Posted on January 3rd, 2012 by Matt Schoeneberger
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Matt and I have written a number of posts regarding the great and powerful OZ (see below for all the links). We have not written anything in awhile, not that there hasn’t been things to write about. I think we just get tired of beating our heads against the wall. Anyway, there was a good post over at Science Based Medicine recently about Dr OZ that I thought I would recommend.
Here are the posts we have done regarding Dr OZ
see 2nd book review of The Fast Metabolism Diet
Let’s talk about this paper, part of the CALERIE study: Effect of Calorie Restriction with or without Exercise on Body Composition and Fat Distribution
I made a promise to myself, and may have mentioned it here, that I would no longer review single papers without also discussing the body of evidence. Today, I’m breaking that promise because I want to highlight this study as an example of what I feel is great control of important variables for the topic.
Next to a metabolic ward study, where participants live in a hospital and all food intake and activity are monitored, this design is about the best you’re going to find in the exercise and nutrition literature. The fact that all meals and snacks are provided greatly increases the ability of the participants to adhere to the eating plan. We know that people often under-estimate and therefore under-report their calorie intake so this is a very important variable to control. (Hill 2001)
This goes the same for the exercise – 3/5 exercise sessions per week were supervised and all others were recorded using portable heart rate monitors. Excellent! This is far better than researchers telling subjects “we want you to do x number of minutes at x intensity on your own” and then praying it gets done. Cuz researchers pray – scientists are almost all religious…
There will be a three brief book reviews below. But first. Seriously, is there no end to the amount of bullshit that is found in books and articles on the subject of weight management? For those of you that have read many of our posts, you will know that Matt and I have spent a fair amount of energy pointing out, often with great detail, that certain authors of books and articles have served up big piles of horse dung. They state very specific and spectacular claims for an array of things that are often a “secret”, or “little known fact”, usually with NO quality evidence in support it (see Slow Burn, Skinny Bitches, and the Tone It Up girls for examples). We feel compelled to point this shit out because it is so blatantly wrong and it distracts people from the stuff that actually works. Not to mention it often confuses people which can lead to the “nobody knows what they are talking about” or the “anybody can find support for anything” type of statements. To be clear, I am not saying that people can’t make mistakes. There is no doubt I have and will likely do it again. However, there is a big difference between the occasional mistake or oversight while being transparent with how and what you used to support such a position and the deluge of extravagant statements that are stated in a way that clearly portrays some type of authority and gives little or no evidence to support such a claim, aka Bullshit. My reason for this little rant is my recent review of a few books. I reviewed these books because people asked me my opinion of them. As I told these people and anybody else who asks me about a book or article; before I can give an honest, and hopefully intelligent answer to their question, I would need to actually read the material. I was curious about these books for a number of reasons so I decided to look them over. Before I get to a few words about them there are just a couple more things I need to say. Read more »
Just “eat less and move more”, yes, but how do you do that? As this diagram depicts, there are many factors that influence our eating and exercise behaviors.
From; Zheng, H. & Berthoud, H. (2008). Neural systems controlling the drive to eat: Mind versus metabolism. Physiology; 23: 75-83
Ahhh, testosterone. It’s the hormone that makes dudes dudes. And if a dude with low testosterone levels can raise the available levels of this important hormone in his body he can expect such benefits as “improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease.” (Bassil)
I was pointed to a supplement which aims to help men do just that: raise testosterone, naturally. It’s called T+ and it’s brought to you by Onnit. I’ve heard that it’s being promoted by some people affiliated with the UFC but I didn’t look into it. To be honest, I wanted to know as little as possible about the marketing behind the product so I could give an objective review of the ingredients.
Disclaimer: I have not tried this product, nor will I. For those of you who will say I can’t possibly review a product without trying it you might as well leave right now. This is not a review of my experience with the product (even if it was, my experience may or may not lend you useful information) but instead a review of the evidence in support of the ingredients and a discussion of how the product might work and on whom.
