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marylin monroe
Showing posts with label mitochondrial biogenesis. Show all posts
Showing posts with label mitochondrial biogenesis. Show all posts

Building a Bigger Engine: Resistance After Endurance Training Increases Mitochondrial Biogenesis & Protein Synthesis and Ramps Up Fat Metabolism

Image 1: There is nothing wrong with some "classic cardio" training, especially if you spike it up to build your mitochondrial engine
In a recent review of the literature, J.M. Wilson from the University of Tampa analyzed the results of 27 studies to determine whether and to which extend concomitant endurance training does / could have detrimental effects on the outcomes of resistance training (Wilson. 2011). And I suspect that it will not surprise you that Wilson found negative correlations "between frequency (-.26 to -.35) and duration (-.29 to -.75) of endurance training [and] hypertrophy, strength, and power." What is yet also noteworthy is a similarly significant (p<0.05) correlation with lower body fat levels and maximal heart rates on part on those strength athletes who did some sort of endurance exercises. Now, a more recent study which is soon going to be published in Journal of Applied Physiology sheds some more light on the complex interplay of endurance and resistance training and the potential benefits of combining both to build a "bigger mitochondrial engine" (Sahlin. 2011).

Interestingly, the Swedish scientists started out with a diametrically opposed hypothesis. Sahlin et al. expected that the signaling of mitochondrial biogenesis, of which it is common knowledge that it is promoted by "classic" low(er) intensity endurance exercise, would be impaired by resistance exercise. To validate their hypothesis, the scientists had a group of ten healthy subjects (7 males and 3 females; age, 26 ± 1.2 (mean ± SE) yr; height, 177 ± 2.9 cm; weight, 72 ± 3.5 kg) perform either 60min of endurance exercise (65% of VO2Max on a cycle ergometer) alone (E), or in combination (R+E) with a subsequent bout of 6 sets of leg presses at workloads corresponding to 70, 75, 80, 80, 75 and 70 % of the individual 1RM with 3 min rest between each set (cf. figure 1)
Figure 1: Graphical overview of the study outline (based on Sahlin. 2011).
Muscle biopsies were taken before and after the exercise protocol, to which the subjects had been randomly assigned and which was repeated 2 weeks (4 weeks in the female participants to avoid any influence of the menstrual cycle) later with subjects from the E group performing E + R and vice versa. The results, I'll say so much, were by no means what the researchers had expected.
Figure 2: Changes in lactate and muscle glycogen content in response to endurance (E) and combined endurance and resistance (E+R) training (calculated based on Sahlin. 2011).
While there were the expected differences in lactate levels, and glycogen content of the biopsied legs (cf. figure 2), the increase in the phosphorylation of mTOR and its upstream regulator Akt (you should know these promoters of protein synthesis from the posts in the Intermittent Thoughts series and my dissertations on other studies, by now ;-) was not only exclusive to the endurance + resistance training group (E+R), it was probably also much more pronounced than one might expect with 6 sets of leg presses and lead to an almost dramatic increase in p56Sk1 phosphorylation (do I have to mention that this happened "although" the subjects trained >12h fasted and remained fasted for the whole study period?) - a relatively reliable marker for protein synthesis (cf. figure 3).
Figure 3: Changes of key enzymes envolved in the phosphorylation of key enzymes in the protein synthetic cascade in response to endurance (E) and combined endurance and resistance (E+R) training (calculated based on Sahlin. 2011).
Morover, and totally contrary to what the scientists had expected, the expression of the key enzyme for mitochondrial biogenesis and increased fatty acid oxidation, PDK4 was significantly elevated, not suppressed, in response to the additional leg training (cf.  figure 4).
Figure 4: PDK4 phosphorylation (arbitrary units) in response to endurance (E) and combined endurance and resistance (E+R) training (calculated based on Sahlin. 2011).
The research hypothesis that a (relatively short, but intense) bout of resistance training subsequent to a mitogenic "classic" cardio regimen would blunt the beneficial effects of the latter on mitochondrial biogenesis is thusly more than falsified. As it turns out, the 6% increase in total work-load due to the addition of the 6 sets of leg presses makes a huge and desirable (!) difference (way beyond what an over-simplified workload = output equation would explain) in terms of "building a bigger engine" - an engine that will keep you lean on a bulk and help you lean out while your dieting.

If you are no powerlifter, it is thus probably no mistake to keep some "classic cardiovascular" exercise in your regimen, especially if you spice it up with a subsequent short bout resistance exercise - another option, and I am repeating myself here, would obviously be a high intensity cardio session (cf. HIIT). That being said, change has time and again proven to be the key to continuous improvements in exercise performance, muscular growth and strength, to incorporate both spiced up "classic cardio" and HIIT in your routine could not only improve your results (in view of the protein synthetic response, you could even "grow" on such an E+R day), it will also prevent you from getting bored with performing the same routine day in and day out and if you asked me, that is an even more fundamental key to success than a X% increase in the phosphorylation of whatever key enzyme ;-)

Cardio & Weights - Mutual Exclusives or Synergists? Two New Studies Suggest: Cardio "Before" and After Workouts Offers More Benefits Than Downsides for Strength & Mass

Could "cardio" really be more than just a necessary evil on your way to a physique like this?
Yesterday testosterone booster (see "Capsaicin or 28-OB...") and today already the next "bro favorite": The never ending debate about "cardio and weights" (or should I rather write "cardio vs. weights"). If you are no newcomer to the SuppVersity you will be aware that this is not the first time, we are tackling this issue (e.g. "Cardio Before or After Weights?" or "Before, After or In-Between"). While most of the previous posts did however deal with the question of "How do I do the least damage to my resistance training, if I want to do cardio, as well". The two studies, I have in stock for you, today, would suggest that this question in and out of itself is quite nonsensical and that the "correct", or at least way more productive question must be: "How can I use cardio to promote my strength and mass gains?"

Curious? All right, let's take a look at what Tufano, Lundberg and their respective coworkers have in stock for you (Tufano. 2012; Lundberg. 2012)
  • The Tufano study confirms that doing cardio after an intense leg workout facilitates recovery- A question yet remains: What are the long term consequences? At least as long as you stick to doing just 20 minutes of cardio at 70% of your maximal heart rate, some cycling after a an eccentric leg workout (6 sets of 10 reps of eccentric leg extensions, specifically designed to induce maximal DOMS).

    Figure 1: Isometric strength after eccentric leg extensions in no, low and mean intensity cycling group expressed relative to pre values (Tufano. 2012).
    In the most recent study from the Department of Kinesiology at the Center for Sport Performance of the California State University the 10 women in the medium intensity cycling arm, who had cycled for 20 minutes at 70% of their individual heart rate recovered faster the muscle damaging workout than the women who went home without a "heavy cool down". What's actually even more astonishingly, though is that they also recovered faster than a third group of women who performed the 20min workout at only 30% of their VO2max.

    While there were no differences in pain scale or dynamic strength during the 4-day recovery phase, the isometric strength of the women in the 20min @ 70%VO2max arm of the study showed significant super-compensation effects on day 3 and day 4, so that Tufano et al. conclude:
    "Enhanced blood perfusion during moderate-intensity aerobic recovery, in conjunction with a short-term training effect, may enhance isometric strength after DOMS. Therefore, moderate intensity aerobic activity is suggested as a recovery method after multiple eccentric muscular actions." (my emphasis in Tufano. 2012)
    That certainly sounds as if another bro-scientific myth was tumbling and about to fall. Still, Tufano et al. are also right to point in the discussion of their results, that we need further research into the chronic effects of moderate-intensity aerobic 'recovery exercise' after resistance training - I mean, who guarantees that doing this after every workout week after week, month after month won't eventally turn against you?
What? You are not interested in recovery, anyway? All you want is grow and you doubt that the small increase is indicative of earlier supercompensation and that strength and grows would be two different pairs of shoes, anyway? Well, in that case here is another pro-cardio study:
  • The first important question this study answers is: How do you cycle with just one leg. You see the answer in the small inset of the image above.
    Aerobic before resistance training leads to minor increase in mTOR response and does not seem to hinder muscle gains! This one certainly flies in the face of what you may have been told by credible and less credible experts for your whole life. I mean, if anything, cardio was supposed to keep the gains lean. While the consensus is that it will diminish your gains -- right? Well, according to the latest study from the Mid Sweden University and the venerable Karolinska Institute and University Hospital in Stockholm this could turn out to be just another counterproductive bro-scientific myth: Skipping cardio altogether is not simply bad for your overall health an conditioning, as it would seem, it could even be beneficial for your gains, as well.

