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10 Semen is back in the news, ready to cure the

blues.
By Alan Aragon

11 3 versus 6 meals per day for hunger control.


By Alan Aragon

Copyright December 1st, 2012 by Alan Aragon


Home: www.alanaragon.com/researchreview
Correspondence: aarrsupport@gmail.com

Reserving carbs for night time: breakthrough diet


solution or reverse dogma?
By Alan Aragon

Systematic review and meta-analysis of different


dietary approaches to the management of type 2
diabetes.
Ajala O, English P, Pinkney J. Am J Clin Nutr. 2013
Mar;97(3):505-16. [PubMed]

Carbohydrates and exercise performance in nonfasted athletes: A systematic review of studies


mimicking real-life.
Colombani PC, Mannhart C, Mettler S. Nutr J. 2013 Jan
28;12(1):16. [Epub ahead of print] [PubMed]

Astaxanthin supplementation does not augment


fat use or improve endurance performance.
Res PT, Cermak NM, Stinkens R, Tollakson TJ, Haenen
GR, Bast A, van Loon LJ. Med Sci Sports Exerc. 2012 Dec
27. [Epub ahead of print] [PubMed]

Postprandial energy expenditure in whole-food


and processed-food meals: implications for daily
energy expenditure.
Barr SB, Wright JC. Food Nutr Res. 2010 Jul 2;54. doi:
10.3402/fnr.v54i0.5144. [PubMed]

Effects of high-calorie supplements on body


composition and muscular strength following
resistance training.
Rozenek R, Ward P, Long S, Garhammer J. J Sports Med
Phys Fitness. 2002 Sep;42(3):340-7. [PubMed]

Alan Aragons Research Review December 2012

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Page 1

Reserving carbs for night time: breakthrough diet


solution or reverse dogma?
By Alan Aragon
____________________________________________________
Intro & background
It all began with the opposite idea: carbs at night were a no-no
for weight loss. The common lore was that carbs after 6 pm went
straight to fat storage. The short-sighted reasoning was that as
bed time approaches, metabolism slows down, and eating carbs
at this time meant not using them for their intended purpose to
fuel physical activity, not sleep. Some people bent this rule by
making exceptions for carb consumption in the immediate postexercise period for those who were forced to train in the
evening. With that small wrinkle aside, the general
recommendation was to taper down carb intake as the day
progressed.
In addition to the aforementioned lore perpetuated among lay
circles, the scientific literature has done its fair share of keeping
the carbs at night = fat gain idea alive. For example, in a study
published this past January, Baron et al used 7 days of wrist
actigraphy in 52 subjects to examine the relationship of meal &
sleep timing bodyweight regulation.1 They found that protein
and carbohydrates consumed 4 hours before sleep, as well as
carbohydrates after 8 pm were associated with a higher total
caloric intake. The authors concluded that eating either in the
evening or before sleep might predispose individuals to weight
gain. This finding was similar this groups previous research,
which concluded that caloric intake after 8 pm may raise obesity
risk, independent of sleep timing and duration.2
Questioning the old dogma
Educated skeptics automatically scoffed at the idea of the prebed or evening eating having some sort of inherent obesogenic
quality. There really was no plausible physiological mechanism
to explain how this could happen. The common explanations
were far-fetched, and did not take into account 24-hour fat
balance. In other words, if shifting carb intake to later in the day
blunted fat oxidation at that time, then the converse happens
earlier in the day (more daytime fat oxidation), which brings
everything back to neutral by the end of the 24-hour period.
Another important criticism of the research linking weight gain
with eating the bulk of calories later in the day is that its
observational, rather than controlled. This leaves it vulnerable to
unaccounted variables that muddy the results. As the clich goes,
correlation does not automatically equal causation.
The game-changing studies
The collective shift in opinion of night-time carb intake is
largely attributable to two studies. Although there are other
studies in this vein,3 the ones Ill discuss made the most impact
due to their longer duration and other design strengths. The first
landmark study thats often used as a weapon in the movement
against late-night carb dogma was published way before the tide
shifted. In 1997, Keim et al compared the 6-week effects of
Alan Aragons Research Review December 2012

eating 70% of the days calories in the morning versus the


evening.4 Unlike the previously discussed observational
research, this study was a controlled intervention with several
notable design strengths. Subjects lived in the research centers
metabolic suite throughout the length of the study. Physical
activity (including formal training) was standardized. A mix of
cardio and progressive resistance training was done. The group
consuming most of its calories in the later part of the day
retained more lean mass, and also lost more fat in the initial
phase of the crossover. However, the fat mass reduction
amounted to less than 1% difference compared to the earlyeating condition, and it only occurred in one of the crossover
phases. The main point of this study is that shifting a
carbohydrate-dominant dietary intake (293 g carb, 88 g prot, 49
g fat), to the later part of the day can potentially result in better
lean mass retention. Unfortunately, this study has never been
replicated.
The next and most recent research milestone supporting evening
carb intake is a 6-month controlled trial by Sofer et al,5 which
compared the effects of carbs eaten mostly at dinner versus
spread throughout the day, in diets comprised of 1300-1500 kcal.
Unlike the previously discussed research which examined
different placement of total calories, this is the first study to ever
focus on different placement of carbohydrate specifically. The
results were intriguing, indeed. All of the anthropometric
improvements (weight loss, waist girth reduction, & body fat
reduction) were greater in the experimental evening-carb
treatment. The control diet was also outperformed for improving
glucose control, inflammation reduction, lipid profile, and
satiety ratings. Interestingly, satiety was rated higher than
baseline in the experimental group by the end of the trial.
Leptin levels decreased to a lesser degree in the experimental
group, which also showed increased adiponectin levels. The
latter two phenomena are important since they provide the
framework for a mechanistic speculation of why the
experimental group outperformed the control group. Its possible
that the greater drop in leptin levels in the control group was
responsible for causing greater reductions in satiety, thereby
dictating a greater caloric intake and compromising fat loss. The
increased adiponectin levels in the experimental group may have
increased insulin sensitivity and glucose tolerance, providing a
complimentary physiological environment for metabolic
improvements alongside the increased satiety.
In a separate analysis of this trial,6 the ghrelin profile of the
experimental group started off as a convex curve, and became
concave by the end of the 6 months. In other words, ghrelin
levels (which correlate directly with hunger) in the experimental
group were suppressed during the day, and rose up towards the
end of the day, whereas the control groups ghrelin levels
elevated progressively throughout the day, and dropped off
towards the end of the day. The experimental meal patterns
larger/carb-heavy dinner meal was thus more favorably aligned
with the days ghrelin-mediated hunger profile.
Questioning the new dogma
In light of these findings, the pendulum of the old dogma has
been swinging far into the opposite direction. Funny enough,
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Page 2

