Maximum Wellness

Understanding a person's metabolism – the process in which the body converts food consumed into fuel to expend during all of its functions – is a key component to any successful weight/fat loss program. Resting metabolic rate (RMR) represents roughly 65% of all the calories a person expends during a day - keeping the heart beating, temperature control, breathing, and circulation activities. Some people have a fast metabolism – one that effectively processes and converts the food you eat into energy, versus a slow metabolism that stores more of the energy from daily food intake.RMR, also referred to as basal metabolic rate (BMR) - is the total amount of calories that a human body requires to maintain itself.  Other metabolic components include the thermal effect of eating – the energy cost of chewing, digesting, and absorbing nutrients, which increases the RMR by 5 to 15%; physical activity expenditure – daily exercise - that adds another 15 to 30% to RMR; and non-exercise activity thermogenesis (NEAT), that represents walking, sitting down, getting up, and any restless-type activity.During my thirty years of multiple hospital-affiliated sports performance, fitness, and wellness programs, we measured a person's RMR using a metabolic cart, which was also used to determine their ventilatory threshold and maximum endurance capacity – all factored into a client's macro-nutrient intake and exercise guidelines to reduce excess weight and body fat, while preserving or increasing lean muscle. There are equations that have been used to compare against the RMR measurements.Harris-Benedict (HB):Men: (13.75 x W) + (5 x H) – (6.76 x A) + 66Women: (9.56 x W) + (1.85 x H) – (4.68 x A) + 655Weight (W) is in kilograms Take your weight in pounds / 2.2 = weight in kilogramsHeight (H) is in centimetersTake your height in inches x 2.54 = height in centimetersA = ageThe main issue with the HB calculation is that it does not take into consideration your increase or decrease in lean body mass (muscle).A more accurate formula is the Cunningham equation: RMR = 500 + (22 x LBM in kilograms). This formula requires obtaining a body composition from a DXA scan or the use of body composition devices, like bio-impedance, and skin calipers (less accurate with obese individuals). You divide your LMB in pounds by 2.2 to get kilograms.If you would like to learn more about metabolic rate, check out maxwellnutrition.com. You can also find information on other RMR formulas at https://www.lizino.net/facts-about-resting-metabolic-rate/ 

The Journal of the American College of Cardiology reported on the results of a modeling study in August 2022 that concluded, “the association of CRF (cardiorespiratory fitness) and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness.”The study – "Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex" – further concluded that, “being unfit carried a greater risk than any of the cardiac risk factors examined.”The study group included a diverse group – age, gender, and race – of 750,302 U.S. veterans aged 30 to 95, who were followed for a median of 10.2 years. Age and gender-specific CFR categories were created based on peak MET (metabolic equivalent) achieved on a standardized treadmill test – one MET equal to 3.5 ml/kg/min. According to the study investigators, “the lowest mortality risk was observed at approximately 14.0 METs for men and women, with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher compared with extremely fit individuals.”In a related editorial, my friend, Cardiologist, Carl (Chip) J. Lavie, MD, whom I worked closely with during my tenure as Director of Health and Fitness for the Ochsner Heart and Vascular Institute, commented, “indeed, "improving CRF should be considered a target in CVD prevention, similar to improving lipids, blood sugar, blood pressure, and weight.”If you would like to read the abstract from this study, here's the link.https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.05.031For more detailed information on similar studies, go to maxwellnutrition.com.

Sarcopenia is the aging loss of lean muscle, resulting from a loss of strength – dynapenia – and a related anabolic resistance – the inability to regenerate lean muscle at the same rate, as a younger individual. This degenerative process can begin without interventions, such as increased protein intake and resistance training, in the fourth decade and accelerate after the age of sixty.New research – Dietary Protein Intake Is Positively Associated with Appendicular Lean Mass (ALM) and Handgrip Strength Among Middle-Aged US Adults - published in the December issue of the Journal of Nutrition, comments that, “protein intake predicts skeletal muscle mass and strength among older adults, but knowledge of similar associations among middle-aged adults is lacking.”In order to determine the effect of protein intake on lean mass maintenance in middle-aged adults, researchers from Purdue University in Indiana, assessed appendicular lean mass, adjusted for BMI (body mass index), and handgrip strength data from 1209 men and women from 2011 to 2014 aged 40 to 59 years of age. ALM is the sum of lean tissue in the arms and legs.Daily protein intake per kilogram of body weight was determined by two- 24-hour recalls. The participants protein intake was broken into three categories: less than the recommended daily allotment of 0.8 grams per kilogram (2.2 pounds) of body weight; moderate protein intake of between 0.8 to 1.2 g/kg/; and high at greater than 1.2 g/kg.The ALM - the sum of lean tissue in the arms and legs - was assessed by DXA Scans and handgrip strength. The investigators used the National Institutes of Health criteria for the ALM to define the categories of “low lean mass and “weakness.”The results reflected, “among middle-aged adults, 15.6% of men and 13.4% of women had low lean mass and 3.5% of men and 2.3% of women exhibited weakness.” It was further determined that, compared with the moderate protein group, the high protein group had a higher handgrip strength and the low protein group had lower grip strength among men and women. The researchers concluded that higher protein intakes were associated with greater ALM and handgrip strength relative to BMI. The take-away is that a protein intake above the recommended daily intake of 0.8 g/kg/day, may need to be increased after the age of 40. 

Dementia, which globally effected over 50 million people in 2019, is characterized by a progressive and unrelenting deterioration of mental capacity – compromising everyday activities.  Dementia is a symptom of underlying brain degeneration caused by vascular disease or traumatic brain injury, such as from accidents or contact sports like American football, brain tumors, and the list goes on.Dementia is classified into two distinct areas: Alzheimer disease and vascular dementia. Since a stroke doubles the risk of developing dementia, it's estimated that more than a third of the dementia cases could be prevented by reducing the risk to a stroke.According to research – Consumption of Coffee and Tea and the Risk of developing Stroke, Dementia, and Post-Stroke Dementia: A Cohort Study, which appeared in December 2021, in the open access, peer-reviewed journal Plos Medicine, “epidemiological and clinical studies have shown the benefits of coffee and tea separately in preventing dementia. However, little is known about the association between the combination of coffee and tea and the risk of dementia.” Chinese researchers sought to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke, dementia, and poststroke dementia, based on data from a large population-based cohort – the UK, a population-based cohort study that recruited more than 500,000 participants (39 to 74 years old), who attended 1 of the 22 assessment centers across the UK between 2006 and 2010.365, 682 participants reported their coffee and tea consumption. The researchers determined that, “coffee intake of 2 to 3 cups/day or tea intake of 3 to 5 cups/day, or their combination intake of 4 to 6 cups/day were linked with the lowest hazard ratio (HR) of incident stroke and dementia.”It was also determined that consuming 2 to 3 cups of coffee with 2 to 3 cups of tea daily were associated with a 32% lower risk of stroke and a 28% lower risk of dementia – with the intake of coffee alone or in combination with tea being associated with lower risk of poststroke dementia. The Chinese investigators concluded that, “our findings support an association between moderate coffee and tea consumption and risk of stroke and dementia. However, whether the provision of such information can improve stroke and dementia outcomes remains to be determined.”

In August of 1985, I designed and implemented the performance nutrition and conditioning plan that transformed the former undisputed World Light Heavyweight Champion Michael Spinks from his light heavyweight weigh-in weight of 175 pounds to 200 pounds. On September 21st, Spinks won a 15-round historic victory over the reining, undisputed World Heavyweight Champion Larry Holmes. Previously, no light heavyweight boxer had ever successfully moved up and beaten the world heavyweight champion. Both Spinks and I made history on that night. Losing scale weight, while preserving or increasing fat free mass (FFM), can be quite challenging, as any bodybuilder can attest to. Researchers from the University of Alicante in Spain and California State University in Northridge, California published research – Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review – in the September 2021 issue of the journal Nutrients. The researchers used a literature review to develop an evidence-based overview of dietary-nutritional strategies for the loss of fat mass (FM) and maintenance of FFM in resistance-trained athletes.The first area of concern is caloric intake, which for resistance athletes, “should be set based on a target BW (body weight) loss of 0.5–1.0%/week, in order to maximize retention of FFM.” The researchers point out that athletes with an initial lower percentage of body fat should take a more conservative approach to caloric restriction (CR).As for protein intake, 2.2–3.0 grams/kilogram of body weight per day (g/kg BW/day) should be distributed throughout the day in three–six meals and ensuring in each of them an adequate amount of protein (0.40–0.55 g/kg BW/intake), note the investigators.Relative to integrating protein intake around resistance training, “an intake 2-3 hours before training and another 2-3 hours post-training is preferable.”Carbohydrate consumptions needs to be adapted to the athlete's activity level, in order to support the energy demands of the training (2–5 g/kg BW/day). “Individuals, who wish to engage in more severe CHO restriction (e.g., ketogenic conditions),” comment the researchers, “may increase the risk of FFM loss, despite a similar capacity to preserve strength.”The fat macro-nutrient intake should ensure a minimum of greater than or equal to 0.5 grams per kilogram of BW per day.From a micronutrient standpoint, the researchers point out that there is a need to overcome any potential deficiencies in vitamin B1, B3, B6, vitamin D, and the minerals magnesium, calcium, zinc, and iron. A good starting point is to use a multivitamin/mineral formula containing, note the researchers, 10 or more vitamins and minerals at recommended daily intake levels in healthy people.Creatine - produced naturally in the body from the amino acids glycine, methionine and arginine - is used in the phosphocreatine energy system in explosive activities lasting 0–10 seconds. The researchers comment that, “athletes may benefit from creatine supplementation indirectly, since it has been observed that creatine supplementation in combination with strength training could increase the training-induced proliferation of satellite cells and myonuclei in skeletal muscle, resulting in increased muscle fiber growth.”For more information about developing a creatine muscle gain protocol in conjunction with your physician, I refer you to my book, Lean & Hard, the body you've always wanted in 24 workouts (John Wiley & Sons).Read the rest at maxwellnutrition.com ...

Researchers from multiple departments of Boston University report in October 2021 in JAMA Network Open that a higher midlife estimated cardiorespiratory fitness level was associated with a lower burden of subclinical atherosclerosis and vascular stiffness, along with a lower risk of hypertension, diabetes, chronic kidney disease, cardiovascular disease, and mortality. Vascular stiffness refers to left ventricular afterload and the resulting coronary perfusion – leading to cardiovascular disease (CVD). It's measured by pulse wave velocity (PWV), which can slow with aging – leading to systolic (top blood pressure number) hypertension. Prior research has shown that a higher CRF level lowers the risk to CVD and all-cause mortality by itself and/or in conjunction with other CVD risk-reduction measures, such as with the Mediterranean eating strategy and weight control. The American Heart Association recommends that primary care physicians assess CRF in their clinical practices. As referenced in the Boston University research – Association of Estimated Cardiorespiratory Fitness in Midlife with Cardiometabolic Outcomes and Mortality – “CRF is measured via cardiopulmonary exercise testing; however, this method requires in-person assessment with specialized equipment and trained personnel, rendering it expensive and less accessible.” Luckily, non-exercise estimated CRF (eCRF) algorithms have been developed using readily available clinical information, such as age, sex, waist circumference, resting heart rate, and physical activity. In my former hospital-affiliated sports performance, fitness, and wellness programs, we used 12-lead EKG cardiopulmonary VO2 max testing – with a cardiologist interpretation of the data to determine the appropriate heart rate training intensity zones for both athlete and non-athlete.As for the eCRF, I have successfully used the Polar algorithms and heart rate monitoring devices (polar.com) to provide guidance to members of the US Army Special Operations Command.Read the rest on MaxWellNutrition.com

Cardiovascular disease (CVD) is still the leading cause of death worldwide. The good news is that modifying CVD risk factors, such as an unhealthy diet, physical inactivity, not smoking, and limiting alcohol intake, can reduce the risk to complications, an early demise, or unnecessary risk to Covid-19 and its pervasive variants.A recent study – "Using an Erythrocyte Fatty Acid Fingerprint to Predict Risk of All-Cause Mortality: The Framingham Offspring Cohort "– appearing in the June 2021 online issue of the American Journal of Clinical Nutrition (AJCN), sought to compare a combination of RBC (red blood count) FA (fatty acid) levels in predicting all-cause mortality.Those biomarkers included the FA's measured in blood plasma and RBC membranes, specifically looking at the omega-3's EPA, and DHA - which are most notably associated with reduced risk to CVD.  Those referenced FA's are found in fish oil and walnuts, among other dietary sources.The study also references a 2018 report, which included 2500 participants in the Framingham Offspring Cohort, who were followed for a median of 7.3 years (i.e., between ages ∼66 and 73 y) – with a baseline RBC EPA + DHA content [the omega-3 index].  A higher omega-3 index was significantly and inversely associated with risk for death from all causes.Those, “individuals in the highest quintile were 33% less likely to succumb during the follow-up years compared with those in the lowest quintile,” comments the AJCN.There have been similar associations seen in the Women's Health Initiative Memory Study, the Heart and Soul Study, and the Ludwigshafen Risk and Cardiovascular Health Study. However, these prior investigations evaluated only one FA metric, as an exposure variable.The Framingham Offspring Cohort participants (2240 eligible), who had RBC fatty acid measurements and relevant baseline clinical covariates, were without prevalent cardiovascular disease. The participants were evaluated during eleven years of follow-up looking specifically at the association with eight standard risk factors (age, sex, total cholesterol, HDL cholesterol, hypertension treatment, systolic blood pressure, smoking status, and prevalent diabetes) and 28 FA metrics with all-cause mortality.The bottom line is that a physician can now assess the patient's FA levels - along with their medical history and other appropriate lab values - to prescribe or recommend the appropriate intake level of supplementary omega-3's – prescription or over the counter preparations.

New research – "Mild Cognitive Impairment and Dementia Reported by Former Professional Football Players over 50 Years of Age,  An NFL-Long Study", which appeared in the March 2022 issue of Medicine & Science in Sports & Exercise, reports on the increased risk that former NFL players over the age of 50 have for mild cognitive impairment (MCI)A diverse group of researchers from the Department of Exercise and Sports Science and Center for the Study of Retired Athletes, University of North Carolina and the Department of Neurosurgery/Neurology, Medical College of Wisconsin, among others, concluded that, “Self-reported MCI prevalence and dementia prevalence were higher in former NFL players than national estimates and were associated with numerous personal factors, including mood-related disorders and a high number of self-reported concussions.”The estimates of MCI risk in Americans is 24 to 32%. While not completely understood, the risk seems to be related to be age, race, social, educational, health status (osteoarthritis and cardiovascular disease) and mood (depression).The investigators comment that, “Traumatic brain injury (TBI) may also increase risk for developing MCI and dementia-related disorders. With respect to sport-related TBI, the prevalence of MCI may be higher in former National Football League (NFL) players with three or more self-reported concussions compared with those with fewer, but not necessarily for Alzheimer's disease (AD).”The overall incidence of AD in former NFL players is higher than for the average American man – with the greatest disparity tied to males under 70 years old.Based on the need to clarify a retired NFL players risk to MCI, after the age of 50, the investigators contacted 15,025 former NFL players of all ages. Former players were eligible for the study, if they had at least one full season and were 50 years or older. They were asked to complete an online questionnaire or paper hard copy.The justification by the researchers for a 50-year old cutoff age was that, “It represents the lower-bound age in which neurodegenerative diseases with typical earlier onset first occur (e.g., early onset/autosomal AD, behavioral variant of frontotemporal dementia).”The questionnaire used was expanded from a prior questionnaire in an ongoing study – Neurologic Function Across the Lifespan: A Prospective, Longitudinal, and Translational Study for Former National Football League Players (NFL-Long).The questionnaire examined the general health of former NFL players, while also acquiring information regarding the former player's personal demographics; football playing history; medical history; concussion history; musculoskeletal injury history; self-reported psychological, physical, and cognitive functioning; health-related quality of life; and current substance use-and health-related behaviors.It was determined that, “In this subset of former NFL players, history of 10 or more sport-related concussions, lifetime diagnoses of depression and/or anxiety, and greater recent pain intensity were each associated with higher prevalence of MCI and dementia.” In addition, “Sleep apnea was also associated with a greater prevalence of MCI. Older age and self-identifying as non-White were associated with a greater prevalence of dementia.”As to the implications, “This study, concluded the researchers, “suggests that there may be preventative and therapeutic targets that might mitigate the onset of MCI or dementia-related disorders.”If you would like to read this study and /or order nutritional products made and sourced in the US – carrying the Good Manufacturing Practices (GMP) designation, and meeting purity standards, go to maxwellnutrition.com.

