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"The new anti ephedrine onslaught"

By Will Brink, author of:

Body Building Revealed
Body Building Revealed
Muscle Gaining Diet, Training Routines by Charles Poliquin & Bodybuilding Supplement Review

Fat Loss Revealed
About Supplements
Real World Fat Loss Diet & Weight Loss Supplement Review

This article is dedicated to the new anti ephedrine onslaught that appears to be going on in the media.

If you want a little background check out this link: http://www.signonsandiego.com/sports/20030219-9999_1s19ephedra.html  Extract: '...already too familiar with the link between 'supplements' and the deaths of athletes, the sports world was hardly shocked by yesterday's determination that the herbal stimulant ephedrine probably contributed to the death of Baltimore Orioles pitcher Steve Bechler, a 23- year-old who died of heatstroke after a spring-training workout in Florida.

An email from Will Brink:

The anti ephedrine camp seems to be making another wave of worthless emotional based statements, which as usual, lack any real data. This tactic is of course an old one.

As the once man said:

'All propaganda has to be popular and has to adapt its spiritual level to the perception of the least intelligent of those towards whom it intends to direct itself.' - Adolf Hitler, Mein Kamp

Most of you may have heard of a new 'study' supposedly showing how dangerous ephedrine is and the death of baseball player Steve Belcher is being blamed on ephedrine.

Both are complete shams!

Ok, below is my lay commentary of this 'study' followed by BrinkZone members Doug Kalman MS, Jose Antonio, Ph.D., FACSM, and Richard B. Kreider, PhD, letter to the editor of the journal that published the study with a nice analysis of the data of the study.

Finally, is a link to a press released from Miami Research Associates (also written by Doug Kalmen) that looks at the death of this base ball player the media is blaming in ephedrine.

Enjoy the read

..........

- "Anti Ephedrine Campaign's latest bogus study". By Will Brink

Well gang the anti supplement powers that be, are at it again with a new 'study' that supposedly shows the dangers of ephedrine.

Typical of the 'don't confuse us with the facts' media, this study is being plastered all over the news and held up as a reason to pull ephedrine containing products off the market.

At this point, it appears they are so desperate to find proof that ephedrine is a health hazard, they are willing stretch the truth to absurd levels.

What am I referring to? A new study called 'The Relative Safety of Ephedra Compared with Other Herbal Products' published in Annals of Internal Medicine (2003;138:000-000).

This study is not bad science, it's not science at all.

What the authors did was examine reports put into the American Association of Poison Control Centers Toxic Event Surveillance System Database Annual Report for 2001, and make conclusions about the safety of ephedra based on those numbers.

For example, the authors state:

'Ephedra is widely used in dietary supplements that are marketed to promote weight loss or increase energy; however, the safety of this product has been questioned because of numerous case reports of adverse events.'

Translated: they have already decided that ephedra is unsafe and are going to prove it no matter what they have to do. Hence, the authors were biased (more on that in a minute) from the start and made it their job to confirm their biased belief.

Basically what these authors did was compare the adverse reaction reports from American Association of Poison Control Centers Toxic Event Surveillance System vs reports on other herbs and shock of all shocks, conclude that compared to other herbs such as ginko and kava, that ephedra has more side effects.

Well Duh. They concluded that ephedra containing products accounted for 64% of all reported adverse effects from herbs compared with kava and Ginkgo biloba (see letter data showing that's not even true).

They state:

'This risk was defined as the ratio of adverse reactions to ephedra versus other products, divided by the ratio of their relative use in the United States.'

Translated: a fancy way of saying that they compared apples to oranges (ephedrine vs ginko or Kava) and concluded ephedrine accounted for a higher rate of reported side effects.

This is equivalent to comparing coffee (a stimulant) to fruit juice and coming to the shocking conclusion that coffee has more side effects than fruit juice!

Now, why didn't they compare it to say other diet products, in particular diet drugs with similar mechanisms?

You would find that pharmaceutical diet drugs are involved in considerably more adverse events than ephedrine based products, and those events, on average, are of a more serious nature.

(Very Important Point....)

Let's not forget the recent study published in the Journal of Strength and Conditioning Research, that found an ephedrine caffeine based supplement was superior for weight loss with less side effects than the popular diet drug Xenical (Orlistat), one of the most commonly prescribed diet drugs in the United States.

Of course, in truth none of this info from this new report from the Poison Control Centers can be used to represent the true risk of any drug or nutrient as it is simply people calling into claim some product made them ill.

It does tell public health officials if some product in particular should be looked for un expected side effects, etc, but it's of little use in making real decisions regarding the safety profile of any drug or nutrient.

That's what true double blind placebo controlled human studies are for, of which there are MANY with ephedrine.

What about those studies with ephedrine? Every single study to date with more than a decade of research-has concluded the side effects are minor, transient, and short lived.

The authors didn't bother to mention any of the real data that exists on ephedrine but focused on a single study that had a high drop out rate from the study.

Of course ephedra is not without risk and there are many people who should not use it, such as those with high blood pressure and other contraindications, but as weight loss compounds go, it is exceedingly safe.

Safer in fact than most over the counter medications found in stores, such as aspirin and acetaminophen.

Bottom line is, considering the billions of doses sold of ephedra containing products and the millions of people using such products, the number of adverse events reported is amazingly small.

The authors of this bogus study conclude:

'Ephedra use is associated with a greatly increased risk for adverse reactions compared with other herbs, and its use should be restricted.'

Translated: they had an agenda to show ephedra was unsafe, and found a unscientific way of showing it vs following the real data that exists or comparing ephedra to drugs for the same purpose that are more toxic than ephedrine.

But wait, it gets better.

If you recall I mentioned the authors were clearly biased. Why? All of the authors of this so called study have worked for various lawfirms who are involved in anti-ephedra lawsuits!

That's right, the authors of this report are paid by law firms and called as expert witnesses in cases against companies (e.g., Cytodyne, MuscleTech, Next Nutrition, TwinLabs, GNC, Phoenix Labs, Chemins Labs, etc.) that produce and market supplements containing ephedra!

Yes folks, that's how low the anti ephedra camp is willing to go; to any lengths to get ephedra banned, and the facts based on science be damned.

If you would like to read the full study can view it on line at: http://www.acponline.org/journals/annals/ephedra.htm

And if you would like to view the annual poison control data to see what crazy things are reported can see it at the Poison Control Center web site at: http://www.aapcc.org/

Finally...

If you want to see my opinion on the best ways to use ephedrine based products, avoid side effects, etc, should read my book Fat Loss Revealed found at: About Supplements Website

If you want more of my opinions on supplements that build muscle mass you can find that information and in my latest ebook Body Building Revealed here: Body Building Revealed Website

..........

- An Analysis of the Relative Safety of Ephedra By Doug Kalman MS, Jose Antonio, Ph.D., FACSM, and Richard B. Kreider, PhD,

In an early Internet release, the Annals of Internal Medicine posted an upcoming brief communication concerning the dietary supplement ephedra (1).

This study raised media frenzy concerning the regulatory status of ephedra.

The authors utilized the Toxic Exposure Surveillance System (TESS) report of 2001 and compared it with ephedra sales data provided to them by SPINS, a market analysis firm.

In addition, the authors also utilized a magazine report to approximate the total sales of ephedra within the United States for the year 2000 (2).

There are several methodological and fundamental flaws with the design and conclusions made by Bent et al.

The TESS raw data indicates that 55.5% of all Poison Control Center reports related to Ma Huang (ephedra) alone or in combination with another herb (multi-botanical) were in people under the age of 19.

Additionally, 27.9% of all of the exposures were in children less than 6 years of age (3).

This information is vital as in 7,927 exposures; the Poison Control Centers deemed 14% (1,178) to be an adverse reaction.

In clinical research the guidelines set forth by the International Committee on Harmonization (ICH) defines an adverse reaction/event (AE) 'any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment' (4).

The TESS system defines an adverse reaction (AR) as 'an adverse event occurring with normal, prescribed, labeled or recommended use of the product, as opposed to overdose, misuse or abuse'.

The TESS system also captures AR's that are 'unwanted effects due to an allergic, hypersensitive, or idiosyncratic response to the active or inactive ingredients, or excipients'.

Thus, the definitions and establishment of clear causality or relationship is not clear within the TESS system and when contrasted with normal research guidelines for defining and AE/AR appear to be questionable.

The Center for Drug Evaluation and Research (CDER) policy on AR/AE's is that accumulated case reports (AER's) cannot be used to calculate incidence or estimates of drug risk (5).

This misguided calculation is exactly what the authors attempted to do.

The 2001 TESS report details that the vast amount of exposures were unintentional (85.2%).

In the ephedra analysis, 46.7% of the exposures were of the unintentional variety (using TESS definitions and data from table 22B).

It cannot be downplayed that the TESS report only captured data on 12 known herbs, Drs. Bent et al mistakenly state that ephedra accounts for 64% of all herbal related adverse reactions, however, there are hundred of herbals sold on the U.S. market, not 12, thus their conclusion is overstated.

The sales data that Drs. Bent et al utilized in an attempt to correlate the TESS data with sales is incomplete. The SPINS database does not capture data by zip code nor does it capture the true mass market (i.e., Walmart, Costco, GNC Corporate stores), thus any data generated by the SPINS agency is only a small snapshot of what is truly happening in the sales of ephedra or ephedra-related products.