what used to be a dieters fear of carbs at night turned into a fear


of carbs during the day. The problem is, this concern is based on
what essentially boils down to two studies. If we want to get
picky and point out the specific comparison of carb placement,
then we only have Sofer et als study. Although its results are
very provocative, its methodological limitations should be
weighed into judgement as well. Dietary intake was selfreported. I would venture to guess that the sporadic and hectic
schedules of the subjects (Israeli police officers) could only
widen the inherent margin of error in self-reported intake. The
prescribed diet of 1300-1500 kcal consisted of 40-50% carb,
20% prot, and 30-35% fat. This translates to a targeted protein
intake of 65-75 g/day. Subjects in the experimental group
averaged 98.3 kg, making protein intake 0.66-0.76 g/kg, which
is less than the already-low RDA of 0.8 g/kg. This obviously is
not an optimal protein target in terms of promoting satiety and
maximal retention of lean mass.7,8 On these grounds alone, the
studys relevance to athletic populations who typically
consume at least 2-3 times more protein is highly questionable.
Another important limitation was the absence of any mention, let
alone any tracking or control of physical activity. This omission
of accounting for the energy-out side of the equation could
critically challenge the datas validity since changes in body
composition are based primarily on the dynamics of energy
balance. A more meticulous design would have involved a
standardized/structured training program, or in its absence, the
use of an objective means of tracking energy expenditure such as
doubly labeled water. Its worth emphasizing that optimized
macronutrient targets and a well-structured training program are
clearly missing in this study, which happens to the main bit of
research driving the current circadian carb timing beliefs.
Its also important to examine the magnitude of changes between
the experimental and control groups; this is where the hype
collapses into triviality. Bodyweight in the experimental group
decreased 2.54 kg (5.58 lb) more than the control group. This
difference would be substantial in a 6-8 week period, but
remember, this occurred in the span of 6 months. Body fat
reduction in the experimental group was 1.8 percentage points
greater than the control group. Again, this is a very small
difference relative to the lengthy timeframe, and did not reach
statistical significance. Waist reduction in the experimental
group was 2.3 cm (slightly less than an inch) greater than the
control group. When adjusted for baseline differences, this
figure is reduced to 1.1 cm.....in 6 months! BMI and waist
circumference reductions were not statistically significant when
adjusted for differences in baseline values. So, out of the 4
anthropometric measures, only one of them (total weight loss)
was significantly greater in the experimental group and this
difference was still very small despite qualifying as statistically
significant.

recent years. However, the latter evidence is scarce and fraught


with limitations that ultimately render it interesting food for
thought until more relevant, compelling data accumulates. Keep
in mind that a particular diet protocol may have research support
(there are dozens of dietary philosophies with some degree of
research backing), but this does not guarantee that it will be the
perfect fit for everyone. Experimental or observational research
outcomes should always be put to the test of individual response.
Adherence to any given protocol is the most crucial determinant
of its success. The hypothetical benefits of any given dietary
approach must me modified or discarded altogether if they
compromise adherence capacity. As a final note, in the case of
certain athletic goals with a high carbohydrate demands,
hypothetical circadian timing schemes for weight/fat loss should
take a backseat to positioning carb intake for optimizing exercise
performance, regardless of whether the bout occurs early or late
in the day (or both).
As I see it, theres a hierarchy of importance for carbohydrate
timing through the day. First off, make sure the total for the day
is consumed. Secondly, time the constituent doses so that they
maximize, and do not hinder training performance. Tied for
second, on non-training days, position carb intake to suit your
personally preferred distribution pattern (regardless of what
opposing lines of research might suggest). Third and lowest on
the hierarchy of importance is the option to experiment with
hypothetical optimization techniques currently under scientific
investigation.
References
1.
2.

3.
4.

5.

6.

7.

Conclusions and practical considerations

Baron KG, Reid KJ, Kern AS, Zee PC. Role of sleep timing
in caloric intake and BMI. Obesity (Silver Spring). 2011
Jul;19(7):1374-81. [PubMed]
Berg C, Lappas G, Wolk A, Strandhagen E, Torn K,
Rosengren A, Thelle D, Lissner L. Eating patterns and
portion size associated with obesity in a Swedish
population. Appetite. 2009 Feb;52(1):21-6. [PubMed]
Berkhan M. Is late night eating better for fat loss and
health? June 16, 2011. [Leangains]
Keim NL, Van Loan MD, Horn WF, Barbieri TF, Mayclin
PL. Weight loss is greater with consumption of large
morning meals and fat-free mass is preserved with large
evening meals in women on a controlled weight reduction
regimen. J Nutr. 1997 Jan;127(1):75-82. [PubMed]
Sofer S, Eliraz A, Kaplan S, Voet H, Fink G, Kima T,
Madar Z. Greater weight loss and hormonal changes after 6
months diet with carbohydrates eaten mostly at dinner.
Obesity (Silver Spring). 2011 Oct;19(10):2006-14.
[PubMed]
Sofer S, Eliraz A, Kaplan S, Voet H, Fink G, Kima T,
Madar Z. Changes in daily leptin, ghrelin and adiponectin
profiles following a diet with carbohydrates eaten at dinner
in obese subjects. Nutr Metab Cardiovasc Dis. 2012 Aug 14.
[Epub ahead of print] [PubMed]
Campbell B, Kreider RB, Ziegenfuss T, La Bounty P,
Roberts M, Burke D, Landis J, Lopez H, Antonio J.
International Society of Sports Nutrition position stand:
protein and exercise. J Int Soc Sports Nutr. 2007 Sep 26;4:8.
[PubMed]
Wilson J, Wilson GJ. Contemporary issues in protein
requirements and consumption for resistance trained
athletes. J Int Soc Sports Nutr. 2006 Jun 5;3:7-27. [PubMed]

There is evidence supporting the tapering-down of carb intake


towards the end of the day for the goal of weight reduction, but
the observational nature of this research weakens its validity. On
the other hand, there is controlled research supporting the
opposite paradigm, which has been mounting in popularity in

8.

