immune function, and reduces the creatine in other diseases and injuries endurance performance.19,20 One study chances of suffering upper respiratory (i.e. Alzheimer’s disease, muscular supplemented athletes with 4mg of tract infection symptoms in athletes dystrophy, concussions, etc.) that astaxanthin for 6 months leading to an undertaking heavy training.22,23 The could benefit from improved energy improvement in the number of squats latest evidence suggests colostrum may production. In summary, creatine in just 3 months.20 improve lean body weight (compared can be used to improve strength, D-Ribose is a naturally occurring to whey protein) and helps maintain muscle size and reduce exercise sugar that has been studied in heart testosterone levels during exercise.24 fatigue. It’s recommended for athletes failure, fibromylgia and exerciseNutrition Myth Buster: Is creatine who compete in short duration, high performance as a way to improve muscle harmful or helpful? intensity sports like football, volleyball energy production. A double blind, Creatine is one of the most studied or weight lifting, but there is little placebo-controlled trial looked at the sport performance supplements. benefit for endurance athletes such as effects of supplemental ribose on body Numerous studies have found it to runners or cyclists. composition and exercise performance in 20 male bodybuilders. They were What You Need To Know given 10g/day of D-ribose for 4 weeks It is now well established that a balanced diet and appropriate supplementation while on a strength training program. can enhance sports performance. Protein is an essential dietary component, The results showed an improvement and whey protein in particular offers several health benefits. Branch chained in the total work performed and in amino acids are essential amino acids that improve recovery times from both bench press strength.21 More research resistance and aerobic activity, as does the amino acid L-carnitine. Other is needed to confirm this effect, as a nutrients that improve sports performance include astaxanthin, D-ribose number of other studies have found and colostrum. that supplementation with D-ribose

Advances 9 when it becomes too high (ie. after a Weight Loss: The Importance of large meal) by depositing the sugar into our cells for storage. Glucagon has Balancing Blood Sugars the opposite effect. Its job is to release sugar from our cells into the blood and Research has uncovered a multitude a decision to make: how much sugar increase blood sugar when we have not of factors that contribute to weight does it currently need? If our body eaten recently (See Figure 1 on page 12). gain and the deposition of fat within requires energy immediately, then it This reciprocal relationship and the body (see Box 1). But at the core will use the available sugar. However, if balancing act is crucial for weight of many of these factors is the poor the amount needed is less than that in management. If excess insulin is regulation of blood sugar levels. It is the bloodstream, the excess sugars will constantly produced in response to crucial to keep blood glucose relatively be stored as fat reserves.2 At the same excess glucose, we get increased fat stable, avoiding the rollercoaster of time, our body turns off its fat burning accumulation. An even worse scenario sudden peaks and steep crashes. With efforts and increases blood sugar levels occurs when too many spikes in sugar such irregular patterns, your body to promote fat gain and prevent fat loss. and insulin cause the body tissues to actually craves more food and is less Any time our body reaches peaks become unresponsive to the hormone. efficient at burning fat.1 The end result and valleys of blood sugar levels, In this case, tissues cannot uptake is a larger waistline. hormones have to step in and perform glucose and your body is at risk of Carbohydrates in our diet can an adjustment. Two hormones in becoming “insulin resistant” (a key drastically influence our blood sugar particular are responsible for this pathophysiological feature of Type 2 levels because they are digested and balancing act: insulin and glucagon. Diabetes Mellitus where sugars build broken down into simple sugars like The Roles of Insulin and Glucagon up and damage organs). glucose. Once glucose is absorbed In a very basic sense, insulin is To keep insulin and glucagon into the bloodstream, our body has responsible for lowering blood sugar working together in harmony, we need

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

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

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Proudly ADVANCED Canadian www.AOR.ca ORTHOMOLECULAR RESEARCH 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 Immunity for the Athlete: of intense training, inadequate rest and other life stressors.2,3,4 High Supplements to Reduce Effects of levels of cortisol, the primary stress hormone, have been found in athletes experiencing overtraining.4 When Overtraining cortisol is high, the body enters a catabolic state where survival is the It has long been known that exercise much of a good thing becomes priority, not repair. Vigorous exercise is a key component in a prescription detrimental to the immune system. In training damages the muscle and results for a healthy lifestyle. With respect the research, this is often noted as the in oxidative stress and inflammation. to the athlete, the issue is not whether “J” curve (see Figure 1) of exercise as it This is a normal part of the process you are getting enough exercise, but relates to infection, particularly upper of adaptation. The body enters a rather how exercise can be potentially respiratory tract infections (URTI). 1 hyper anti-inflammatory stage which harmful when it relates to your immune The model demonstrates that when an is followed by immunosuppression health. As an athlete, understanding athlete engages in moderate exercise, partly due to cortisol (considered an the relationship between exercise and the risk of infection decreases compared anti-inflammatory hormone).2 Here, infection is very important for long to someone who is sedentary.1 the immune system is weakened term success. However, with high-intensity exercise for 3-72 hours, but this window of The “J” Curve (e.g marathon training), the risk of immunosuppression can be prolonged Many individuals who begin an infection may rise above average and with repeated cycles of stress followed exercise routine often note that their athletes may become more prone to by inadequate rest and recovery immune health is much stronger infection. time.4 This leaves room for increased since becoming athletic. As the athlete Overtraining risk of infection and injury. When progresses in their training, however, The “J” curve concept can also be overtraining is severe enough and there often comes a time when too explained by defining some phases of burnout is imminent, cortisol levels will

