Showing posts with label study. Show all posts
Showing posts with label study. Show all posts

Saturday, March 7, 2015

Gastric bypass surgery leads to more weight loss complications study finds

640_surgery.jpg

For the first time, researchers have compared the efficacy and outcomes of two of the most common weight loss surgeries to help bariatric surgery patients make the best decision for their health and weight loss goals.
In a new study published in JAMA Surgery, researchers analyzed the weight loss and complications for laproscopic Roux-en-Y gastric bypass (RYGB) with adjustable gastric banding (AGB), and found that gastric bypass surgery resulted in greater weight loss, but more complications.
Previous studies looked at gastric bypass or gastric banding surgeries individually, making it hard to know whether the patients were comparable to make head-to-head comparisons, researcher Dr. David Arterburn, of the Group Health Research Institute, Seattle, told FoxNews.com.
“Our study adds to the confidence that doctors can talk to patients about these procedures,”  he said. “It more likely reflects the real-world experience of most patients getting this procedure in the U.S.”
According to the American Society for Metabolic and Bariatric Surgery, an estimated 179,000 bariatric surgery procedures were performed in 2013. Gastric bypass surgery accounts for 47 percent of bariatric procedures worldwide, while adjustable gastric banding accounts for 18 percent. The Centers for Disease Control and Prevention (CDC) estimates 78.6 million Americans— 34.9 percent of the population— are obese.
The new research included 7,457 patients from 10 different health systems across the country, with doctors practicing in a range of settings. The patients underwent surgery from 2005 to 2009. In 2010, researchers followed up, examining Body Mass Index (BMI) change and the 30-day rate of major adverse outcomes, as well as subsequent hospitalization and intervention.
With their findings, researchers used propensity matching, a statistical approach, to account for patient differences. While the study was not a randomized trial, the statistics allowed them to create the most balanced comparison they could, accounting for measurable statistics such as weight, age, racial and ethnic diversity.
Researchers found that patients who underwent gastric bypass had an average maximum BMI loss of 14.8, while those who had a lap band lost 8 points— nearly half the weight loss. For a patient who lost 14.8 BMI points, they would drop from the “obese” range into the “overweight” category. AGB patients would still be considered obese, but healthier because of overall weight loss. The overall study patient BMI was 44.
Bariatric surgery patients fall in two groups, depending on their BMI: Those with a BMI of 35 or more have weight-related health conditions and those with a BMI of 40 or more, regardless of complications.
On average, a bariatric surgery patient has a BMI of 47. Patients with a 40 BMI are about 100 pounds overweight.
Arterburn noted that although the band procedure is technically reversible, it still requires another major operation.
“These are generally not things you go back and redo without significant consequences,” he said.
The main complication researchers found were blood clots in the legs and lungs that occurred within the first 30 days after surgery. Bypass patients had a 3 percent chance, compared to banding patients who had a 1.3 percent chance. Other short-term complications within the study period included not being discharged from the hospital, having to repeat the procedure and death. One gastric bypass study patient died in the first 30 days; none of the banding patients died.
According to Arterburn, the study serves to show that there are clear trade-offs between the two procedures and that patients should be educated and work with their doctor to make the best decision for them.
“There’s not a clear balance sheet where one’s the winner-  but that’s the way it often is in medicine,” he said.
For a patient considering bariatric surgery, the first step is to know if you’re eligible based on BMI and health complications, Arterburn said. Understanding what the surgery means— including its risks and benefits— can allow a patient to talk to their doctor to customize their decision for what’s right for them.
“This should be about sharing this kind of information with the patient so they’re well informed about the different procedures so they can make their own personal appraisal about what’s important to them,” he said. “It really shouldn’t be about the surgeon recommending a particular procedure for a given patient as the only thing driving these decisions. Patients need to be well-informed so they can make the choice.”
By Nicole Kwan
Source: http://www.foxnews.com/health/2014/10/29/gastric-bypass-leads-to-more-weight-loss-but-more-complications-study-finds/
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Strongman Training is as Effective as Traditional Resistance Training in Improving Body Comp Muscular Function Performance Study Claims The Data Suggests Otherwise

This image of heavy sled pulls was taken during one of the strongmen training sessions in the study at hand - for the full protocol see Table 1 (Winwood. 2014)
Brad Schoenfelds recent study on the differential effects of 3x10 vs. 7x3 rep x set resistance training regimen (reread corresponding SuppVersity Article) took much of the wind óut of the sails of the proponents of classic hypertrophy training (3-4 sets of 8-12 reps) as the one and only training method for anyone thriving for maximal muscle gains.

