Quick Hit Summary

The International Society of Sports Nutrition (ISSN) held their 2014 annual conference in Clearwater Beach, FL. Many presentations, from both an "applied" and "research" point of view were given during this 2 day event. In Part 1 of our review, we discuss those that fell on Day 1 of the conference. Specific ones highlighted include those presented by Juan Carlos Santana, FNSCA (Weight Cutting Strategies for Elite MMA Fighters), Krista Varady, PhD (Alternate Day Fasting – Effects on Health & Body Composition), Darryn Willoughby, PhD (Ursolic Acid Supplementation), Mark Tarnopolsky, PhD (Creatine – Not Just for Sport), and Steven Orris MS CSCS USAW CISSN (Strength Training and Sports Nutrition for the College Athletes). Additionally I share with you a couple tidbits on the expo portion of the event.

11th Annual ISSN Conference – “A Sports Supplements Extravaganza!”

Figure 1. Catching up with friends at ISSN. From left to right – Dr. Lonnie Lowery, Dr. Mike T Nelson, Korey Van Wyk & myself (Sean Casey). Brilliant men wear glasses. Image via Mike Nelson.

Iron Radio Live from the 2014 Conference At the conclusion of the ISSN Conference, Dr. Lonnie Lowery, Dr. Mike T Nelson, Korey Van Wyk & myself recorded a live episode of Iron Radio, recapping the highlights of the two day event. Be sure to check it out !

For the 2nd year in a row, I had the opportunity to attend the International Society of Sports Nutrition (*ISSN*) Conference and learn from some of the top minds in the field. Similar to last year, a diverse group was present – sports nutritionist, physical preparation coaches, personal trainers, exercise enthusiast and PhD’s researching all the aforementioned areas of physical performance. Needless to say, a pretty smart, in-shape, fun and good looking crowd! Oh yeah, for those who enjoy the water, the conference took place on the white sands of Clearwater Beach, overlooking the Gulf of Mexico.

Although nothing equates to attending the two day event “live”, luckily for you, my pen was swift, my mind was sharp and I took solid notes which I’m pleased to share with you on CasePerformance. With that being said, let’s kick off Part I of our two part report!

CISSN Exam

Figure 2. CISSN Logo. Image used with permission

My 2014 ISSN experience kicked off a day prior to everyone with a test – Ugh, I know, right? Actually, I had been looking at the CISSN for some time and since the opportunity was provided at the conference, figured it would be as good as time as any. For those not familiar with the CISSN, it stands for *C*ertified Sports Nutritionist from the *I*nternational *S*ociety of *S*ports *N*utrition and of the two certifications offered through the ISSN, it is the more stringent.

As many of you know, along with applied experience in the field, I am a Registered Dietitian (RD) and have degrees in both Nutritional Science and Kinesiology-Exercise Physiology. Despite this, I’ve been asked by a surprising number of clients/potential clients if I have any special certification in sports nutrition. The question has been asked while interviewing for various positions in the past as well. Although being certified doesn’t make one “great” at what they do, I do feel it establishes a baseline level of competency and something that can help set yourself apart vs. the competition. I am pleased to note that I did successfully pass the exam and for those wondering, here is how I prepared…

Preparation wasn’t too bad as I’ve kept a pretty close eye on current sports nutrition recommendations and research in general. I started off be reviewing through the ISSN Position Stands . Although some of them may be a bit dated, they’re still a pretty solid source of information. Hand-in-hand with reviewing through the position stands was use of the CISSN Study Guide , a 178 question review of what one is expected to know heading into the exam. The third tool I used in preparation of the exam was the Sports Nutrition and Performance Enhancing Supplements book. If I had to list these study resources in order of importance in preparation for the exam I’d list 1) Study Guide 2) Sports Nutrition & Performance Enhancing Book 3) Position papers.