Alan Aragons Research Review December 2012

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Systematic review and meta-analysis of different


dietary approaches to the management of type 2
diabetes.
Ajala O, English P, Pinkney J. Am J Clin Nutr. 2013
Mar;97(3):505-16. [PubMed]
BACKGROUND: There is evidence that reducing blood glucose
concentrations, inducing weight loss, and improving the lipid profile
reduces cardiovascular risk in people with type 2 diabetes.
OBJECTIVE: We assessed the effect of various diets on glycemic
control, lipids, and weight loss. DESIGN: We conducted searches
of PubMed, Embase, and Google Scholar to August 2011. We
included randomized controlled trials (RCTs) with interventions that
lasted 6 mo that compared low-carbohydrate, vegetarian, vegan,
low-glycemic index (GI), high-fiber, Mediterranean, and highprotein diets with control diets including low-fat, high-GI,
American Diabetes Association, European Association for the Study
of Diabetes, and low-protein diets.. RESULTS: A total of 20 RCTs
were included (n = 3073 included in final analyses across 3460
randomly assigned individuals). The low-carbohydrate, low-GI,
Mediterranean, and high-protein diets all led to a greater
improvement in glycemic control [glycated hemoglobin reductions
of -0.12% (P = 0.04), -0.14% (P = 0.008), -0.47% (P < 0.00001),
and -0.28% (P < 0.00001), respectively] compared with their
respective control diets, with the largest effect size seen in the
Mediterranean diet. Low-carbohydrate and Mediterranean diets led
to greater weight loss [-0.69 kg (P = 0.21) and -1.84 kg (P <
0.00001), respectively], with an increase in HDL seen in all diets
except the high-protein diet. CONCLUSION: Low-carbohydrate,
low-GI, Mediterranean, and high-protein diets are effective in
improving various markers of cardiovascular risk in people with
diabetes and should be considered in the overall strategy of diabetes
management. SPONSORSHIP: None listed.

Study strengths
This paper is relatively ground-breaking since its the first
systematic review/meta-analysis to compare the effects of the
main different diet types on glycemic control, weight loss, and
blood lipids in type 2 diabetes (T2D). The question of how diet
composition might affect these parameters is of utmost
importance due to the increasing prevalence of the disease
worldwide. Studies meeting the inclusion criteria had to be
randomized controlled trials (RCTs) that were at least 6 months
long, carried out on adults. In order to be included, the trials had
to meet quality standards specified in the Cochrane handbook for
systematic reviews. This helped minimize confounders such as
selection bias, attrition (drop-out) bias, and detection bias. 20
studies were included, containing final analyses in 3073
subjects.

none of the control diets compared with the Mediterranean diet


in this analysis were typical, Atkins-style low-carbohydrate
diets. The authors acknowledged that the control diets differed in
macronutrient composition, and subjects sometimes differed in
their baseline characteristics. A major confounder is that weight
loss varied among the trials, making it impossible to exclude
weight loss per se (rather than diet composition) as an
independent factor in the outcomes. Another limitation common
to these analyses is the use of mainly sedentary subjects. Thus,
the results are not necessarily applicable to physically active and
athletic populations.
Comment/application
The low-carbohydrate (20-60 g/d), low-GI, Mediterranean, and
high-protein diets (20-30%) were all found to be effective in
managing T2D. Collectively, they outperformed the control diets
which included low-fat ( 30%), high-GI, American Diabetes
Association, European Association for the Study of Diabetes,
and low-protein diets. The main findings of this analysis were as
follows, according to the endpoints assessed (expressed as
weight mean difference):
GLYCEMIC CONTROL (percentage decrease in glycated
hemoglobin compared to control diets):
o Low-carbohydrate diet: -0.12%
o Low-GI diet: -0.14%
o Mediterranean diet: -0.47% (note: this diet was the
highest performer in this category)
o High-protein diet: -0.28%
WEIGHT LOSS:
o Low-carbohydrate diet: -0.69 kg
o Low-GI diet: +1.39 kg
o Mediterranean diet: -1.84 kg (note: this diet was the
highest performer in this category, and the only one to
show a significant reduction compared to the control
diets)
o High-protein diet: +0.44 kg
CHANGE IN LIPIDS:
o Low-carbohydrate diet: significant increase in HDL
(+0.08 mmol/L), no significant reduction in LDL or
triglycerides.
o Low-GI diet: significantly increased HDL (+0.05
mmol/L), no significant reduction in LDL or
triglycerides.
o Mediterranean diet: significantly increased HDL (+0.04
mmol/L) , no significant reduction in LDL.
o High-protein diet: no significant changes were seen in
blood lipid profile compared to the control diets.

Despite its examination of RCTs, this is a meta-analysis, which


cannot escape classification as observational research. It thus
cannot show causation. I should note that meta-analyses, when
done right, can indeed reflect the collective state of the evidence
on a given issue. A somewhat unavoidable limitation was that
the comparisons between diets did not cover all possible
permutations. For example, although the greatest improvement
relative to the control diet was seen in the Mediterranean diet,

Overall, these results do not support official/authoritative dietary


recommendations for the management of T2D, which
recommend low-fat ( 30%), high-carbohydrate (50-60% of total
energy) diets. Nevertheless, the following quote sums up what I
feel to be the most important finding programs can vary widely
in carb content and still be effective: Dietary behaviors and
choices are often personal, and it is usually more realistic for a
dietary modification to be individualized rather than to use a
one-size-fits-all approach for each person. The diets reviewed in
this study show that there may be a range of beneficial dietary
options for people with T2D.

Alan Aragons Research Review December 2012

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Study limitations

Page 4

Carbohydrates and exercise performance in nonfasted athletes: A systematic review of studies


mimicking real-life.
Colombani PC, Mannhart C, Mettler S. Nutr J. 2013 Jan
28;12(1):16. [Epub ahead of print] [PubMed]
BACKGROUND: There is a consensus claiming an ergogenic
effect of carbohydrates ingested in the proximity of or during a
performance bout. However, in performance studies, the
protocols that are used are often highly standardized (e.g. fasted
subjects, constant exercise intensity with time-to-exhaustion
tests), and do not necessarily reflect competitive real-life
situations. OBJECTIVE: Therefore, we aimed at systematically
summarizing all studies with a setting mimicking the situation of
a real-life competition (e.g., subjects exercising in the
postprandial state and with time-trial-like performance tests such
as fixed distance or fixed time tests). DESIGN: We performed a
PubMed search by using a selection of search terms covering
inclusion criteria for sport, athletes, carbohydrates, and fluids,
and exclusion criteria for diseases and animals. This search
yielded 16,658 articles and the abstract of 16,508 articles
contained sufficient information to identify the study as noneligible for this review. The screening of the full text of the
remaining 150 articles yielded 17 articles that were included in
this review. These articles described 22 carbohydrate
interventions covering test durations from 26 to 241 min (mostly
cycling). RESULTS: We observed no performance
improvement with half of the carbohydrate interventions, while
the other half of the interventions had significant improvement
between 1% and 13% (improvement with one of five
interventions lasting up to 68 min and with 10 of 17
interventions lasting between 70 and 241 min).
CONCLUSION: Thus, when considering only studies with a
setting mimicking real-life competition, there is a mixed general
picture about the ergogenic effect of carbohydrates ingested in
the proximity of or during a performance bout with an unlikely
effect with bouts up to perhaps 70 min and a possible but not
compelling ergogenic effect with performance durations longer
than about 70 min. SPONSORSHIP: The Swiss Federal
Commission of Sports supported this study with a grant, but it
did not influence the execution of the study.

