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

Are You ABCDE-Deficient? Common Nutrient Deficiencies in the US. Plus: How Food Fortification & New "Daily Values" Affect the Intakes of Vitamin A-E, Calcium Iron & Co

Nutrition labels on fresh blueberries - do we really need them?
I sill remember that I was shocked, when I bought a pack of blueberries and found a nutrition label underneath the plastic cover of my expensive 150g health-investement...

That's probably 2 months ago and the reason I do remember this event now is the publication of a paper that examines the effect a change in the "daily values" (i.e. the references), the figures in the obiquitous black and white table are based on, would have on the average US citizen's nutritional intake of the vitamins A, D, E, C, B-12 and folate, and the minerals calcium and iron.
"Daily Values" (DV), fortified foods and nutrient adequacy: Before I dig deeper into the actual study results, it's probably wise to point out that fortified foods are the link between the DV's and micro-nutrient intake of the average American. If manufacturers continue to fortify foods to the same %DV for each nutrient, the extent to which potential changes in DVs would affect nutrient intake adequacy depends on the proportion of nutrient intakes derived from fortified foods and the magnitude and direction of change in the DV.
According to the data Mary M. Murphy and her colleagues from the National Institutes of Health/Office of Dietary Supplements present in their latest paper, there is still a large gap between the current DV values, which represent the RDAs (recommended daily allowances) from 1968 and have been matched to
"the highest level of intake judged to be adequate to meet the known nutrient needs of practically all healthy persons in a specific age-gender group" (Murphy. 2013)
on the one hand, and supposedly "improved" candidates that could replace them: The population weighed and the population coverage varieties of the RDA & EAR.
  • RDA = the average daily dietary nutrient intake level that is sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals in a particular life-stage and gender group
  • EAR = the average daily nutrient intake level that is estimated to meet the requirements of half of the healthy individuals in a particular life-stage and gender group
As you can see in Table 1 these new recommendations are not - as you may have expected -  significantly higher than the current daily values. If you look closely, you will in fact notice that some of them are significantly lower!
Table 1: Current DVs for select vitamins and minerals and potential DVs based on population-weighted and population-coverage RDAs and EARs. AT,a-tocopherol; DV, Daily Value; EAR, Estimated Average Requirement; RAE, retinol activity equivalent; RE, retinol equivalent (Murphy. 2013).
In the case of vitamin B12 and copper, for example, the difference between the "reformed" recommendations would amount to -50%. The population-coverage RDA for vitamin C, on the other hand, is 50% higher than the old "daily values" (DV) and still more than 10x lower than the 1,000mg of ascorbic acid, of which you may have read on the Internet that it was the bare minimum intake of vitamin C (more about vitamin C).
Figure 1: Percentage of U.S. population aged >4y with dietary intakes below the EAR based on current intakes and assuming
constant %DVs in fortified foods under the current, as well as two potential DV scenarios, i.e. the population-weighed EARs or the population-coverage RDAs become the revised DV values (Murphy. 2013)
Irrespective of the "low" RDA and the high number of fortified foods, ascorbic acid is yet still one of the those micro-nutrients the diets of more than 40% of the US are deficient in. And as the overview in Figure 1 goes to tell you, this would not change, if any of the new RDAs or EARs became the new DVs, so that the amounts of vitamin C in fortified food was adjusted.

Not an improvement by any means

In a more thorough sub-analysis, the scientists observed that the differences in the proportion of the total population with usual intakes less than the EAR would be <2% of 5 out of 8 nutrients (vitamins D, E, and B-12; folate; iron), regardless of whether the policy makers sued the population weighted EARs or the population-coverage RDAs as a basis for the revision of the DVs.

To put it plainy: This means that the micronutrient intake of more then 3 million individuals would still fall below the EAR in the total population (U.S. Census Bureau. 2005).

Even worse, if someone in the upper echolons was bribed.... ah, I mean convinced by the conclusive evidence we have that using the population-weighted EARs instead of the population coverage RDA would be the best thing to do, this would increase the risks of inadequate iron and folate intake in women of childbearing age. Both, iron and folate deficiency, can result in irreversible damage to the unborn child (Scholl. 2000; McArdle. 2013). The same is true for vitamin A (Wallingford. 1986) of which Murphy et al. write that it "was identified as a shortfall nutrient (although intakes are not currently in the category ‘‘of concern’’) for the U.S. population" (Murphy. 2013).
http://suppversity.blogspot.de/2012/11/standard-american-diet-has-optimal.html?spref=fb
"The Standard American Diet Has 'Optimal' Fatty Acid Ratio to Induce Diabesity." | read more
What has to be done? I hope you don't actually want me to answer this question - do you? I mean let's be honest - if people get 17–28% of total intakes of folate, iron, and vitamins A, B-12, and C and 8–12% of calcium and vitamins D and E from fortified foods (this is what Murphey et al. found) and are still deficient, you could obviously argue that we simply have to put even more vitamins and minerals into the nutrient deficient, energy dense junk the average Westerner is shoveling his piehole everyday.

But let's be honest: Wouldn't it be better to kill two birds with one stone by educating people that the stuff they eat is making them fat and sick - no matter how much artificial vitamins the "food" industry is pumping into their highly addictive, revenue-centered high-tech designer products?

References:
  • McArdle, Harry J., Lorraine Gambling, and Christine Kennedy. "Iron deficiency during pregnancy: the consequences for placental function and fetal outcome." The Proceedings of the Nutrition Society (2013): 1-7.
  • Murphy, Mary M., et al. "Revising the Daily Values May Affect Food Fortification and in Turn Nutrient Intake Adequacy." The Journal of nutrition 143.12 (2013): 1999-2006.
  • U.S. Census Bureau. 2005 Middle series data from annual projections of the resident population by age, sex, race, and Hispanic origin: lowest, middle, highest, and zero international migration series, 1999 to 2100 (NP-D1-A). Washington: Department of Commerce; 2000 [cited 2012 Jun 16]. Available from: http://www.census.gov/population/www/projections/natdet-D1A.htm 
  • Scholl, Theresa O., and William G. Johnson. "Folic acid: influence on the outcome of pregnancy." The American journal of clinical nutrition 71.5 (2000): 1295s-1303s.
  • Wallingford, J. C., and B. A. Underwood. "Vitamin A deficiency in pregnancy, lactation, and the nursing child." In: Bauernfeind JC, ed. "Vitamin A deficiency and its control." New York: Academic Press, 1986:101–52.

Calcium, Magnesium, Potassium & Co in Food, Water & Supps - Getting Enough is Easy, Knowing How Much Is Not!

Image 1: "Minerals? Yeah that's the stuff you need to avoid cramping" While this is certainly true, the mineral loss during "normal" workouts is largely overblown, the most important and actually only necessary ingredients in respective drinks, even for Ironman Triathletes, are salt, water and sugar and what's worse this prejudice conceals the importance of electrolytes for our general health.
While it is Thursday, it is plain to see that this is not Adelfo Cerame's weekly SuppVersity post. There have been a couple of issues with the promised workout videos and neither I nor Adelfo wanted to postpone them yet another week so that we decided to rather publish videos + Adelfo's weekly update tomorrow instead of a reduced snippet today. To make sure you have more than enough food for thought to bridge the time, I applied a coupe of tweaks to a longer snipped from the next installment of On Short News that dealt with the protective effects of high(er) intakes of calcium, magnesium and potassium on the incidence of vascular dementia (=dementia in response to low blood flow to / oxygenation of the brain) and Alzheimer's dementia (=dementia due to the build up of plaque in the brain). As you may already have seen, the result got somewhat epic, so let's not waste anymore time and get straight into the original data before it's too late and we have already become demented ;-)

Don't forget your minerals or they'll soon be just one of the many things you tend to forget

