Saturday, July 25, 2009

Is what's on the label really in your supplement?

Most of us into health and nutrition dabble in supplements. Some whey protein here; a vitamin D capsule, maybe some fish oil, there. We do this because we believe what we've read about these things being a good idea. But what if what's on the label isn't what's in the tin? How do we really know we're getting what's promised by the label?
At the recent Z-Health 9S:sustenance course, overviewed here, we talked a lot about supplements: about what ones are worth taking, yes, but also about where to source them, once you've made the decision to use them. Based on that discussion, i did some further digging. It's not a story with a happy ending. Sorta more like left who's on stage at the end of Richard III: oh goodie the exciting, poetic, smart villain is dead, while this cheating asshole is left to run the kingdom but at least no one will be fighting anymore. hoo frickin' rah.

So this post presents a brief overview of legislation in the US around dietary supplements, problems with supplement quality and contamination, what good manufacturing practice (aka cGMP is) what third party certification like Consumer Labs or USP does with GMP (overivewed, anyway), a glimpse at the EU situation, and why June2010 is not the end of the War of the Roses.

History and Current Unregulated Practice. In the US, since 1994, there's been no requirement to have the Food and Drug Administration (FDA) assess either what goes into supplements or how they're made. Indeed, the FDA explicitly does NOT certify supplements (the way it does drugs and biologics). As its own web site says:
FDA does not approve dietary supplements.
Unlike new drugs, dietary supplements are not reviewed and approved by FDA based on their safety and effectiveness. Most dietary supplements that contain a new dietary ingredient (a dietary ingredient not marketed in the United States before October 15, 1994) require a notification to FDA 75 days before marketing.

The notification must include the information that was the manufacturer or distributor's basis for concluding that the dietary supplement will reasonably be expected to be safe. After dietary supplements are on the market, FDA evaluates their safety through research and adverse event monitoring.
Why might such oversight at the level of the FDA be important? Well, our fave sup companies might not be delivering the goods. Consider this story from June this year on a consumerlabs.com test of various supplements:
Potency problems
In ConsumerLab.com testing last November, four out of seven supplements contained less ginkgo than claimed on their labels, and one failed to break apart properly to release its ingredients. Seven out of nine failed in tests in 2003, as did six out of 13 in 2005.
"It is now believed that ginkgo is among the most adulterated herbs," the company reports.
Tests by California scientists of two dozen ginseng supplements, reported in a nutrition journal in 2001, found that many differed from their labels. The concentrations of some ginseng compounds varied by up to 200-fold from product to product.
In ConsumerLab.com tests, six out of nine chondroitin supplements failed testing in April 2007. One had only 8 percent of what it claimed to contain, and one "maximum strength" product had none.
Vitamins and minerals had problems, too. A "high potency" iron supplement contained less than half the amount claimed. Of 23 top-selling vitamin C pills, one provided less than half the amount promised; the suggested dosages of some others were beyond recommended safe levels. Of 10 vitamin A supplements, one provided twice its stated amount, raising concern about toxic side effects.
Last year, nearly 200 people were sickened by supplements containing up to 200 times the amount of selenium stated on the label. Symptoms included hair loss, discolored and painful fingernails, muscle cramps, joint pain, diarrhea and fatigue.
Ok they above sounds like a rip off: claiming to have something in it that just isn't there. But the problems don't stop there. What about putting crap into the supplement that isn't on the label and may be a banned substance or just some crap drug? This too has apparently happened:
Spiking Your Shake
"Random batch spiking" has a long history in the supplement business. It works like this: "The manufacturer sprinkles an illegal substance into an over-the-counter dietary supplement," says Feliciano. "The legal ingredients are claimed on the label, but they don't disclose the drug."