Study limitations
As I mentioned in the discussion on the previous page, metaanalyses and systematic reviews are observational in nature, and
thus are incapable of demonstrating causation. Another
limitation was that despite the use of trained subjects, none of
the studies that met the inclusion criteria used subjects with a
mean VO2max that would classify them as elite endurance
athletes at a high international level (~70-80 mL/kg/min). Also,
with the exception of one study containing both sexes, all of the
eligible studies had only male subjects. It should be noted that
the results of this study are not necessarily applicable to
strength/power/hypertrophy-focused training.
Comment/application
The main findings of this systematic review were as follows:
Performance was not significantly different with the
following interventions: carb-loading, only mouth-rinse,
only running mode, only cycling TT carbohydrate vs. water
intervention up to 60 min, and one of the two cycling TT
carbohydrate vs. water interventions between 61 to 90 min.
In contrast, a significantly better TT performance was
reported with all three cycling TT carbohydrate vs. water
interventions lasting 12 minutes or more. For all cycling
submaximal + TT carbohydrate vs. water interventions
combined, four interventions were not significantly
different, whereas six interventions showed a 3% to 13%
performance improvement.
Across all interventions (TT and S+TT), no significant
performance differences compared to placebo were seen
with 11 trials, while with the remaining 11 trials showed a
significant performance improvement ranging between 1%
and 13%.
Overall, no significant performance benefit was seen with
most of the bouts lasting less than 70 minutes, while only 10
of the 17 studies showed significant improvement.
Carbohydrate dosing per hour of training ranged from 25 to
110 g, with the majority of studies examining the effect of
roughly 45-60 g/hr.

...athletes almost intuitively do not compete in a fasted state.


Further, a test mode assessing how long a subject can exercise
at a given intensity is common in performance studies (e.g.,
time-to-exhaustion tests). This is also does not reflect the reallife situation as usually a sporting event, at least in elite sports,
requires performing either as fast as possible for a given
distance (e.g., races) or as well as possible within a given time
(e.g., team sports).

The authors importantly point out that the current consensus is


that the ingestion of carbohydrates near or during exercise is
necessary for improving performance and that this idea is often
accepted as a universal truth. However, since the present
analysis excluded trials where subjects were tested after an
overnight-fast, the applicability of the aforementioned consensus
was not reliable. The present review only included trials where
testing was done in the post-prandial state (2-4 hours after a
meal). Although it can be argued that this places a major
restriction on the inclusion criteria, the entire point of the
analysis was to examine the influence of carbohydrate ingestion
near/during training under conditions that mimic real-life. By
virtue of being in the fed state, additional carbohydrate does not
appear to reliably enhance endurance performance in bouts
lasting up to roughly 70 minutes. In contrast, a greater
consistency of effectiveness of fed-state carbohydrate ingestion
was seen a\when exercise reaches approximately the 2-hour
mark and beyond. My hope is that future consensus statements
and position papers will consider papers such as the present one,
which break the mold and examine a little thing called reality.

Alan Aragons Research Review December 2012

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Study strengths
This is first systematic review to ever examine the effect of
carbohydrate ingestion near training in subjects who were not in
a fasted state. It also is the first to combine this criterion with the
exclusion of studies using a time-to-exhaustion testing model
instead of a fixed time or fixed distance time trial (TT), which is
more reflective of real-world race conditions. Heres an excerpt
worth quoting since it rings true in my observations with
competitive athletic clientele across a wide range of sports:

Page 5

Astaxanthin supplementation does not augment fat


use or improve endurance performance.
Res PT, Cermak NM, Stinkens R, Tollakson TJ, Haenen GR,
Bast A, van Loon LJ. Med Sci Sports Exerc. 2012 Dec 27.
[Epub ahead of print] [PubMed]
INTRODUCTION: Astaxanthin is a lipid-soluble carotenoid
found in a variety of aquatic organisms. Prolonged astaxanthin
supplementation has been reported to increase fat oxidative
capacity and improve running time to exhaustion in mice. These
data suggest that astaxanthin may be applied as a potent
ergogenic aid in humans. PURPOSE: To assess the impact of 4
wks astaxanthin supplementation on substrate use and
subsequent time trial performance
in
well-trained
cyclists.
METHODS: Using a double-blind
parallel design, 32 young, welltrained male cyclists or triathletes
(age: 251 y, weight: 731 kg,
VO2peak:
601
mLkgmin,
Wmax:
3957
W)
were
supplemented for 4 wks with 20 mg
astaxanthin per day (ASTA) or a
placebo (PLA). Before and after the
supplementation period, subjects
performed 60 min of exercise (50%
Wmax), followed by a ~1 h time
trial. RESULTS: Daily astaxanthin
supplementation significantly increased basal plasma
astaxanthin concentrations from non-detectable values to 18719
gkg (P<0.05). This elevation was not reflected in greater total
plasma anti-oxidant capacity (P=0.90) or attenuated
malondialdehyde levels (P=0.63). Whole-body fat oxidation
rates during submaximal exercise did not differ between groups
and did not change over time (from 0.710.04 to 0.680.03
gmin and 0.660.04 to 0.610.05 gmin in the PLA and ASTA
group, respectively; P=0.73). No improvements in time trial
performance were observed in either group (from 2369 to
2397 and from 2386 to 2446 W in the PLA and ASTA
group, respectively; P=0.63). CONCLUSIONS: Prolonged
astaxanthin supplementation does not augment anti-oxidant
capacity, increase fat oxidative capacity, or improve time trial
performance in trained cyclists. SPONSORSHIP: No funding
was received for this study.
Study strengths

performed) is more reflective of real-life race situations. All


subjects were provided a standardized a standardized dinner
before the day of testing.
Study limitations
This study was relatively short (4 weeks), and the results might
be limited to the endurance-type exercise examined. The study
sample was all male, so effects in women remain speculative.
The astaxanthin supplement also included vitamin C & E, so its
impossible to ascertain whether or not these co-factors had
inhibitory effects on the action of astaxanthin (although its not
likely). A tighter design nevertheless would have included those
nutrients in the placebo as well, or excluded them altogether.
Comment/application