14 Advances drop due to adrenal insufficiency and Figure 1. chronic fatigue, lethargy and apathy will set in, and illness and injury will be Research Shows Athletes Have an Increased Risk of 3,5 more prevalent. Respiratory Infections at High Levels of Exercise Intensity Infection in Distance Runners Research led by Nieman and colleagues measured the incidence of The J-Curve Above URTI for marathon athletes training for Average a race. It was determined that runners training more than 96km/wk doubled their odds for illness compared with Average those training less than 32 km/wk.6

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

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

16 Advances Manage Your Training burnout can affect anyone from the high performance athlete to the regular gym goer. By making use of a few carefully chosen Burnout supplements you can reduce the impact burnout can have on your training schedule.

Replenishes B vitamins Prevents post exercise depleted by increased stress muscle soreness

Prevents magnesium Reduces risk of upper deficiency which can impair respiratory tract infections muscle function

Improves reaction time and Relieves colds and cold boosts exercise capacity symptoms faster

Supports muscle repair and recovery Improves energy production

Increase endurance Supports immune function

Improves muscle function Reduces recovery time The Age Factor Move to the ‘Beet’ of Nitric Oxide NO production in the body decreases after the age of 30, and blood vessel Often, the smallest, simplest molecules foods such as beets, spinach, lettuce, production of NO is almost totally have the greatest importance. Nitric bok choy, celery and so many of the compromised between the ages of 60- oxide (NO) is made up of one atom of healthiest vegetables in the world. In 80.3,4,5 But the ability of the blood vessels nitrogen and one atom of oxygen. It is fact, researchers think that higher NO to respond to NO doesn’t change. So while one of the most important molecules production through increased nitrate dietary nitrate and nitrite consumption able to influence metabolic activities and nitrite consumption may be in can benefit younger, recreationally active and have diverse effects throughout large part responsible for the health people during exercise and at rest (in fact, the body. Previously, it was thought benefits attributed to diets such as the most of the athletic performance studies that the main pathway by which NO Mediterranean diet and the DASH have used healthy male subjects in their was produced in the body was from diet (the Dietary Approaches to Stop 20s, and most have found benefits), it may the amino acid arginine, which is Hypertension) which exceeds the hold even greater benefits for middle- what made arginine such an attractive acceptable daily intake for nitrate set aged and elderly people. In fact, a small workout supplement for gym-goers, by the World Health Organization by study noted that older adults around the athletes and even heart patients. 550%.1 Vegetarian diets and the newer age of 70 did not even actually absorb However, scientists now understand trend of a vegan diet are also known nitrate from nitrate-rich foods but did that NO is produced even more to produce lower blood pressures and so from nitrate supplements, making effectively through the consumption hence better cardiovascular function supplementing with nitrates even more of nitrates and nitrites found in and exercise endurance.2 important as you age.6

18 Advances Exercise and Your NO Levels If you exercise, then you are already Dose-Dependent Effects of Nitrate on Exercise and What It Means For You doing one of the best things you can Effect: Peak changes resulting from nitrate supplementation occurred 2-3 to protect yourself against the age- hours after consumption. related decline in NO production in your blood vessels and against arterial Conclusion: Take your nitrate supplement about 2 hours before engaging in stiffness.3 But exercise also increases 30-60 minutes of exercise. If you’re a long distance runner or cyclist, take your the responsiveness of the blood vessels supplement 0-60 minutes before exercising and during. If your supplement to NO! A study on healthy older adults is in a lozenge form, take it 15-30 minutes before exercise as well as during aged 60-72 years found that the blood exercise for longer events. vessels of those who exercised, burning the equivalent of calories to walking Effect: A dose of 260 mg of nitrate had almost no effect on exercise, similar to 1 hour a day, were almost 10% more the placebo. This is the same maximum daily intake recommended by Health responsive to nitroglycerin (an NO Canada. source given orally) than those who Conclusion: While the daily recommended amount of nitrate in Canada were less active.7 will still offer health benefits, you will probably need more if you want the NO and Your Fitness Levels performance benefits. NO helps regulate many different functions in the body including sleep, Effect: An acute dose of 1040 mg of nitrate improved oxygen consumption immunity, bone health, multiple aspects efficiency by 3% compared to a dose of 520 mg of nitrate at 1.7% during of cardiovascular health such as the blood moderate exercise. However, supplementing with around 500 mg of nitrate pressure, blood clotting, cholesterol, and over 3-6 days may improve oxygen consumption by up to 7%. more. Of course, all of these influence Conclusion: During moderate, steady state or long-distance exercise, the health and fitness. But more specifically, more nitrate you take, the better you will perform. However, supplementing NO can benefit exercise capacity, fitness with a lower dose for several days before might work even better. and athletic performance in several interlinked ways. Effect: The 520 mg dose of nitrate delayed the time to fatigue by 14% while NO has come to be known as the the higher dose of 1040 mg only delayed it by 12%. “endothelial-derived relaxation factor”. Conclusion: An acute, moderate dose of nitrate is sufficient to delay fatigue What this means is that NO is produced during shorter bursts of high-intensity exercise. 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 for people with disorders related to second similar study was done on healthy oxygen and nutrients get delivered to the mitochondrial dysfunction and during men and women around 25-35 years of muscles and the heart, allowing them aging since mitochondrial damage age. It showed that VO2 was 4% lower to function better at the same exercise accumulates with age and is thought after 2.5 hours of steady state exercise intensity. This is called improving your to be related to a host of common age- after just 5 days of supplementation,