While the studies and reviews on the effects of minerals, especially calcium (and as of late also magnesium), on cardiovascular health is about as abundant as the assessments of their individual and joint benefits and / or pitfalls, their role in the etiology of another, quieter, but not less prevalent pandemic is still insufficiently studied. Against that background, the results Ozawa et al. present in a recently published paper in the Journal of the American Geriatric Society could well provide some novel insights on whether or not forgetting to keep an eye on your mineral intake now will make you forget more than just a couple of minerals in the more or less distant future - and that even if none of the 1081 community dwelling elderly (>60y) Japanese the scientists followed up for 17 years is even remotely related to you ;-)
Figure 1: Hazard ratios for all-cause, vascular and Alzheimer's dementia for patients in the lowest to highest quartiles of potassium (≤1,856 / 1,857–2,149 / 2,150–2,559 / ≥2,560), calcium (≤431 / 432–531 / 532–638 / ≥638) and magnesium (≤147 / 148–169 / 170–195 / ≥196) intake in mg/day (top) and difference in intake of selected foods in the highest vs. lowest quantile of overall mineral intake (bottom; all calculated based on Ozawa. 2012)
Aside from the general association of higher potassium, calcium, and magnesium intake with lower incidence of dementia, which was - given the overall low median intake - more or less to be expected, there are a couple of other very noteworthy things I want you to take note of (see figure 1; data adjusted for age; sex; low education; history of stroke; hypertension; diabetes mellitus; total cholesterol; body mass index; smoking; alcohol intake; regular exercise; and energy, vitamin C, cholesterol, saturated fatty acid, monounsaturated fatty acid, and polyunsaturated fatty acid intake):
  • a higher mineral intake was had a more pronounced beneficial impact on vascular compared to Alzheimer's dementia (-77% vs. -46% max. reduction)
  • for potassium and calcium the general rule of thumb is "the more, the better" (the deviation from that rule in the individual analysis for Alzheimer's is statistically nonsignificant), but I don't this is mediated by the overall low intake of both and thus only valid within the given range of ~700-900mg of calcium and ~2600-3000mg of potassium - intakes you can by the way easily get from your diets alone
  • aside from the usual suspects, i.e. (green) vegetables, fruits and fish, dairy is among the most important source of minerals and high dairy eaters tend to be high mineral consumers, while low / no dairy eaters tend to be in the lowest quartiles of overall mineral intake
as well as a couple of things you cannot read off the graphs, e.g.:
  • women had  significantly higher mineral intakes than men, i.e. 68.3% of the persons in Q4 for overall mineral intake were women
  • age had no effect whatsoever on the overall intake of potassium, calcium and magnesium
  • a low(er) education (<6 years of schooling) was a good predictor of low total mineral intakes, just as it is by the way in view of an overall worse diet quality (this is however less pronounced than conventional wisdom would suggest)
  • intriguingly, people with diabetes had on average higher mineral intakes than people without diabetes, almost certainly a non-causative relationship that is probably mediated by supplements and nutritional counseling the diabetics received
  • contrary to the US, there was no association between high salt and low Ca, Mg, or K intakes, this is also surprising because the "average" middle aged Japanese consumes way more than 5g of salt (Nagata. 2004) and thus 2x more than the US "tolerable upper intake level" of 2300 mg (Cogswell. 2012)
Apropos US, in view of a couple of other studies that have only recently provided support for the widely held, but in fact rarely scrutinized believe that, the lack of adequate amounts of potassium and magnesium, in particular, is associated not only with the age-related cognitive decline and even dementia, but also with such profane things as "simple" obesity, e.g. ...
  • Donfrancesco et al. report higher potassium and magnesium intakes were associated with lower BMIs in 1168 men and 1112 women aged 35-79 yrs from 12 Italian regions (Donfrancesco. 2012)
  • almost identical results in a study by Shay et al. that found associations with lower BMIs for potassium and magnesium 1794 men and women (ages 40-59 y) from 8 US population samples (Shay. 2012)
... it would unquestionably make sense to eventually stop bashing on sodium and start promoting the consumption of magnesium- and potassium-rich foods, instead.
Figure 2: Percentage of the population mineral intakes below the EAR for individuals aged ≥2y (data from NHANES 2003–2006; n = 16,110; Fulgoni. 2011).
Did you know that according to latest data from the CDC (Cogswell. 2012) less than 2% of US adults meet the dietary recommendations for potassium (≥4700 mg K/d) and that the lack of potassium was even more pronounced in the elderly (0.5% of the >72y-old US citizens meet the dietary requirements) and obese (0.7% meet the recommendations. With two out of five Americans also failing to meet even the required amount of magnesium in the diet, it appears more than questionable why the good-meaning (I don't doubt they are but too often they are mislead of have the good of the wrong people in mind) policy makers don't put magnesium and potassium into the water supply instead of toxic junk such as chlorine and fluoride...

I mean, you will probably remember from "On Short News on July 28, 2012" that each milligram of magnesium per liter drinking water could decrease the heart disease risk of people with an unbalanced mineral intake by 5%! But, alas, who am I to make such bold suggestions?
Now, while the importance of watching your dietary magnesium and potassium are pretty obvious and probably nothing you have not heard before, there is still one question left to be answered - a question that will point us away from RDAs and EARs and back to foods, which never contain only one of the aforementioned minerals in isolation. So here is the question: What do we make of calcium? In the Ozawa study it appeared to be clearly useful, but that was with intakes of >638mg/day in the highest quintile of the study population! The average European citizen, on the other hand, consumes roughly 1g = 1,000mg, i.e. 36% more than the Japanese and still we (us Europeans) are about as sick, if not sicker than the average Japanese? How come?  

Potassium, check; magnesium, check; calcium, ... wait a minute! What about phosphorus? 

Aside from the mere possibility that we could already be consuming way too much calcium (which is not supported by science as long as those 1,000mg come from your diet and not from supplements; cf. "Higher Calcium Intake Greater Fatty Acid Oxidation"), the most straight forward explanation would be an imbalanced intake of phosphorus. For the average European the latter is at about 1,675mg/day (mostly from dairy, cereals and meats - 27.9, 23.4, 17.4.% of daily intake, respectively) and thus clearly twice the amount our (the European) version of the well-meaning policy makers are telling us each and every one of us should be consuming on a daily basis.
Figure 4: Relative potassium intake in European countries according to source; note: with 4,110mg/day the average potassium intake in the Euopean Union is much higher than in the US, highest intakes were observed in Spain, lowest in Germany (Welch. 2009)
Did you know that the average magnesium intake in Europe (409mg/day) is much higher than in the US? And guess what, the usual suspects, i.e. dairy and cereals aside, non-alcoholic beverages are the #2 source (19% of total mg intake) of dietary magnesium in Europe! I would, an observation Welch et al. attribute just like the almost "optimal" (wrt to the US recommendations) average potassium intake of 4,110mg/day to the high quality tap and bottled mineral water, and other non-alcoholic beverages (and certainly not to reverse osmosis or the consumption of mineral-free distilled water, which is something you can use to satisfy the water requirements of your radiator or  iron, but not those of your body ;-).
Figure 3: Hazard risk analysis based on the Cholesterol and Recurrent Events (CARE) study (n = 4127; Tonelli. 2005)
In fact, we have broached on another of these imbalances in the context of the effects that were observed with higher magnesium : calcium ratios in drinking water (cf. red box above + "On Short News on July 28, 2012"), before. With phosphor we have yet another "antagonistic partner" of calcium, of which Ritz et al. have only recently argued that its increasing use as a food additive (check out the label of whatever processed food you buy, chances you find a XZY-phosphate on it are >50%) poses a serious health risk. To support their argument, the researchers cite data from a 2005 study by Tonelli et al. that indicates that even serum phosphor levels that are well within the normal range (2.0-4.0mg/dl) were associated with significantly increased CVD risks (cf. figure 3; suggested read: "Does Low Vitamin D Protect Us From Dietary Phoshporus Overload?").