Chris Lockwood, formerly the senior category director of diet, energy, food, and beverage at the supplement retailer GNC and now a doctoral candidate in exercise physiology at the University of Oklahoma, recalls taking a popular protein powder in the early 1990s: "When I first took it, I got great gains. I felt great. I got strong. I got lean. But then something happened to it." Years later, he related his experiences to one of the product's formulators who confirmed for him that the powder had been spiked with Clenbuterol, an asthma drug that supercharges your metabolism.
So what is a consumer to do?
There are in the US alone about 4 various standards groups that certify supplements against the Good Manufacturing Process. These are Consumer Labs, mentioned above, the NSF, NPA and USP (we'll come back to these in a second). According to Wikipedia's entry on cGMP, this means,
Since sampling product will statistically only ensure that the samples themselves (and perhaps the areas adjacent to where the samples were taken) are suitable for use, and end-point testing relies on sampling, GMP takes the holistic approach of regulating the manufacturing and laboratory testing environment itself. An extremely important part of GMP is documentation of every aspect of the process, activities, and operations involved with drug and medical device manufacture. If the documentation showing how the product was made and tested (which enables traceability and, in the event of future problems, recall from the market) is not correct and in order, then the product does not meet the required specification and is considered contaminated (adulterated in the US). Additionally, GMP requires that all manufacturing and testing equipment has been qualified as suitable for use, and that all operational methodologies and procedures (such as manufacturing, cleaning, and analytical testing) utilized in the drug manufacturing process have been validated (according to predetermined specifications), to demonstrate that they can perform their purported function(s).
Process Check vs Spot Check. In other words how the stuff is made is checked, not just a given batch "randomly" selected to be tested by a lab. On some bulk supplement sites, they will post batch "certificates of purity" as a kind of quality control - and a person then has to take it on faith that that certificate matches up with the batch actually in the holder's control and that is then being parceled out from that batch (in another process, introducing another opportunity for contamination) into smaller tins.

In contrast, with GMP, the process of how a supplement is made is submitted to the certification body, assessed against the certification group's standards, and then audited in practice. The specific details of each group's auditing process are detailed on their sites, but here are the types of things they consider for certification:

USP (US Pharmacopia)
The USP Verified Mark helps assure consumers of a manufacturer's commitment to quality and helps them easily identify and choose a product that
  • contains the ingredients listed on the label, in the declared potency and amount
  • does not contain harmful levels of specified contaminants
  • will break down and release into the body in a specified amount of time
  • and has been made according to the FDA's Good Manufacturing Processes
A list of USP cert'd supplement companies can also be found on their web site.

"Will break down and release into the body" is a pretty important thing, isn't it? Seems obvious, but some supplements in those ConsumerLabs.com random tests have been shown to be inert - they don't break down at all even in acid, never mind water, like ever.

NSF
What does NSF certification of a dietary supplement mean to consumers?
NSF International was one of the first organizations to develop an independent product evaluation program to address the rapidly growing dietary supplements industry.
The purpose of our voluntary program is to test and certify dietary supplements products to
  • verify the identify and quantity of dietary ingredients listed on the product label;
  • ensure the product does not contain undeclared ingredients or unacceptable levels of contaminants; and
  • demonstrate conformance to currently recommended industry Good Manufacturing Practices (GMPs) for dietary supplements.
They seem to be missing that disolvability eh? But you can also check if your brand uses the NSF for their certification. Likewise if you're concerned about banned substances, NSF makes a business of certifying for this compliance, too.

Why so many certification labs? It's a business. NSF also tests tools. ConsumerLabs tests everything. USP and NPA don't. Why might a company choose one cert over another? Good question. Certifications cost money. One might also believe that the auditing practices of one group seem more amenable than another. It's worth digging into each program to see what you would find most comforting.

Natural Products? For instance, some of us like to privilege "natural" products in our supplements over synthetics. Whether there is a clear difference in terms of absorption or not can be debated, and indeed the vitamin D2 vs D3 debate is a great example of such a discussion (though vitamn D2 is from natural products that are vegetarian sourced and then irradiated rather than from squished fish and animal parts, but i digress).

For that preference, there is a GMP certification group focusing on standards for naturals. Called, naturally enough, the Natural Products Association. Their guidelines for GMP spec are quite detailed, too. They have a considerable list of companies on their listings as well, and it's great that these can be checked.

UK/EU
In the EU, the standards seem to be incredibly weak. Ya have to demonstrate that in quantity and quality, they are safe. Placebo is safe: having nothing in the supplement including what's on the label, is safe. Despite this breadth, the UK fought them: why pay money to say what you've been selling for years is safe, went the argument - at least in part. Gosh, sport, i dunno. Maybe it's NOT. That said, some folks think the legislation is protecting law makers rather than conusmers. But then what IS a consumer to do who wants to make sure what's on the label is what's in the tin?