CDC.gov says that each year millions of people over 65 years of age fall – with one out of five causing serious injury, such as broken bones, or head injury, while three million older individuals are treated in emergency rooms for fall injuries. Over 800,000 older patients are hospitalized due to fall injury – most often head and hip trauma.Researchers from the faculty of Kinesiology, University of Regina and College of Kinesiology, University of Saskatchewan in Canada report that interventions, “which improve radius and tibial bone geometry and muscle density (MuD) in the surrounding areas may be clinically important for decreasing the risk of falls and fractures in older adults.”The Canadians writing – Efficacy of Creatine Supplementation and Resistance Training on Area and Density of Bone and Muscle in Older Adults – which appeared in the November 2021 issue of Medicine & Science in Sports & Exercise, reference that, “creatine (Cr) supplementation (methylguanidine-acetic acid) during supervised whole-body resistance training (1 yr) decreased the rate of areal bone mineral density (aBMD) loss in the femoral neck and increased femoral shaft subperiosteal width compared with placebo in postmenopausal women.”There is a lack of research looking into the effect of oral creatine monohydrate supplementation with or without resistance training (RT) on cortical and trabecular bone structure properties in older individuals. It's known that resistance training supports bone structure and remodeling, irrespective of concurrent creatine supplementation.Therefore, the Canadians chose to investigate the efficacy of Cr supplementation relative to sex differences under supervised, whole-body RT on properties of bone and muscle in older adults.Seventy participants – 39 men and 31 women with an average age of 58 years - were randomized to supplement with Cr at 0.1 grams per kilogram/day, or placebo (Pl) during three days per week of whole-body resistance training for one year.Bone geometry (radius and tibia) and muscle area and density (forearm and lower leg) were assessed using peripheral quantitative computed tomography. The primary exercises placed specific strain on regions of the forearm (i.e., radius) and lower leg (i.e., tibia), which included dumbbell wrist pronation and supination, lever machine elbow flexion and ankle plantarflexion and plate-loaded tibia dorsiflexion. Secondary exercises included the hack squat, hip (abduction, adduction, flexion, and extension), leg curl, leg extension, low-back extension, chest press, lat-pull.The Canadians determined that, “older adults who supplemented with Cr experienced a significant increase in lower-leg MuD compared with those on placebo, which may be important because low MuD is an independent risk factor for falls and disability in older adults.” It was concluded that, “1 yr of Cr supplementation (0.1 g·kg−1·d−1) and supervised resistance training increased total bone area in the tibia and lower leg MuD in older adults.”If you would like to read this study and order creatine monohydrate made in the US, under good manufacturing practices (GMP) and third-party tested, go to maxwellnutrition.com.

In light of the ongoing, world-wide death rate attributed to Covid-19, combining a healthy lifestyle with recognized medical interventions – vaccines and medications – is critical to address the current and future pandemics. Healthy interventions include physical activity, following an anti-inflammatory eating plan – emphasizing fruits, vegetables, omega-3 fish (Mediterranean diet) - minimizing the effects of Covid-associated stress (diminished social interaction), and developing healthy sleep patterns. These interventions can go a long way to support people with obesity, hypertension, diabetes, and pulmonary dysfunction, who are at higher risk of Covid severity.Researchers from Spain, reporting in the December online issue of the peer-reviewed journal Nutrients, highlight the role how holistic lifestyles interventions have proven to attenuate the effects of Covid-19 in the “exposome” – life-course exposures starting from the prenatal period onward.Roughly one-quarter of the world's population is considered inactive – not achieving 150 minutes of weekly, moderate activity, or 75 minutes of vigorous activity.  Social distancing and lockdowns have only acerbated inactivity out of necessity. The Spanish researchers comment that, “regular PA (physical activity) is associated with a 31% and 37% risk reduction of community-acquired infectious diseases and subsequent mortality, respectively, compared to inactive controls.”  According to their investigation, The Exposome and Immune Health in Times of the COVID-19 Pandemic, “even just four weeks of either moderate-or high- intensity interval exercise can lead to a remarkable improvement in natural killer (NK) cell number and function (i.e., ‘killing capacity').” The researchers further site evidence that, “elderly women who were physically active had a better immune response after vaccination than those who were less active.”From a body weight management perspective, the worldwide prevalence of obesity has almost tripled since 1975, with 39% and 13% of adults now considered to have overweight and obesity, respectively. There is meta-analytical evidence, “that individuals with obesity are not only at greater risk of COVID-19 infection, but also of having a worse prognosis (higher risk of severe disease and mortality) than their normal-weight peers,” note the Spanish researchers. The researchers conclude that, “body weight management should be a key public health concern in the prevention/management of the current COVID-19 pandemic.”Research have proven that when overweight individuals switch from a 14-hour eating window to ten to an eleven-hour eating duration over 16 weeks, they reduce their energy intake by 20% and demonstrated a reduction in body weight.Simply stated, “due to its antioxidant, anti-inflammatory and immunomodulatory benefits, and its protective effect against predictors of morbidity and mortality in patients with COVID-19, such as CVD (cardiovascular disease), the Mediterranean diet could be a promising and relatively easy-to-apply method to attenuate the severity of SARS-CoV-2 and eventual future viral pandemics.”While micronutrients, such as Vitamins A, C, B complex, and the minerals zinc and selenium deserve immune support recognition relative to Covid-19, Vitamin D may stand alone for its ability to provide adaptive and innate immune support. In fact, “there is evidence suggesting that vitamin D supplementation can have a positive effect on COVID-19 symptoms and severity. Compared with a lower dose (1000 IU), daily oral supplementation with 5000 IU of vitamin D3 for two weeks reduced the time to recovery of symptoms such as cough and gustatory sensory loss among mild-to-moderate COVID-19 patients with sub-optimal vitamin D status.”Sleep disturbances have emerged, as a consequence of the Covid-19 pandemic – due in p

The advent of wearable devices that track daily step count has provided not only population-based weight loss guidelines, but also recommendations for cardiovascular improvement.  Prior physical activity national guidelines recommended at least 150 minutes per week of moderate-to-vigorous-intensity exercise – which did not quantify stepping intensity with mortality risk.Until now, most research has been targeted to an older demographic versus a younger, racially diverse population. Researchers, from a diverse group of investigators, chose to estimate the association of steps per day with premature age in Black and White men and women ages 41 to 65.The prospective cohort study- Steps per Day and All-Cause Mortality in Middle-Aged Adults in the Coronary Artery Risk Development in Young Adults, which appeared in the online edition of JAMA Network Open in September 2021, was part of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants, age 38 to 50 years, wore an accelerometer on the hip for seven consecutive days during all waking hours from 2005 to 2006. Participants were followed for 10.8 years. Data was analyzed in 2020 and 2021 – with an objective to establish mortality status.Step volume was categorized as: less than 7,000 steps/day as low, 7,000 to less than 10,000 as moderate, and greater than 10,000 daily steps as high. Participants, or designed family members, were contacted twice yearly to determine vital status. Requests were made, where applicable, for death certificates, hospital records for death, and autopsy reports.When the data was compiled, the investigators determined that, “in this cohort study of Black and White middle-aged women and men, higher daily steps were associated with a lower risk of all-cause mortality. Adults taking at least 7000 steps/d, compared with those taking fewer than 7000 steps/d, had approximately 50% to 70% lower risk of mortality. Taking more than 10,000 steps/d was not associated with further reduction in mortality risk.”It was concluded that, “taking at least 7000 steps/d during middle adulthood was associated with a lower risk of mortality. There was no association of step intensity with mortality. Improving physical activity levels in the least active segment of the population by encouraging increasing steps/d may be associated with lower mortality risk.”Photo by Jeremy Bishop on Unsplash

Human beings possess an internal time management mechanism (circadian central clock) that coordinates dark and light activities, while managing such activities as, skeletal muscle preservation, liver health, and fat tissue (peripheral clock), that occur during fasting (especially night-time), activity, and the recovery-repair process that occurs during sleep.As we age or when we succumb to certain conditions and disease processes, like insulin resistance and type 2 diabetes, homeostasis (balance) in our clock mechanisms can be negatively affected, without intervention.Such interventions can involve exercise – the timing of which may normalize or stabilize a dysfunctional human clock mechanism. This anomaly is especially true for night shift workers, even those without metabolic challenges.According to "Exercise Training Elicits Superior Metabolic Effects, When Performed in the Afternoon Compared to Morning in Metabolically Compromised Humans," which appeared in December of 2020 in Physiological Reports, “exercise training is the first-line strategy to counteract skeletal muscle insulin resistance and ameliorate elevated plasma glucose levels.”The study authors, from the Netherlands, comment that, “the recent insights into the role of the circadian clock in the etiology of T2DM (type 2 diabetes) have raised the suggestion that the timing of exercise may affect the training-mediated effects on glucose homeostasis.” The researcher report that, “consecutive bouts of high-intensity interval exercise during two weeks, acutely induce more beneficial 24-hour glycemic profiles in T2DM subjects, when performed in the afternoon, as compared to a morning training regime.”To investigate whether the timing of exercise affected long-term metabolic health training adaptations in metabolically compromised individuals, the investigators analyzed data from a study assessing the effect of exercise training on a large range of metabolic health outcomes.The study group, which included thirty-two adult males (58 ± 7 years), with a body mass index greater than 26 (overweight) at risk for or diagnosed with type 2 diabetes, performed twelve weeks of supervised exercise. Twelve volunteers exercised in the morning from 8.00–10.00 a.m., while twenty individuals exercised in the afternoon from 3.00–6.00 p.m. The exercise sessions consisted of twice weekly stationary cycling for 30 minutes at 70% of a pre-determined workload, and one day of resistance exercise, using three sets of ten repetitions at 60% of maximum voluntary contractions in large muscle groups (leg extension, leg press, chest press, lat. pulldown, triceps and biceps curls). Pre-participation laboratory and physiological assessment, with appropriate exclusion criteria was performed – leading to the conclusion that, “compared to participants who trained in the morning, participants who trained in the afternoon experienced superior beneficial effects of exercise training on insulin-stimulated peripheral glucose disposal, insulin-mediated suppression of adipose tissue lipolysis, fasting plasma glucose levels, exercise performance, and fat mass.”In addition, “exercise training in the afternoon also tended to elicit superior effects on basal hepatic glucose output.”The researchers concluded that, “the timing of an exercise training session is a crucial environmental cue, when aiming to improve glucose homeostasis in metabolically compromised subjects, and elucidates that performing afternoon exercise training might be more optimal than exercising at morning hours.”

It's estimated in the U.S. that five million young athletes compete on high school swim teams – with an additional 336,000 competing on club teams. The National Collegiate Athletic Association (NCAA), says between 2015-2016, 22,000 college swimmers were participating in competitive leagues. Master level swimmers, who may reenter to compete in the sport at an older age, number about 65,000.According to Swim-Training Volume and Shoulder Pain Across the Life Span of the Competitive Swimmer: A Systemic Review, which appeared in the January 2020 issue of the Journal of Athletic Training, “injuries in competitive swimming primarily arise from repetitive strain and microtrauma. This is not surprising, when one considers the amount of swimming to which the athletes are exposed.”The investigators from the Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium, and the Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, note that, “because of these demanding and time-consuming training programs, competitive swimming has essentially developed into a year-round intensive sport, with athletes at young ages focusing solely on swimming.” It's also pointed out that in 10 to15-year swimming careers swimmers often practice 5 to 7 days per week and sometimes twice daily, which led to overtraining, and increased the risk of soft tissue injury, pain, and dissatisfaction. Shoulder pain is particularly frequent - with prevalence rates reported as high as 91%, is a major cause of missed practice.These researchers sought to determine, if there was a correlation between a specified amount of swim training and shoulder pain in competitive swimmers, by examining relevant studies within PubMed, Web of Science, and Medline.It was determined that 12 studies met the qualified criteria, as grouped by age: young (less than 15 years old), adolescent (15-17 years), adult (18-22), and masters (23-77).Based on the data of this first of a kind analysis, the researchers concluded that, “evidence suggests that swim-training volume was associated with shoulder pain in adolescent competitive swimmers.” As for recommendations, it was stated that, “year-round monitoring of the athlete's swim training is encouraged to maintain a well-balanced program. Developing athletes should be aware of and avoid a sudden and large increase in swimming volume.It was also pointed out that additional research is necessary to determine cutoff values, in order to make data-based decisions regarding the influence of swim training.”From my own experience helping both high school and collegiate swimmers, especially female athletes, there is a consistent anterior (front) shoulder dominance resulting from the volume of overhead, forward strokes - with inadequate posterior shoulder stabilization exercise during the dry land training.In other words, if your throw, hit, or swim forward, you need to train in reverse to rebalance the shoulder to reduce the risk to unnecessary shoulder injury.Be sure to check out maxwellnutrition.com – a science-driven, wellness content & nutritional supplement platform – where you will be able to see important, timely nutrition research and order, with direct shipping, the highest bio-available nutrition supplements, made in the United States.

In 2018, the World Health Organization said the prevalence of a cancer diagnosis reached 18.1 million people – with 9.6 million cancer deaths.  Positive lifestyle – such as exercise and diet – reduce the risk to certain forms of cancer. Adherence to a Mediterranean-style eating strategy – higher intake of fruit, vegetables, and whole grains, limited lean meat, fish, and olive oil - reduces the risk to colon and breast cancer.Research is still searching for the optimum plan once an individual is diagnosed with cancer. According to "The Facts About Food After Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies," which appeared in the August 2020 issue of the online, peer reviewed journal Nutrients, “to prevent malnutrition, energy and protein requirements for cancer patients are largely widespread by international guidelines, but little is known about the food choices and dietary regimen a cancer patient should benefit from.”The Italian study researchers point out that, “many ‘cancer diets' are often restrictive, avoiding a whole nutrient class (i.e., meat or dairy products) in the misleading belief that certain foods “feed the tumor.” The Italians sought to determine any possible associations between diet patterns, after a cancer patient's diagnosis, that is affected by a solid tumor, relative to outcomes – mortality, cancer progression, and recurrence.Those study criteria included a meta-analyses (similar studies) that used an adult population over 18 years of age diagnosed with breast, gastrointestinal, gynecological, lung, and urological cancers; post-diagnosis dietary patterns – such as consumption of fruit, vegetables, diary, meat, fish, and cereals; prospective or retrospective cohort studies; over-all survival, all-cause mortality, cancer-specific mortality, death from a non-cancer cause, cancer progression, disease-free survival, cancer recurrence, and recurrence-free survival.The study authors determined that, “the overall results of this systematic review highlight that none of the food categories should be eliminated by cancer patients. Especially, there is no clear association between consumption of meat or animal products and cancer progression/recurrence or CSM (cancer specific survival), after a cancer diagnosis.”However, the Italians also emphasized there was, “a significant positive association between detrimental dietary patterns, such as Western-type Diet (characterized by processed meats, sugar-sweetened soft drinks, and refined grains) and cancer progression.”Note the investigators, “on the contrary, high consumption of fiber, such as whole grain cereals, green and cruciferous vegetables, seem to be protective against cancer progression and mortality.”In conclusion, “detrimental dietary patterns, such as the Western Diet and the high consumption of some food categories (saturated/trans fats, high-fat dairy products) could worsen prognostic outcomes in breast, colorectal and prostate cancer patients. Nevertheless, animal proteins, such as fish, poultry, low-fat dairy products and meat, should not be excluded from cancer patient's diet.”More research is needed relative to a cancer post-diagnostic diet, as it applies to the most common forms of cancer – lung, stomach, gynecological, bladder, and pancreatic cancer.For more information, go to maxwellnutrition.com.

