Vitamin A Educates T-Cells, Joins Forces With Vitamin D Against Liver Cancer. Milk Better Than Sugary Electrolyte Solutions for Rehydration? Helicobactor Pylori: Probiotics from Breast Milk & Feces Better Than Amoxicillin!

Lactobacilli are hip, vitamin A is not - at the SuppVersity you still get news on both

1kg! That's the amount of weight you could probably lose if you rid yourself of all the microbes in your gut - from the weight of the bacteria alone, of course. Whether this would be a good idea or not, is however very questionable. On the one hand, we do have the still not fully understood studies on obesity-resistant germ free mice and an accumulating amount of evidence that having the "wrong" bacteria in the gut is at least associated with an increased obesity risk (Blaut. 2012). On the other hand, however, we are seeing new studies on the various benefits of having the "right" gut microbiome being published on an almost daily basis. So what?

Before we take a closer look at a definite benefit of having the "right" gut bacteria, though, let's start out with another likewise gut-related news item on the role of retinoic acid in T-cell education. In a way it's funny, it starts right where the bacteria reside, could have immune-modulatory effects that are way more pronounced and far reaching than probiotics and is still hardly discussed.

Vitamin A is of critical importance to (intestinal) T-cell education

If you have ever asked yourself how the immune cells in your body know what they are supposed to do, Catharine Ross' latest paper that was published in the American Journal of Clinical Nutrition and is based on a short talk the researcher from the Department of Nutritional Sciences at the Pennsylvania State University held at a conference earlier this year may provide at least some additional insides into the role a still way underrated molecule plays in this "T cell education" (Ross. 2012): Vitamin A!

Figure 1: Model of T cell differentiation, from uncommitted naive T cells into different T cell subsets that produce different cytokines and thus promote different functional activities (adapted from Ross. 2012)

As you can see in figure 1, retinoic acid does not simply promote the differentiation of regulatory T cells, which help to suppress inflammatory reactions, it also plays a significant role in normal mucosal immunity (in the gut, the airways and elsewhere) by modulating T cell activation and regulating cell trafficking. Moreover, vitamin A promotes antibody responses to T cell–dependent antigens. Needless to say that

"[...] in a state of vitamin A deficiency, inflammatory T cell reactions may be inadequately opposed and therefore become dominant [...] Although data from human studies are still needed, the framework now developed from studies in mice and rat models suggests that adequate vitamin A status, [...] is  important for maintaining a proper balance of well-regulated T cell functions and for preventing excessive or prolonged inflammatory reactions." (Ross. 2012).

Discovery a beta carotene derived vitamin A receptor blocker is only one of a couple of intriguing findings wrt to vitamin A.

One thing that sticks out from the complex interactions (see figure 1), really is the way by which the interaction of vitamin A with the T-cells in the gut crucially determine the efficiency of the 'fist line defenses' and their downstream effects on the whole organism. It is by no means co-incidental that diarrhea is rampant in areas of the "third world", where a large amount of the population is vitamin A deficient (Beaton. 1994). And in fact studies have shown consitently that

"RA is essential for 'imprinting' gut-homing specificity on T cells activated by intestinal DCs [dendritic cells] and suggested that MLN DCs are a source of RA that drives T cell differentiation toward the gut-homing phenotype" (Ross. 2012)

Moreover, oral tolerance to foreign antigens and thus an allergy free live requires a form of immune suppression, which can be proffered or hampered by sufficient and insufficient vitamin A intakes. In that, the exact effects of vitamin A will depend on the cytokine milieu the T-cells are exposed to. Examples are...

• an exaggerated IL-17 response with vitamin A deficiency, on the one hand, and
  
• an increase of the inflammatory response due to high vitamin A in an IL-15 environment 

Based on these observations, Ross rightly points out that "when RA is used for therapeutic purposes, it should be used cautiously in subjects with various inflammatory bowel conditions and sensitivities to dietary antigens." (Ross. 2012) People with gluten intolerance, celiac and other allergic reactions, for example would probably be better off avoiding the consumption of any form of supplemental vitamin A (on top of what's in their regular diet). Someone with high IL-17 and IL-6 levels as they have been observed in non-celiac inflammatory bowel disease, type 1 diabetes, multiple sclerosis and rheumatoid arthritis, on the other hand, could actually benefit from vitamin A's (especially ATRA) presence during activation of CD4⁺ T cells, because it will - even in the presence of IL-6 - "favor the development of the a Treg lineage at the expense of T cells secreting IL-17" and could thus help reduce chronic inflammation and keep autoimmune reactions at bay (Schambach. 2007; also Ramgolam. 2010).

More news

• 

  Figure 2: Who cares about cell viability, the survival time (in days) matters

  Combination therapy with vitamin A and a vitamin D (not D3, but calcitriol) analog EB1089 kills liver cancer cells. And it does so more effectively than any of the two molecules alone. That's the actually unsurprising result of a study that has been conducted at the Beijing Army General Hospital in China. The researchers injected nude mice with molecules that made them develop hepatocellular cancer. Afterwards, the rodents received either 10 μmol/L retinoic acid (vitamin A), 10 nmol/L EB1089 or both as a combination treatment.
  
