Intermittent Thoughts on Intermittent Fasting - Finally Getting Started - Setting Yourself Up For Success!

Image 1: Socrates unquestionably did not look like he knew anything about intermittent fasting or physical culture, but he knew a lot about how to unlock the potential of his students.

In the last parts of the series you have learned so much about the biochemical underpinnings of how your diet and exercise regimen can change the way you look, feel and perform that you should by now have a general idea of why people, like Duong, "all of a sudden" drop tons of body fat, without having to resort to the still much-heralded combination of low-intensity-steady state "cardio" sessions and frequent low-fat high carb mini-meals. You should, however, also have grasped the idea that copying Duong's or Adelfo's regimen probably won't get you where you want to be. My intention thus is (and has always been) to teach you all the stuff you will need to find your own way... just as children will not learn to read if you just read books to them, you will never be able to constantly progress unless you totally surrender yourself to the advice of a highly paid personal trainer who babysits you 24/7 or - and I would assume that this is the way more desirable alternative - learn how to do his job on your own. In this installment of the Intermittent Thoughts and probably a few follow ups, I am thus going to "think" about how you can decide on the necessary steps you have to achieve your personal goals.

Do you want to know how to set yourself up for failure?

If I wanted to make it easy for me, I would follow the example of many health and fitness authors and provide you with a 3-10 item list of how you can "set yourself up for failure". This is easy, because you do not even have to know what works. It is enough to now what does not work. Yet even though there are much more things that don't work, than things that do work,  the word(s) "overeating" or even "constant overeating" would be totally misplaced on the list of "don'ts" of a skinny person who insists to do an intermittent fast and still wants to gain weight. Without "constant overeating" in the restricted feeding windows this is not going to happen.

Image 2: The new "MyPlate" is probably the most prominent example of moribund one-diet-fits-them all solutions (even if it was not intrinsically flawed, as well)

As you may notice, it gets pretty difficult for me, not to set you up for failure, even if I am providing advice that would be spot on for 90% of my readers. This is why I will not give you any answers, at all, but ask questions. I will ask questions that will enable you (based on the information of the future installments and concrete examples I will weave into future Intermittent Thoughts) to come up with the answers yourself - in didactics, this is referred to as a "socratic dialogue" (Rose. 2001), where the lecturer is trying to ilicit information from students through a direct line of reasoning... I suspect that this may sound counter-intuitive, after all it sounds as if it implied that you already know what the answers would be. That, however, is not the case. Socrates made his pupils discover for themselves things they could know - and that is fundamentally different from inquiring about things you do know.

Who are You and what do You want to achieve?

As I am doing it at the beginning of each semester with my real world students, the first thing I will ask you to do is to introduce yourself. What relevant information would you have to provide? Are you being fed up of being the fat or skinny kid, the girl or guy who is always just "a friend", the last one to be picked when you are playing football with peers, the pre-diabetic who got scared, when the doctor told him that if he did not start jogging and eating "healthy" *haha* whole grains will sooner or later be injecting insulin? If you do not have an answer to this question, yet, chances are you won't be able to help yourself make a change - and if you do not want to change, why are you even contemplating an intermittent fast?

Image 3: Are you sure "getting skinny" is really what you want, former fat kid?

Outside of the realm or professional athletics, the issue we are approaching right now is something that is commonly overlooked by many trainees and oftentimes not accordingly valued by their trainers (if they have any) - it is the complex interrelation of personal motivation and goals. Let's assume you were the "fat kid" all your life. Is you goal actually to "get skinny"? Probably not. And in case it is - just stop eating. If you take in enough fluid, and maybe a protein shake with some olive oil from time to time, you will probably live long enough to see a skinny image of yourself in the mirror, someday. Will this provide the social acceptance you have been longing for, all these years? I don't think so. It would rather have you descend deeper into the social abyss...

Why are you here? What is it that motivates you to "study" at the SuppVersity?