With the surge of the Delta Covid-19 variant, the world has a new pathogen enemy among us—the hidden terrorist that spares no one, especially those unvaccinated. What began in Wuhan, China in December of 2019 and declared in March of 2020 a pandemic, Covid-19, the disease spawned by the SARS-CoV-2 virus, has transformed life as we know it. It's here to stay in some form or another.The effects of lockdowns, the use of protective masks, social distancing, and more has had a direct impact on an individual's nutrition status and movement pattern.A person's susceptibility to Covid-19 has as much to do with their nutrition status, as it does to any comorbidities on board, such as obesity, hypertension, pulmonary dysfunction, diabetes, and cardiovascular disease. Researchers, from Spain, Columbia, and Greece, used a narrative review, “with the aim of collecting published literature and articles regarding dietary patterns, body composition, nutritional deficiencies, vitamin interventions, and physical activity in the COVID-19 pandemic.”The study—Nutrition in the Actual Covid-19 Pandemic. A Narrative Review—which appeared in the June online issue of Nutrients, found that the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels, as increased risk factors of COVID-19 affection and physiopathology.”What's more, “hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids, highlighting the potential health effect of vitamin C and D interventions.”The search methods, from February 1st, 2020, through April 13th, 2021, included PubMed, Embase, SciELO, Science Direct Scopus, and Web of Science, employing MeSH-compliant keywords including, COVID-19, Coronavirus 2019, SARS-CoV-2, 2019-nCoV, Nutrition, Diet, Dietary Patterns, Body Compositions, Vitamins, Nutritional, Immunology, Physical Condition, and Physical activity.Here's the summary of the findings, as noted in the narrative review of the data base:The COVID-19 lockdown promoted unhealthy dietary changes (inactivity, daily intake, snacks, alcohol), increasing body mass and fat, and showing obesity-overweight people poor diet habits.Obesity is a risk factor for COVID-19.A healthy balanced diet is an integral part of personal risk management.Vitamins C and D improve health-related outcomes in COVID-patients.Sufficient vitamin intake and an active lifestyle are strongly recommended as a preventive measure to the general population.There is a large prevalence of malnutrition among hospitalized patients with COVID-19.Nutritional support and rehabilitation exercise are needed to avoid muscle atrophy and sarcopenia in COVID-19 hospitalized patients. They should be considered as an integral part of the therapeutic approach.Deficient states of vitamin C, D, B12 selenium, iron, ω-3, and medium and long-chain fatty acids increase the probability of hospitalization and mortality from COVID-19.The gut microbiome profile is altered due to COVID-19, being involved in the magnitude of COVID-19 severity via modulating host immune responses.A healthy gut microbiome serves as a preventive and protective factor, appropriate nutrition and probiotics are good strategies for its enhancement.Active lifestyle and physical activity allow a lower risk, and mortality rate in COVID-19 patients, due to its positive effect on metabolic health and inflammation.The reviewers were quick to point out that more research of this evolving disease and its variants is needed relative to the impact of nutrition and other lifestyle modifications consistent with risk stratification.Read more at MaxWellNutrition.com

Covid-19—the infectious disease initiated by SARS-CoV-2—that primarily attacks respiratory (breathing) function—has not only spread rapidly over the prior year, but also has spawned more contagious variations, such as the current Delta variant.The human immune system—innate and adaptive—activates the body's response to the Covid-19 antigen. Individuals with comorbidities, like obesity, hypertension, pulmonary dysfunction, diabetes, and cardiovascular disease, are at increased risk to adverse complications.Supporting the body's challenge to the invading antigen is an individual's dietary behavior that influences nutritional status. With respect to Covid-19 and the association of dietary behaviors, researchers from the Department of Preventive Medicine, Research and Information Services, and the Department of Medicine, Feinberg School of Medicine, Northwestern University in Chicago, chose to use data from the UK Biobank (UKB) to examine the dietary behaviors measured in 2006-2010 and Covid-19 infections in 2020. The American researchers linked the UKB geo-data to UK Covid-19 surveillance data to account for Covid-19 exposure. The UKB is an international health resource of over 500,000 participants aged 37–73 years at 22 centers across England, Wales, and Scotland. The UKB participants, who underwent physical measurements, assessments about health and risk factors (including lifestyle and dietary behaviors), and blood sampling at baseline (2006–2010), agreed to follow-up on their health status.  Country-wide surveillance data was used to identify UKB participants exposed to COVID-19.Based on the data analysis, it was determined that, “consuming more coffee, vegetables, and being breast fed, as well as, consuming less processed meat intake were independently associated with lower odds of COVID-19 positivity. These associations were attenuated (reduced), when accounting for the UK's COVID-19 case rate (i.e., exposure).”The data analysis reflected that, “habitual consumption of 1 or more cups of coffee per day was associated with about a 10% decrease in risk of COVID-19, compared to less than 1 cup/day,” while, “consumption of at least 0.67 servings/d of vegetables (cooked or raw, excluding potatoes) was associated with a lower risk of COVID-19 infection.” The UKB American investigators found that processed meat consumption (refers to any meat that has been transformed through salting, curing, fermenting, smoking, or other process to enhance flavor or improve preservation) of as little as 0.43 servings/day was associated with a higher risk of COVID-19. However, comment the Americans, “red meat consumption presented no risk, suggesting meat per se does not underlie the association we observed with processed meats.”Finally, it was found that, “a long-term favorable association between being breastfed as a baby and COVID-19 infection in UKB contribute to the growing evidence in support of nutrition early in life for optimal immunity for life.”The study analysis concluded, “our results support the hypothesis that nutritional factors may influence distinct aspects of the immune system, hence susceptibility to COVID-19.”To read this study, you can find it under the “open access research” on maxwellnutrition.com.

In 2007, my book, Lean & Hard – the body you've always wanted in 24 workouts, was published by John Wiley & Sons. L&H offered a comprehensive six week, four workouts per week diet, nutritional supplement schedule, resistive exercise, and sprint-interval program, all designed to increase lean muscle mass. The L&H book was based on a research study of my concepts that followed a cross section of athletes and non-athletes over six weeks, when I was an Associate Professor in the LSU School of Public Health and Preventive Medicine. One of the nutritional supplements tested in the applied research study and utilized in the book was creatine, an organic acid that is created internally from the action of the amino acids arginine, glycine, and methionine, which are constructed in the liver and regulated through kidney function.Creatine predominantly resides in skeletal muscle—mostly as phosphocreatine—with roughly two percent degrading to creatinine, a metabolic by-product, which is why too much creatine may skew a creatinine clearance test assessing kidney function. Creatine use by athletes has been widely studied for its side effect of weight gain, which was initially thought to be fluid gain, but after years of research, has now been determined to be lean muscle development—when used correctly.I came to the conclusion, after seeing the results of the LSU applied study and my continued research on creatine, that someday creatine monohydrate would offer additional benefits to an ageing population—specifically to address sarcopenia—the age-related loss in muscle strength (dynapenia), muscle mass, muscle quality, and physical performance (frailty issues).That day has now arrived. New research, “Current Evidence and Possible Future Applications of Creatine Supplementation for Older Adults,”  appearing in the March 2021 online, peer-reviewed journal Nutrients, comments that, “sarcopenia typically occurs in 8–13% of adults ≥60 years of age, and, is associated with other age-related health conditions, such as osteoporosis, osteosarcopenia (muscle related bone loss), sarcopenic obesity, physical frailty, and cachexia (muscle loss due to disease).”Muscle mass decreases by 0.45% in men and by 0.37% in women. However, these decrements climb to 0.9% for men and to 0.7% for women starting in their seventh decade. The age-related decrease in muscle strength—a strong predictor of poor health outcomes, such as mobility disability, falls, fractures, and mortality in older adults—occurs more rapidly (2–5 times fold faster) than the reduction in lean (muscle) mass.The Canadian and Australian study authors performed a narrative review evaluating the current research involving creatine (CR), with and without resistive training (RT), on properties of muscle and bone in older adults, “in order to provide a rationale and justification for future research involving CR in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia.”Here's what was determined. As it pertains to addressing sarcopenia, “CR (≥3 grams/day) and RT (≥7 weeks; primarily whole-body routines) can improve some measures of muscle accretion, strength, and physical performance in older adults. Independent of RT, a CR loading phase and/or high relative daily dosage of creatine (≥0.3 g/kg/day) may be required to produce some muscle benefits in older adults.” Relative to creatine usage with osteoporosis—the age-related loss of bone mineral density – “collectively, the vast majority of studies show no greater effect from CR, with and without RT, on properties of bone in older adults.”To read the rest, go to maxwellnutrition.com

Prior research has established that the consumption of green tea or coffee has been said to reduce the all-cause mortality in the general public. However, as to the similar effects in those with health challenges, such as diabetes, research is either controversial or devoid – until now.Japanese researchers publishing the “Additive Effects of Green Tea and Coffee on All-Cause Mortality in Patients with Type-2 Diabetes Mellitus: the Fukuoka Diabetes Registry”, which appeared in October 2020 in the open-access online  BMJ (British Medical Journal) Diabetes Research & Care, determined that, “higher consumption of green tea and coffee was associated with reduced all-cause mortality: their combined effect appeared to be additive in patients with type-2 diabetes.”The Japanese researchers from the Departments of Medicine and Clinical Sciences, Graduate School of Medical Sciences and the Division of Internal Medicine, Fukuoka, Japan, comment that green tea derives benefits from fresh leaves of Camellia sinensis - containing various chemicals, such as phenolic compounds, theanine, and caffeine, which possess antioxidant, anti-inflammatory, or anti-bacterial properties. Coffee, note the Japanese, contains phenolic compounds and caffeine that offer antioxidant, anti-inflammatory, and ant-mutagenic benefits – especially, to type-2 diabetics, those with abnormal lipid profiles, and malignancy.To reach this conclusion, the investigators, after appropriate exclusion criteria, used data from 4923 study participants enrolled between April 2008 and October 2010, in the Fukuoka Diabetes Registry, “a multicenter prospective study designed to investigate the effects of modern treatments and lifestyle on the prognoses of patients with diabetes mellitus.”Using a self-administered questionnaire, the participants provided information regarding their diagnosed diabetes duration, smoking habits, alcohol intake, leisure-time physical activity, sleep duration, depressive symptoms, and history of coronary heart disease, stroke, and cancer. Their smoking habits and alcohol intake were classified as either current or not.  Body weight, height and body mass index were ascertained – along with blood pressure. Medical charts were reviewed for all medications, including insulin, oral hypoglycemic agent, antihypertensive drugs, antiplatelet drugs, and statins. The Japanese used self-reported answers to dietary questions to categorize the participants into the following four groups by beverage: green tea - none, ≤1 cup/day, 2–3 cups /day, ≥4 cups/day, and coffee - none,

When the Covid-19 management strategy unfolded over 2020—which included assessment, treatment, prevention, and immunization—return to normal safety protocols became a complex, yet vital part, of preventing further devastation to human life and the world's economy.As time and the control of the coronavirus disease unfolded, the major North American professional sports leagues were among the first to implement a return-to-play (RTP) scenario—with the appropriate prevention measures in place—like no fans, player and staff bubbles, daily Covid-19 testing, sequestering players that tested positive, and much more.As a result of the unknown incidence of “cardiac sequelae” (consequences of a particular condition)—resulting from Covid-19 infection, a conservative RTP cardiac testing program mirroring the American College of Cardiology recommendations, was implemented for all athletes, who tested positive for Covid-19.In new research—"Prevalence of Inflammatory Heart Disease Among Professional Athletes with Prior COVID-19 Infection Who Received Systemic Return-to-Play Cardiac Screening”—which appeared in March of 2021 in the online issue of JAMA Cardiology (Journal of the American College of Cardiology), a diverse group of medical experts sought to, “to assess the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current RTP screening recommendations.”This descriptive study, a cross-sectional evaluation of cardiac testing, performed between May to October 2020, followed the Strobe (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.  It included 789 professional athletes from Major League Soccer, Major League Baseball, National Hockey League, National Football League, and the men's and women's National Basketball Association—with an average age of 25—composed of 777 men, of which 460 athletes had prior symptomatic COVID-19 illness, and 329 were asymptomatic or paucisymptomatic (minimally symptomatic). A summary of the study group's cardiac health status was as follows: “Thirty athletes were sent for additional cardiac testing, as a result of abnormalities on the initial cardiac screening tests that raised concern for potential COVID-19– associated cardiac injury. Cardiac magnetic resonance (CMR) imaging was performed in 27 of these 30 athletes. Downstream testing confirmed diagnoses of inflammatory heart disease in 5 of 27 athletes: 3 athletes with CMR-confirmed myocarditis (inflammation of the heart muscle) and 2 athletes with CMR-confirmed pericarditis (swelling of the thin, saclike tissue surrounding the heart). The remaining 25 of 30 athletes (83.3%) who underwent additional testing, did not ultimately have findings to suggest acute cardiac injury and returned to play.”RTP cardiac screening for professional athletes testing positive for COVID-19, noted the investigators, “demonstrated that 0.6% (5 of 789 athletes) had imaging findings, “suggestive of inflammatory heart disease, that resulted in restriction from play in alignment with American Heart Association/ACC guidelines.” The researchers concluded that, “while long-term follow-up is ongoing, few cases of inflammatory heart disease have been detected, and a safe return to professional sports activity has thus far been achieved.”That's great to know for the athletes, their families, and sports fans everywhere. If you would like to read the study, go to maxwellnutrition.com.