  Compared to vitamin A or the calcitriol analog alone, the combination treatmend resulted in a significanlty higher reduction of the viability of hepatocellular cancer cells. Based on TUNEL analysis, Zhang et al. did also establish that individual cancer cells had a higher apoptotic ratio in the combined drug group than in the groups for which the drugs were used separately. Most importantly, however, the tumor weight was decreased and the mice on the combination treatment lived significantly longer (see figure 2; Zhang. 2012)

• 

  In the same publication, Pritchett and Pritchett recommend 1.0-1.5ml / kg body weight per hour of chocolate milk as the optimal post-workout drink to be consumed in the 2 h after a workout.

  Skimmed milk, the ideal post-workout rehydration formula? According to L James' paper in Lamprecht's compendium Acute Topics in Sport Nutrition, milk is a way better choice then the standard sugar + electrolyte rehydration formulas. Interestingly this is not due to the minerals in the milk, or the sugar, but, as James argues, a direct consequence of the milk proteins, which help restore "fluid balance after exercise-induced dehydration to a greater extent than a carbohydrate-electrolyte sports drink." As James points out it will yet have to be elucidated, whether the simple addition of whey protein to a standard sugar + electrolyte formula would exert similar effects (James. 2013).
• Probiotics to kill Helicobacter Pylori? While not every bacteria stands a chance against the nasty gut bug H. Pylori, certain Lactobacillus spp. strains obviously do. At least, if the results of a recent in-vitro + in vivo rodent study by Pei-Shan Hsieh can be replicated in human studies.

  

  Figure 3: Urease activity in H. pylpori after co-incubation with the specific probiotic and resulting bacteriostatic ratio (100% = bacteria free; data adapted from Hsieh. 2012)

  Lactobacillus acidophilus TYCA08, L. acidophilus TYCA15, L. johnsonii MH-68, and L. salivarius subsp. salicinius AP-32 were the most effective strains the researchers from National Chung Hsing University in Taichung, Taiwan, analyzed. And believe it or not, the latter of these, i.e. L. johnsonii MH-68, and L. salivarius subsp. salicinius AP-32, both of which are  by the way found in feces, were even minimally more potent effective than Amoxicillin, a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections. L. acidophilus TYCA15, however, steals the show. This probiotic that occurs naturally in breast milk reduced the urease activity of H. Pylori by -97.1% (see figure 3).
  
  In the consecutive rodent study, Hseieh et al. did yet still use 10⁹ CFU/mL of either AP-32 alone, MH-68 alone, or an equal mix of cultures of the two strains and both, "either alone or as a mixture in powder form were effective in reducing H. pylori load in gastric mucosa and help in reducing gastric inflammation and in regulation of gastric acid production." (Hsieh. 2012)

Thats it for today and for this weekend. As mentioned yesterday, there was simply not enough time to do the necessary research for the follow up to the Athlete Triad Series, so that this will have to wait. So don't dig an even deeper whole in the mean time. Maybe you want to do some of the psychomotor tests mentioned in yesterday's news, and check whether you are already overtrained!? How steady are your hands, for example? And whatever the result may be, don't forget to enjoy the rest of the weekend!

References:

• Beaton GH, Martorell R, Aronson KA, Edmonston B. McCabe, G, Ross, AC, Harvey, B. Vitamin A supplementation and child morbidity and mortality in developing countries. Food Nutr Bull 1994;15(4): 282–9.
• Blaut M, Klaus S. Intestinal microbiota and obesity. Handb Exp Pharmacol. 2012;(209):251-73.
• Hsieh PS, Tsai YC, Chen YC, Teh SF, Ou CM, King VA. Eradication of Helicobacter pylori Infection by the Probiotic Strains Lactobacillus johnsonii MH-68 and L. salivarius ssp. salicinius AP-32. Helicobacter. 2012 Dec;17(6):466-77.
• James L. Milk Protein and the Restoration of Fluid Balance after Exercise. In Lamprecht M (ed): Acute Topics in Sport Nutrition. Med Sport Sci. Basel, Karger, 2013, vol 59, pp 120–126. 
• Pritchett K, Pritchett R. Chocolate Milk: A Post-Exercise Recovery Beverage for Endurance Sports. In Lamprecht M (ed): Acute Topics in Sport Nutrition. Med Sport Sci. Basel, Karger, 2013, vol 59, pp 127–134.
• Ramgolam VS, Markovic-Plese S. Interferon-beta inhibits Th17 cell differentiation in patients with multiple sclerosis. Endocr Metab Immune Disord Drug Targets. 2010 Jun;10(2):161-7.
• Ross AC. Vitamin A and retinoic acid in T cell-related immunity. Am J Clin Nutr. 2012 Oct 10.  
• Schambach F, Schupp M, Lazar MA, Reiner SL. Activation of retinoic acid receptor-alpha favours regulatory T cell induction at the expense of IL-17-secreting T helper cell differentiation. Eur J Immunol. 2007 Sep;37(9):2396-9. 
• Zhang J, Zhang H, Zhang X, Yu Z. Synergistic effect of retinoic acid and vitamin D analog EB1089-induced apoptosis of hepatocellular cancer cells. Cytotechnology. 2012 Oct 16.