The Nutrition Business Journal estimates that in 2000, ephedra and ephedra related products generated $1,050,000,000 (6).

Utilizing the NBJ market analysis, the best estimate is that 26,250,000 servings (or individual capsules/tablets) of ephedra or ephedra related products were sold in 2000.

The sales figures are based upon retail mass market, mail order, practitioners, Internet sales and natural food/health chain channels (6).

In the Bent report, it is stated that an assumption was made that ephedra related sales were one-half of all non- retail herb sales and this accounted for 0.82% of herbal product sales.

The confliction in detail does not make sense. It appears that the SPINS data is inaccurate when comparing it to the more comprehensive NBJ data.

Thus, this section of the Bent paper appears to be out of context and unreliable.

While we as scientists and health care providers need to know the evidence (direct, not computed) concerning the safety of ephedra or ephedra related products, we must not fail to use the published peer-reviewed clinical studies as the basis for an understanding.

While the clinical trials are limited in subject size as compared to Phase III drug studies, they do give us a basis for understanding the potential for serious adverse events and what population is best suited for potential use of these products.

It is clear that people under the age of 19 should not take this herb; there simply have been no studies in that age group (on the herbal ephedrine).

The TESS data states 55.5% of all exposures were from people 19 or younger.

The comparison of ephedra versus other herbs inherently inaccurate as the TESS data only captured 12 total named herbs.

Given the TESS data for ephedra reporting an adverse reaction rate of 14% (TESS conclusion) and a mortality rate of 0.000757% (comparison of 6 deaths versus 7,927 exposures), one would expect a better comparison to be made using this data.

For example with relation to kava, there was one death in 336 exposures (0.002976%), thus we can also conclude that kava is 3.9 times as likely to cause death as ephedra.

It should also be noted that the adverse reaction frequency was similar for Gingko biloba (13.7% vs 14%) as ephedra and the AR for kava was much higher (17.5%).

Perhaps, a less negative conclusion would not serve the purpose of the study.

The manipulative presentation of the data shared by Bent et al viewed alongside the fact that the authors have and still testify for plaintiff law firms on behalf of anti-ephedra litigation, leads to speculation that this study's intent was to establish their published paper as evidence that ephedra is dangerous.

An informed professional audience must wonder where the truth actually lays. Whose future and benefit does this paper serve?

Douglas S. Kalman MS, RD, FACN Miami Research Associates 6280 Sunset Drive Suite 600 Miami, FL. 33143

Disclosure: Mr. Kalman has testified in cases related to ephedra on behalf of Cytodyne Technologies, Inc.

Jose Antonio, Ph.D., FACSM Adjunct Professor Exercise Science & Health Promotion Florida Atlantic University 777 Glades Road P. O. Box 3091 Boca Raton, FL 33431-0991

Richard B. Kreider, PhD, EPC, FACSM, FASEP Professor & Chair Exercise & Sport Nutrition Laboratory Center for Exercise, Nutrition, and Preventive Health Department of Health, Human Performance & Recreation Baylor University PO Box 97313 Waco, TX 76798-7313

Disclosure: Dr. Kreider has served as an expert in litigation for Metabolife.

- Was Steve Belcher’s Untimely Death Avoidable?

The link to a press released from Miami Research Associates (also written by Doug Kalmen) that looks at the death of this base ball player the media is blaming in ephedrine. http://www.brinkzone.com/Press_Release_Ephedra_in_Spor_1.pdf

..........

About William D. Brink
 
Will Brink is a columnist, contributing consultant, and writer for various health/fitness, medical, and bodybuilding publications. His articles relating to nutrition, supplements, weight loss, exercise and medicine can be found in such publications as Lets Live, Muscle Media 2000, MuscleMag International, The Life Extension Magazine, Muscle n Fitness, Inside Karate, Exercise For Men Only, Body International, Power, Oxygen, Penthouse, Women’s World and The Townsend Letter For Doctors.

He is the author of Priming The Anabolic Environment and Weight Loss Nutrients Revealed. He is the Consulting Sports Nutrition Editor and a monthly columnist for Physical magazine and an Editor at Large for Power magazine. Will graduated from Harvard University with a concentration in the natural sciences, and is a consultant to major supplement, dairy, and pharmaceutical companies.

He has been co author of several studies relating to sports nutrition and health found in peer reviewed academic journals, as well as having commentary published in JAMA. He runs the highly popular web site BrinkZone.com which is strategically positioned to fulfill the needs and interests of people with diverse backgrounds and knowledge. The BrinkZone site has a following with many sports nutrition enthusiasts, athletes, fitness professionals, scientists, medical doctors, nutritionists, and interested lay people. William has been invited to lecture on the benefits of weight training and nutrition at conventions and symposiums around the U.S. and Canada, and has appeared on numerous radio and television programs.

William has worked with athletes ranging from professional bodybuilders, golfers, fitness contestants, to police and military personnel.

See Will's ebooks online here:

Body Building Revealed
Body Building Revealed Website
A complete guide bodybuilding supplements and eating to gain lean muscle

Fat Loss Revealed
About Supplements Website
A review of diet supplements and guide to eating for maximum fat loss
 
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Mixing Glutamine and Creatine

Why would anybody want to combine glutamine and creatine other than simply to get the benefits of both? Well, although there isn’t research clearly showing the benefit of this combination, there may be some theoretical logic behind it.

Creatine is known to increase total body water. Now there are several studies that show much of this is in skeletal muscle. So creatine is causing an "osmotic" gradient causing water to be taken into the muscle cells.

Glutamine has also been shown to cause osmotic swelling of cells. In fact, it is believed that the effect that glutamine has on protein synthesis may simply be the result of this cell swelling, not a direct effect.

Glutamine’s cell swelling properties are dependent on sodium being co-transported into the cell with the glutamine. And in fact, it is the sodium itself that is attracting the water. A little known fact about creatine is that it too is dependant on sodium for cellular uptake. A couple of studies showing that taking carbs with your creatine increased creatine uptake mistakenly led most people to believe that insulin was responsible for the additional uptake of creatine. One recent study has shown this not to be the case however, leaving the probable mechanism similar to that of glutamine’s (1). Unfortunately if glutamine and creatine share the same mechanism of cell swelling, they will most likely not be additive. In other words, if they both do the same thing in the same way, taking two together won’t do any more than taking only one in higher amounts.

Bottom line…Glutamine is a good supplement and offers many health benefits to athletes. Creatine, on the other hand, is a proven ergogenic aid and may very well have other effects on protein synthesis beyond cell swelling. For instance, nearly 70% of the energy derived for protein synthesis is provided by the phosphocreatine energy shuttle and not from glycolysis. I wouldn’t go so far as to say that a creatine supplement that has additional glutamine in it would be superior to creatine alone, with respect to the effects of creatine. If the company claims that their product offers both the benefits of creatine and glutamine in one supplement, great, knock yourself out if it’s still cost effective.

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Creatine and Children

Hi. My son is involved in sports at school. He has recently become interested in weight training. He has read about creatine in the bodybuilding magazines and now he is convinced this is what he needs. I want him to be successful in sports, but I’m not so sure about him taking creatine. Are there any dangers associated with kids taking creatine?

Thanks.

I understand your concern about your son. I also understand your concern about creatine. To start out, let me say that there has been no medical research done to explore the effects of oral creatine supplementation on children. All subjects thus far have been old enough to legally sign a waiver and/or consent form (required by the IRB). Let me tell you a little bit about what creatine is and how it works.

Creatine was discovered back in 1832. Creatine is not an amino acid, but is a similar nitrogen-containing compound called an "amine". Creatine is found naturally in several foods, especially meats and animal products. Consuming a normal non-vegetarian diet, the average person will consume about 1 gram of creatine per day. However, this average person needs about 2 grams per day for normal functioning. If dietary intake is insufficient, the body simply makes more creatine from the amino acids glycine, arginine and methionine primarily in the liver, kidney, and pancreas. The body will adjust synthesis of creatine to dietary intake so the necessary amount is always available.

Creatine is involved many physiological systems by virtue of its role in energy management within cells. Creatine, in the form of creatine phosphate, serves as a donor of high-energy phosphate groups that can be used to reform ATP from ADP. Considering that 95% of all creatine in the body is stored in muscle tissue, the logic of increasing creatine levels to enhance performance is obvious.

I won’t go into all of the many studies done on creatine and performance. To answer your question, however, I can inform you of at least two studies done on creatine supplementation in children. One study involved children with muscular dystrophy. Creatine was orally administered over a period of 155 days to a 9-year-old child with Duchenne muscular dystrophy. Just as in previous studies using normal subjects and trained athletes, the child experienced improved muscle performance during creatine supplementation with no adverse effects. Another study looked at the effect of creatine in kids with mitochondrial encephalomyopathies. In subjects aged 9 – 26, creatine was taken for at least 3 months. After creatine supplementation for at least 3 months, all patients showed an increase in maximal power of 8% to 17% and a prolonged time in submaximal endurance testing (not done in one patient) of 30% to 57%. One patient with KSS, who has been receiving creatine for almost 2 years, has maintained the improvement in muscle power. In all patients, improvement was noticeable after 2 to 4 weeks, and no adverse effects were reported.

So, there you have it. Any recommendations about children and creatine can only be based on available research. Although there isn’t a lot of it at present, everything done so far indicates that it has the same safety profile as it does in adults. Good luck.