Having been exposed to the medical, metabolic, and physiological gender-based factors associated with weight gain, weight loss, body composition changes, and the psychological aspects in a diverse cross-section of male and female participants in my prior hospital-affiliated wellness and weight management programs over the last thirty years, I can attest to the fact that what you eat, when you eat—along with age and health profile, account for many of the complex issues associate with weight control.Biologically speaking (circadian rhythm), late night eating certainly has its drawbacks on metabolic rate, cardiometabolic health, hormone secretion (melatonin production), and fat oxidation versus storage.Prior research and common sense have demonstrated that eating chocolate late at night has been associated with long-term weight gain, especially in postmenopausal women (average age of 51), who are vulnerable to weight gain. It appears now that chocolate and the timing of its consumption may have earned a bad rap.Research—"Timing of Chocolate Intake Affects Hunger, Substrate Oxidation, and Microbiota: a Randomized Controlled Trail”—reported in the July online issue of the FASEB journal (the journal of the Federation of American Societies for Experimental Biology), suggests that, “chocolate, in the morning or in the evening/night, in a narrow window of time (1 hour), results in differential effects on hunger and appetite, substrate oxidation, fasting glucose, microbiota composition and function, and sleep and temperature rhythms.” “The intake of a rather high amount of chocolate (100 grams),” comment the researchers from Brigham and Woman's Hospital in Boston, “concentrated in a narrow (1 hour) timing window in the morning could help to burn body fat and to decrease glucose levels in postmenopausal women.”This determination involved 19 postmenopausal females, who completed a nine week, randomized, controlled, cross-over trial of “ad libitum food” intake —with either 100 grams of chocolate (~33% of their daily energy intake) in the morning, defined as within one hour after waking time, or at evening/night —within one hour before bedtime, compared to no chocolate intake. The duration of each intervention was two weeks, which included a transition period.The study participants underwent the following tests and measurements:Body weight (baseline and three additional timed dates), height, body fat, dietary food intake record, visual analog scale before and after each meal (hunger & appetite assessment), body temperature, activity, sleep duration, number of awakenings, nap frequency and duration, metabolic rate assessment, salivary cortisol determinations, fasting glucose, and analysis of their gut microbiota (short-chain fatty acids from fecal samples).The study found that the 19 postmenopausal participants did not gain body weight with the chocolate intake. In fact, comment the investigators, “while the volunteers had an increase of energy intake due to chocolate's extra calories (extra 542 kcal), as compared to the non-chocolate condition, they spontaneously reduced their ad libitum energy intake by 16%, when eating chocolate in the morning.”This situation occurred even though the females consumed milk chocolate that has been shown to have less of an effect in decreasing appetite than dark chocolate.Further stated, “results show that when eating chocolate, females were less hungry and had less desire for sweets than with no chocolate, especially when taking chocolate during the evening/night. Moreover, daily cortisol levels were lower when eating chocolate in the morning than at evening/night.”  Read the rest at MaxWellNutrition.com. 

As the saying goes, the key to longevity is to age gracefully. That includes our skin, the largest organ of the body. Skin aging is defined by its components: natural, heat, and photoaging—critical factors that cause skin aging damage.According to Boosting the Photoaged Skin: The Potential Role of Dietary Components, which appeared in the May 2021 online issue of the journal Nutrients, “skin photoaging is caused by long-term exposure to ultraviolet (UV), and manifests as rough, dry, and sagging skin, deeper skin wrinkles, excessive skin pigmentation, or angiotelectasis, even leading to various benign or malignant tumors, such as solar keratosis, squamous cell carcinoma, and malignant melanoma.”Addressing skin damage may involve methods, such as the use of sunglasses, window films, and clothing—along with topical treatment of active ingredients, and medical cosmetology.From a prevention standpoint, what you eat may prove to be the best skin defense. The Nutrients study authors from Korea and China, comment that, “phytochemicals, functional proteins and peptides, functional sugars, functional oils, probiotics, vitamins, and minerals are well-known to improve the photoaging-associated morphological abnormalities and functional decline.”The Korean and Chinese literature reviewers sought to, among other objectives, “provide insight into the preventive and therapeutic potential of various food-derived active ingredients in skin photoaging and their underlying mechanisms.”The oral administration of phytochemicals has been shown to have beneficial effects at reducing the risks associated with skin aging, while boosting photoaged skin. Carotenoids, such as astaxanthin and lycopene, are two such examples.Astaxanthin, note the reviewers, “has diverse functions in skin biology, including photoprotective, antioxidant, and anti-inflammatory effects. Oral administration of astaxanthin is protective against UV-induced skin deterioration and is helpful to maintain healthy skin.” Lycopene, found in tomatoes and tomato-based products, “is recognized as a potent antioxidant. Lycopene has been found to be efficient in skin photoaging.”The polyphenols dihydromyricetin, a flavonoid, and ellagic acid, a polyphenol dilactone, both found in fruits and vegetables, are used for anti-photoaging treatment. Resveratrol - a naturally occurring polyphenolic phytoalexin found in grapes, red wine, peanuts, mulberries, and fruits, “in a placebo-controlled, double-blind clinical study, caused facial skin moisturization and elasticity to be enhanced, “while facial skin roughness and depth of wrinkles were reduced, in subjects, who were orally supplied with a resveratrol–procyanidin blend.”Green tea catechin is a natural iron chelator and antioxidant. In a study using oral supplementation with green tea polyphenols containing catechin, epicatechin, epigallocatechin gallate, epicatechin gallate, epigallocatechin, and glucuronidase/sulfatase, the blend, “protects against the UV-induced sunburn response, immunosuppression, and photoaging of the skin.”The Korean and Chinese  researchers site a 12-week, double-blind, placebo-controlled study employing supplementation with green tea polyphenols that, “significantly reduced the UV-induced erythema in facial skin, improved skin elasticity, roughness, density, and water homeostasis, and increased the blood flow and oxygen delivery to the skin.”Read the rest on maxwellnutrition.com.

It's no secret that being overweight or obese may predispose those individuals to associated diseases – particularly type 2 diabetes, metabolic syndrome, and cardiovascular disease. It's uncommon to find individuals, who follow plant-based diets in that cohort – due to the high-fiber, low-fat content of vegan-style eating strategies – in conjunction with the increased thermal effect of these diet plans, which accounts for approximately 10% of the total energy expenditure.Another feature of the vegan-type diets is its reduction of both muscle and liver fat, while increasing mitochondrial (energy burning) and postprandial (after eating) metabolisms. Just how successful have these diet strategies been for overweight adults, is food for thought for researchers.In November of 2020, JAMA Network Open reported the results of an original investigation – Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults, which concluded that, “a low-fat plant-based dietary intervention reduces bodyweight by reducing energy intake and increasing postprandial metabolism. The changes are associated with reductions in hepatocellular (liver) and intramyocellular (muscle) fat and increased insulin sensitivity.”The study authors, from Physicians Committee for Responsible Medicine (Washington, DC), Yale School of Medicine (New Haven, Conn.), CNR Institute of Neuroscience (Padua, Italy), Institute of Endocrinology (Prague, Czech Republic), University of Utah (Salt Lake City), and George Washington University School of Medicine & Health Sciences (Washington, DC), recruited 244 participants between January 2017 and February 2019 in Washington, DC., to participate in a 16 week- randomized clinical trial Enrollment included adults between 25 and 75 years old – with a body mass index between 28 (overweight) and 40 (obese). Those participants in the intervention group followed a vegan diet composed of approximately 75% of the energy from carbohydrates, 15% protein, and 10% fat – which took the form of vegetables, grains, legumes, and fruits. The eating plan was devoid of animal products or added fats. The control diet group was asked to make no changes to their standard diet, while both groups limited alcohol consumption to 1 drink for women and 2 for men. Both groups were asked to maintain their current exercise level and medication, unless changed by their personal physician.At baseline and at study conclusion, 3-day dietary intake assessments were analyzed, appropriate laboratory assessments were completed, after an overnight fast – along with height, weight, body composition and visceral fat determinations assessed.The researchers found, “the dietary intervention reduced body weight, apparently owing to its tendency to reduce energy intake and increase postprandial energy expenditure. The intervention also improved glycemic control and reduced insulin concentrations, owing in part to reduced lipid accumulation in liver and muscle cells and thus reduced insulin resistance in these organs.”It appears that this research also validated prior research. “The present finding that the increase in thermic effect of food was associated with decreased fat mass and increased insulin sensitivity confirm the findings of previous research,” which led the researchers to state that, “this intervention may be an effective treatment for overweight adults.”For more information, go to maxwellnutrition.com.

According to "Food Timing, Circadian Rhythm and Chrononutrition: A Systematic review of Time-Restricted Eating's Effects on Human Health," which appeared in the December 2020 issue of the online, peer-reviewed journal Nutrients, “a recent systematic review and meta-analysis of 19 studies showed that TRE leads to weight loss and a reduction in fat mass with a preservation of fat-free mass and also has beneficials effects on cardiometabolic parameters, such as blood pressure, fasting glucose concentration, and cholesterol profiles.”Read the rest on MaxWellNutrition.com

Prior research, which appeared in the British Journal of Sports Medicine in 2016, corroborates that physical activity has a protective effect against an individual's overall cancer mortality risk, specifically, as it applies to colorectal and breast cancer.Current research, “Effect of Time of Day of Recreational and Household Physical Activity on Prostate and Breast Cancer Risk (MCC-Spain Study),” which appeared in the September 2020 issue of the International Journal of Cancer, said, “a recent meta‐analysis on breast cancer reported an approximate 20% reduction in risk associated with physical exercise for both premenopausal and postmenopausal women.”Additionally, “evidence for recreational physical activity and prostate cancer is less consistent, although long‐term occupational physical activity seems to reduce prostate cancer risk.”Factors, such as circadian rhythm disruption from dietary patterns, work hours, environmental cues (light exposure) and melatonin production, can affect cancer risk. The circadian rhythm is knocked off balance, when external factors—like light exposure during sleep—may interfere with the normal nighttime production of melatonin. Mayoclinic.orgsays that melatonin, which declines with age, is a hormone producted and released in the brain - increasing when it's dark and decreasing when it's light.  The study authors, from various university and government departments in Spain, report that, “in 2007, the International Agency for Research on Cancer classified shift work, which includes circadian disruption as probably carcinogenic to humans.” Further stating that, “exposure to artificial light at night and particularly exposure to blue light spectrum light has been associated with higher breast and prostate cancer risk.”In 2018 in the same study population, researchers report in the International Cancer Journal that a study examining circadian timings and chronotype (a human attribute that correlates with diurnal preferences for activities in morning or evening), concluded that morning exercisers had the highest protection, when following diurnal patterns of diet compared to those having late supper (last evening meal).Using a refined cohort of 5365 participants—breast cases: 1438 female controls: 1593; prostate cases: 1004, male controls: 1330)—in the MCC-Spain population that included five cancer types and 10,106 subjects (51.8% males), data was collected between September 2008 to December 2013 in 23 hospitals, and the rosters of primary health care centers (controls) in 12 Spanish provinces.The 5365 participants, who initially responded to circadian timing questionnaires, had a computerized questionnaire administered by experienced personnel in face-to-face interviews—with subsequent information taken, as to residential history, personal and family medical history, sociodemographic factors, occupational and lifestyle history, height, weight, along with securing biological samples.The participants were told, “we are going to ask you about any physical activity done outside working hours, including walking, any exercise, and going to the gym. We are interested in any physical activity you did continuously and for at least six months throughout your life.” Then, the participants were asked, “what activity do you do, or did you use to do?” Appropriate medical information was obtained, so as to identify multiple facets of breast and prostate cancer status in those respective participants.The Spanish study authors “observed that the overall protective effect of recreational and household physical activity for cancer may vary depending on the time of the day of the activity.”Read the rest on MaxWellNutrition.com

The May 2021 Issue of the online, peer reviewed journal Nutrients provided an excellent narrative review of the ketogenic diet from researchers in the Department of Biology, Western Kentucky University.  Ketogenic diets, which traditionally have emphasized keeping total carbohydrate intake to less than 50 grams per day, have increased in usage from its inception in the 1930's to treat epilepsy. Restricting carbohydrate consumption, emphasizing moderate protein intake and increasing caloric consumption from fat, causes the body to draw more from fat for energy than from glucose metabolism.According to the Nutrients research – The Potential Health Benefits of the Ketogenic Diet: A Narrative review – “recent studies utilizing Low-carbohydrate, High-fat (LCHF) diets, such as the ketogenic diet, show promise in helping patients lose weight, reverse the signs of metabolic syndrome, reduce, or eliminate insulin requirements for type II diabetics, reduce inflammation, improve epigenetic profiles, alter the microbiome, improve lipid profiles, supplement cancer treatments, and potentially increase longevity and brain function.”That's important, since WebMD estimates that 27 million people are Type 2 diabetic – 86 million pre-diabetics. In addition, the Centers of Disease Control and Prevention (CDC) says almost 40% of adults and around 20% of American children are obese.The Western Kentucky reviewers segment the ketogenic diet (KD) into two classifications versus the standard American diet. The therapeutical keto diet's caloric distribution is 5% carbohydrate, 5% protein, and 90% fat, while the standard keto variation is 5% carbohydrate, 20% protein, and 75% fat. The standard American diet is 55% carbohydrate, 15% protein, and 30% fat.The researchers point out that “ketosis is normally achieved through either fasting or carbohydrate restriction. It is important to clarify that a low-carb diet typically refers to a diet with an intake of 50 to 150 g of carbohydrate per day. However, although this is a lower amount of carbohydrates than the standard American diet, it is not low enough to enter nutritional ketosis. Only when a patient restricts carbohydrates to less than 50 g/day will the body be incapable of fueling the body by glucose and will switch to burning fat.”The areas of focus by the Kentucky investigators centered on the effects of the keto diet (KD) on the microbiome (intestinal bacteria), epigenome (changes “on top” of the genome, which modify our gene expression), diabetes, weight loss, cardiovascular disease, and cancer.The microbiome is composed of trillions of microscopic organisms housed in the intestinal tract – supporting 70% of our immune function. While there is limited long-term data on the effects of the keto diet, “based on various studies, many predict that the diet will positively affect the microbiome by increasing the Bacteroidetes and Bifidobacteria species associated with improved health and decreasing microbial species known to increase health risks,” comment the reviewers. As for the epigenome, our heritable markers, it's suggested that by changing our environment to a more favorable status, we can affect our genetic predisposition to heritable disease risk. According to the reviewers, “the benefits of the ketogenic diet might also go beyond treating existing disease, and instead help prevent chronic and degenerative disease.”Read the rest at maxwellnutrition.com

"Why Do Men Accumulate Abdominal Visceral Fat?" That's the topic of research published in 2019 in Frontiers of Physiology. “The accumulation of abdominal visceral fat in men, which is a strong independent predictor of mortality, is mainly due to the higher dietary fat uptake by their abdominal visceral fat,” according to the researchers from Ketchum University in Fullerton, California and Washington University in St. Louis. Premenopausal women accumulate fat below the belt – gynoid or pear shape - while men accumulate fat in the visceral abdominal area – android or apple shape. Post-menopausal females are at greater risk to developing an apple shape that gives them a comparable risk to a man for type 2 diabetes and cardiovascular disease.It's important to understand the physiology of body fat accumulation over time. Body fat comes in various classifications – brown, beige, which are capable of thermogenesis (heat producing), and the predominant white, non-thermogenic fat.White fat comes in different forms – subcutaneous (under the skin), visceral (that surrounds internal organs), and ectopic (located within the internal organs).As the visceral, high risk fat builds up, the “belly” enlarges, which also includes the subcutaneous fat. While the waist measurement can be a good indicator of the subcutaneous fat, it's a poor indicator of the deeper visceral fat.Visceral fat encompasses both intraperitoneal and retroperitoneal fat, which surround the pancreas, duodenum, kidneys, and the ascending and descending colon. Unlike the subcutaneous fat, it's the retroperitoneal and intraperitoneal fat, which increases the risk to metabolic syndrome – a cluster of events that predispose the individual to type 2 diabetes, cardiovascular disease and cancer risk.It appears that a man's abdominal, visceral fat accumulates from excess consumption of dietary fat. The researchers comment that, “dietary fat is digested and absorbed by the small intestine. The absorbed dietary fat is secreted by the enterocytes in two major forms: chylomicrons and VLDLs (very low-density lipoproteins).”Studies indicate that chylomicron transport significantly increases more dietary fat storage in men than in women. Those chylomicrons, note the researchers, “preferentially promote the accumulation of the abdominal, visceral fat.”The researchers recommended, “spreading out the amount of dietary fat intake into several smaller meals, which should reduce the likelihood of abdominal, visceral fat accumulation by reducing both the size and number of chylomicrons.” Exercise is also another avenue to control visceral fat accumulation. “Based on our proposed mechanisms,” comment the university researchers,  “exercising and eating a diet low in fat—or at least spreading the fat intake into several smaller meals—should help in slowing down the development of abdominal, visceral fat.”In 2006, my book, The Fat Burning Bible (John Wiley & Sons) was released. The book provides a strategic plan to address the accumulation of excess body fat with age. Since male and female physiologies are as different as night and day, the book can be a guide to a gender specific plan of attack to reduce total and high-risk visceral fat.For more information, go to maxwellnutrition.com.