The first step in setting yourself up for success is thus to set an appropriate long term goal. I know that each and every one of you will tell me that he is "freakin' motivated" and "ready to do whatever it takes" to achieve his/her goals... so!? Then give me the elevator pitch of what you want to achieve... if it took you longer than 2 seconds to put your main goals into a single sentence, I must tell you that you have not yet taken the first and most fundamental step to set yourself up for success. Even the slightest doubts on your part as far as your goal is concerned will eventually become major obstacles on journey to a "new" or "better" you. That does not mean that your goals cannot change in the course of your journey (it is very likely that they will and in most cases it is even necessary), but if you were not sure, whether you want to go to Canada or to the South Pole, don't you think it would be better to stay at home, then?

Figure 1: Initial motivation (as assessed by the MPAM-R questionaire on a 7-point Likert scale) of male and female trainees going to a commercial gym and correlation (r-values) with adherence to the exercise program (adapted from Ryan. 1997)

Maybe it will help you if we take a look at what others set out to achieve. In a 1997 study, Richard M. Ryan and his coworkers at the Universities of Rochester and Southern Utah conducted a study where they asked 66 male and 89 female gym-goers for their personal motives and correlated this information on initial motivation with the subjects adherence to their respective exercise programs. The results are quite interesting, because although physical fitness and appearance were ranked highest, they showed the least correlation with the individuals adherence to the exercise program. In the case of "appearance" - my often-cited "I just want to look good naked" - there was even no (statistical significant) correlation at all. In other words, it did not matter how bad people wanted to improve their physical appearance - if this was their main motive to go to the gym. It did not help them to stay on track. Or as the scientists put it:

The implications of these findings [...] suggest that body-related motives are not, on average, sufficient to sustain regular exercise regimens, and thus should not be made the most salient justification for engaging in exercise.

Image 4: For Arnold (you know he is my favorite ;-) "the pump is like cumming ... like having sex with a woman" ... well, we all know how much he enjoys both, and it was the former joy, the one from the pump, him on track and made him succeed (still from video).

The scientists suggest that trainers & trainees would be better off if they emphasized "the inherent enjoyment associated with physical activity and/or the growth of competences that exercise promotes". Now, think about yourself and the people surrounding you. Think about the "losers" and the ones who had success. Do you see a pattern? Think about their faces when they come to the gym. Think about how they approach the weight stack. Think about what they say and how they respond, when you ask them: "What do you train today?" Do you see the pattern? Think of Arnold

Your muscle get a real a tight feeling [...] that's the pump [...] it feels different, it feels fantastic [...] it is as having sex with a women [...] I am cumming day and night ... it's terrific, I am in heaven (if you don't believe he said that, watch the video)

Do you see the pattern? Think of the fat lady that was holding on to the inclined treadmill, trampling away sweating, when you were doing your HIIT on the stair-master. Do you see a pattern?

Well, obviously both Arnold and the lady wanted to improve their physique. For the Governator, however, it was a necessary consequence of his life-style, a life-style that was based on doing what he loved to do. For the lady you saw on the treadmill, on the other hand, it was something alien - a physique "those other all have", something "nature has given those skinny anorexic chicks", something she "can work for as hard as she wants, but will never achieve". Be honest with yourself: Who are you? Arnold or the lady on the stairmaster?

Did I just hear you say that "it is not my fault, Dr. Andro!"?

Image 5: "Good" or "bad" this DNA helix is a part of your setup for success. Trust me - a few pathologic exceptions aside - it will only hinder your success if you lull yourselves into believing that it does.