In the UK, some companies do send their products to be tested. But that's product testing, not product process auditing. When they want to prove their goodness in terms of GMP, they can go the ISO (international standards) route and get ISO 9001:2008 accreditation.
ISO 9001:2008 specifies requirements for a quality management system where an organization
  • needs to demonstrate its ability to consistently provide product that meets customer and applicable statutory and regulatory requirements, and
  • aims to enhance customer satisfaction through the effective application of the system, including processes for continual improvement of the system and the assurance of conformity to customer and applicable statutory and regulatory requirements.
All requirements of ISO 9001:2008 are generic and are intended to be applicable to all organizations, regardless of type, size and product provided.
So far, myprotein.co.uk, claims to be the sole UK supplement maker with the 9001:2000 certification, never mind the ultra recent 2008 version (it takes the better part of a year or more to get to that certified process so no wonder myprotein has just been able to announce the slightly earlier standard).

Becuase i say so? Another company that makes natural products in the UK and claims to use Good Manufacturing Practice, for made-in-uk supplements, however, doesn't say how that claim is verified.
Another supplement shop suggests that GMP in the UK is self-regulated: it's GMP compliant if we say it is:

What is GMP?
Good Manufacturing Practice (GMP) offers quality assurance; it is a set of strict pharmaceutical regulations, codes, and guidelines that ensure that food supplements are constantly manufactured and controlled to a high standard which is suitable for use. Within the UK it is only legally applicable to medicines and veterinary medicines, however, GMP is a self-regulatory code within the supplements industry which is used alongside the regulations that are set out within the Food Supplements Directive.

Simply Supplements’ purchasing team ensure that all of our supplements comply with the Food Supplements Directive and that countless products are GMP certified.
I have not been able to find anything to show either that there is anything other than a shop claiming that their supplements follow GMP protocols in order to claim GMP "certified." That said, it seems like the only real EU-wide objective approach is the ISO 9001:2000/2008 certification. As in the states, there are a variety of groups set up to help organizations meet these criteria and get their practices assessed by accredited labs.

June 2010: Law comes back to the Supplement Wild West - sort of. Back in the states, apparently by June 2010, supplement companies will have to be compliant with minimum GMP to sell their wares (pdf of whole rule here). Hoorah. Sounds wonderful, doesn't it. Here's the irony. Remember, this law/ruling is for Dietary Supplement makers. So watch this exception:
The most important and obvious change is that the final rule does not apply to dietary ingredient suppliers and manufacturers. The burden of compliance with cGMPs fully lies with the dietary supplement’s manufacturer and requires dietary supplement manufacturers to test 100% of the incoming dietary ingredients.
Excuse me? So this sort of means that while manufactures have to be able to say what their processes are and list that their processes follow GMP, and that will take some cost and effort, who's to say what's on paper is what they do? Who is going to police this? The FDA itself is woefully understaffed. And while it can carry out random inspections, is the cost of a fine cheaper than the cost of changing manufacturing practice?

GMP - better than a kick in the head. There's something to be said, perhaps, for companies who have taken it upon themselves to pick up the cost of quality assurance third-party certification. There can be corruption everywhere, to be sure. Inspectors paid off, etc etc, but for the most part, why bother with the certification then? There seem to be a thriving fleet of businesses making money on supplements without any breath of certification.

So, take away: the above may help explain why some products cost a *little* more than others. Certification is not the big cost, but production mechanisms, practices and oversight for compliance DO cost more.

If the result of that process is both a safe-from-contaminent and quality product such that what's on the tin is *in* the tin, then that is value for money.

If you're not sure if your favorite supplement shop is GMP certified by a third-party, why not ask them? If enough people do ask, they might up their game. They may say no, they can't afford to raise prices. Likewise, you may decide it's too great a risk of potentially wasting your money *not* to get your sups from a GMP certified source.

ps - supplements that are likely *worth* investing in, based on the best of what we know?