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HMB’s Effects on Muscle Growth

I am a big fan of EAS products. I have always used their products and have been very satisfied with the results. Mostly I use their meal replacement products like Myoplex and I really like Phosphagen HP. I’ve always thought EAS was a good company. I was wondering what you thought about that HMB stuff? I took it once and didn’t grow near as much as I did the first time I used creatine. Is HMB just a bunch of hype or what? Please respond as quickly as possible.

Let me set the record straight by saying that HMB does not make muscles grow. However, HMB can greatly facilitate muscle growth if you are training hard/heavy enough. Let me explain…

Several studies have shown that HMB is a precursor of cholesterol (1,2). In muscle, HMB is first converted to cytosolic ß-hydroxy-ß-methylglutarate-Co-A (HMG-CoA), which can then be used for cholesterol synthesis (1). Dietary HMB can serve as a precursor for intracellular cholesterol synthesis in tissues such as muscle that rely on manufacturing their own cholesterol from scratch. Now, the most likely mechanism for HMB and muscle growth is that stressed or damaged muscle cells (like after you train) may not be able to make sufficient HMG-CoA to make cholesterol for cellular functions, including proper functioning of cell membranes. Therefore, supplemental HMB serves as a ready source of HMG-CoA in muscle cells where it is needed to make cholesterol to restore cell membrane function after training.

Don’t worry; there is some science to support this explanation. HMB is known to dramatically decrease muscle damage as evidenced by less leaking of creatine phosphokinase (CPK) out of muscle cells (3,4,5) and lower 3-methylhistidine levels (a marker of muscle protein breakdown). Also supporting this concept are several studies showing that inhibition of cholesterol synthesis in muscle with cholesterol lowering drugs can result in muscle damage (6), poor function (7,8) and even muscle cell death (9).

Bottom line…If you are not training hard enough (i.e. training properly and intelligently), you will not likely experience any benefit from HMB supplementation. If, however, you are training heavy and training each muscle with sufficient frequency, you will find HMB supplementation decreases soreness and increases your ability to train while still recovering from the last workout. More frequent training means a more frequent growth stimulus and, in turn, faster progress.

Mr. Haycock,

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Vitamin C and strength athletes

I always hear that taking Vitamin C supplementation is a good idea. Is this true for strength athletes? 

Vitamin C has a lot more benefits than simply helping you out when you have the common cold. Vitamin C has been shown to have a positive effect on the immune system. Supplementing with Vitamin C only when you have a cold is a mistake. Vitamin C is a micronutrient that should be incorporated in all strength athletes' nutrition plans. 

Vitamin C is a water-soluble vitamin so there is no worry of building up a toxicity level. Excess intake of water soluble vitamins not just Vitamin C is excreted through your urine. One benefit to Vitamin C is that it helps repair connective tissues. Now with all the hard training powerlifters do, training heavy day in and day out takes a toll on the tendons and ligaments after time. Supplementing with Vitamin C can help in the recovery process from your tough workouts. As you probably already know recovery from your workouts is one of the most critical parts of your training. If you are not recovering you end up overtrained or injured. So in turn your progress goes out the window. 

Next Vitamin C has a positive effect on powerlifter's favorite hormone - TESTOSTERONE. That's right! It also can help reduce Cortisol levels, which is something we all have to worry about. When the body goes through a perceived stress, whether it is a stressful situation at work or home, intense resistance training session or even strict dieting, the body releases more of this catabolic hormone. Now this hormone does have its benefits but what powerlifters have to watch out for is its muscle wasting properties. 

So now you have heard it here first. Too much stress will lead to an increased Cortisol level that causes not only muscle wasting but also an increase in fat storage. I bet you didn't know that! Vitamin C can help decrease Cortisol levels so when you are training hard for your next competition, supplementing with this super vitamin can really make the difference in your recovery and immune function. 

Let's not forget the positive effects it has on our hormones. The hard training powerlifter should take in the neighborhood of 3,000mg of Vitamin C per day and it can be increased even more when you are sick. Don't take it all at once since you will waste most of it. Take 500 to 1000mg three times a day as this will do the trick. 

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Do You Know Which Sports Supplements Will Help You Reach Your Goals and Which One's Are Just Wasting Your Money? 

Yes, sports supplements do work and can be that key ingredient to get you where you want to go. 

Keep in mind, however, that you need to get your training and nutrition programs in line first, before you can truly see the benefit of sports supplements. 

Unfortunately, there are many sports supplement companies out there that are taking your hard earned dollars and giving you nothing of value in return. 

Hardly seems fair, does it? 

I'm here to let you know what sports supplements work, what supplements don't, and why. And not all sports supplements are appropriate all the time. It depends on your goals. 

We'll explore core sports supplements that should be a part of all nutrition and training programs as well as body building supplements for specific goals, such as building muscle, burning fat or for a pre workout energy boost. 

What are "core" sports supplements?

Core supplements are fitness supplements that I consider to be more an integrated part of a proper and healthy overall nutrition plan. 

They make it easy for you to meet your nutritional requirements and become part of your overall sports supplement and nutrition strategy. 

They are so much a part of your nutrition plan that you could call them nutritional supplements instead. I even refer to these supplements more as part of my nutritional plan as opposed to my supplement plan. 

What are some of these indispensable core supplements? 

1 - Multivitamins 
2 - Multiminerals 
3 - Essential Fatty Acids 
4 - Antioxidants 
5 - Meal Replacement and Protein Powders 

Yes, I consider Meal Replacement Powders and Protein Powders to be important core sports supplements. 

They allow you to get proper the necessary nutrients you body needs, as well as meet your protein requirements in an easy and convenient (and nowadays, tasty) fashion. 

In today's fast paced world, I feel these supplements are essential to helping you stick to a proper nutrition plan. 

It's difficult enough trying to prepare and eat 6 meals a day, let alone plan out the proper food combinations to make sure you are feeding your body everything it needs to function at its best. Not to mention making sure that your meals contain high protein foods. 

You should never go without core supplements in order to purchase other supplements. If you have the finances to do so, you can add to the core but never sacrifice them for any other supplements. 

But ignoring them to purchase the latest, greatest testosterone boosting, growth hormone shooting, fat melting, Z-100 gizmo subdural "injection" like supplement would be like buying all the latest workout fashions and never actually going to the gym. 

Don't make that mistake. Please. You'll just be wasting your money and missing out on what sports supplements have to offer. 

The next step up in your supplementation program would include such things as the following: 

1 - Creatine 
2 - Glutamine 
3 - A quality ZMA (specifically forumlates Zinc/Magnesium) product 

Sports supplements, like most things about fitness, has numerous opinions, and it's tough to know who to trust. Most everyone offering an opinion is tied in some way to a supplement company. 

Here's one who isn't. He's Will Brink. You may have heard of Will. He's a world famous fitness and supplement writer, authoring a great number of articles on sports supplements and nutrition. He's a recognized expert who knows his stuff. 

He's written two new best selling ebooks, Body Building Revealed and Fat Loss Revealed. Both are must have's for anyone interested in sports nutrition or sports supplements. 

Click the links for more information - 

Body Building Revealed 

Fat Loss Revealed 

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Carnitine Supplement Review 

CARNITINE(y-trimethylamine-beta-hydroxybutarate, C7H15NO3) is an dipeptide amino acid made from two aminos, methionine and lysine in the presence of vitamins B-1, B-6 and the mineral, Iron. Vegetarians and endurance athletes may deplete both forms of Carnitine(the naturally occurring L-Carnitine, and/or Acetyl-L-Carnitine). 

HOW DO ADEQUATE TISSUE STORES OF CARNITINE AID PERFORMANCE?
Carnitine has a major role in the following specific physiological functions:

(1) It transfers fatty acids across mitochondria cell membranes for conversion to muscle contractile energy. 
(2) It increases the rate the liver metabolizes fats. 
(3) It dramatically prevents DNA degeneration and promotes repair of DNA strand mutation from free radical stress. 
(4) It reduces the build up of acids and metabolic wastes. 
(5) It increases oxygen availability and respiratory efficiency. 

ENDURANCE ATHLETES RAPIDLY DEPLETE CARNITINE.
The best food sources of Carnitine are organ meat, fish, muscle meats, and milk products. The optimal daily diet supplies only 300 mg. per day, but the endurance athlete requires between 3000-4000 mg. per day! Even when an athlete obtains max-dietary sources, intense training can deplete Carnitine stores more rapidly than the body can replenish it. 

Subjects who cycled at only 55% VO2 Max lost 20% of their muscle store of Carnitine.(JOURNAL OF APPLIED PHYSIOLOGY, 1983;55:489.) Maximal exercise causes a much greater drop causing extreme depletion similar to that of patients who suffer from Carnitine deficiency disease.(BIOCHEMISTRY BIOPHYSICS ACTA, 1990;1034:17-21. 

During the first hour of exercise Carnitine mobilizes fatty acids in muscle mitochondria supplying 35-39% of the caloric needs, but after 90 minutes or so later at the same rate of exercise fatty acid conversion becomes the predominant fuel supplying 65-70% of the caloric requirements. During prolonged exercise, blood lipids increase dramatically. There is always more than adequate fatty acids available for conversion IF there is adequate levels Carnitine to "ferry" long chain fatty acids through mitochondrial membranes. Symptoms of Carnitine deficiency are extreme muscle weakness with high blood lipids.(JOURNAL OF LABORATORY CLINICAL MEDICINE, 1984;104:166-175, and MEDICAL SCIENCE SPORTS EXERCISE, 1984;16:263-268) Body fat peripheral accumulation is enhanced when these excessive serum lipid counts are not carried to the mitochondrial matrix for conversion to energy. 