An even more recent study by Paul Winwood et al. thats about to be published in the upcoming issue of the #1 journal for everything strength training, i.e. the Journal of Strength and Conditioning Research, does not just support the findings of Schoenfeld et al. it claims "that short term strongman training programs are as effective as traditional resistance training programs in improving aspects of body composition, muscular function and performance." (Winwood. 2014)
Maybe adding some HIIT training compensates the body fat gain with strongman training

Never Train To Burn Calories!

Tabata = 14.2kcal /min ≠ Fat Loss

30s Intervals + 2:1 Work/Rec.

Making HIIT a Hit Part I/II

Making HIIT a Hit Part II/II

HIIT Increases Post-Workout GH
Next to the fact that the two protocols in the study at hand were neither volume-matched nor based on the same exercises, there is yet another highly significant difference between the study at hand and the aforementioned powerlifting vs. classic resistance training study by Schoenfeld et al. the conclusion of the Winwood study is only "statistically correct". From a practical point of view, on the other hand, the body composition part of it is total bullshit.

If you take a look at the actual "body composition" data, even a blind man sees that the strongman protocol that consisted seven weeks /two obligatory training sessions per week) of the resistance training protocols outlined in Table 1 and two facultative, non-supervised and recorded sessions of prehabilition exercises, as well as two cardiovascular training sessions per week.
Table 1: Outline of the training protocols; * indicates that the exercise is performed explosively (Winwood. 2014)
The first thing you should realize after taking a look at the "traditional" protocol is that its traditional, but not the protocol you would traditionally use if your main goal was to build muscle. The number of repetitions is too low there is no individual training for the arms - both of which are characteristics most hypertrophy regimens share.
Published ahead of print warning: I am not 100% sure that the data in the tables of the full text are accurate. The changes in strength parameters, for example are all negative. The article, on the other hand, speaks of increases, which is why I simply removed the "-", when I plotted the graph in Figure 1, which is now in line with the results discussed in the text.
This alone wouldnt be that bad, if the conclusion that both training regimen had identical effects on the body composition of the subjects wasnt simply flawed.
Figure 1: Changes in body composition and strength (Winwood. 2014)
Ok, the differences may not be statistically significant, but if one regimen, i.e. the "traditional" training improves, while the strongman training compromises the body composition of young men, I would be very hesitant to state that "strongman training programs are as effective as traditional resistance training programs in improving aspects of body composition" (Winwood. 2014).

If the trend the researchers must obviously have overlooked (or ignored) continues, the guys in the "traditional group" will soon look like ripped mens fitness cover models, while the guys in the strongmen group will develop a pot belly. Not exactly what anyone could want. Even if you dont care about being jacked, looking at the effects on body fat, the "traditional" strength training protocol would also classify as the healthier training regimen.
Suggested read: "Want to Get Ripped & Strong? "Battling the Rope" Could be THE Exercise to Do! The "Battle" is More Demanding Than Squats, Lunges and Deadlifts - Only Burpees Come Close" | more
Bottom line: Although the study does not, as the researchers claim, provide evidence for the efficacy of strongmen training as body composition improvers, the two regimen are in fact equally effective in improving strength and performance variables.

If you are more into increases your 1RM squat and deadlift (ES = 0.66), change of direction (COD) turning ability and total COD time, horizontal jump, and sled push performance you should gravitate towards traditional training. If, on the other hand, you are looking to improve your 1RM bent over row, 5 m sprint performance and COD acceleration, strongmen training should be your first choice.

