Frequency of Use, Information and Perceptions of

Conjugated Linoleic Acid

By: Kimberly Tippetts Abstract

Extensive research has been conducted in both animal and human models, which demonstrate the efficacy of Conjugated Linoleic Acid (CLA) as both a weight loss and a lean body mass dietary supplement. Conversely, very little research has been conducted concerning the practical human application of CLA, (i.e. the frequency of supplementation, information individuals possess, perceptions about, and general experiences people have had with CLA). The purpose of this study was to gather a limited amount of applicable information to begin to fill the noticeable information void. A sixteen statement confidential online survey was provided for a number of participants to share their opinions and understanding of CLA. The survey results showed that while only a small population of survey participants had general information about CLA, a larger percentage of participants indicated that they would both use and/ or recommend the use CLA for lean body mass gain more than they would for weight loss. Based on this finding, it would be beneficial to conduct further product research amongst a narrower sample population such as bodybuilders.

1

Methods

An invitation to participate in a study regarding the use of CLA was made to over 400 individuals. Sample size was derived from eight states, recruited by means of verbal request, promotional handout, text message, email invitation or Facebook request (see Appendix A). Of the 400+ people notified of the survey, over half were associated with the fitness industry. Of those notified, 131 healthy adults between the ages of 18-65 volunteered to take part. Participants of the survey were asked to classify themselves into one of five categories, which included: a person who likes to workout, a fitness instructor, a personal trainer, a bodybuilder or none of the above.

The first category, a person who likes to workout, was created based on the likelihood that the person who is exercising with the intent to lose weight or gain lean body mass may potentially supplement with CLA. The second and third categories, fitness instructor and personal trainer, were specifically included in the survey because they are frequently asked for nutritional advice on ways to lose weight or gain lean body mass. The fourth category, bodybuilder, was included in the survey based on the results of primary research conducted on numerous bodybuilding websites. These primary research results found that daily supplementation of CLA was recommended. The final category available for participants was none of the above, indicating that they did not exercise nor were they involved in the fitness industry.

The survey followed the Likert style and consisted of sixteen statements (see

Appendix B). The statements were designed to determine if participants previously

2 supplemented with CLA, why they had supplemented with CLA and if they would recommend CLA to others. The survey was posted online (see Appendix C) for four weeks.

Once a volunteer accessed the survey, basic instructions appeared at the top of the page. The instructions read: “This survey is available to any healthy adult between the ages of 18-65. Please take a few minutes to read through the following questions and answer them as honestly as you are able. If you strongly agree or agree to questions 7 and 12, please include a short response in the space provided.”

By continuing with the survey, the volunteer agreed that they were healthy, between the ages of 18-65 and providing their honest answer to each statement.

The survey generally took respondents two minutes or less. Individual results were recorded (see Appendix D) and compiled (see Appendix E).

3

Introduction

The fitness and supplement industries both promote CLA for its capabilities of increasing weight loss and lean body mass. They both claim that it can improve body composition by increasing metabolic rate and enhancing muscle growth. One article claimed that taking CLA would make losing weight and body fat simpler

(Trend Statement Staff, 2013). This same article suggested that CLA is able to turn fat into lean muscle mass (Trend Statement Staff, 2013). This is a false statement since it is impossible to change fat into lean muscle tissue, you can however replace one with the other. An article published by the Dr. Oz Show claimed that CLA shrinks fat cells in the abdominal region by assisting the process of cells releasing fat (The Dr. Oz Show Staff, 2013). It appears that these industries are taking the positive results from both human and animal studies and comingling them to sell

CLA to the general public. Because of these flawed claims a survey was created and conducted to uncover what information and perceptions users have about CLA.

The information a person possesses regarding CLA may lead to questions regarding individual effectiveness compared to potential health risks associated with the use of CLA. The answers to these questions may impact individual use.

Once perceptions are formed, users will decide whether or not to supplement with

CLA, which will in turn create personal experiences. Once a person gains experiences with CLA, they will have first hand personal information. There has been a great deal of research conducted on the efficacy of CLA when used for weight loss or lean body mass gain both in humans and in animals. However, not much

4 research has been conducted regarding the frequency of use, information individuals possess or perceptions people have regarding the use of CLA as a dietary supplement.