The short answer for those who don’t want to read all the mumbo jumbo: This product may help raise testosterone levels in hypogonadal men (low testosterone) but probably won’t do much for men with healthy testosterone levels. It more likely will increase sex drive (mental) unrelated to a rise in testosterone levels, which is a great benefit if you need it. It may also increase sperm count and sperm motility, increasing fertility. Cool if you need it, possibly very not cool if you don’t.
As you’ll see below in the Performance Blend section, supplement companies often group ingredients together and give the blend a name, so they don’t have to list how much of each ingredient is in the product, only the amount of the entire blend. This might be an attempt to keep their recipe a secret, but mostly it just hides the uselessness of the ingredients due to the quantities used in the product. I call this label candy. They put a bunch of words on the label to make unsuspecting and uneducated buyers (not meant as a put-down) think the product is kick-ass when most of those ingredients aren’t in the product in amounts that make them effective.
T+ by Onnit: The ingredients and the evidence for them
This product consists of three main blends, two of which I’ll be discussing.
Onnit Testo Blend (3.525 grams)
Magnesium aspartic acid, mucuna, Longjack Root, Nettle Root.
Magnesium aspartic acid
There are two papers given in support of the use of magnesium aspartic acid. Cinar et al investigated the effects of exhaustive exercise and magnesium supplementation on testosterone levels. Subjects were assigned to one of three groups: sedentary + 10mg/kg magnesium, active + 10mg/kg magnesium, active with no supplement for weeks duration. Activity was 90-120 minutes of tae kwon do 5 days/week. A rise was seen in each group in free and total testosterone from before exhaustive exercise to after, as well as from before supplementation to after. A larger increase in each was seen in the exercise + no supplement group as compared to the sedentary + supplement group, not surprisingly. The only conclusion I can draw from this research is that exhaustive exercise raises free and total testosterone more effectively than magnesium aspartic acid. Interestingly, the authors focus on the fact that group 2 (exercise + supplement) had the highest levels of testosterone at the end and that they saw the highest increase in total testosterone as a result of exhaustion, rather than pointing out that similar increases were seen in group 3 (exercise + no supplement) and in fact group 3 had a larger increase in FREE testosterone after exhaustion.
Topo et al gave men 3.12g/day of sodium D-aspartate for 12 days and measured the response of leutinizing hormone* (LH) and testosterone. Both LH and testosterone increased significantly in 20 out of 23 subjects after 12 days. Cool! FYI, T levels rose from 4.5 to 6.4 ng/ml (450 to 640 ng/dl – more common units) which is nothing to scoff at. Nothing at which to scoff? Meh, grammar… What’s interesting is that they noted this response in 20/23 subjects. I’d love to know why it didn’t work in the other 3 subjects.
*leutinizing hormone is secreted by the anterior pituitary gland and stimulates testosterone production in the testes.
Shukla et al investigated the effects of M Pruriens (5g/day) on infertile men and found an increase in LH, FSH, T and decreases in prolactin and FSH. The rises in testosterone were on the order of 100-150 ng/dl of the means. I must reiterate, this effect is seen in infertile, hypogonadal men.
So far, the research is telling us we need between .75 grams (assumed by 10 mg/kg body weight) and 3.12 grams per day of Magnesium aspartic acid, and 5 grams of M Pruriens per day, to achieve desired effects. We’re already over our 3.525 grams of the blend.
There are two papers listed in support of this ingredient. One is a paper by Lopatkin, et al describing the benefits of plant compounds on lower urinary tract infections and their association with BPH (benign prostatic hypertrophy). Not one mention is made in regards to sex hormone binding globulin (SHBG) in the entire paper, which is why this ingredient is included in T+. The authors of this paper refer us to others’ work for the mechanism of action, but I’m unable to get full text of the referenced article. In the UTI trial, a blend is used which includes 120 mg urtica root extract (nettle). I’ll give the benefit of the doubt here and say that nettle root’s effects on BPH are through, at least in part, binding to SHBG.
