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marylin monroe
Showing posts with label rotator cuff. Show all posts
Showing posts with label rotator cuff. Show all posts

SuppVersity EMG Series - M. Deltoideus, M. Infraspinatus, Supraspinatus and Teres Minor: The Very Best Exercises for Broad Shoulders and Capped Delts

Image 1: The muscles of the deltoids (red) on the
front (left) and back (right) of the body and the
rotator cuff
(violett), the group of muscles
and tendons that stabilize the shoulder.
I don't know about you, but somehow I feel sad that this is already the last installment of the SuppVersity EMG Series. While it certainly was a hell lot of work to compile all the information, I am very pleased that (a few exceptions aside) you, the 'students' of the SuppVersity; appreciate and put into practice some of the information, I am putting out here. That being said, it is actually quite fitting that the series ends on a body part, even bodybuilders hardly ever stop fine-tuning: the complex musculature of the shoulder,
  • the anterior, lateral and posterior part of the m. deltoideus, also known as the pars clavicularis, which attaches to the clavicle, the pars acromialis attaching to the acromion and the pars spinalis that is directly attached to the spina scapulae,
  • the rotator cuffs, which comprise the m. infraspinatus, which arises from beneith the scapula at the fossa infraspinata scapulae and facilitates internal rotation, the m. supraspinatus, which is situated right above the former and is involved in the lateral adduction of the arm, and the m. teres minor, which is attached laterally to the scapula at the margo lateralis scapulae and figures in the abduction of the arm; the m subscapalaris, which completes this commonly overlooked muscular quartet attaches to the inner part of the scapula and facilitates internal rotation, abduction and adduction of the shoulder.
Of the two muscle groups the former, i.e. the "delts", is the one that will give your that broad-shouldered look, everyone is striving for, while the latter constitute a necessary yet commonly overlooked prerequisite to build it. Eventually the muscles of the rotator cuff provide the stability which is necessary to properly execute those front presses, lateral rises, reverse flys and all the other common exercises for round, muscular shoulders! It is vitally important to keep this synergism in mind, when designing a routine - and if the risk of shoulder injuries due to underdeveloped stabilizer muscles does not shock you, maybe the information that a strong foundation in form of properly trained rotator cuff muscles will help you with "increasing your bench", so that the next time a bro asks you "Hey bro, how much ya bench!" you may well impress him with a new personal best (in case that is what you're training for ;-)
ChestBicepsBackCoreLegsTricepsShoulders
Navigate the SuppVersity EMG Series - Click on the desired body part to see the optimal exercises.
But enough of the mourning and mocking, let's get some meat on your shoulders, or rather, let's get to the meat and potatoes of shoulder training - the SuppVersity proudly presents: The most effective exercises, as measured by electromyography (10 male resistance-trained subjects, mean age 22y, mean body-fat 13%; data from Boeckh-Behrens & Buskies. 2000) for building massive delts and a powerful rotator cuff...

I. The Best Exercises for the Anterior, Lateral and Posterior Parts of the Delts

Image 2: Turns out the injury-prone neck
press is the most versatile delt-exercise as
it hits both the anterior, as well as the lateral
part of the delts about as hard
(image from sportkrachtfitness.nl)
I probably will never get tired of telling you that complete isolation, as in "petri-dish" experiments, is nothing you will be able to achieve in the gym - not even if you use one of those fancy new devices, the name of which would suggest that they would facilitate exactly that ;-) In the real world (and, believe it or not, the gym is part of it) your muscles will always work synergistically to move the weight from point A to point B. It is however very well possible to influence which muscle group and even which individual muscle takes the lion's share of the workload by selecting the right exercises and / or manipulating the way you perform a given exercise.Always remember this, when you take a look at the following list of the "most effective exercises" (correctly I should say the exercises with the highest EMG activity).

    for the lateral part...

  1. Lateral raise - DB, internal rotation (view)
  2. Reverse fly - machine, ext. rotation
  3. Neck press - BB, seated
    for the posterior part...