VO2, or the amount of oxygen you need related diseases (including vascular with this effect lasting until the end to use at a given exercise intensity, and dysfunction or hypertension. of the study which was 15 days long.12 is one of the main goals and outcomes Beetroot Juice Studies Just to be sure that the authors were of endurance training. The fitter an Most beetroot juice studies have been correct in assuming that the nitrate endurance athlete is, the harder and done on cycling, walking and running, in the beetroot juice was responsible longer they can work with less oxygen and with the exception of some elite, for these benefits, a study compared at a given exercise intensity. highly trained athletes, they have all the effects of nitrate-rich beetroot The presence of NO seems to found improved performance.9,10 A juice against nitrate-depleted beetroot increase energy production efficiency. clinical study compared the effects juice on exercise.13 They were right: Supplementing with a nitrate source of beetroot juice versus a placebo on the nitrate-rich beetroot juice lowered causes muscles to use less energy during exercise in recreationally active men blood pressure, improved performance contractions, do more work, and delay between 20 and 40 years of age.11 During at all exercise intensities (both walking fatigue during exercise. Supplemental moderate exercise, the beetroot juice and hard running), and delayed fatigue nitrates have also been shown to allow group had lower oxygen consumption during intense exercise after just 6 days mitochondria to produce more energy in both the lungs and the muscles, and of supplementing while the nitrate- more efficiently by enhancing their during intense exercise their fatigue depleted beet juice did not. Finally, a function.8 This is especially important was delayed over the placebo group. A similar group of authors decided to see

Advances 19 what the optimal dose of nitrate was People with arterial or cardiovascular sodium nitrate as a direct supplement that would have these effects.14 Their diseases are no exception. Studies have and have found similar benefits as findings were very interesting (on page shown that people with peripheral those using nitrate-rich beet juice. If 19), but ultimately they found that arterial disease get the same benefits beet juice is not your thing, you can while a dose of juice containing 1040 from beetroot juice during exercise as opt for a nitrate supplement, such as mg of nitrate increased the efficiency mentioned above.16 AOR’s NOx Boost or EnergyNOx. of oxygen usage during moderate AOR’s Stamina Shot has been designed NOx Boost lozenges capitalize on exercise more than 520 mg of nitrate to provide the Canadian recommended two important facts: that nitrate did, there was no extra benefit in taking daily intake equivalent of nitrate from is converted into nitrite and then the higher dose for delaying fatigue. potassium nitrate in one small bottle, into NO in the body, but more A recent study even showed that supplemented with nitrate-containing importantly, that this conversion athletes in intermittent interval type beetroot juice and a touch of magnesium occurs much faster when nitrate is sports could benefit from nitrate for additional muscle function benefits. dissolved in the mouth than when supplements.15 Young men involved Stamina Shot is coloured naturally by swallowed. NOx Boost lozenges in recreational team sports underwent the beet juice and with red raspberry contain all the ingredients to ensure a test meant to simulate short bursts juice, and contains vitamin C and green that this conversion occurs effectively. of intense activity with brief breaks tea extract as part of AOR’s proprietary They are naturally sweetened with in between like in hockey, soccer and NOx3,2,1 Technology™ to enhance the natural low glycemic sweeteners, other such sports. Just 30 hours of conversion of nitrate to active NO. coloured and flavoured naturally with supplementing with a nitrate-rich beet Whether you are in sports, working out, berry and beet extracts, and contain juice improved test performance by dealing with cardiovascular issues or are a small amount of vitamin C to over 4%. Based on other findings, the middle-aged, just 1-2 bottles of Stamina complete AOR’s NOx3,2,1 Technology™ authors suggest that the improvements Shot can provide you the boost you need. requirements. So for the quick pre- were due to increased NO levels, Supplemental Nitrate Studies workout or mid-workout boost, better glucose use and better muscle Since nitrate is the active component NOx Boost provides a tasty way to contractility. in beet juice, some studies have used replenish your NO levels and boost