From the fact that you did not head right to the gym to jerk... ahh I mean pump off ;-) I gather that you are not on the extreme "arnold'esque" side of the continuum - in other words: Things have not worked out the way you intended in the past, have they? You know what? That's your advantage! Thusly you save yourself at least a few of the 1001 mistakes that lurk on the way that lies between the "old" you and the "new" one... which reminds me: Do you already have your elevator pitch ready? What? You still "just want to look good naked"? Well, that is fine with me. Just be aware that even if you went to bed tonight, woke up the next morning, stood before the mirror in your bedroom and ... finally looked good naked, it will probably only take few weeks to restore your looks to your old "inner self", which obviously would not have changed, when the beauty fairy struck you with her magic wand in that fateful night.

You need to realize that whatever the central aspect of your motivational elevator pitch is going to be ...

• looking good naked (how do you define that?)
• never being called "skinny bitch/bastard", again (are you sure that is only an issue of how you look?)
• not being the fat guy/girl, any more (what do you think will change, then?)
• eventually get rid of the constant fatigue (could the fatigue be the result of trying to achieve unrealistic aims?)
• adding +20lbs of lean muscle to my frame (what will you have achieved then? will this be enough? or are you going to want more?)
• losing -50lbs of fat (is it just the figure on the scale you are looking for?)
• getting off your diabetes drugs (do you have an idea why you maneuvered yourself into this situation in the first place?)
• living into your 100s (do you just want to live long or is this more about good health into the old age?)
• and so on and so forth

 ... chances are, you would already be there, or at least on your way to achieve them, if there was not this one person that was standing in your way: YOU! No excuses! Taking responsibility for where you are at now, regardless of which "bad advice" you have been following or "how bad your genes" may be - your status quo is the foundation on which you are going to reinvent yourself - not just your training or your "diet". If that works out, patience and perseverance will be the only thing it will take you to eventually arrive, where you see yourselves in your elevator pitch.

Homework for the next installment: Post your elevator pitch

Figure 2: Robb Wolf once mentioned the "performance - health - longevity triple point" in one of his numerous insightful blogposts on his webpage. In essence the figure above expands on his idea: You obviously cannot max out on all of the items. Notwithstanding, all of them are attached to the very same life-style foundation and the practical overemphasis of any of them may have pathological consequence (Adonis complex, depression, drug addiction, obesity, anorexia, ...).

As a  "homework" I want you to fine-tune and post your elevator pitch in the comment section of this post. Not only will you thusly make yourself accountable for what you will feel, look and perform in a few weeks or months from now, you will also help me tailor the next parts of this series, which are going to deal with the actual "programming of success" by making appropriate life-style interventions, to your goals. So don't miss out on this chance and give the world a preview of what the characteristic feature(s) of the "new you" is going to be.

And don't forget, where you came from. Maybe you've just been straying around, because your present elevator pitch incorporates two or more of the partly diametrically opposed extremes in figure 2? Think about it. Have you ever seen an Olympic athlete partying 5 days à week, who goes to bed at 4am has pizza for "breakfast" at 4pm and improves the world record at 8pm? Probably not. So incorporating diametrically opposed extremes into your elevator pitch is about as much a no-go as having none at all, remember that before you go public - I mean, what would the world think if your plan to have french fries instead of the pizza and them perform a new world record fails?

Fat & Fit! Cardio Training Triggers Genetic Switches Which Won't Make you Lean, But Maybe Healthier.

Image 1: Does this remind you of
someone at your local gym? (Image
from Stanford School of Medicine)

As a trained physicist I am more interested in the "why's" than in the "what's". It is old hat that the combination of diet (usually incorporating a moderate caloric reduction) and exercise still is the most promising way to sustainable weight loss and metabolic health. The molecular and genetic underpinnings of their almost magical synergy, however, have still not been 100% elucidated. A recent study (Fu. 2011) from the Tianjin Medical University in Tianjin, China, does now contribute another piece to the complex puzzle that is our metabolism.