I also was unable to access the 2nd study referenced on the Onnit website for nettle root, but found other work by the same group of German scientists. It seems there is some plausible evidence for the action of nettle root binding to SHBG. (Schottner)
Tambi, et al investigated the effects of 200 mg eurycoma longifolia in late-onset hypogonadal men in 2011. Of 320, only 76 men completed the treatment and follow-ups and only these men were included in the data analysis. This is strange, since reasons for the others’ departure are not given – one could assume regular attrition or a lack of adherence due to poor response to the supplement. In the 76 men who completed the protocol, testosterone rose from mean 5.66 to 8.31 nmol/L, which is statistically significant but leaves them still on the lower end of the recommended range.
Ismail et al, in 2012, studied 300mg eurycoma longifolia’s effects in healthy men on testosterone, IGF-1, SHBG, DHEAS levels as well as a host of sexual performance/libido questionnaire answers, physical fitness and body fat changes. No changes were seen in any of the hormones, physical fitness tests or in body fat %. Whoops! The questionnaires did show some positive outcomes in libido, sexual interest, and erectile function. Cool! But keep in mind this is not from a boost in testosterone.
As you can see, the amount in the blend (3.525 grams) falls short of being able to include each ingredient in the quantities found in the evidence. This doesn’t mean Onnit hasn’t done a ton of R&D and found lesser levels of these ingredients to be effective, especially in combination, but no mention of such is made on their website.
Omni Performo Blend (1.7 grams)
BCAA, beta-alanine, glutamine
Branched-chain amino acids are well-supported for their ameliorating effects on exercise-induced muscle soreness – at a dose of about 5g/day or 5g/exercise session. Onnit T+ has a whopping 750 mg of BCAA. You’ll have to forgive my skepticism, but I doubt this will result in a noticeable effect in the user. In case you don’t understand why, 750 mg is equal to 0.75 grams – as compared to the 5g effective dose mentioned above. FYI, I’m refraining from using the f-word and lots of LOLs right now. The paper referenced in support of BCAA is a short review – each study within uses at least 3 grams of BCAA to achieve its desired effect. (Da Luz)
Let’s back up. The Omni Performo Blend totals 1700 mg, or 1.7 grams. It includes beta-alanine, BCAA, and glutamine, in that order. In a proprietary blend, the ingredients are announced on the label in order of their weight, highest to lowest. Can you see what I’m saying?
The paper used in support of beta-alanine – which has enough support in certain cases – focuses solely on its effect to improve punch force and frequency in an amateur boxing match. If they’re going after the fighting market, this makes sense, right? Sure, except that researchers used 1.5g dose… 4 times/day. Whoops. That’s 6 grams of beta-alanine to achieve the desired effect in the paper and somewhere between .75 and .95 grams in the supplement. (1.7 g in the blend minus .75 g of BCAA and leaving wiggle room for glutamine) I’m showing some serious self-control here, people. No f-bombs or anything signifying my outrage. (
The makers of T+ don’t bother listing any references for glutamine, but I found one from 2011. In this study, glutamine was responsible for attenuating muscle soreness and maintaining peak torque values during knee extension exercise after an exhaustive eccentric exercise bout. (Street) Great! So, how much did the researchers use? .3g/kg, or an average of about 25 grams per participant per day. LOL! I guess there isn’t that much in the Performo blend…
Wrap it up!
Okay, there is also a blend geared toward counter-acting estrogen, but I’m not going to go into that. For one, I don’t have the energy for it right now. The other reason being that estrogen isn’t the worst thing ever so I’m not sure blocking its creation is even a good thing – this is very situation/patient specific. So, I’m skipping that part of the supplement and I feel okay about it, since I think we learned enough about the product already.
To anyone who may want to try this product, I highly encourage you to get before and after blood tests done. First, your initial blood work might reveal that a product like this is unnecessary for you and second, you will know for sure what affects the product has on your actual hormone levels. Measure LH, FSH, T, Free T, SHBG and maybe prolactin. I use LabsMD.com to order blood work and have had nothing but good experiences thus far.