Conjugated Linoleic Acid refers to a family of geometric and positional isomers of the omega-6 fatty acid linoleic acid (cis-9, cis-12, octadecadienoic acid).

Geometric isomers are compounds that have the same molecular formula but are different geometric structures Positional isomers are molecules that have identical substituents (functional groups) with different bonding locations. Linoleic acid is an

18-carbon (“octa-deca”) fatty acid chain containing double bonds on the 9 and 12 carbons separated by two single bonds (Kelly, 2001). CLA is formed when chemical reactions shift the locations of one or two of the double bonds in a way that the bonds are no longer separated by two single bonds. Several dozen CLA isomers may result depending on which double bonds are relocated and the resultant isomeric reconfigurations (Kelly, 2001). CLA is polyunsaturated (a carbon chain that contains multiple double bonds between carbon atoms) and conjugated (joined together) by having two double bonds, without an intervening carbon atom. The more common forms have double bonds located between carbons 8 and 10, 9 and10 and 12 or 11 and 13. These bonds may occur as geometric isomers in a cis (on the same side of the carbon-carbon double bond) or trans (opposite side of the carbon-carbon double bond) configuration.

5

Figure 1. CLA isomers cis-9 (c9), trans-11 (t11) and trans- 10 (t10), cis-12 (c12) (“Conjugated Linoleic

Acid”, 2013).

There are several natural dietary sources containing CLA. Dietary amounts range from 0.9 milligrams (mg) up to 137 (mg) per gram of fat. Small amounts are found in shrimp (0.9 mg), olive oil (2.7 mg), peanut butter (3.2 mg) and dairy products such as yogurt (11-17 mg), butter (54 mg) and homogenized milk (92 mg).

Larger amounts are found in ruminant meats such as ground beef (130 mg) and lamb (137 mg) or from enhanced foods and supplements. The predominate CLA isomer people consume in foods such as beef and dairy is cis-9, trans-11 (Churruca,

Fernandez-Quintela, Portillo, 2008). It has been proven that CLA levels in meats can be increased by means of cooking (Fragakis & Thomson, 2007). CLA is considered to be a non-essential fatty acid, meaning that the human body is able to produce an adequate amount for its needs; so consuming dietary sources is unnecessary.

Because it is non-essential, there are no Dietary Reference Intake (DRI) recommendations for CLA at this time. Dietary supplement manufactures recommend taking between one-four grams of CLA per day (g/d). Scientific studies researched for this project used CLA in various ranges from 3.4 g/d (Chen, S. et al,

2012) to five g/d (Pinkoski, C. et al, 2006).

6 CLA was accidently discovered in 1979 at the University of Wisconsin,

Madison by Dr. Michael Pariza. A study conducted by Dr. Pariza discovered that mice treated with a beef extract applied topically to their skin, developed fewer tumors when exposed to strong chemicals than those mice not treated with same topical treatment (Ha Y, Grimm N, Pariza M. 1987). The term CLA was not coined until 1987 when CLA was discovered to display anti-carcinogenic (a substance that inhibits the development of cancer) activities when topically applied to the skin of mice (Ha Y, Grimm N, Pariza M. 1987 & Pariza, 1987). Further studies were then conducted on animals to test for various effects the isomers may have on body composition (such as weight loss and lean body mass gain), immune function, reduction of atherosclerosis and anti-catabolic and anabolic effects. In 2008, CLA was given a Generally Regarded As Safe (GRAS) status by the Food and Drug

Administration (FDA) in foods such as fluid milk, yogurt, fruit juices, soymilk and nutritional bars.