Runrepeat.com, the world’s largest online, athletic shoe review company, as noted on its site, surveyed 3961 current runners to understand how many of those runners began their first steps to fitness during the Covid-19 pandemic. It appears that 28.76 % of the current runners were motivated to strap on their running shoes and head out during the pandemic.This result compares to doing outdoor activities, as the top trend in 2020 and in 2021—consisting of running, hiking, walking, cycling, and any other form of outdoor workouts, exercises, or training. Exercising outdoors, notes the website, “was voted the best way to stay fit in 2021 by 59.1% of active adults, increasing 14.6% from the start of 2020.”It was also determined that 19.82% of the novice runners were less likely to participate races in-person over the following 12 months—an assumed pandemic-related fear of crowds. “Motives for running are changing—physical health is the primary motivation for 72% of new-pandemic runners, up 18.03% from runners who began running before the pandemic,” according to the website.The survey noted the following data points: 34.27% less likely to run for competition or achievement, 31.44% less likely to run for social interaction, 14.81% less likely to run for mental or emotional health, 3.00% less likely to run for their confidence or self-esteem.The study investigators concluded that, “there has been a significant boom in running during the pandemic. The situation and circumstances that these people have taken up running are drastically different than their pre-pandemic counterparts.”Another trend that has grown in popularity is exercising at home – spawned by the pandemic world-wide lockdowns. Notes the survey, “a lot of people made the decision to start investing in at-home gym equipment or make use of the fitness equipment they already had”—with the percentage of active adults seeing at-home fitness equipment, as the best way to stay fit increased by 49.6%, making it the fastest growing trend of 2021. In the US, this trend has grown explosively by 218.3%.The pandemic took a hit on sports participation – with the percentage of active adults relying on sports to stay fit decreasing by 25.2% over the year, noting only 6.0% still seeing it as their best option for 2021. Female sports participation saw a decrease in this trend—down 53.0%—which was more than double that for men, who were down by 23.8%.Another characteristic change, resulting from the pandemic, was the positive impact of online fitness content, courses, classes, and subscriptions. “The trend of online fitness exploded in America, with 134.7% more active American adults switching to this new trend to reach their fitness goals, as the pandemic continues into 2021,” noted the survey. To find the latest wellness research and products made in the USA, go to maxwellnutrition.com. To access the survey, go to  https://runrepeat.com/new-pandemic-runners

According to the Journal of Sport and Health Science, hamstring strains are one of the most common sports injuries. The journal reports that, “a review of the medical database of the National Football League (NFL) between 1987 and 2000 indicated that 10% of all injuries in American college football players likely to play in the NFL were hamstring strain injuries.” It’s also been reported that “12% of all injuries in NFL training camps were hamstring strain injuries—making it the second most commonly seen injury.”One of the main causes of hamstring injury is fatigue—both systemic and muscular. Research, which appears in the December 2019 issue of the Journal of Strength & Conditioning Research reported that, “47% of hamstring injuries were sustained during the final 15 minutes of the first and second halves of match play in soccer.”The take-away message is that excess fatigue—with deficits in hamstring strength-endurance - places the athlete at greater risk to sustain a hamstring strain, or tear—taking significantly longer to recover.The December 2019 issue of the Journal of Athletic Training comments that, “lateral ankle sprains (LAS’s) are common musculoskeletal injuries among the general population.” As a sports-related injury, “approximately 11,000 ankle sprains occur per year in US collegiate athletes, and ankle-ligament sprains were most frequent in men’s basketball players,” notes the research.Yet, many people do not perceive the LAS, as being a substantial injury – with 73% of those sustaining a LAS reporting reinjury. Up to 40% of these so called “copers” – with reoccurring LAS - will develop chronic ankle instability (CAI).The researchers comment that individuals with CAI describe feelings of instability or episodic ‘giving way’ and physical or subjective dysfunction lasting more than 1 year, after the initial LAS.The gluteal muscles, notes the journal, play an important role in global movement of the hip, as well as, pelvic stabilization during closed chain exercises.The take-away message is that it’s important to develop hip abduction (away from midline) strength to reduced LAS and CAI.The shoulder, specifically the posterior rotator cuff, is one of the most injured sites that overhead, throwing athletes experience in their throwing careers—at any level of play. Understanding scapular function and its dynamic role in rotator cuff function is critical to prevent needless, non-contact injury.The serratus anterior (SA) and trapezius play important roles in moving and stabilizing the scapula during upper extremity motion, according to research— "Serratus Anterior and Upper Trapezius Electromyographic Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis"—which appeared in the November 2019 issue of the Journal of Athletic Training.The serratus anterior—a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula—acts to pull the scapula forward around the thorax. “Serratus anterior weakness is often present in overhead athletes and can result in shoulder dysfunction due to altered scapular kinematics, such as winging and tipping,” notes the research.The trapezius—a diamond-shaped, flat, triangular muscle located on each side of the upper back—functions as a shoulder stabilizer with the serratus anterior and the rhomboids. The trapezius moves the scapula and supports the arm.In overhead throwing athletes, there typically is an intramuscular imbalance between the SA and upper trapezius (UT). It appears that push-up plus exercise strengthens the SA, while minimally activating the UT.Read the rest on MaxWellNutrition.com

In the coming months, new research will be presented in the journal Medicine & Science in Sports & Exercise that will corroborate one of the benefits of acute exercise (single session) - its ability to lower the post meal (postprandial) plasma triglyceride (blood fat) response to a high fat meal, as well as, increase fat utilization (oxidation). To do so, the acute exercise session must be able to overcome what’s termed as “exercise resistance.” That’s not to be confused with “anabolic resistance,” or the inability of a senior individual to repair, as quickly and effectively as, their younger counterpart, without intervention.It appears from  upcoming research that the exercise duration must account for at least 5,000 steps or the metabolic equivalent. From previous step-count research, we’ve learned that obese individuals – a body mass index of 30 or greater – tend to take between 4600 to 6,000 total daily steps, irrespectively of intensity.Since the research paper is sequestered until publication, I’m not able provide any further details until its release date. However, I can go back to October 2020 to research – Hourly 4-s Sprints Prevent Impairment of Postprandial Fat Metabolism from Inactivity – which appeared in the same publication.Researchers from the Human Performance Laboratory at the University of Texas at Austin concluded that, “that hourly very short bouts (4 seconds) of maximal intensity cycle sprints interrupting prolonged sitting can significantly lower the next day’s postprandial plasma triglyceride response and increase fat oxidation, after a high-fat meal in healthy young adults.”Given that these improvements, comment the researchers, “were elicited from only 160 seconds of non-fatiguing exercise per day, it raises the question, as to what is the least amount of exercise that can acutely improve fat metabolism and other aspects of health.”The Texas researchers point to prior research that stated that in order to overcome the negative effects – like reducing the rise in post-meal triglycerides (risk to cardiovascular disease) of prolonged sitting, an individual had to exercise for 60 to 75 minutes per day at a moderate intensity. Using eight healthy, untrained and recreationally active subjects – four men and four women – the researchers looked, “to determine if very brief (4-s) cycling performed at maximal intensity in blocks of five repetitions per hour is effective in counteracting the effects of prolonged sitting on postprandial lipid (fat) metabolism.”  The participants sat for 8 hours. Then, their postprandial metabolism was measured the next day (SIT), which was compared - with an exercise trial of five repeat-cycle sprints (inertial load ergometer) - lasting only 4 seconds each - performed every hour for 8 hours (SPRINTS). Taken in context, each hour, 20 seconds of sprint exercise was performed totaling 160 seconds of SPRINTS for the entire 8-hour day. Prior to the testing, resting metabolic rate studies were performed to asses caloric intake to maintain a stable body weight - with an additional 20% of calories was added to account for exercise. The morning of each trial, the participants took a high-fat/glucose tolerance test (HFGTT) – followed by sitting for six hours – with a fasted blood sample taken. The tests extended at 2, 4, and 6 hours, after the ingestion of a high-fat and glucose shake. Fat oxidation rates were determined at baseline, 2, 4, and six hours from expired gases postprandially (after a meal).The investigation determined that hourly 4-second “all-out” sprints - performed five times per hour on the stationary cycle - while sitting for 8-hours reduced the next day’s postprandial plasma triglyceride incremental by 31%, compared with sitting for 8 continuous hours. .Read the rest at  maxwellnutrition.com.

In a systematic review of literature published before March 15th, 2021 - regarding an association between Vitamin D deficiency and the risk of  Covid-19 in an aged population, French researchers report that, “vitamin D deficiency appears to expose these subjects to a greater risk of adverse outcomes. Because of its simplicity of administration, and the rarity of side effects, including vitamin D in preventive strategies for certain viral diseases, it appears to be an attractive option.”This study – "Relation Between Vitamin D and Covid-19 in Aged People: A Systematic Review" – which appeared in the April 2021 issue of the online, peer reviewed journal Nutrients, used 707 studies identified to assess adverse outcomes and the benefits of Vitamin D supplementation for people 60 years and older with Covid-19 exposure. Studies included data from aged patients on vitamin D use and Covid-19, while basic science articles, editorials, and correspondence was excluded from the analysis.Since its inception in December of 2019, Sars-CoV-2, Covid-19, has become a worldwide pandemic. Most infections cause mild-to-moderate signs, while severe forms – acute respiratory distress secondary to lung damage - of the disease can lead to death, especially in aged people or those with comorbidities, such as obesity, hypertension, pulmonary issues, and heart disease.It’s also known that respiratory complications beyond seven days were caused by a dysregulation of the immune system – referenced as a cytokine storm. Vitamin D has proven to support an immune response through activation of the innate immunity, which reduces the overactivity of the adaptive immune system.According to the researchers, “there was a high prevalence of low vitamin D levels, even in countries with abundant sunshine, particularly in aged people. Observational studies suggest an association between low serum vitamin D level and susceptibility to acute respiratory tract infection.”Further, comment the French researchers, “concerning the relationship between vitamin D level and outcomes in COVID-19, patients with vitamin D deficiency have worse clinical outcomes than non-deficient patients in terms of mortality.”Also noting that, “aged people are at greater risk of severe forms of COVID-19 infection and at risk of vitamin D deficiency, prompting some authors to suggest that vitamin D supplementation may improve the prognosis of aged people infected by SARS-CoV- 2.”The good news is that you can check your vitamin D status with a blood test. Depending on the laboratory reference range, a vitamin D blood value of less than 20 ng/mL is considered deficient, while a reference range of between 20-30 ng/mL is considered insufficient. Your primary care physician can provide you with appropriate supplement guidelines, which might include a prescription vitamin D, if deficient.For more information, go to maxwellnutrition.com.

Prediabetes, which affects over 86 million adults in the United States, is established by achieving a fasting blood sugar in the range of 100-125 mg/dl and / or an impaired glucose tolerance test.The good news is that prediabetes can be, in many cases, returned to a normal blood sugar status, with appropriate, positive lifestyle changes, that involve a combination of dietary restriction and exercise.There is also evidence that type 2 diabetes may be reversed with more invasive strategies – such as bariatric surgery - in a select, overweight/viscerally fat population.According to research – a “Single Bout of Premeal Resistance Exercise Improves Postprandial Glucose Metabolism in Obese Men with Prediabetes” – which appeared in the April 2021 issue of Medicine & Science in Sports & Exercise, the (2002) Diabetes Prevention Program Research Study demonstrated that lifestyle interventions, which targeted a 7% weight loss with 150 minutes per week of moderate-intensity endurance exercise, “reduced the incidence of T2D by 58% and was significantly more effective than treatment with metformin alone in individuals with prediabetes.”Yet there is insufficient research to establish the effects of resistance exercise (RE) on glucose metabolism in prediabetics. Some evidence has demonstrated that, in older, overweight subjects with prediabetes, twelve weeks of RE improved glucose tolerance, but not insulin sensitivity, during an oral glucose tolerance test.The Medicine & Science researchers, from Washington University School of Medicine in St. Louis and the Department of Orthopedics, Duke University in North Carolina, chose to establish the effects of a single bout of RE on post-meal (postprandial) glucose metabolism, after a mixed meal in obese, sedentary men with prediabetes.Ten sedentary, prediabetic, obese men enrolled in the randomized, cross-over study. After an overnight fast, the participants were guided to complete a single session of RE – seven exercises, 3 sets of 10-12 repetitions at eighty percent of their predetermined maximum strength (1-rep max), or an equivalent rest period.After the RE, the subjects consumed a mixed test meal, while simultaneously having an intravenous glucose infusion, to establish their basal and post-meal rate of glucose appearance and disappearance from their plasma, insulin insensitivity, and an insulinogenic index to measure beta cell function in the pancreas. “Skeletal muscle biopsies were obtained 90 min post-meal to evaluate pyruvate-supported and maximal mitochondrial respiration. Whole-body carbohydrate oxidation was assessed using indirect calorimetry,” according to the researchers. The researchers concluded that, “a single bout of RE moderately reduced the glycemic response to a mixed meal, significantly improved insulin sensitivity, and reduced the glucose-normalized insulin response in obese, middle-age men with prediabetes.”It was also noted that, “there were limited effects on postprandial glucose clearance, insulinogenic index, whole-body carbohydrate oxidation, or skeletal muscle pyruvate-supported respiration.”As with any such research, with a small group of subjects, additional research is needed to determine how RE brings about positive changes after a meal, which typically in the US, is high in fat and sugar.Before you embark on changes to your exercise or diet, especially if you are a male, who is sedentary and obese, with known or undiagnosed prediabetes or type 1 or 2 diabetes, check with your primary care physician.For more information, go to maxwellnutrition.com.