Electrolyte Supplement Blocks Exercise Induced Elevations in LDH, Urea, Leucocyte Infiltration into the Heart & the Congestion of Renal Blood Vessels

For the average gymrat it is probably not a question of life or death, but an increase in recovery due to a decrease in detrimental muscle damage in response to dehydration should be an very good argument to get some salt and glucose in after / around your workouts.

Electrolytes have been at the heart of several SuppVersity articles as of late (check them out). Few of them did however have a direct link to exercise. Reason enough to discuss the results of a pertinent paper that was published by two scientists from Cairo University (Osman. 2013). At first sight, the study Hala F. Osman and  Azza M. Atya conducted does not appear to be very exciting. After all, the effects of electrolyte supplements on re-hydration after a workout are nothing that would not have been analyzed in previous studies. Moreover, the study at hand, which has been published in the latest issue of the World of Applied Sciences Journal, is a rodent study and the results would actually be pretty boring if the poor critters had not been sacrificed right after a lengthy HIIT session comprising 5x4 min intervals at 25m/min with 2min break in between, in order to beyond the conventional blood analyses and take a look at their hearts and kidneys.

Rodents don't complain

Now based on human studies we already know what happens in the blood, when we exercise vigorously, CK rises, LDH rises, the serum electrolyte levels get messed up, etc.

Figure 1: Changes in serum electrolyte levels (chloride, magnesium, calcium, phoporus, potassium, natrium) after the HIIT-esque workout w/ or w/out electrolyte supplementation (Osman. 2013)

The exercise induced changes in the electrolyte levels Osman & Atya observed in the rodents were in fact very similar to those that have been reported in human studies. What's more important, though is the fact that they persisted only those rats that did not receive the Rehydran-N solution daily for 45 days + immediately after the workout (see figure 1).

"[...] sodium ions decreased significantly  (P 0.05) after exercised while after  supplementation  by  Rehydran-n  and  Rehydran-n+ (Mg+Ca) citrate in group III and IV the level of sodium ion restored near to the control value. While  potassium ions level increased significantly (P 0.05) in exercised group. The supplementation by Rehydran-n and Rehydran  n+ (Mg+Ca) citrate in group III and IV not affected on the level of potassium and not return the value near to control value." (Osman. 2013)

One thing that is at odds with previous research in humans, is the acute -18.6% drop in magnesium levels. Interestingly, this drop was blunted even when the rodents received the magnesium free NaCl + K electrolyte supplement. The immediate provision of magnesium in the Rehydran-n + Mg + Ca arm of the study, on the other hand, raised the Mg2+ levels by +18% and did thus also result in a transient electrolyte imbalance.

Rehydration prevents organ stress

As I already hinted at in the introduction, having slightly screwed electrolyte levels, as well as elevated amounts of creatine kinase, lactate dehydrogenase and urea in the blood are more or less negligible problems compared to any direct ill health effects the dehydration and the corresponding loss of electrolytes could have on the structural integrity and health of your heart and kidneys. Effects such as those Osman and Atya saw when they analyzed the organs of the animals who did not compensate for the electrolyte loss by the immediate provision of adequate amounts of salt after a workout:

Figure 2: Sections of heart tissue after the workout (Osman. 2013)

"Figure [2] microscopic sections of heart from exercised group [2b] showed leucocytic cells infiltration in cardiac myocytes. Whereas other sections from Rehydran-n treatment  group [2c]  revealed  few  focal intermuscular  inflammatory  cells  infiltration.  While  Rehydran-n+  (Mg+Ca)citrate  treatment  group [2d] showing  no  histopathological  changeslike  those  in control group [2a]." (Osman. 2013)

Kidney sections of rat from control group revealed no histopathological changes. While in  prolonged exercising group showing hyalinosis [=degeneration] of  glomerular tufts. Moreover in Rehydran-n group vacuolations of epithelial lining renal tubules [=accumulation of waste that will be flushed out later on]. Rehydran  n+ (Mg+Ca) citrate treatment group congestion of renal blood vessel was observed [=one reason the better stick to salt, only].

Now, these results certainly sound more frightening than they actually are. Our bodies are (just like those of rodents, by the way) well equipped to handle the occasional cell / organ damage. And the heart is - believe it or not - "only" a muscle. It works slightly different, but can take at least as much beatings as our skeletal muscle tissue. Beatings of which the creatine kinase (CK) and lactate dehydrogenase (LDH) levels in the supplemented groups clearly show that they are are ameliorated by the the provision of electrolytes.

