Tag Archives: Caffeine

Good to the Last Drop

by Jose Antonio PhD FISSN FNSCA.  There’s some silly shit (albeit funny) you can find on coffee cartoonFacebook.  One of the more common themes are health-conscious individuals who are going on their latest ‘detox’ kick.  Now this article isn’t going to beat the proverbial crap out of ‘detoxing’ (even though there’s plenty to beat up on).  Hint:  it’s why we have a liver and kidneys.  What’s funny/ironic/inane/vapid (you get my drift) is that for many of these individuals, they will stop drinking coffee because as we all know, coffee is bad bad bad; you know, that whole detox thing.  To show you how I feel about that, I quote Ebenezer Scrooge (“A Christmas Carol”): Bah Humbug.

Now how do I know refraining from coffee is absurd, particularly from the standpoint of health?  Or to rephrase, how would YOU come up with reasonable and well-thought out conclusions regarding coffee or anything nutrition-related thing for that matter?  Voodoo?  The Magic of David Copperfield?  Witchcraft?  Bro-Science? Schmo-Science? My-Momma-Told-Me-So? Because you saw it on Pinterest?

If you answered yes to any of the above, you’re a complete moron.  If the folks who ‘detoxed’ by not drinking coffee bothered to get at least semi-educated on the science of coffee, then perhaps they wouldn’t be hoodwinked by the nonsense that pervades the internet.  Yes, there is a plethora of science to show that coffee drinking is pretty damn good for you.caffeine

Now before you think I make this stuff up, here’s some food for thought.  Or better yet, facts to chew on.  It’s in bullet point form for those of you with the attention span of a mosquito.

  1. Both caffeine (5 mg/kg/BW) and coffee (5 mg/kg/BW) consumed 1 h prior to exercise can improve endurance exercise performance.(1)
  2. Coffee treatment attenuated the decrease in the muscle weight and grip strength, increased the regenerating capacity of injured muscles, and decreased the serum pro-inflammatory mediator levels compared to controls.(2)
  3. Coffee treatment had a beneficial effect on age-related sarcopenia.(2)
  4. Increasing coffee consumption over a 4 year period is associated with a lower risk of type 2 diabetes, while decreasing coffee consumption is associated with a higher risk of type 2 diabetes in subsequent years.(3)
  5. Coffee consumption may be protective against periodontal bone loss in adult men.(4)
  6. Coffee consumption is associated with a reduced risk of total mortality.(5)
  7. Daily coffee consumption may reduce the risk of gastric cancer in high-risk populations, especially among women.(6)
  8. In patients with chronic liver disease, daily coffee consumption should be encouraged.(7)
  9. Coffee consumption has been associated with a lower risk of type 2 diabetes.(8)
  10. This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.(9)
  11. Both caffeinated and decaffeinated coffee may be protective against deterioration of glucose tolerance.(10)
  12. We found no statistically significant association between coffee consumption and the risk of overall, advanced, or fatal prostate cancer.(11)
  13. In this large prospective study, caffeinated coffee intake was inversely associated with oral/pharyngeal cancer mortality.(12)
  14. Coffee may reduce both motor and cognitive deficits in aging.(13)
  15. These results from three large cohorts support an association between caffeine consumption and lower risk of suicide.(14)

Take Home Message – The question that YOU need to ask yourself is this.  What is the compelling reason to NOT consume coffee?  Okay, to some it tastes like mud. But hey, put some cream and sugar in it, and that’ll make it dance on your taste buds.  Or the other reason might be this: “I really don’t want to be healthier.”  I’ve heard sillier things.caffeinated_cities_small

Can you drink too much?  Well of course you can.  There are rare cases of folks overdosing on caffeine (not coffee).  But just to give you an example of how difficult it is to overdose on caffeine, here are some numbers for you.

  • One guy ingested 24 grams in a suicide attempt; he suffered complications of severe rhabdomyolysis and acute renal failure requiring subsequent hemodialysis.(15)
  • Another guy died after consuming 12 grams.(16)
  • A woman went into cardiac arrest after a 10 gram dose.(17)

Now if we stick to the 10 gram dose as being ‘too much,’ heck that’s equal to 100 cups of coffee!  Even the most maniacal coffee addicts that I know of aren’t that crazy!

Bottom line:  drink coffee.  It does the body good.


1.            Hodgson AB, Randell RK, Jeukendrup AE. The metabolic and performance effects of caffeine compared to coffee during endurance exercise. PLoS One 2013;8(4):e59561.

2.            Guo Y, Niu K, Okazaki T, Wu H, Yoshikawa T, Ohrui T, et al. Coffee treatment prevents the progression of sarcopenia in aged mice in vivo and in vitro. Exp Gerontol 2014;50:1-8.

3.            Bhupathiraju SN, Pan A, Manson JE, Willett WC, van Dam RM, Hu FB. Changes in coffee intake and subsequent risk of type 2 diabetes: three large cohorts of US men and women. Diabetologia 2014.

4.            Ng N, Kaye EK, Garcia RI. Coffee Consumption and Periodontal Disease in Men. J Periodontol 2013.

5.            Je Y, Giovannucci E. Coffee consumption and total mortality: a meta-analysis of twenty prospective cohort studies. Br J Nutr 2014;111(7):1162-73.

6.            Ainslie-Waldman CE, Koh WP, Jin A, Yeoh KG, Zhu F, Wang R, et al. Coffee intake and gastric cancer risk: the singapore chinese health study. Cancer Epidemiol Biomarkers Prev 2014;23(4):638-47.