In the February 2020 online issue of the Journal of Urology, a study – "The Association Between Popular Diets and Serum Testosterone Among Men in the United States" – concluded that, “men adhering to low fat diets had lower serum testosterone levels, even when controlling for comorbidities, age, body mass index, and activity levels.” It was further noted that, “as differences in serum testosterone between the diets were modest, the avoidance of fat restrictive diets should be weighed against the potential benefits on an individual basis.” This conclusion reached by the Illinois medical researchers came, as a result of a review of the NHANES (National Health and Nutrition Examination Survey) from 2000, 2003, 2011, and 2012 - involving 3128 men, age 18 to 80, who completed a 2-day dietary history and testosterone testing. Inclusion criteria included following the American Heart Association low fat and Mediterranean diet.The AHA low fat diet limits the daily saturated fat intake to less than 7 percent of calories, trans fat to less than 1 percent of total calories, and sodium to 1500 mg a day. It encourages balancing the food intake over three meals, which are consumed at regular intervals The Mediterranean diet is composed of extra virgin olive oil, seafood, legumes, like lentils or chickpeas, nuts and seeds, leafy greens, a moderate amount of red wine, and herbs and spices, such as oregano. “Multivariable analysis controlling for age, body mass index, activity level, diabetes, comorbidities and prostate cancer showed that men with a nonrestrictive diet had higher serum testosterone than those adhering to a low-fat diet,” noted the study. It’s important to point out that a proposition of the men in the study group were at an age, where serum testosterone may have been declining. Urologyhealth.org says that, “overall about 2.1% (about 2 men in every 100) may have TD (testosterone deficiency). As few as 1% of younger men may have TD, while, as many as, 50% of men over 80 years old may have TD.”The symptoms of TD include low sex drive, fatigue, reduced lean muscle mass, irritability, erectile dysfunction, and depression. Should you suspect that low T is a factor in your lifestyle, then check with personal physician for guidance. For more information, go to maxwellnutrition.com

In today’s world of high sports participation and recreation, much less the effects of normal human aging, and irrespective of the contact and non-contact trauma that the physical games we play can yield, pain, injury, and skeletal diseases are common occurrences.Anterior cruciate ligament (ACL) sprains and tears, many of the non-contact type, are at epidemic proportions in female athletes participating in sports like basketball, soccer, and volleyball. Research points to the increased female ACL injury risk being associated with the anatomical design of the female hip, poor landing technique during jumping activities, reduced muscle stiffness, and faulty recruitment of the hamstring musculature during deceleration, to name a few. The female athlete is at four times the risk to an ACL injury versus their male counterpart – with, as much as, a 24% increased risk to ACL injury in the uninjured knee, upon return to sport.According to research – "The Influence of Specific Bioactive Collagen Peptides on Knee Joint Discomfort in Young, Physically Active Adults: A Randomized Controlled Trial"– which appeared in the February 2021 issue of the online journal Nutrients, “collagen type I and II are the most important structural and functional components of the extracellular matrix of tendons, ligaments and cartilage.”The researchers from Germany and Austria cite research that says, “an increased risk of anterior cruciate ligament rupture or shoulder dislocation is also attributed to an impaired architecture of the connective tissue. Although most complaints are related to sport, non-athletes may also sustain recurrent overuse injuries.”Once tissue or a joint is damaged, inflammation, a normal reaction to trauma, is initiated, which can be associated with pain. “Regardless of whether muscles, tendons or cartilage tissue are affected, the cause is a disproportion between load and load tolerance of the tissue,” as noted in the Nutrient’s paper.Excessive training, inadequate recovery periods, and constant competitive stresses on the muscles and joints can be extrinsic factors that potentially increase the incidence of stress-induced injuries in every age group.Intrinsic factors – like reduced flexibility of a muscle group, loss of range of motion in a joint, and anatomical differences, such as a leg-length discrepancy, can place the active individual to increased injury risk.The researchers reference the outcomes of preclinical studies, which indicate that consumable collagen peptides have a particularly high absorption rate - the result of their low molecular weight and the high proportion of proline and hydroxyproline, that permits, “a high resistance to intestinal digestion and higher transport efficiency.” It’s also proven that collagen-derived peptides accumulate in the cartilage tissue, where they can stimulate extracellular matrix molecules, and, therefore, counteract progressive tissue degeneration.The European investigators note prior research that, “imply that the intake of 5 g of specific collagen peptides for 12 weeks is sufficient to significantly reduce pain intensity during physical activity. Based on the survey of the participants, it can be assumed that medical treatment options, such as drugs or physiotherapy could be reduced by the pain-relieving effect of collagen peptides.”The investigators chose to confirm the efficacy of the same collagen peptides in a comparable study population. Read the rest on maxwellnutrition.com.

 Cardiovascular exercise (CV), and other such classifications of fitness endeavors, has extensive research to support the American College of Sports Medicine’s broad definition as “exercise medicine.” Current, established activity guidelines include recommending a minimum of 150 minutes of moderate-intensity exercise, or 75 minutes of high-intensity weekly exercise to maintain or improve cardiorespiratory fitness and health, while reducing the risk to non-communicable diseases – type 2 diabetes, cancer, osteoporosis, stroke, and more.The nomenclature of CV exercise has specific variations, such as endurance exercise, in the form of moderate-intensity, continuous training (MICT), and high-intensity interval exercise (HIIE) - referenced as high-intensity interval training (HIIT), and sprint interval training (SIT). HIIT involves alternating intervals at greater than 80% of maximum endurance capacity (VO2 Max) or 85% of your maximal heart rate (220-age), typically 1 to 4 minutes in duration – with lower intensity, active or passive recovery, while SIT uses short – full go – intervals, typically less than 30 seconds, with short, passive recovery.Writing in the March 2021 issue of Medicine & Science in Sports & Exercise – Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: a Meta-Analysis - researchers from the Sports Medicine Department, Clinical Epidemiology and Applied Biometrics Department, and the Psychosomatic Medicine and Psychotherapy Department, University Hospital of Tubingen in Germany, used a meta-analysis (many similar studies) to investigate the clinical benefits distinguishing each exercise modality (HIIE and MICT) in health and disease. The data search began in January of 2018 and culminated in July of 2020.The seven key clinical endpoints of the literature analysis included: “physical fitness (VO2 max), endothelial function (flow-mediated dilation [FMD]), body composition (body mass index [BMI], body mass, and body fat), blood pressure (systolic and diastolic blood pressure), blood lipids (HDL, LDL, triglycerides, and total cholesterol), inflammation (C-reactive protein [CRP]), and insulin and glucose metabolism (fasting glucose, fasting insulin, glycated hemoglobin [HbA1c], and insulin resistance (HOMA-IR).”After a comprehensive analysis of the data, the researchers said, “overall, HIIE showed to be more effective in improving cardiovascular health and cardio- respiratory fitness, whereas MICT was superior in improving long-term glucose metabolism.”From an aging perspective, the data analysis determined that relative to endothelial function, which protects tissues from toxic substances, regulates the blood clotting mechanism, controls the transition of fluid and certain substances between the blood and tissues, and inflammatory control in tissues - it was determined that the HIIE had higher effects than did the MICT – the result of the “interval-like” exercise training programs inducing a, “higher shear stress, and promoting an increased nitric oxide release.” The Germans recommended that, “in the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.”And, that risk stratification needs to start with your personal physician. For more information on this topic and more, go to maxwellnutrition.com.

Since the advent and spread of the SARS-CoV-2 acute respiratory syndrome in 2019, classified as Coronary Virus Disease-19 (Covid-19) in February 2020, then transcending to pandemic status in Match 2020 by the World Health Organization, scientists have been searching for efficacious medical treatments and environmental guidelines to halt the spread, treat the symptoms, and reduce the risk to contraction. As of this writing, there is no cure. However, with three vaccines in the inoculation phase, it appears that the spread and death rate worldwide is going down, as more people receive the vaccinees – pending the Covid-19 disease variant impact. The bottom line is to strengthen the human immune system’s – innate and adaptive - ability to recognize, then destabilize the Covid-19 disease in its tracks.One non-medical area of research is related to nutraceuticals – nutrients – that may complement prescription medications to address the Covid-19 symptoms, or to support a preventive approach.According to research – Effect of Oral L-Glutamine Supplementation on Covid-19 Treatment, which appeared in the July 2020, open science journal Clinical Nutrition Experimental – researchers from Biruni University Faculty of Medicine in Afghanistan – conclude that, “adding enteral L-Glutamine to the normal nutrition in the early period of Covid-19 infection, may lead to a shortened hospital stay and lead to less need for ICU.”Glutamine, a conditionally essential amino acid, is the most abundant amino acid, containing 60% of the total free amino acids in the body – with the main synthesis sources circulating in plasma being skeletal muscle, adipose tissue, and lungs. Glutamine is found in dairy foods, such as yogurt, cottage cheese, and all forms of whey protein powder – blend, isolate, and hydrolysate.Glutamine performs most of the transport of nitrogen from the skeletal muscle to the visceral (abdominal) tissues, and, is used as a glucose-efficient primary fuel for many rapidly dividing cells, including enterocytes, colonocytes, lymphocytes, and fibroblasts, comment the researchers.As for a direct immune modulation effect, glutamine is a precursor to the powerful, endogenous liver antioxidant glutathione. “It is one of the most researched amino acids on multiple aspects of medical nutritional care, including conditions, such as gastrointestinal diseases, oncology, burn injury, HIV/AIDS, and chronic wound management,” as noted in the Biruni research.To reach their conclusions, the Afghan investigators screened 381 Covid-19 patients – sixty meeting the inclusion criteria - those who had lower respiratory tract involvement in computed thorax tomography (thorax CT), and positive real-time reverse-transcriptase-polymerase-chain reaction (RT-PCR) test in oro-nasopharyngeal swab.The study demographics included, “thirty Covid-19 patients (12 female, 58.2 ± 8.4) using L-Glutamine and 30 Covid-19 patients (14 female, 58.8 ± 7.4) with similar age, gender, and clinical status,” as a control group.In addition to appropriate laboratory analysis, C-reactive protein (inflammatory marker), complete blood count, kidney and liver function, among others, the nutritional status of all patients, body mass index, any weight loss in the last three months, was also recorded.Read the rest at MaxWellNutrition.com.

Building muscle, nine essential amino acids (EAA) at a time, is the driving force behind muscle protein synthesis (MPS) – overcoming the normal effects of muscle protein breakdown (MPB) - resulting from a host of situations like, exercise training, rehabilitation sessions, surgery, trauma, and the advanced age-related loss of muscle (sarcopenia), with the associated loss of strength (dynapenia).  A net balance between MPS and MPB – where synthesis is higher than breakdown – equates to an anabolic (building response) versus the reverse – catabolism (breakdown).Using resistance training as an example, once the session is complete, the body begins the process of releasing intracellular (muscle cells) EAA to support MPS. In essence, your body robs from Peter to pay Peter to the extent of the cellular muscle damage caused by the intensity and the volume of the session.Body builders know that recovery from intense, frequent training – six muscle training sessions per week, sometimes with daily split routines (AM & PM), starts with a post-absorptive meal or EAA supplementation within 2 hours after session completion.According to, Essential Amino Acids and Protein Synthesis: Insights into Maximizing the Muscle and Whole-Body Response to Feeding, which appeared in the December 2020 issue of the online, peer-reviewed journal Nutrients, “intracellular amino acid recycling is not 100% efficient.” MPB can exceed MPS in the post-absorptive state, resulting in a net loss of muscle protein. In order to replace the lost muscle protein, “exogenous (consumed) EAA are required to increase circulating concentrations to induce a stimulation in MPS, while simultaneously reducing MPB.”The study authors, from Arkansas, Korea, and Tennessee, point out that dietary EAA represent, “the primary stimuli for an increase in MPS and subsequent expansion of the skeletal muscle protein pool,” while also serving, as a resource for the “splanchnic” (organs in the abdominal cavity) and tissue during periods of stress (like trauma) or inadequate EAA dietary consumption.Lean body mass – muscle – contributes a significant amount of the body’s protein. Yet, note the researchers, “other tissues may account for more than half of the total protein turnover in the body,” – with skeletal muscle accounting for an estimated 25-50% of whole-body protein turnover.The Nutrient authors investigated how changes in peripheral EAA, after ingesting various protein and free amino acid formats, altered muscle and whole-body protein synthesis. The male participants - healthy, young, and older – refrained from physical activity for 72 hours. Then, after an overnight fast, an isotope infusion was utilized to determine mixed MPS and whole-body protein synthesis.It was determined that a greater amount of the peripheral EAA concentration was tied to not only MPS, but also to WBPS (whole-body protein synthesis). The EAA concentration included EAA and BCAA (branch chain acids), specifically leucine, which has been demonstrated to serve, according to the researchers, as a “trigger” to facilitate MPS by mTOR (mammalian target of rapamycin complex) signaling.To read the rest and for more information, go to maxwellnutrition.com.

Based on epidemiology data, as to the higher incidence of risk to complications related to Covid-19 exposure in African Americans, science has been exploring a number of possible reasons. New research – “Does the High Prevalence of Vitamin D deficiency in African Americans Contribute to Health Disparities” – which appeared in the online, peer-reviewed journal Nutrients in February of 2021 – says there is a higher prevalence of Vitamin D deficiency in many African Americans – the result of people of African descent having brown-black melanin skin pigment, versus Angelo-Celtics, who have a yellow-to-reddish melanin. That means African Americans are particularly at risk for vitamin D deficiency (less than 20 ng/mL in the blood) at high latitudes, where vitamin D synthesis depends on exposure to solar UVB radiation. At high latitudes, the UVB radiation dose is lower – causing a lower Vitamin D production, which starts in the skin. The researchers from the University of California, Berkley, Sunlight, Nutrition and Health Research Center in San Francisco, Harvard T.H. Chan School of Public Health, and Brigham and Women’s Hospital – both in Boston, comment that, “vitamin D deficiency can be corrected rapidly and inexpensively.”Vitamin D, a seco-hormone, which is a critical component of skeletal integrity, also regulates the activity of many thousand protein-encoding human genes. Vitamin D’s conversion from 25(OH)D2 to 1,25(OH)D3 is a multi-step process in the body. The process begins, when “vitamin D3 is synthesized in human skin by the UVB-dependent conversion of 7-dehydrocholesterol to vitamin D3. Vitamin D3 is then converted to 25(OH)D3, a precursor of the crucial vitamin D steroid hormone, 1,25-dihydroxyvitamin D3, or calcitriol, in a reaction requiring magnesium.”Evidence points to the fact that higher serum 25(OH)D levels can reduce the risk or severity of acute respiratory tract infections, possibly including COVID-19 – with Vitamin D’s positive impact on innate and acquired immunity.The researchers cite evidence, which says the, “incidence and mortality of COVID have been far higher in African Americans than in European Americans; after adjustment for age, African Americans are 4.5 times more likely to die from COVID-19 than European Americans.As for Vitamin D’s effect on reducing Covid-19 patients from advancing into intensive care units, “in a non-randomized intervention study conducted in Spain among hospitalized patients hospitalized for COVID-19, high doses of vitamin D (as 25(OH) D3) were administered in combination with standard care; only 1/50 required admission to the intensive care unit compared to 13/26 comparable control patients.”Vitamin D is mainly found in fish and fortified foods, such as milk, and sun exposure (if possible), which is why vitamin D supplementation, based on laboratory studies, is required to meet Institute of Medicine’s (IOM) level of at least 20ng/mL. However, “levels between 20 and 30 ng/mL have also been associated with lower risks of colorectal cancer, total mortality, dementia, multiple sclerosis, and bone mineral density.”Yet, according to the Nutrient’s investigators, “three-quarters of African Americans not already taking supplements have levels that do not ensure adequacy even by the IOM definition (20 ng/mL), and 96% have levels below 30 ng/mL. Notably, for African Americans living in Boston, 4000 IU/day was required to achieve serum levels of 30 ng/mL.”Read the rest at MaxWellNutrition.com

Stress is no stranger to human existence. It’s a normal part of living and functioning in a gravitational state on this planet. But, as Buddha said, “be moderate in all things.” Too much of anything, on a chronic basis, can eventually be deleterious to one’s health.Hungarian-born Hans Selye MD, Ph.D, the “so-called” father of stress research, developed and implemented his famous concept, “General Adaptive Syndrome (GAS),” a response of the body based on the demands placed on it. The body’s three stage response – alarm, resistance, exhaustion – manifest, as follows, notes Medicalnewstoday.com.“At the alarm reaction stage, a distress signal is sent to a part of the brain called the hypothalamus. The hypothalamus enables the release of hormones called glucocorticoids. Glucocorticoids trigger the release of adrenaline and cortisol, which is a stress hormone. The adrenaline gives a person a boost of energy” – at cost of raising the heart rate, blood pressure, and blood sugar.The control mechanism is the autonomic nervous system (ANS) – sympathetic nervous system (SNS) - fight or flight system - and the parasympathetic nervous (PNS) - relaxation or recovery response – all affecting heart rate variability (HRV), what happens between heart beats (R-R interval), resulting from an elevation in the hormone cortisol.During the resistance stage, which is controlled by the PNS, “the body tries to counteract the physiological changes that happened during the alarm reaction stage,” notes the website.If the stress gets under control, then the heart rate and blood pressure begin to return to normal. However, if the stressor remains, the body will stay in a state of alert, and stress hormones continue to be produced.Should the stressor or situation become protracted, then the body goes into the final stage of GAS – exhaustion – depleting its energy resources by continually trying – eventually failing to recover from the initial alarm reaction stage.Symptoms may manifest in the form of fatigue, depression, anxiety, and a feeling of the inability to cope. That’s when long-term stress may trigger the start of cardiovascular disease, type 2 diabetes, colitis, and other such stress-inflammatory conditions.According to research – Magnesium Status and Stress: The Vicious Circle Concept Revisited – which appeared in the January 2021 issue of the online, peer-reviewed journal Nutrients, “magnesium is a naturally occurring calcium channel blocker, is involved in the maintenance of electrolyte balance (e.g., regulation of sodium–potassium ATPase activity), and plays a key role in membrane excitability.”Magnesium, the second most abundant intracellular essential mineral, is a cofactor in hundreds of enzyme processes – specifically protein and nucleic acid synthesis, regulation of metabolic pathways, neuronal transmission, neuromuscular function, and normalization of cardiac rhythm.The adult human body contains roughly from 21 to 28 grams of magnesium – with 50–60% being stored in the bones, while the remainder is distributed in soft tissues such as muscles.The study authors, from various medical facilities and universities in France, comment that, “magnesium is also an essential component of the extracellular fluid (ECF) and the cerebrospinal fluid (CSF) in the central nervous system,” with, “only 1% of the total magnesium is extracellular and 0.3% of this circulates in serum in three different forms: Free (unbound; 60%), which represents the biologically active form; albumin-bound (30%); or in a complex with other ions (10%).”Read the rest on MaxWellNutrition.com.

