Revisiting Supplementation

23 09 2013

articlesupplementsimage

Earlier this year I started up a short series on vitamin supplementation. Since this time I’ve read numerous additional articles and studies and thought it would be a good idea to post my latest thoughts on vitamin supplementation.

As I said in my first post, vitamin supplementation is not absolutely necessary for everyone and most vitamins and minerals should be achieved through eating a well-balanced diet of whole foods. Take the term supplementation literally; you should really only supplement with something if you cannot get adequate amounts from your diet. With this in mind, let’s start with the most commonly used supplement out there: multivitamins.

Multivitamins

Earlier this year, my general stance on multivitamins was that they were a good way to ensure intake of all vitamins and the benefits surely outweighed the risks. Even the Harvard School of Public Health agreed: “Looking at all the evidence, the potential health benefits of taking a standard daily multivitamin seem to outweigh the potential risks for most people.” However, the more I read, the more I become skeptical of effectiveness of multivitamin products. The major issues?:

  • Most multivitamins provide levels around the recommended daily allowance (RDA), which accounts for a minimum level of health, not an optimal level.
  • Most multivitamins contain a majority of micronutrients that are readily met through even the poorest of diets. You end up getting very little of what you actually need, and too much of what is unnecessary.
  • Multivitamins lack the other compounds of real food which are necessary for absorption and that contribute to optimal health.
  • Too much focus on including a plethora of vitamins and minerals, not enough focus on the necessary vitamins and minerals, nor optimal dosing.

I have multivitamins in the house, but I stopped taking them earlier this summer. When I stopped, there was no noticeable change in my energy levels, general well-being, or overall health. Instead, I began to concentrate on individual vitamins and minerals that are difficult to get through a balanced diet, which is now the recommendation that I would make for others. Multivitamins are great in concept, but their effectiveness has not been proven. Due to this, most people will be much better off spending their money on only the vitamins and minerals that are the most difficult to get, which include…

Vitamin D

The RDA for vitamin D is roughly 400-800 IU, but the optimal level is, at minimum, 2000 IU; as I mentioned in my post on Vitamin D earlier in the year, daily intake of closer to 4000 IU is recommended. The only people who do not need to concern themselves with vitamin D are those that live within the tropics and have frequent sun exposure with bare skin (wearing a t-shirt and shorts is not enough). For the majority of my readers, those of us in the northern hemisphere, vitamin D supplementation is absolutely necessary for optimal health, especially in the winter. Don’t overlook this important vitamin!!!

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Vitamin K

The RDA for vitamin K is roughly 60-120 mcg, and the optimal level is roughly 1000 mcg. The problem with getting enough vitamin K is that most foods containing the vitamin have very poor bioavailability, or in other words, the human body is simply unable to extract the full amount from the food. Due to this, supplementing with vitamin K might be necessary.However, if you eat a diet that contains a lot of leafy greens (kale, spinach, collards, broccoli, brussels sprouts, etc.) and lean animal protein (especially whole eggs), you likely needn’t worry about additional supplementation.

Iron

A friend of mine recently told me that she was thinking about getting an iron supplement. My reaction: Why? Her answer: Because a friend of mine said it helped with her premenstrual cramps. Okie dokie. Here’s the thing about iron: yes, it is a common deficiency (especially among women) in our society, but you shouldn’t start taking an iron supplement on a whim. I suffered from an iron deficiency for years, supplemented with over-the-counter pills and liquids for a few years, and since my levels returned to normal I have been able to maintain healthy levels of iron through my diet. The cause of my deficiency remains a mystery, but those typically at risk include children and pre-menopausal women, most notably those with diets restrictive of animal sources (vegans and vegetarians). If you suffer from the symptoms below, please consult your physician to see if iron supplementation is right for you:

  • fatigue
  • dizziness
  • pallor
  • hair loss
  • twitches
  • weakness

Calcium

Deficiency is common in older people and those with low dairy intake. If you do not consume dairy and do not eat a lot of kale, collard greens, broccoli, or other greens, you will almost surely be calcium-deficient. These whole foods contain far more bioavailable calcium than their supplemental counterparts, so increasing these foods in the diet should be option #1, but supplementing with a high quality calcium supplement could be a secondary option. My first suggestion would be to start with a whey protein supplement, as whey contains 20% of the RDA for calcium and also provides additional protein- something that will only benefit the body. If you are considering a calcium supplement, please first consult your physician; multiple studies have linked calcium supplementation with an increased risk of cardiovascular disease and several forms of cancer, so proceed with caution. Again, whole foods are the best choice.

Magnesium

I covered this in-depth in its own piece a few months ago, but long story short:magnesium supplementation can be quite beneficial for athletes. For the general population, if you don’t consume a diet that contains ample amounts of nuts, seeds, beans and/or leafy greens, you may very well be magnesium-deficient.