CLA is touted as an ergogenic aid (a substance that can be ingested to enhance high-intensity exercise) in the fitness industry to increase weight loss and lean body mass. The two most common claims made are the ability to assist with weight reduction from the t10, c12 isomer and the ability of the c9, t11 isomer to increase the quantity of lean body mass (Park, Y. et al, 1999). Recent evidence suggests that CLA supplementation may play a role reducing the body’s ability to form fat (Campbell & Kreider, 2008). It is suggested that once ingested, the isomers c9, t11 and t10, c12 may be incorporated into the phospholipid membrane of cells.

Once the isomer t10, c12 has become part of the cell, the uptake of lipids may be

7 decreased by less active fat cells and increased by more active cells, utilizing fatty acids for energy more efficiently. Claims have been made regarding CLA’s anabolic ability to increase lean muscle mass (Pinkoski, C. et al, 2006). Studies indicate that the urinary marker of myofibrillar degradation which directly results from a decrease in muscle fiber catabolic effects from strength training on muscle protein, and an increase in protein synthesis (Seedman & Seedman, n.d.). This would create more of an anabolic state to increase building muscle mass while also losing fat.

Once CLA has been incorporated into the cell membrane, it influences the cells responsiveness to specific hormones and changes the way muscle cells grow and develop (Berning & Nelson 1998). Muscle mass can therefore be increased due to increased levels of specific hormones, cell messengers and growth factors within muscle cells.

There have been hundreds of studies conducted on rodents and cows indicating that CLA has a significant effect on body composition. Many conclusions of animal studies indicate that CLA increases lean body mass, decreases fat mass, and has a positive effect on health (Seedman & Seedman, n.d.). A prominent study concluded that mice fed CLA decreased their fat mass, and had an increase in lean body mass (Bhattacharya, A. et al, 2006). Another study indicated that mice fed a diet supplemented with CLA had a decrease in body weight (Banu, J. et al, 2006).

There have been many studies conducted on humans to determine the effectiveness of CLA. The majority of these studies indicate that CLA has little or no positive effect with regards to weigh reduction or lean body mass gain. A study conducted on humans supplementing with CLA combined with resistance training

8 found that the CLA group had a small increase in lean body mass and small loss in fat mass compared to the placebo group. Overall, the study concluded, there were relatively small benefits to taking CLA (Pinkoski, C. et al, 2006). Another study examined the effects of CLA isolated into the separate isomers c9, t11 and t10, c12

(Malpuech-Brugere, C. et al, 2004). At the conclusion of the study, researchers were unable to see any statistically significant differences in body composition between members of the five different groups. They concluded that CLA does not have the same weight reducing effects in human subjects as it does in animals. While research indicates that CLA has a positive impact on decreasing body weight and increasing lean body mass in rodents and cows, there is conflicting evidence that it has a significant effect in humans (Malpuech-Brugere, C. et al, 2004).

Supplement manufacturers promote CLA as being an effective ergogenic aid.

Many companies claim that CLA is capable of aiding with weight loss, increasing the metabolic rate, and reducing body fat in humans. Manufacturers also lead potential users to believe that scientific research has proven that CLA helps reduce stored body fat and increases lean body mass by reducing the fat cells ability to accumulate fat. These claims made by supplement manufacturers regarding the use of the CLA have been proven by multiple studies conducted on human subjects to be flawed.

The majority of those studies have found that CLA is ineffective when taken for the purpose of weight loss and lean muscle mass gain. It is unclear if the manufacturers are basing their claims on animal or human studies, which may be confusing for the consumer. It is also unclear to the consumer what they are actually purchasing.

Many CLA manufacturers do not place information on the bottle label regarding

9 which isomer(s) the bottle contains, whether or not it is a pure form of CLA, or if it is a mixture of different isomers.

CLA is relatively simple and convenient to purchase because it can be found in most local pharmacies, health food stores or various websites on the Internet.

Capsules containing 60%-80% CLA are sold commercially as dietary supplements.

The main problem with purchasing commercially prepared CLA supplements is that they typically contain a mixture of the c9, t11 and t10, c12 isomers. Because the isomer c9, t11 is used more for lean body mass gain while t10, c12 is used for weight loss; it is unclear to the consumer what they are actually purchasing.