All-in-all, I don’t think this is a bad product – at least at its core. I think the psychological affects of increased libido and sexual interest as well as possible physiological effects, depending on your starting point, of raised testosterone and other hormonal effects are important and could benefit the end-user. But again, for majority of healthy men the rise in testosterone is unlikely based on the evidence. What bothers me most is the performance blend and it bothers me enough to turn me off to the product. If I were looking to boost T or to increase libido I would look at some of the active ingredients by themselves and choose the ones with the best evidence. This would most likely be much more cost effective as well.
As always, intelligent comments and questions (maybe even a critique) are always welcomed.
Bassil, N., Alkaade, S., & Morley, J. E. (2009). The benefits and risks of testosterone replacement therapy: a review. Therapeutics and clinical risk management, 5(3), 427–48. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2701485&tool=pmcentrez&rendertype=abstract
Cinar, V., Polat, Y., Baltaci, A. K., & Mogulkoc, R. (2011). Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biological trace element research, 140(1), 18–23. doi:10.1007/s12011-010-8676-3
Da Luz, C. R., Nicastro, H., Zanchi, N. E., Chaves, D. F., & Lancha, A. H. (2011). Potential therapeutic effects of branched-chain amino acids supplementation on resistance exercise-based muscle damage in humans. Journal of the International Society of Sports Nutrition, 8(1), 23. doi:10.1186/1550-2783-8-23
Donovan, T., et al., beta-alanine improves punch force and frequency in amateur boxers during a simulated contest.International journal of sport nutrition and exercise metabolism, 2012. 22(5): p. 331-7.
Ismail, S. B., Wan Mohammad, W. M. Z., George, A., Nik Hussain, N. H., Musthapa Kamal, Z. M., & Liske, E. (2012). Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in Men. Evidence-based complementary and alternative medicine : eCAM, 2012, 429268. doi:10.1155/2012/429268
Lopatkin, N., Sivkov, a, Walther, C., Schläfke, S., Medvedev, a, Avdeichuk, J., Golubev, G., et al. (2005). Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms–a placebo-controlled, double-blind, multicenter trial. World journal of urology, 23(2), 139–46. doi:10.1007/s00345-005-0501-9
Schöttner, M., Spiteller, G., & Gansser, D. (1998). Lignans interfering with 5 alpha-dihydrotestosterone binding to human sex hormone-binding globulin. Journal of natural products, 61(1), 119–21. doi:10.1021/np9701743
Shukla, K. K., Mahdi, A. A., Ahmad, M. K., Shankhwar, S. N., Rajender, S., & Jaiswar, S. P. (2009). Mucuna pruriens improves male fertility by its action on the hypothalamus-pituitary-gonadal axis. Fertility and sterility, 92(6), 1934–40. doi:10.1016/j.fertnstert.2008.09.045
Street, B., Byrne, C., & Eston, R. (2011). Glutamine Supplementation in Recovery From Eccentric Exercise Attenuates Strength Loss and Muscle Soreness. Journal of Exercise Science & Fitness, 9(2), 116–122. doi:10.1016/S1728-869X(12)60007-0
Tambi, M. I. B. M., Imran, M. K., & Henkel, R. R. (2012). Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia, 44 Suppl 1, 226–30. doi:10.1111/j.1439-0272.2011.01168.x
Topo, E., Soricelli, A., D’Aniello, A., Ronsini, S., & D’Aniello, G. (2009). The role and molecular mechanism of D-aspartic acid in the release and synthesis of LH and testosterone in humans and rats. Reproductive biology and endocrinology : RB&E, 7, 120. doi:10.1186/1477-7827-7-120
It is a frequent occurrence for many people losing weight to hit a weight loss plateau. They are losing fairly consistently for a few weeks or even a few months and then nothing. The number on the scale is no longer moving down. At first people will think, quite rationally, LOL, that the scale is broken or someone has messed with it. After the denial has pasted, there is usually some level of panic and confusion. All of this mental and emotional turmoil is really unnecessary because the cause of the plateau, i.e., lack of weight loss, is rather straight forward and well understood. Here is the magical, super-secret reason; the person is NO longer causing a discrepancy between how many calories their body burns and how many they eat. This means that you have to eat less calories and/or burn more calories by exercising more. I wish there was more to it, but that is really the crux of the problem. Because this is a common occurrence and because there are some silly ideas of why this is happening I will dive into some of the details.