Fish oil/Omega-3

Yep, fish oil is important. Do it.

Yep, fish oil is important. Do it.

Essential fatty acids (EFAs) omega-6 and omega-3 are essential to human health and must be consumed in the diet. The North American diet contains a plethora of omega-6 foods, but very few omega-3s. An optimal ratio of the two EFAs is 1:1, so everyone should make an effort to eat fatty fish a few times a week or to supplement with a fish oil supplement. I covered this supplement here.

Creatine

Often thought of as a supplement for bodybuilders and gym junkies, creatine has gotten a weird reputation. Creatine is naturally produced in the human body and is a major component in supplying energy to cells, namely muscle. Yes, creatine has demonstrated reliability when it comes to things like overall power output and strength, but it is also very beneficial for people who do not frequent the gym. Non-meat eaters are a population that should surely be supplementing with creatine. As roughly half the creatine stored in the human body comes from the diet (which can only be derived from animal sources), vegetarians and vegans have significantly lower levels in their bodies. This can result in poor energy levels and decreased cognition. Creatine supplementation studies have shown a significant increase in cognition/intelligence, as well as the ability to ward off the symptoms of depression, most notably in vegetarian/female populations. If you are a meat-eater, you may not need creatine supplementation (unless you have personal strength goals at the gym, in which case you should definitely be supplementing), but for non-meat eaters, creatine supplementation should be seriously considered.

Aside from these supplements listed above, there really aren’t many other that I would advise looking into. One of my favourite online images will serve to give you a very good idea of which supplements can be trusted for what:

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The graphic isn’t perfect- for example there have been reliable studies conducted on magnesium demonstrating an increase in serum magnesium in the body, a decrease in blood pressure and an increase in aerobic capacity and muscle oxygenation- but it’s a nice overview with fairly accurate indication of what you should and should not spend your money on. In the end there are tons of supplements on the market claiming to do many things, but the reality of the matter is that most are good in theory, but poor in practice. Eat whole foods, do your homework, and if you are taking a supplement, be honest with yourself and listen to your body- are you actually getting any benefit from the supplement? If not, save your money and improve your diet!

For more information on nutritional supplementation, or for questions related to specific supplements, please feel free to post a comment below!

Happy Monday!

DW

 

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Supplements 101: Creatine

28 02 2013

jamesst4

What is creatine?

I could get really scientific here, but I’m going to try to keep this as simple as possible, while still explaining what happens in the body. Creatine is naturally produced in the human body from the breakdown of amino acids, half of which we create, half of which we get in our diet through animal meat (save for vegetarians, who have lower levels of stored creatine than non-vegetarians).  It is transported in the blood to supply energy to all cells in the body, primarily muscle (95%). Energy is made available to cells when adenosine triphosphate (ATP) is broken down into adenosine diphosphate (ADP) and a phosphate molecule (P). Creatine supplies energy by transporting ADP so that it can reform into ATP. It does this by interacting with an enzyme called creatine kinase (CK) (which is located on the body’s energy-producing organelles, mitochondria), taking a phosphate molecule from the mitochondria and releasing energy. Creatine then becomes creatine phosphate (CP) and in turn takes this extra phosphate to the area of work, re-interacts with CK, and releases the phosphate to join with another ADP molecule, creating an ATP molecule ready to release energy.

Long story short, creatine is the substance that efficiently keeps all our cells supplied with energy. Creatine is natural, helpful and very important.

What are the benefits of taking creatine?

Although creatine is mostly used for strength and mass gains, it has also been proven to be useful in other areas as well.

Before addressing the benefits, I’d like to touch on a commonly discussed question: Does supplementing creatine actually lead to strength and mass gains? The short answer is that yes, it does work- for most people. Unfortunately, creatine supplementation does not affect us all in the same way. Individual variables dictate the effect of the supplement, but the reasons that creatine works for some and not others is still up for debate. Research suggests that these “non-responders” either have very few type II muscle fibers, eat a lot of meat and already carry high levels of creatine, lack certain catalytic enzymes, or are simply not taking a high enough supplemental dose. With that in mind…

Creatine has shown to be beneficial in the following areas:

– Performance gains in anaerobic power movements (NOTE: this does not apply to aerobic exercise, and may even be a performance impediment in this case)

– Strength gains

– Mass gains (by increasing muscle protein synthesis and decreasing muscle protein breakdown)

– Improved body composition (some studies have shown increases in lean mass even in the absence of a resistance training program)

This photo is accurate.

This photo is accurate.