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

Advances 21 into cardiovascular exercise for too long Curcumin: Cellular Protector and a duration it can enter into a catabolic state in which tissues start to break Performance Booster down; excess stress hormone (cortisol) is produced which contributes to this Curcumin is widely used and well What Happens to the Body During catabolic process of tissue breakdown. recognized as a highly valued component Intense Exercise Microscopic tears can occur in the of the turmeric root. Used extensively Exercise can provide several health muscle fibers making healing a slower in India for cooking and medicinal benefits to the body, but it can also process if overtraining is continued. purposes, it boasts many health cause stress to the cells comprising The risk of injury is also increased promoting chemicals and has been the muscle and other tissues. The muscles when overtraining occurs.4 In terms subject of intense research over the last that allow one to move, and the of the heart, studies on marathon few years. It is now well established that muscle tissue that allows the heart to runners show that the right ventricle curcumin protects against inflammatory pump blood through the body are all of the heart is more susceptible to disease, diabetes, prostate cancer, vulnerable to damage from various damage when overexertion occurs. Alzheimer’s and heart disease, among sources, one being exercise. However, Overtraining leaves the immune other health issues.1 More recently, we also know that exercise is vital for system in a weakened state and taxes the health promoting properties of these tissues in order to strengthen the body’s organs. So the question curcumin have been further investigated them and to allow them to continue might be asked, what can be done to to determine how they affect exercise to perform their intended functions. protect the body’s cells and tissues performance. Curcumin is not only a Therefore, regular cardiovascular during exercise? Supporting the body potent antioxidant that helps to protect exercise is important and beneficial with antioxidants such as curcumin cells when they are under stress, but it also overall. is known to have several benefits has the ability to protect and strengthen As the heart rate increases during for protecting against the damaging the cardiovascular system and to boost exercise, the level of oxygen in the blood aspects of exercise. Numerous research exercise performance, specifically by is improved and natural painkillers studies have investigated the various improving endothelial function and called endorphins are increased in the beneficial effects of curcumin in improving muscle recovery time.2,3 body. However, if the body is pushed relation to physical exercise.

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

Advances 23 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 identified multiple biological targets that an aerobic exercise regimen can. duration, intensity and mode of exercise. and intricate mechanisms of action Both animal and human studies have Some experimental evidence drawn that characterize curcumin as a potent highlighted numerous benefits of from animal models of inflammation ‘drug’ for numerous ailments. Curcumin curcumin and future research will likely has suggested that curcumin can provide can modulate the functional influence identify others. a similar anti-inflammatory effect to of immune cells and the related cross- AOR is proud to be the exclusive that of nonsteroidal anti-inflammatory talk during inflammation to improve Canadian provider of Longvida® drugs (NSAIDs) such as ibuprofen, immune status against diseases. curcumin, a highly bioavailable form Celebrex or Vioxx.7 However, curcumin As a potent antioxidant and powerful of curcumin with over 100-fold is free from the negative side effects that anti-inflammatory, curcumin has several bioavailability increases when compared are associated with these drugs, such mechanisms of action in the body that to other forms of curcumin. Longvida® as cardiovascular complications and help to improve physical performance curcumin is the only curcumin that gastrointestinal effects. Curcumin is able and improve health in general. Studies yields free curcumin in the blood. This to attenuate inflammation by targeting have demonstrated that curcumin is means that it is able to cross the blood- several factors including growth able to modulate the immune system, brain barrier for maximum effectiveness. regulators, cell signalling molecules put out the fires of inflammation, and AOR’s Longvida® curcumin containing and transcription factors, proteins that decrease muscle soreness for improved products include: CurcuVIVA, regulate the flow of genetic information recovery time. It acts to improve CurcuMIND, Curcumin Active, in the cells.8 endothelial function to the same extent Inflammation Relief and Fem Ease. Inflammation is a condition that involves uncontrolled activated immune What You Need to Know responses. Numerous studies have Curcumin is a powerful cellular protector that can have very beneficial and suggested that curcumin is able to positive exercise performance effects in people who are active. This well-known modulate the immune response and and potent natural antioxidant ingredient derived from the turmeric root is able play an important role in the treatment to reduce and prevent inflammation and also provide a performance boost by of inflammation and metabolic diseases. modulating the immune system, decreasing muscle soreness to improve recovery Results from both in-vitro and in-vivo time, and also by enhancing endothelial function in the same manner as exercise studies have provided strong evidence does. Curcumin is a safe and effective exercise recovery enhancer, and it even towards the therapeutic potential produces some of the same cardiovascular benefits as aerobic exercise itself. of curcumin. This research has also

24 Advances 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 For those who struggle Not just for women, yields free curcumin in the blood. Curcumin Active provides the highest dose of curcumin, CurcuViva is with joint pain as Fem Ease provides an for general use, and CurcuMind supports cognitive health. well as exercise effective formula to induced inflammation, target muscle cramping Inflammation Relief and pain provides a range of ingredients to target your pain