Capsules can be purchased in 500 milligram (mg) up to 3000 mg doses and range in quantity from 50 to 100 capsules per bottle. While there is no DRI for CLA, various manufactures recommended taking a range of one to four grams per day (g/d) for best results. The various studies reviewed for this research paper used CLA in dosages ranges of 3.4 g/d to five g/d.

There are several short-term and long-term health risks resulting from the use of CLA, however, extensive testing has not been conducted beyond two years.

Acute effects (which may be caused by poor quality or contaminates in the capsules) include: gastrointestinal upset, including nausea, diarrhea, dyspepsia and fatigue

(Fragakis & Thompson, 2007). These effects are typically mild and subside shortly after the individual ceases use of the ergogenic aid. A potential chronic effect of the

CLA isomer t10, c12 is insulin resistance in people with abdominal obesity (Fragakis

& Thompson, 2007). Another study concluded that the use of CLA might increase the risk of developing diabetes (Robertson, n.d.). Daily use of CLA by obese men in

10 the amount of 4.2 g/d was found to cause lipid peroxidation (the process of oxidative deterioration of lipids containing any number of carbon-carbon double bonds) (Fragakis & Thompson, 2007). It has also been discovered that the use of

CLA increases the storage of vitamin A “retinal” in liver and in breast tissues

(Fragakis & Thompson, 2007).

Research Question

Due to the lack of quality product information, this study was designed to discover and compile data regarding frequency of use, perceptions people posses and experiences people have had with CLA supplementation. How frequently are people supplementing with CLA and for what purpose? Are these people aware of natural sources, effective dosage and potential health risks associated with CLA supplementation?

11 Findings and Analysis

Question one of the CLA survey asked the participants to classify themselves

as a person who likes to workout, a fitness instructor, a personal trainer, a person

who likes to workout or none of the above. Participants were asked to mark all

categories that applied. Of those surveyed, 66% of the participants indicated that

they like to workout; 16% said they were fitness instructors; 5% said they were

personal trainers; 4% said they were bodybuilders; and 23% said they were none of

the listed categories. Those who exercise with the intent to lose weight or gain lean

muscle were included in the survey because they are most likely the ones who

supplement with CLA. Fitness instructors and personal trainers were specifically

targeted to participate in this survey due to the likelihood of nutritional advice

being given to individuals inquiring about weight loss or lean-muscle-mass options.

Bodybuilders were specifically targeted based on the recommended use of CLA for

the purpose of lean muscle mass gain by numerous bodybuilding websites.

1. I Am: A Person who A Fitness A Personal A Bodybuilder None of the likes to workout Instructor Trainer Above 66% 16% 5% 4% 23%

Question two inquired about frequency of use of CLA for weight loss.

Respondents were asked if they are currently or have ever used CLA to assist with

weight loss. Of those who participated in the survey, 10% said they are currently or

have used CLA, while 90% indicated that they are not currently nor have they ever

12 supplemented with CLA for weight loss.

Question three was designed to determine if a participant would ever use

CLA for weight loss. The majority of the respondents were neutral, followed by those who either disagreed or strongly disagreed to supplementing with CLA for weight loss.

3. I would use CLA for weight loss Neutral Disagree Strongly Agree Strongly Agree Disagree 50% 18% 17% 12% 3%

In question four, when asked if participants were currently using or have used CLA to gain lean muscle mass, only 9% indicated yes while 91% indicated no.

When analyzing questions two and four, there proves to be a slight percentage increase of respondents who are currently using or have used CLA for weight loss than for lean muscle gain.

Question five asked if participants would supplement with CLA for the purpose of gaining lean muscle mass. The majority of the respondents again were neutral followed by those who disagreed or strongly disagreed to the use of CLA for the purpose of lean muscle mass gain. When analyzing questions three and five, an increase in respondents indicated that they would be more likely to use CLA for lean-muscle mass gain than for weight loss.

13 5. I would use CLA to gain lean muscle mass Neutral Disagree Strongly Agree Strongly Agree Disagree 47% 20% 17% 15% 2%

To gather what information participants had about CLA, question six of the survey inquired about where or how participants learned about CLA and why they began using it. The majority of the respondents had never tried CLA, but of those who had, the largest percentage said they had read articles featuring testimonials from others who had experienced positive results from taking CLA.