The main findings of this study were a lack of difference in


substrate utilization (fat versus carbohydrate oxidation, depicted
above) at rest and during exercise, as well as a lack of time trial
performance benefit in the astaxanthin group compared to
placebo. These null findings were apparent despite an increase in
circulating levels of astaxanthin after 4 weeks of
supplementation. These results run contrary to previous positive
findings in research on mice.1,2 Of course, this throws a bit of a
wrench into marketing campaigns that hype astaxanthin as a
training performance enhancer or fat burner.
In addition, astaxanthin supplementation failed to improve total
antioxidant capacity. In contrast to this finding, Choi et al found
that 12 weeks of astaxanthin supplementation significantly
lowered oxidative stress.3 The authors of the present study
speculate that the higher fitness level of their subjects (as well as
shorter study duration) prevented any significant treatment
effects from being detected.

This study is conceptually strong given the rapidly mounting


attention that astaxanthin supplementation has received in both
the scientific and lay media. Another strength was the use of
trained subjects. This minimizes the confounding potential of
newbie responses, which can be more exaggerated or variable.
Instead of merely assessing fuel utilization at rest and during
exercise, this study also assessed performance. A diligent design
move (which Im thankfully seeing more & more of) was the use
of a time trial rather than time-to-exhaustion testing model. As
mentioned in the previously examined study, time trials (fixed
time or fixed distance in which the most amount of work is

Recent results seen by Earnest et al conflict with those seen in


the present study.4 Significant improvements (5%) beyond
placebo in time trial performance were seen, although substrate
utilization was unaffected. Notably, only 14 of the original 21
subjects completed the 4-week trial, and only 7 from each
treatment were assessed. This made for a substantial statistical
compromise, increasing the possibility for skewed outcomes.
The present studys standardization of the pre-testing meal,
significantly higher astaxanthin dose (20 mg/day versus 4
mg/day), and larger sample size lend greater validity to its
results. Thus far, the saga of astaxanthin at least in the area of
sports nutrition has had a bumpy start.

Alan Aragons Research Review December 2012

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Postprandial energy expenditure in whole-food and


processed-food meals: implications for daily energy
expenditure.
Barr SB, Wright JC. Food Nutr Res. 2010 Jul 2;54. doi:
10.3402/fnr.v54i0.5144. [PubMed]
BACKGOUND: Empirical evidence has shown that rising
obesity rates closely parallel the increased consumption of
processed foods (PF) consumption in USA. Differences in
postprandial thermogenic responses to a whole-food (WF) meal
vs. a PF meal may be a key factor in explaining obesity trends,
but currently there is limited research exploring this potential
link. OBJECTIVE: The goal was to determine if a particular PF
meal has a greater thermodynamic
efficiency than a comparable WF
meal, thereby conferring a greater
net-energy
intake.
DESIGN:
Subjective satiation scores and
postprandial energy expenditure were
measured for 5-6 h after isoenergetic
meals were ingested. The meals were
either 'whole' or 'processed' cheese
sandwiches; multi-grain bread and cheddar cheese were deemed
whole, while white bread and processed cheese product were
considered processed. Meals were comparable in terms of
protein (15-20%), carbohydrate (40-50%), and fat (33-39%)
composition. Subjects were healthy women (n=12) and men
(n=5) studied in a crossover design. RESULTS: There were no
significant differences in satiety ratings after the two meals.
Average energy expenditure for the WF meal (137+/-14.1 kcal,
19.9% of meal energy) was significantly larger than for the PF
meal (73.1+/-10.2 kcal, 10.7% of meal energy).
CONCLUSION: Ingestion of the particular PF meal tested in
this study decreases postprandial energy expenditure by nearly
50% compared with the isoenergetic WF meal. This reduction in
daily energy expenditure has potential implications for diets
comprised heavily of PFs and their associations with obesity.
SPONSORSHIP: This study was funded by funds from the
Howard Hughes Medical Institute and Pomona College.
Study strengths
This study is innovative since it was the first (and to my
knowledge, the only) to compare the thermic effect of meals
with matched macronutrient composition but different degrees of
processing/refinement. An important question was investigated,
since degree of food processing is rarely factored into the
potential for weight gain (or struggle for weight loss). Low
statistical power inherent in the small sample size was alleviated
by a crossover design (all subjects underwent both treatments).
Study limitations

would normally be consumed as a complete/mixed meal in


almost any industrialized setting. Another limitation is that,
ironically, the whole food meal was technically still composed
of refined/processed stuff, as opposed to single-ingredient whole
foods. Perhaps a more meaningful comparison would be a meal
replacement powder versus a macronutrient-matched meal
comprised of actual whole foods such as meat and potatoes. The
authors recognized this limitation, and mentioned that they
wanted to compare two meals that were familiar to the Western
diet, and could be easily interchangeable. I still disagree with
this aspect of the studys design. A final limitation is the open
question of how prior exercise might influence the thermic effect
of the meals.
Comment/application

As seen above, the main finding of this study was a significantly


higher diet-induced thermogenesis (DIT) over a 6-hour test
period. This amounted to a DIT of 137 kcal for the whole food
meal, and 73 kcal for the processed food meal. This difference is
substantial in both proportional and absolute terms. In a
hypothetical situation where this 64 kcal difference was carried
out across 3 meals in a day, the daily difference would be 192
kcal, which in the long-term could significantly impact body
mass. Interestingly, no significant differences were seen in
satiety ratings despite the difference in DIT.
The peculiar thing about this marked difference in postprandial
energy expenditure is that both meals consisted of non-whole
foods; both were based on foods (cheese & bread) that were
processed and altered from their original source. The whole
food meal had about double the fiber of the processed meal, but
this only amounted to 3.5 & 6 g more fiber in each of the two
serving sizes, respectively. This alone cannot account for the
thermic difference. Protein was 5% higher in the whole food
meal (7 & 10 g more than the processed meal in the two serving
sizes, respectively), but even this in combination with the greater
fiber amount is not likely to fully account for the thermic
difference. Sugar content was almost identical between each
treatment (table here). The authors speculate that the greater
mechanized preparation of the processed food would cause less
peristalsis and greater loss of bioactive compounds. In turn, this
would result in fewer metabolites, which would require less
enzyme production, resulting in simpler absorption and
metabolism. The collective reduction in these processes could
have been responsible for the lower energetic cost.