Figure 3: Creatine kinase (CPK), lactate dehydrogenase (LDH) and urea elevations (in %) after 5x4min treadmill runs with 2 min rest in-between (Osman. 2013)

"The present results are in accordance with the exhausted exercised rats resulted in an increased growth in serum CPK activity. This increase, however was markedly reduced in the rats after administration of antioxidant. For instance, 16h exercise in rats caused a marked rise in  activity levels of serum LDH. Increase in serum LDH  activity is mainly due to release from heart and skeletal muscles into blood stream. [...] Different  types  of  stressors  cause  an  increase in activities of serum creatine phosphokinase and lactate dehydrogenase in humans and animals which is an indication of tissue damage." (Osman. 2013)

Now you may be asking yourselves, whether similar effects can be expected in human beings!? Well, the answer should be obvious: "Similar", yes. 100% identical, no. Maughn et al., for example, demonstrated similar (re-)hydration benefits in human subjects in the 1994 - it should be obvious thought that they refrained from cutting their subjects open and checking what happened to their hearts so that we can only speculate about the extend of cellular / structural damage and the corresponding compensatory effects in humans.

Table 1: Ingredients of a single sachet of Rehydran-N which was bought by the reaserchers at a local pharmacy - no sponsorship involved

What can be said for with some certainty, though, is that it is unlikely that you would need more than one sachet of the electrolyte formula with its 0.3g K, 0.7g NaCl, 0.58g tri-sodium citrate and 4g glucose to achieve similar effects. After all, Osman & Atya modeled the amount of electrolytes the rodents received to what human beings would get from one serving of Rehydran-N. It is thus for once not necessary to calculate a human equivalent dose of the electrolytes in the water of the lab animals.

No glucose no effective rehydration

What is however necessary is the inclusion of the sugar or rather glucose in the rehydration formula, because the latter increases the efficacy of the formula significantly.

"The discovery that sodium transport and glucose transport are coupled in the small intestine so that glucose accelerates absorption of solute and water was potentially the most important medical advance this century."(Anonymous in Lancet. 1978)

So don't skip on the miniscule amount of glucose - even if you are suffering from carbophobia and believe that any amount of carbohydrates is going to make you hold water. Trust me, if anything will make you hold water its their absence and the suboptimal uptake of the electrolytes in the absence of glucose that will make you look like a watery version of the Michelin Man.

---

NaHCO3 loading increases performance & decrease LDH activity.

Bottom line: Despite the fact that they may have been derived in a rodent study, the results Osman and Atya present in their most recent paper re-emphasis the need for adequate (re-)hydration before, during and even more so after workouts. In the vicinity of a workout, the latter is best achieved, using a simple salt + glucose mixture that can, but does not necessarily have to include ~360mg magnesium- and ~800mg calcium-citrate. You should yet keep in mind that the the increased levels of Mg2+ and Ca2+ can become burden on your kidney, although they appear to have beneficial effects on the heart (see figure 2).

And as far as the ostensibly beneficial decrease in LDH in the Rehydran-N + Mg + Ca group is concerned, this may well be a simple result of the alkalizing effect of magnesium and calcium ions. Assuming this is correct, similar benefits should occur in response to sodium bicarbonate, aka baking soda supplementation (learn more). The latter is after all part of the standard anti-rhabdomyolysis (=rapid breakdown of damaged skeletal muscle tissue) protocol where it does prevent both, further damage to the musculature and permanent damage to the kidneys (Vanholder. 2000).

References: 

• Anonymous. Water with sugar and salt. Lancet. 1978 Aug 5;2(8084):300-1.
• Maughan RJ, Owen JH, Shirreffs SM, Leiper JB. Post-exercise rehydration in man: effects of electrolyte addition to ingested fluids. Eur J. Appl. Physiol. Occup Physiol., 69: 209-15.
• Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. 2000 Aug;11(8):1553-61. Review.

Deep Mineral Water Maximizes Recovery After Dehydrating Exercise: Significant Effects Within the First 4h, Measurable Effects Even 24h Post - Mechanism Not Clear

Thirsty? Drink mineral water and recover faster!

If you have seen the FIFA World Cup quarter finals, France vs. Germany, you will be aware that the Germans could use a supplement that speeds up regeneration after dehydrating physical activity in the heat. Interestingly enough, a "supplement" like that has been identified only recently by Loreta Stasiule and her colleagues from the Lithuanian Sports University (Stasiule. 2014).

In the corresponding paper, which has been published in the Journal of the International Society of Sports Nutrition roughly a week ago, the researchers report the results of a randomized, double-blind, placebo-controlled crossover human study to evaluate the effect of ingestion of natural mineral water extracted from a depth of 689 m on recovery from prolonged fatiguing aerobic running conducted at 30°C.

You can still drink your protein shake just add the water on top!

Are You Protein Wheysting?

Blends over Isolates!