HOW MUCH CARNITINE AND WHAT KIND. 
Oral L-Carnitine has been shown correct deficits from endurance training to between 40-90 minutes. (RESPIRATORY QUARTERLY, 1990;61:80-84.) Some of the early studies with L-Carnitine dose amounts have shown that a dose of 4000 milligrams per day improved VO2 Max performance dramatically. (CARNITINE THE VITAMIN BT PHENOMENOM, Dell Publ.1984, EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY,1985;54:131-135, CLINICAL ASPECTS OF HUMAN CARNITINE DEFICIENCY, Pergamon Press, NY,1986.) 

As previously mentioned, the best planned diets of food-sourced L-Carnitine(LC) supply only 300 mg. of LC, but the need exceeds 3000 mg. for prolonged or intense exercise activities beyond 90 minutes. L-Carnitine(LC), Acetyl-L-Carnitine(ALCAR) are excellent choices for oral repletion. 

From over 20 reliable studies out of over 70 "other works" reviewed, it is my present persuasion that use of both LC & ALCAR in a 50-50 mixture may have a slight advantage over using only one form of Carnitine. Effective dose rates appear to be between 2-4000 mg. per day for a 2-week loading period may be the most inexpensive means to raising blood serum levels and muscle stores of this valuable endurance substrate. Even when extreme endurance athletes regularly take 4000 grams per day, no toxic side effects have been observed. 

BEWARE OF FALSE CLAIMS.
One "manufacturer" boasts that "Carnitine boosts testosterone levels", however I was unable to locate any reliable research that even remotely reports or supports this statement. 

PRECAUTIONARY NOTE!
There is a form of Carnitine called "dl-Carnitine" or "Racemic Carnitine",a 50% right-handed and 50% left-handed chiral Carnitine that ACTS TOXICALLY in human nature, causing depletion of Carnitine stores rather than increasing them. Only the left-handed,("L"), L-Carnitine or Acetyl-L-Carnitine is applicable, recognized, and metabolized in human physiology. I advise all readers to AVOID dl-Carnitine supplements, and READ THE LABELS carefully before purchase. 

Dr. Bill Misner, Ph.D.

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Best Source of Whey Protein

Despite the difficulty of keeping up with new protein products, few people really stop to ask what’s the difference. 

Raw whey is the runny yellow stuff that’s left floating at the top of milk after it coagulates. Ummm..yummy. Whole whey consists of about 94% water and 6% whey "solids". Of the whey protein solids, 75% is lactose, 14% is protein and the remaining 11% is made up of minerals and fat.

Whey protein concentrate is simply concentrated whole whey. This is done through spray drying which removes most all of the water. Whey concentrate contains whey protein as well as some lactose, fat, and minerals. This is less expensive to produce than whey protein isolate because it requires fewer steps during processing.

Whey protein isolate is just that, isolated whey proteins. Most of the moisture, lactose, and fat are removed through ion exchange processes leaving nearly 95% protein. This is considerably higher than raw whey protein concentrate, which contains roughly 13% whey protein. You’ll know you have some protein isolate if it foams up after you stir it rapidly or use a blender. Stir it and let it sit for a couple of minutes and you’ll see the foam rise to the top. Whey protein concentrate may also make foam, but only slightly. If you have a glass of what the manufacturers claim is pure whey isolate and it doesn’t foam, I would be suspicious.

Finally, some manufactures have put an additional twist on whey protein isolate, subjecting it to an enzymatic process that partially hydrolyzes or breaks down the protein globulins into smaller low molecular weight peptides. This form of whey protein isolate is called whey protein hydrosolate. Manufacturers claim that this allows for more rapid absorption and therefore a more rapid infusion of amino acids into your body after a workout. They fail to mention that your gut will also break down whole whey proteins into low molecular weight peptides all by itself.

Most protein powders will contain a mix of whey protein concentrate with whey protein isolate added in order to bring the protein content up. Hydrosolates are added as a bell or whistle, whichever you like.

So which whey protein product is best? I couldn’t really say. They are all very similar now. Which form of whey protein you buy shouldn’t really matter in the long run, either. The most important aspect of protein and your diet is quantity. The more protein you eat, the less important quality becomes and vice versa. Don’t forget expense. Cost just might be the best whey of deciding which product to purchase.

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Why is it important to consume water or sports drinks after games and workouts?

You can live a few weeks without food, a few days without water, and a few minutes without oxygen. In other words, aside from oxygen, water is the most important element we put into our bodies.

Your body is comprised of 55 to 70 percent water and blood is almost 80 to 90 percent water. It is involved in almost every body process. A lack of water can lead to both mental and physical changes. Water performs the following roles:

1. cleans your body by flushing toxins that are produced through normal living 
2. lubricates your joints 
3. keeps your skin from drying out 
3. keeps your internal organs hydrated 
4. controls your body temperature 

When your body gets hot, water is lost through your skin in the form of sweat. This is a good thing, because as sweat evaporates from your skin, your body cools off--like having a built-in air conditioner. However, for your built-in air conditioner to keep working, you need to replenish your body with water.

If you don't drink enough to replace sweat losses, your blood can become thick and your circulation slows down. This places a strain on your heart. If fluid losses are great, your body will not have enough water to produce sweat--at this point, your body temperature can rise to a dangerous level.

While an average adult loses about 2 quarts (eight 8-oz. glasses) of water a day, an athlete can lose as much as 3 quarts of water in an hour of hard exercise. If these fluids aren't replaced, dehydration can result.

"Dehydration has a dramatic, negative effect on exercise performance," according to Bob Murray, Ph.D., director of the Gatorade Exercise Physiology Laboratory and an Ironman triathlete. "In fact, even mild dehydration--as little as a 1 percent loss in body weight--can hurt your performance by causing dizziness, headache, and slower reaction times. And it can increase the risk of heat illness."

If left untreated, dehydration will get worse and can be deadly. Look for early warning signs in yourself and your teammates to prevent dehydration. If you see any danger signals, talk to your coach and/or seek immediate medical attention.

"But won't I feel thirsty if I start to become dehydrated?" The answer is: not always. In many cases, exercise actually disrupts the thirst response. When exercising you lose a lot of water before you feel thirsty, and you stop feeling thirsty before you are fully rehydrated. Therefore, you can't rely on thirst sensations to take care of your need for water. As an athlete, you need to push fluids--consciously drink more than what you feel like drinking--especially when you exercise in the heat.

For all these reasons, athletes need to drink water or other beverages before, during, and after exercise.

Before Exercise: Drink one to two glasses of fluid (8 to 16 fluid ounces) two hours before a game or practice to make sure that you start out well-hydrated. Fifteen minutes before you start exercising, drink another glass (8 fluid ounces).

During Exercise: Drink 4 to 6 ounces of fluids every 15 to 20 minutes during exercise to replace lost fluids and prevent overheating. Cold fluids are best since they are absorbed rapidly and cool your body's core faster.

After Exercise: It is important to keep drinking fluids after you are done exercising because it takes a while for your body to rehydrate. To be sure that you have had enough to drink, weigh yourself before and after exercise. For every pound of weight you lost, drink at least 1 pint (16 fl. oz) of water.

"Don't be fooled into thinking that weight lost during exercise is fat weight--fat weight is lost gradually and won't show on the scale for several days," cautions Maureen Plombon, M.S., R.D., F.A.D.A., past president of the Virginia Dietetic Association and a nutrition consultant. Nearly all of the weight lost during exercise is from water.

Dehydration can come on fairly quickly, but it can also build up over several days of exercising without drinking enough fluids. Athletes who exercise intensely every day or twice a day, especially in hot and humid conditions, may need to drink as much as 1.5 pints of water (24 fl. oz) for every pound they lose to restore their water balance.

Monitor your water loss by using the following formula:

    Pre-Exercise Weight - Post-Exercise Weight + 100 = percent Weight Loss

You should have a 0-percent weight loss every day (i.e., your weight should not change after exercising). Even a 2-percent weight loss can cause a decrease in performance and indicate mild dehydration.

In addition to water, some athletes need to replace the electrolytes--sodium and potassium--lost in sweat. This is especially true during exercise lasting for more than one hour. Many sports drinks contain electrolytes and carbohydrates in concentrations that speed the absorption of water. Plus, the electrolytes in sports drinks stimulate thirst, which promotes rehydration. Sports drinks are of most benefit to endurance athletes, as well as those who train to exhaustion daily, compete in multiple events in one day, or participate in two-a-day workouts.

If taste and boredom become a barrier to drinking the fluids you need, vary the beverages you choose: fruit juices, plain water, sparkling water, sports drinks, lemonade, and herbal (decaffeinated) teas. You can also eat more foods that have a high water content--watermelon, tomatoes, lettuce, soup. However, be aware that drinks with caffeine, like coffee, tea, and some soft drinks, have the opposite effect. Caffeine increases the body's need to urinate, and thus should be avoided when you're trying to rehydrate. Similarly, alcoholic beverages have a dehydrating effect.