As I mentioned above, to lose weight, you must burn more calories than you eat. However, as simple and true as that is, there are a few important variables that will determine how many calories your body will burn. I will not be going into all the variables that influence the intake side. Before proceeding into the fascinating world of BMR, TEE, NEAT, EPOC, and other acronyms, which I seem to have a strong affinity for, I need to dispel a common myth about weight loss plateaus. The MYTH goes something like this;
“I don’t know what is going on, but I have not lost any weight over the past 2 weeks, even though I was losing about 2 lbs a week for a few weeks” response from a friend or “expert” (MYTH) “you are not losing weight because you are not eating enough (usually referring to the number of calories eaten), and not eaten frequently enough*, 6 times a day, so to bust through the plateau, you need to eat MORE (increase your calories) and more often”
This somewhat pervasive response is wrong, false, incorrect, not helpful, illogical and; well you get the point. The following will show why it is so.
I read a good paper this weekend, I know you’re jealous (I think I might need to start wearing brightly colored mismatch clothes). Anyway, the paper is; Time to abandon the notion of personal choice in dietary counseling for obesity? (Appelhans et al). The basic premise is that people who struggle with maintaining a healthy weight are not lazy or weak willed. But rather, are strongly influenced by forces, biological and environmental, that they are often unaware of. These factors influence behaviors in a way that makes it very difficult to achieve a healthy weight. Therefore, just telling someone to eat less, exercise more, even with specifics attached (i.e., 30 grams protein per meal, exercise for 30 min, 3 times a week, at 70% of MHR, etc), is likely not enough to overcome these other mitigating factors.
The paper covers three particular areas;
At this time I am not going to go into detail on each of these. In fact, I would recommend reading the paper, as the authors did a good job of summarizing the research on these topics.
What I think is important is the understanding, or realization that there are many things that can influence eating and exercise behaviors (actually ALL behaviors). Additionally, these tend to influence us on the unconscious level, so we are not aware of their influence while it is happening. This obviously makes it hard to modify their impact while it is happening. However, there is hope. There are strategies that can be utilized during a time when your conscious/rational mind (often referred to as System 2; see Kahneman) is in control.
This gets me thinking about a great book that came out a few years ago. I think it starts with an S….Oh ya, I got it now, its called SPEED! I hate to be so self-promoting (well actually I don’t hate it, but it always feels a little weird talking about yourself), but Matt and I really did tackle the weight loss thing in a way that virtually nobody else was. We didn’t do this to be different, but rather because the evidence was clear to us that there are many things besides “low carb vs high carb” or “weight training vs cardio” or any of the many other dietary or exercise variables that are often discussed ad nauseum (To be clear, there are aspects within these components of weight management that ARE important, however, an excessive focus on them will result in an oversight of other equally or possibly more important aspects of weight management) . We felt there was a need to view the weight management thing in the context of the Bio-Psycho-Social model of behavior. There are a number of researchers that stress this view as well (see Dr. Guyenet for some good posts about it). However, this approach is usually not taken in the popular press. Well, until SPEED (ooops I did it again). This is probably due to the fact that this view acknowledges that weight management is actually very complex (see this post for a bit more on that) and does not lend itself easily to simple solutions or catchy sound bites.
To conclude, weight management is actually a rather complex situation which is heavily influenced by factors functioning below our conscious awareness. This does not mean it is hopeless. There are things that can be done that will help a person minimize the influence of these unconscious aspects of behavior. I think there is a good book call SPEED that discusses many of them
Appelhans, B. et al (2011). Time to abandon the notion of personal choice in dietary counseling for obesity? J Am Diet Assoc; 111(8): 1130-1136.