Unfortunately, acute studies such as this leave open questions


about how these effects may have accumulated (or dissipated)
over a period of weeks or months. Also, only 600 & 800 kcal
servings were tested, as opposed to an entire days eating. The
meal itself (cheese sandwich), while not incredibly far-fetched,
is still at least to me rather uncommon in terms of what

However, its very important to weigh these findings against


whats been seen in the body of evidence at-large. Meal
replacement products (powders, shakes, and bars), have
performed consistently as well (and in some cases even better)
compared to whole food diets over chronic periods.5-11 So, while
less processing might look superior in the present study, longerterm meal replacement research has stiffly challenged this idea.

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Effects of high-calorie supplements on body


composition and muscular strength following
resistance training.

Comment/application

Rozenek R, Ward P, Long S, Garhammer J. J Sports Med Phys


Fitness. 2002 Sep;42(3):340-7. [PubMed]
BACKGROUND: Seventy-three healthy, male subjects randomly
divided into 3 groups participated in a study to determine the effects
of 2 high-calorie nutritional supplements on body composition,
body segment circumferences, and muscular strength following a
resistance-training (RT) program. METHODS: In addition to their
normal diets group 1 (CHO/PRO; n=26) consumed a 8.4 Mj x day(1) (2010 kcal) high calorie, high protein supplement containing 356
g carbohydrate and 106 g protein. Group 2 (CHO; n=25) consumed
a carbohydrate supplement that was isocaloric with CHO/PRO.
Group 3 (CTRL; n=22) received no supplement and served as a
control. All subjects were placed on a 4-day x week(-1) RT program
for 8 weeks. RESULTS: Dietary analysis revealed no significant
differences in total energy consumption or nutrients at any time in
the non-supplemented diets of the 3 groups. Significant (p= or
<0.05) increases in body mass (BM) and fat-free mass (FFM) were
observed in CHO/PRO and CHO compared to CTRL. Mean (+/SD) increases in BM were 3.1+/-3.1 kg and 3.1+/-2.2 kg,
respectively. Fat-free mass significantly (p= or <0.05) increased
2.9+/-3.4 kg in CHO/PRO and 3.4+/-2.5 kg in CHO. Muscular
strength, as measured via 1RM in the bench press, leg press, and latpull down increased significantly (p= or <0.05) in all groups. No
significant differences in strength measures were observed among
groups following training. CONCLUSIONS: Results indicate that
high-calorie supplements are effective in increasing BM and FFM
when combined with RT. However, once individual protein
requirements are met, energy content of the diet has the largest
effect on body composition. SPONSORSHIP: None listed.

Study strengths
This was the first & only study to directly compare carb-protein
(CHO/PRO) versus carb-only (CHO) high-calorie nutritional
supplement in subjects placed on a structured, progressive
resistance training program. A non-supplemented, training-only
control group was a nice touch to cover all the bases for
comparison. The primary investigators and training supervisors
were blinded as to which group was receiving which treatment.
Hydrodensitometry was used to assess body composition
changes. Strength testing was done in addition to body
composition assessment.
Study limitations

As depicted above, the main findings were a lack of difference


in mass (total & lean) and strength gains between the CHO/PRO
and CHO treatments. Unsurprisingly, only the nonsupplemented control group lost fat mass. Although there was a
slight trend toward the superiority of CHO/PRO for increasing
1RM strength gains (see chart above), no statistically significant
differences were seen in the strength increases between groups
including the non-supplemented control. This null result was
seen despite the supplemented groups consuming roughly 2000
kcal more than the control group (non-supplemented intakes of
all groups ranged roughly 2300-2600 kcal). As cautioned by the
authors, the across-the-board similar strength increase was
potentially due to the neurological adaptations common to the
beginning stages of resistance training. A notable finding was
the apparent lack of fat gain. This could be attributed to the
newbie status of the subjects combined with a relatively high
volume of rigorous, progressive training (60-90 minutes, 4 days
per week), where it did not previously exist in their lifestyles.

The subjects were specifically chosen on the basis of having


minimal weight training experience and mild habitual physical
activity. In short, they were novices rather than experienced
trainees. This increases the potential for newbie gains masking
actual treatment effects. I was surprised to see that the actual
ingredients of the supplements was not specified. It would have
been useful to know what the sources of protein and
carbohydrate were, since different types can impart different
effects (they could have at least listed the brand so readers can
dig up the details). The authors acknowledged that due to the
limited study duration (8 weeks), the strength gains might
largely have been due to neural adaptations. Again, this
confounder speaks to the potentially greater utility of a trained
sample as opposed to the novices they chose to study.

Perhaps the most noteworthy finding was that in the CHO/PRO


group, an additional 106 g protein did not impart any apparent
muscular size or strength gains compared to the isocaloric CHO
treatment. In fact, the latter gained a nonsignificantly greater
amount of lean mass, likely in the form of glycogen. Average
protein intake for the CHO/PRO group minus supplementation
was 121.6 g (1.6 g/kg). Supplementation brought this up to
227.6 g (2.9 g/kg). Protein intake of CHO minus
supplementation was 109 g (1.4 g/kg), and supplementation
brought this up to 133 g (1.7 g/kg). For trainees in an energy
surplus (roughly 4300-4600 kcal/day in total was consumed), its
clear that their pre-existent protein intake at 1.4-1.6 g/kg was
already maximally sufficient for imparting muscular size &
strength gains.12,13 If this experiment was carried out in trained
subjects, Id expect to see at least some fat gain.

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1.

2.

3.

4.
5.

6.

7.

8.

9.

10.

11.

12.

13.