These are only two selected examples of the available evidence that suggests that we are still totally underestimating the effects of "electrolytes", in general, and their ratios, in particular, on our neurological and metabolic health - and, even worse, doctors, policy makers, experts and gurus keep making mostly unwarranted recommendations to increase our intake of one and decrease the intake of another mineral, when in fact the lack of synergists (e.g. normal amounts of dietary magnesium to complement calcium) and absence or abundance of antagonists (e.g. potassium and magnesium for salt and calcium, magnesium and potassium for phosphorus) are the actual problems we are dealing with.
Figure 5: Don't forget that there are personal, regional and historical difference in total and relative mineral intakes and never supplement, high amounts of isolated minerals simply because Mr or Mrs average would benefit, without checking how "average" you actually are in terms of your solid, fluid and supplemental mineral intake (data for image based on Crawford. 1971; data on US water hardness according to the Water Research Center)
Implications: I guess based on all the information on the allegedly complicated interactions between the different minerals, you will by now have realized that statements like "everybody will benefit from taking 300mg of supplemental magnesium" let alone "everybody must take at least 300mg of supplemental magnesium" are about as useful as the constant advice to cut your salt, cut your fat and cut your calories people are confronted with on a daily basis. The chances that person X may benefit are probably high, but they are certainly much lower than the chances that you will survive the sting of a bee - and even that will still kill 53 US citizens per year.

Individualization, evaluation are therefore obligatory steps which must necessarily come before supplementation, which would - as some of the data in the figure 4 did already suggest - rarely be necessary, if the average inhabitant of the Western hemisphere did not top his sugary, salty and phosphate-laden fast-food diet with beverages that are either devoid of any minerals or will simply exasperate the existing imbalances.

Too many people (and I believe this is particularly true for the US) seem to have forgotten that we have not always been forced to filter all the minerals out of our water just to make the chlorinate, fluorinated, and "estrogenated" sludge that streams out of the faucet suitable for human consumption. Think of that and the data in figure 5, the next time the as of late often second-guessed recommendation that you got to have "at least X cups of water per day" resurfaces and of how little use each of them is, when it does not contain any of the electrolytes your body needs to handle the water appropriately.
References:
  • Cogswell ME, Zhang Z, Carriquiry AL, Gunn JP, Kuklina EV, Saydah SH, Yang Q, Moshfegh AJ. Sodium and potassium intakes among US adults: NHANES 2003-2008. Am J Clin Nutr. 2012 Aug 1. 
  • Crawford MD, Gardner MJ, Morris JN. Cardiovascular Disease and the Mineral Content of Drinking Water. Br. Med, Bull. 1971; 27,1: 21-24.
  • Donfrancesco C, Ippolito R, Lo Noce C, Palmieri L, Iacone R, Russo O, Vanuzzo D, Galletti F, Galeone D, Giampaoli S, Strazzullo P. Excess dietary sodium and inadequate potassium intake in Italy: Results of the MINISAL study. Nutr Metab Cardiovasc Dis. 2012 Jul 24.
  • Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54.
  • Ozawa M, Ninomiya T, Ohara T, Hirakawa Y, Doi Y, Hata J, Uchida K, Shirota T, Kitazono T, Kiyohara Y. Self-Reported Dietary Intake of Potassium, Calcium, and Magnesium and Risk of Dementia in the Japanese: The Hisayama Study. J Am Geriatr Soc. 2012 Aug 2. 
  • Ritz E, Hahn K, Ketteler M, Kuhlmann MK, Mann J. Phosphate additives in food--a health risk. Dtsch Arztebl Int. 2012 Jan;109(4):49-55. Epub 2012 Jan 27. 
  • Shay CM, Van Horn L, Stamler J, Dyer AR, Brown IJ, Chan Q, Miura K, Zhao L, Okuda N, Daviglus ML, Elliott P; for the INTERMAP Research Group. Food and nutrient intakes and their associations with lower BMI in middle-aged US adults:  the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP). Am J Clin Nutr. 2012 Aug 1. 
  • Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G; Cholesterol And Recurrent  Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005 Oct 25;112(17):2627-33. 
  • Water Research Center. Hard Water  Hardness Calcium Magnesium - Water Corrosion Mineral Scale. < http://www.water-research.net/hardness.htm > retrieved Aug 16, 2012.
  • Welch AA, Fransen H, Jenab M, Boutron-Ruault MC, Tumino R, Agnoli C, Ericson U, Johansson I, Ferrari P, Engeset D, Lund E, Lentjes M, Key T, Touvier M, Niravong M, Larrañaga N, Rodríguez L, Ocké MC, Peeters PH, Tjønneland A, Bjerregaard L, Vasilopoulou E, Dilis V, Linseisen J, Nöthlings U, Riboli E, Slimani N, Bingham S. Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr. 2009 Nov;63 Suppl 4:S101-21.

Ask Dr. Andro: Are There NO Changes in the New N.O.-Xplode 2.0 Advanced Strength Formula?

The official SuppVersity Supplement Shoot-Out!
The longstanding veteran, NOXplode AVPT,
is challenged by a clone of its own, 
NOXplode 2.0 Advanced Strength -
which will be the last pre-workout standing?
Question Dr. Andro: What the... is BSN trying to scam costumers? At first sight the labels of the old and the new Advanced Strength version of N.O.-Xplode seem to be absolutely identical.

Answer Dr. Andro: I am usually not soliloquizing, but in this case I thought that many of you may have had the same thought, when they spotted the new(?) BSN N.O-Xplode 2.0 - Advanced Strength in the "new products" column of their favorite supplement vendor: a lot of boastful claims in the product description, but no eye-catching changes in the actual formula.... Reason enough to devote a few hours of my precious time to scrutinize the labels of the old N.O.-Xplode AVPT and the purportedly "new" N.O.-Xplode 2.0 Advanced Strength.


N.O.-Xplode AVPT vs N.O.-Xplode 2.0 - Fight!

Well, let's start with the most obvious. The packaging got redesigned! I would not mind, but actually I find the new "darker" design looks a little cooler... well, I guess the ugly blue "now 25% more" sticker was bordering unfair competition, anyway. After all, BSN has been selling this "value" *lol* edition of the AVPT version of NOXplode for years now. So, if you are looking for a nice-looking addition to your supplement stash and red is your favorite color, the new BSN NOXplode 2.0 container could be just what you've always been waiting for  :-)

If, on the other hand, you are more interested in the content of the fancy new container, I suggest you follow my lead, click at the image above and have a look at the labels... let's see, what have we got here?

The basics - Calories, Carbs, Vitamins and Co.

The FDA approved nutritional information is the part of the label that - the information on the carb content aside - will interest people the least, I guess. Nevertheless, I had hoped to see improvements in the types of vitamins the guys from BSN used. An adequate dose of methylcobalamine (B12), some pyridoxal-5-phosphate instead of the inactive pyridoxine HCL, we are bombarded with in all protein containing supplements, anyways, and some active methyl-tetrahydrofolate instead of the folic acid that the FDA is forcing upon you in each in every foodstuff you eat, would have been nice, yet obviously too expensive improvements (cf. table 1)

AVPTNOXplode2.0Dr. Andro's thoughts
Total calories25kcal25kcalidentical
Total carbs6g6gidentical
Total sugars0g0gwtf! As if a glucose polymer was no sugar
Vitamin B6 from pyridoxine HCL25mg20mginstead of reducing the amount BSN had better invested in some P5P, the bioactive version of pyridoxine
Folate from folic acid400mcg300mcgobviously someone @BSN got wind of the studies which show that the cheap folic acid (in excess) does more harm than good... I guess you know why they did not replace it with a reasonable dose of the active methyl-tetrahydrofolate
Vitamin B12 from cyanocobalamine120µg120µgidentical, but still not absorbable (cf. "Want B12? Drink Milk")
Calcium from Calcium Phosphate75mg75mgidentical & insignificant
Phosphor from various phosphates535mg200mgsomeone got wind that the average Western diet already contains way too much phosphate and that the phospates in the original formula were the reason for diarrhea in some people
Magnesium from various phosphates360mg60mgin view of the lack of magnesium in typical Western diets, the higher dose in the old formula was better - as long as your stomach could tolerate it ;-)
Sodium from various phosphates 235mg300mgwell, isn't that great? Cut down magnesium, ramp up sodium... I guess its more stomach friendly, but is it also healthier?
Potassium from various phosphates75mg75mgit is unfortunate and ridiculous that the FDA does not allow more than this amount per serving
Table 1: Comparison of the fundamental nutrients, vitamins and minerals in the formula
(based on nutritional information from BSN and a major online vendor)

The Problem... ahh, I mean "Proprietary" Blend ;-)

Now, things are getting a little complicated. How do you evaluate a supplement where you know that something is in there, but have no clue in which amount? Well, I guess this would not matter if we were talking about the FDA-invented difference between sugar and glucose polymers (isn't it interesting that the FDA let's the supplement companies make a difference, here?), it is however of tremendous importance to know whether the undisclosed overall amount of the AVPT or ASPM (Advanced Strength & Performance Matrix) part of the 18.0g and 19.6g proprietary blend in NOXplode AVPT and NOXplode 2.0 Advanced Strength contain 90% or 30% glucose polymers. With the latter being the first ingredient on the label, we can only be sure that it is the major ingredient in this part of the formula and since we know that we get 6g of non-sugar carbs, there probably is little room for the additional working ingredients in this part of the formula, anyway.