An individual, who is overweight or obese, with a dysfunctional lipid pattern, especially triglycerides, a blood fat elevated from excessive consumption of simple carbohydrates and saturated fats (fast food), may be at greater risk to postprandial (after a meal) hypertriglyceridemia (elevated triglycerides). According to "Clinical Relevance of Non-Fasting and Postprandial Hypertriglyceridemia and Remnant Cholesterol," which appeared in 2011 on PubMed.gov, “non-fasting triglycerides are measured at any time within up to 8 hours, after any normal meal, while postprandial triglycerides are measured at a fixed time point within up to 8 hours of a standardized fat tolerance test.”“In the general population, 38% of men have non-fasting/postprandial triglycerides > 2mmol/L (>176 mg/dL), while 45% of men have non-fasting/postprandial triglyceride levels of 1-2 mmol/L (89-176 mg/dL); corresponding fractions in women are 20% and 47%,” notes the study authors from the Human Performance Laboratory, Department of Kinesiology and Health Education, University of Texas at Austin.The implications are, “non-fasting triglycerides ≥5 mmol/L vs. 14 hours a day and taking only 1650 steps per day, a 1-hour bout of running at 67% maximal oxygen consumption (VO2max) failed to improve postprandial hypertriglyceridemia the next morning.”It seems, notes the research, “that physical inactivity (i.e., high sitting and severely reduced step count) rendered the participants resistant to the normal acute improvements in indices of cardiometabolic health that are normally derived from a 1-hour bout of running” - a phenomenon labeled “exercise resistance” -becoming, “resistant to the normal acute improvements in indices of cardiometabolic health that are normally derived from a 1-h bout of running.”The takeaway message is that despite one hour of running at what would be considered a moderate pace – something many people would not tolerate – the prolonged running bout failed to kick start the metabolism, when sitting too long and taking few, total daily steps. It could be concluded that the extended running bout may have fatigued the runner, such that they sat longer and took fewer steps the rest of the day. That begs the question of what is the minimum step count to assist dietary restrictions to lower the post-meal elevated blood fat levels – understanding that a high saturated fat meal may keep the triglycerides elevated for up to 10 hours? Many heart attacks come in the early morning hours (2 to 3AM), following an evening high fat meal.For more information and to read the rest, go to maxwellnutrition.com.

Research has documented that within the first 6 to 8 hours post exercise, competition, or training – the window of recovery – the combined intake of protein (PRO) and carbohydrate (CHO) per hour – based on body weight (kilograms), is the appropriate mode to accelerate glycogen repletion in the liver, muscles, and circulatory system.The reasoning is the sum of the parts – carbohydrate and protein ingestion – may be greater than either component in isolation. However, research is somewhat inconsistent. The physiological effect is caused by the insulinogenic effects, when a fast -digesting whey protein isolate – high in the essential, branch chain, anabolic amino acid leucine – is selected, as the post-recovery protein of choice.It’s also reported that the optimum refeeding of carbohydrate over the 6 to 8-hour recovery window is 1.2 grams per kilogram (2.2 pounds) of body mass, while the optimum protein refeeding is roughly 0.3 grams per kilogram.Yet, some research says that after a carbohydrate refeeding of greater than 0.8 g/kg/hour a saturation effect takes hold – with more being less, potentially negating the effects, if protein is added to the mix.In a study – Co-Ingestion of Carbohydrate and Protein on Muscle Glycogen Synthesis After Exercise: A Meta-Analysis – which was reported in the February 2021issue of Medicine & Science in Sports & Exercise, researchers from the Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine in Massachusetts, and the Oak Ridge Institute of Science and Education, in Tennessee, the primary objective was, “to aggregate results from multiple studies to characterize the effects of CHO-PRO on glycogen synthesis, during recovery from exercise compared with CHO alone.”The meta-analysis (numerous similar studies), which included research from PubMed and the Cochrane Library database, took place in July of 2019 – with a second search in March of 2020. “The population, intervention, control, and outcome for this meta-analysis were healthy, trained or untrained men or women, CHO-PRO, CHO only, and glycogen synthesis, respectively,” commented the investigators.Read the rest on maxwellnutrition.com

1944 research determined that Greenland Eskimos, who despite a diet high in fat, had a lower incidence of coronary heart disease (CHD) – specifically due to the type of fat found in their diet, which was high in fish (seal & whale), despite a low in consumption of fruits and vegetables.It was determined that the coronary heart disease risk reduction in the Eskimos was due, in part, to a high intake of omega-3 polyunsaturated fatty acids in their fish selections, that confer benefits of a reduction in high-risk triglycerides (TG), anti-inflammatory and anti—arrhythmic effects, vasodilation, reduced blood pressure, improved arterial and endothelial function, favorable autonomic tone, and reduced platelet aggregation.According to “An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health”, which appeared in the January 2021 online, peer-reviewed journal Nutrients, “TG levels are a historically well-studied, independent risk factor for CHD. Ω-3 (omega-3) or fish oil diet supplementation is evidenced to lower TG levels in a dose-dependent fashion, whereby 3–4 g/day of eicosapentaenoic acid (EPA), or a combined EPA and docosahexaenoic acid (DHA) reduces blood levels by 20–50% in those with high TG’s.”I had the distinct pleasure to work with and learn from one of the study authors, Carl J. Lavie, MD, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinic School, The University of Queensland School of Medicine in New Orleans, during my prior tenure, as the Director of Health and Fitness for Lavie’s institute.To this date, Lavie still provides interpretation of cardiovascular testing for my diverse client population.In their review of the omega-3 history and research, Lavie and his study colleagues note prior controversies over the purported omega-3 benefits taken from popular media, “which wrongly suggested that Ω-3 ingestion, including that from fish, increased prostate cancer risk, with many commentaries thereafter advising against the use of supplemental fish oil.”On the contrary, the study investigators comment that, “habitual high intake of fish and seafood in men, who have prostate cancer, however, has been linked to significantly improved survival. Accordingly, Japanese men, who consume approximately 8 times more fish than their American counterparts, have a rate of prostate cancer mortality many-fold lower.”It was further noted by the investigators that in 2018, three large trials added to the omega-3 controversy.The ASCEND trial determined that there was no reduction in cardiovascular disease (CVD) risk, when 1 gram per day of EPA plus DHA was used for primary prevention in patients with diabetes. “There was no significantly lowered incidence of serious vascular events in 15,480 patients after mean 7.4 years of follow up.”However, comment the study authors, “there was a statistically significant 18% relative risk reduction in vascular death, defined as death from CHD, stroke or other vascular causes, which seems to be a meaningful endpoint that was not emphasized in this paper.”In the VITAL trial, which administered 2000 IU/day vitamin D3 and 1 gram/day Ω-3 (EPA + DHA) for primary prevention of CVD and cancer in 25,871 patients, there was no difference between the intervention and placebo groups at a median of 5.3 years.Read the rest on maxwellnutrition.com.

It’s estimated that the annual cost of recreational or sports-related injury and rehabilitation is roughly nine billion for young adults seventeen to forty-four years of age. In many cases, such as in an injury to the anterior cruciate ligament (ACL), with associated surrounding ligament damage – meniscus and medial collateral ligament - early osteoarthritis is in the future. When I was affiliated with the St. Louis Blues Hockey Organization, as their Performance Conditioning & Nutrition consultant, from 1989 to 1999, hockey research reported that you could anticipate an injury for every 1000 man-hours on the ice. With a 3-hour practice limitation, when you place 50 players (during training camp) on the ice, you’ve burned up 150 man-hours in one practice session. Thirty percent of the injuries were non-contact, fatigue related.A primary focus of injury management, treatment, and if applicable, pre/post-surgical, is the management of inflammation, which is a normal, important aspect of the body’s repair process – until it gets out of control or protracted. Modes of treatment, such as cryotherapy, anti-inflammatory prescriptions, and even nutritional interventions, like omega-3 supplementations, may be contraindicated in the initial therapy intervention. To read the rest or more information on this topic and wellness research, go to maxwellnutrition.com.

Common sense tells you that the longer the duration of exercise, the larger the energy expenditure – more calories burned. The intensity of the exercise – either as a percentage of maximum endurance capacity (VO2 Max) or maximum heart rate (220-age) – determines the type and percent of energy expended – carbohydrate (muscle and liver glycogen) and adipose fat (fatty acids and glycerol).When exercise is stopped, a process called enhanced or excess post-exercise oxygen consumption is activated - once again, determined by the exercise duration and intensity. As more fatty acids (FA) are expended post-exercise, as reflected in a lower respiratory exchange rate (RER), the FA expensed can go on for hours in untrained and endurance-trained people.According to "The Importance of Fatty Acids as Nutrients During Post-Exercise Recovery," which appeared in the March 2020, online issue of the journal Nutrients, “the peak in circulating FA concentration in the immediate recovery (first hour post-exercise) period following submaximal exercise has been suggested to be due to a delayed spill-over effect from the increased adipose tissue lipolysis (fatty acid breakdown) induced during exercise.”As time progresses in the early recovery period, “the whole-body lipolytic rate, determined from the plasma glycerol rate of appearance, increases by up to 400% above resting values during exercise of 1 to 4 h at 40%–65% of VO2peak” – which roughly translates to 55 to 75% of max heart rate. It’s known that elevated circulating insulin levels can inhibit adipose tissue lipolysis (fatty acid breakdown). It’s also recognized that, “plasma insulin concentrations are decreased during exercise and remain lower in early recovery compared with pre-exercise or resting conditions until glucose or meal ingestion.”Thus, “a lower plasma insulin concentration can also contribute to an increased adipose tissue lipolytic rate in early recovery,” note the study authors from Denmark.The Danish researchers comment that, “coinciding with the low RER values in early recovery, oxidation of plasma-derived FAs is increased in the first 3 hours and represents the major part of the FAs oxidized during the early recovery period.” In my prior hospital-affiliated weight management programs, we monitored our participant’s RQ (respiratory quotient) - representing the spread of energy utilization at rest – and the RER during maximum Pulmonary VO2 testing to determine the optimum fat burning heart rate training zone.The study authors conclude by saying, “whole-body FA oxidation is increased for several hours following aerobic exercise, even with carbohydrate-rich meal intake during recovery from exercise.”I’ve previously commented that a person is as young as they are metabolically active. It’s been my experience to see some post-menopausal (average age of 51) women and obese men - with a high RQ coming into my weight management program - signifying that, over time (Rome was not built in a day), they had become proficient at storing fat. It usually took 6 weeks of combined aerobic exercise in a target heart rate zone – based on testing – of 50 to 70 percent of maximum heart rate – along with circuit training (ten exercises) – to get back to a baseline to begin to expense excess body fat and inches.The solution is to keep moving – with a modicum of dietary controls – to keep the system metabolically active well into old age.For more information, please go to maxwellnutrition.com

Anyone following college and professional sports has witnessed the lengths that colleges and professional organizations are talking to keep their respective players and fans safe from the ravages of COVID-19, while attending sporting events, albeit with limited seating capacity.Sporting events have been cancelled or postponed due to a team experiencing multiple player COVID exposures. Arenas have been mandated, at times, to have no fans in attendance, due to the corresponding local population, exceeding a 5% population COVID-19 exposure rate.According to research - The Benefits of Vitamin D Supplementation for Athletes: Better Performance and Reduced Risk of COVID-19 - which appeared in December 2020, in the online, peer-reviewed journal Nutrients, "a hypothesis now under scientific consideration is that taking vitamin supplements to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations could quickly reduce the risk and/or severity of COVID-19.The research investigators from Sunlight, Nutrition, and Health Research Center in San Francisco, Vitamin D Wiki in Washington State, and the Departments of Human Nutrition, Foods, and Exercise and Center for Transformative Research on Health Behaviors at Virginia Tech University, comment that, "clinical trials have confirmed that vitamin D supplementation reduces risk of acute respiratory tract infections, and approximately 30 observational studies have shown that incidence, severity, and death from COVID-19 are inversely correlated with serum 25(OH)D concentrations (how vitamin D is measured in the blood)."These investigators, in a narrative review of the data and literature to date, chose to evaluate, "the use of vitamin D supplementation to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations to optimal values, which may be at least 40 ng/mL for sports. The benefits of vitamin D for athletic performance and general well-being are similarly reviewed."In terms of the Vitamin D lab values - mean 25(OH)D concentrations of less than 15 ng/mL were generally associated with an increased severity and risk of death for COVID-19 patients. A mean 25(OH)D concentration of less severe, hospitalized COVID-19 patients were determined to be in a range between 17 to 30 ng/mL.The researchers note that, "the 10 observational studies suggest that 25(OH)D concentrations

Exercise and caloric restriction are a proven combination to reduce scale weight. The real key, however, is to reduce excess body fat - subcutaneous (under the skin), visceral (around vital organs), and ectopic (within the organs).From an exercise perspective, it's all about frequency, intensity, and time - the "fit principle." Of the three variables, the appropriate intensity to optimize fat max - maximal fat burning - requires testing or the use of heart rate percentages that estimate fat max.When exercising, the primary energy sources are derived from a percentage of fat and carbohydrate - depending on the intensity of exercise. The higher intensity the less fat is used and vice versa. The fat max zone can be determined via a VO2 Max test correlated to a percentage of maximum heart rate.The V stands for volume, and the O2 is the chemical formula for oxygen we breathe. Your VO2 at the stage of maximal exertion is called your maximal oxygen consumption (VO2 max). The test is usually performed in a laboratory by a trained medical professional.The VO2 Max test measures milliliters of oxygen per kilogram of body weight (1 kilogram = 2.2 pounds) used per minute. By measuring VO2 max relative to body weight, we are able to determine endurance and stamina levels. Then, we can relate this to a heart rate at any point during the test.For max heart rate (HRmax) determination, the age-predicted HRmax formula used by the American College of Sports Medicine (ACSM) is 220-age.According to research - "Fat Oxidation Rate As a Function of Plasma Lipid and Hormone Response in Endurance Athletes" - which appeared in the January 2020 issue of theJournal of Strength and Conditioning Research, "the regulation of adipose (fat) tissue lipolysis (breakdown) and the release of FFAs (free fatty acids) from adipose tissue to the muscle is an important route of control for fat oxidation (burning)."Researchers from Spain sought to investigate, "the relationship among fat oxidation rate, plasma lipids (total cholesterol, triglycerides, HDL good cholesterol, and LDL bad cholesterol), and hormone concentrations (adrenaline, noradrenaline, catecholamine, insulin) in well-trained athletes."The Spanish investigators recruited twenty-six trained triathletes, who completed a graded stationary cycle test to exhaustion - increasing the intensity every 10 minutes. Fat oxidation rates were determined using the indirect calorimetry method.Each individual's maximal fat oxidation (MFO) rate - the intensity at which MFO occurred (fat max), and the intensity at which fat oxidation became minimal (fat min) were determined. Blood samples for lipid and hormone analysis were collected at the end of each stage of the graded exercise test.It was determined that the fat oxidation rate became significant at 60% of VO2 max or 75% of HRmax, while maximizing at 70% of VO2 max or roughly 80% HRmax. As an individual reaches their VO2 max, they approach their HRmax.From a lipid and hormone perspective, the researchers determined that, "low-density lipoprotein (LDL) and triglycerides (TG) decreased and showed lowest levels at 60%VO2max and reaching significant increases after 80%VO2max. High-density lipoprotein (HDL) reached significant increase at 60%VO2max. Adrenaline and noradrenaline increased until the end of the incremental exercise, and significant differences were from 50%VO2max."The take-away message is that fat burns in the flame of oxygen at roughly 70-80% HRmax. From my experience, I have found the lower end of the range starts at 55% of HRmax.Subtract your age from 220. Then take 55 and 80% for your lower and upper fat max training zone - ideally staying closer 70%, as the higher number.To read the rest, and for more information and research-based nutritional products made in the USA, visit maxwellnutrition.com.