The exam was 200 questions in length and I had a total of three hours to complete it. For someone who hadn’t taken a formal paper and pencil exam in 3+ years, this ended up being loonnnnggggg. Overall the questions were pretty straight forward and I’m confident that if one reviews the aforementioned resources, they’ll do well with the exam.

With the CISSN in the rearview mirror, I relaxed, enjoyed food and drink and prepared myself for Day 1 presentations…

Juan Carlos Santana, FNSCA – Weight Cutting Strategies for Elite Mixed Martial Arts Fighters

For many sport athletes, “making weight” is a key aspect of their sport. Done right and it’s a smooth process, leaving the athlete ready to rock. On the flip side, if done poorly, the athlete is left mentally and physically exhausted before the competition even begins. In this presentation, Juan Carlos Santana, director and CEO of the Institute of Human Performance, discussed strategies he uses in helping elite Mixed Martial Arts (MMA) fighters achieve the former of the two scenarios. In order to do this, Mr. Santana made the following recommendations:

• Food – Controlling hunger via frequency, quality and quantity of food

• Supplements – (Beta alanine – 3 to 4 g/d; Coffee (Pre workout: 250 mg ?caffeine? … slide said 250 mg ‘coffee’ but I think he was referring to caffeine); Vitamin D – 5000 IU/d; Fish Oil – 3 to 6g/d; Multi-Vitamin + Iron for women; Whey Protein (total protein of > 1 g/lb Pro)

• Timing of nutrition around workout periods

• Staying within 5-10% of weight class year round.

• Stay Hydrated

• 24 Hour Cut

After making these recommendations, Mr. Santana went into a more in-depth discussion on how a weight cut looks for an athlete. For example, starting 8 weeks out from the competition (i.e. – at the start of the fight training camp), a fighter fighting in the 170 lb weight class should come in < 187 lbs. Over the 8 weeks of training camp, the fighter will lose ~5-7 lbs, leaving an “EASY” 8-10 lb drop on cut day. How does one make such a significant cut on that final day before weigh in? In order to accomplish this, a fighter manipulates his/her water levels using a two pronged approach

• 1) Water consumption (leading up to weigh in) and

• 2) Bath & steam

With respect to #1… In the few days leading up to the cut, a fighter drinks 1.5-2 gallons of water per day; the day prior to the cut, this may even be as high as 2-3 gallons. As a result, the body’s diuretic hormones are going full throttle, trying to rid the body of the excess water being consumed. Then, on Thursday afternoon/evening (ie – the day before weigh in), the fighter stops drinking water. However, due to the presence of elevated diuretic hormones still present within his/her system, water is flushed from the body without being replaced. End result – a drop in weight.

With respect to #2… Starting the evening before the weigh in, the fighter creates a steam bath in his/her bathroom. Using a repetitive 20 minute cycle, a fighter will spend 10 minutes in the tub (filled with hot water), 5 minutes out of the tub (still in presence of steam in bathroom) and 5 minutes sitting outside in normal room temperature. This cycle is then repeated 2-3x.

Immediately following this “cut”, and subsequent weigh in, the fighter rehydrates him/herself up to a normal body weight. Thus, by fight time on Saturday, they’re recovered and ready to perform.

Krista Varady, PhD – Alternate Day Fasting: Effects on Health and Body Composition

Figure 3. Fat loss while using ADF for a period of 8 weeks – studies 1 & 2 or 12 weeks – study 3. For study 2: LF = Low Fat (25% kcal needs), HF = High Fat (45% kcal needs). Study 3: ADF = Alternate Day Fasting, EX = Exercise. For reference, body composition was assessed via bioelectrical impedance analyzer (BIA) in all three studies. Data adapted from original sources.¹²³

As discussed in a previous newsletter, using intermittent fasting (IF) as a means to assist fat loss is a concept I find to be quite interesting; especially in light of the fact that it stands in sharp contrast to the "eat early, eat frequently" small meal approach that was being promoted while I was going through university. In this presentation, Dr. Krista Varady, Associate Professor of Nutrition at the University of Illinois, discussed a specific type of fasting, alternate day fasting (ADF), and the positive effects it’s had in obese populations. As implied by the name, ADF involves alternating fast days with feed days. However, using Dr. Varady’s model, it’s not a complete fast. Rather subjects are allowed to eat 25% of their normal energy requirements within a given 2 hour time block (12-2pm). On the feed days, participants are restriction free; allowing them to eat as much as they desire.