Published in the latest issue of the clinical and experimental branch of Metabolism Li Fu and his colleagues report the results of an experiment in the course of which 40 mice were assigned to one out of four intervention groups, two of which exercised on a mouse-treadmill for 60min/d five times per week in the course of the 6 week experiment:

• normal chow + treadmill exercise (NE)
• high fat diet + treadmill exercise (HE)
  
• normal chow + sedentary (NC)
  
• high fat diet + sedentary (HC)
  

The effect of the individual treatments at the transcriptional level, and selected genes were evaluated via oligonucleotide microarray measurements and confirmed by real-time polymerase chain reaction. As could be expected, the data showed "that 6 weeks of aerobic exercise improved the plasma lipid profile and reversed the glucose intolerance" in the high-fat fed mice.

Figure 1: Changes in body weight and blood parameters vs. sedentary control on normal diet
(calculated based on data from Fu. 2011)

Of greater importance, however, are the 503 genes of which the scientists found that they were "differentially expressed in samples of HCmice as compared with those of the NC group". By inter-group comparisons, Fu et al. were able to assign 40 of these genes to the effects of aerobic exercise.

Figure 2: Univariate variance analysis on body weight and plasma parameters (data adapted from Fu. 2011)

As the data (significance values) from a univariate variance analysis in figure 2 goes to show, the high fat diet (HFD) was associated with significant negative (red) effects on body weight, free fatty acids (FFA) and high density lipoprotein (HDL). Aerobic exercise, on the other hand, had beneficial effects on insulin total cholesterol and triglycerides, it did not, however, as so many frantic dieters expect, significantly reduce body weight. Neither did it prevent the HFD induced weight gain and that despite profound effects on the other negative effects of high fat feeding measured in this study.

These results stand in line with observations of Gary O'Donovan and colleagues (O'Donovan. 2011), published in the same journal. In a cohort of 183 nonsmoking white men aged 35 to 53 year O'Donovan and other researchers from the United Kingdom found profound differences in traditional and novel cardiometabolic risk factors (high-density lipoprotein cholesterol, triglycerides, alanine aminotransferase, and insulin resistance) between subjects who were fat and fit (like the exercised HFD mice) and those who were fat and unfit (like the unexercised HFD mice).

Image 2: Check out Johan's
amazing transformation to see
what mind-boggling results
you can achieve.

Taken together, these two studies confirm what many of you probably already knew: Aerobic exercise can ameliorate, yet not reverse, the damage you are inflicting upon your self by bad dietary habits (these are not the same for mice and men! A high fat diet - done properly - does not have to be detrimental to human health). Most importantly, aerobic exercise alone (and compensatory overeating) won't make you lose fat - in combination with appropriate lifestyle changes (note: I do not use the word "diet"!) and muscle building resistance training, it will do both: help you lean out and live a longer and healthier (an probably happier!) life.

The SuppVersity Student Spotlight: Johan Otterström - Learning the "Bitter Truth About Sugar" Cost Johan 120 Pounds of Body Fat and May Have Saved His Life

Image 1: Johan Otterström after
shedding a mind-boggling
120 pound of fat - awesome, man!

I knew, or rather I hoped that you, my dear 'students', would be similarly interested in seeing, how useful all those small pieces of a puzzle, which, somewhere in the distant future, may finally deserve the appellation "exercise and nutrition science", actually are in the hands of someone who understands how to combine them in a way that makes sense for him, as an individual. Nevertheless, I was surprised by the overwhelming and, except for a few of the usual jealousies, positive feedback, Duong Nguyen received.

I am thus especially happy that today, two weeks after the first installment of the SuppVersity Student Spotlight was published, I have another story to tell you: It's the inspiring story of a hungry Swedish kid and his in both senses Super Human (listen to Johan @ Carl Lenore' SHR) transformation from an ailing 330-pounder into the epitome of a physical culturist - Johan Otterström.

The SuppVersity Student Spotlight! I want your stories! You do not have to be as ripped as Duong to inspire others. Maybe you are the admirable former fat guy, who fought off diabetes, the cancer survivor or former anorexic, who is about to start a new healthier life or "just" a geeky physicist like me, who loves the way working out and eating healthy makes him/her feel - whoever you are, tell me your stories and give others the chance to be inspired by your success!