With COVID-19 surging after the Christmas and New Year’s holiday season, and the two vaccines, to date, relatively slow in the initial inoculation phase, any potential, safe, preventive therapy, as an adjunct to current modes of treatment, is a blessing.Researchers from the United Kingdom, United States, and New Zealand report in the December 2020 issue of the online, peer reviewed journal Nutrients, that, “vitamin C’s antioxidant, anti-inflammatory, and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19.”The research, Vitamin C – An Adjunct Therapy for Respiratory Infection, Sepsis, and COVID-19, states that, “the evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections, and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections.”Vitamin C, a water-soluble nutrient, is derived by humans only from the diet or supplementary intake – owing to a gene mutation prior to the human evolutionary period, unlike certain other species. The researchers point out that in the European Union, the average vitamin C requirement is 90 mg/day for men and 80 mg/day for women, while the Swiss Society of Nutrition recommends that, “everyone supplement with 200 mg to fill the gap for the general population, and especially, for adults age 65 and older.”The Linus Pauling Institute, here in the US, recommends 400 mg of vitamin C per day for adults 50 years and older.“Pharmacokinetic studies in healthy volunteers,” comment the researchers, “support a 200 mg daily dose to produce a plasma level of circa 70 to 90 μmol/L. Complete plasma saturation occurs between 1 g daily and 3 g every four hours, being the highest tolerated oral dose, giving a predicted peak plasma concentration of circa 220 μmol/L.”Read the rest on mackieshilstone.com.

Research is well documented on the benefits of moderate-to-vigorous intensity physical activities – meaning engaging in exercise that causes your breathing to be at or below a breathless state.Former Oregon track coach and co-founder of Nike – Bill Bowerman - referred to moderate physical activity (MPA), as being below a breathless state, in which you are able to carry on an activity, like running, while simultaneously talking out loud – “the Talk Test.”Bowerman’s innovative approach, defining the anaerobic or ventilatory threshold, was validated years later.The 2018 Physical Activity Guidelines for Americans suggests that adults should accumulate at least 150 to 300 minutes per week of (MPA), 75 to 150 minutes per week of vigorous intensity physical activity (VPA), or an equivalent combination of physical activity of both intensities.The VPA, as it pertains to best use of time – as intensity goes up, the duration comes down - has proven quite effective in sports to simulate the work-to-rest ratios that the game imparts to the competitor.Yet, according JAMA (Journal of the American Medical Association) Internal Medicine research – Association of Physical Activity Intensity with Mortality, which appeared online in November of 2020, “it remains uncertain whether, for the same amount of total MVPA, VPA may actually offer additional health benefits compared with MPA.”Researchers from China, Chile, Spain, and Brazil used 403,681 adults from the National Health Interview Survey from 1997 to 2013, who provided data on self-reported physical activity - linked to the National Death Index records through December 31, 2015.Statistical analysis was performed from May 15, 2018, to August 15, 2020. Participants were excluded, if they lacked physical activity data, had disabilities that might affect daily activity, or incapable of performing moderate or vigorous physical activity.It was speculated by the researchers that, “for the same amount of total physical activity, a higher proportion of VPA is associated with lower mortality.”When the data was compiled and analyzed, the researchers determined that, “for the same amount of total physical activity, participants with a greater proportion of VPA to MPA had a lower all-cause mortality.”“For instance,” noted the investigators, “among participants doing any MVPA, more than 50 to 75% of VPA to total physical activity was associated with 17% lower all-cause mortality, even after adjusting for total amount of MVPA.”However, it was also noted that, “we did not find a consistent inverse association of proportion of VPA with CVD (cardiovascular disease) and cancer mortality.”The bottom line: Participants performing 150 to 299 minutes per week of MPA and those individuals reporting 150 minutes per week or more of VPA had the lowest all-cause mortality risk.From a heart rate intensity perspective, it’s been demonstrated that exercising in the range of 72 to 87% of maximum heart rate can improve cardiorespiratory fitness. Maximum heart rate is found by subtracting your age from 220. Then, take 72 and 87% of that number to have a projected heart rate training zone.The caveat is that it’s best to speak with your personal physician, as to the best duration, mode, and intensity of exercise – based on your personal health profile.

Medscape.com reported in March 2020 that researchers from the Department of Epidemiology, School of Public Health, Southern Medical University in China, determined that, “habitual fish oil supplementation was associated with a 13% lower risk for all-cause mortality, a 16% lower risk for CVD (cardiovascular disease) mortality, and a 7% lower risk for CVD events in the general population.The study, "Associations of Habitual Fish Oil Supplementation Population-based Cohort Study, "which appeared in the British Medical Journal, used a total of 427,678 men and women aged between 40 and 69, who had no CVD or cancer at baseline were enrolled between 2006 and 2010 and followed up to the end of 2018.The inverse associations of fish oil use with CVD events, commented the researchers, “seemed to be somewhat stronger in participants with hypertension than in those without hypertension, which was consistent with a meta-regression analysis showing a more favorable effect of fish oil on blood pressure in those with hypertension.”It was noted that the beneficial effect of fish oil on CVD may have to do with the lowering of blood pressure, plasma triglycerides, and heart rate – all of which exert a protective effect against CVD development. Also, several prior studies have shown that Omega-3 fatty acids in fish oil improve flow mediated arterial dilation – a measure of endothelial function.Lastly, prior research has determined that Omega-3 fatty acids have shown to possess “antiarrhythmic (irregular heartbeat) properties and can reduce thrombosis (blood clot).”All of which led to the following conclusion: “These findings indicate that habitual use of fish oils is associated with a marginal benefit for CVD events in the general population, supporting their use for the prevention of mortality from all causes and CVD. You are now able to determine your Omega-3 index though a blood test, which gives you a range from low to high – along with an Omega-6/ Omega-3 ratio – with Omega-6 being proinflammatory and Omega-3, anti-inflammatory. I reference in my book, Stop Renting Your Health: Own It, on page 112, a prior study in the New England Journal of Medicine, which reported that people with a total omega-3 level of 6.9% were 90% less likely to die of sudden cardiac death than those people with a total omega-3 level of 3.6%. Be sure to check with your doctor, before you supplement with omega-3’s, since you want to make sure that that they fit into your respective health profileYou can download a free copy of my book on mackieshilstone.com.Happy New Year.

According to researchers from the Vitamin D, Skin, and Bone Laboratory, Section Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University School of Medicine, and the Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, “although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40–60 ng/mL (100–150 nmol/L) to achieve the optimal overall health benefits of vitamin D.”I opened with this definitive statement on what blood level of the tested form of Vitamin D—25(OH)D–is necessary to achieve, since the Boston co-study author, Michael F. Holick, in my opinion, is one of the world's leading experts on this topic.Immunologic Effects of Vitamin D on Human Health and Disease—the study–which appeared in the December issue of Medicine & Science in Sports & Exercise, qualifies current recommendations of Vitamin D deficiency—a blood level of less than 20 ng/mL—and insufficiency—between 20 to 30 ng/mL–with a specific blood range–“preferably 40-60 ng/mL”—for the, “optimal overall health benefits of Vitamin D.”The researchers comment that vitamin D, which regulates calcium and phosphate metabolism, is critical in maintaining skeletal integrity, while also functioning as an immunomodulatory hormone—a seco-hormone. Holick and his fellow co-author, Nipith Charoenngam, note that there is a vitamin D link with the incidence and severity of many disorders, such as psoriasis, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and infectious diseases—specifically, “experimental studies have shown that vitamin D has significant biologic activities on the innate and adaptive immune systems.”Holick and his Thailand associate executed a review examining the biologic effects of vitamin D on the immune system and its association with several types of immune-related diseases and conditions, in addition to the impact that Vitamin D has relative to prevention and treatment of immune-related diseases.Vitamin D gains access to the human system via sunlight exposure, diet, and supplements. The active forms include vitamin D2—ergosterol—obtained in the diet from yeast, sun dried and irradiated mushrooms, and plants, while the active form—D3—is manufactured internally from dietary sources, such as cod liver oil and oily fish.Once in the system, the liver converts both D2&3 to 25(OH)D, then the kidneys complete the task by transforming the 25(OH)D to its active form—1,25(OH)2D.In order to meet the recommended vitamin D intake, the Endocrine Society Guidelines state that adults, who are at risk for vitamin D deficiency, should strive for 1500-2000 iu's (international units) per day—with an upper limit of 10,000iu's.The review concluded that, among other variables, “most of the evidence, to date, suggests that maintenance of a healthy vitamin D status is important for modulating the body's immune function. Low serum levels of 25(OH)D are associated with multiple immune-related diseases, including autoimmune disorders and infectious diseases.”Read the rest at MackieShilstone.com.

Anyone who's been involved in athletics at any level—professional, college, recreational, or those older individual with the reoccurring aches and pains of general living—appreciates the benefits of over-the-counter non-steroidal anti-inflammatories (NSAID's), or the prescription version, as first-line pharmaceutical drugs to treat pain and localized inflammation—under physician guidance.These medications inhibit cyclooxygenase enzymes, which are responsible for the discomfort associated with overuse issues.Like a financial statement, which lists both assets and liabilities, NSAID's have their own negative aspects, when overused. Those complications, with chronic or overuse, may include cardiovascular (CV) outcomes, hypertension, coronary heart disease, atrial fibrillation, and congestive heart failure, especially with high-risk people.As it pertains to a higher risk population—like American-style football (ASF) athletes of larger sizes, such as the offensive and defensive linemen, retired ASF players, and those ASF players with numerous orthopedic injuries in their medical history, all who later in life may have a higher incidence of hypertension and cardiovascular disease—NSAID use may be contraindicated.According to Nonsteroidal Ant-Inflammatory Drugs and Cardiovascular Risk in American Football, which appeared in the December 2020 issue of Medicine & Science in Sports & Exercise, “ASF participation is associated with the development of early hypertension and acquired pathologic CV phenotypes—all associated with significant weight gain. Epidemiologic data also suggest increased CV mortality among retired professional ASF athletes, who had the largest playing time body mass index (BMI).There are still uncertainties, as it pertains to habitual NSAID use and increased CV risk in AFS.Researchers from Emory University, Georgia Institute of Technology, Woodward Academy in Atlanta, and the Cardiovascular Performance Program at Massachusetts General Hospital in Boston, “sought to characterize NSAID use patterns and the association with cardiovascular risk in a diverse cohort of high school and collegiate ASF athletes.”The testing group of young athletes included a total of 226 ASF players, 60 endurance athletes, and 63 nonathletic controls, who were studied pre and postseason. Echocardiography, vascular applanation tonometry, and clinical data assessment were obtained. Qualitative NSAID use throughout the season was recorded at postseason.It was determined that, “within a large cohort of combined HS and collegiate ASF athletes, habitual NSAID use was more common among those with established CV risk factors, and importantly, increased weight across the ASF season was associated with an increased frequency of NSAID use.”The researchers also said, “second, and just as concerning within this diverse ASF cohort, sport-related ASF NSAID use more commonly began early, in middle school, before full physical maturation.”It was concluded that, “our data suggest that increased weight, a critical pathologic factor linking early ASF-associated CV risk with adverse long-term outcomes, is also associated with increased NSAID use during competitive ASF training.”“Taken together, commented the researchers, “we believe that our findings provide compelling rationale that habitual NSAID use may adversely affect CV risk among competitive ASF athletes and should therefore be considered in the CV risk stratification of high-risk ASF athletes.”As with any medication—prescription or over-the-counter—it's best to be used under the guidance of your personal physician, in order to avoid potential contraindications or complications.

According to research—"Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity"—which was published in the November issue of the online, peer reviewed journal Nutrients, “the world had recorded 40,628,492 cases and 1,122,733 deaths from COVID-19 by 19 October 2020.”The study researchers, from Cape Coral, Florida, San Francisco, California, and the Medical University of South Carolina, report that COVID-19 began in the winter in the northern hemisphere—with both cases and deaths being lowest in the summer. That was especially true in Europe. Rates began increasing again in July, August, or September in various European countries.This data caused the researchers to comment, “it (COVID-19) is thus generally inversely correlated with solar UVB doses and vitamin D production.”Prior research has concluded that Vitamin D, “is a powerful epigenetic regulator, influencing more than 2500 genes and impacting dozens of our most serious health challenges, including cancer, diabetes mellitus, acute respiratory tract infections, and autoimmune diseases, such as multiple sclerosis.”It's thought that the impact of COVID-19's damage control corresponds with a “cytokine storm”—causing an uncontrolled and excessive innate immune system release of pro-inflammatory signaling molecules called cytokines, which can damage tissue.The researchers comment that, as of their study submission date, of, “the Clinical Trials registry maintained by the U.S. government, only four will investigate prevention, and three of those are enrolling health care workers, a group that is highly exposed to COVID-19.”In their investigation of the relationship between Vitamin D status and COVID-19 susceptibility and impact, the researchers cite, among other European data, a U.S. observational study, the largest observational study to date from Quest Diagnostics–with data for 191,779 patients–having a mean age of 50 years, who were tested for SARS-CoV-2 between March 9th and June 19th, with 25(OH)D tests in the preceding 12 months at Quest.25(OH)D—(25-hydroxy-Vitamin D) is the standard laboratory test to assess Vitamin D status.The study, note the authors, “reported the following rates of SARS-CoV-2 positivity vs. 25(OH)D concentration: 39,120 patients 55 ng/mL (nanograms per milliliter).”Labtestsonline.org says, “the Endocrine Society defines vitamin D deficiency as a 25-hydroxyvitamin D blood level below 20 ng/mL (50 nmol/liter) and vitamin D insufficiency as a level between 21–29 ng/mL (52.5–72.5 nmol/liter).”Emerging evidence has demonstrated that, “higher serum 25(OH)D concentrations are associated with the reduced risk and severity of COVID-1”—with “the strongest evidence to date (coming) from 14 observational studies that report inverse correlations between serum 25(OH)D concentrations and SARS-CoV-2 positivity and/or COVID-19 incidence, severity and/or death.”Also in the November Nutrients issue was research—Vitamin D Supplementation Associated to Better Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Quasi-Experimental Study—which had as its objective to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after the diagnosis of COVID-19 was effective in improving survival among hospitalized frail elderly COVID-19 patients.Read the rest on MackieShilstone.com