Protein requ. of athletes

High EAA protein for fat loss

Fast vs. slow protein

5x More Than FDA Allows

"689 m?" - if that's what you're thinking right now, just forget this hilarious detail and think of it as mineral water - I seriously doubt that the exact depth is relevant by any means. What really counts, is the mineral composition of the mineral and regular waters the subjects consumed after running on a motorized treadmill at 40% of their VO2max at a room temperature  of 30°C until a 3% decline in body mass was observed. The total amount of water the subjects had to consume was standardized and amounted to 1.5 times their body mass loss.

Table 1: Concentrations of the minerals and trace elements in drinks used inthe study (Stasiule. 2014)

The water supplements were evenly divided into five equal parts and were ingested at 30 min intervals. To compare their effects, measures of physical performance (aerobic power and lower-body muscle power) and blood CK activity were assessed at 4, 24, and 48 h during the recovery period. To control for possible confounding effects of individual variation, a randomized, double-blind crossover design was used with trials spaced 7 days apart.

Figure 1: VO2max and VO2Max Pulse changes (%) during the post-exercise period (Stasiule. 2014).

If you take a look at the outcome of these trials (Figure 1), its hard to deny that the effects are significant, but irrelevant for the German national soccer team. The next match, the semi finals, is on Tuesday, next week and that's way beyond those 48h where the advantage of mineral over regular water vanishes. The same is true for the accelerated recovery of muscle strength (not shown in Figure 1), which would be particularly useful in dead-ball situations ;-)

You can also use whey while rehydrating: A recent study in the peer-reviewed scientific journal Amino Acids shows that the provision of extra protein "neither enhances nor inhibits post-exercise rehy- dration, when a volume equivalent to 150 % of sweat losses is ingested in 1 h" (James. 2014). In other words: You don't have to drink only mineral water, you can add some whey protein on top of it - and if you're supersmart, you use mineral water to prepare that shake.

Bottom line: Ok, deep mineral water works but why is that the case? Honestly, I don't have a definite answer. One possible explanation the authors have to offer is "that stroke volume recovered better in the DMW trial and that this led to a faster and better recovery of VO2max." As they point out, the expansion of the plasma volume is a well-recognized early response to endurance training and is observed even as an acute response to a single bout of intense exercise. The onset of the phenomenon is extremely rapid and the consequent hypervolemia can improve performance by inducing better muscle perfusion and by increasing stroke volume and maximal cardiac output.

In view of the beneficial effects of the sulfur amino acid taurine, the sulfur and, via a totally different mechanism, the total electrolyte and trace mineral content could and certainly do figure as well. In fact, the latter, i.e. the high comparatively high amount of electrolytes may eventually facilitate the aforementioned maintenance / recovery of an optimal plasma volume and the observed improvements in muscle power recovery which depend on optimal electrolyte levels as well.

Reference:

• James, Lewis J., et al. "Effect of whey protein isolate on rehydration after exercise." Amino acids 46.5 (2014): 1217-1224. 
• Stasiule, Loreta, et al. "Deep mineral water accelerates recovery after dehydrating aerobic exercise: a randomized, double-blind, placebo-controlled crossover study." Journal of the International Society of Sports Nutrition 11.1 (2014): 34.

Milk & Exercise a Perfect Match? A Summary of the Latest Scientific Studies on Its Ability to Sustain Muscle Growth, Protect from Muscle Damage, Binges and Dehydration

Is milk the perfect fluid replacement + anti-post-workout binge + muscle protector for gymrats, fitness junkies and professional athletes? 

It stands out of question. Compared to Coke and many of the so-called "sports-" or "energy drinks" that are in fact no much more than over-caffeinated liquid sugar bars, milk is a healthy beverage. Whether it's also a potent ergogenic though, is still intensely debated.

A recent study from the McMaster University in Hamilton, Ontaria, for example, indicates that the initial surge in post-workout protein synthesis cannot be sustained solely by the low amount of protein in regular milk (Volterman. 2015). Its inability to trigger longlasting increases in protein synthesis and thus to promote a positive whole body protein balance does yet not negate the already proven benefits milk and some of its less-known constituent (I am not talking about whey or casein!) may have for athletes and gymrats.

You can learn more about dairy at the SuppVersity

Dairy Has Branched-Chain Fatty Acids!

Is There Sth. Like a Dairy Weight Loss Miracle?

There is Good A2 and Bad A1 Dairy, True or False?

Lactulose For Your Gut & Overall Health

Is There a "Fat Advantage" for Dairy Lovers

Dairy, Diabetes, Estrogen, IGF-1, Cancer & More

You want to know what kind of advantages this may be? Well, here is a brief overview of the latest scientific evidence that is either directly or indirectly related to potential beneficial effects of milk:

• Consumption of 500 ml of milk post-exercise-induced muscle damage can limit decrements in muscle function in females, and limit increases in soreness and serum markers of muscle damage in females and males.
  