  • fish oil or equivalent broad spec fatty acids
  • vitamin d
  • coq10
for performance ergogenics, additionally
  • protein/bcaa
  • creatine
if not confident of the vitamin quality of one's food:
  • a multi
  • some e
  • some magnesium
If into strength stuff

whey protein, creatine, b complex - the research on these guys is so long standing now and so repeated in terms of results, it's hard to argue. THough i would say pea protein and rice protein are also great alternatives - as algae oil seems to be for fish oil.

So for the few things that have been shown to add real benefit, may be worth chasing down the ones with the highest certified potency/quality/purity?
 

Friday, July 24, 2009

Occlusion training: Sparking Muscle Growth when Injured or Just Sick of Heavy Loads

ResearchBlogging.orgWhen we hear the words "muscle hypertrophy" most of us think of body building and super duper muscle mass.

But hypertrophy itself is a natural and indeed necessary part of strength development. And it can be hard to induce hypertrophy when coming back from an injury or just when pooped of dealing with heavy weig Occlusion training (restricting venus return for very short periods) has intriguingly been associated with muscle hypertrophy. This recent review shows that its combined use with low loads can be great for rehab of ACL injuries as well as general athletic prep.
The Use of Occlusion Training to Produce Muscle Hypertrophy
Loenneke, Jeremy Paul BS; Pujol, Thomas Joseph EdD, CSCS
Strength and Conditioning Journal:
June 2009 - Volume 31 - Issue 3 - pp 77-84
doi: 10.1519/SSC.0b013e3181a5a352
Articles

LOW-INTENSITY OCCLUSION (50-100 MM HG) TRAINING PROVIDES A UNIQUE BENEFICIAL TRAINING MODE FOR PROMOTING MUSCLE HYPERTROPHY. TRAINING AT INTENSITIES AS LOW AS 20% 1 REPETITION MAXIMUM WITH MODERATE VASCULAR OCCLUSION RESULTS IN MUSCLE HYPERTROPHY IN AS LITTLE AS 3 WEEKS. A TYPICAL EXERCISE PRESCRIPTION CALLS FOR 3 TO 5 SETS TO VOLITIONAL FATIGUE WITH SHORT REST PERIODS. THE METABOLIC BUILDUP CAUSES POSITIVE PHYSIOLOGIC REACTIONS, SPECIFICALLY A RISE IN GROWTH HORMONE THAT IS HIGHER THAN LEVELS FOUND WITH HIGHER INTENSITIES. OCCLUSION TRAINING IS APPLICABLE FOR THOSE WHO ARE UNABLE TO SUSTAIN HIGH LOADS DUE TO JOINT PAIN, POSTOPERATIVE PATIENTS, CARDIAC REHABILITATION, ATHLETES WHO ARE UNLOADING, AND ASTRONAUTS.


Great scott. Do you see capitol letters as shouting? this authors must be really excited about the research.

The part that is exciting is that if you can give a population a way to train their muscles and build their muscles at loads that are much lighter that what would be needed otherwise, you can imagine that the opportunities to get repair happening or growth happening could be, er, huge. Hypertrophy huge.

So let's take a quick peek at what hypertrophy is understood to be, and then at how occlusion training is generally applied.

Hypertrophy. Well, we know that if bodybuilders talk about hypertrophy they're talking about building muscle mass. But as said, anyone developing strength will get some hypertrophy happening. Why? How do we get stronger? That's complicated, but a simplified model would be: in the first instance, we are learning simply how to fire the muscles we have to do some new task, like lifting something heavy. So for someone who's never lifted, when starting a lifting program, say, they make big leaps in their strength in the first 8-12 weeks. A lot of that is neurological.

The other part of muscle building is laying down new muscle fibers to deal with trauma. When we train, we break down muscle tissue often deliberately in order to create an adaptation/growth. SO muscle literally gets pulled apart from time to time. Ironically, that is not what causes delayed onset muscle soreness (or DOMS). DOMS hits 24 - 48 hours after working out muscles (hence the delay part) and some theories are that it's the result of new muscle fibers butting up against each other and settling in - so it's the repair process rather than the damage process that is painful. Neat.