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Protein Supplements: Fact & Fantasy

If you've ever hung around power gyms, you've probably heard a lot of talk about protein and amino acid supplements. Many bodybuilders are zealous in their beliefs about these products, and they may try to convince you to take them. Here are the facts:

You need protein to build muscle, and athletes have a slightly higher need for protein than non-athletes. But ingesting more protein than you need is not going to make you build more muscle or bulk up faster. Extra protein will be broken down and either:

* used for energy if calories or carbohydrates are inadequate, or

* stored as fat if protein intake exceeds calorie needs.

"Exercise, not extra protein, is the key to developing bigger muscles," points out Clark. She outlines a few problems with eating too much protein:

* It makes you urinate more frequently because protein breaks down into a waste product that is flushed out through the urine. This can strain your kidneys and contribute to dehydration, not to mention the inconvenience of frequent bathroom breaks.

* A stomach full of protein won't allow you to have an appetite for the carbohydrates needed to fuel your muscles.

Even when building muscle, you can easily meet your need for protein by eating certain foods. For example, a 150-pound teenage boy who is still growing can meet his protein need of 135 grams/day (0.9 grams per pound) by eating 9 ounces of chicken, fish, or meat; 3 cups of skim milk; 2 cups of vegetables; and 15 servings of bread or grain products. This food plan also provides the carbohydrates, B vitamins, iron, zinc, calcium, and other nutrients that a growing athlete needs.

A number of individual amino acid supplements, in particular arginine and ornithine, are popular among bodybuilders as natural ways to stimulate anabolic growth hormones. These claims have not been proven; there appears to be little benefit in taking amino acid supplements for athletes who have an adequate intake of protein. More research is needed to determine if taking individual amino acids or mixtures of amino acids is safe.

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Howz it Work?: Glutamine

Anybody who has been bodybuilding during the last ten years or so is certainly familiar with glutamine. Even if you have only bought a tub of protein lately you have probably heard about glutamine. Everybody seems to be claiming that it is the bell or whistle that makes their protein so "special". Go to any bodybuilding contest and you will hear several competitors swear by it. So what does it do? Why does everybody give it so much credit? Well, the answer might surprise you.

Glutamine is the most abundant free amino acid in the body. Most free amino acids are quickly incorporated into body proteins as they become available. Glutamine however, due to its unique functions, is kept in pools, mostly in muscle tissue. Skeletal muscle comprises approximately 60% of total body glutamine stores. The second major location for glutamine is the lungs. Glutamine also accounts for about 35% of amino acid nitrogen in plasma where it is the major vehicle for nitrogen transfer between tissues.

Not all amino acids are necessary in the diet because they can be made within the body from other amino acids. If the body can’t make an amino acid however, it must be present in the diet and is labeled "essential". Those that your body can manufacture are called "non-essential". Glutamine is generally considered a non-essential amino acid because the body can make it from other amino acids with the help of glutamine synthase (clever name huh?). Glutamine synthase is found in high concentrations in skeletal muscle.

People with average protein intakes generally consume about 5 to 10 grams of glutamine per day. Although glutamine is officially a non-essential amino acid because it can be made in the body from other amino acids, if the demand for glutamine exceeds the body’s ability to make it, bad things start to happen, especially in skeletal muscle and the immune system. In such cases, glutamine becomes essential, and is now widely labeled a conditionally essential amino acid.

During stress, glutamine is released primarily buy skeletal muscles where it is then shuttled to tissues that need it. The lungs are the second largest contributor of free glutamine during stress. When faced with chronically high levels of stress, muscle and the lungs must bare the brunt of supplying the rest of the body with glutamine. This is in part responsible for the wasting associated with illness.

Glutamine plays a crucial role in maintaining function in rapidly dividing cells such as lymphocytes and mucosal enterocytes, of the immune system and digestive tract respectively. Cells of the immune system like lymphocytes rely on glutamine as a metabolic fuel. Enterocytes of the small intestine have a high rate of turnover and are the largest "consumer" of glutamine in the body. Glutamine supplementation increases the height of microvilli, as well as increasing the robustness of the mucosal lining in the GI tract. This serves to ensure optimal nutrient absorption as well as protect you from foreign bacteria you inadvertently put in your mouth.

Glutamine also buffers the body from high levels of ammonia by binding to it. Glutamine can then release ammonia when needed to form other amino acids, amino sugars, nucleotides, or to be excreted as urea.

Glutamine can be used for gluconeogenesis, and it contributes to nucleotide, amino sugar, and protein biosynthesis. Glutamine, along with cysteine, and glycine, plays a key role in glutathione synthesis. Glutathione is a coenzyme and is an important intracellular antioxidant.

There is a strong positive relationship between intracellular glutamine levels and protein synthesis. During muscle-protein wasting associated with injury or disease the levels of free glutamine in muscle tissue falls. In order to find out the consequences of this, MacLennan et al. looked at the relationship between the rate of muscle protein synthesis and intramuscular glutamine concentration (1). These investigators used in-vitro methods in order to acutely view changes in protein synthetic rates. Increasing intramuscular glutamine levels by 200% led to a 66% increase in protein synthesis in the absence of insulin. When they added insulin to the mix, a 30% increase in intramuscular glutamine was accompanied by an 80% increase in protein synthesis. Clearly, increasing the amount of free glutamine inside your muscles increases protein synthesis. Anyone reading this should have one question in mind however, is it possible to increase intramuscular glutamine levels by 200% by using a supplement?…More on that in a minute.

Some in vitro evidence exists that shows glutamine to have a direct effect on protein synthesis, however, this effect may be conditional (2). Zhou and colleagues found that glutamine has a stimulatory effect on the rate of protein synthesis in stressed myotubes but not in normal-cultured myotubes. Myotubes are muscle fibers in their early stages of development. Now, they found that the protective effect of glutamine on skeletal muscle protein might be associated with "heat shock proteins" or HSP. One common HSP in skeletal muscle is HSP70. They found that the level of HSP70 correlated with the levels of glutamine. What does this mean to you? It’s hard to say. It’s too early really at this point to make any conclusive remarks.

If the effect of glutamine on protein synthesis weren’t enough, it appears glutamine may also be anticatabolic. Research has shown that glutamine may exert anticatabolic effects similar to insulin. (3) MacLennan et al. was able to show that, glutamine was just as anti-catabolic as insulin. The anti-catabolic effects of glutamine were not enhanced when combined with insulin, indicating a similar mode of action. This type of anticatabolic effect results in the preservation of soluble or non-contractile proteins with no protective effect on myofibrillar proteins. This would make sense considering glutamines effects on protein breakdown were through a similar mechanism to insulin. This study shows that glutamine is indeed anti-catabolic, but it won’t help you hold on to those muscle proteins that really count.

You may have seen glutamine advertised as a "cell-volumizer". Well, this is true in a way. Glutamine itself doesn’t actually cause cells to swell. It is the sodium that must be co-transported with glutamine that causes the cell to swell. Either way it is a good thing. A consequence of the sodium-dependent entry of glutamine, is an osmotic, or "swelling" of the cell with water. Glutamine has been given a number of anabolic properties such as the stimulation of both protein and glycogen synthesis. The mechanism through which glutamine activates key enzymes in these metabolic pathways may involve this glutamine/sodium-induced cell swelling.(4)

Keep in mind that all of the studies we have looked at have used in-vitro techniques. This is a far cry from in-vivo conditions.

Glutamine may play a role in glycogen repletion after exercise.(5) In a study by Varnier et al. subjects cycled for 90 min at 70-140% VO2max to deplete muscle glycogen; then constant infusions of glutamine or a mixture of alanine and glycine or saline were administered. Muscle glutamine remained constant during saline infusion, decreased 18% during alanine+glycine infusion, but rose 16% during glutamine infusion. By 2 hrs. after exercise, muscle glycogen concentration had increased more in the glutamine-infused group than in the saline or alanine+glycine groups. The rate that blood glucose was incorporated into glycogen was not increased; suggesting that glutamine itself was serving as a substrate for glycogen synthesis rather than increasing glycogen storage from dietary carbs. What this means is that glutamine was being used for gluconeogenesis. This would not be the most practical use of a glutamine supplement. Besides, it would be difficult to mimic the effects of glutamine infusion with an oral glutamine supplement.

So what if you combine glutamine with a glucose polymer? The positive effect of oral glutamine combined with glucose on post exercise glycogen storage was shown to only occur outside of muscle, most likely in the liver.(6) Glutamine does not enhance glycogen synthesis in skeletal muscle beyond what glucose polymers do alone.

The authors of the study combining glutamine with glucose polymers commented that, from their data, only 47-50% of orally administered glutamine can be expected to make it past the liver and other organs, into the blood stream. And only about 10% can be expected to reach extracellular spaces.(6) Now, this is the main argument against glutamine. 90% of the glutamine you take orally never even makes it to your muscles. This isn’t to say it is wasted. Your GI tract loves glutamine from reasons explained earlier. If you are having intestinal problems nothing is better. If you are trying to increase protein synthesis by loading glutamine, it isn’t going to work.

So, is glutamine a "must have" supplement for any aspiring bodybuilder? No, probably not. Is it helpful under situations where overtraining is rearing its ugly head? You bet. Everything considered, glutamine is one of those supplements that probably will benefit anybody preparing for a show, but if you are an off-season, well-fed bodybuilder getting plenty of recovery and using a whey protein supplement, there are more important supplements to spend your money on.