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

26 Advances 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 magnesium levels.5 Results indicated magnesium is essential for proper women adhered to a magnesium- that the muscle, blood, and brain glucose bone development and that physical deficient diet of 112 mg per day and a levels immediately increased during activity is also crucial for bone magnesium supplement of 200 mg per exercise, and then gradually decreased to mineralization. Accelerated bone mass day to reach the Recommended Dietary near basal levels in the recovery periods loss has been observed in subjects with Allowance per day. In the second of each groups. These glucose levels were low magnesium intake. One study month, the women stopped taking the significantly enhanced to approximately proved this point by studying eighteen supplement to intentionally result in a two-fold in the magnesium group. elite swimmers and assessing their magnesium-deficient diet. At the end of Lactate levels in the muscle, blood, bone mass density (BMD), lean soft each month, the women were asked to and brain significantly increased in tissue, and nutrient intake. Statistical cycle at increasing intensity until they both groups during exercise, and brain analysis demonstrated a significant reached 80% of their maximum heart lactate levels in the magnesium group association between lean soft tissue rate, at which time they were subjected were further elevated than those in the and BMD.6 When magnesium intake to a battery of tests. The results showed control group during exercise. Lactate is was included in the analysis, it was when magnesium was deficient at metabolized by neurons in the brain as a found to be a significant, independent the time of the cycling test during the source of fuel. Lactate levels significantly predictor of BMD. When the analysis workout in month 2, their metabolic decreased after exercise in both groups. was adjusted for energy, vitamin D, efficiency was reduced as both heart Overall, magnesium enhanced glucose calcium, and phosphorus intake, rate and oxygen intake increased, availability in the muscles and in the magnesium remained a significant indicators that the body was working central nervous system, and increased predictor of BMD. much harder to perform the same task. lactate clearance in the muscle during Choosing a Magnesium Form That Animal studies have also demonstrated exercise. Lactate clearance from the Supports an Active Lifestyle that magnesium enhances exercise muscles is important for preventing As with many minerals, supplemental performance. The results of a study muscle pain. magnesium is found in various forms. using two different groups of mice Magnesium for Strong and Resilient Calcium and magnesium may be investigated magnesium’s effect on fitness Bones in Athletes combined with another stabilizing performance in mice given supplemental Having strong bones is important molecule to form what is called a chelate. magnesium and mice with normal for athletes. It is well known that The molecules that are formed from

Advances 27 Type of Magnesium Conditions Benefited By Magnesium Supplementation Magnesium Malate Fibromyalgia Related Pain Chronic Fatigue Low Energy Level Poor Endurance

Magnesium Aspartate Physical Strain (ie. from athletic activities) Low Energy Level Sore Muscles Chronic Fatigue

Magnesium Orotate Cardiac Disorders (ie. cardiomyopathy) Exercise Induced Heart Pain

Magnesium Glycinate Muscle tension Calming Stress Chronic pain

these combinations have a significant can also occur as a result of stress from In a double-blind randomized study, impact on how well magnesium is emotional or physical origin. Whether 23 competitive triathletes competing absorbed and utilized in the body. The muscular hypertonicity arises from in an event consisting of a 500-meter following forms of magnesium may be physical or emotional causes, the swim, a 20-km bicycle race, and a most suitable for athletes and active result is the same: lactic acid build-up 5-km run were studied after 4-week individuals. and joint compression, both of which supplementation with placebo or 17 Magnesium Aspartate: This form can impede physical performance and mmol/day of magnesium orotate. has higher bioavailability compared cause muscle pain. Results of the study demonstrated that to oxide and citrate. There were some Magnesium Malate: This less well- the swimming, cycling, and running promising clinical trials conducted in known combination has been studied times decreased in the magnesium the 1960s that found a combination of for use in fibromyalgia. Since malate is orotate group compared with the magnesium and potassium aspartates a substrate in the cellular energy cycle, controls. Serum glucose concentration had a positive effect on fatigue, and it can help improve ATP production. increased 87% during the test in they reduced muscle hyperexcitability.7 There is some preliminary evidence the control group and 118% in the Physiologically this makes sense since that it may reduce muscle pain and magnesium orotate group, while serum both magnesium and aspartic acid tender points in fibromyalgia patients.9 insulin increased 39% in the controls are critical players in cellular energy This form of magnesium may help to and decreased 65% in the magnesium- production which is important for reduce muscle pain as a result of muscle orotate group. The magnesium orotate everyone whether an athlete or not. taxation during athletic activity. group had a higher venous oxygen This form is not as commonly used Magnesium Orotate: This is another pressure than the control group and but has been used for chronic fatigue relatively unknown chelate combination lower blood leukocyte counts and syndrome. containing orotic acid. This form has cortisol levels. Magnesium orotate was Magnesium Glycinate: Glycine is a good bioavailability and has been able to boost athletic performance and well-known calming amino acid. This studied specifically for heart health. decrease stress in the triathletes.12 combination has good bioavailability Orotates can penetrate cell membranes, Other Forms of Magnesium and does not have a laxative effect since enabling the effective delivery of the Magnesium L-threonate: This form glycine is actively transported through magnesium ion to the innermost of magnesium has recently been the intestinal wall. Due to the calming layers of the cellular mitochondria and studied to improve memory, brain and relaxing effect of both glycine and nucleus. Orotates themselves increase function and ease mental stress. One magnesium, this combination has been the formation of RNA and DNA which preliminary study in animals found that used successfully for chronic pain and can help heart cells repair and therefore it significantly enhanced both short- muscle hypertonicity.8 Easing muscle improve function. This combination has term and long-term memory, boosting tension is important for athletes that been shown to improve heart failure, scores by 15% for short-term memory rely on their muscle power for optimal symptoms of angina and exercise and 54% for long-term memory performance. Muscle hypertonicity performance in clinical trials.10,11 compared to magnesium citrate.13