Which brings us to hypertrophy, in particular myofibrillated hypertrophy, which is the laying down of new actual muscle fibers or myofibrils. These are tiny fibers and not where the body builders' bulk comes from. That's generally sarcoplasmic - also important to protect the myofibrils and usually goes hand in hand with myofibrillated hypertrophy. We'll come back to that another time. Suffice it to say, what kind of growth is where sets, reps and REOCVERY come into play in terms of this balance and which kind of hypertrophy a program is privileging.

So let's say we're looking at getting the muscles around a knee injury built back up. The person is at a place where they can body squat, maybe do some light weight work, but (a) it may not be desireable for the person to do TONS of reps, but unless they do tons of reps with a light weight, desired hypertrophy - new muscle tissue growth - is not going to happen. Enter this really cool aspect of hypertrophy training, Occlusion training.

Likewise, OT *may* be useful to give athletes a break from high load work. Note, this does not mean do OT during a back off weak: the whole point of a back off weak is to let the body recover, not push it to adapt further.

Occlusion Training. Occlusion is a beautiful sounding word, isn't it? It's usually seen in visual contexts - to occlude something is to block it from view. If you put your mother's picture in front of that ugly stone someone gave you from their holiday in Crete, you have occluded the view of the offensive object that your loved ones won't let you chuck.

In occlusion training, we're talking about another kind of block. In this case, blocking the flow of blood - a bit, and for intervals. So what? How can that be good?

Well, an idea is, restricting blood flow causes fast twitch fibers to get involved in the process sooner than they otherwise would. Likewise a biggie in the effect is the production of blood by-products, and ones that trigger significant increases in GH. (i have visions now of Mike Mahler tying up his quads while doing lightweight kettlebell swings).

Caveats of Application. SO when we talk about restricting blood flow, what are we really talking about? IF we cut it off, don't our limbs drop off? Well, yes. So here, we're talking about restriction as opposed to total constriction, and also for particular intervals. And for light loads.

Ok what does that mean in practice? There are a variety of approaches described in the article that involve walking and the effects on strength. Pretty cool stuff. The authors, however, offer a sample protocol for strength:
A typical low-intensity prescription would involve an intensity of 20-50% of 1RM with a 2-second cadence for both the concentric and eccentric actions. The 1RM is calculated from the maximum amount of weight you can lift once under normal blood flow conditions. Three to five sets of each exercise are completed to volitional fatigue. This is done to ensure that there is a high metabolic buildup. The rest periods are 30 seconds to 1 minute in length and occur between every set, with the occlusion still being applied (5,6,27,35,36,39). At the conclusion of the last set, blood flow is restored to the muscle.
Cook et al. (6) compared different protocols of occlusion using percent maximal voluntary contraction (%MVC) and found that 20% MVC with continuous partial occlusion was the only protocol that elicited significantly more fatigue than the higher intensity protocol.
Again, the important take away here is LIGHT loads for a few sets. Likewise the PROXIMAL end of the targetted muscle is what gets bound, as shown in the image below.

from the article: note binding for knee work is at the top of the thigh - the proximal end of the vastus

The above is not encouragement to go try tying off your friend's legs and asking them to jump around :) As the authors state about future work:

Future research on occlusion training should focus on studying the health risks associated with long-term use and determine populations in which this type of training may be contraindicated (6). Although the research has yet to define populations in which occlusion training is dangerous, we postulate that those with endothelial dysfunction should not use occlusion training because of the reduction in blood flow. Research should also further study the microdamage to blood vessels and subtle changes in blood flow, both of which may stimulate thrombosis (38). Also, one should seek to evaluate the gene expression at later stages of postexercise recovery after occlusion and in response to occlusion training (7). Finally, studies should begin to focus on the local regulators of muscular growth, such as growth factors and reactive oxygen species, to elucidate the mechanism for the present cooperative effects of exercise and occlusive stimuli (39).

Take away: if you're looking to build up strength especially after an injury, short term use of occlusion training may be a good way to get back in the game. Likewise, if you're getting fatigued by heavy lifting or jus the thought of having to pick up a really heavy bar to make a difference is getting you down, doing some short term occulsion sets because of their effective LOW reps and LIGHT weight, may be just the thing to keep you training and provide the mental break necessary to get back at it.