    To probe the effects of aerobic training on a whole host of hypetrophy and performance related factors, Tommy R. Lundberg and his colleagues recruited 9 physically active men (23+/-1 yr, 18+/-6 cm, and 75+/-6 kg) who "had been involved in recreational aerobic exercise two to three times per
    week and/or habitual RE one to two times per week for more than a year" (Lundberg. 2012) and had them perform a 45-min one-legged cycle ergometry exercise
    "The target load was 70% of the Wmax (cadence = 60 rpm). After 40 min, workload was in-creased by +20 W, and subjects were requested to continue until failure to maintain the prescribed cranking cadence, which typically occurred within 1–4 min (2 min 43 s)" (Lundberg. 2012)
    that was followed by 14 maximal concentric–eccentric knee extensions for each leg 6 h later (2 sets, 7 reps, 90s rest; starting with the AE+RE leg).
    "Thus, one limb was subjected to aerobic and resistance exercise (AE+RE), and the contralateral limb to resistance exercise (RE) only." (Lundberg. 2012)
    Before, as well as 15 and 180min minutes after the subjects underwent this training sessen, biopsies were taken and the glycogen content, the mRNA levels of vascular endothelial growth factor (EGF), peroxisome proliferator–activated receptor--gamma-coactivator-1 (PPAR-gamma), muscle RING-finger protein-1, atrogin-1 and myostatin, as well as the phosphorylated proteins mammalian target of rapamycin (mTOR), p70S6 kinase, ribosomal protein S6 and eukaryotic elongation factor were  measured. To ensure that no dietary factors would interfere with the results meals had been fully standardized on the day of the testing:
    "A standardized meal (pasta, tomato sauce, and juice) consisting of 2.21 g CHO/kg body weight, 22 g protein/kg bw, and 0.04 g fat/kg bw was provided at 8:00 p.m. the night before the experimental day. Subjects also had a standardized breakfast (1.01 g CHO/kg bw, 0.31 g protein / kg bw, and 0.24 g fat / kg bw) 1 h before the aerobic exercise session and lunch (2.02 g CHO/kg bw, 0.62 g protein/kg bw, and 0.49 g fat /kg bw) consumed 3 h before RE. These meals consisted of commercial energy drinks (Ensure Plus; Abbott Laboratories BV, Zwolle, The Netherlands). Water was allowed ad libitum at any time during the intervention." (Lundberg. 2012)
    As nice as it is to see a tightly controlled study, investigating a relevant topic and with trained healthy participant like this, I am really not a fan of these 'compare the left to the right leg' studies. And still, the fact that I am happy about any study into the whereabouts of different training modalities is neverthelsess not the only reason I am not going to beat a dead horse here.
    Figure 2: Unilateral peak concentric (CON) and eccentric (ECC) power (W) in knee extension and leg press during the experimental bout; data expressed relative to group baseline (Lundberg. 2012)
    The other and probably more relevant reason is that the data you see in figure 2 as surprising at it may seem  -- I mean who would have thought that the resistance training (RT) only leg would see a greater decline in force production during the experimental bout compared to baseline -- does not look like it had been skewed into this surprising direction by carry-over effect from one leg to the other or systemic factors such as central nervous system fatigue or the depletion of liver glycogen levels.

    In particular, we don't see anything of the expected drop in resistance training performance in the AE + RE leg due to the previous cardio workout. Even if it was only small, maybe statistically non-significant, common wisdom would dictate that it should be present! What we are seeing instead, however is a beneficial instead of a detrimental pre-conditioned effect in the 'cardio leg', of which you can hardly argue that it speaks in favor of the hypothesis that doing cardio must necessarily hamper your gains, if you allow enough time and food in between the morning and the evening workouts.

    It certainly looks as if the myth of the strength busting effects of any aerobic activity was about to fall and the corresponding protein expressions, the scientists measured before, 15min and 180min after the trial onyl support this notion.

    The image that emerges, when you take a closer look at the data in figure 3 is actually quite clear. At "pre" already, i.e. immediately before the resistance training part begins, the 'cardio leg' has and edge over the previously rested leg it won't lose in the course of subsequent hours. After all, despite the fact that at T = 180min some of the values have returned to baseline and/or the levels in the resistance training only leg have caught up, there is never a significant advantage of the resistance training only, over the aerobic + resistance training leg in the whole 3h period (respectively at the three intervals at which the biopsies were conducted).
    Figure 3: Selected markers of mitochondrial biogenesis and protein synthesis before during and 15, respectively 180min after the resistance training bout in the AE + RE and the RE only leg (a.u.; data adapted from Lundberg. 2012)
    Personally, I would still not consider these observations conclusive evidence of the superiority of aerobic + strength training in terms of its potential as a muscle builder (that it is a mitochondrial builder stands out of question). What is however undebatable (at least in this particular case), is that doing aerobics earlier in the day and lifting weight later in the day will not have a negative impact on either the performance or the measured markers of the exercise induced growth stimulus the resistance training session will have. It is rather, as the scientists point out that ...
    "[...] concurrent exercise elicited greater mTOR and p70S6K phosphorylation compared with RE. Although these differences were modest, if anything, they indicate that translational capacity was reinforced rather than compromisedby the AE + RE intervention. In parallel, myostatin was suppressed for longer time in AE + RE, with no obvious sign of exacerbated protein degradation. Thus, in contrast to the posted hypothesis, it seems that concurrent AE + RE may enhance skeletal muscle anabolic environment." (my emphasis in Lundberg. 2012)
    I guess, there is actually little to add to that, despite the important warning that you must keep an eye on your overall training volume, in case you want to follow this approach. In the end this means that you are switching to a two-times-a-day regimen, which can take its toll not just on the ability of your muscles to adapt and recover, but more importantly on the ability of your central nervous system to cope with this additional stressor. 
      Can I do HIIT instead? For the first study, the answer probably is no. It makes no sense to use HIIT training as a regenerative means after a workout. For the second study I would guess the answer is yes. After all, the aerobic morning workout was pretty strenuous and glycogen depleting, so I don't see any reason why a brief HIIT training in the 10-20min range would not yield the same if not even better priming effects (cf. "The Anabolic Effects of HIIT" )
      Bottom line: I would not say that any of these studies gives you, who are hopefully interested to build muscle and maintain optimal health a free ticket to do as much cardio, whenever you want. What this compilation does yet do, is debunk the myth that you have to become a sedentary slob and discard the cardiovascular and obvious fat loss benefits the implementation of moderate amounts of aerobic training into your regimen will yield just because aerobics will necessarily comprimise your gains, let alone burn away your muscles.

      Timed appropriately and used in moderate, instead of excessive amounts, some 'cardio' could in fact offer an overlooked means to provide a greater growth stimulus and promote faster recovery - and that next to all the health- and conditioning related benefits, I guess even the hardcore-bros won't doubt.

      References:
      • Lundberg TR, Fernandez-Gonzalo R, Gustafsson T, Tesch PA. Aerobic exercise alters skeletal muscle molecular responses to resistance exercise. Med Sci Sports Exerc. 2012 Sep;44(9):1680-8.
      • Tufano JJ, Brown LE, Coburn JW, Tsang KK, Cazas VL, Laporta JW. Effect of aerobic recovery intensity on delayed-onset muscle soreness and strength. J Strength Cond Res. 2012 Oct;26(10):2777-82.