  That's not something I say, but something, scientists from the Institute of Technology in Carlow, Ireland, conclude based on their observations in 32 team sport players (male n = 16; female n = 16) who were randomly, but equally divided into four groups: male milk, male carbohydrate, female milk, and female carbohydrate. Immediately following muscle damaging exercise, participants consumed either 500 ml of milk or 500 ml of an energy-matched carbohydrate solution. Skeletal troponin I (sTnI), creatine kinase (CK), peak torque, counter movement jump height, 20 m sprint performance and passive and active soreness were recorded prior to and 24, 48 and 72 h post-exercise-induced muscle damage (EIMD).
  

  

  Figure 1: Brief overview of the most important facts (Rankin. 2015).

  What the scientists found was that the women experienced likely to very likely beneficial effect on attenuating losses in peak torque at 60°/s from baseline to 24, 48 and 72 h, and a likely beneficial effect in minimizing decrements in sprint performance and soreness over 72 h. Furthermore, the milk consumption was unlikely to have a negative effect on serum markers of damage from baseline to 48 and 72 h.
  
  For males, on the other hand, milk had an unclear effect on muscle function variables. Milk had a most likely/likely beneficial effect on limiting muscle soreness from baseline to 72 h, and a possible beneficial effect on attenuating increases in CK. The effect on sTnI was unlikely to be negative from baseline-72 h. In that, the female participants demonstrated smaller increases in sprint time, passive soreness, active soreness (non-dominant leg) and sTnI values and did thus benefit to a greater yet not significantly greater extent from the 500 ml of milk - that's a difference that could be both sex- and/or protein-specific; I mean, for a man, 500 ml of milk yield significantly less protein on a per kg body weight basis than the same 500 ml do for a woman. That's a difference that could well partly explain why women benefit more from milk vs. carbohydrates only compared to men.
• The consumption of skimmed milk following 30 min of moderate-vigorous cycling exercise reduces subsequent energy intake in female recreational exercisers.
  
  Obviously, working out will only help you shed body fat if the increased energy expenditure during the workout is not (over-)compensated by increased food intake after your workouts. Against that background the results from a recent study from the Northumbria University (Rumbold. 2015) are significant, because they indicate that 600 mL of skimmed milk have a significantly more pronounced "anti-binging" effect than 600 mL of an isocaloric orange drink when they are ingested immediately after a workout.
  

  

  Figure 2: Absolute and relative energy intake during the milk vs. orange juice trials (Rumbold. 2015).

  As the data in Figure 2 indicates the 9 female recreational exercisers (19.7 ± 1.3 years) who completed a standardized exercise regimen consisting of an VO2 peak test and 30 min of moderate-vigorous exercise (65% V̇O2peak) consumed 25.2% ± 16.6% less energy on an ad-libitum pasta meal that was served 60 minutes after the workout.
  
  If we assume that they women didn't compensate for the "missing" 25% of the energy later during the day and assuming that they did the workout 2x per week, the 169kcal per workout would yield a total fat loss of 1.9kg per 6 months - well, if the 7,000kcal deficit per 1kg of fat equation actually held ;-)
• Milk-based drinks are more effective rehydration options compared with traditional sports drinks. The additional energy, protein, and sodium in a milk-based liquid meal supplement facilitate superior fluid recovery following exercise.
  
  The aim of a recent study from the Griffith University study was to compare the rehydration potential of a carbohydrate-electrolyte beverage with several varieties of milk following exercise-induced fluid losses. Fifteen male participants (age 24.9 ± 5.5 years, height 179.3 ± 4.9 cm, body mass 75.8 ± 6.6 kg (mean ± SD)) lost 2.0% ± 0.2% body mass through intermittent cycling before consuming a different beverage on 4 separate occasions.
  
  The drinks that were tested included cow's milk (286 kJ·100 mL(-1)), soy milk (273 kJ·100 mL(-1)), a milk-based liquid meal supplement (Sustagen Sport (Nestle); 417 kJ·100 mL(-1)), and a sports drink (Powerade (Coca Cola Ltd); 129 kJ·100 mL(-1)). Beverages were consumed over 1 h in volumes equivalent to 150% of body mass loss. Body mass, blood and urine samples, and measures of gastrointestinal tolerance were obtained before and hourly for 4 h after beverage consumption.
  

  

  Figure 3: Overview of the most important study results (Desbrow. 2014).

  The results show that the net body mass at the conclusion of each trial was significantly less with Powerade (-1.37 ± 0.3 kg) than with cow's milk (-0.92 ± 0.48 kg), soy milk (-0.78 ± 0.37 kg), and Sustagen Sport (-0.48 ± 0.39 kg). Net body mass was also significantly greater for Sustagen Sport compared with cow's milk trials, but not soy milk. Upon completion of trials, the percentage of beverage retained was Sustagen Sport 65.1% ± 14.7%, soy milk 46.9% ± 19.9%, cow's milk 40.0% ± 24.9%, and Powerade 16.6% ± 16.5%.
  
  If it were not for the fact that some of the subjects were complaining over increased bloating and fullnessduring all milk trials compared with Powerade, there would thus be no reason to go for the "classic" high carb + electrolyte solutions.