  1. Reverse fly - machine, int. rotation (view)
  2. Reverse fly - DB, internal rotation
    for the anterior part...

  1. Military press - BB, seated
  2. Neck press - BB, seated
  3. Lateral raise - DB, internal rotation
  4. Bench press - BB
  5. Front raise - DB, external rotation

* BB = barbell; DB = dumbbell

    Figure 1: EMG activity of anterior, lateral and posterior part of the m. deltoideus during selected exercises relative to the military press (anterior), the DB lateral raise (lateral) and the DB reverse fly (posterior); calculated based on data from  from Boeckh-Behrens & Buskies (2000)
    The EMG data in figure 1 confirms what trainers all over the world have been propagating for decades. A pressing movement for the front delt (anterior part), some lateral raises for the lateral part and a few reverse flys for the posterior delts is all it really takes to built "cannon-ball delts". Another common wisdom, which says that front raises were among the most effective exercises for the anterior deltoid, on the other hand, gets busted. Even done with your ams externally rotated, the DB front raise is 41% less effective than the "gold standard", the barbell military press. A possible reason (and major drawback of all EMG data) for the "inferior" activation of front delt by the DB front raise are significantly lighter loads compared to the BB military press. If the subjects had used 120lbs for the military press, but only 25pounds per DB for front raises, for example, the muscle activity per pound of weight for the DB front raise would in fact have been roughly tree times higher - 929µV/120lbs=7.71 for the BB military press vs. 548µV/25lbs=21.92 for the DB front raise. That being said it stands out of question that, within a volume program, there certainly is a place for an isolation exercise such as the DB front raise, even if it is not a classic "mass building" exercise, the outstanding characteristic of which is maximal muscular overload, after all.
    Image 3: With its naturally arched
    movement, the DB shoulder press
    may be a viable, if not preferable
    alternative to the BB military and
    BB neck press (image everkineti.com)
    Exercise tip: While the respective EMG values for dumbbell exercises have not been measured in the study, it is very likely that exercises such as the DB overhead press provide an extra stimulus over their barbell equivalent that is related to the more natural arch of motion, where you get a good stretch at the bottom and can really squeeze the muscles in the contracted position, when the dumbbells approach (they do not cling!) each other at the top of the movement.

    That being said, the DB overhead press is also a viable alternative for the BB neck press as the position center of gravity is more in line with your head throughout the movement. It may thus be assumed that the the stimulus shifts away from the front and towards the lateral deltoid, as it is the case with the neck vs. the military press.
    Form, I cannot emphasize that enough, becomes more and more important with lighter weights, and as your shoulder is peculiarly prone to injury and generally much weaker than your legs, for example, it is not only advisable, but simply a matter of physical limitations to use lighter weights. That being said, the previously cited example of the DB front raise shows that lighter weights do not equal inferior muscle stimulation, as - done properly - respective isolation exercises generate way more torque per pound of weight you are handling than their mass building counterparts.
    Figure 2: Reduction in EMG activity of selected variants of the DB lateral raise and the reverse fly relative to lateral raises with external rotation, DB raises with 90° arm/torso angle and internally rotated machine reverse flys; calculated based on data from  from Boeckh-Behrens & Buskies (2000)
    Form does yet not only determine overall intensity, the way you are doing your shoulder exercises also has a profound influence on the degree to which the three parts of your deltoids are activated. Doing DB lateral raises internally rotated, for example, reduced the activation of the lateral part of your delts by -16%, using a neutral, i.e. a hammer grip (thumbs facing up) was associated with a -12% reduction in EMG activity. In the case of the DB reverse fly the use of an arm to torso angle of 45°, instead of 90°, reduces the load on the lateral part of the deltoids by -29% and gripping the handles of the reverse fly machine from the out- instead of the inside (external vs. internal rotation of the arm), takes away -20% of the stimulus (cf. figure 2).