      Sodium Bicarbonate (NaHCO3) Increases PGC1-A & Speeds Up Mitochondrial Adaptation - HIIT + Bicarb = Perfect Match

      Study suggests, significant increases in mitochondrial builder PGC1-a with HIIT + bicarbonate
      If this is not your first visit to the SuppVersity, I am confident you've read about the ergogenic effects of sodium bicarbonate aka baking soda before. If you haven't here is the short version: Sodium bicarbonate will act as a systemic acid buffer during workouts. That's in contrast to beta-alanine which works exclusively in the muscle, but has very similar, in some studies albeit significantly more pronounced and first and foremost acute beneficial effects on exercise performance.

      No loading, no waiting, no hoping. You simply wash down 20g of bicarbonate (better 0.3g/kg body weight) before the race of your life and - as long as your tummy can stomach it - see / feel the benefits during the race.
      You can learn more about bicarbonate and pH-buffers at the SuppVersity

      The Hazards of Acidosis

      Build Bigger Legs W/ Bicarbonate

      HIIT it Hard W/ NaCHO3

      Creatine + BA = Perfect Match

      Bicarb Buffers Creatine

      Beta Alanine Fails to HIIT Back
      In his thesis paper, Michael E. Percival investigated the effects of bicarbonate supplementation on the cellular adaptation process in response to high intensity interval training (HIIT).
      "Acute and chronic high-intensity interval exercise is a potent stimulus to influence a number of physiological adaptations with implications for health and athletic performance. [...] Due to the intense nature of this training modality and associated disturbance to muscle pH, which has been implicated in fatigue, it has been hypothesized that augmenting the body’s natural buffering capacity through nutritional means may be a strategy to augment training adaptations. One way of doing this is through the ingestion of NaHCO 3 prior to exercise, which has shown to have ergogenic effects allowing athletes to perform more work with each training session. In addition, greater mitochondrial and performance adaptations are seen when HIIT is preceded by NaHCO3 ingestion even when work is matched (Edge. 2006; Thomas. 2007; Bishop. 2010)."
      Percival's goal was now to finally establish what exactly it is that gives bicarbonate the adaptational edge, so to say. To this ends, Michael E. Percival had his subjects, nine active men (22 ± 2 y; 78 ± 13 kg, VO²peak = 48 ± 8 mL/kg/min; mean ± SD) perform the same 10 x 60 s HIIT cycling protocol on two occasions, either with
      • 0.2 g/kg body weight sodium bicarbonate (BICARB) or 
      • an equimolar dose of a placebo, sodium chloride (PLAC),
      both ingested in two equally sized doses that were ingested 30 minutes after the breakfast - a means to minimize gastrointestinal distress | and in the study at hand it worked: There was not difference in gastrointestinal complaints between placebo and bicarbonate trial.
      Figure 1: Pre vs. post PGC1a and muscular glycogen content (Percival. 2014)
      The two trials were separated by 1 week, the subjects had to perform their 10 all out cycling bouts at an intensity of ~263 ± 40 W - more than enough to bring all of them up to the 90%+ heart rate zone. , interspersed by 60 s of recovery. Total work during each trial was identical for a given subject.
      A brief reminder of the benefits of bicarbonate: Regulation of hydrogen ions (H + ) or pH within homeostatic concentrations is critical for proper physiological function. The factors contributing to the change in muscle pH seen during intense exercise are numerous and the role of each factor remains hotly debated. However, classically it is believed that a large contributor of H + is through the accumulation of lactate produced from glycolysis. Next to internal buffers, which are exhausted relatively quickly, the shuttling of H + and lactate across the sarcolemma is also believed to play an important role in the maintenance of pH during intense exercise. This is due to the extracellular buffering capacity HCO3 - which is believed to promote the efflux of H + from active muscles ( Hollidge-Horvat. 2000; Bishop. 2004).

      Table 1: Overview of the studies Carr et al. reviewed in their meta-analysis (Carr. 2011)
      One way to facilitate this process is obviously the provision of exogenous bicarbonate in form of NaHCO3. According to the most recent meta-analysis by Carr et al. (2011), even acute dosing will lead to performance enhancements of 1.7% during short high intensity activities as sprinting. As Percival points out, it does eventually not matter how "sodium bicarbonate imposes its ergogenic effects, the ability to allow athletes to work harder may enhance the exercise stimulus", anyways, and thus contribute to faster / greater size and strength gains. There is yet also accumulating evidence "that NaHCO3 supplementation can improve adaptations independent of greater work output." One of the underlying factors, i.e. the increase in the mitochondrial builder protein PGC-1a has been identified in the study at hand.
      Figure 2: Bicarbonate increases mitochondrial respiration specifically during longer-duration exercise (Bishop. 2010) - the study at hand does not just confirm the results of the previous rodent study, it does also provide information about the underlying mechanism that's responsible for the accelerated mitochondrial adaptation w/ sodium bicarbonate.
      The latter is important, because otherwise the significant differences in PGC1-a expression (see Figure 1), of which the study at hand indicates that they are the most probably reason for the previously cited significant adapational benefits from bicarbonate supplementation (compare Figure 2), could be a mere function of the training volume.

      Based on the data from blood draws and needle biopsies from the vastus lateralis we can now conclude that it is the increase in PGC-1α mRNA, which was increased after 3 h of recovery to a greater extent in BICARB vs. PLAC (~7- vs. 5-fold, p < 0.05) that is responsible for the enhanced adaptations after chronic supplementation.

      Speaking of which, as I've previously pointed out, I truly believe that the serial loading protocol, as described by Driller et al. (2012) is the most promising dosing scheme for the long(er)-term use of sodium bicarbonate supplements (read my write-up for more information). Issues with increasing blood pressure or calcium loss as they have been reported for very high sodium chloride intakes in susceptible individuals should, as I repeatedly pointed out, not be an issue (Luft. 1990). In pre- and post-menopausal women on high-protein diets, the addition of small amounts of sodium bicarbonate is in fact an effective way to increase calcium retention and thus any potential negative effects on bone health that may arise as a consequence of protein-induced hypercalciuria (Lutz. 1984).
      The increase of PGC1-a is significant, because the signaling protein has previously been shown to exert "IGF-1 Promoting, Myostatin Reducing, Muscle Building Effects" | learn more
      Bottom line: While I am pretty sure that many people will still be more attracted by the shiny ads for beta alanine containing supplements, there is little doubt that baking soda is the cheaper and at least acutely more effective buffering supplement.

      That being said, the elevated PGC1-a levels in the study at hand add to the existing evidence that bicarb is more than a pre-/intra-workout acid buffer. And while it's still not 100% clear if it is a result of an increased use of intra-muscular glycogen or a consequnce of a reduced acid level during exercise, the increase in PGC1-a of which SuppVersity readers know that it has "IGF-1 Promoting, Myostatin Reducing, Muscle Building Effects" (learn more) make chronic sodium bicarbonate supplementation regimen even more interesting than they've been before | Comment on FB!
      References:
      • Bishop, David, et al. "Induced metabolic alkalosis affects muscle metabolism and repeated-sprint ability." Medicine and science in sports and exercise 36.5 (2004): 807-813.
      • Bishop, David J., et al. "Sodium bicarbonate ingestion prior to training improves mitochondrial adaptations in rats." American Journal of Physiology-Endocrinology and Metabolism 299.2 (2010): E225-E233. 
      • Carr, Amelia J., Will G. Hopkins, and Christopher J. Gore. "Effects of acute alkalosis and acidosis on performance." Sports medicine 41.10 (2011): 801-814. 
      • Driller, Matthew W., et al. "The effects of serial and acute NaHCO3 loading in well-trained cyclists." The Journal of Strength & Conditioning Research 26.10 (2012): 2791-2797.
      • Edge, Johann, David Bishop, and Carmel Goodman. "Effects of chronic NaHCO3 ingestion during interval training on changes to muscle buffer capacity, metabolism, and short-term endurance performance." Journal of applied physiology 101.3 (2006): 918-925.
      • Hollidge-Horvat, M. G., et al. "Effect of induced metabolic alkalosis on human skeletal muscle metabolism during exercise." American Journal of Physiology-Endocrinology And Metabolism 278.2 (2000): E316-E329. 
      • Luft, Friedrich C., et al. "Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man." Journal of hypertension 8.7 (1990): 663-670. 
      • Lutz, Josephine. "Calcium balance and acid-base status of women as affected by increased protein intake and by sodium bicarbonate ingestion." The American journal of clinical nutrition 39.2 (1984): 281-288.
      • Percival, Michael E. "Sodium bicarbonate ingestion augments the increase in PGC-1α mRNA expression during recovery from intense interval exercise in human skeletal muscle." Diss. McMaster University, 2014.
      • Thomas, Claire, et al. "Effects of high-intensity training on MCT1, MCT4, and NBC expressions in rat skeletal muscles: influence of chronic metabolic alkalosis." American Journal of Physiology-Endocrinology and Metabolism 293.4 (2007): E916-E922.