6. I am using or have used CLA because: My coach, personal trainer or nutritionist recommended it. 5% Someone suggested it would work for me. 7% I have read articles with testimonials on its effectiveness 8% I have seen how effective it is in someone else. 2% I try everything new to see if it works for me. 2% I have not tried CLA. 88%

Question seven inquired if participants were aware of food sources that contain CLA. The largest percentage of those surveyed was not aware of food sources. Those who were aware of food sources were asked to give examples. The following are the examples participants gave: dairy, red meat, grass fed cattle, lamb, turkey, kangaroo meat, eggs, some mushrooms, and sunflower. One respondent stated, “Significant sources [of CLA] can only be obtained from supplements”.

14 7. I am aware of food sources containing CLA Not Aware Somewhat Aware Very Aware 77% 17% 6%

Question eight inquired about the belief participants had regarding the consumption of CLA to assist with weight loss. The largest portion of the respondents said they were neutral followed by those who agreed that supplementing with CLA would help them lose weight.

8. I believe supplementing with CLA will help me lose weight Neutral Agree Strongly Disagree Strongly Agree Disagree 74% 10% 8% 6% 2%

Question nine inquired about the belief participants had regarding the consumption of CLA to assist with gaining lean body mass. Again the largest percentage of those individuals surveyed were neutral on the subject while 13% agreed that supplementing with CLA would help them gain lean muscle mass. A slightly larger percentage agreed that supplementing with CLA would help them gain lean-muscle mass than to help them lose weight.

9. I believe supplementing with CLA will help me gain lean muscle mass Neutral Agree Strongly Disagree Strongly Agree Disagree 71% 13% 8% 6% 2%

When respondents were asked if they were aware of effective amounts of CLA to supplement with in question ten, most were not aware while

15 14% indicated that they were somewhat aware. This question may have been confusing for participants because it is unclear what an effective dose may be. CLA supplement bottles typically contain milligram capsules while instructions indicate to the consumer to take gram dosages; many consumers may not know the conversion of milligrams to grams. Manufacturers recommend supplementing with one-four g/d while many scientific studies used a range of 1.5 g/day to 7 g/day. It is unclear what effective doses may be.

10. I am aware of effective amounts of CLA to supplement with Not Aware Somewhat Aware Very Aware 80% 14% 6%

When asked if participants were familiar with scientific literature regarding the uses of CLA in question 11, most were not familiar. There has been a great deal of research conducted on the efficacy of CLA for the purpose of weight loss and lean- muscle mass gain in both animal and human subjects. Research indicates that CLA is very effective in animals. Results are inconclusive in human models, which indicates that future research needs to be conducted.

11. I am familiar with scientific literature regarding the uses of CLA Not Familiar Somewhat Familiar Very Familiar 76% 22% 2%

Question 12 inquired about negative side effects participants may have experienced when supplementing with CLA. Most respondents were neutral followed by those who disagreed to having experienced side effects. Participants

16 who had used CLA listed the following negative side effects: upset stomach, nausea and increased muscle soreness when working out and taking six grams per day.

12. I have supplemented with CLA and experienced negative side effects Neutral Strongly Disagree Agree Strongly Agree Disagree 60% 19% 19% 2% 0%

Question 13 asked if participants were aware of what chemical forms of CLA are most effective. Of the 127 participants to answer this question, 114 respondents were not aware of which chemical form was effect, while 13 were either very aware or somewhat aware. Most of those who participated in the survey were unaware of which chemical form of CLA to take. The two most common isomers used in CLA research are t10, c12 and c9, t11. T10, c12 is said to increase weight loss while c9, t11 is said to increase lean muscle mass. When purchasing CLA, it is unclear which isomer the consumer is purchasing because it is not labeled on the bottle. Most manufacturers produce capsules containing a mixture of the two isomers.