    Dessicating the Lateral Raise

    If you make good use of what you have learned at the end of the previous paragraph, you can improve the load on the target muscle, while handling lighter weights and decreasing your risk of injury - I know, the big weights are more impressive, but after all what's the use of using the biggest weights, if you are not making progress, both strength- and size-wise, because of improper form? I mean, it is one thing to cheat on the last 1-2 reps of a set in order to squeeze out the very last drops of gasoline from your muscular tanks, it is however something completely different to compromise form, just to be "the guy who lifts the heavy weights". There is hardly any movement, where this becomes so obvious as with the DB lateral raise. If you do not do it yourself, you certainly know someone who grabs the 50lbs dumbbells, holds them vertically before his groin and then powers, or I should say, "rips" them up to his sides, lets them bang down and starts all over again until, after he eventually racked the weights, he grabs his shoulder or wrist in agony, yet not without the pride of having used a heavier weight than the guy next to him.
    Note: The following analysis is based on a VERY simple mechanical model and does not consider factors such as increased load per square area of muscle fiber in the stretched position, effects of static or complete contraction etc... Notwithstanding, if you like the following part of this write-up, please spread the word (via Facebook, Twitter, etc.) and let me know (in the comment section or the SuppVersity Facebook page) that it would be worth the effort to do similar and even more depth analysis in the future!
    You already know from the previous paragraphs and the EMG data in figure 2, that it is imperative to keep the arms externally rotated, i.e. to pretend you were trying to pour out an imaginary liquid from the dumbbell at the top of the movement, if you do not want to lose 16% of the muscle tension in the first place... Well, but what about the aforementioned guy who does not even get the chance to think about pouring out any liquid other than that in his shaker bottle, when he is performing his ballistic weight exercises? Which of his mistakes, do you think compromises the effectiveness of the lateral raise most?
    1. Flexing the elbow too much (often up to 90°) and thus reducing the lever? Or,
    2. Not raising the dumbbells to shoulder height, i.e. keeping the angle between arm and torso <<90° (often <<70°)
    Well, from a physical perspective, which always provides a very selective and (over-)simplified view of reality, the answer would be "1. flexing the elbow too much". Surprised?
    Figure 3: Effects of arm/torso angle and elbow flexion on torque during the DB lateral raise
    (data calculated based on a very basic physical model)
    While raising the dumbbells to 75°, takes away less than 5% of the torque (cf. figure 3), flexing the elbow to 90° reduces the torque on the lateral parts of your deltaoids have to overcome by a whopping -50%! Think about that, when you look at the guy with the 50lbs dumbbells the next time you are at the gym. Chances are that you, with your 30lbs DBs are way stronger than he is, as long as you do not give in and reduce your elbow flexion more than those 15% that relieve some of the stress on the joint, but only minimally reduce the torque on the muscle.

    II. The Best Exercises for the Rotator Cuff

    I hope that, over all that you have learned about delt-training by now, you did not forget, what I mentioned at the very beginning of this installment of the SuppVersity EMG Series: Rotator cuff training equals active injury prevention. While most trainees do not even feel them working, the muscles of the rotator cuff are crucial for the stability of the most flexible and volatile joint in your whole body, your shoulder. It is imperative for these largely overlooked and often undertrained muscles to hold the ligaments and bones of your shoulder in position so that your other muscles such as the deltoids or the pectoralis can do their job. To build a strong m. infraspinatus, m. supraspinatus and m. teres minor, is thus also the foundation of building a "bigger bench" to impress your bros at the gym. If you don't believe that, you may listen to strength coach Charles Poliquin, who has the following anecdote to tell:
    One of my pro hockey players, Jim McKenzie, improved his 14-inch, close-grip bench by 51 pounds in 12 weeks, from 280 to 331 pounds, by focusing on rotator cuff strength.
    And though I doubt the universality of Poliquin's "research", as far as the non-athletic regular gym-goer is concerned, it is certainly noteworthy that his years of experience in working with athletes have told him that "rotator cuff strength should be about 9.8 percent of what you can lift in the bench press [for] pain free bench pressing". That means, if you are benching 200lbs you should not wonder if your shoulder begins to hurt, if you are not able to use 20lbs dumbbells when doing external rotations lying on a mat on the floor ...
    Figure 4: EMG activity of the major muscles of the rotator cuff during selected exercises relative to the DB external rotations done lying sideways on the floor; calculated based on data from  from Boeckh-Behrens & Buskies (2000)
    A pros pos external rotations as the data in figure 4 goes to show this is by far the best isolation exercise for the muscles of the rotator cuff. In essence, it does not really matter if you want to do them with a dumbbell standing, lying on the floor or with an elbow on a bench, or if you prefer doing them using a cable pulley. The differences are negligible, in view of the huge difference improper exercise execution would make - so you better do an exercise you like with light weights and feel the muscle working than an exercise that has been shown in study XYZ to be the most effective with a weight you can hardly handle and where you do not feel the target muscles working. This, by the way applies to the static doorway pushback, which is basically an "inverted pectoral stretch" where you push with the backside of your arm (angle arms/torso 90°) backwards against an immobile object like a doorway, as well. If you do not feel like this static exercise is working for you chose a different one.
    Image 4: DB lateral raise with
    arms 30° horiz. adducted for the
    m. supraspinatus (Jobe. 1986)
    Isolating the m. supraspinatus with lateral raises: According to Jobe & Moynes (1986) the DB lateral raises performed with a 30° horizontal adduction of the arms fully isolates the m. supraspinatus if you rotate your shoulders so that your palms are facing the floor (the good old "emptying the bottle" technique). Doing 1-2 sets of lateral raises this way certainly is a time efficient way of incorporating a strengthening exercise for the upper part of the rotator cuff into your routine. You will have to use much lighter weights than on regular lateral raises, though.