If we assume you actually do the facilitative cardio sessions (I assume the lazy study participants didnt because it wasnt controlled), you may even achieve the same improvements in body composition (-0.4% body fat) on the strongman regimen. Furthermore we should not forget: Abs are made in the kitchen, not in the gym (learn more) - without reliable data on the quantity & quality of the food the subjects consumed the changes in body composition are hard to ascribe (solely) to the different training regimen.
Reference:
  • Winwood, PW, et al. "Strongman  versus  traditional  resistance  training  effects  on  muscular  function  and  performance." Journal of Strength and Conditioning Research (2014). Publish Ahead of Print. DOI: 10.1519/JSC.0000000000000629
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Friday, March 6, 2015

Performance Enhancing Gut Microbes First Study to Show Having The Right Gut Bugs Doubles Exercise Endurance

Yogurt & Co are good for athletes. But is this due to the bacteria?
As a regular here at the SuppVersity, you are well aware of the far-reaching effects of having the "right" or "wrong" bacteria in your tummy. The claim that having the "right" bacterial make-up in the gut could have beneficial effects on your performance in the gym or on the track is something you should not believe too credulously. If we had a study to prove these benefits, things would be different, though - a study like the one a group of researchers from the National Taiwan Sport University are about to publish in the scientific bible of resistance training, the Journal of Strength and Conditioning Research (Hsu. 2014).

In said study which is still available only as an accepted manuscript, Hsu et al. investigated the association of intestinal bacteria and exercise performance in specific pathogen-free (SPF), germ-free (GF), and Bacteroides fragilis (BF) gnotobiotic mice (animals in which only certain known strains of bacteria and other microorganisms are present).
You can learn more about the gut & your health at the SuppVersity

Bugs Dictate What You Crave

Sweeteners & Your Gut

Foods, Not Ma- cros for the Gut

Lactulose For Gut & Health

Probiotics Dont Cut Body Fat

The Macrobiotic MaPi2.0 Diet
To this ends, the scientist had the rodents swim to exhaustion to determine whether enteric bacteria alter antioxidant enzyme levels, exercise performance and physical fatigue. In addition, they tested the antioxidant enzyme activities, physical performance and anti-fatigue function after monocolonizing GF mice with B. fragilis (BF).
Figure 1: Time to exhaustion during exercise test and body composition of the miceaccording to the make-up of their gut microbiome; data expressed relative to group means (Hsu. 2014)
What they found was an increased time to exhaustion for the previously germ-free (GF) mice after theyd been colonized with B. fragilis (BF). Similar results were observed for the specific pathogen-free and Bacteroides fragilis gnotobiotic mice, who were also more enduring than the obesity resistant (Bäckhed. 2007) germ-free mice.
Do we have human data, as well? No, we dont have human data thats comparable to the one presented in the study at hand, but we do have evidence of beneficial (ergogenic) effects of probiotics and prebiotics in human "athletes". Examples? Well, the oral administration of the probiotic Lactobacillus fermentum VRI-003 and mucosal immunity in endurance athletes (Cox. 2010). Improved oxidative status in athletes during intense exercise training (Martarelli. 2011). Reduced risk of infection (Gleeson. 2011; West. 2011). And if thats not enough, what about keeping on top of your game by preventing and managing travellers’ diarrhoea (Tillett. 2006)!
As any SuppVersity veteran would expect, the germ-free mice were leaner than the rest of the pack. At the same time, the "sterile" mice did yet also have a lower liver, muscle, brown adipose, and epididymal fat pad weight than the SPF and BF mice.
Figure 2: Selected markers of antioxidant status in serum and liver; expr. rel. to group means (Hsu. 2014)
The markers of antioxidant defenses, the scientists measured were highest in the lean + light germ-free mice and their specific pathogen-free cousins. Against that background its at least somewhat surprising that the performance differences are pretty significant.
Pre- instead of probiotics: Personally, I believe that prebiotics, i.e. substances that promote the growth of the "right" bacteria are more promising agents than probiotics ("live" bacteria). Studies have shown that prebiotic at dosages above 2.5 g, which is far higher than that occurring in natural foods, increases the abundance of lactic acid and butyrate-producing bacteria. In that, galacto-oligo- saccharides (GOS) and  fructo-oligo- saccharides (FOS), are the prebiotics with the most positive outcomes.
As West points out in a 2012 mini-review as part of the BJSM "A–Z of nutritional supplements" series, the "potential benefits of supplementation with prebiotics on athletic performance are most likely indirect: they may be associated with the maintenance of gut health and perhaps a reduced risk of some illnesses which might enhance the athlete’s ability to train and compete." (West in DiMarco. 2012). Altering GI microbiota through the use of prebiotics may yet also favourably influence host metabolism. Athletes who are dieting, for example, will benefit from the reduction in appetite increase in gut peptide concentration in response to thec consumption of 16 g per day of FOS (Cani. 2009).
So what are the practical implications, then? As the authors emphasize, "[t]his is the first study to show that the intestinal microflora plays an important role in exercise performance." The way the microbial make-up regulates the antioxidant enzyme defense system is yet not in line with the observed reduction in physical fatigue Hsu et al. observed in the study at hand.