      Intermittent Thoughts On Intermittent Fasting - AMPK III/III: Natural Rythmicity for Maximum Fat & Minimal Muscle Loss

      Image 1: The quest for fat loss, muscle size, health and longevity reminds me of the famous egg-laying wool-milk-sow.
      (img austria-lexicon)
      At the end of last weeks installment, I provided you with an extensive, yet obviously "incomplete" list of AMPK-"promoters", among which the  organosulfur compound alpha lipoic acid (ALA) turned out to be of chief interest in the subsequent enjoyable and inspiring "intellectual intercourse" I had with Banga, Dr. J, Bomb Jack and of course Lerner in the comments section of the post. Now, the fundamental question that arose from this discussion was how supplementation with ALA (or agents with similar effects on 5' adenosine monophosphate-activated protein kinase expression) could be used as a tool to promote fat, not weight loss while preserving or even building lean muscle mass and optimizing health and longevity - basically it's the quest for the egg-laying wool-milk-sow, an imaginary animal and a commonly used German metaphor for a jack-of-all-trades device. And I can assure you that an ultimate solution to this problem is just as hard to find as this mythical animal an image of which you can see on the right.

      When AMPK is the good guy, mTOR must not necessary be the bad guy

      We have learned in the past couple of installments that its modulatory effect on the AMPK/mTOR seesaw, which, even in your average citizen of the affluent Western hemisphere, is oftentimes imbalanced towards the "anabolic" mTOR side, these days. Against that background I have pointed towards the myriad of beneficial metabolic effects of AMPK activation, which could in fact ameliorate, if not reverse, many of the ailments that have befallen our fat-anabolic (remember without mTOR, fat cells cannot differentiate, cf. Bell. 2000, where blockage of the mTOR pathway with rapamycin inhibited adipocyte differentiation) society.
      Illustration 1: Lifestyle factors like nutrition, nutrient timing, sleep etc. determine the fundamental balance between AMPK and mTOR, but supps can skew / tweak the balance
      I hope that highlighting the merits of AMPK in the lat two installments of the series did not give the impression that mTOR its anabolic counterpart on the seesaw (cf. illustration 1) was "useless" or even dangerous, as the sheer amount of recently published studies on the implication of mTOR in the etiology of cancer could make you believe.
      Image 2: A breast cancer cell (img from The Guardian); if you want it (not yourselves!) to live longer, don't feed it with leucine, Ladies!
      The mTOR-cancer connection: In the course of these first 10 months of 2011 more than 16,000 studies have been published that focus or at leas mention the involvement of an (over-)stimulation of the mTOR pathway in cancer development. It is yet plain short-sighted stupidity to believe that measures like dietary leucine restriction (and subsequent down-regulation of the mTOR pathway) would protect you, let alone cure cancer. It is certainly correct that mTOR promotes proliferation in cancer cells, but it does so in about every other cell in your body. Moreover, studies on the effect of leucine deprivation on mTOR signalling in breast cancer patients showed that not only was "leucine restriction is not sufficient to inhibit mTOR signaling in most breast cancer cell lines", but was "associated with activation of survival molecule Akt, making leucine deprivation an undesirable approach for breast cancer therapy" (Singh. 2011). And with regard to the use of "true" mTOR inhibitors such as rapamycin, David Sabanti remarks in a recent review:
      As induction of apoptosis rather than cytostasis is increasingly considered a prerequisite for an effective anticancer agent, it will be crucial to understand when rapamycin has such effects and where it does not, and to learn how to trigger apoptosis with additional therapies.
      Now, the use of novel pharmacological mTOR-inhibitors aside, any dietary approach (such as leucine deprivation) would obviously prevent apoptosis, because it would act via mTORC1 inhibition to increase Akt-expression and (cancer-)cell survival (Sun. 2005; O'Reilly. 2005). Would you risk your "metabolic currency", i.e. your muscle, and sacrifice quality of life for the futile hope that you could thusly keep cancer "at bay"? I hope not, because in that case you still have not grasped the fundamental idea that in life its not about black and white, but about black and white and a balance between the two.
      This takes us back to the egg-laying wool-milk sow or, without the metaphorical ornamentation, the issue of losing fat weight, while gaining muscle weight. From all you have learned before, it appears quite obvious that - intermittendly fasted or not - gaining muscle and losing fat literally at the same time is virtually impossible. On the other hand, you could obviously first milk and fleece your egg-laying wool-milk sow and then collect the eggs, it has been laying before you grabbed, milked and fleeced it. I assume you will notice that, again, this is a cycle: milk, fleece, collect eggs,... milk, fleece, collect eggs, ... fast, train, feed... fast, train, feed. As you see, nature is not very inventive in her fundamental concepts. She will always rely on her tried and proven cyclicality. Now, if we cannot escape that, we can at least try to tweak it depending on our goals. While for Mr. Supp in illustration 1 this would be only a step to the left to help Mr. AMPK to get the better of Mr. mTOR) or a step to the right to help Mr. mTOR gain control over the AMPK/mTOR seesaw. For us, in the real world, the most obvious thing we could resort to in order to achieve similar results are supplements.

      When to take what to optimize fat loss and minimize muscle loss in the AMPK phase

      In the comments related to the last installment, Bomb Jack suggested that taking ALA during a fast to jack the naturally high AMPK level up even more, would theoretically make sense, but he mentions that he had seen "studies about [ALA] causing lean tissue loss on the long run". One of these studies was conducted by Yi Wang et al. in 2010 on 24 month old male C57BL/6 mice (Wang. 2010). Half of the mice received 0.75% alpha-lipoic acid in their drinking water for one month, the rest of the mice served as a unsupplemented control.
      Image 3: 22 month old C57BL/6 mouse, in view of the fact that mice live ~2.5 years this is already a granny; in other words, the 24 month old mice in the Wang study were really old.
      How much is 0.75% in the drinking water of mice in human equivalents? To calculate that you need to know that the mice in the study weighed ~30g, that the average mouse drinks ~5.8ml per day (Bachmanov. 2002) and that a 0.75% solution means that 100ml contain 0.75g of the given solute. Now you calculate the absolute dose per day, which would be 5.8ml/day * 0.75g /100ml = 0.435mg/day divide that by 30 to get the dose per gram of body weight and multiply it by 1000 to get the dose per kg => 14.5mg/kg. To get the human equivalent dose (HED) you then use the formula I explained before and your calculator will tell you that the HED of 14.6mg/kg in a mouse would be roughly 1.2mg/kg in a human being (~95mg for the average adult).
      Although the human equivalent (~95mg/day; cf. red box above) of the dose the mice received was way less than most commercially sold supplements contain and by far less than the 800mg - 1,200mg of alpha lipoic acid that has been used with positive results in many trials that involved diabetic patients, the results the Wang et al. observed were pretty pronounced. In the ALA group...
      • food consumption decreased: -18% - 4.50 ± 0.30 g/d vs. 5.50 ± 0.30 g/d in control mice
      • body weight decreased: -15.8% - 5.27 ± 0.62 g total body weight loss
      • energy expenditure increased:  +25% - 7.64 ± 0.10 kcal/kg0.75/h vs. 5.90 ± 0.10 kcal/kg0.75/h
      • glucose utilization increased: +10% judged by the respiratory quotient
      • insulin sensitivity increased: -47% area under the curve in glucose tolerance test
      • mitochondrial biogenesis increased: +138% relative abundance of mtDNA content
      • PGC-1α* in skeletal muscle increased: + 80.0% 
      • GLUT-4 in skeletal muscle increased: + 105.0%