Johan Otterström's 'Fat Approach' to A Fitter, Healthier and Happier Self

Image 2: The "old" 330 pound Johan.Despite working out
and dieting like mad, for each pound he lost, Johan gained
two or more pounds back. It was more than just another diet,
it was a lifestyle change that finally turned things around
and transformed Johan into a walking advertisement
of physical culture.

Looking back, now that I am 44, I must say that I have always had problems with getting too fat. Even when I was still a little child my appetite must have been enormous. At least this is what my mother keeps telling me. Time and again, she had to hurry to get home and prepare my baby formula, because I got so angry from being hungry.

For a major part of his life, hunger was Johan's constant companion

Two years ago I was close to 150 kg or 330 pounds and not exactly happy with the situation. I’m 180 cm tall, which is less than 6 feet, and had, during that time, occasional problems with my heart racing like crazy - scary stuff, but I brushed it off as being related to stress.

I have been working out for almost 20 years, and had really begun to take it seriously over the past 2 years. Even at my heaviest, I was still working out in the gym 5 days a week. I had tried a lot of different diets. Some had even been successful... in the short term, but eventually I always gained the fat back and ended up a few pounds heavier than before.

Until a "bitter truth" dawned on him

Things began to change, when I stumbled onto the a YouTube video called “Sugar the bitter truth”, an excellent presentation about obesity by Dr. Lustig, where he elaborates that the fundamental reason for the western obesity epidemic were high fructose corn syrup (in the US) and plain table sugar, which has almost as much fructose. Taking the same amount fructose as opposed to glucose caused a lot more to be stored as fat.

Video 1: Watching Dr. Lustig's video on the intricate relation of the western obesity epidemic and the ever increasing consumption of sugar in general and high fructose corn syrup, in particular, brought about some 'fat' changes in the way Johan was thinking about the food he ate.

I started eliminating the sugars from my diet and later I found the LCHF diet, which stands for Low Carb High Fat. I was a bit skeptic at first, but I started following this diet and was amazed at how little food I started eating because of the satiety from protein and the high amount of fat, including saturated fats. During the two years I have never counted any calories and have never gone to bed hungry.

Fat and protein finally satisfied Johan's insatiable hunger

After hearing Conelly, Andrich, Lenore, Norton and Dr. Andro talk about the importance of protein on the BodyRX show I gradually increased my protein intake to about 300 grams per day over the last 6 months or so. At first I was worried that I would add on fat but it doesn’t look like that and what's more, my strength is coming back up! Last week started doing 6 raw eggs in my shakes and feel good and full from them.

I have not been so interested in the figures on the scale. The mirror is what will tell you the truth about what's going on with your body, so I check my weight only sporadically. In fact, it has been quite stable during this year. What's amazing though, is that I keep seeing more and more veins popping out, which tells me that I am probably gaining some muscle while loosing some fat, at the same time.

"Checked last week and was now 98 kg on creatine and a week of beer drinking on holiday."

Image 3: The stubborn fat a-
round the midsection is Johan's
body's last line of defense, but I
bet won't take him another two
years to get rid of that.

I probably don't have to tell you that I lost most of my weight during the first year. My goal, right now is to keep the fat off and to gain back the strength I lost - I am not quite there, yet, but I am getting close.

Brief and with perfect form, that's the way Johan enjoys to work out

I usually walk to and from the gym 2 x 20 minutes, that’s the extent of my cardio. I train one body part at the time five times a week in what most people would call a bodybuilding rep-range (8-12), where I try to make the most of the weight, in order to train the muscles, not the tendons and to avoid further injuries. I keep my workouts short (30-35 min, 12-15 sets) and have found that this type of training suits pretty well with low-carb dieting. Furthermore the combination of an active lifestyle, strength training and low-carb dieting makes the arduous and boring cardio sessions many people still think necessary for weight loss redundant.