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Eat More Protein To Burn Fat

If you've been working out with weights for any length of time, you know the importance of supplying your body with frequent feedings of quality protein so that your body will be able to have the necessary building blocks to build muscle in the shortest amount of time possible. 

How much protein should you be consuming each day? Well, that debate has been raging for many years. Eventually, the mainstream will accept what those in the bodybuilding community have known for a long, long time. 

In order to increase muscle mass, you should be consuming at least one gram of protein per pound of bodyweight per day. This is a good starting point. 

After awhile you may gradually increase your protein intake, monitoring your progress as you go, to determine if a higher protein intake allows you to make better progress. 

Personally, I make better progress when my protein intake is somewhere between one and 1.5 grams of protein per pound of bodyweight, spread out over 6 meals per day. 

The above paragraph may not be new to any of you. What you might not realize, however, is that protein is also extremely important when dieting to burn off excess body fat. 

Yes, it’s important to keep your protein intake high when dieting to make sure that you don’t burn off any muscle tissue in your quest to get ripped. 

But that’s not what I’m talking about. I’m talking about taking in protein in order to boost your metabolism and burn more fat, in addition to helping preserve and build your lean muscle tissue. 
In a study published in the American Journal of Physiology, one group was fed a high protein diet (just over one gram per pound of bodyweight per day) while the second group consumed a protein diet near equal to that of the RDA. 

The group eating the high protein diet burned more fat than the group consuming protein near equal to the RDA. 

One reason for this could be an increased "thermic" effect. The thermic effect of the RDA group was elevated 16% after eating. 
However, in the high protein group the thermic effect increased 42% after eating, almost 3 times that of the RDA group. 

This thermic effect of digesting your food peaks approximately one hour after eating. Spreading your daily caloric intake over 6 meals a day, eating every 2 to 3 hours, helps to take advantage of the increased metabolic rate that accompanies eating. 

In other words, the more often you eat, the higher your metabolic rate, i.e. the number of calories your body burns each day. 

In addition, by adding more protein to each meal, you also increase your metabolism. Your body requires more energy (i.e. calories) to process protein than it does carbohydrates. 

Let's review some simple changes you can make right now in your nutrition program to rapidly increase your body's ability to not only build muscle but burn fat also. 

1) Eat 5 to 6 smaller meals per day, as opposed to 2 or 3 larger ones. This will ensure that you supple your body with the nutrients necessary to build muscle, as well as increase your resting metabolic rate. 

It will also prevent your body from kicking into "starvation" mode, which can happen when you go too long between meals. 

If this happens, your body will start burning muscle for energy and increase your body fat stores, as well as slowing down your metabolism. All of these are things you want to avoid. 

2) Eat a high protein diet consisting of at least one gram of protein per pound of bodyweight. This helps ensure that your body has the protein available to increase maintain a positive nitrogen balance, which can lead to an increase in your muscles mass. 

It will also increase your metabolic rate, allowing you to burn more body fat than a low protein diet, without as large a decrease in your daily caloric intake, which will also help avoid the "starvation" mode discussed in the previous paragraph. 

Try these simple changes in your nutrition program to help you rapidly increase your muscle mass, burn off unwanted body fat and achieve the ripped muscular body that you've always wanted. 

Gregg Gillies

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"Creatine: More than a sports nutrition supplement"

By Will Brink. (Author of Body Building Revealed http://musclebuildingnutrition.com  - a complete guide bodybuilding supplements and eating to gain lean muscle, and Fat Loss Revealed http://aboutsupplements.com  - a review of diet supplements and guide to eating for maximum fat loss.)

Although creatine offers an array of benefits, most people think of it simply as a supplement that bodybuilders and other athletes use to gain strength and muscle mass. Nothing could be further from the truth.

A substantial body of research has found that creatine may have a wide variety of uses. In fact, creatine is being studied as a supplement that may help with diseases affecting the neuromuscular system, such as muscular dystrophy (MD). Recent studies suggest creatine may have therapeutic applications in aging populations for wasting syndromes, muscle atrophy, fatigue, gyrate atrophy, Parkinson's disease, Huntington's disease and other brain pathologies. Several studies have shown creatine can reduce cholesterol by up to 15% and it has been used to correct certain inborn errors of metabolism, such as in people born without the enzyme(s) responsible for making creatine. Some studies have found that creatine may increase growth hormone production.

What is creatine?

Creatine is formed in the human body from the amino acids methionine, glycine and arginine. The average person's body contains approximately 120 grams of creatine stored as creatine phosphate. Certain foods such as beef, herring and salmon, are fairly high in creatine. However, a person would have to eat pounds of these foods daily to equal what can be obtained in one teaspoon of powdered creatine.

Creatine is directly related to adenosine triphosphate (ATP). ATP is formed in the powerhouses of the cell, the mitochondria. ATP is often referred to as the "universal energy molecule" used by every cell in our bodies. An increase in oxidative stress coupled with a cell's inability to produce essential energy molecules such as ATP, is a hallmark of the aging cell and is found in many disease states. Key factors in maintaining health are the ability to: (a) prevent mitochondrial damage to DNA caused by reactive oxygen species (ROS) and (b) prevent the decline in ATP synthesis, which reduces whole body ATP levels. It would appear that maintaining antioxidant status (in particular intra-cellular glutathione) and ATP levels are essential in fighting the aging process.

It is interesting to note that many of the most promising anti-aging nutrients such as CoQ10, NAD, acetyl-l-carnitine and lipoic acid are all taken to maintain the ability of the mitochondria to produce high energy compounds such as ATP and reduce oxidative stress. The ability of a cell to do work is directly related to its ATP status and the health of the mitochondria. Heart tissue, neurons in the brain and other highly active tissues are very sensitive to this system. Even small changes in ATP can have profound effects on the tissues' ability to function properly. Of all the nutritional supplements available to us currently, creatine appears to be the most effective for maintaining or raising ATP levels.

How does creatine work?

In a nutshell, creatine works to help generate energy. When ATP loses a phosphate molecule and becomes adenosine diphosphate (ADP), it must be converted back to ATP to produce energy. Creatine is stored in the human body as creatine phosphate (CP) also called phosphocreatine. When ATP is depleted, it can be recharged by CP. That is, CP donates a phosphate molecule to the ADP, making it ATP again. An increased pool of CP means faster and greater recharging of ATP, which means more work can be performed. This is why creatine has been so successful for athletes. For short-duration explosive sports, such as sprinting, weight lifting and other anaerobic endeavors, ATP is the energy system used.

To date, research has shown that ingesting creatine can increase the total body pool of CP which leads to greater generation of energy for anaerobic forms of exercise, such as weight training and sprinting. Other effects of creatine may be increases in protein synthesis and increased cell hydration.

Creatine has had spotty results in affecting performance in endurance sports such as swimming, rowing and long distance running, with some studies showing no positive effects on performance in endurance athletes. Whether or not the failure of creatine to improve performance in endurance athletes was due to the nature of the sport or the design of the studies is still being debated.

Creatine can be found in the form of creatine monohydrate, creatine citrate, creatine phosphate, creatine-magnesium chelate and even liquid versions. However, the vast majority of research to date showing creatine to have positive effects on pathologies, muscle mass and performance used the monohydrate form. Creatine monohydrate is over 90% absorbable. What follows is a review of some of the more interesting and promising research studies with creatine.

Creatine and neuromuscular diseases

One of the most promising areas of research with creatine is its effect on neuromuscular diseases such as MD. One study looked at the safety and efficacy of creatine monohydrate in various types of muscular dystrophies using a double blind, crossover trial. Thirty-six patients (12 patients with facioscapulohumeral dystrophy, 10 patients with Becker dystrophy, eight patients with Duchenne dystrophy and six patients with sarcoglycan-deficient limb girdle muscular dystrophy) were randomized to receive creatine or placebo for eight weeks. The researchers found there was a "mild but significant improvement" in muscle strength in all groups. The study also found a general improvement in the patients' daily-life activities as demonstrated by improved scores in the Medical Research Council scales and the Neuromuscular Symptom scale. Creatine was well tolerated throughout the study period, according to the researchers.1

Another group of researchers fed creatine monohydrate to people with neuromuscular disease at 10 grams per day for five days, then reduced the dose to 5 grams per day for five days. The first study used 81 people and was followed by a single-blinded study of 21 people. In both studies, body weight, handgrip, dorsiflexion and knee extensor strength were measured before and after treatment. The researchers found "Creatine administration increased all measured indices in both studies." Short-term creatine monohydrate increased high-intensity strength significantly in patients with neuromuscular disease.2 There have also been many clinical observations by physicians that creatine improves the strength, functionality and symptomology of people with various diseases of the neuromuscular system.

Creatine and neurological protection/brain injury

If there is one place creatine really shines, it's in protecting the brain from various forms of neurological injury and stress. A growing number of studies have found that creatine can protect the brain from neurotoxic agents, certain forms of injury and other insults. Several in vitro studies found that neurons exposed to either glutamate or beta-amyloid (both highly toxic to neurons and involved in various neurological diseases) were protected when exposed to creatine.3 The researchers hypothesized that "… cells supplemented with the precursor creatine make more phosphocreatine (PCr) and create larger energy reserves with consequent neuroprotection against stressors."