– Improved cognitive function and fluid intelligence (notably of vegetarians and vegans who have lower levels of creatine than meat eaters, as well as in the elderly)

– Increased muscle strength in people with muscular dystrophies, and potentially improved functional performance.

– Increased life span (creatine essentially allows our energy-producing mitochondria to work at a slower pace, producing less byproducts that can be harmful to cells)

When should we be taking creatine?

Some people think you should take creatine in small doses throughout the day. Some people think you should take it before, during or after working out. From what most research suggests, it doesn’t necessarily matter when you take it, as long as you put it in your body. The one variable to consider is that ingesting carbohydrates can increase the retention of creatine levels within muscle, so if you take creatine with carbs, you’ll get more bang for your buck.  With this in mind, I would say that the best time to take creatine is immediately following a workout, with your 3:1/4:1 carb:protein shake.

NOTE: Avoid taking creatine with caffeine. The interaction between the two substances has shown to prevent a rise in intracellular creatine levels. So don’t take creatine in the morning if you’re a coffee drinker.

How much creatine should we consume?

This is another topic that is up for debate. General recommendations are to have a loading phase of about a week where roughly 20 g (arbitrary supraphysiological number determined years ago) is taken daily, followed by daily consumption of 2-3 g for the rest of time. However, some do not believe that this protocol is optimal. The human body produces 2 g of creatine daily (1 g through diet, 1 g through synthesis), and an average person burns through roughly 2 g daily. We know that the body can only store a certain amount of creatine; average humans carry roughly 1 g per pound of lean muscle and we can optimally stuff in about 1.5 g per pound of lean muscle (therefore the more lean muscle mass you have, the more creatine your body can store). If we think about how much we create/consume daily (2 g) and the amount we can actually store (1-1.5 g per pound of lean muscle, which can be roughly 50 g in an average male), supplementing at 2-3 g per day doesn’t seem like it will give much of a creatine boost (even if you do supplement at 20 g daily for a week). Logically, it would seem that we could benefit from much higher dosages of creatine (some literature suggests supplementing with 20 g every day).

NOTE: For what it’s worth, I took creatine on a daily basis for 5-6 years, supplementing at about 5 g daily. I did it without thinking, because studies told me that it would help me be big and strong. I honestly don’t recall seeing huge improvements in my strength when I began supplementing. Last year I stopped taking creatine and I saw absolutely no change in my physique or strength. For the past year I’ve been creatine-free, I’ve dialed-in my nutrition and both my physique and strength are better than ever. In hindsight, I don’t think I was supplementing with a high enough dose.

Don't be this guy.

Don’t be this guy.

Who should be taking creatine?

Most people can derive some sort of benefit from supplementing with creatine. Power, strength, and figure athletes should certainly be supplementing. Vegans and vegetarians should be supplementing. The elderly should be supplementing. If you want your cells, both physical and cognitive, to fire on all cylinders, you should consider supplementation. Much like fish oil and vitamin D, creatine offers many positive benefits without any risks. It is also a very affordable supplement, which is nice. As always, consult with a physician before beginning to supplement with any new substance.

How do I find a high-quality creatine supplement?

Creatine monohydrate is the supplement you are looking for. In your search you will likely also come across creatine ethylester and Kre-Alkalyn, but don’t waste your time. In contrast to the others, creatine monohydrate is the supplement used in nearly every clinical study. It is one of the most stable and neutral forms of creatine in solution (and creatine comes in powder form, so you have to mix it with liquid), it is not degraded into harmful creatinine during normal digestion, and 99 percent is either absorbed by muscle tissue or excreted through sweat or urine. It is also typically the cheapest form you will come across.

As always, look for well-reputed brands that haven’t had major product recalls, and I would advise buying pure creatine monohydrate instead of pre-manufactured “stacks” combining creatine with other “helpful” substances. Take control over what you are putting into your body and stick to the simple stuff that works.

Other considerations

People with with kidney disease should avoid use of creatine, for risk of compounding the problem. Reports of damage to healthy kidneys by creatine supplementation have been scientifically refuted.

Long-term oral intake of 3 g pure creatine per day has shown to be risk-free. Additional research has shown that oral creatine supplementation at a rate of 5 to 20 grams per day appears to be very safe and largely devoid of adverse side-effects, while at the same time effectively improving the physiological response to resistance exercise, increasing the maximal force production of muscles in both men and women. A meta analysis performed in 2008 found that creatine treatment resulted in no abnormal renal, hepatic, cardiac or muscle function.

There is a lot more science to discuss, but I’m going to leave it at that! For additional questions on creatine supplementation, don’t hesitate to post a comment below or contact me personally! Also, after writing this article, I think I may begin to re-supplement with creatine at a higher dose (15-20 g daily). If I do so, it will be a very controlled experiment and I will follow-up on this post with my results.

DW