Dr. Varady’s first human based study in this area was completed in 2009 and involved 16 obese subjects following an ADF dietary approach for a period of 10 weeks. Weeks 1 & 2 served as control weeks where participants simply recorded their food intake during a weight maintenance period. This was followed by two 4 week blocks of ADF. During the first of these blocks, study participants were provided meals on their fasting days. In contrast, during the second of these blocks, participants received dietary counseling on how to plan ADF meals on their own. At the conclusion of the study, it was found that subjects lost a significant amount of body fat (~ 5.4 kg) while preserving lean body mass. Rate of weight loss was similar between both phases of the ADF. Interestingly, to my surprise, study participants only increased dietary intake to 110% of their needs on feed days. From a cardiovascular/lipid standpoint, the ADF led to significant improvements in LDL cholesterol (- 25%) and triglycerides (-32%).

In a second study out of Dr. Varady’s lab, Klempel et al sought to find if having a low or high fat diet (25 vs. 45% kcal needs) influenced the efficacy of ADF on weight loss and cardiovascular health in 32 obese individuals. Similarly to their previous study, the trial lasted 10 weeks with a 2 week control phase followed by an 8 week ADF phase in which all meals (fasted 25% estimated kcal needs; feed days – 125% estimated kcal needs) were provided to the subjects. At the conclusion of the trial, researchers once again found significant losses in fat mass (high fat group – 5.4kg; low fat group – 4.2kg) without any changes in lean body mass. Improvements in cardiovascular health took place as well. Although no major differences were found between groups with respect to outcomes, Dr. Varady did mention that the higher fat group seemed to be “happier” throughout the trial.

The next question tackled by Dr. Varady’s lab was "Is it possible to exercise on this diet?". In search of this answer, Bhutani et al randomized 64 obese individuals into 1 of 4 groups for 12 weeks: 1) ADF 2) Exercise (EX) 3) EX + ADF 4) Control.³ The exercise consisted of 25 minutes of steady state cardio on an elliptical or bike at 60% HRmax during weeks 1-4 before jumping up in intensity (+5 min duration & +5% HRmax) on weeks 4,7 and 10. At the end of end of the study period, it was found that all three intervention groups maintained lean body mass. However, only the ADF and ADF + EX groups experienced significant losses of fat mass, with greatest losses in the ADF + EX group (5 kg vs. 2 kg). From a cardiovascular/lipid profile standpoint, both ADF groups saw significant reductions of the pro-atherogenic small LDL particles but only the ADF+EX group saw increases in HDL levels (+18%). Dr. Varady noted that individuals who ate their meal immediately following the exercise session cheated much less on their diets. Additionally, the ADF diets were challenging to follow for the first 2 weeks. After that it was pretty smooth sailing.

During the Q&A that followed the actual presentation, Dr. Varady mentioned that her research team recently finished up a yearlong study examining the effects of ADF vs. CR on long term weight management. In the study, all subjects completed 6 months of weight loss dietary measures followed up by 6 months of weight maintenance. During the latter of the two phases, the reins were relaxed a bit in the ADF group; they increased their dietary intake from ~500 kcal to ~1000 kcal on fasting days. (NOTE – I do not recall to what degree kcal intake increased in the CR group). Although they’re still collecting and analyzing the data, it appears each group lost equal amounts of weight during the weight loss phase. However, during the maintenance portion of the study, the ADF group was better able to maintain vs. the CR group. Unfortunately, I don’t have any specific data I can share on this study. Dr. Varady thought it would be published at some point in 2015… so keep your eyes out for this one!