I hope you understand the problem we are facing here. The one (and only) thing, we can do, is to compare the order in which the ingredients are listed (the latter complies to the relative amount of the individual ingredient, with those ingredients with the highest amounts being listed first) and evaluate whether the changes BSN has made in terms of the specific ingredients and their ratios do make sense.


AVPT NOXplode2.0Dr. Andro's thoughts
Total weight of proprietary blend18.0g19.6gthis means that BSN has generously rounded up the +1.6g diffrence in what they advertise as "2 more grams of active ingredients" (cf. BSNOnline)
N.O. Meta-FusionL-Arginine AKG, L-Citrulline Malate, RC-NOS™ (Rutacarpine 95%), L-Citrulline AKG, L-Histidine AKG, NAD (Nicotinamide Adenine Dinucleotide), Gynostemma Pentaphyllum (Leaves & Stem) (Gypenosides 95%)L-Arginine-Alpha Ketoglutaric Acid, L-Citrulline-Malic Acid Interfusion, L-Citrulline-Alpha Ketoglutaric Acid, L-Histidine-Alpha Ketoglutaric Acid, NAD (Nicotinamide Adenine Dinucleotide), Gynostemma (90% Gypenosides) (Leaves & Stem)BSN has removed the rutacaropine, which induces vasodilation via CGRP (Duan. 2007) and added a lower amount of l-histidine AKG which does of course figure in the generation of NO, but has of yet not been shown to independently induce vasolidation; maybe the BSN-guys thought it would fit well with the (probably) extended amount of beta alanine, since β-alanyl-L-histidine, i.e. carnosine is what we actually want
AVPT / ASPMModified Glucose Polymers (Maltodextrin), Di-Creatine Malate, Trimethylglycine, Creatine Ethyl Ester -Beta-Alanine Dual Action Composite (CarnoSyn®), Sodium Bicarbonate, Sodium Creatine Phosphate Matrix, Creatinol-O-Phosphate-Malic Acid Interfusion, Glycocyamine, Guanidino Proplonic Acid, Cinnulin PF® (Aqueous Cinnamon Extract) (Bark), Ketoisocaproate Potassium, Creatine AAB (Creatine Alpha-Amino-N-Butyrate)Modified Glucose Polymers (Maltodextrin), Beta-Alanine (CarnoSyn®), Di-Creatine-Malic Acid Interfusion, Betaine HCL, Sodium Bicarbonate, Creatine-Sodium Phosphate Matrix, Creatinol-O-Phosphate-Malic Acid Interfusion, Glycocyamine, Creatine Ethyl Ester HCL, Guanidino Propionic Acid, Cinnamon Extract (Bark) (Cinnulin PF®), Ketoisocaproate Potassium, Creatine-Alpha-Aminobutyric Acid Matrix (Creatine AAB™)the same fancy creatines without any substantial research supporting their superiority over creatine monohydrate as in AVPT (personally I see no reason to boast with the slogan "no creatine monohydrate", after all CM is the only form of creatine that has proven in scientific studies time and again that its working!); it seems, though, as if the beta alanine content increased - while this would be a good thing, its mere speculation based on its position within the list of ingredients in the proprietary blend; why BSN replaced the 'real' betaine (trimethylglycine) with the 'digestive aid' betaine HCL eludes me
Ener-Tropic Xplosion™L-Tyrosine, Taurine, Glucuronolactone, Methylxanthine (Caffeine), L-Tyrosine AKG, MCT's (Medium Chain Triglycerides)[Coconut], Common Periwinkle Vinpocetine 99%, Vincamine 99%, Vinburnine 99% (Whole Plant)L-Tyrosine, Taurine, Glucuronolactone, Methylxanthine (Caffeine), L-Tyrosine-Alpha Ketoglutaric Acid, MCT's (Medium Chain Triglycerides), Lesser Periwinkle (95% Vinpocetine, 98% Vincamine, 98% Vinburnine [Whole Plant])BSN is trying to trick you on this one by just using a different name for the same ingredient - the common and the lesser periwinkle denote the same plant, the only difference is that the purportedly improved NOXplode 2.0 contains an inferior extract
Phospho-Electrolyte Replacements / CompositeDi-Calcium Phosphate, Di-Potassium Phosphate, Di-Sodium PhosphateDi-Calcium Phosphate, Di-Potassium Phosphate, Di-Sodium Phosphateits telling that the "replacement" in the AVPT became a "composite" in NOXplode 2.0 - I already alluded to the inferior mineral composition of the "new" version in table 1
Glycerol Hydrating Polymers™ / Glycerol Polymer ComplexPotassium Glycerophosphate, Magnesium Glycerophosphate, Glycerol StearatePotassium Glycerophosphate, Magnesium Glycerophosphate, Glycerol StearateI suppose BSN changed the name to "polymer complex", because it sounds way more sophisticated; in fact, its the same stuff as in the AVPT version
Table 2: Detailed analysis and comparison of the ingredient profile of the proprietary blends of NOXplode AVPT and NOXplode 2.0 Advanced Strength (based on nutritional information from BSN and a major online vendor)
As you can see from the juxtaposition of the ingredient profiles in table 2, the changes are mediocre at best and the potential increase in the beta alanine content is the only improvement I can find... what about you?

Conclusion - Love It or Hate It!

I guess, some of you are expecting me to rip BSN's marketing coup apart. Well, I guess I could, but let's be honest, obviously there was and still is a huge amount of trainees out there who loved the old formula and kept buying it even when everybody told them that arginine was not working, the new XY was all the rave and their first generation pre-workout would not be worth the cost of its container. In case you are one of those patrons who made the old NOXplode the best-selling preworkout supplement of all times, chances are you will like its almost identical twin, as well. If, on the other hand you, you hated the old version and/or are satisfied with your current pre.workout regimen, I see no reason to invest the 35.99$ into a professionally redesigned redesigned red plastic container.

Profitable Revelation! Inhabitants of the Affluent Western Hemisphere Don't Meet "Their" RDAs For Important Nutrients. "Scientists" Call to Action, I Call to Calm Down.

Image 1: Nothing sells like FDA-approved supplements and federally supported fortified foods. And whenever you want to sell more snake oil, just pay for another study on "nutrient deficiencies"
There are two things you can shovel truckloads of money with in the realms of dietary supplements and convenience foods. Those are dreams, such as the dream of a lean and muscular physique and FDA approved but for customers non-verifiable promises of  the absence of future ailments. And while such profane things as wanting to get big and buffed or even simply "looking good naked" is looked down upon by the majority of average Joes and Janes (I don't want to go into the underlying psychological reasons here ;-), the use of the latter is generally regarded as a useful if not necessary means that will not just help us preserve our health, but will also sooth our guilty conscious of not being able to break ourselves of our bad dietary habits. Against that background it's good that we have such great scientists and policy makers who will base their wise decisions on totally unbiased and all-encompassing scientific data from research teams such as as the one from DSM Nutritional Products Limited in Kaiseraugust, Switzerland, and Parsippany, NJ, USA (Troen. 2012).

On average, we are all the same, right!? Our governments obviously don't think so...