Loenneke, J., & Pujol, T. (2009). The Use of Occlusion Training to Produce Muscle Hypertrophy Strength and Conditioning Journal, 31 (3), 77-84 DOI: 10.1519/SSC.0b013e3181a5a352

Thursday, July 23, 2009

Smart SMALL Dosing of Caffeine can be Super Performance Booster

ResearchBlogging.orgThere is a FABULOUS survey article on caffeine use in sports performance from May 2009. Big Take away: caffeine, yes, does have a performance enhancement effect on a whole lot of stuff BUT there are also down sides. BUT BUT it seems that dose and timing have an effect PLUS small doses are JUST AS effective as larger ones. isn't that frickin' cool?


Journal of Strength and Conditioning Research:
May 2008 - Volume 22 - Issue 3 - pp 978-986
doi: 10.1519/JSC.0b013e3181660cec

Caffeine Use in Sports: Considerations for the Athlete
Sökmen, Bülent; Armstrong, Lawrence E; Kraemer, William J; Casa, Douglas J; Dias, Joao C; Judelson, Daniel A; Maresh, Carl M

Abstract

The ergogenic effects of caffeine on athletic performance have been shown in many studies, and its broad range of metabolic, hormonal, and physiologic effects has been recorded, as this review of the literature shows. However, few caffeine studies have been published to include cognitive and physiologic considerations for the athlete. The following practical recommendations consider the global effects of caffeine on the body: Lower doses can be as effective as higher doses during exercise performance without any negative coincidence; after a period of cessation, restarting caffeine intake at a low amount before performance can provide the same ergogenic effects as acute intake; caffeine can be taken gradually at low doses to avoid tolerance during the course of 3 or 4 days, just before intense training to sustain exercise intensity; and caffeine can improve cognitive aspects of performance, such as concentration, when an athlete has not slept well. Athletes and coaches also must consider how a person's body size, age, gender, previous use, level of tolerance, and the dose itself all influence the ergogenic effects of caffeine on sports performance.
Cool. What the study suggests is that well hmm, all the use of taurine or (my fave) tyrosine to boost hard workouts etc may be set aside for a low dose snort for a few days leading up to that "intense training."

Now the big contribution of this article for practical applications in coaching is that it looks at a bunch of effects that need to be considered to build an appropriate "dosing strategy"

Power/Speed Very Fast. The article begins its consideration by looking at caffeine's effects on power. Main hit: peak power in 6 secs of the wingate test. So benefit to phosphagen system dominant activities. Caffeien also seems to lower pain perception. hmm. IF you've ever done a wingate test that could be a Good Thing. Not so clear (yet) there's any big boost to glycolytic-heavy events.

Cognitive Function and Skill. Intriguingly in sports like Tennis, the paper shows, hitting accuracy has gone up. Now is that because of its mental altertness effects? or the CA++ happening? The authors really emphasize that caffeine use has to be thought of not as a single factor effect, but look at the range of ways it acts on physiologic as well as cognitive function. And habituation. A biggie on figuring out dosing is how habituated to it a person already is.

Withdrawl. Likewise, the inverse of being on caffeine is going off it. So if there's a desire to increase the effectiveness by getting off it for awhile before a competition, then the authors recommend being sure to do so at least a week before, since reactions to withdrawl are individual but generally peak 24-48 hours after stopping. From personal experience, these can be harsh. The authors actually suggest tapering off rather than cold turkey to reduce training impact.

The key thing in the study is not being a big caffeine head already so that one is not tolerant of it.

Dosing. And what do we mean by caffeine head? Apparently not necessarily a coffee drinker. Coffee it seems can actually blunt the effects of caffeine, so for performance, we're talking capsules.

THen the question is how much and when? low level doses during the day (75mg) improved cognitive function over the day. Costs? sleep gets screwed up, which has its own negative effects on other aspects of performance. SO how use the fact that caffeine effects peak about 75mins post ingestion and are cleared from the body in about 6-7 hours post ingestion?

Again, super cool that a dose as small as 5mg (that's it; just 5mg) can have a huge effect on someone not habituated to caffeine. And that in men, 10mg (and that's it) significantly reduced the experience of leg pain in a cycling experiment. What about the habituated? The authors say that recent work has shown that there's no bigger ergogenic effect in taking anything greater than 9 mg·kg.