        * PGC-1α ramps up thermogenesis, stimulates mitochondrial biogenesis, promotes the remodeling of muscle tissue, controls lipid and glucose metabolism (Liang. 2006)
      And all that was accompanied by significant increases in AMPK and decreases in mTOR and P70S6K phosphorylation. In view of the results of the Wilson study, which showed that a much smaller (~40%) increase in AMPK activity went hand in hand with decrease in protein synthesis we can safely assume that the latter is (unfortunately) responsible for both the desirable increases in energy expenditure, glucose metabolism and mitochondrial biogenesis, as well as the not so desirable loss of appetite (you do not need to eat, when you run on stored substrate) and body mass (cf. figure 2).
      Figure 1: Relative changes in phosphorylation status of AMPK, mTOR, p70S6K and 4E-BP1 in old mice supplemented with 0.75% ALA in their drinking water for 1 month compared to unsupplemented control (data calculated based on Wang. 2010)
      On the other hand, the decrease of the amount of phosphorylated Eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1), of which Anthony et al. have shown in 2002 that its phosphorylation (which usually occurs consequent to the activation of the mTOR pathway) is not necessary for the increase in protein synthesis that occurs upon leucine administration (Anthony. 2002), was not statistically significant. This could be important, as dephosphorylation of 4E-BP1 and not decreases in p70S6K appear to be hallmark features of cancer cachexia, i.e. profound muscle loss in cancer patients (Tisdale. 2008).
      Figure 2: Absolute (left) and relative (right) changes in body composition in old mice supplemented with 0.75% ALA in their drinking water for 1 month compared to unsupplemented control (data calculated based on Wang. 2010)
      And indeed, if you, as a diligent student of the SuppVersity who knows about the subtle differences between absolute and relative data, do not focus on the absolute (figure 3, left) but rather on the relative (firgure 3, right) changes in body composition, you will have to concede that the mouse grandpas underwent a transformation you would usually expect to see in the course of the contest preparation for a bodybuilding show. While the mice "on ALA" did lose ~20% of their body weight, they also cut down from 18% to 9% body fat and (-60% fat mass) and increased the relative amount of lean mass from 74% to 87%. For a 300lbs bodybuilder this would be like cutting 32lbs of fat while losing "only" 16lbs of muscle, to end up 48lbs lighter and with a body fat percentage of 9% at 252lbs - not yet really stage ready, but certainly not bad, given the fact that he would not even have to diet to achieve that result (remember: his appetite would have decreased and his energy expenditure increased).

      Rythmicity is the key when it comes to seesawing and supplementation 

      The mouse vs. human issue aside, the Wang study has another caveat in terms of drawing conclusions regarding the use of ALA and other AMPK promoters during an intermittent fast - the mice did not fast ;-) Reason would dictate, though, that ingesting ALA with drinking water 24/7 on a dietary regimen with constant food availability would actually be a disadvantage compared to taking ALA specifically at the onset of the fast (i.e. when your last meal would be digested) to keep AMPK, which would already been raising at that point (and thus mTOR declining) maximized in the course of the fasting period. On the other hand, taking ALA or any other AMPK promoter after your workout and before your meal would appear to be plain out stupid, as intermittent fasting does only make sense if you really reap the maximal anabolic benefit from the short feeding window. Against that background, popping alpha lipoic acid post workout and thus potentially increasing AMPK appears (remember that we do not have any studies explicitly investigating the effects of taking ALA post-workout vs. at other times of the day, so that these are just yet to be validated hypotheses!) to be counter-indicated, as it would potentially blunt the mTOR and p70S6K response to exercise and food-intake.
      Image 2: R- and S- isomer of alpha lipoic acid (Shay. 2010)
      "Alpha lipoic acid, yeah! But can I buy the cheap racemic mixture or is it worth paying the extra bucks for the R-ALA?" Actually, it was Daniel Spasic who posted a similar question on my Facebook pinwall and thus made me look into the purported advantages of R-ALA, again. 

      I mean we all "know" that R-ALA is the preferable form, but do you remember where you know that from? 

      Well, me neither and so I dug back into the host of studies BASF was doing back in the 1990s, until their business department finally realized that a natural anti-diabetes drug is not only non-patentable, but could also compromise the sales of patentable pharmacological drugs like Chlorpropamide (patented in the mid-1980s; cf. DrugPatentWatch) which happens to be made of Propylamine, which in turn - you guessed it - is produced by BASF and sold to BigPharma and the Agrobusiness who use the same ingredient to produce of Prochloraz, and other well-known fungicide... but I am getting taken away, here.

      Image 2: The scientific
      evidence pro R-ALA
      is quite conclusive;
      the S-isomer, however,
      could potentially negate
      its benefits and is
      useless, at best!
      The main point is that there is clear-cut evidence that the R-isomer has not only a longer half-life and a greater bioavailability (Herrmann. 1996), but is also the "true" anti-oxidant: In a 1997 study by Streeper et al., for example, S-lipoic acid had no effect on insulin-mediated glucose uptake in obese Zucker rats, while R-lipoic acid increased the latter by +64%. In the same study chronic intake of R-lipoic acid reduced plasma insulin and free fatty acid levels. S-lipoic acid, on the other hand, increased insulin levels and had no effect on free fatty acids - probably a direct consequence of the reduced expression of glucose-transporter protein (GLUT4) the scientists observed in the S-ALA supplemented rats. This may now sound like the racemic mixture, which is in fact the ~50/50 R-ALA/S-ALA mixture you can buy for a few bucks at every GNC would be toxic - this certainly ain't the case. On the other hand, would you buy an anticoagulant with an with vitamin K in it, i.e. a product with two active ingredients with partly antagonistic effect? I don't think so...
      And for those of you who like to think in images: Taking ALA right at the beginning of your short feeding window would be as if Mr. Supps from illustration 1 took a step to the left, just when Mr. mTOR turn on the right of the seesaw was about to gain momentum - Mr. Supps with his alpha lipoic acid would be a real spoilsport, then, wouldn't he? If, on the other hand, Mr. Supps knows how to play the game, he will follow the AMPK/mTOR seesaw's natural rythm, grab some alpha lipoic acid and step to the left, when, at the beginning of the postprandial phase (~2h after the last meal), it actually is Mrs. AMPK turn, wait until she has had her share and then jump to the right in order to hand Mr. mTOR a leucine-rich protein shake. By doing this, i.e. taking ALA at the onset of the fast, ~2h after the last meal and a leucine rich (post-workout-)protein shake to ramp up protein synthesis right at the beginning of the feeding phase, the natural rythm would not only be preserved, it would also be amplified. And what would translate into a more energetic seesawing in our metaphorical world or Mr. Supps, Mrs. AMPK and Mr. mTOR, should translate to improved fat loss during the fast and a pronounced muscle anabolic response to the daily "refeeds", as you may well call your meals if you compress the feeding window to <6h. If the mice in the Wang study had gotten this rythm right, they would probably have made it to the Mouse-Bodyduilding Masters ;-)

      The "hungry" side of neuronal AMPK activation

      Before I end, this pretty epic (in terms of the details we have covered) yet not very productive (in terms of how much ground we have made) installment of the Intermittent Thoughts, I want to briefly mention a very important and actually completely logical, since natural difference between the effects of increased AMPK phosphorylation in skeletal muscle and increased AMPK phosphorylation in the brain. While the former triggers all the fat-loss friendly adaptations you read about in this, as well as in previous Intermittent Thoughts, the later will have you forage through your fridge in no time - regardless of whether it's feeding time or not ;-)