Darryn Willoughby, PhD FISSN – Ursolic Acid Supplementation: A Comparison with Leucine in mTORC1 Up-Regulation

Figure 4 Apple peel and cranberries – Two natural sources of ursolic acid (UA). The UA content of apple peels ranges from 0.8 – 0.2 mg/cm^2 with Fuji and Smith varieties at the high end followed by Granny Smith and next Gala.¹¹ UA content of cranberries ranges from 0.129 – 1.090g/kg of fresh weight.¹² Apple image source.¹³ Cranberry image source.¹⁴

Dr. Darryn Willoughby, a professor and researcher at Baylor University, as well as the most muscular guy I’ve ever seen proctor an exam (Dr. Willoughby proctored my CISSN exam), gave an interesting presentation on the effectiveness of Ursolic Acid (UA) vs. Leucine (Leu) on the key proteins currently thought to be responsible for muscle growth – mTORC1, Akt and p70S6K. For those not familiar with UA, it’s a compound derived from apple peels, cranberries and other fruit. Previously, research completed by Ogasawara et al indicated that giving rats 250 mg UA/kg (Human Equivalent Dose = 40.5 mg/kg) via intraperitoneal injection immediately following a resistance training session stimulated the mTORC1 pathway.⁴ (Emphasis placed on 'intraperitoneal injection' as it appears that <1% is actually bioavailable when consumed orally.⁵) Thus, the important question that remains to be answered is if UA is actually beneficial in humans when ingested orally.

How much UA is present in supplements on the market today? In general, most of the supplements I’ve seen call for 450-600mg/day of a rosemary extract containing 25% UA. Thus, making the 3 grams (37% UA) in Dr. Willoughby’s study a pretty whopping dose in light of current supplements on the market!

In order to shed some light on the potential effectiveness of UA in humans, Dr. Willoughby presented preliminary data on a trial run by his research team.⁵ In it, 9 resistance trained men complete three different resistance training sessions that involved 4×8-10 reps on both the leg press and leg extension machines. Immediately following the training session, participants consumed 3 grams of a placebo, UA or Leu. Additionally, to make things a bit more realistic and ensure that "participants were not in a hypocaloric state while taking measurements." each individual consumed a light meal replacement bar (180 kcal, 11g CHO, 7g protein, 12g fat) at 1 hour pre as well as 2 hours post exercise. In the 6 hours that followed the training session, markers of protein synthesis (mTORC1) were assessed. As one would expect, 3 g of Leucine did increase mTOR activity. However, UA did NOT increase mTOR activity.

Bottom Line on Ursolic Acid supplements & muscle growth… Although Dr. Willoughby noted that more research needs to be completed, it appears that even in 3g oral doses (37% UA), this supplement fails to enhance mTOR activity. In pursuit of muscle growth, I recommend spending your money elsewhere.

Mark Tarnopolsky MD PhD – Creatine Not Just for Sports

Creatine – Beyond Brawn … One topic not discussed by Dr. Tarnopolsky was the beneficial effect that creatine has on blood sugar control. If interested in finding out more on this topic, be sure to check out Creatine – Diabetes & Glycemic Control. Also, do you love a little history? If so, be sure to also check out Creatine – A Historical Look which was the featured article in our Aug-Sept ‘13 newsletter.