28 Advances BEET the Odds!

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Stamina Colada: 1 Stamina Shot + 2 oz Coconut Water + 6 oz Unsweetened Pineapple Juice

Proudly ADVANCED Canadian www.AOR.ca ORTHOMOLECULAR RESEARCH 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 Magnesium Ascorbate: Magnesium an excellent safety profile and can be remains a solid option for delivering ascorbate is a buffered (non-acidic) very beneficial for improving certain magnesium into the body. form of vitamin C that will not health conditions. It is important to Magnesium Taurate: Both magnesium contribute to gastric irritation in acid- understand which form of magnesium and the amino acid taurine share the sensitive persons. Magnesium ascorbate will be best suited to address your ability to improve cardiac function; is synthesized from a combination of health needs. A combination product each has a potentiating effect on insulin ascorbic acid and magnesium to form such as AOR’s Advanced Magnesium sensitivity and also a calming effect on magnesium ascorbate. Magnesium Complex combines 4 valuable forms neuromuscular excitability. The actions ascorbate delivers antioxidant of magnesium to meet your body’s of both have striking similarities when protection since it provides magnesium magnesium needs. This formula has it comes to cardiovascular health. They in combination with vitamin C. been formulated with the optimal both have blood pressure reducing Concluding Thoughts on Magnesium dosages and forms of magnesium effects, stabilize nerve cells, improve Magnesium is essential for the body (including magnesium aspartate, the contraction of the heart muscle in order to maintain good health and magnesium ascorbate, magnesium and have an antithrombotic effect.15 is certainly beneficial for athletes. In malate and magnesium glycinate) to Additionally, low levels of vitamin B6 supplement form it is known to have ensure maximum effectiveness. have been shown to further deplete both magnesium and taurine. What You Need to Know Magnesium Pidolate (or picolinate): Magnesium is an essential ingredient in your diet and helps your body to This form of magnesium has generated perform numerous functions from nerve control to detoxification to muscle interest because it is very inexpensive relaxation. Those who take part in exercise and strenuous physical activities will and can easily be made into a liquid require more magnesium than a sedentary person. Magnesium supplements are supplement. There really have not available in several different forms. Depending upon your own personal health been any substantial research trials needs and digestive ability, one form may be better than another and offer supporting its specific health benefits. specific benefits. A combination magnesium product such as AOR’s Advanced The down side of this form is that the Magnesium Complex will cover all of your bases and ensure you are obtaining pidolate molecule does not have any the many benefits that a magnesium supplement can provide to your body. additional health benefits.