Morover, the decisions of those policy makers are not just rooted in science, they also hold another, maybe even more important good in highest esteem: Equality! And though, equality is one of the principles the Western civilization often boasts of, it seems as if when it comes to our dietary "needs", as defined by the individual dietary guidelines, you, my mostly American friends, must be somewhat different.
Figure 1: Reference intakes for selected vitamins in Germany, UK and the Netherlands expressed relative to the US RDA (data based on overview in Troesch. 2012)
This would at least be the logical conclusion you would have to draw based on the in parts pronounced differences between German and US RDAs (see figure 1), which would suggest that my I need ~30% more vitamin D than you do, while our friends in the UK either don't need it at all or cannot agree on a reference intake and my neighbors to the West, must assume that they get more than enough vitamin D from sunbathing at the beaches of the North Sea to get away with only 100IU of vitamin D per day; and their low recommendations for vitamin E are probably based on the rationale that they traditionally use beef fat instead of vegetable oils to fry their fries *rofl*

You are deficient, my friend! Go get your fortified foods ans supplements, NOW!

Now, as funny as that may seem, in the end these discrepancies only underline three fundamental problems that are rarely addressed when scientists analyze data to finally get to the (nutritional) root course of modern disease:
Want to learn about where you stand in terms of the RDA?

I got some help from my friends over at Highbrow Paleo, who felt the following tools are particularly helpful to estimate or calculate your daily micro- and macronutrient intakes:
You know that I am not a big believer in logging your food intake and making calories in vs.calories out calculations. So, for your own psychological well-being try not to get addicted to these tools only to end up as yet another food neurotic on certain bulletin-boards ;-)
  1. the RDAs are more or less arbitrary - While we do know pretty certain which dosage of a certain nutrient is vitally important, when everything else, i.e. nutrition, exercise, stress, etc. is "normal" (whatever that may be), we have almost no clue how deficiencies, let alone the overabundance of one nutrient affect the need / optimal intake of another. A good example here would be calcium - one of my favorites, by the way: While we are stuffing our elderly (in particular women) with calcium supplements to "protect" their bones with little success, Dawson-Hughes et al. have shown in 2009 already that you can effectively reduce bone resorption, i.e. the leeching of calcium from the bones, by supplemental potassium bicarbonate, while just throwing more calcium and vitamin D at older men and women will at best increase renal calcium excretion, at worst lead to kidney stones and vascular calcification (Dawson-Hughes. 2009)
     
  2. the RDAs are light years are usually one or two decades behind contemporary science - Despite being an outspoken critic of the current vitamin D hysteria, the absence of a concrete RDA for vitamin D in the UK is just one of the most obvious examples of how the endless discussions of top-class experts lead to an grossly negligent gap between the latest results from scientific research (which in and out of itself often take months to be published and years or decades to be accepted) and their concrete implementation into the guidelines.
     
  3. the RDAs lack any regard of individuality or specificity - although the different RDA's in the USA, Germany, the UK and the Netherlands would suggest otherwise, you are all identical clones of an imaginary average Joe or Jane for the policy makers; and as if that was not enough, the same applies for the nutrients as well: "Vitamin A? Yeah, that's beta carotene, right?" And vitamin A vs. carotene (even alpha vs. beta caroetene) is only one of the many examples (others are folate vs. folic acid; alpha tocopherol usually equated with "vitamin E" vs. gamma-tocopherol, let alon the tocotrienols, etc.), for which we know by now that lumping them together under common names, can easily lead to imbalances with pathological consequences.
Against that background my rationale for posting the following data on what scientists believe Mr. and Mrs. average US/UK/GER/NL citizen are missing out on and of which nutrients they may in fact get plenty is to create an incentive to take a couple of minutes and plug your own food data into one of the countless free online devices (see red box above for some references) to see where you as an individual are standing - and I bet, the majority of you will see results that are fundamentally different from those Troesch et al. summarize in their paper:
  • Vitamin D: Irrespective of whether or not you believe that it does make sense to consume the lion's share of a "vitamin" that is supposed to be produced in your skin and is thus, due to its actions on almost every cell of your body, essentially not a vitamin, but a hormone, it is somewhat alarming that even in the Netherlands, where the RDA is hilarious 100IU 5-25% of the men and 25-50% of the women fail to achieve their recommended daily allowance - 2 1/2 large egg yolks alone would provide them with more than that! With the higher RDA's in Germany and the USA, the percentage of people who do not meet their daily allowances is >75%!
  • Vitamin A: I am by no means surprised that vitamin A is not mentioned in the scientists mini-summary in the abstract. After all, it's bad for you! Right? No... freaking, no! And it's certainly likewise not good for way more 75% of the US citizens not to meet their RDAs for vitamin A and that despite the fact that the scientists lumped all "vitamins A" together! In the Netherlands and the UK, ~50% have an adequate intake and over here in Germany only 25-50% of my the average Joes and Janes are below their RDA cut-off, which could, just as the vitamin D problem by the way, readily be solved by eating a piece of liver from time to time. Some fatty fish, eggs and of course vegetables on a daily basis would yet serve the same purpose and would, which may turn out to be of even greater importance deliver a very balanced spectrum of various forms of pre-vitamin A (carotenes) and retinol.
  • Figure 2: Changes in reasoning behind supplement use in 2010 (French. 2011)
    Folic Acid and other B-vitamins: An interesting observation can be made for the B-vitamins, where the citizens of the land of both fast food and eager food-intoxi.... ah, I mean "fortification" (obviously the US) appear to be way better off than their poor fellows in Europe. Especially here in Germany, we should really wonder that we are not much sicker than you, after all, not all our products are enriched with high amounts of bio-unavailable folic acid so that we more than 75% of us do not meet our RDAs for this unquestionably important, but in its unnatural supplemental form not very controversial vitamin. In 2006, for example, Troen et al. report reduced immune function from excess folic acid build-up in the blood of post-menopausal women (Troen. 2006) and Halsted reports in a more recent paper that the "widespread use of supplemental multivitamins" in conjunction with the "fortification of the US diet with folic acid has resulted in high serum ... "[...] folate levels in much of the population" (Halsted. 2008)
    high folate levels that have been associated with increased risk of cognitive decline in aging people with low vitamin B12 status, decreased natural killer T-cell immune function and increased risk of recurrent advanced precancerous colorectal adenomas and breast cancer" (Halsted. 2008)
    Against this background it should be allowed to ask, whether the "average American" with his "adequate" (>95%!) folic acid intake really is better off than the "average German" who is unlikely to get his RDA of folic acid (>75%). 
For the scientists who (surprise!) happen to work for DSM Nutritional Products Ltd., the observations they present in form of stylized "traffic lights", with all those yellow and red "lights" signifying impeding danger and the need to take action, suffice to conclude that there is not just a gap "between vitamin intakes and requirements for a significant proportion of the population even in the most affluent countries", but that the latter would also be "a call to action 100 years after the term 'vitamine' [sic!] was coined" (Troesch. 2012)
If this post got you interested in an in-depth look at nutrient fortification its uses, abuses, benefits and downsides, I suggest you check Paul Jaminet's article on the issue at his "Perfect Health Diet Blog" (Jaminet. 2012). It would be pointless for me to repeat what Paul has already laid out in his concise and - as us physicists like it - well-referenced summary ;-)
And while Mrs Troesch and her co-authors do not state that explicitly, it should be obvious what this "call to action" will amount to... !? Right! More nutrient "fortified" foods and more randomly assembled multi-vitamin products, instead of less junk and more health (=real) food in everyone's diet.