    III. Conclusion- Three Plus One Equals Injury-Free Strength and Size

    An imperative prerequisite for building impressive deltoids and thus broad, rounded shoulders is a stable foundation in form of strong rotator cuff muscles, if you neglect the latter you will either plateau or - even worse - injure yourself sooner or later. That being said, especially your front delts are hit very hard during pretty much all pressing movements for chest and triceps, it is thus neither really necessary nor advisable to do more than one (if any) "isolation" exercise in the form of a compound movement like the barbell or dumbbell military press, a movement, which by the way will also greatly help to bring up "the upper chest" many bodybuilders feel they are lacking. If you complement this basic "mass builder" with some lateral raises and reverse flys, the one and only thing that is really left to do on "delt day" is a rotator cuff exercise of your choice and you are ready for some highly anabolic rest and recovery ;-)

    An EMG-Optimized Routine

    Image 5: You can rotate in some
    Arnold Presses, if you feel you did
    not hammer your front delts heavy
    enough with the military press
    There is of course a myriad of ways of combining the individual exercises, my personal recommendation for overall deltoid development and rotator cuff strength (based on EMG measures) would yet be as follows...
    1. Military Press - BB or DB seated, 6-8 reps
    2. Lateral raise - DB elbow-flexion <15°(!), 10-12 reps
    3. Reverse fly - machine or DB, internal rotation, 10-12 reps
    4. External DB rotations - lying on the floor, 12-15 reps
    You may notice that I do not make volume (i.e. set) recommendations. This is due to the fact that I found that everyone has to find what works best for him / her in terms of optimal volume, training frequency and body part splits. This may also change over time / according to lifestyle factors / nutrition and supplementation.

    Impingement No More: Study Outlines 6 Week Protocol That Reduces, in 15% of the Cases Even Resolves Shoulder Pain

    Image 1: A 1990 study by Lo et al. reports that 43.8% of athletes who are competing in sports with upper arm involvement complain about shoulder problems, 29% with constant pain (Lo. 1990)!
    If you are thinking about sex, lies, ex-presidents and obese interns at the White House, when you hear the word "impingement" your language proficiency is not the best and / or you are one of those guys (or girls) who prefers his gossip weekly over the latest issue of a fitness, let alone a bodybuilding magazine (unlikely for SuppVersity students, but who knows?). If you don't belong to this group and / or have just begun to massage your aching shoulder, however, the results of a recently published study on the effectiveness of a 6-week scapular muscle rehabiliation exercise regimen that was specifically designed to alleviate the pain and improve the limited flexibility of athletes with mild to moderate shoulder impingement could be of great interest to you.