More recent studies, in vitro and in vivo in animals, have found creatine to be highly neuroprotective against other neurotoxic agents such as N-methyl-D-aspartate (NMDA) and malonate.4 Another study found that feeding rats creatine helped protect them against tetrahydropyridine (MPTP), which produces parkinsonism in animals through impaired energy production. The results were impressive enough for these researchers to conclude, "These results further implicate metabolic dysfunction in MPTP neurotoxicity and suggest a novel therapeutic approach, which may have applicability in Parkinson's disease."5 Other studies have found creatine protected neurons from ischemic (low oxygen) damage as is often seen after strokes or injuries.6

Yet more studies have found creatine may play a therapeutic and or protective role in Huntington's disease7, 8 as well as ALS (amyotrophic lateral sclerosis).9 This study found that "… oral administration of creatine produced a dose-dependent improvement in motor performance and extended survival in G93A transgenic mice, and it protected mice from loss of both motor neurons and substantia nigra neurons at 120 days of age. Creatine administration protected G93A transgenic mice from increases in biochemical indices of oxidative damage. Therefore, creatine administration may be a new therapeutic strategy for ALS." Amazingly, this is only the tip of the iceberg showing creatine may have therapeutic uses for a wide range of neurological disease as well as injuries to the brain. One researcher who has looked at the effects of creatine commented, "This food supplement may provide clues to the mechanisms responsible for neuronal loss after traumatic brain injury and may find use as a neuroprotective agent against acute and delayed neurodegenerative processes."

Creatine and heart function

Because it is known that heart cells are dependent on adequate levels of ATP to function properly, and that cardiac creatine levels are depressed in chronic heart failure, researchers have looked at supplemental creatine to improve heart function and overall symptomology in certain forms of heart disease. It is well known that people suffering from chronic heart failure have limited endurance, strength and tire easily, which greatly limits their ability to function in everyday life. Using a double blind, placebo-controlled design, 17 patients aged 43 to 70 years with an ejection fraction <40 were supplemented with 20 grams of creatine daily for 10 days. Before and after creatine supplementation, the researchers looked at:

1) Ejection fraction of the heart (blood present in the ventricle at the end of diastole and expelled during the contraction of the heart)
2) 1-legged knee extensor (which tests strength)
3) Exercise performance on the cycle ergometer (which tests endurance)

Biopsies were also taken from muscle to determine if there was an increase in energy-producing compounds (i.e., creatine and creatine phosphate). Interestingly, but not surprisingly, the ejection fraction at rest and during the exercise phase did not increase. However, the biopsies revealed a considerable increase in tissue levels of creatine and creatine phosphate in the patients getting the supplemental creatine. More importantly, patients getting the creatine had increases in strength and peak torque (21%, P < 0.05) and endurance (10%, P < 0.05). Both peak torque and 1-legged performance increased linearly with increased skeletal muscle phosphocreatine (P < 0.05). After just one week of creatine supplementation, the researchers concluded: "Supplementation to patients with chronic heart failure did not increase ejection fraction but increased skeletal muscle energy-rich phosphagens and performance as regards both strength and endurance. This new therapeutic approach merits further attention."10

Another study looked at the effects of creatine supplementation on endurance and muscle metabolism in people with congestive heart failure.11 In particular the researchers looked at levels of ammonia and lactate, two important indicators of muscle performance under stress. Lactate and ammonia levels rise as intensity increases during exercise and higher levels are associated with fatigue. High-level athletes have lower levels of lactate and ammonia during a given exercise than non-athletes, as the athletes' metabolism is better at dealing with these metabolites of exertion, allowing them to perform better. This study found that patients with congestive heart failure given 20 grams of creatine per day had greater strength and endurance (measured as handgrip exercise at 25%, 50% and 75% of maximum voluntary contraction or until exhaustion) and had lower levels of lactate and ammonia than the placebo group. This shows that creatine supplementation in chronic heart failure augments skeletal muscle endurance and attenuates the abnormal skeletal muscle metabolic response to exercise.

It is important to note that the whole-body lack of essential high energy compounds (e.g. ATP, creatine, creatine phosphate, etc.) in people with chronic congestive heart failure is not a matter of simple malnutrition, but appears to be a metabolic derangement in skeletal muscle and other tissues.12 Supplementing with high energy precursors such as creatine monohydrate appears to be a highly effective, low cost approach to helping these patients live more functional lives, and perhaps extend their life spans.

Conclusion

Creatine is quickly becoming one of the most well researched and promising supplements for a wide range of diseases. It may have additional uses for pathologies where a lack of high energy compounds and general muscle weakness exist, such as fibromyalgia. People with fibromyalgia have lower levels of creatine phosphate and ATP levels compared to controls.13 Some studies also suggest it helps with the strength and endurance of healthy but aging people as well. Though additional research is needed, there is a substantial body of research showing creatine is an effective and safe supplement for a wide range of pathologies and may be the next big find in anti-aging nutrients. Although the doses used in some studies were quite high, recent studies suggest lower doses are just as effective for increasing the overall creatine phosphate pool in the body. Two to three grams per day appears adequate for healthy people to increase their tissue levels of creatine phosphate. People with the aforementioned pathologies may benefit from higher intakes, in the 5-to-10 grams per day range.

About the Author - William D. Brink 

Will Brink is a columnist, contributing consultant, and writer for various health/fitness, medical, and bodybuilding publications. His articles relating to nutrition, supplements, weight loss, exercise and medicine can be found in such publications as Lets Live, Muscle Media 2000, MuscleMag International, The Life Extension Magazine, Muscle n Fitness, Inside Karate, Exercise For Men Only, Body International, Power, Oxygen, Penthouse, Women’s World and The Townsend Letter For Doctors. He is the author of Priming The Anabolic Environment and Weight Loss Nutrients Revealed. He is the Consulting Sports Nutrition Editor and a monthly columnist for Physical magazine and an Editor at Large for Power magazine. Will graduated from Harvard University with a concentration in the natural sciences, and is a consultant to major supplement, dairy, and pharmaceutical companies. 

He has been co author of several studies relating to sports nutrition and health found in peer reviewed academic journals, as well as having commentary published in JAMA. He runs the highly popular web site BrinkZone.com which is strategically positioned to fulfill the needs and interests of people with diverse backgrounds and knowledge. The BrinkZone site has a following with many sports nutrition enthusiasts, athletes, fitness professionals, scientists, medical doctors, nutritionists, and interested lay people. William has been invited to lecture on the benefits of weight training and nutrition at conventions and symposiums around the U.S. and Canada, and has appeared on numerous radio and television programs. 

William has worked with athletes ranging from professional bodybuilders, golfers, fitness contestants, to police and military personnel. 

See Will's ebooks online here: 

Body Building Revealed http://musclebuildingnutrition.com 

A complete guide bodybuilding supplements and eating to gain lean muscle

Fat Loss Revealed http://aboutsupplements.com 

A review of diet supplements and guide to eating for maximum fat loss

He can be contacted at: PO Box 812430
Wellesley MA. 02482. 
BrinkZone.com
Email: wbrink@earthlink.net

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Avoid Supplements With BD or 1,4-Butanediol

Recently, the New England Journal of Medicine reported the deaths of two individuals who had consumed a supplement called BD, which is also sometimes marketed by its chemical name, 1,4-butanediol.  1,4-butanediol is an industrial solvent that, when ingested, is converted to gamma-hydroxybutyrate (GHB), a drug with depressant effects, primarily on the central nervous system.  The supplement containing 1,4-butanediol are sold under the names Thunder Nectar, InnerG, Amino Flex, ReJuv+Nite, Liquid Gold, Thunder, Serenity, X-12 and N-Force, and are available primarily on the internet.  These supplements are taken to enhance muscle mass, or to treat depression or insomnia.

The health risks of 1,4-butanediol are similar to those of its counterparts, gamma-hydroxybutyrate and gamma-butyrotacto9ne (GBL0, which have been banned.  These include acute toxic effects, which may be fatal.  Symptoms of use are wild mood swings, ranging from being combative one moment to an abrupt loss of consciousness.

RECOMMENDATION: Bulging biceps won’t do you any good if you’re dead.  Avoid these dangerous supplements.

Physical May 2001 10/14/01

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All you wanted to know about Creatine

1. What is it and where does it come from?

Simply put, creatine monohydrate is the most popular and effective bodybuilding supplement on the market. Everyone consistently using creatine is making HUGE, AMAZING gains!

There is one good reason why three out of four of the '96 summer Olympic medallists used creatine: it works and it works well. A French scientist first discovered creatine in 1832, but it was not until 1923 that scientists discovered that over 95% of creatine is stored in muscle tissue. The first published report of creatine having bodybuilding effects was The Journal of Biological Chemistry in, get this, 1926! Although we’ve known about creatine for quite some time, the first real use of it to enhance performance was the 1992 Olympic games in Barcelona, Spain.

So, what is creatine? Our bodies naturally make the compound, which is used to supply energy to our muscles. It is produced in the liver, pancreas, and kidneys, and is transported to the body's muscles through the bloodstream. Once it reaches the muscles, it is converted into phosphocreatine (creatine phosphate). This high-powered metabolite is used to regenerate the muscles' ultimate energy source, ATP (adenosine triphosphate).