References:
  1. Dawson-Hughes B, Harris SS, Palermo NJ, Castaneda-Sceppa C, Rasmussen HM, Dallal GE. Treatment with potassium bicarbonate lowers calcium excretion and bone resorption in older men and women. J Clin Endocrinol Metab. 2009 Jan;94(1):96-102.
  2. Halsted CH. Perspectives on obesity and sweeteners, folic acid fortification and vitamin D requirements. Fam Pract. 2008 Dec;25 Suppl 1:i44-9. Epub 2008 Sep 30. Review. 
  3. Jaminet, Paul. Food Fortification: A Risky Experiment? PerfectHealthDiet.com. March 23, 2012 < http://perfecthealthdiet.com/2012/03/food-fortification-a-risky-experiment/ > retrieved on June 18, 2012.
  4. French S. Natural Marketing Institute. The US Botanical Market: Latest Consumer Insights. Natural Marketing Institute. March 2011.
  5. Troen AM, Mitchell B, Sorensen B, Wener MH, Johnston A, Wood B, Selhub J, McTiernan A, Yasui Y, Oral E, Potter JD, Ulrich CM. Unmetabolized folic acid in plasma is associated with reduced natural killer cell cytotoxicity among postmenopausal women. J Nutr. 2006 Jan;136(1):189-94.
  6. Troesch B, Hoeft B, McBurney M, Eggersdorfer M, Weber P. Dietary surveys indicate vitamin intakes below recommendations are common in representative Western countries. Br J Nutr. 2012 Jun 13:1-7.

Ketogenic Dieting and Vitamin & Mineral Imbalances!? Differential Effects of Classical Ketogenic and Medium Chain Triglyceride Ketogenic Diet on Vitamin and Mineral Status in Children

"Keto diets are unhealthy! You simply do not get enough quality nutrients if you do not eat your healthy pasta, bread and other starchy carbs." I suppose many of you - just like me - cannot tolerate the black-and-white thinking of either of the two, the high or the low/no carb camp and are thus as interested in the recently published results from a 12 month dietary intervention using either a classical ketogenic diet (Christodoulides. 2011), which uses long chain triglycerides as its primary source of fatty acids, or a medium chain triglyceride ketogenic diet, where the majority of fatty acids came from MCT oils [unfortunately the scientists used Liquigen or MCT oil (both SHS International) instead of a natural source of MCTs, like coconut oil] on vitamin and mineral status of 49 children (age 2-16 years).

Although the results are somewhat skewed due to the extensive use of supplements - apart from the MCT oil in the MCT group, all children received an additional mulit vitamin [either Forceval Junior capsules (Unigreg, Morden, UK) or Phlexy-vits powder sachets (SHS International)], the results (cf. figure 1) suggest that, after all, ketogenic dieting cannot be that detrimental to you vitamin and mineral status as one might expect.
Figure 1: Effects of 12 month on classical or MCT based ketogenic diet on vitamin and mineral status in 49 children.
(data adapted from Christodoulides. 2011)

It is particularly interesting that while vitamin E increased dramatically in the long-chain fatty acid fed "classical keto" group (no wonder in view of the amount of vitamin E present in most long-chain seed oils), the vitamin A level in that group dropped similarly dramatically.

In comparison, the changes in Zinc, Selenium and Magnesium appear to be negligible. In the case of magnesium the observation that
the pairwise comparison with baseline in children who provided data at both time points showed a significant decrease at 3 and 6 months and a highly significant decrease [of magnesium levels] at 12 months
especially in the classical diet is a cause of concern for "those using the diet to treat children with intractable epilepsy", where low(er) magnesium levels appear to correlate with seizures and magnesium supplementation is used as part of the common treatment strategy.

I leave it up to you to decide, whether your think that either a classical or, let alone, a MCT based (with MCTs from supplements instead of whole food sources) diet can be more than a temporary intervention or treatment strategy. Despite the positive evidence that you won't die from mineral insufficiencies or vitamin deficiencies within 12 month of vitamin and mineral supplemented (I assume every keto dieter will take a good multi vitamin anyway) ketogenic dieting, I am still not even remotely considering this to be an option for me.

Science Round-Up Seconds: The Macro-Mineral Alphabet & the Potential Health Hazards of Diet-Induced Latent Acidosis

You lose 600x more sodium than magnesium during a workout. The RDA is yet only ~3-4x higher (Montane. 2007).
If you already listened to the podcast of yesterday's installment of the SuppVersity Science Round Up (if you have not already done so, you can dowload the podcast, here), you may have noticed that I confused the minimal potassium (K) to sodium ratio (Na), which is probably ~1:1, and the "original" K:Na ratio in the "paleo diet".

According to Sebastian et al. (2002) the latter is ~8-9:1 in other words: 8-9 mols of potassium per mol of sodium. That's miles apart from the 1:2-3 ratio the average Westerner (the exact ratio varies depending on which study you refer to) uses as a springboard to hypertension ;-)

The (un-)definite mineral synergism / antagonism chart

Another thing you may have noticed with yesterday's show is the fact that the show was pretty "topic centered". My personal feeling is that it has a much better flow this way and that not despite, but because Carl and I did not cover such a broad range of topics. I cherish the hopefully non-futile hope that you feel the same, but am obviously open for any constructive criticism from your side

The SuppVersity macromineral chart provides a general overview of the complex interactions that exist between calcium, phosphorus, magnesium, sodium, chloride and potassium (compiled based on various sources)
. This, by the way, does also apply to the corresponding installment of the Seconds, of which you will soon realize that it is not a non-related add-on, but will expand, explain and summarize interesting aspects we've covered in the live show (note: from next week on the Science Round-Up will air at 12PM EST, same URL as usual).

On that note, let's start with an "expansion" I already promised to deliver towards the end of the show: some information on the synergism and antagonism of the macrominerals. It's a pretty complex matter and the following illustration is based on generalizations. Some of them, like the low-level exception to the antagonism between calcium and magnesium, of which I believe that it is important to know are explicitly mentioned, others are not.

A very good example of the former, i.e. the important second order interactions is the influence sodium has on the antagonism between potassium and magnesium. The latter disappears, when sodium levels are high and magnesium is needed as a sodium antagonist. Similarly, the often-touted antagonism between magnesium and calcium is actually a co-factor relation, where any "antagonism" is only the result of imbalances between the two.

The good, the bad and the ugly: Just a question of the "wrong" perspective

One thing that should actually be obvious, but is often ignored in all the hoopla about the "good" and "bad" guys among the macro-minerals is that "antagonisms" do not contradict the essential nature of all of the electrolytes, which are - antagonistic or not - in the end all actors in the same metabolic play.
Figure 1: Average ratio of mineral content (new:old) of 20 vegetables and 20 fruit: data based on comparison of  UK Government’s Composition of Foodsdata at two time points separated by approximately 50 years (Mayer. 1997)
I mean, take calcium and phosphorus as an example, they are both essential for the structural integrity of your bone and the fact that calcium has a reputation of being the "good guy", while phosphorus is the "bad guy" is just a necessary consequence of the overabundance of the latter, i.e. phosphorus from grains, soft drinks, dairy products, meats, fish, seeds, nuts, eggs and due to the change in mineral ratios (cf. figure 1) even most fruits and vegetables in the food chain of Mr. Joe Average, these days.

According to a 2009 paper by Dana Cordell et al. this may well change in the not all too distant future, after all "the quality of remaining phosphate rock is decreasing and production costs are increasing" (Cordell. 2009). With estimates saying that the demand for phosphorus is going to double within the next 40 years, it stands to reason that the decried overabundance of phosphorus, which is, among other things, also responsible for lowering the zinc content of the produce (cf. Peck. 1980) may be partly reversed within the next decades... I mean, we all know that nothing is as "convincing" as with financial interests, right?

The strong ion difference determines your pH levels

What's the difference between macro-minerals and their "little brothers" the trace minerals? Calcium, sodium, potassium, phosphorus, magnesium, chloride and sulfur are macro-minerals, because you need them in amounts that are greater than 100mg per day. Of the trace minerals, on the other hand you need less (in most cases much less) than 100mg per day. That does not mean though that Iron, zinc, copper, chroium, flouride, manganese, iodine, molybdenum and selenium were less important - it's merely a quantitative distinction.
While it stands to reason that there is a reason, calcium, sodium, magnesium and potassium are also called "electrolytes", astonishingly few people can actually give an ad hoc explanation why this is the case - and that despite the fact that their lives depend... no, not on the answer, but on the existence and physiological function of electrolytes ;-)

If you have listened closely to your physics teacher, you will yet probably be aware that an "elecrolyte" (electro- ~ charge, -lyte ~ carrier) is a positively or negatively charged molecule (ion) and nothing out of the ordinary in nature.