Aoi W, Naito Y, Takanami Y, Ishii T, Kawai Y, Akagiri S,


Kato Y, Osawa T, Yoshikawa T. Astaxanthin improves
muscle lipid metabolism in exercise via inhibitory effect of
oxidative CPT I modification. Biochem Biophys Res
Commun. 2008 Feb 22;366(4):892-7 [PubMed]
Ikeuchi M, Koyama T, Takahashi J, Yazawa K. Effects of
astaxanthin supplementation on exercise-induced fatigue in
mice. Biol Pharm Bull. 2006 Oct;29(10):2106-10.
[PubMed]
Choi HD, Youn YK, Shin WG. Positive effects of
astaxanthin on lipid profiles and oxidative stress in
overweight subjects. Plant Foods Hum Nutr. 2011
Nov;66(4):363-9. [PubMed]
Earnest CP, Lupo M, White KM, Church TS. Effect of
astaxanthin on cycling time trial performance. Int J Sports
Med. 2011 Nov;32(11):882-8. [PubMed]
Kroeger CM, Klempel MC, Bhutani S, Trepanowski JF,
Tangney CC, Varady KA. Improvement in coronary heart
disease risk factors during an intermittent fasting/calorie
restriction regimen: Relationship to adipokine modulations.
Nutr Metab (Lond). 2012 Oct 31;9(1):98. [PubMed]
Davis LM, Coleman C, Kiel J, Rampolla J, Hutchisen T,
Ford L, Andersen WS, Hanlon-Mitola A. Efficacy of a meal
replacement diet plan compared to a food-based diet plan
after a period of weight loss and weight maintenance: a
randomized controlled trial. Nutr J. 2010 Mar 11;9:11.
[PubMed]
Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis
LM, Lewis RA, Yep MA, Lycan TW. Efficacy of meal
replacements versus a standard food-based diet for weight
loss in type 2 diabetes: a controlled clinical trial. Diabetes
Educ. 2008 Jan-Feb;34(1):118-27. [PubMed]
Ashley JM, Herzog H, Clodfelter S, Bovee V, Schrage J,
Pritsos C. Nutrient adequacy during weight loss
interventions: a randomized study in women comparing the
dietary intake in a meal replacement group with a traditional
food group. Nutr J. 2007 Jun 25;6:12. [PubMed]
Noakes M, Foster PR, Keogh JB, Clifton PM. Meal
replacements are as effective as structured weight-loss diets
for treating obesity in adults with features of metabolic
syndrome. J Nutr. 2004 Aug;134(8):1894-9. [PubMed]
Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M,
Frier HI. Weight management using a meal replacement
strategy: meta and pooling analysis from six studies. Int J
Obes Relat Metab Disord. 2003 May;27(5):537-49.
[PubMed]
Ditschuneit HH, Flechtner-Mors M, Johnson TD, Adler G.
Metabolic and weight-loss effects of a long-term dietary
intervention in obese patients. Am J Clin Nutr. 1999
Feb;69(2):198-204. [PubMed]
Campbell B, Kreider RB, Ziegenfuss T, La Bounty P,
Roberts M, Burke D, Landis J, Lopez H, Antonio J.
International Society of Sports Nutrition position stand:
protein and exercise. J Int Soc Sports Nutr. 2007 Sep 26;4:8.
[PubMed]
Tipton KD, Wolfe RR. Protein and amino acids for athletes.
J Sports Sci. 2004 Jan;22(1):65-79. [PubMed]

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others were then compared to the subjects score on the Beck


Depression Inventory (BDI).
Semen is back in the news, ready to cure the blues.
By Alan Aragon

Hello again, Gallup et al


A Valentines Day seasonal tradition in the sciency (and not-sosciency) lay press is to make news headlines about a study by
Gallup et al, which investigated the relationship between semen
exposure and mood in women.1 Does it matter that this research
was published in 2002 and never followed up? Of course not.
From a journalistic perspective, theres no sense in neglecting a
story thats a sure-bet for attracting a large readership. Lets take
a closer look at this research.
The inspiration for the study

87% of the subjects were sexually active. Among these subjects,


BDI scores varied according to frequency of condom use. Those
who never used condoms had significantly lower BDI scores
than those who usually or always used condoms. In addition,
significantly lower levels of depression symptoms were seen in
those who did not use condoms compared to those who
abstained from intercourse. Number of days since last engaging
in sexual intercourse was correlated with BDI scores as well, and
this too was influenced by condom use. Those who used
condoms most or all of the time showed no significant
correlation with BDI score. However, for those who did not use
condoms, greater length of time since their last bout if
intercourse was positively correlated with depressive symptoms.
Of all the variables (which included days since sex, frequency of
sex, and duration of relationship), condom use was most closely
correlated with variance in depression.
A highly tabloid-worthy finding was that only 4.5% of those
who never used condoms reported having attempted suicide.
This statistic was 7.4% with the sometimes group. In contrast,
the usually and always groups checked in at 28% and
13.2%, respectively. The latter two groups thus were
significantly more likely to commit suicide.
Limitations & future directions

Back in 1986, the journal Medical Hypotheses published a case


study by Ney,2 who documented a 23 year-old, depressed, childabusing mothers improvement in mood. This apparently was a
result of taking evening primrose oil (EPO, which is rich in
gamma-linolenic acid), which may have initiated the return of
her sex drive after a 6-week period of post-partum abstinence,
which initially was intended for allowing the episiotomy to heal.
It was during this period that depression and aggression toward
her child manifested. Ney speculated that the EPO helped revive
decreased prostaglandin levels that were contributory to her
depression. Upon the return of sexual activity, he proposed that
the physical exposure to the biologically active constituents of
her husbands semen was instrumental in the return of her sense
of well-being. The concluding paragraph of Neys study is worth
quoting:

Gallup et al diligently acknowledged that their findings are


merely correlational, and therefore subject to more rigorous
investigation that can demonstrate causation. They conceded that
more definitive measures of anti-depressive effects of semen
would involve ...more direct manipulation of the presence of
semen in the reproductive tract and, ideally, the measurement of
seminal components in the recipients blood. Another potential
confounder they acknowledged was that 7 out of the 10 sexually
active women in the sample used oral contraceptives. Therefore,
the possibility that oral contraceptives could at least be partially
responsible for anti-depressive effects cannot be ruled out. Yet
another potential confounder is that the higher frequency of sex
in subjects who never used condoms could have independently
inhibitory effects on depression.

Although the role of exogenously given prostaglandins in


improving libido and mood has not been established, there
appears to be some link. The change in this woman's well
being may be due to the absorbed estrogen or testosterone
hormones, but in the amounts available from the sperm, it
would seem that the prostaglandins would have a greater
impact. If the deductions of this paper are correct, the oil of
the evening primrose may be an important adjunctive
treatment for postpartum depression and infant abuse or
neglect.

The authors ultimately conclude that their data support Neys


seminal research, suggesting that the vaginas absorption of
biologically active components in semen (e.g., sex hormones and
prostaglandins) has the potential to alleviate depressive
symptoms. Are they correct? Gallup et al themselves admitted
that their findings ...raise more questions than they answer.
However, its fairly certain that as next Valentines Day
approaches, Gallup et als work will once again make headlines,
and men all over the world will launch campaigns to convince
their partners that they found the antidote for depression.

