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marylin monroe
Showing posts with label hypertension. Show all posts
Showing posts with label hypertension. Show all posts

Baking Soda For Stressed White Blood Cells: 0.3g/kg NaCO3 90min Before an Anaerobic Workout Protect Your Immune Cells From "Stress" and Oxidative Damage

Image 1: Pure baking soda is not (yet?) a staple of the supplemental arsenal of many athletes. The scientific evidence with regard to its immediate ergogenic effects is ambigious and the mere presence of the word "sodium" in "sodium bicarbonate" scares the hack out of those athletes (bodybuilders and figure competitors) who may benefit most from a few grams of this potent alkalizer.
"Sodium"! This word alone is usually enough to scare bodybuilders and fitness athletes to death. "Sodium!? Isn't that the stuff that makes me look bloated?" The answer is easy: No! While sodium will help you retain enough water in your body to perform in the gym, the amount of sodium you ingest usually has little impact on the amount of water you will be holding, only when you start modulating your sodium intake, your body will react with changes in the renin-andiotensin-aldosterone system and you will be fluctuating "nicely" back and forth from super-bloated to weak and dehydrated... this is yet commonly ignored within the fitness community and thus it is no wonder that most supplement producers are anxious not to include any ingredients in their products that would show up on the label as "sodium" - after all, there are still costumers out there who have not enrolled at the SuppVersity and will thusly run away screaming as soon as they take a closer look on the label of a product they were just about to buy.

It is thusly no wonder that (at least to my knowledge) KreAlkalyn, where NACO3 is the working ingredient of the highly advertised buffering system, is the only product using sodium bicarbonate, or soda ash, as it is also called, as one of its main constituents (more on this topic in the SuppVersity Creatine Special). In medical settings NACO3 was and, in parts, still is still the "drug" of choice to combat acute acidosis. It is thus no wonder that Daniel J. Peart and his colleagues from the University of Hull in the United Kingdom, as well as the Bond University in Queensland, Australia are not the first scientists who speculated that athletes, especially those competing in (primarily) anaerobic sports, could benefit from the alkalizing effects of their grandmothers' secret weapon in the war against fungi and bacteria on her kitchen furnishings (Peart. 2011).
Image 2: "Cholesterol is the devil and sodium is his little brother!" Everyone who still believes everything the medical orthodoxy says, please raise your hands!
A note on the dangers of "salt": Firstly, baking soda is "only" ~28% sodium, which means that for every 4 grams you ingest you get roughly 1 g of sodium. Secondly, it is arguable how much of the sodium is effectively taken up and will be floating around in your blood. As T. Lakhanisky points out in his dossier for the Belgian government: "The uptake of sodium, via exposure to sodium carbonate, is much less than the uptake of sodium via food. Therefore, sodium carbonate is not expected to be systemically available in the body." (Lakhanisky. 2002) And thirdly, there is more and more evidence that suggests that the chloride rather than the sodium content of common table salt (NaCl = NatriumChloride) is the root cause of "sodium induced hypertension" in "sodium sensitive" individuals / animal models. Only recently, a study by Schmidlin et al. showed that chloride loading induced hypertension in the stroke-prone spontaneously hypertensive rat despite profound sodium depletion (Schmidlin. 2010). So, if you asked me, rather than pointing at salt as the #2 on the list of greatest evils (obviously cholesterol is still #1, here) the medical orthodoxy would be better advised to address the imbalances between sodium and potassium, which are so characteristic of the western diet, instead of painting yet another black and white picture where sodium is the bad guy and potassium the dangerous mineral that cannot be sold OTC in dosages >80mg.... but hey, this would be the topic for a whole new blogpost and as gross as it may sound, the chance that you get diarrhea from the baking soda is probably 1000x higher than the remote possibility of increases in blood pressure. A 1990 study by Luft et al. even found that the blood pressure of 10 mildly hypertensive and normal subjects decreased by 5mmHg after 7 days in the course of which they drank 3 liters of sodium bicarbonate containing water per day (Luft. 1990)
In their study, Peart et al. had a group of seven recreationally active men (age 22.3 ± 2.9 years,
height 181.6 ± 4.5 cm, body mass 78.1 ± 8.1 kg, and physical activity 4.2 ± 0.6 h/week) "with no history of supplementing their diet with ergogenic agents" perform a 4-min bout of all-out exercise on an air-brake cycle ergometer on three different occasions (spaced exactly 1 week apart). While the first was an acclimatization session the second and third bout were performed after the ingestion of either 0.3g/kg sodium bicarbonate (trial 2) or plain table salt (trial 3) in "low-energy flavored water" 90 minutes prior to exercise.
Figure 1: Blood ph levels after ingestion of placebo or 0.3g/kg sodium bicarbonate (data adapted from Peart. 2011)
As you can see in figure 1, the ingestion of ~23.4g of baking soda produced a rather slight but significant shift towards a more alkaline blood ph level (compared to placebo), which became much more pronounced after the exercise bout (p<0.003). Interestingly, there was yet no significant difference (p>0.26) in exercise performance as measured by average and peak power (means ± SD; average power 292 ± 43 W vs. 291 ± 50 W; peak power 770 ± 218 W vs. 775 ± 211 W; work completed 71 ± 10 kJ vs. 68 ± 10 kJ) between the groups.