Kahneman, D. (2011). Thinking, Fast and Slow. New York. Farrar, Straus and Giroux.
Functional training along with core/stability training are common buzz words in the personal training/fitness industry. Regrettably, like many things in this industry (do I sound jaded?), it sounds good but how it is usually applied is silly. Additionally, there is a lack of quality evidence for much of what is said regarding these aspects of training. I am not going to dive into the research at this time. However, I do strongly encourage any trainer or exercise professional to read the research (see below for my recommended readings) before you have people perform circus tricks. My main point is that for the majority of people who want to look and feel better (most people really want the looking better part, which usually means losing a good amount of fat, and will take the feeling better part if it comes along with the first part), there is no physiological need to stand on a BOSU ball or any other unstable surface in order to lose fat and/or function better in daily life. For a nice short piece on the subject click here.
What spurred me to write this short post is the following video that Matt had found recently. We found it very amusing. I thought I would pass it along.
Papers I found interesting regarding functional/core/stability stuff:
SEARCHING FOR STABILITY: The efficacy of unstable training – Posted by Steve Magness @ http://www.scienceofrunning.com
Zech et al (2010). Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review. J Athletic Training; 45(4):392–403
Behm, et al (2010). CSEP-Position Stand: The use of instability training to train the core in athletic and non-athletic conditioning. Appl Physiol Nutr Metab
Lederman (2010). The myth of core stability. J Bodywork Movement Therapies
Nuzzo et al (2008). TRUNK MUSCLE ACTIVITY DURING STABILITY BALL AND FREE WEIGHT EXERCISES. J Strength Conditioning
Fisher et al (2011). Evidence-based resistance training recommendations. Med Sport 15 (3): 147-162,
5 Hour Energy supplement seems to be a very hot item. But why? Does it have a bunch of nutrients in it that gives you more energy? NO! Is it cheap? NO! It does, however, only have 4 calories and is in a small bottle. And lets not forget the shit load of advertising for it. When it is looked at objectively it is really just an over-priced caffeine and B-vitamin supplement.
The ONLY ingredient in this supplement that will actually contribute to an increase in the feeling of alertness/energy is CAFFEINE. Caffeine has many potential benefits as well as a few potential negative effects. Overall, caffeine, when used intelligently, can be very safe and effective. So why not just go to the source? Why not use pure caffeine? It is far cheaper and even more portable than 5 Hour Energy. For example, a 90 caplet bottle of Jet-Alert from Wal-Mar only costs about $3.80. One bottle of 5 Hour Energy likely has about 100mg of caffeine (the exact amount is not given). Each bottle costs about $2 (only if you buy multiple bottles at a time). Therefore, one bottle of Jet Alert would equate to about 180 bottles of 5 Hour Energy or $360. So you could spend about $4 to get the same amount of “energy” as 180 bottles of 5 Hour Energy which would set you back about $360. WOW!
Now some people will say, “Hey, what about the B-vitamins?”. What about them? There is no evidence that supplementing with high doses of B-vitamins (relative to the RDA), in this case B12, B6, Niacin and Folic acid, will lead to higher levels of energy. But let’s say they would help; why not take a B-complex supplement? You could easily get ALL of the B-vitamins in a high dose for about 10 cents a day.
5 Hour Energy, like most supplements, is more hype than substance. Why not go to the source? Get some caffeine pills, a bottle of B-vitamins, and save yourself a bunch of money!
I do want to point out that caffeine is not a panacea for low-energy problems. There can be real medical problems causing your fatigue. There is also the very high likelihood that you are NOT getting enough quality sleep. Keep this in mind if you feel that your energy levels are always low and not the result of a bad nights sleep.
We’ve reviewed many popular weight loss supplements and, unfortunately, most of them are complete bullshit. So in order to help you out we put together this (short) list of supplements that really help with weight loss. Most of this is an excerpt from our book, SPEED, where we originally made the recommendations. So you’re aware, we do not get paid to endorse any supplements. NONE.