Gallup et als findings

References

So, 16 years after the publication of Neys study, Gallup et al set


out to test his hypothesis by recruiting 293 female college
students who anonymously completed a questionnaire designed
to assess sexual activity in terms of intercourse frequency and
type of contraception. Condom use was the indirect indicator of
the presence of semen in the reproductive tract. This factor and

1.

Alan Aragons Research Review December 2012

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2.

Gallup GG Jr, Burch RL, Platek SM. Does semen have


antidepressant properties? Arch Sex Behav. 2002
Jun;31(3):289-93. [PubMed]
Ney PG. The intravaginal absorption of male generated
hormones and their possible effect on female behaviour. Med
Hypotheses. 1986 Jun;20(2):221-31. [PubMed]
Page 10

3 versus 6 meals per day for hunger control.


By Alan Aragon
____________________________________________________

I read an articlesaying that eating3mealsperday


controls hunger better than 6 meals per day. He said
that this has been proven with a scientific study. Is this true?
Thanks.

Assumption built into the question


This line of thinking has been gaining popularity in the recent
wake of research related to intermittent fasting and meal
frequency. However, the idea that 3 meals per day controls
hunger better than 6 meals is questionable. Is there a study
showing this? Yes. But the outcomes of a study cannot
definitively prove anything. The most it can do is contribute
to, and thus, help shape the evolving body of evidence. The
weight of the evidence (the direction it leans, if it leans in any
particular direction in the first place) is what determines our
current opinion of a given claim or idea. In the case of meal
frequency and hunger control, the answer is far from simple.
Lets take a chronological look at the recent surfacing of
research focusing specifically on 3 versus 6 meals. These meal
distributions have perhaps the greatest relevance to the majority
concerned with this question.
The research
An 8-week trial by Cameron et al compared the effects of low
meal frequency (3 meals per day) with a high meal frequency (3
meals plus 3 snacks per day).1 Energy restriction was
approximately 700 kcal below maintenance. No significant
differences were seen in bodyweight and body fat reduction
between the groups. No significant differences in subjective
appetite ratings or objective measurements of appetite-regulating
gut peptides (PYY the fullness hormone & ghrelin the
hunger hormone) were detected.
Leidy et al compared the 11-hour effects of eucaloric diets
composed of either normal protein (79 g per day) or higher
protein (138 g per day) distributed over 3 versus 6 meals, and
found contrasting results.2 Unsurprisingly, the higher-protein
conditions resulted in greater fullness ratings independent of
meal frequency. The 6-meal pattern resulted in lower daily
fullness ratings, as well as lower PYY concentrations.
A subsequent 12-week study by Leidy et al (the final 5 weeks
compared meal frequency) examined the chronic effect of 3
versus 6 meals per day in a diet whose energy restriction was
750 kcal below maintenance.3 The higher-protein diet (25% of
total energy) resulted in lower late-night hunger compared to the
normal protein diet (14% of total energy). The 3-meal pattern
resulted in greater evening & late-night fullness compared to the
6-meal condition, but only within the higher-protein diet.
A 6-month trial by Bachman & Raynor compared the effects of a
low frequency (3 meals per day) with a grazing pattern (at least
Alan Aragons Research Review December 2012

100 kcal every 2-3 hours).4 Total energy intake ranged 12001500 kcal per day. Despite significant reductions in BMI, no
between-group differences were seen. Unsurprisingly, no
differences in total energy intake were seen. The grazing group
averaged 5.8 meals per day, and reported a significant reduction
in hunger from 0 to 6 months. In contrast, no such hunger
reduction was reported in the lower-frequency group averaging
3.2 meals per day.
In the most recent study to-date, Ohkawara et al compared the
24-hour effect of 3 versus 6 meals on 24-hour fat oxidation
(using whole-room calorimetry) and subjective appetite ratings.5
No significant differences were seen in fat oxidation. There were
no differences in ratings of fullness, but greater hunger was
reported in the 6-meal condition.
Summary & application
To re-cap, one 8-week study reported no difference in appetite
control,1 one 11-hour study reported lower fullness in the 6-meal
condition,2 one 12-week study (whose final 5 weeks compared
frequency effects) found greater hunger control in the 3-meal
pattern when higher protein was consumed,3 one 6-month study
reported hunger reduction with 6 meals but not with 3 meals,4
and finally, one 24-hour study reported greater hunger in the 6meal condition.5 As the evidence stands, it cannot correctly be
claimed that 3 meals per day is consistently superior to 6 meals a
day for hunger control. The data is highly equivocal, with no
clear winner. To me this is good news, since meal frequency for
controlling appetite can be optimized according to personal
preference and individual response. This sort of flexibility is
contrary to the philosophy of a single-best way which is a
common theme in a wide range of nutritional topics. However,
there is a downside to these findings. The elusiveness of a
singularly supreme approach to meal frequency is not good for
building marketing hype.
References
1.

2.

3.

4.

5.

Cameron JD, Cyr MJ, Doucet E. Increased meal frequency


does not promote greater weight loss in subjects who were
prescribed an 8-week equi-energetic energy-restricted diet.
Br J Nutr. 2010 Apr;103(8):1098-101. [PubMed]
Leidy HJ, Armstrong CL, Tang M, Mattes RD, Campbell
WW. The influence of higher protein intake and greater
eating frequency on appetite control in overweight and
obese men. Obesity (Silver Spring). 2010 Sep;18(9):172532. [PubMed]
Leidy HJ, Tang M, Armstrong CL, Martin CB, Campbell
WW. The effects of consuming frequent, higher protein
meals on appetite and satiety during weight loss in
overweight/obese men. Obesity (Silver Spring). 2011
Apr;19(4):818-24. [PubMed]
Bachman JL, Raynor HA. Effects of manipulating eating
frequency during a behavioral weight loss intervention: a
pilot randomized controlled trial. Obesity (Silver Spring).
2012 May;20(5):985-92. [PubMed]
Ohkawara K, Cornier MA, Kohrt WM, Melanson EL.
Effects of increased meal frequency on fat oxidation and
perceived hunger. Obesity (Silver Spring). 2012 Sep 13.
doi: 10.1002/oby.20032. [Epub ahead of print] [PubMed]

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Page 11

Here is a clip featuring Phil Heath, the current Mr. Olympia for
the second consecutive year. Hes being interviewed by some
unknown/funny/skinny dude, and the result will bring a smile to
your face. How can anyone not be a Heath fan?

If you have any questions, comments, suggestions, bones of


contention, cheers, jeers, guest articles youd like to submit, or
any feedback at all, send it over to aarrsupport@gmail.com.

Alan Aragons Research Review December 2012

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