Baking soda: A non-ergogenic ergogenic?

The latter observation, i.e. no or statistically non-significant increases in acute exercise performance upon sodium bicarbonate ingestion, stands in line with ~75% of the previous findings, a recent meta-analysis by Carr et al. summarizes as follows:
The remaining 38 studies and 137 estimates for sodium bicarbonate produced a possibly moderate performance enhancement of 1.7% (90% CL ± 2.0%) with a typical dose of 3.5 mmoL/kg/BM (∼0.3 g/kg/BM) in a single 1-minute sprint, following blinded consumption by male athletes. In the 16 studies and 45 estimates for sodium citrate, a typical dose of 1.5 mmoL/kg/BM (∼0.5 g/kg/BM) had an unclear effect on performance of 0.0% (±1.3%), [...] Study and subject characteristics had the following modifying small effects on the enhancement of performance with sodium bicarbonate: an increase of 0.5% (±0.6%) with a 1 mmoL/kg/BM increase in dose; an increase of 0.6% (±0.4%) with five extra sprint bouts; a reduction of 0.6% (±0.9%) for each 10-fold increase in test duration (e.g. 1-10 minutes); reductions of 1.1% (±1.1%) with nonathletes and 0.7% (±1.4%) with females. Unexplained variation in effects between research settings was typically ±1.2%.
Despite these rather mediocre immediate effects of bicarbonate pre-loading, the main finding of the study at hand hints at hitherto overlooked long(er)-term immune benefits the consumption of sodium bicarbonate might have.
Figure 2: HSP-72 expression in mono- and lymphocytes in response to anaerobic exercise after ingestion of placebo or 0.3g/kg sodium bicarbonate (data adapted from Peart. 2011)
As you can see in figure 2 the stress-induced HSP-72 expression in white blood cells (lymphocytes and monocytes) in response to the HIT exercise was almost completely abolished. Along with the nullification of the already low amount of oxidative stress (cf. T-BARs in figure 3), these results suggest that bicarbonate supplementation has a stress-protective effect on immune cells during anaerobic exercise.
Figure 3: Oxidative stress due to anaerobic exercise as measured by TBAR expression after ingestion of placebo or 0.3g/kg sodium bicarbonate (data adapted from Peart. 2011)
It is yet important to note that the scientists point out that it "is unclear at this stage whether the attenuation was due to a reduced state of acidosis, reduced oxidative stress or a combination of both." Moreover, it is difficult to say which consequences this would have on future bouts of exercise and whether and to which degree athletes would actually benefit - or, if we think of the hormesis hypothesis and the ongoing debate concerning the effects of antioxidants on exercise induced adaptations - maybe even compromise their performance, would yet need further investigations.

We may yet assume that, just as it is the case with antioxidants, the dosage will have to be matched to the individual workload to see optimal results. With people exercising just enough to see any adaptations seeing no and people who do crossfit 2x a day seeing the most beneficial results from (partially) blocking the exercise induced oxidative stress.

Pre-Hypertension Ain't Benign: Up to 80% Increased Risk of Cardiovascular Morbidity W/ "High Normal" Blood Pressure and Less! Plus: Foods & Supps to Reduce Your BP

"High normal" is misleading - there is no such thing as a "high normal" BP
"Ah, that's not so bad!" If that's what your doctor said, when he last measured your blood pressure and said "129/84" when he looked at the display of the Sphygmomanometer he must have been living beneath a rock for the past decades.