13. I am aware of which chemical form of CLA is most effective Not Aware Somewhat Aware Very Aware 90% 8% 2%

Survey participants were asked where they were most likely to purchase CLA in question 14. Approximately half indicated that they would do so at a health food store followed by the Internet, a pharmacy, a grocery store and other, respectively.

CLA is relatively simple and convenient to purchase. One can find common forms of

17 product in most local pharmacies, health food stores or through various websites on the Internet.

14. If I were to purchase CLA, I would most likely do so through A Health Food The Internet A Pharmacy A Grocery Other Store Store 47% 18% 15% 11% 9%

Question 15 inquired whether or not respondents would recommend the use of CLA to others for the purpose of weight loss. Most of the participants who were surveyed were neutral followed by those who strongly disagreed to recommending the use of CLA to others for weight loss.

15. I would recommend using CLA to others for weight loss Neutral Strongly Disagree Agree Strongly Agree Disagree 66% 17% 13% 4% 1%

The final question asked participants if they would recommend using CLA to others for the purpose of lean muscle gain. Again most respondents were neutral followed by those who strongly disagreed to recommending the use of CLA.

16. I would recommend using CLA to others for gaining lean muscle mass Neutral Strongly Disagree Agree Strongly Agree Disagree 68% 14% 11% 7% 1%

18 Of those surveyed, more would recommend the use of CLA for lean-muscle mass gain than for weight loss. An overall trend throughout this survey was for using CLA for lean-muscle mass gain rather than weight loss. When asked if they would use CLA for weight loss or lean-muscle gain, more respondents indicated that they would use if for lean-muscle gain. When asked if they believed supplementing with CLA helped them lose weight or gain lean-muscle mass, more respondents agreed that it would help them gain lean-muscle mass. And finally when asked if they would recommend using CLA to others for weight loss or lean-muscle mass gain, more respondents agreed to recommending it for lean-muscle mass gain.

19 Conclusion

Extensive research has been has been conducted in both animal and human models, which demonstrate the efficacy of CLA as both a weight loss or lean body mass gain. Conversely, very little research has been conducted concerning the practical human application of CLA (i.e. the frequency of supplementation, information individuals posses, perceptions about, and general experiences people have had with CLA). The purpose of this study was to gather a limited amount of applicable information to begin to fill the noticeable information void. A sixteen statement confidential online survey was provided for a number of participants to share their opinions and understanding of CLA. When survey participants were asked about their familiarity with applicable scientific literature, most respondents indicated they were not. Of those participants who had supplemented with CLA, many chose to do so because of published articles featuring testimonials of users who had experienced positive results while supplementing with CLA.

The survey results showed that while only a small population of survey participants had general information about CLA, a larger percentage of participants indicated that they would both use and/or recommend the use of CLA for lean body mass gain more than they would for weight loss. Based on this finding, it would be beneficial to conduct further product research amongst a narrower sample population such as bodybuilders.

20 References

Banu, J, Bhattacharya, A, Rahman, M, O’Shea, M, & Fernandes, G. (2006). Effects of conjugated linoleic acid and exercise on bone mass in young male mice. Department of Medicine, Division of Clinical Immunology, University of Texas Health Science Center, Sand Antonio, Texas. 78229-3900, March 2006.

Bhattacharya, A, Rahman, M, McCarter, R, O’Shea, M & Fernandes, G. et al (2006). Conjugated linoleic acid and chromium lower body weight and visceral fat mass in high-fat-fed male mice. Department of Medicine, Division of Clinical Immunology, University of Texas Health Science Center, San Antonio Texas, 78229-3900, May 2006

Bhattacharya, A, Rahman, M, Sun, D, Lawrence, R, Mejia, W, McCarter, R, O’Shea, M & Fernandes, G. (2005). The combination of dietary conjugated linoleic acid and treadmill exercise lowers gain in body fat mass and enhances lean body mass in high fat fed male mice. Department of Medicine, Division of Clinical Immunology, University of Texas Health Science Center, San Antonio, Texas 78229-3900, May 2005.