"I take a hand full of supps year-round and add one or two to experiment with from time to time"

Image 4: While he was first
afraid, it could make him fat,
Johan could not go without
his three whey protein
shakes any more. They
have become a staple to
which he has lately added
two raw eggs, as well.

As far as supplements go, staples of mine are

• 3 whey protein shakes a day,
• some fish oil,
• a basic multi-vitamin,
• one of the standard thermogenic fatburners,
• a preworkout with creatine, and
• 10-20g of BCAAs (10g intra-workout)

Lately, I've been enjoying the good mood from d-aspartic acid (cf. older SuppVersity news on DAA) and started taking a combination of 100 mg DHEA and PES' Erase to keep estrogen at bay - we will see if that will help with shedding the stubborn fat that is still covering my abs. Honestly, I feel like I am one of those "creatine non-responders", but I take it anyhow, primarily because the research on its various benefits, including recovery, is solid.

How to get in touch with Johan: If want to reach out to Johan, to get to know more about him, his training, his supplementation or whether he is married already or would like to go on a date with you, you can do so via Facebook. His screen name - who would have guessed - is Johan Otterström ;-)

Changing your lifestyle will change your self

Everyone can lose weight. To lose fat and keep it off is yet way more difficult. If you make the appropriate lifestyle-changes, the fat will be melting on its on. Your progress will be slow, but steady, and, what's even more important you will find that it is much easier to sustain. Making drastic changes, may not be easy, at first, but I have found that with the low- but not not zero carb diet, I am embracing right now, I don't sacrifice much, for all the benefits I am getting in return.

Lack of Drive? Theacrine Will Get You Going - Every Day! Camellia Kucha Alkaloid Acts via Dopamine and Adenosine

Image 1: Coffee vs. tea, if it comes to the persistent dopaminergic "get going" effect it appears that a hitherto hardly known tea variety, Camellia Kucha has the edge on the #1 average westerner's #1 morning drink.

Caffeine is the #1 drug for anyone looking for that little extra of burst of energy and yet there are people who claim they would kill for their morning coffee, while others swear by having one cup right before bed to keep the blood sugar levels from dropping during the night. Whatever your personal preference may be, it probably did not escape your notice that cup no.10,000 does not exert the same magic as cup  no. 10, decades ago. The reason for that is a pretty rapid habituation effect, the extend of which varies remarkably from person to person.If you do belong to the vast majority of people for whom  the morning coffee has become more of an entrenched habit than an energizer, you will therefore probably be interested in the results of a recent study by Allison A. Feduccia and her colleagues from the Ernest Gallo Clinic and Research Center at the University of California at San Francisco, the School of Life Sciences at the San Yat-sen University in China and the Nutritional Science and Toxicology Department at the University of California (Feduccia. 2012).

Theacrine the non-sensitizing, no-tolerance locomotor activator from Camellia kucha

Feduccia et al. have been able to show that the intra-peritoneal administratoin of the human equivalent of 8mg/kg theacrine (1,2,7,9-tetramethyluric acid) a naturally occurring purine alkaloid with structural similarities to caffeine and established anti-inflammatory and analgesic (=pain reducing), as well as anti-depressant effects (Wang. 2010; Xie. 2009), boosts the physical activity of rodents by more than 130% (note: since i.p. injection have a higher bioavailability you better make the HED 10+mg/kg, if you want to see similar results; this is all the more true, in view of the fact that the lower 4mg/kg equivalent did not produce significant increases in motor activity in the study at hand).

Figure 1: Increase in locomotor activity after intra-peritoneal administration of the 24 or 48mg/kg Theacrine (human equivaled, HED: 4mg/kg or 8mg/kg; data adapted from Feduccia. 2012)

As the data in figure 1 shows the effects, which are mediated via adenosinergic (A1 and A2A) and dopaminergic (D1 & D2) pathways were pronounced yet not statistically significant in the low dose (human equivalent for 80kg ~ 320mg) group and highly significant (p < 0.01 ambulatory distance; p < 0.001 stereotypic counts) in the high dose group.