If that sounds familiar, it may be useful to show him a recent meta-analysis of pertinent papers from the early 2000s - a metapa-analysis like the one Yuli Huang and her colleagues from the Department of Cardiology at the Nanfang Hospital at the Southern Medical University in Guangzhou, China, published in BMC Medicine a couple of days ago (Huang. 2014).
"Pre-hyper-tensive? Pah that's not me!" If you just thought that, I'd hope that you are right, but honestly... in view of the fact that 3 out of 10 US citizens have a blood pressure in the 129-139 / 84-95 mmHg and against the background that the latter has long been considered as "high normal" I am afraid that some of you may qualify for the >50% increase in heart disease risk as a result of "suboptimal" blood pressure values.
In said paper Huang et al. present the results of an extensive database search in the course of  two independent reviewers identified 18 prospective cohort studies with a total of 468,561 participants the researchers used to evaluate the cardiovascular and coronary heart disease (CVD and CHD) risk in prehypertensive individuals.
Figure 1: Risk increases for cardiovascular morbidity (all subjects, left), stroke and cardiovascular heart disease (right); difference expressed relative to subjects w/ normal BP (Huang. 2014)
According to data from the Centers for Disease Control and Prevention in Atlanta, "[a]lmost 30% of American adults have prehypertension" (CDC website). What the CDC website does not tell you, though, is that being prehypertensive and not just the correspondingly increased "risk of developing hypertension" the authors of the info-document on www.cdc.gov mention in the next sentence is a problem.

If you look at the data, the Chinese researchers present in their latest paper, it turns out that even a blood pressure below what is usually considered "high normal", i.e. a systolic blood pressure between 130 and 139 in concert with a diastolic blood pressure of 85 to 89 mm Hg. In fact, Huang et al. report at statistically significant increase in cardiovascular morbidity of 46% even in those of the almost 5000,000 study participants with "below high normal" levels of 120-129 / 80-84 and thus in a BP range where your doctor may even say: "Hey that's pretty good!"

If you happen to be lucky enough to be a women, the risk will be slightly reduced. If, on the other hand, you are a man, your CVD morbidity risk will increase by 80% - irrespective of your age, by the way.
Not on the list on the left, but in the SuppVersity News: " Olive Leave Extract Equally Effective at Lowering Blood Pressure as ACE Inhibitor Captopril" | read more
Men or not, you better do something about it: Usually I would summarize the misery in this last paragraph, but in this case, it appears more appropriate to remind you of the beneficial effects of regular physical activity (walking, running, lifting) and the usefulness of a whole foods, high nut (Casas-Agustench. 2011), high magnesium (Rosanoff. 2010; Kass. 2012), high potassium diet (Geleijnse. 1994; use supplements only if you can't get enough from your diet).

Supplements that may be useful are taurine (Militante. 2002), fish oil (Campbell. 2013), dark chocolate / cacao (Desideri. 2012), vitamin C (short term; Juraschek. 2012), green tea extracts (Bogdanski. 2012), pomegrenate (Asgary. 2013; juice), melatonin (Scheer. 2004) and - as on every list of suggested supplements - whey protein (Lee. 2007) ;-)
References:
  • Asgary, Sedigheh, et al. "Clinical Evaluation of Blood Pressure Lowering, Endothelial Function Improving, Hypolipidemic and Anti‐Inflammatory Effects of Pomegranate Juice in Hypertensive Subjects." Phytotherapy Research (2013).
  • Bogdanski, Pawel, et al. "Green tea extract reduces blood pressure, inflammatory biomarkers, and oxidative stress and improves parameters associated with insulin resistance in obese, hypertensive patients." Nutrition Research 32.6 (2012): 421-427.
  • Campbell, Fiona, et al. "A systematic review of fish-oil supplements for the prevention and treatment of hypertension." European journal of preventive cardiology 20.1 (2013): 107-120.
  • Desideri, Giovambattista, et al. "Benefits in Cognitive Function, Blood Pressure, and Insulin Resistance Through Cocoa Flavanol Consumption in Elderly Subjects With Mild Cognitive Impairment The Cocoa, Cognition, and Aging (CoCoA) Study." Hypertension 60.3 (2012): 794-801.
  • Geleijnse, J. M., et al. "Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension." Bmj 309.6952 (1994): 436-440. 
  • Juraschek, Stephen P., et al. "Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials." The American journal of clinical nutrition 95.5 (2012): 1079-1088.
  • Kass, Lindsy, J. Weekes, and Lewis Carpenter. "Effect of magnesium supplementation on blood pressure: a meta-analysis." European journal of clinical nutrition 66.4 (2012): 411-418.
  • Militante, J. D., and J. B. Lombardini. "Treatment of hypertension with oral taurine: experimental and clinical studies." Amino Acids 23.4 (2002): 381-393.
  • Rosanoff, Andrea. "Magnesium supplements may enhance the effect of antihypertensive medications in stage 1 hypertensive subjects." Magnesium Research 23.1 (2010): 27-40.
  • Scheer, Frank AJL, et al. "Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension." Hypertension 43.2 (2004): 192-197.