Is there a supplement that has more far reaching benefits than creatine? Not only is it the best legal ergogenic aid on the market for aneorobic enthusiasts, but assuming one sticks with creatine monohydrate, its dirt cheap! However, that’s old news, and as such, most ergogenic creatine studies hold little interest to me anymore… However, what does hold my interest, as it relates to creatine, is all the benefits it has BEYOND sport performance (see sidebox). For this reason, I was particularly interested in Dr. Mark Tarnopolsky’s presentation which focused on the non-sport benefits associated with creatine. There was a plethora of topics Dr. Tarnopolsky mentioned in his talk. I’ll highlight a couple…

Dr. Tarnopolsky discussed how creatine supplementation was proving beneficial for those with various muscular dystrophies. For instance, referencing a meta-analysis that he co-authored, following creatine supplementation, the mean increase in isometric strength in this population was 8.47%⁶. This enhanced strength translated to improved quality of daily living in many of the cases (vs. placebo). Additionally, creatine supplementation appears to counteract some of the known side effects associated with corticosteroid use, a staple treatment for many individuals with muscular dystrophy.

Another area of research discussed by Dr. Tarnopolsky is the positive effects creatine has on preserving brain tissue following a traumatic brain injuries (TBI) such as concussions. For instance, using an animal model to replicate TBI, Sullivan et al found that prophylactic creatine supplementation led to a 36% reduction in cortical damage in mice and a 50% reduction in rats.⁷ Although there hasn’t been any studies examining prophylactic use in humans, 0.4 g/kg/d of creatine use following TBI has been shown to enhance recovery and reduce post trauma symptoms in children/adolescents between the ages of 1-18.⁸

A few final points I’d like to highlight from Dr. Tarnopolsky’s presentation 1) Creatine is SAFE!!! 2) There are many phase 1 and phase 2 trials currently underway regarding potential benefits of creatine use in disease states. However, it’s hard to get funding (pharmaceutical companies can’t profit from it). 3) Did I mention creatine was SAFE?!

Steven Orris, MS CSCS CISSN – Strength Training & Sports Nutrition for the College Athlete: Real World Advice

Steven Orris, director of strength and conditioning and adjunct professor at Nova Southeastern University, discussed his approach to sports nutrition while working in a college setting. To assist in the education of the athletes, each team at NSU designates a nutrition captain who acts as the spokesperson for the team with respect to meals. Additionally, captains are responsible for relaying information back to the team. From an educational standpoint, key topics that Mr. Orris zeroes in on include 1) Breakfast – How to fuel for a 6am workout 2) Hydration – How much is needed and the effects of hydration on performance. 3) Recovery – What to eat and when. 4) Supplements 5) ISSN Position Stands . Other areas that student athletes often need assistance in include life skills such as budgeting, shopping, cooking etc. When providing sports nutrition advice to athletes, Mr. Orris stressed the importance of providing practical advice. Often, it’s not enough to just tell an athlete to eat X amount of kcal or macros. Rather one needs to provide examples of food/food combos that will meet kcal/macro recommendations.

Mr. Orris closed his talk by giving 3 different take home tips for those working in a collegiate setting. First, he recommends making sure that the entire Athletic Department buys into the nutrition plan. Without full support from the sport coach, athletic director, etc, it will be very hard to get off the ground. Secondly, put yourself in the shoes of student athlete – Can you plan 3 meals and snacks to provide the nutrition necessary to maximize performance with the options available to them? Last, figure out the end goal; once that is determined, work backwards, outlining the necessary steps till you find yourself at the starting point.

The Supplement Expo

Once again the ISSN conference featured a supplement expo that featured great tasting protein bars and enough pre workout stimulants to fuel me during my 18 hour drive back home following the conference. A couple points of potential interest that I can share about the expo…

• There was a greater emphasis on ergogenic supplements designed specifically for women. In fact, there was a new start-up company there whose sole mission was providing ergogenic supplements to fuel the female athlete.

• On multiple instances, I found myself discussing protein spiking and the legal issues related to it. Similar to myself, the people I talked with were interested to see how it would all turn out.

Day 2 Report to Follow!

That’s a wrap on Day 1 of the 2014 ISSN conference. I think that’s more than enough information for you to digest in one sitting. Stay tuned as we’ll dive into Day 2 of the conference that included presentations on HMB, Phosphatidic Acid, Keto-Adaptation, Power Eating in the Kitchen and more!