Nice, but what exactly is the advantage over caffeine?

In order to be able to give you a better idea of the actual effect size, as well as to underline the importance of the fact that even after 7 days of repeated administration, the locomotor activity counts did not change compared to day 1, I plotted data from a similar study on the effects of a low-dose of oral caffeine (HED ~280mg) on the locomotor activity of rats (Ball. 2009).

Figure 2: Ambulatory distance at day 1 and day 4 with and without daily administration of 3.5mg/kg caffeine (Ball. 2009).

As you can see in figure 2 the effects of caffeine are not only less pronounced, the sensitization effect is in fact so pronounced that after only 4 days, the rodents actually needed their daily dose of caffeine to get going - and even with it, their locomotor activity decreased by - 26% compared to baseline. Now compare that to the persistent +167% increase in locomotor activity (likewise measured by ambulatory distance) with theacrine and tell me which one would be more likely to get you through week after week of your demanding day work?

Update (05-20-2012): In response to questions on Facebook and the comment area, here on the SuppVersity, a brief summary of my formerly not mentioned, since unsuccessful attempts to identify whether or not you can buy this tea in the US or Europe. It appears as if, "Kucha" was a certain variety of the assamica variety of camellia sinensis. The latter is very commonly used in black teas, but the "Kucha" variety is probably the one with the highest theacrine content. According to Ye et al. it does contain 1.3-3.6% of the alkaloid in dried leaves - the exact content varied with season and the part of the leaves that was analyzed (Ye. 2003). If we assume a maximal extraction rate of ~80% in hot water, this would mean that a cup of tea brewed with a 2g bag could contain ~20,8-57,6mg of theacrine, which is obviously way too little to be effective. Which would make theacrine a potential candidate for a nutritional supplement - yet probably nothing you can ingest in significant amounts from your diet alone.

References:

• Ball KT, Poplawsky A. Low-dose oral caffeine induces a specific form of
  behavioral sensitization in rats. Pharmacol Rep. 2011 Nov;63(6):1560-3. PubMed
  PMID: 22358105.
• Feduccia AA, et al, Locomotor activation by theacrine, a purine alkaloid structurally similar to caffeine: Involvement of adenosine and dopamine receptors, Pharmacol Biochem Behav (2012), doi:10.1016/j.pbb.2012.04.014
• F. Wang Y, Yang X, Zheng X, Li J, Ye C, Song X. Theacrine, a purine alkaloid with anti-inflammatory and analgesic activities. Fitoterapia 2010;81:627–31.
• Xie G, Wu M, Huang Y, Cao Y, Lai-dong L, He-liangl Z, et al. Experimental study of
  theacrine on antidepressant effects. Chin Pharmacol Bull 2009.
• Ye Chuangxing, Hiroshi A, Zheng Xinqiang, Wang Xiujuan, Gao Kun, Zhang Hongda. New discovery of pattern of purine alkaloids in wild tea trees. Zhongshan da xue xue Bao. Zi ran ke xue ban = Acta Scientiarum Naturalium Universitatis Sunyatseni. 2003, 42(1):62-65

Motivation Trumps Supplementation! Moderate, Starvation Free Weight Loss With Carnitine & Motivational Support

What if one of those would be displayed prominently on every Snickers bar and other candy - would that be unethical?

I must admit that I probably have a positive bias towards the latest study, Satoshi Odo, Koji Tanabe an Masamitsu Yamauchi who work for Lonza a company that describes itself as "a global leader in life sciences" and the Aichi Gakusen University in Japan have just published in the online Journal Food and Nutrition Sciences. Why? Well, it demonstrates the value of education, motivation and making people take responsibility for their own well-being. Something that's still largely unappreciated and maybe even feared by the medical orthodoxy and it's victims... ah, pardon me, "patients", of course.