In your body electrolytes are used to establish ionically charged gradients, similar to the gradient that exists between the positive and negative pole of a battery. These gradients are situated on the cell embranes in excitable tissues, such as muscle and verve, where they facilitate or hinder the influx / efflux of other charged particles.

One of these gradients, in fact probably the physiologically most significant one, by the way, is established by positive sodium (Na+) and potassium (K+) ions and their negative counterpart chloride (Cl-) - exactly those electrolytes you've heard about in yesterday's show (remember: whenever you hear "salt" it actually means Na + Cl).

The electrolytes are not the only charged particles ...

From your chemistry lessons you may remember that there are are not just ionic atoms, but also ionic molecules and that the electron configuration of these particles will determine how they bind, interact and react. But I guess, we have had more than enough complicated theory for today, so if you want to know how the anions and how the strong ion difference (SID) is calculated, check out this brief overview over at acid-base.com.

Rather than going into the details of the mechanism, I decided that it would probably of greater value to wrap the Seconds up with a brief overwiev of the downstream effects of a metabolic state, of which Pizzorno, Frassetto and Katzinger point out that it is not necessarily characterized by acidemia, i.e. pH levels below the "magic" (if we were honest, we'd you'd have to write arbitrary, here) cut-off limit of pH 7.35:
High intensity exercise can also lower your blood pH, an effect you can counter with sodium bicarbonate
"Acidosis only becomes acidaemia when compensatory measures to correct it fail. To illustrate the difference between acidosis and acidaemia, take the following example: two processes occurring simultaneously in the same individual, such as a respiratory acidosis combined with a metabolic alkalosis. In this case, if the respiratory trend toward acidosis is greater than the metabolic trend, a pH of less than 7·35 may be reached, and would be considered acidaemia, despite the presence of a metabolic alkalosis. The intensity of each ‘process’ will determine the pH, but the terms themselves (acidosis, alkalosis) do not indicate a certain pH." (Pizzorno. 2009)
In other words, you don't have to suffer from diabetic or otherwise pathogenic "acidosis", to suffer from one of the following ill health-consequences:
  • Hip fracture incidence per 100,000 study participants; aggregated data from cohorts from 33 countries (Frassetto. 2001)
    Calcium loss, bone loss, osteoporosis - Unfortunately, this is not only the best known side effect of "being too acidic", it's also the only one people take serious. In that, scientists and laypress alike have zoned in on the high intake of animal proteins as the main confounding factor. But despite the fact that the high sulfur content (methionine, cysteine & co) does certainly contribute to the problem, the data in the figure at the right should make it quite clear that the stuff we eat and don't eat with our meats is at least as much to blame for the misery. In view of the fact that
    "[...] cereal grains themselves are net acid-producing and alone accounted for 38% of the acid load yielded by the combined net acid-producing food groups in the contemporary diet" (Sebastian. 2002)
    the average (processed) grain addicted US citizen with his/her quasi non-existent vegetable intake would end up way on the left side of the x-axis of the graph on the right hand side, even if he ate not a single gram of animal protein - we would just have to relable the axis to "vegetable / acid forming food intake (including grains!)".
  • Increased renal nitrogen excretion and hampered protein synthesis - One of the less known effects of an increased acid/base ratio is an increase in nitrogen excretion that will obviously not simply hamper your gains, but can also set you up to sarcopenia (age-induced muscle loss).

    Correcting a diet-induced low grade metabolic acidosis with K-bicarbonate reduces the nitrogen loss of 750mg - 1000mg per day (per 60kg BW) in post- menopausal women (Frassetto. 1997)
    In the end, the excretion of nitrogen is nothing, but an adaptive mechanism and a consequence of the catabolism of tissue protein. It is, if you will, a basic necessity for your body to rob your muscle and other tissue of glutamine and all other amino acids, that can be convert to glutamine in the liver, from where it is delivered to the kidney where it's used to synthesize ammonia and excrete the potentially toxic acid load. This will obviously mitigate the severity of the acidosis, it does yet also entail a net loss in muscle and organ protein that cannot be compensated for by an increase in acid forming protein in your diet.

    As the data in the figure to the right goes to show you this is a process that's regulated on a day to day basis and the relief in nitrogen loss (data in mg/day/60kg) provided by bicarbonate supplementation (days 0-18) is transient and disappears as soon as you return to your regular low-base, high acid diet (days 19-30).
  • Impairments of the growth hormone / IGF-1 axes - Brunnger et al. tested in 1997 whether experimental acidosis would have an effect on the growth hormone / IGF-1 axis and observed a "significant decrease in serum IGF-1 concentration without a demonstrable effect on IGF binding protein 3", which points towards an acid induced "primary defect in the growth hormone/IGF-1 axis" that occurs "via an impaired IGF-1 response to circulating growth hormone with consequent diminution of normal negative feedback inhibition of IGF-1 on growth hormone" (Brunger. 1997). Interestingly, Mahlbacher et al. were able to show that the administration of IGF-1 can in turn ameliorate acidosis and thus correct the previously discussed nitrogen wasting (Mahlbacher. 1999).

    Learn more about the effects of GH, IGF1 and it's splice variants MGF & co and their influence on skeletal muscle hypertrophy in the respective part of the Intermittent Thoughts on Building Muscle (go to the overview).
    In fact, potential physiological effects of the acid-induced impairment of the GH / IGF-1 axes had been observed much earlier, already. McSherry et al. for example report in a 1978 article in the Journal of Clinical Investigations that children with short stature and classic renal tubular acidosis developed normally, when they were treated with adequate amounts of alkalizing agents.

    That similar negative effects can be observed even in the presence of "low-grade 'tonic' background metabolic acidosis" was confirmed by Frassetto et al. who observed statistically significant increases (+11%) in 24-hour mean growth hormone secretion in post-menopausal women with diet-induced low-grade metabolic acidosis, when their dietary acid load was neutralized with adequate amounts of potassium bicarbonate (Frassetto. 1997).

    In a subsequently published study the scientists argue that the concomitantly observed increases in osteocalcin and bone metabolism would confirm the physiological significance of these changes (Frassetto. 2001). The effects on bone add to the well-known beneficial metabolic effects of growth hormone ( and line up with the recently reported association between low growth hormone levels and memory impairments (Wass. 2010).

    In view of the bad press GH and IGF1 are getting, it is important to point out that we are talking about a normalization of the GH/IGF-1 axis, here. It is therefore unlikely that the restoration of a normal acid-base balance will have any of the anti-longevity and pro-cancerous (see next bulletin point) effects of growth hormone and IGF-1 you may have read about in the pertinent literature.
  • Potential protective / anti-cancer effects - While conclusive scientific evidence for the involvement of low-grade acidemia in the etiology of cancer is still missing, it has long been speculated that the genetic and epigenetic perturbations, which will turn normal cells into cancer cells may be triggered (among other factors) by disturbances in the acid-base equilibrium. As Ian Forrest Robey points out in his 2012 review of the literature, a diet induced
    "[a]cid-base disequilibrium has has been shown to modulate molecular activity including adrenal glucocorticoid, insulin growth factor (IGF-1), and adipocyte cytokine signaling, dysregulated cellular metabolism, and osteoclast activation, which may serve as intermediary or downstream effectors of carcinogenesis or tumor promotion." (Robey. 2012)
    If you want to learn more about the "state of the art research" on the potential link between latent dietary acidosis and the development of cancer, I suggest you simply read the free fulltext of the paper on PubMed
I guess, now that you've learned about some of the intricacies of adequate mineral intakes and balances, the acid / base balance, nitrogen and bone loss, growth hormone and cancer, and listened to the interactions of sodium blood pressure, blood glucose and insulin on yesterday's show, it's about time to come back to the simple things that work - the bottom line, so to say...