      Illustration 2: The differential role of hypothalamic, liver and skeletal muscle AMPK expression (Long. 2006)
      You will certainly remember from previous installments that, in our eukarocyte ancestors, AMPK was the major cellular energy sensing mechanism and has been preserved by humans (and all other mammals) even in these days of nutritional abundance. AMPKs activation is thus a signal for your body that the respective cell is starving (to be precise that the intracellular ratio of ADP+AMP to ATP is rising) - if your brain cells are not already starving, it should therefore be obvious that, contrary to AMPK signalling from the muscle tissue, which usually means "Hey, if you want me to do some work for you, you better provide me with some energy! I see those lazy adipocytes over there have more than enough stored energy...", AMPK signaling from the brain indicates an acute emergency - after all, the biological equivalent of "women and children first" is "brain first! Who cares about the rest?" It should thus not surprise you that
      • an increase in cerebral AMPK phosphorylation results in increased food intake (Andersson. 2004), while dephosphorylation decreases food intake (Kim. 2004); 
      • genetically modified mice with no AMPK activity in the AgRP neurons were leaner and had an increased energy expenditure compared to wild-type mice (Claret. 2007)
      • ghrelin, the hunger hormone, triggers AMPK phosphorylation in the brain and thus increases food intake (Kola. 2008)
      With all that being said, you are probably happy to hear that alpha lipoic acid decreases or at least counters potential increases in AMPK activity in the hypothalamus (Kim. 2004).
      Update (10/29/2011) - The two AMPK-isoforms: As Mounier et al. report in a very recent paper the two isoforms of AMPK, i.e. AMPKα1 and AMPKα2 have very distinct effects on the mTOR induced increase in muscle protein synthesis, and thusly, muscle size (Mounier. 2011). As the scientists point out, AMPKα1 plays "a predominant role in the control of muscle cell size" (meaning it prevents exuberant hypertrophy), while AMPKα2 mediates "muscle metabolic adaptation" (increased glucose uptake, mitochondrial biogenesis, etc.), of which we have learned that they are so vital for our metabolic health.

      Close your eyes and lean out

      On that note, I will close today's lesson with an some interesting information from a study Jonathan P. has brought back onto my radar, recently. It's a study by Dworak et al. on ATP changes during sleep (Dworak. 2010), which underlines the importance of sleep, specifically when you want to lose weight, because at the onset of sleep, the reduction in neuronal activity goes hand in hand with a surge in brain ATP levels, which (as you have learned today) will reduce cerebral AMPK phosphorylation and its negative metabolic consequences. Prolonged waking, on the other hand, has been shown to increase AMPK activity in the brain (Wigren. 2009). So, what are you waiting for? That's all for today... lights out ;-)!

      8x Increase in "Mitochondria Building" Protein PGC1-Alpha W/ Medium Intensity Exercise in Glycogen Depleted Elite(!) Cyclists: Training Revolution or Recipe for Disaster?

      With only 2-7x increases in PGC1-alpha expression HIIT seems to lag behind compared to this "eat low, train low, gain high" strategy, but not every protein essay that glitters in the petri dish will turn into Olympic Gold in the real world ;-)
      As a diligent student of the SuppVersity you should by now have at least a preliminary understanding of how the adaptive machine you call your "body" adapts to the various nutritional and physical challenges most people subsume under the all-encompassing and pretty nondescript terms "diet" and "exercise". Against that background it should not really come as a surprise that researchers from the The Swedish School of Sport and Health Science are soon going to publish the data of an experiment that shows that even (you could probably also say, in particular, although respective evidence is still missing) highly trained athletes can benefit from exercising in a glyocogen depleted state - at least if the yardstick you use to measure the "benefits" is an increase in mitochondrial biogenesis (Psilander. 2012).

      Train high, eat low (carb), train low and...?

      To elicit the differential effects of 6x10 min bouts of cycling at 60% of the individual VO2max (4min of active rest in between) with normal vs. depleted skeletal muscle glycogen stores, Psilander et al. had their 10 highly trained male national elite level competitive road cyclists and mountain bikers (27.8±1.6 years, 74.7±2.0 kg, 183±2 cm, and 4.9±0.1 l/min VO2Max) perform an 8x4min interval training at 88% of their individual VO2Max ~16.5h before they had to report back at the laboratory on the actual testing day (the intervals were seperated by 4min of active rest, i.e. cycling at 100W+).
      Figure 1: Graphical outline of the experimental protocol and its effect on the glyocogen stores of the from the vastus lateralis muscle (based on Psilander.. 2012)
      The protocol (see figure 1) was repeated twice, with adequate time in-between and in random order, with the subjects consuming water only and low carbohydrate meals
      • low carb meals (LC) were eggs and bacon (0.02 g CHO, 0.6 g protein and 0.8 g fat/kg bw) for dinner and breakfast, providing a total of of <0.04 g CHO, 1.2 g protein and 1.6 g fat/kg bw
      before the glycogen depleted trial (LC) and high carbohydrate beverages (maltodextrin-dextrose powder Carbo 134 w/ 1.0g CHO/kg bw) + high carbohydrate meals
      • high carb meals (HC) were pasta with meat sauce and lemonade for dinner (1.83 g CHO, 0.53 g protein and 0.14 g fat/kg body weight bw) and oatmeal and orange juice (1.54 g CHO, 0.31 g protein and 0.12 g fat/kg bw) for breakfast and additional bananas with beverage 3,5,7 and 8 for a total of 12.6 g CHO, 0.9 g protein and 0.3 g fat/kg bw
      before the glycogen repleted trial (HC).

      ... get impressive increases in PGC1-alpha, but no AMPK response at all!

      As the data in figures 1 & 2 goes to show you the nutritional intervention was not without effect the factual glycogen levels (figure 1, right) and the glucose, insulin and fatty acid levels before and after the workout (figure 2) - and, as you would expect it, the corresponding changes in gene and protein expression in the muscle samples the researchers collected approximately 15 min before the depletion (S1) and test exercise (S2), as well as 3 h after the test exercise:
      Figure 2: Free fatty acid levels before depletion (S1) and before (S2) and after (S3) exercise trial, as well as PGC1-alpha and p-AMPK expression (data calculated based on Psilander. 2012)
      Now what you probably won't have anticipated, though is the absence of the expected p-AMPK response to exercise in the low glycogen (LC) trial.
      "The mRNA content of the master regulator of mitochondrial biogenesis (PGC-1a) was not changed 14 h after depletion exercise (pre-test exercise) but was significantly increased 3h after the test exercise in both conditions (Fig.2). The increase was, however, much more pronounced in LG than in NG (8.1-fold vs. 2.5-fold, P<0.01). The mRNA content of two other regulators of mitochondrial biogenesis (PRC and Tfam) also increased significantly but with no difference between conditions (time-dependent effect, Py0.01; [not shown in my graph]). The mRNA content of genes for oxidative metabolism enzymes (PDK4 and COX I) only increased after LG with a significant difference between the two conditions. The mRNA content of CS, Sirt1, NRF1 and PPAR[-delta] did not change under any conditions." (Psilander. 2012)

      Almost 8x elevated levels of PGC-alpha but no change in the "fat burning, GLUT-4 pomoter" AMP-activated protein kinase? How can that be? The answer to this question is actually pretty simple: If the phosphorlyation of AMPK changes in response to changes in the ATP to ADP ratio (the name is misleading, here as scientists have initially believed that the main determinant was the ATP to AMP ratio, which is yet not the case), it should be obvious that it won't change, if the ATP levels are already so low that at most the ADP to AMP, but not the already rock bottom ATP do AMP ratio will be changing.

      What happens if your body senses that it cannot fuel his energetic demands with glucose?

      In the presence of borderline hypoglycemic glucose levels (the normal range starts at 4.4 mmol/L; after the depleted test the subject were at 4.3 mmol/L!) your body would be ill advised to increase glucose uptake. So if this is not an option the only way to make up for the lack of energy are fatty acids. Unfortunately the amount of fatty acids your skeletal muscle can oxidize is strictly rate-limited by your mitochondrial capacity ... now, I am asking you what's the "natural", the logical and in the case of the 10 cyclists in the study at hand also the factual reaction that will get you out of this mess? Right! To build more powerful mitochondria and thus widen the "bottle neck"! And what's going to do just that? Yeah! The ~8x increase in PGC-1alpha expression you see in figure 2. 