Are the hormonal side effects of dairy and its cancerous consequences even worse than they're painted by the steadily growing anti-dairy lobby? Find the answer to this and related questions in a previous SuppVersity article from January 2014 | read more.

Not all that glitters white like milk is gold, though. Only recently scientists from the Tokyo Metropolitan Institute of Gerontology had to realize that milk fat globule membranes, of which previous studies have shown that they may help avoiding metabolic syndrome (Pfeuffer. 2007), do not boost the already beneficial effects of exercise on the frailty status of elderly men and women (Kim. 2015).

Just like the previously discussed disappointing results of the Volterman (2014) study, the results Kim et al. present in their latest study do not negate the existing beneficial effects on satiety / anti-binging, muscle damage and function in response to muscle damaging exercise and rehydration discussed in this article | Comment on Facebook!

References:

• Desbrow, Ben, et al. "Comparing the rehydration potential of different milk-based drinks to a carbohydrate–electrolyte beverage." Applied Physiology, Nutrition, and Metabolism 39.12 (2014): 1366-1372.
• Kim H, Suzuki T, Kim M, Kojima N, Ota N, Shimotoyodome A, Hase T, Hosoi E, Yoshida H. "Effects of Exercise and Milk Fat Globule Membrane (MFGM) Supplementation on Body Composition, Physical Function, and Hematological Parameters in Community-Dwelling Frail Japanese Women: A Randomized Double Blind, Placebo-Controlled, Follow-Up Trial." PLoS One 6;10.2 (2015):e0116256.
• Pfeuffer, M., and J. Schrezenmeir. "Milk and the metabolic syndrome." Obesity reviews 8.2 (2007): 109-118.
• Rankin P, Stevenson E, Cockburn E. "The effect of milk on the attenuation of exercise-induced muscle damage in males and females. Eur J Appl Physiol. (2015): Feb 12. [Epub ahead of print] 
• Rumbold, Penny, et al. "Milk Consumption Following Exercise Reduces Subsequent Energy Intake in Female Recreational Exercisers." Nutrients 7.1 (2015): 293-305.
• Volterman, Kimberly A., et al. "Effects of postexercise milk consumption on whole body protein balance in youth." Journal of Applied Physiology 117.10 (2014): 1165-1169.

Hydrated or Dumb: Dehydration Affects Brain, Muscle and Other Vital Organs - Plus: 15+ Causes of Dehydration + Can the Color of Your Urine Tell You if You Drink Enough?

If you want to stay smart, you should join hands w/ water!

Those of you who are following the 10+ SuppVersity Facebook news on a daily basis, will remember my post about the recent paper - co-authored by Brad Schoenfeld (Ribeiro. 2014) - about the significant "water gain" after workouts. I wrote about that myself, a couple of weeks before in "Cell Swelling Keeps Muscles "Pumped" For More Than 52h. Size Increases of Up to 16% After a Single Leg Workout!" | read more, and mentioned that the intra-muscular swelling is probably a necessary prerequisite, if not driver of skeletal muscle growth.

In today's SuppVersity article, I will now take a step back, away from the musclehead's only interest and peek at other health aspects that are influenced by the hydration status not just of your muscles, but of your whole body.

Hydration Tip of the Century: Many of you will accidentally (or because they read it here, at the SuppVersity, before) already follow this advice, but I still would like to emphasize that the dairy protein you're probably consuming after your workout is not only going to boost your muscle, but also your "water" (=positive hydration) gains. In 2010 James et al. were able to show just that: A post-workout beverage with 40 g/l carbohydrate + 25 g/l milk protein are more effective at augmenting fluid retention than 65g of pure carbs carbohydrate (James, 2010).

In one of the most recent papers on this issue, Natalie A. Masento and her colleagues from the University of Reading reviewed the surprisingly profound effect of dehydration on cognition and mood, of which Masento et al. write that it is "particularly relevant for those with poor fluid regulation, such as the elderly and children" (Masento. 2014).

"With evidence to suggest that individuals are routinely at a risk of mild dehydration day to day (Greenleaf. 1965), particularly vulnerable populations such as children and older adults, there has been an increased interest in studying whether additional water consumption might benefit cognitive performance. The small collection of published water intervention studies involving either young adults or school children report consistent positive effects of water intervention on particular cognitive abilities" (Masento. 2014)

If you take a look at the overview, the researchers compiled (it's too long and eventually repetitive to post it here), you will find studies everything from self-reported fatigue, tiredness and headaches to objectively measured declines in cognitive performance, eye-hand coordination, word recognition, visual attention and - as mentioned in the previously cited article physical performance markers, such as grip strength.

How come? I mean, why does dehydration have such a profound impact?

The above, probably is the question that's preying on your mind right now and I have to admit, I have - just like the researchers from the University of Reading - no conclusive, water-tight *pun intended* answer to that question.