Words and wisdom trump pills and meal plans

Actually the researchers did nothing we would not have seen in countless of studies before. They recruited 24 male subjects with an, in US terms, pretty low BMI of 25 - 28 kg/m² and a waist circumference of 85-100 cm who had not been following any kind of regular exercise program before the intervention. The subjects were then assigned to one out of four groups:

L-carnitine does also affect IGF-1 levels (read more)

• Car +M: 500mg/day carnitine / no instruction

• Car -M: 500mg/day carnitine / plus instruction

• Pla +M: placebo / no instruction

• Pla -M: placebo / plus instruction

The hypothesis the scientists had in mind was that the motivation program, which comprised (1) a face-to-face 30 min session with the principal investigator at the baseline visit, where the subjects were informed about L-carnitine and its metabolic functions, learned about the beneficial effect of weight loss on the risk of metabolic diseases, and were encouraged to perform daily physical activities like “taking stairs” instead of “using escalators”, (2) wearing a step-counter and evaluating its data on a daily basis, (3) doing a 7-day food log before the intervention began and comparing the latter to a second food log that was to be filled 7 days prior to their last visit at the lab.

"I am so freakin' motivated, but I don't want to eat less..."

All that sounds pretty non-sensical (and I guess there may be a cultural aspect to it, due to which it may be slightly less effective in the US), but the "success" of this "motivational intervention" - as minuscule as it may have been over the course of this 4-week intervention without a prescribed diet / exercise regimen - cannot be denied (see figure 1 & figure 2).

Figure 1: Changes in body composition and daily activity level in the course of the 4-week "intervention" (Odo. 2013)

This is particularly true, if you take into consideration that despite being "motivated to keep daily calorie intake between 1500 and 1,800 kcal", the energy intake of most of the subjects exceeded 2500 kcal/day and did thus not really differ from baseline in figures 1 the scientists also evaluated the effect the dietary / supplement intervention had on glucose and lipid metabolism and found

• 

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  decreased triglyceride levels in Car +M  

• no sign. effect on total cholesterol 
• n.s. increase in LDL in all but the Car +M group  
• no sign. change in HDL  

• non-significant increase in adiponectin in Car +M

• no changes in HbA1c in any group
• significant increases in insulin in the non-motivated groups

And last but not least Odo et al. investigated what they call "safety parameters". Every normal human being would call the latter a standard blood panel, which did, as you would expect, not show and pathological changes (I mean what could exercise and carnitine do to those guys?) and ran a couple of liver and kidney tests, where - and this is interesting - only the non-motivated, non-supplemented group showed a single statistically significant, but physiologically irrelevant change in urea nitrogen levels, which increased from 13.0 to 15.0mg/dL.

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Bottom line: Actually there are two messages you can take away from the study at hand. One is that carnitine works. Taken at a dosage as low as 500mg/day alone yielded in parts borderline, but still significant health improvements in the absence of any prescribed dietary or exercise intervention. The more important message, on the other hand pertains to the effect of the "motivational protocol". Despite the fact that you will probably agree that this was not exactly what should become the "gold standard" for future interventions the mere knowledge of why the subjects were supposed to eat less, make healthier food choices and be more active was enough to make a significant difference. And that irrespective of whether the subjects ended up receiving the carnitine or the placebo supplement.

As mentioned before, there certainly is a cultural bias involved here, but is that reason enough to say: "Wtf, this won't work for Americans anyway!" Should results like this not rather be an incentive to try and change a climate, where people rather wait for the next weight loss drug than to start taking their life into their own hands, before their diabetes has made their fingers so numb that this is no longer possible? I would think so and that's actually part of the reason the SuppVersity and the SuppVersity Science-Round Up on Super Human Radio exist.