30 Advances 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, 2:25. 3. Hoffman and Falvo. Protein – Which Is Best? Journal of Sports Science and Medicine (2004) 3, 118-130. 4. Hulmi et al. Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein. Nutrition & Metabolism 2010, 7:51. 5. 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. 2008 Oct;28(10):651-8. 6. Aragon AA and Schoenfeld BJ. Nutrient timing revisited: is there a post-exercise anabolic window? J Int Soc Sports Nutr. 2013 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. 2004 Mar;55(2):131-41. 8. Kanaley JA. Curr Opin Clin Nutr Metab Care. 2008 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. 2003 Oct;6(5):269-75. 10. 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. 2012 May 8;9(1):20. 11. 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):485-490. 12. 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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 2. Thom E. Effect of Chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used long- term in overweight and obese people. Journal of International Medical Research 2007; 35:900. 3. 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; 166:1466–1475. 4. 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):7-13. 5. 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; 5:21-27. 6. 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):1023-5. 7. 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; 58:4141-44. 8. Liu Jiankang. The effects and mechanisms of mitochondrial nutrients a-lipoic acid on improving age-associated mitochondrial dysfunction: an overview. Neurochem Res 2008; 33:194-203. 9. Singh U and Jialal I. Alpha-lipoic acid supplementation and diabetes. Nutrition Reviews 2008; 66(11):646-657. 10. Koh et al. Effects of Alpha-lipoic acid on body weight in obese subjects. Am J Med 2011; 124(1):85e1-e8. 11. 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 7:1-13. 12. 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. 2012 Dec;149(3):315-22. 13. 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):421-7. 14. 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; 98:340-8. 15. 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):1307-12. 16. 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). 2013 20. 17. Baile CA et al. Effect of resveratrol on fat mobilization. Ann N Y Acad Sci. 2011; 1215:40-7. 18. Foster-Powell K et al. International tables of glycemic index and glycemic load values: 2002. 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. 1997 Oct. 2. Smith, LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med. Sci. Sports Exerc. 2000 Vol. 32, No. 2, pp. 317–331. 3. 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. 2014 Feb;48(4):287-8. 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. 2013 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: 316- 328. 7. Peters EM and Bateman ED. Ultramarathon running and upper respiratory tract infections: an epidemiological survey. S Afr Med J.1983; 64:582-584. 8. Vetter RE, Symonds ML. Correlations between injury, training intensity, and physical and mental exhaustion among college athletes. J Strength Cond Res. 2010 Mar;24(3):587-96. 9. Chandra PK. Nutrition and Immunity. Am J Clin Nutr. 1991; 53:1087-1101. 10. Cohen S et al. Psychological stress and susceptibility to the common cold. N Engl J Med. 1991; 325:606-612. 11. Heath GW et al. Exercise and the incidence of upper respiratory tract infections. Med Sci Sports Exerc. 1991; 23:152-157. 12. Tvede N et al. Cellular immunity in highly trained elite racing cyclists and controls. Scand J Sports Med .191; 1: 163-166. 13. Kono I et al. Weight reduction in athletes may adversely affect the phagocytic function of monocytes. Phys Sportsmed. 1988; 16: 56-65. 14. Ansari SA et al. Role of hands in spread of respiratory viral infections. J Clin Microbiol. 1991; 29: 2115-2119. 15. Irwin M et al. EEG sleep and natural killer cell activity in depressed patients and control subjects. Psychosom Med. 1992; 54: 10-21. 16. Nieman DC et al. Carbohydrate supplementation affects blood granulocyte and monocyte trafficking but not function after 2.5 h of running. Am J Clin Nutr. 1997; 66: 153-159. 17. Nehlsen-Cannarella SL et al. Carbohydrate and cytokine response to 2.5 h of running. J Appl Physiol. 1997; 82: 1662-1667. 18. Woolf K et al. B-vitamins and exercise: does exercise alter requirements? Int J Sport Nutr Exerc Metab. 2006; 16: 453-84. 19. Institute of Medicine. Dietary Reference Intakes for B vitamins. Wash (DC): National Academies Press; 2000.

32 Advances 20. Driskell J. Summary: Vitamins and trace elements in sports nutrition. Sports Nutr. 2006: p. 323-331. 21. Lukaski HC. Vitamin and mineral status: effects on physical performance. Nutrition. 2004;20: 632-644. 22. Institute of Medicine. Dietary intakes for Calcium, Phosphorus, Magneium, Vitamin D and Fluoride. Wash (DC): The National Academies Press; 1997. 23. Noreen EE et al. The Effects of an acute dose of Rhodiola Rosea on Endurance Exercise Performance. Journal of Strength and Conditioning. 2012, May 24. 24. Ziemba AW et al. Ginseng treatment improves psychomotor performance at rest and during graded exercise in young athletes. Int J Sport Nutr. 1999; 9: 371-377. 25. Biophys Acta-Biomembr 1984; 793: 221-231. 26. Eur J Clin Pharmacol. 1992; 42; 385-8. 27. Biol Sport 1998; 15:135-144. 28. Shing CM et al. Effects of bovine colostrum supplementation on immune variables in highly trained cyclists. J Appl Physiol.2007; 102: 1113-22. 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. 2009 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. 2009 Jul;90(1):1-10. 2. Pettersen BJ et al. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr. 2012 Oct;15(10):1909-16. 3. Golbidi S & Laher I. Exercise and the aging endothelium. J Diabetes Res. 2013;2013:789607. 4. Lauer T et al. Age-dependent endothelial dysfunction is associated with failure to increase plasma nitrite in response to exercise. Basic Res Cardiol. 2008 May;103(3):291-7. 5. Taddei S et al. Age-related reduction of NO availability and oxidative stress in humans. Hypertension. 2001 Aug;38(2):274-9. 6. 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. 2012 Mar;32(3):160-8. 7. Nguyen PK et al. Physical activity in older subjects is associated with increased coronary vasodilation: the ADVANCE study. JACC Cardiovasc Imaging. 2011 Jun;4(6):622-9. 8. Larsen FJ et al. Dietary inorganic nitrate improves mitochondrial efficiency in humans. Cell Metab. 2011 Feb 2;13(2):149-59. 9. Hoon MW et al. The effect of nitrate supplementation on exercise performance in healthy individuals: a systematic review and meta- analysis. Int J Sport Nutr Exerc Metab. 2013 Oct;23(5):522-32. 10. Bescós R et al. The effect of nitric-oxide-related supplements on human performance. Sports Med. 2012 Feb 1;42(2):99-117. 11. 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). 2009 Oct;107(4):1144-55. 12. 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. 2010 Oct;299(4):R1121-31. 13. Lansley KE et al. Dietary nitrate supplementation reduces the O2 cost of walking and running: a placebo-controlled study. J Appl Physiol (1985). 2011 Mar;110(3):591-600. 14. Wylie LJ et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013 Aug 1;115(3):325-36. 15. Wylie LJ et al. Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. Eur J Appl Physiol. 2013 Jul;113(7):1673-84. 16. Kenjale AA et al. Dietary nitrate supplementation enhances exercise performance in peripheral arterial disease. J Appl Physiol (1985). 2011 Jun;110(6):1582-91. 17. Reay JL et al. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol. 2005 Jul;19(4):357-65. 18. Liang MT et al. Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res. 2005 Feb;19(1):108-14. 19. 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):441-50. 20. Kim SH et al. Effects of Panax ginseng extract on exercise-induced oxidative stress. J Sports Med Phys Fitness. 2005 Jun;45(2):178-82. 21. Liang MT et al. Effects of Panax notoginseng (Chinese ginseng) and acute exercise on postprandial glycemia in non-diabetic adults. J Complement Integr Med. 2012 Jan 4;8. 22. Gross D et al. Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Arch Chest Dis. 2002 Oct- Dec;57(5-6):242-6. 23. Shin W et al. Korean red ginseng inhibits arginase and contributes to endothelium dependent vasorelaxation through endothelial nitric oxide synthase coupling. J Ginseng Res. 2013 Mar;37(1):64-73.