    The scientifically proven 6-week anti-impingement protocol

    For their trial, K. De May and his colleagues from the Department of Rehabilitation Sciences and Physiotherapy of the Faculty of Medicine and Health Sciences at the University Hospital in Ghent, Belgium, recruited 47 athletes (25 men and 22 women; mean 24.6 years); BMI 22.70kg/m²) who had been spending 6+ hours a week playing competitive overhead sports [volleyball (17), tennis (10), canoe polo (2), baseball (2), swimming (11), and badminton (5)] and had been suffering from recurrent or constant shoulder impingement symptoms for at least 3 months. After an initial screening in the course of which the impingement was diagnosed by experienced practitioners, the subjects were assigned to a pretty simple, daily exercise program that consisted of four exercises
    • Image 2 (De May. 2012): Images of the exercises in the same order as in the description to the left: Prone extensions, forward flexion, external rotation, horizontal abduction + external  rotation from 90° position of flexion
      Prone extension (view) - The subject is prone with the shoulders resting in 90° of forward flexion. From this position, the subject performs bilateral extension to a neutral position with the shoulder in neutral rotation. 
    • Forward flexion in side lying (similar, but lying on the side)- The subject is in a side-lying position, with the shoulder in neutral. The subject performs 90° of unilateral forward flexion in a sagittal plane.
    • External rotation in side lying (view) - The subject is side lying with the shoulder in neutral position and the elbow flexed 90°. From this position, the subject performs 90° of external rotation of the shoulder with a towel between the elbow and trunk to avoid compensatory movements.
    • Prone horizontal abduction with external rotation (like this, but with arms in position shown in image 2) - The subject is prone with the shoulders resting in 90° of forward flexion. From this position, the subject performs bilateral horizontal abduction to a horizontal position, with an additional external rotation of the shoulder at the end of the movement.
    à 3 sets of 10 repetitions each, with 1 minute rest between sets and a weekly randomized exercise order (to ensure you train all muscle parts equally and don't just replace one imbalance with another one). Before and after the 6-week intervention period, the participants had to answer a standardized questionnaire (the Aside from a questionnaire, the so-called "Shoulder Pain and Disability Index" (SPADI; cf. Brechenridge. 2011) and were hooked up to an EMG apparatus to measure their specific muscular activation patterns.
    Figure 1: Pre- and post maximum voluntary isometric contraction (MVIC) in manual muscle test positions specific to each muscle of interest (value expressed relative to mean EMG activity for all 4 muscles; left) and absolute changes in EMG activity during arm elevation (right) from pre- to post intervention (De Mey. 2012)
    The MVC data in figure 1 (left) was obtained in manual muscle test positions specific to each muscle of interest and in 5-sec MVIC intervals with 5 seconds breaks in between the activation. And yielded the following insights (De Mey. 2012):
    • all 3 trapezius muscle parts exhibited increased maximum voluntary isometric contraction (MVIC) values after the exercise program (figure 1, left)
    • all 3 trapezius muscle did contract less forcefully during arm elevation, while no change was seen for the serratus anterior (figure 1, right)
    • the upper trapezius to serratus anterior (UT/SA) ratio significantly decreased after the training program, whereas the UT/ MT and UT/LT ratios did not change (data not shown).
    Image 3: Illustration of the anatomy of the subacromial space
    The significantly improved Shoulder Pain and Disability Index (SPADI) score (29.86 to 11.70 after 6 weeks; .60% reduction on average; 7 patients were basically pain-free after 6 weeks!) has therefore to be considered a result of a combined reduction of trapezius activation (not strength!) during the scapular plane elevation and the concomittant increase in the UT / SA ratio, which probably left more space for the impinged tendons to pass through the narrow subacromial space (see image 3).

    Judged based on the results of other studies and what is generally described as a significant improvement in SPADI scores (8-13.2pts) in the literature, the researchers point out that
    ...[i]n our study, this was the case in 23 athletes. In 7 players, full recovery was attained based on a SPADI score of 0 during postmeasurements. The results of this study are very promising since limiting shoulder symptoms in active overhead athletes suffering from persistent mild symptoms might serve as a secondary injury prevention measure, limiting continued low-grade shoulder pain, fear avoidance, and ultimately surgical management requirement. (De Mey. 2012)
    If the prospect of surgery-free total pain relief is not enough to invest a couple of minutes into rehab everyday, you are either the laziest slacker, I know, or don't know how f*** bad that hurts and how debilitating a chronic injury like this can be!

    Implications: So, regardless of whether your shoulder does already hurt or you are smart and willing enough to spend a couple of extra minutes on "prehab" exercises I highly suggest that you
    • don't be stupid and take 2-3 weeks off from all your regular upper body exercises and focus on working on the muscular imbalances which are the underlying reason of existing shoulder pain in 90% of the cases to then gradually resume your regular training with light weights and low(er) volume on all those pushing movement the average gymbro loves to do
    • be smart and incorporate 2 of the exercises into every other workout to make sure that you can preserve your presently pain-free state and don't end up ruining your progress, just because your ego told you that it would look better to do another 5 sets of bench presses than a couple of prone extensions and external rotations
    And don't forget to revise your complete training regimen - are you doing the same number of sets for your upper chest and front delts as you do for your whole back? If so, it's about time for a more balanced regimen, one that will not only help you prevent muscular imbalances in the first place, but also facilitate constant progress towards a symmetrical and aesthetic physique.