References

¹ Varady KA, Bhutani S, Church EC, Klempel MC.Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. Am J Clin Nutr. 2009 Nov;90(5):1138-43.

² Klempel MC1, Kroeger CM, Varady KA. Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism. 2013 Jan;62(1):137-43.

³ Bhutani S1, Klempel MC, Kroeger CM, Trepanowski JF, Varady KA. Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans. Obesity (Silver Spring). 2013 Jul;21(7):1370-9.

⁴ Ogasawara R1, Sato K, Higashida K, Nakazato K, Fujita S.Ursolic acid stimulates mTORC1 signaling after resistance exercise in rat skeletal muscle. Am J Physiol Endocrinol Metab. 2013 Sep 15;305(6):E760-5.

⁵ Darryn Willoughby, PhD FISSN – Ursolic Acid Supplementation: A Comparison with Leucine in mTORC1 Up-Regulation. 2014 ISSN Conference Presentation.

⁶ Kley RA1, Tarnopolsky MA, Vorgerd M. Creatine for treating muscle disorders.
Cochrane Database Syst Rev. 2013 Jun 5;6:CD004760.

⁷ Sullivan PG1, Geiger JD, Mattson MP, Scheff SW. Dietary supplement creatine protects against traumatic brain injury. Ann Neurol. 2000 Nov;48(5):723-9.

⁸ Sakellaris G1, Kotsiou M, Tamiolaki M, Kalostos G, Tsapaki E, Spanaki M, Spilioti M, Charissis G, Evangeliou A. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. J Trauma. 2006 Aug;61(2):322-9.

⁹ Wilson JM1, Lowery RP, Joy JM, Andersen JC, Wilson SM, Stout JR, Duncan N, Fuller JC, Baier SM, Naimo MA, Rathmacher J. The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate free acid supplementation on muscle mass, strength, and power in resistance-trained individuals: a randomized, double-blind, placebo-controlled study. . Eur J Appl Physiol. 2014 Jun;114(6):1217-27.

¹⁰ Kraemer WJ1, Hatfield DL, Volek JS, Fragala MS, Vingren JL, Anderson JM, Spiering BA, Thomas GA, Ho JY, Quann EE, Izquierdo M, Häkkinen K, Maresh CM. Effects of amino acids supplement on physiological adaptations to resistance training. Med Sci Sports Exerc. 2009 May;41(5):1111-21.

¹¹ Rosa T.S. Frighettoa, Rodolfo M. Welendorfb, Eduardo N. Nigrob, Nélson Frighettob, Antonio C. Sianic. Isolation of ursolic acid from apple peels by high speed counter-current chromatography. Volume 106, Issue 2, 15 January 2008, Pages 767–771. Abstract only

¹² Kondo M1, MacKinnon SL, Craft CC, Matchett MD, Hurta RA, Neto CC. Ursolic acid and its esters: occurrence in cranberries and other Vaccinium fruit and effects on matrix metalloproteinase activity in DU145 prostate tumor cells. J Sci Food Agric. 2011 Mar 30;91(5):789-96. doi: 10.1002/jsfa.4330. Epub 2011 Feb 23.

¹³ Jason Popesku. Apple peelings.20 December 2008, 10:15:49.This file is licensed under the Creative Commons Attribution-Share Alike 2.0 Generic license. Accessed on July 22 2012 from: http://commons.wikimedia.org/wiki/File:Peeling_apples_for_applesauce.jpg

¹⁴ Namiwoo.日本語: クランベリー.25 December 2012, 11:34:07This file is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license. Accessed July 22 2014 from:http://commons.wikimedia.org/wiki/File:%E3%82%AF%E3%83%A9%E3%83%B3%E3%83%99%E3%83%AA%E3%83%BC.JPG