Advances 33

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. 2008 Dec 1;76(11):1590-611. 2. 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. 2007 Jun;292(6):R2168-73. 3. Akazawa N et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutrition research, 2012. 4. N Kawanishi et al. Curcumin attenuates oxidative stress following downhill running-induced muscle damage. Biochem Biophys Res Commun. 2013 Nov 22;441(3):573-8. 5. Takahashi M et al. Effects of Curcumin Supplementation on Exercise-Induced Oxidative Stress in Humans. Int J Sports Med. 2013 Oct 28. 6. 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):651-6. 7. 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. 2009 Mar;31(2):89-93. 8. Wing-Hin L et al. Neuropharmacol. Curcumin and its Derivatives: Their Application in Neuropharmacology and Neuroscience in the 21st Century. Jul 2013; 11(4): 338–378. Additional Sources Srivastava G and Mehta JL. Currying the heart: curcumin and cardioprotection. J Cardiovasc Pharmacol Ther. 2009 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. 2013 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. 1994 Nov;102(5):616-22. 2. Health Canada Website: http://www.hc-sc.gc.ca/fn-an/nutrition/reference/table/ref_elements_tbl-eng.php, accessed March, 2014. 3. Setaro L et al. Magnesium status and the physical performance of volleyball players: effects of magnesium supplementation. J Sports Sci. 2013 Sep 9. 4. Henry C. Lukaski and Forrest H. Nielsen. Dietary Magnesium Depletion Affects Metabolic Responses during Submaximal Exercise in Postmenopausal Women1,2 J Nutr 132:930-935 (2002). 5. Chen HY et al. Magnesium enhances exercise performance via increasing glucose availability in the blood, muscle, and brain during exercise. 2014 Jan 20;9(1):e85486. 6. Matias CN et al. Magnesium intake mediates the association between bone mineral density and lean soft tissue in elite swimmers. Magnes Res. 2012 Jul-Sep;25(3):120-5. 7. Nagle FJ et al. The mitigation of physical fatigue with “Spartase”. FAA Office of Aviation Medicine Reports. Rep Civ Aeromed Res Inst US. 1963 Jul;26:1-10. 8. Lamontagne C et al. (2012) Rapid Resolution of Chronic Back Pain with Magnesium Glycinate in a Pediatric Patient. J Pain Relief 1:101. 9. 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): 39-41. 11. Geiss KR et al. Effects of magnesium orotate on exercise tolerance in patients with coronary heart disease. Cardiovasc Drugs Ther. 1998 Sep; 12 Suppl 2:153-6. 12. Golf SW et al.On the significance of magnesium in extreme physical stress. Cardiovasc Drugs Ther. 1998 Sep;12 Suppl 2:197-202. 13. 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;18:215–223. 14. Slutsky I et al. Enhancement of learning and memory by elevating brain magnesium. Neuron. 2010 Jan 28;65(2):165-77. 15. McCarty MF. Complementary Vascular-Protective Actions of Magnesium and Taurine: A Rationale for Magnesium Taurate. Medical Hypotheses (1996) 46. 89-100. Additional Sources Chen HY et al. Magnes Res. 2012 Jul-Sep;25(3):120-5. doi: 10.1684/mrh.2012.0317. 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, 49-59.

34 Advances 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 A convenient shot combining the Faster acting with unique lozenge by pairing the benefits of ginseng power of NOx3,2,1 with beetroot delivery system with NOx3,2,1 technology juice and magnesium Great taste and naturally Reduces lactic acid levels Supports muscle function and sweetened Improves physical and mental exercise capacity Can be used before, during or stamina Consume 1-2 bottles before or after to enhance your athletic Increases endurance during exercise performance Best used before exercise High Bioavailability Fast Relief

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