Unlike steroids or drugs, creatine is 100% natural and occurs naturally in many foods; therefore, it can never be banned from any sports or international competitions (unless they banned eating meat). Many foods especially herring, salmon, tuna, and beef contain some creatine. However, the very best source of creatine by far is creatine monohydrate because it contains more creatine per weight of material than any other source. Bodybuilding.com sells only high quality 99.9% pure pharmaceutical-grade creatine monohydrate.

2. What does it do and what scientific studies give evidence to support this?

Creatine is bodybuilding's ultimate supplement, and for good reason. For one thing, creatine can significantly increase lean muscle mass in just two weeks. It is also responsible for improving performance in high-intensity exercise, increasing energy levels, and speeding up recovery rates. It’s no wonder athletes who use it have such of an edge over those who do not. Soon nearly every athlete who competes will use it (if they don't already). Creatine's ability to enhance energy reserves in muscles comes from its muscle protein synthesizing action, while minimizing protein breakdown. This occurs because creatine has the awesome effect of super-hydrating muscle cells with water. It enhances muscles' growth too-making muscle fibers bigger and stronger.

Quite a few studies have been done on creatine to figure out why and how it works so well. There have been over twenty double blind (meaning neither the researchers nor the subjects knew who was getting what), placebo-controlled studies conducted on creatine in the past five years. They proved that creatine increased energy levels, resulting in increased strength, endurance levels, and recovery rates. Another unexpected benefit attributed to creatine was discovered as well: creatine accelerates fat loss, while building lean body mass!

3. Who needs it and what are some symptoms of deficiency?

First, anyone who is ready to have more energy, build more muscle faster, and have more endurance should try supplementing with creatine monohydrate. Next, anyone who would like to be more toned by increasing lean muscle mass, recuperating faster, and losing that extra little fat roll should supplement with creatine monohydrate. Last, anyone who is involved in intense physical activity, experiencing physical stress and fatigue, and likes incredible results should supplement with creatine monohydrate.

4. How much should be taken? Are there any side effects?

Excellent results have been observed in taking creatine monohydrate in two different ways. The first way is called loading. This method works very well for anyone who has never taken creatine before. Just as the name implies, it involves loading up or saturating your muscles with creatine. During the first four days to a week, take 20 to 30 grams per day. Mix it with non-acidic juice or water. Grape juice works well. After this loading period, take a regular intake of between five to fifteen grams per day to keep your muscles saturated (no need to over do it). The other method is a more gradual approach to supplementing with creatine monohydrate. Over the course of an extended period, one basically skips the loading phase and just supplements with five to fifteen grams per day, everyday. The best results have been noticed when creatine is combined with a high carbohydrate base, such as dextrose (glucose) and taken about one-half hour before training.

The best part about creatine-no adverse effects have been reported in any studies. NONE! Creatine is totally safe and effective. Creatine has never been shown harmfully toxic. Nevertheless, just like with anything, it is not recommended to over-supplement once your muscles are saturated with creatine-there is no reason to. This means, stick to the recommended dosages, and be prepared to experience the very best muscle, strength, energy, and endurance gains possible!

Creatine Questions and Answers

Q: I heard that creatine and caffeine can be consumed at the same time. But an article I read claims caffeine inhibits the absorption of creatine into muscle tissue. Which is true?

A: There was a controversial research study published in 1996 in the Journal of Applied Physiology about creatine and caffeine; however, if you study that article closely, you'll find that caffeine had no effect on creatine uptake into muscle. A more recent study by Vanakoski, et al. in 1998 investigated the pharmacokinetics of caffeine and creatine, both alone and in combination. They reported when creatine was used alone or even in combination with caffeine that, "creatine was rapidly and efficiently absorbed, as reflected by plasma concentrations." Because researchers concluded that creatine was efficiently absorbed even when combined with caffeine, it does not appear from the results of this study that caffeine exerts a negative effect on the uptake of creatine into muscle tissue.

Q: I have heard conflicting information about cycling creatine. Should I or shouldn't I?

A: Some studies support creatine cycling and others do not. There are a couple of different "cycling" strategies you can try: 1. Stay on creatine all the time, but reload once every six weeks; 2. Load for a week, stay in your maintenance phase for six weeks, then stop taking creatine completely for a couple of weeks. Repeat.

Q: I mix creatine with my workout drink in the morning, but sometimes I don't actually finish it until several hours later. Is creatine stable in solution this long?

A: Creatine is not totally stable in solution, so it's definitely not a good idea to keep it mixed with liquid for days, but there shouldn't be a problem mixing it six to eight hours before it's consumed. Any longer than that and you may be pushing it.

Q: Creatine supplementation seems to increase muscle strength. Would it make a person's heart stronger since it is a muscle too?

A: Research has shown that the cardiac tissue of laboratory animals does, indeed, take up creatine; not to the same magnitude as skeletal muscle but to some degree. There are reports of patients with chronic heart failure having low levels of myocardial creatine, and in that situation, administration of creatine is beneficial.

Q: There's been a lot of press coverage in the past about creatine and muscle cramping. Are studies underway to investigate this?

A: Many scientific studies have been published and presented about creatine over the past years, and we have never seen any scientific evidence that creatine increases an athlete's chances of experiencing muscle cramps or "pulls." In fact, results from one recent study conducted at the University of Memphis (entitled "Effects of Creatine Supplementation During Training on the Incidence of Muscle Cramping, Injuries, and GI Distress") revealed no reports of muscle cramping in subjects taking creatine-containing supplements during various exercise training conditions. Among the test subjects were elite junior swimmers, college football players, and trained and untrained endurance athletes.

Q: Is the loading phase with Creatine necessary to experience any benefits?

A: Necessary is a rather strong word. The loading phase is not required when using Creatine, but results of our university studies indicate that the loading phase helps you reach that magic muscle-creatine saturation point quicker than if you just started out with the maintenance dose. You can reach the same creatine saturation point by taking one serving of Creatine for 30 days as you would from loading for 5 days, but most people aren't interested in waiting a month for results they could see in a week or less.

Q: Are there any unfavorable effects with using Creatine?

A: Creatine occurs naturally in many foods, with an especially high concentration in red meats and fish. While using Creatine, you may notice increased urination, but this is simply due to the extra volume of liquid you'll be drinking when mixing your Creatine. If you do not wait three to four hours between doses, you may experience some stomach discomfort. This is easily resolved by spacing your Creatine dosages throughout the day or cutting dosages in half for one to two days.

Q: What is the advantage of taking creatine in a powder versus a capsule or tablet form?

A: Powder can be absorbed by the bloodstream more efficiently than a pill, which has a coating that must be digested first. Also, creatine is taken in gram amounts-which means, you'd need to take 20 1-gram capsules or 40 tablets per day to load. Needless to say, powder is much more efficient.

Q: If I'm trying to lose fat, should I worry about the calories in Creatine?

A: No. Creatine has no caloric value. 

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Ma Huang

Two main ingredients make up the core of a great thermogenic. First and foremost, is the herb ma huang (Ephedra sinica), which contains ephedrine and five other related ephedrine alkaloids (this is also the ingredient that varied the most in our independent lab test investigation). The more cutting-edge products also contain an additional synergistic compound called bitter orange, which contains the newest thermogenic ingredient, synephrine. Some researchers now believe that synephrine may be an even more effective metabolic enhancing compound than ephedrine. However, the latest research suggests that the combination is highly synergistic and that the two should be used together (in a specific ratio) for optimal fat-burning. Supporting and further amplifying the effects of these two are caffeine and other methylxanthine compounds, which are generally extracted from standardized guarana, kola nut, and/or green tea.

Some products also contain aspirin, but there are strong scientific and medical reasons why many researchers don’t recommend those. We’ll tell you more about that later in this article.

Anyway, here’s the "skinny" on each of the primary thermogenic components.

Ma huang

A high-quality, concentrated extract of ma huang is the leading ingredient in any high-powered thermogenic because of its active compound, ephedrine. But it also contains more than just ephedrine. Although most of the original clinical studies on thermogenics used synthetic ephedrine—for reasons of precision and simplicity—natural extracts of the ma huang plant are considered superior to the synthetics in several respects.

For starters, ma huang contains six ephedrine-like alkaloids: ephedrine plus pseudoephedrine, norephedrine, norpseudoephedrine, methylephedrine and methylpseudoephedrine. We call this a "full spectrum" ephedrine source. What’s important about this is that pseudoephedrine and other substances from high quality extracts can extend and enhance the thermogenic effects beyond the synthetic compounds, and can further increase the energy—stimulating effects.

Another reason ma huang is superior to synthetic alkaloids, is that research shows the above active ingredients are digested and absorbed into the bloodstream more steadily than with their synthetic counterparts. As a result, there’s no sudden rush of ephedrine into the body. Rather, there is a consistent and extended, natural "timed-release" effect. This steady, more consistent absorption results in greater bioavailability, which essentially means that the natural extracts are more potent. For this reason, some of the leading researchers now believe that you only need to take a good thermogenic twice a day—with or before breakfast and at about mid-afternoon—instead of three times a day as suggested in earlier research on the synthetic forms. Being able to skip that 4:00-6:00 p.m. dose can make all the difference in the quality of rest and sleep you get in the evening. Ironically though, because many companies are not really up on the latest research, many thermogenics still recommend three doses per day. And this third dose can interfere with your sleep. And if there’s anything the bodybuilding world learned from six-time Mr. Olympia, Dorian Yates, it’s the importance of recuperation—consistent, high-quality rest and sleep—in r