"Despite the expansion of this research area, we still do not have a clear understanding as to how acute water intervention may influence mental performance and its associated neural activity. Researchers have suggested psychological mechanisms related to limited attentional resources during thirst. However, evidence has also highlighted the  importance of physiological mechanisms, with findings that the expectancy of water alone does not influence cognitive performance." (Masento. 2014)

Hitherto proposed mechanisms include references to the Global Workspace Model (Baars. 1993) and being distracted by the often subconscious thought "Where do I find water".

Gray matter activation clusters in dehydration (Streibürger. 2012).

Of potentially greater interest (at least to me) are theories that involve physiological mechanisms, such as the already confirmed...

• shrinkage of total brain volume shrinkage (Streitbürger. 2012; Kempton. 2011) and 
• over-recruitment of specific brain areas during cognitively demanding tasks,

as well as other significant changes at the neural level which contribute to the previously mentioned decline in cognitive performance and awareness (Kempton. 2011).

Luckily, these changes can be reversed by the provision of water in minutes, as long as the subjects are only mildly dehydrated. In view of the

"lack of data related to baseline hydration states of individuals and no further published work using imaging techniques to examine hydration state" (Masento. 2014) 

We do yet once more have to acknowledge that "we know that we know nothing" or, put differently, that these proposed mechanisms are merely speculative.

Potential causes of dehydration: It's not just working out in the heat or simply forgetting to drink (very common in the elderly), there is a multitude of other things that promote dehydration and here are a couple of examples: ✋Low sodium + chloride (can't store water), ✋high calcium, magnesium, zinc, chromium intake, ✋ extreme high sodium or potassium intake, ✋low phosphor intake; ✋high vitamin D, pantothenic acid (B5), pyridoxine (B6) intake; ✋low adrenal output; ✋high protein intakes (esp. when protein is abused as energy source); ✋laxatives, diuretics or other meds or supps -- One thing, however, does not cause dehydration: ☕ Coffee!

Another physiological mechanism that has been suggested is the albeit age-dependent reaction of the central nervous system in response to the ingestion of significant (500ml) amounts of water, of wich May & Jordan found that it causes

• a significant drop in heart rate and an increase in vasodilation in young adults (May. 2011), and the opposite effects, i.e.
• a significant increase in blood pressure in the healthy old subjects in a 2002 study by Schroeder et al. (Schroeder. 2002)

- whether this difference may be brought about by different baseline hydration status, is not clear. What is obvious, though, is that the cardiovascular reactivity promotes cerebral blood flow, which, in turn, will encourage the circulation of substances such as oxygen and glucose that are known to stimulate neural activity and associated behavioural performance (Gold. .1995) in healthy, non-diabetic individuals.

If you think about this hypothesis, i.e. the beneficial effects of water-induced increases, and the detrimental effects of reductions in glucose and oxygen availability in the brain and other organs that would occur, even upon mild dehydration, it seems perfectly logical, a mechanism similar to that has after all been proposed to account for the improved cognitive function due to physical exercise (Kashihara. 2009).

The urine color chart is a valuable tool to judge your hydration status (Wakefield. 2002)

"So how much water to I need?" -- I know. I am mean... the question that's been preying on your mind ever since the introduction. I still did not answer it - right?

Well, you can find the answer in your toilet bowel (see color chart on the right for a guide). You just have to check the color of your urine to know if you're drinking enough... well, at least if you didn't have beets, which will turn it red-brown or red, blackberries, which will give it a red tinge, carrots, which will produce a rusty yellow, paprika, which will make it look orange, rhubarb, which turns it re-brown, then orange, sometimes even yellow-pink, rusty or yellow-brown... and of course the nasty neon-green that's caused by the tons of useless riboflavin (aka vitamin B2) in your urine.

References:

• Baars, Bernard J. "How does a serial, integrated and very limited stream of consciousness emerge from a nervous system that is mostly unconscious, distributed, parallel and of." Experimental and theoretical studies of consciousness 174 (1993): 282.
• Greenleaf, John E., and Frederick Sargent. "Voluntary dehydration in man." Journal of Applied Physiology 20.4 (1965): 719-724.
• Kempton, Matthew J., et al. "Dehydration affects brain structure and function in healthy adolescents." Human brain mapping 32.1 (2011): 71-79. 
• Masento et al. "Effects of hydration status on cognitive performance and mood". British Journal of Nutrition (2014) [ahead of print].
• Ribeiro, Alex S., et al. "Resistance training promotes increase in intracellular hydration in men and women." European Journal of Sport Science ahead-of-print (2014): 1-8.
• Schroeder, Christoph, et al. "Water drinking acutely improves orthostatic tolerance in healthy subjects." Circulation 106.22 (2002): 2806-2811.
• Streitbürger, Daniel-Paolo, et al. "Investigating structural brain changes of dehydration using voxel-based morphometry." PloS one 7.8 (2012): e44195.
• Wakefield, Bonnie, et al. "Monitoring hydration status in elderly veterans." Western Journal of Nursing Research 24.2 (2002): 132-142.