In view of the fact that the general assumption is that " intensive and sustained exercise training and high-level competition generate large amounts of free radicals that likely exceed the buffering capacity of the biological system, leaving athletes susceptible to oxidative stress", you would expect the Bacteriodes fragilis mice to perform the worst.

On the other hand, the mice harboring Bacteroides fragilis are significantly more muscular than the lightweight germfree mice... well, we could continue this discussion forever, but eventually the one result that may have a practical implication is the increased performance after mono-colonization in the germ-free mice. If nothing else, this result which happens to be the first evidence of performance enhancing effects of having a gut microbiome, would imply that you better recolonize your gut as soon as possible after a course of antibiotics. How the various different microbial status might regulate performance, on the other hand, will have to be elucidated in future studies - human (!) studies, that is | Comment on Facebook!
References:
  • Bäckhed, Fredrik, et al. "Mechanisms underlying the resistance to diet-induced obesity in germ-free mice." Proceedings of the National Academy of Sciences 104.3 (2007): 979-984.
  • Cani, Patrice D., et al. "Gut microbiota fermentation of prebiotics increases satietogenic and incretin gut peptide production with consequences for appetite sensation and glucose response after a meal." The American journal of clinical nutrition 90.5 (2009): 1236-1243.
  • Cox, Amanda J., et al. "Oral administration of the probiotic Lactobacillus fermentum VRI-003 and mucosal immunity in endurance athletes." British Journal of Sports Medicine 44.4 (2010): 222-226. 
  • DiMarco, N. M., et al. "A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance—Part 30." British journal of sports medicine 46.4 (2012): 299-300.
  • Gleeson, Michael, et al. "Daily probiotics (Lactobacillus casei Shirota) reduction of infection incidence in athletes." (2011). 
  • Hsu et al. "Effect of Intestinal Microbiota on Exercise Performance in Mice." Journal of Strength and Conditioning Research.  DOI: 10.1519/JSC.0000000000000644 | Publish Ahead of Print.
  • Martarelli, Daniele, et al. "Effect of a probiotic intake on oxidant and antioxidant parameters in plasma of athletes during intense exercise training." Current microbiology 62.6 (2011): 1689-1696.
  • West, Nicholas P., et al. "Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes." Nutrition journal 10.1 (2011): 30.
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Thursday, March 5, 2015

Study Suggests Frozen Veggies Worse Than Common Wisdom Says Frozen Asparagus Zucchini and Green Beans Lose More Antioxidants During Boiling