      Practical implications: From protein essays to results?  

       Now that we have gotten the mechanisms straight, there is but one question we have to answer - what does that mean for you? When and for whom does it make sense to train with depleted gycogen stores? And in an even broader context - what does that tell us about low-carbing and (intermittent) fasting?
      1. Before you even consider making this a staple of your regimen, I would encourage you to read the whole SuppVersity Athlete's Triad Series
        Even (or especially?) for trained athletes competing in largely aerobic sports, training in a state of depleted glycogen store can serve as a viable tool to elicit even higher (2-7x; cf. Gibala. 2009, Nordsorg. 2010. Psilander. 2010) increases in increases (8x!) PGC1-alpha and (allegedly) mitochondrial biogenesis as you would see them in response to high intensity interval training at much lower intensities (but correspondingly longer durations). 
      2. Training in a fasted state does not per se guarantee / put you at risk of being glycogen depleted, neither does intermittent fasting and or "training on empty". As long as you replete your glycogen stores after your workouts you won't see similarly pronounced increases in PGC1-alpha in response to "regular" aerobic training at a low intensity. You will, on the other hand, still see increases in AMPK and, what's even more important, you will be able to perform at much higher intensities! A fact that is particularly important for the strength trainees out there.
      3. While it may make sense on occasion, and merely based on it's beneficial effects on purported  mitochondrial biogenesis (I don't have to remind you that we don't have any information on whether the increase in PGC1-alpha did even translate into an increase in mitochondrial biogenesis in the absence of adequate glycogen / ATP levels!), I want to reemphasize the scientists very hint that "[l]ongitudinal studies examining protein levels and performance are required" before it can be recommended to include this practice as a staple into your routine!
      4. Life is to complex for black-and-white thinking, and so are AMPK, mTOR & co! Learn more in the Intermittent Thoughts.
        Long-term exercise in a glycogen-depleted state without adequate carbohydrate intake and thus glycogen repletion is not for nothing one of the causative factors of the athlete's triad (see Part I & II of the SuppVersity Athlete's Triad Series). I would therefore be very surprised if the long-term outcomes of low-carbing + (intermittent) fasting w/out regular glycogen repletion would be anything but negative, regardless of its beneficial effects on PGC1-alpha. After all, the study at hand clearly shows that you will also be missing out on the benefificl effects of increased p-AMPK expression of which you know based on what you have read in the Intermittent Thoughts on Intermittent Fasting Series that it is one of the, if not the central argument in favor of intermittent fasting.
      The practical take home message of this study is therefore that exercise + diet induced targeted glycogen depletion before a workout (not via an overnight fast, only; that would leave your muscle glycogen stores largely intact, while your body is burning fat and tapping into your hepatic glycogen reserves) can become one among a whole host of tools in your workout-toolbox. You can use it sporadically, but you should not need another study to be able to predict that the downsides of chronic use are going to outweigh (purported - again, we are measuring markers only, here!) short term benefits.

      On a last note: I guess you know that the SuppVersity is the place where you will hear about respective longitudinal data first, right? To make sure you don't miss that I suggest you go to www.facebook.com/SuppVersity like the page or register for updates at twitter.com/ProfDrAndro!

      References:
      • Gibala MJ, McGee SL, Garnham AP, Howlett KF, Snow RJ, Hargreaves M. Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC-1alpha in human skeletal muscle. J Appl Physiol. 2009 Mar;106(3):929-34.
      • Nordsborg NB, Lundby C, Leick L, Pilegaard H. Relative workload determines exercise-induced increases in PGC-1alpha mRNA. Med Sci Sports Exerc. 2010 Aug;42(8):1477-84.
      • Psilander N, Wang L, Westergren J, Tonkonogi M, Sahlin K. Mitochondrial gene expression in elite cyclists: effects of high-intensity interval exercise. Eur J Appl Physiol. 2010 Oct;110(3):597-606. Epub 2010 Jun 23.
      • Psilander N, Frank P,  Flockhart M, Sahlin K. Exercise with low glycogen increases PGC-1agene expression in human skeletal muscle. Eur J Appl Physiol. 02 Oct 2012 [ahead of print]

      Intermittent Thoughts On Intermittent Fasting - AMPK II/III: Leucine, HMB and a Glimpse on Other AMPK Modulators

      Image 1: You pick a health, diet or diabetes supplement and I find the study that shows that in one way or another its effect is related to AMPK ;-)
      I ended yesterday's installment of the Intermittent Thoughts on Intermittent Fasting Series on a pretty bold statement about the benefits of preworkout BCAA supplementation that would, at first sight, contradict common sense, or rather what common sense would dictate based on all you have read about the beneficial effects of BCAA supplementation on mTOR-related muscle protein synthesis (MPS) and the complementarity of mTOR and AMPK as regulators of anabolic (e.g. MPS, adipogensis ,etc.) and non-anabolic "scraping, rebuilding, recycling and repairing" processes. Since, after all, Bomb Jack, who posted a comment on last weeks installment of this series, is right: It would be logical that supplementation with BCAAs (he mentions HMB specifically) during the fast should result in dephosphorylation (~deactivation) of AMPK and thus negate its desirable effect on (metabolic) health.

      And in fact, in the Wilson study I wrote about on Saturday the postprandial increase in AMPK phosphorylation, was blunted by the provision of carbohydrates, leucine or a combination of both (cf. yesterday's news) and you would assume that HMB supplementation would do the same, but the latter is - at least for chronic supplementation with low amounts (320mg/kg in rats ~ 52mg/kg in humans) of HMB - not the case (Pimentel. 2011), as the data I plotted in figure 1 clearly shows:
      Figure 1: Effect one month of saline (control) or 80mg/day HMB on mTOR and AMPK phosphorylation and GLUT-4 expression in extensor digitorum longus (EDL) muscle of rats (Pimentel. 2011).
      In the Pimentel study, there was, if anything, a non-significant increase in the AMPK and its purported downstream effect on GLUT-4 mediated glucose uptake  - both of which common sense would have told us to be compromised by HMB supplementation. While the lack of information on the "timing" or, more specifically, the interval between the last feeding and the intragastric administration (gavage) of 320 mg/kg body weight of HMB is a drawback in view of the significance of these results in an intermittent fasting context, rats usually eat at night and thus the administration of the 80mg of HMB (the rats weighed only 250g) "daily at the same time (during the light period)" will probably have coincided with a "fasting" period.

      How can we explain that mTOR expression increased, while AMPK remained constant?

      Are the different result a consequence of the metabolic magic of HMB? Well, before we analyze that in detail, there is another significant difference, we have to account for - in fact, a much more obvious one, which the amount of amino acids the rats were given in the Wilson and the Pimentel study, respectively (cf. figure 2).
      Figure 2: Dosage, not type of supplement would be the most probable explanation for the different effects of leucine and HMB supplementation on AMPK phosphorylation in the Wilson vs. the Pimentol study.
      I hope you did not already forget that, the main function of AMPK is to prevent that your cells run out of fuel or, to be precise, to avoid the ratio of "used" energy ADP and AMP (adenosine di- and monophospate) to ATP (adenosine triphospate) to continue to rise beyond a tolerable level. I further assume that you will be familiar with the fact that branched-chain amino acids bypass oxidation in the liver and thus become readily available energy sources for skeletal muscle (Renny. 2011). Now, if you put one and one together the answer seems pretty obvious: If the dosage of amino acids is sufficient (remember that those 270mg leucine are 4x more leucine than the the rats in the Wilson study got for "breakfast") to restore ATP levels to "appropriate" levels, the decrease in the ADP/ATP ratio will allow part of the AMP-activated protein kinase to be dephosphorylated.