SO considering that the usually size of a caffeine pill is 200mg, are we perhaps overdosing?? The authors might say "that depends." What's your dosing strategy??

HYDRATION AND CAFFEINE. And did you know, the authors point out, that it's a big misconception that caffeine leads to dehydration. As to the popular use of blending caffeine with everything else? dunno - yet "The effects of ingesting caffeine with a carbohydrate solution, with an amino acid solution, and during creatine loading require further study."

Bottom line: caffeine use can be great for certain types of sports performance stuff; low dosing with as little as 5-10 mg (that's nothing - but it's super something) can be hugely significant.Key thing: figuring out a dosing strategy is "multi-factorial" - it's not well i gotta run all day tomorrow so i'll amp up caffeine in the morning with my double espresso." Dam.

DOSING STRATEGY: small. The above is a great example of what makes a survey article super: it's able to look at a wealth of data on a topic over years and see where the consensus lies, if there's consensus. Here, it's pretty clearly, happily, less is more, and can be a whole lot of more, when dosed smart.

Citation:
Sökmen B, Armstrong LE, Kraemer WJ, Casa DJ, Dias JC, Judelson DA, & Maresh CM (2008). Caffeine use in sports: considerations for the athlete. Journal of strength and conditioning research / National Strength & Conditioning Association, 22 (3), 978-86 PMID: 18438212

Do Running Shoe Types Reduce Injury? How about No. But what about No Sneakers?

Ok, in a sort of inverse correlation here as to one more reasons why running shoes suck, and that freeing your feet is a Good Idea - and that thin soled shoes like vibram five fingers may be much better for improving your resistance to injury, this relatively just in.

A new prospective study shows that when a running shoe store recommends a specific type of trainer for you, based on your foot type (you may stand on a type of light box or do a "wet test" for foot print, to be told based on your arch the kind of shoe you need), that is supposed to be more helpful to your stride etc etc, injury levels do not seem to be decreased.

Journal of Strength and Conditioning Research:
May 2009 - Volume 23 - Issue 3 - pp 685-697
doi: 10.1519/JSC.0b013e3181a0fc63
Original Research

Injury Reduction Effectiveness of Selecting Running Shoes Based on Plantar Shape

Knapik, Joseph J; Swedler, David I; Grier, Tyson L; Hauret, Keith G; Bullock, Steven H; Williams, Kelly W; Darakjy, Salima S; Lester, Mark E; Tobler, Steven K; Jones, Bruce H

Collapse Box

Abstract

Knapik, JJ, Swedler, DI, Grier, TL, Hauret, KG, Bullock, SH, Williams, KW, Darakjy, SS, Lester, ME, Tobler, SK, and Jones, BH. Injury reduction effectiveness of selecting running shoes based on plantar shape. J Strength Cond Res 23(3): 685-697, 2009-Popular running magazines and running shoe companies suggest that imprints of the bottom of the feet (plantar shape) can be used as an indication of the height of the medial longitudinal foot arch and that this can be used to select individually appropriate types of running shoes. This study examined whether or not this selection technique influenced injury risk during United States Army Basic Combat Training (BCT). After foot examinations, BCT recruits in an experimental group (E: n = 1,079 men and 451 women) selected motion control, stability, or cushioned shoes for plantar shapes judged to represent low, medium, or high foot arches, respectively. A control group (C: n = 1,068 men and 464 women) received a stability shoe regardless of plantar shape. Injuries during BCT were determined from outpatient medical records. Other previously known injury risk factors (e.g., age, fitness, and smoking) were obtained from a questionnaire and existing databases. Multivariate Cox regression controlling for other injury risk factors showed little difference in injury risk between the E and C groups among men (risk ratio (E/C) = 1.01; 95% confidence interval = 0.88-1.16; p = 0.87) or women (risk ratio (E/C) = 1.07; 95% confidence interval = 0.91-1.25; p = 0.44). In practical application, this prospective study demonstrated that selecting shoes based on plantar shape had little influence on injury risk in BCT. Thus, if the goal is injury prevention, this selection technique is not necessary in BCT.