      "What was that about the nutrient sufficiency of the vegetarian / vegan diet, you said on the air?" The above figure shows the % of omnivores, vegans and vegetarians who meet the RDAs  for protein and fiber and selected vitamins and minerals (DiMarino. 2013)
      Bottom line: A whole foods convenient-"food" free with the right balance of vegetables, protein, and a reasonable amount of complex largely unprocessed carbohydrates, fats and fruits - call it "ancestral" or "paleo", if you will - is going to provide you with all the minerals you need, it will contain them in the right ratios and supply your body with all the co-factors it needs to use them. It will stabilize your pH levels, normalize your growth hormone / IGF-1 axis and is beyond any doubt the most effective way to get and stay in shape, to reduce your cancer risk, ward off diabetes and lead a life that's not simply long, but also worth living

      If you adhere to these simple rules, there is no reason to be worried about "not getting your minerals" and other essential nutrients. After all, this is what distinguishes you from the "average" western omnivore, vegetarian or vegan who fails to meet most of his or her nutrient requirements (see figure to the right).

      References:
      • Brungger M, Hulter HN, Krapf R. Effect of chronic metabolic acidosis on the growth hormone/IGF-1 endocrine axis: new cause of growth hormone in sensitivity in humans. Kidney Int. 1997; 51:216–221
      • Cordell D, Drangert J-, White S. The story of phosphorus: Global food security and food for thought. Global Environ Change. 2009;19(2):292-305.  
      • DiMarino A. A Comparison Of Vegetarian Diets And The Standard Westernized Diet In Nutrient Adequacy And Weight Status. The Ohio State University. A Thesis Presented in Partial Fulfillment of the Requirements for Graduation with Distinction from the School of Health and Rehabilitation Sciences of The Ohio State University. 2013. 
      • Frassetto L, Morris RC, Jr., Sebastian A. Potassium bicarbonate reduces urinary nitrogen excretion in post-menopausal women. J Clin Endocrinol Metab. 1997: 82:254–259.
      • Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.
      • Mahlbacher K, Sicuro A, Gerber H, Hulter HN, Krapf R. Growth hormone corrects acidosis-induced renal nitrogen wasting and renal phosphate depletion and attenuates renal magnesium wasting in humans. Metabolism. 1999; 48:763–770
      • May RC, Kelly RA, Mitch WE. Metabolic acidosis stimulates protein degradation in rat muscle by a glucocorticoid-dependent mechanism. J Clin Invest. 1986. 77:614–621.
      • Mayer AM. Historical changes in the mineral content of fruits and vegetables. British Food Journal. 1997; 99(6):207 - 211
      • McSherry E, Morris RC, Jr. At tainment and maintenance of normal stature with alkali therapy in infants and children with classic renal tubular acidosis. J Clin Invest. 1978; 61:509–527. 
      • Montain SJ, Cheuvront SN, Lukaski HC. Sweat mineral-element responses during 7 h of exercise-heat stress. Int J Sport Nutr Exerc Metab. 2007 Dec;17(6):574-82.
      • Peck NH, Grunes DL, Welch RM, MacDonald GE. Nutritional Quality of Vegetable Crops as Affected by Phosphorus and Zinc Fertilizers Agron. J. 1980; 72: 528–534.
      • Pizzorno J, Frassetto LA, Katzinger J. Diet-induced acidosis: is it real and clinically relevant? Br J Nutr. 2010 Apr;103(8):1185-94.
      • Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr. 2002 Dec;76(6):1308-16.
      • Wass JA, Reddy R. Growth hormone and memory. J Endocrinol. 2010 Nov;207(2):125-6.
      • Williams B, Layward E, Walls J. Skeletal muscle degradation and nitrogen wasting in rats with chronic metabolic acidosis. Clin Sci. 1991; 80:457–462

      Hair Mineral Analysis: Significant Correlations Between Calcium, Magnesium, Potassium & Sodium and Met. Syn., Insulin Resistance, Waist, BP etc. - Implications?

      Does her hair hold the secret to her fitness body? Actually that's unlikely, but it appears possible that a hair analysis could reveals what's keeping you back from a similarly amazing physique.
      Hair mineral analyses have been discredited by certain snake oil vendors who use them to sell their "oils" in form of an endless list of "essential" supplements you'd have to take if you don't want to end up as dead as the hair they used to produce the analysis. Still, they share one big strength with the more expensive RBC or other cell tests: They give you an idea of your actual calcium, magnesium, sodium and potassium balance.

      Much in contrast to serum levels, by the way. If those are off, it's either due to an acute event (like diarrhea, for example ;-) or you have a real reason to be concerned. There is after all a really good reason these minerals are also called "electrolytes": They are heavily involved in the ion and thus charge-exchange that keeps your heart beating!
      Serum analyses tell you if your heart will keep beating, but what do hair analysis tell you? That's a very valid question and the answer is NOTHING! You can use them to estimate your mineral balance, but a high calcium level in the hair, does not necessarily imply a high level in other body parts. Moreover, correlations as I am about to report them in today's SuppVersity article allow for hypotheses about causative effects, what they don't do, though is to prove cause and effect! Please keep that in mind while reading this article and before your next visit at your favorite quack.
      Before we get to the actual hair mineral analysis data, let's briefly have a look at another set of striking and not so striking differences between the "normal" subjects and those with established metabolic syndrome:
      Figure 1: Serum mineral concentrations, visceral (VAT) and subcutaneous body fat and smoking status in subjects w/ and w/out metabolic syndrome (Choi. 2014)
      If you take a closer look at the data in Figure 1 you will see that - aside from marginal, but statistically non-significant differences in serum phosphor - the often-checked total Ca, Mg, K, Na & Ph concentrations did not differ between the two groups.
      Potassium, insulin resistance & obesity: Later in this article you will learn that there was a negative association between the amount of potassium in the hair of the subjects and their HDL and insulin sensitivity. It's important not to confuse this with the message "potassium is bad for your insulin sensitivity" - in fact, in 1980, Rowe et al. observed significant decreases in plasma insulin response  to sustained hyperglycemia and a ~30% reduction in glucose metabolism (Rowe. 1980).
      Moverover, visceral fat was a much more reliable parameter to distinguish the healthy and unhealthy subjects than subcutaneous fat and... a bit to my surprise: Smoking appears to be associated with a lower metabolic risk than non-smoking.

      Let's take a look at the hair analysis, now

      Much in contrast to the serum levels, the hair mineral analysis did reveal significant inter-group differences and corresponding correlations:
      Of all potentially toxic molecules the researchers measured only the levels of arsenic and lead differed significantly between the two groups. The concentrations of cadmium, mercury, and aluminum were not different between the two groups, on the other hand, did not.
      And what does that mean? If we take a parting look at the data in Table 1, you will see that, the one parameter that makes all the difference is none of the minerals. It's rather an old acquaintance: The total amount of visceral fat. With a p-value of p = 0.000 it's the best parameter we have to identify someone with metabolic syndrome. The hair minerals, on the other hand, may present with associations with individual features of the metabolic syndrome, namely...
      Table 1: Multiple logistic regression analysis for hair mineral concentrations with metabolic syndrome (Choi. 2014)
      • low calcium, low magnesium ➮ high blood pressure, high blood sugar, triglycerides, weight and waist,
      • high sodium, high potassium ➮ low HDL,
      • high copper ➮ low blood pressure, low weight, low waist, high insulin sensitivity,
      • high chromium ➮ high weight, high waist, and
      • high cobalt ➮ low blood pressure
      Now, since, we don't know how exactly the hair mineral content ant the nutritional intake are connected, it is very difficult to make any recommendations based on these observations.

      What appears to be relatively certain, though, is that these new findings don't change anything about my previous recommendation to make sure that you get enough calcium and magnesium - the thing about potassium, on the other hand, strikes me as odd. As an antagonist to calcium, the negative effects of K may yet simply be a result of a Ca deficiency in the average mid-40s subjects in the study at hand.
      References:
      • Choi, Whan-Seok, Se-Hong Kim, and Ju-Hye Chung. "Relationships of Hair Mineral Concentrations with Insulin Resistance in Metabolic Syndrome." Biological Trace Element Research (2014): 1-7.
      • Rowe, John W., et al. "Effect of experimental potassium deficiency on glucose and insulin metabolism." Metabolism 29.6 (1980): 498-502.