Green asparagus from the fridge and  from the market are not created equal - at least not when they finally end up on your plate after a short bath in hot water.
You just have to watch one of the consumer report shows on television to hear it: "Frozen veggies are way better than their reputation would suggest." Actually, here in Germany this sentence has been repeated to soften that Ive even heard people say theyd buy the frozen broccoli because it contained "more vitamins and the other good stuff, you know." And you know what? For some veggies like spinach, for example, this may actually be the case. For others, like broccoli or peas, the nutrient status of the frozen and the raw uncooked vegetable appears to be more or less identical (Favell. 1998). But thats something you cannot say for the green asparagus stems, zucchini and green beans in a recent study from the Università degli Studi di Parma in Italy.
Warning: Dont take this article as an excuse and stop eating veggies completely. The frozen stuff may lose more vitamins, when you boil it, but (a) you can still blanch it and (b) even with significantly reduced antioxidant effects veggies are still among the healthiest things you can eat.
I am not an asparagus expert and can still tell that the cell structure of the Transverse  sections boiled (C - from raw | D - from frozen) is profoundly messed up compared to the raw (A) and blanched (B) variety | legend: c = collenchyma; vp = vascular bundle; p = parenchyma; f = fissure.
In the corresponding experiment, the Italian researchers bought Green asparagus stems (Asparagus officinalis L., var. Grande), zucchini (Cucurbita pepo L., va Quine) and green beans (Phaseolus vulgaris L., var. Giamaica) from a local producer and processed them within 24 hours from harvesting. For each of the veggies four samples were prepared: Raw/uncooked  (R), raw/boiled  (B), blanched (BL) and industrially frozen/boiled (FB)

The raw (ten kilograms of each vegetable), blanched (five kilograms of each vegetable) and industrially frozen  samples  (five  kilograms  of  each  vegetable) had been transported were  transported  to  the  University of  Parma laboratories  under  adequate  refrigerated conditions to avoid the exuberant nutrient loss that occurs upon inadequately slow (re-)freezing.
SuppVersity Suggested Read: " Conventional vs. Organic: Its Not About Getting More, But Getting Less For Your Money. Less Pesticides, Dioxins & Co" | read more if you want to know if the claim "organic is always better" is a similar misconcept as "frozen over fresh".
If you "freeze" your veggies in the freezer compartment of your fridge, this will make the cells blast, so that even before they are cooked, and the nutrients flow out. It is generally assume that the latter would not happen, if the veggies are shock-frosted.
Figure 1: Total antioxidant capacity of green asparagus, zucchini and green beans raw, blanched, boiled and frozen and boiled (Paciulli. 2014); as the data tells you frozen veggies with similar  icy grease on them like you see on the right may not really be a better source of antioxidants than fresh veggies from the farmers or even the supermarket.
If we look at the data in Figure 1, though, it would appear that the cells may have "cracked" already so that they are more susceptible to the subsequent heat assault and the frozen + boiled samples end up having consistently lower total antioxidant (Figure 2) and feric acid reducing capacity than their raw + boiled counterparts.

For a similar reason (nutrient retention), the blanched samples have been cooled immediately after blanching in an ice-water bath for 3 min before they have been transported to the laboratories, where their analysis shows that only the Zucchini lost a small, but significant amount of their total antioxidant activity.
Figure 2: It would be interesting to see if the negative effects of freezing and boiling occur in all vegetables. In view of the fact that previous studies compared raw vs. frozen, but nor raw + cooked vs. frozen + cooked, frozen Broccoli + cooked broccoli could be exactly as "bad" as asparagus, zucchini and green beans.
The thing that is of most practical relevance, tough, is the significant negative effect of freezing + boiling on both, the total antioxidant capacity (Figure 1) and the ferric reducing capacity (Figure 2) of all three vegetables.

The previously "cited" statement that youre better of with the "fresh" frozen veggies is thus probably only right, if you eat them raw. Compared to fresh veggies, the previously frozen asparagus, zucchini and green beans lost almost 11-30% of their antioxidant prowess during the cooking process - and the same may well happen to other veggies, including broccoli, which have been compared in previous studies only on a raw vs. frozen, but not on a cooked vs. frozen + cooked basis. Unless youre afraid that all the good veggies may limit your gains due to their potent anti-oxidant effects, it appears smart to stay away from their frozen varieties.
References:
  • Paciulli, Maria, et al. "Impact of the industrial freezing process on selected vegetables Part I. Structure, texture and antioxidant capacity." Food Research International (2014).
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