The cool thing in the study is that it had a high no. of participants and a goodly fix of stats and it was able to look at stats for a standard set of tasks, Basic Combat Training (BCT).

What was found to influence injury? Suprise surprise: general fitness.
The present study found a number of risk factors that
confirmed previous work in BCT. Higher injury risk pro-
gressively increased with progressively lower aerobic fitness,
lower muscular endurance, older age, less physical activity,
and more cigarette smoking, similar to results in much of the
BCT literature (1,9,14,16,22,28,29,37,41,43).
So next time a buddy says they're getting a particular kind of "stabilization" shoe to help so they don't ankle roll or whatever, they may want to consider these results.

Indeed, what this study did not look at, intriguingly, is what would happen if INSTEAD of using sneakers of any kind, thin soled shoes like tiger Tai Chi's or similar were used. In other words, all other things being equal, would the promises of proprioceptive joy offered by the less is more approach to foot wear, where the twist test of a shoe means more joint mobilization in the foot, more proprioceptive signals shot out to the brain to judge where we are in space, could actually improve injury reduction? My *guess* would be, based on folks's reports of feeling better in less foot wear, that going the other way - out of cushy soles of any kind - just might.

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Wednesday, July 22, 2009

Elite Rings Review - Gymnastic Fitness that's FUN for your workouts

Ok, gym rings, gymnastic rings, fitness rings, whatever you want to call them, they are a BLAST. If you haven't tried 'em - give 'em a go. You may smile during a workout for the first time in ages. This is a really lightweight review to say why you might enjoy 'em too.

Plus, great news: portable, super light Elite Rings are now available directly in the UK, so you can get FREE SHIPPING even in the UK (and canada too, holy cow).

The Secret Life of Kettlebells. If you want to know what a kettlebell feels like (channel that inner kettlebell), get on some rings. Heck, pull ups are all butch and fine and everything. Raw raw, but doing a pull up on rings is funner! You can move, swing about, swing upside down.

When i was at the 9S sustenance course, at every break over five days, the number of folks playing on the rings over a break grew progressively. Guys trying out their muscle ups. Everyone just having a go and a pull, or grabbing one ring and swinging about.

Rings Rule: They're FUN
And if it's FUN we tend to do it MORE. I was doing way more pull ups on those rings than i do at my office where there's even easier access to the pull up bar than i had on the course to the rings. Something about occaisionally turning upside down. Or about being able to adjust the height easily to try new stuff.

Elite Rings
I happen to like Tyler Hass's Elite Rings. Why? It's a great product by someone who loves this equipment, uses it himself, and is a great small business. There's a great chart for how to get going with basic exercises, free training programs on the web site, so you have all you need to get going. That is if just hanging and swinging and pulling and flipping isn't fun enough.

And if the free stuff just isn't enough, theRing Strength DVD is really awesome. And Fun and kinda inspiring.

That there is an olympian Jordan Jovtchev, demo'ing these rings and how-to moves is a pretty cool hook up between expert designer and expert practitioner to learn how these cool moves (yes, including the iron cross) are done.

I've had a link to Tyler's rings on this site for a long time, but i'm still buzzing from the memory of what a gas it was for us to have such easy access to these rings - not something that i can hook up where i live. So if you do have room to hang these from your rafters in a home or garage, or on some monkey bars or wherever, do! IF your gym doesn't have them, you may want to ask them to consider getting them in.

One of the biggest cool things about watching folks on the rings is the smiles. Not something one always sees at the pull up bar or for that matter swinging a heavy bell, or deadlifting.

Just hang off 'em once - let your body with feet on the ground - just move back and forth, and see how long before you're hooking your feet in those rings hanging upside down, swinging back and forth. "It's for spinal decompression." Sure! and that they're outrageously FUN is pretty good too.

Swinging is cool for your vestibular system too. Close your eyes. Open your eyes. Look Left. Look Right. Back and forth.

Swinging is cool for your visual system: near and far drills take on new dimensions for target acquisition and peripheral switching - all while working your grip, your upper body, your core. Rad. I really *hope* you can find a space to throw these up and have a go. The secret life of kettlebells exposed.

Here's to effortless happiness in each of your perfectly fun reps.

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