Berning, J. & Nelson, S. (1998). Nutrition for Sport & Exercise (2nd ed). Gaithersburg, Maryland: Aspen Publishers.

Campbell, B, & Kreider, R. (2008). Conjugated Linoleic Acids. Current Sports Medicine Reports, 7(4), 237-241.

Chen, S, Lin, Y, Huang, H, Hsu, W, Houng, J, & Huang, C. (2012). Effect of conjugated linoleic acid supplementation on weigh loss and body fat composition in a Chinese population. Nutrition, 28(5), 559-565.

Churruca, I, Fernandez-Quintela, A, & Portillo, M. (2008). Conjugated linoleic acid isomers: Differences in metabolism and biological effects. Biofactors, 35(1), 105-111.

Examine Staff (2013, July 11). Conjugated Linoleic Acid. Retrieved from http://examine.com/supplements/Conjugated+Linoleic+Acid/

Fragakis, A, Thomson, C. (2007). The Health Professional’s Guide to Popular Dietary Supplements (3rd ed). American Dietetic Association.

Ha Y, Grimm N, Pariza M. (1987). Anticarcinogens from fried ground beef: heat- altered derivatives of linoleic acid. Carcinogenesis 8(12): 1881-7

Kelly, G. (2001). Conjugated Linoleic Acid: A Review. Alternative Medicine Review. 6(4) 367-382.

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Malpuech-Brugere, C, Verboeket-can De Venne, W, Mensink, R, Arnal, M, Morio, B, Brandolini, M, Saebo, A, Lassel, T, Chardigny, J, Sebedio, J, & Beaufrere, B. (2004). Effects of Two Conjugated Linoleic Acid Isomers on Body Fat Mass in Overweight Humans. Obesity Research, 12 (4), 591-598.

Myoclonic Staff (n.d). Exercise: 7 benefits of regular physical activity. Retrieved from: http://www.mayoclinic.com/health/exercise/HQ01676

MusclePharm® CLA Core™ (2013) Retreived from: http://www.gnc.com/product/index.jsp?productId=15989906

Nagpal, R, Hariom, Y, Anil Kumar, P, Kishan, S, Shalini, J & Francsco, M. (2007). Conjugated Linoleic Acid: Sources, Synthesis and potential health benefits- an overview. Current Topics In Nutraceutical Research, 5(2/3): No. 55-66.

Pariza, M. (2013). Retrieved from: http://www.nutrisci.wisc.edu/facultypages/f_pariza.html

Park, Y, Storkson, J, Albright, K, Lui W, Pariza, M. (1999) Evidence that the trans-10, cis-12 isomer of conjugated linoleic acid induces body composition changes in mice. Lipids, 34: 235-41.

Pinkoski, C, Chilibeck, P. Candow, D, Esliger, D, Ewaschuck, J, Facci, M, Farthing, J & Sello, G. (2006). The Effects of Conjugated Linoleic Acid Supplementation during resistance Training. Medical & Science In Sports and Exercise, 38(2), 339-348. Ritzenthaler, K, McGuire, M, Falen, R, Shultz, T. D., Dasgupta, N., McGuire, M. A. (2001) Estimation of conjugated linoleic acid intake by written dietary assessment methodologies underestimates actual intake evaluated by food duplicate methodology. J Nutr. 131: 1548–1554.

Robertson, B (n.d). CLA as a dietary supplement. Retrieved from http://chealth.canoe.ca/channel_section_details.asp?text_id=4316&channel_i d=44&relation_id=48477

The Dr. Oz Show Staff (2013). 7 Belly Blasters that Really Work! Retreived from http://www.doctoroz.com/videos/7-belly-blasters-really-work

Trend Statement Staff (2013). Can CLA Help People Lose Weight and Gain Muscle? Retrieved from http://www.trend-statement.org/can-cla-help-people-lose- weight-and-gain-muscle/

Seedman, J & Seedman, J. (n.d.). Conjugated Linoleic Acid (CLA). Retrieved from: http://www.exrx.net/Nutrition/Supplements/ConjugatedLinoleicAcid.html

22 Appendices

23