      According to our current understanding, BCAAs in general and leucine in particular trigger the ATP related decrease in AMPK and the complementary increase in mTOR by two distinct pathways, of which Tokunaga et al. write (Tokunaga. 2004)
      [...]leucine stimulates p70α phosphorylation via mTOR pathway, in part, by serving both as a mitochondrial fuel through oxidative carboxylation and an allosteric activation of glutamate dehydrogenase. This hypothesis may support an idea in which leucine modulates mTOR function, in part by regulating mitochondrial function and AMPK.
      In plain English: Leucine increases ATP when it is "burned" as fuel and it docks directly to the the non-active site of glutamate dihydrogenase enzyme and thusly increases the conversion of glutamate to alpha-ketoglutarate which in turn can be fed into the citric cycle to ultimately produce ATP.

      Is it all about (cellular) energy ...

      Figure 3: AMPK phosphorylation in Escherichia coli at different ADP/ATP ratios (data adapted from Xiao. 2011)
      In April 2011 Xiao et al. published a study in Nature with some interesting quantitative data on the ADP/ATP ratio, on the one hand, the phosphorylation status of AMPK, on the other (Xiao. 2011). As my plot of the data in figure 3 shows, with increasing ATP levels (at constant ADP levels of 30µM) the phosphorylation of AMP-activated protein kinase in Escherichia coli BL21 cells declines by roughly -20% from 44% at a 30/0 ADP/ATP ratio to 22% at a 30/800 ADP/ATP ratio.

      Yet, although these results would confirm the hypothesis that the main reason for the discrepancy is dose, or rather, energy related, and each and every nutrient that could potentially raise ATP levels, would eventually decrease AMPK, this still does not explain the increase in mTOR Pimentel et al. observed, despite (statistically non-significant) increases in AMPK.

      ... or is there a place for the "magic" of HMB?

      As you probably know, beta-hydroxy-beta-methylbutyrat (HMB) is an oxidation product of leucine and / or its keto-acid alpha-ketoisocaproate (KIC) (Koevering. 1992). In 1998 Lembert et al. found that even KIC is not a direct substrate for ATP production, instead "KIC must transaminate with glutamate or glutamine to yield alpha-ketoglutarate and leucine" (Lembert. 1998). We may thus assume that similarly HMB cannot be used (directly) to restore cellular ATP pools. Moreover, HMB is thought to be the second (non-energetic) pathway by which leucine acts on protein synthesis / breakdown. According to a 2011 review of the literature by Zanchi et al. (Zanchi. 2011)
      Nissen et al. (1996) suggested that HMB or some other metabolite (since there is no specific inhibitor to BCAT) is the main component responsible for the anti-catabolic effects of HMB because when adopting inhibitors of BCAA transamination, the only BCAA capable of anti-proteolytic effects is leucine, which undergoes a process capable of generating HMB (Slater and Jenkins 2000). Such effects were not observed when other BCAAs were tested (isoleucine and valine), suggesting that HMB or some metabolite may be the key element in promoting the [anticatabolic] effects.
      When usually 5% of the dietary leucine is metabolized into HMB (Wilson. 2008), and these 5% are responsible for the non-ATP dependent effects on phosphorylation of mTOR, p70S6k, and 4E-BP1 of leucine (Eley. 2007), it is no wonder that chronic intake of 80mg of HMB did stimulate mTOR in the absence of increased ATP levels (which would obviously have led to a decrease in AMPK expression that was not present in the Pimentol study), while 270mg leucine, yielding only 13.5mg HMB, did not stimulate mTOR, but was (ab-)used as a substrate to increase cellular ATP levels, thusly reduced AMPK levels and increased protein anabolism - different pathways, similar results: an increase in net protein synthesis.
      Figure 4: Simplified illustration of the two distinct pathways by which leucine can work its muscle protein synthetic (MPS) magic and a hint on the compensatory (/) / amplifying (+) effects of exercise.
      There is however, a third major pathway to the metabolic effects that are brought about by common intermittent fasting programs and this third player makes things even more complicated (cf. figure 4) - it's exercise! You probably remember from yesterday's installment that
      1. during exercise in the fasted state temporarily AMPK increases and the energetically costly muscle protein synthesis (MPS) is reduced, while
      2. after exercise (regardless of whether it was performed fasted or not, cf. "Glycogen-Free Growth") muscle protein synthesis increases due to an exercise-induced stimulation of the mTOR protein synthetic cascade
      Before we dig deeper into this modulatory effects of different modes of exercise in the next installment of the Intermittent Thoughts on Intermittent Fasting, however, I want to conclude today's thoughts with a preliminary list of supplements / medications that have been shown to modulate the phosphorylation state of 5' AMP-activated protein kinase.
      Image 2: If you insist on trying HMB, don't be stupid and buy a capped products, the prices for bulk HMB powder have lately been crushed - a major European carrier, for example, sells 250g at <13€ atm; HMB is thus cheaper than BCAAs, which cost 16Euros in the small 250g pack - did you hear me say that even 13€ is too much, no - you must be mistaken ;-)
      "Should you prefer HMB over leucine as a dietary supplement to promote lean mass gains and prevent muscle loss during the fast?" I assume this is a question many of you will now be pondering about. My answer to this question would be "NO!" Firstly, if you are no construction worker or pursue a similar physically demanding profession, the fear of losing muscle (which is different from "feeling flat", my bodybuilding friends ;-) during a ~16h fast is hilarious, which means that BCAA, Leucine or HMB supplementation, while you sitting fasted at your desk in the office is simply unwarranted. Secondly, when you are exercising the increased energy demand will negate / compensate the negative effect the increase in ATP has on AMPK activity. And thus, thirdly, a large bolus of leucine (or a complete BCAA or EAA product) taken pre-workout will not only ward off proteolysis (as HMB would do) it will also provide the necessary energy to train harder and thus help to increase the exercise induced stimulus on protein synthesis.

      All that and the absence of conclusive scientific evidence that would demonstrate the superiority of HMB supplementation over the provision of adequately dosed BCAA or EAA mixtures (it stands to reason that you cannot compare 3g of HMB to 3g of BCAA) are arguments against the use of β-Hydroxy β-methylbutyric acid. If you wanted to try it, anyway (and have no problem swallowing a powder that tastes like poison), the prices for bulk-powders have gone through the floor, lately ;-)

      How to modulate AMPK "artificially" -  supplements, medications, hormones and more

      In view of the fact, that the discussion of the effects of leucine (BCAAs and HMB) alone took much longer than I had expected and this whole episode took a different turn than I would have expected, the following list is more a preliminary overview than a comprehensive explanation of the effects of various supplements, medications, hormones and hormone-like substances on the AMPK. The latter will follow, as promised, but for today, you will have to content yourselves with what I would like to call a sneak peak on the AMPK-mTOR modulation handbook of which I hope that it will be one of the outcomes of all the past and future work that is going into this series ;-)

      AMPK promoters:
      I still have two things to add to this list, firstly, this list is the result of a VERY cursory and 100% random search and is not even intended to be complete (at this time ;-). The intention (at least for in this installment) is to show you that an overwhelmingly large percentage of purported health supplements, diabetes and obesity treatments work via the AMPK pathway. And, secondly, I decided to limit the references to 1-3 per compound, even if in cases such as Metformin, ALA & Co the number of relevant studies is probably >500. Therefore you better consider the given references as evidence that I did not make up any associations between compound X and AMPK phosphorylation - and, if you want to know more before the release of the next installment, I suggest you go to PubMed and enter the respective keywords and do some digging on your own (your SuppVersity homework of the day - so to say ;-)

      I hope you do not mind that I did not manage to tackle the effects of sleep and exercise in this installment, as I had originally intended. It is, after all, the central characteristic of this series that I sit down in front of the computer and start thinking at point "A", then I dig, here, get distracted there and follow up on "A1" to "A743", so that the output is by no means as structured and straight forward as my lectures and seminars or my SuppVersity blogposts on isolated topics... so, I can only hope that you enjoyed the turn this installment took (at best, because you learned something new) and in the unfortunate case that you did not enjoy what you have just read, you can at least look forward to the next episode of the Intermittent Thoughts on Intermittent Fasting Series ;-)