    You Want to Learn About the 'Best' Exercises for Shoulders & Co? Look No Further!

    ChestBicepsBackCoreLegsTricepsShoulders
    The SuppVersity EMG Series can help you in deciding which exercises should be part of your next workout routine.

    References:

    • Breckenridge JD, McAuley JH. Shoulder Pain and Disability Index (SPADI). J Physiother. 2011;57(3):197.
    • De Mey K, Danneels L, Cagnie B, Cools AM. Scapular Muscle Rehabilitation Exercises in Overhead Athletes With Impingement Symptoms: Effect of a 6-Week Training Program on Muscle Recruitment and Functional Outcome. Am J Sports Med. 2012 Jul 11.
    • Lo YP, Hsu YC, Chan KM. Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med. 1990 Sep;24(3):173-7.

    Muscle Activation of Chest, Core, Delts & Rotator Cuff When You Bench on Unstable Ground, Calcium Supplementation & Vascular Disease. BMI, BAI , Body Fat & CVD Risk

    This week's SuppVersity figure(s) of the week deal with the leading cause of death in the USA (see paper attached to the guy's big toe ;-).
    After reading yesterday's installment of the Science Round-Up Seconds, you already know that it is unlikely that you are going to die from prostate cancer.... but let's face it - we all are going to die one day, so if your death is not natural and not due to prostate cancer? What's going to the reason? Well, according to the latest CDC data you, my American friends are going to die from heart disease - ok, not you, a devoted follower of physical culturist, but the average American a devoted follower of Dr. Oz and the sedentary way of living, has an 0.2‰ chance of dying from heart disease and following one of the 597,689 victims the Western way of life claimed in 2010 (CDC. 2011)

    Chest presses on an unstable surface - A new staple exercise? Or bogus?

    (McHardy. 2013) -- I am not quite sure about the States, but over here in Germany much of the funky news sh*t like squatting on unstable surfaces, benching with your bag on a bogus... ah, pardon bozo ball etc. have literally disappeared from both, the mainstream fitness magazines and the gyms. Heavy iron, machine based circle training and classic, as well as HIIT cardio are what people do, so that the  twenty-seven healthy male subjects from the McHardy study would probably have attracted much attention, when they performed their isometric chest presses at maximal voluntary contraction (MVC), 75% MVC, and 50% MVC on a stability ball.
    Figure 1: Exercise specific rel. activation patterns for DB chest presses; data expressed relative to to mean (McHard. 2013)
    As it was to be expected the additional task of having to stabilize their trunk and body, lead to a significant reduction in MVC force output of the main, as well as the agonistic muscle groups. The core, on the other hand was trained pretty effectively, especially in the low(er) intensity conditions.

    What's somewhat surprising, yet maybe highly relevant and an important argument that would speak against doing your chest presses on a stability ball, though, is the highly significant activation of the infraspinatus, the "small" muscle, most people tend to forget about until they suffer from their first rotator cuff injury.

    Bottom line: Due to an increased risk of injury and non-specificity of the exercise doing shoulder presses on a stability ball is probably useful only as a low weight additional movement used either to warm up or after a primary move like the classic or decline bench presses (learn more about the best chest exercises, here).

    Calcium supplementation and vascular disease + Tip: Use Super Tracker

    (Dpwning. 2013) --  It is one of those never-ending research stories, the quest for the answer to the (important?) question, whether calcium supplementation increases, decreases or does not influence the risk of cardiovascular disease at all.

    As a student of the SuppVersity, you know that casein can build 3.2kg muscle literally overnight (learn more). But did you know that a single serving of one of the best selling casein proteins will satisfy 50% of your daily calcium needs? No? Well, in that case you probably don't know that that both lactose and certain caseinophosphopeptides greatly improve the bioavailability of calcium in dairy products over that of most other natural ans certainly supplemental sources (Cámara-Martos. 2002).
    The latest and certainly not last chapter in this never-ending story has just been published in the medical journal Obesity. It is a meta-analysis conducted on 13 observational studies and 9 clinical trials pertaining to calcium supplement use and the risk of adverse outcomes such as cardiovascular disease (CVD), myocardial infarction (MI) that concludes:
    "Overall, the benefits of calcium supplementation, including the positive effects on bone health, appear to outweigh the theoretical risk of increased cardiovascular events." (Downing. 2013)
    Considering the fact that at least those of you who consume significant amounts (not "one serving") of preferably green vegetables and dairy on a regular basis are not in need of calcium supplements, I'd suggest you leave worrying about questions like this to people who should better look into the overall quality of their diet instead of resorting to supplements to maintain bone and heart health (yeah, low calcium is bad for the heart).

    Bottom line: Supplementation should not be necessary of someone who has both green vegetables and dairy in his/her diet. I would recommend you register a free account over at the USDA's SuperTracker and simply plug in your food choices for a couple of days to see if you get enough calcium and what other nutrients you may or may not be deficient in. Don't be shy, the registration is free - you don't even have to enter an email address and the USDA data base is the best source for accurate information about the nutrient contents of food you will find... just ignore "your plate" and you are good to go ;-)

    Surprising superiority of the BMI over BAI as a marker of cardiometabolic risk

    Table 1: If you go by the p-values which indicate the statitical significance of the correlations the BMI is even better than DEXA measured body fat percentages; nd. signifies no difference in p-value detected, while BMI and %BF tell you that the respective value is the "better" predictor (Lichtash. 2013)
    (Lichtash. 2013) -- Let's get the most important things straight, first. The study we are looking at, here, was conduced on 698 Mexican subjects from 193 families (299 male and 399 female) which represent a cross section through the population of immigrants and the children of immigrants with average body fat percentages of 38% and 25% for female and male participants respectively. We are thus not talking about the average physical culturist, here.

    Nevertheless, I personally was quite astonished, to read contrary to the BMI which was associated with all but two measured traits (carotid intima-media thickness and fasting glucose in men) of cardiovascular disease risk the body adiposity index (BAI) which has a 85% correlation with DEXA measured body fat index (Bergman. 2011) "lacked association with several variables" (Lichash. 2013).
     
    Now if you come to think about the way the BAI is calculated (formula from wikipedia.com)


    It is yet not really so surprising, after all the fat that's stored on the hip and buttocks has long been shown to be ugly and aesthetically displeasing, but not a major concern, when it comes to its impact on your metabolic health. The BIA will thus overestimate the risk of people who carry a relatively high amount of benign body fat and underestimate the risk of abdominally obese men and women, who often have a very low hip circumference.

    Bottom line: The important message of the study at hand is thus not that the BMI was a better, let alone good measure of cardiovascular disease risk, but rather that the BIA, i.e. the raio of hip circumference to body height is an even worse indicator of cardiovascular disease risk for the average (pretty chubby) American with Mexican ancestors.

    That's it for today...

    ... as far as the official short news are concerned. If you want some additional up-to-date information from the realms of health, exercise, nutrition and supplementation sciences, I suggest you visit any of the following SuppVersity Facebook News
    • Are you inflamed enough to lose fat? "Inflammation Is a True Fat Burner: BSO-Induced Glutathione Depletion Wards off Fat Gains on Hypercaloric Diet" (read more)
      Chronically fatigued? Maybe you are just lacking the HDL to get the cholesterol into the adrenal gland!? | read more
    • Who is to blame for the obesity epidemic? If you ask the public, the obese are primarily to blame | see more
    • Meta-analysis shows: Neither high nor low fat diets have definite beneficial effects on blood lipids | learn more 
    • Further evidence for the involvement of antioxidants in the proliferation of cancer. They are the ones that help the cancer cells to survive | freak out 
    • Want to lose 15% chest & ab fat and 10% of the subcutaneous fat on your thighs? Do some ultra endurance cycling | believe it or not
    and/or come back later to check for the latest updates on Facebook or Sunday's SuppVersity article. Have a nice weekend, everyone!

    References:
    • Bergman RN, Stefanovski D, Buchanan TA, Sumner AE, Reynolds JC, Sebring NG, Xiang AH, Watanabe RM. A better index of body adiposity. Obesity (Silver Spring). 2011 May;19(5):1083-9.  
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