7.            Saab S, Mallam D, Cox GA, 2nd, Tong MJ. Impact of coffee on liver diseases: a systematic review. Liver Int 2014;34(4):495-504.

8.            Natella F, Scaccini C. Role of coffee in modulation of diabetes risk. Nutr Rev 2012;70(4):207-17.

9.            Choi EJ, Kim KH, Koh YJ, Lee JS, Lee DR, Park SM. Coffee consumption and bone mineral density in korean premenopausal women. Korean J Fam Med 2014;35(1):11-8.

10.         Ohnaka K, Ikeda M, Maki T, Okada T, Shimazoe T, Adachi M, et al. Effects of 16-week consumption of caffeinated and decaffeinated instant coffee on glucose metabolism in a randomized controlled trial. J Nutr Metab 2012;2012:207426.

11.         Bosire C, Stampfer MJ, Subar AF, Wilson KM, Park Y, Sinha R. Coffee consumption and the risk of overall and fatal prostate cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control 2013;24(8):1527-34.

12.         Hildebrand JS, Patel AV, McCullough ML, Gaudet MM, Chen AY, Hayes RB, et al. Coffee, tea, and fatal oral/pharyngeal cancer in a large prospective US cohort. Am J Epidemiol 2013;177(1):50-8.

13.         Shukitt-Hale B, Miller MG, Chu YF, Lyle BJ, Joseph JA. Coffee, but not caffeine, has positive effects on cognition and psychomotor behavior in aging. Age (Dordr) 2013;35(6):2183-92.

14.         Lucas M, O’Reilly EJ, Pan A, Mirzaei F, Willett WC, Okereke OI, et al. Coffee, caffeine, and risk of completed suicide: Results from three prospective cohorts of American adults. World J Biol Psychiatry 2013.

15.         Campana C, Griffin PL, Simon EL. Caffeine overdose resulting in severe rhabdomyolysis and acute renal failure. Am J Emerg Med 2014;32(1):111 e3-4.

16.         Jabbar SB, Hanly MG. Fatal caffeine overdose: a case report and review of literature. Am J Forensic Med Pathol 2013;34(4):321-4.

17.         Rudolph T, Knudsen K. A case of fatal caffeine poisoning. Acta Anaesthesiol Scand 2010;54(4):521-3.


An Ode to Nutrient Timing


By Jose Antonio PhD FISSN FNSCA CSCS.  A few weeks back, one of my students asked me about a recent meta-analysis published in the Journal of the International Society of Sports Nutrition.  It was a well-written piece authored primarily by Brad Schoenfeld who is perhaps better known for his Lookgreatnaked.com website.  I mean who wouldn’t want to look frickin’ great naked, right?  Like the old Seinfeld comedy TV show demonstrated so poignantly, there’s ‘good naked’ and ‘bad naked.’  I’m a big fan of ‘good naked.’  Anyhow, the student posited the following:  “I read that nutrient timing doesn’t work according to that study published in the JISSN.”  JISSN is aka the Journal of the International Society of Sports Nutrition.  It’s an awesome scientific journal.  Besides, I’m the Editor in Chief.  And that’s reason enough to read it. :-)  Anyhow, getting back to my student’s query.  So much to learn, so little time.  Without delving into the minutae of different types of studies, I replied “that was a meta-analysis, not an original investigation.”  Mainstream journalists don’t realize that a meta-analysis does not provide new data.  It is merely a statistical analysis of existing data.  This is a huge difference.  The gold standard of scientific inquriy is the randomized controlled trial.   Either way.  This Millennial generation seems to believe everything they read; until of course they read something contrary.  No wonder they can’t make up their minds.

Bruce Lee says, "Timing is everything.  Especially when kicking someone's ass."

Bruce Lee says, “Timing is everything. Especially when kicking someone’s ass.”

So what gives?  What’s the devil in the details?  First, to summarize that meta-analysis, it stated in essence: “These results refute the commonly held belief that the timing of protein intake in and around a training session is critical to muscular adaptations and indicate that consuming adequate protein in combination with resistance exercise is the key factor for maximizing muscle protein accretion.[1]  In English, that means that protein timing is of no benefit and that the key factor is total protein intake.  Interestingly, in their Discussion, it is also stated that they “must acknowledge the possibility that protein timing was in fact responsible for producing a positive effect and that the associated increase in protein intake is merely coincidental.”  It makes sense that both timing and total protein intake are important.

Take the hypothetical scenario of a 180 pound man who consumes 180 grams of protein daily (to meet his athletic needs etc).  Would consuming all 180 grams at breakfast be as effective as spreading it out over 6 meals (30 grams every 3 hours)?  Uh hell no. What fool would eat like that? So when you eat (i.e. timing) is a critical factor.

Please note the distinction between protein timing with the sole purpose of promoting skeletal muscle hypertrophy and nutrient timing, which encompasses a variety of strategies that are related to performance and recovery.  I’ll get to what constitutes nutrient timing later.  But first let me shed some light on the issue of protein timing specifically.nutrient timing photo

In reality, there are only two studies, using resistance-trained subjects, whose protein intake was sufficiently high (1.8-1.9 g per kg per day) and matched, that employed a ‘protein timing’ strategy.  Please note however that most studies, for reasons that are too detailed to be covered here, typically compared protein to carbohydrate.  Those studies are quite important for historical reasons.  One day I’ll explain why over some beer and sushi.

Nevertheless, these two ‘protein timing’ studies were done by Paul Cribb PhD FISSN and Jay Hoffman PhD FISSN, respectively.  These were ‘apples to apples’ comparisons.  Not aardvark to orangutan comparisons (which in reality is most of what is called ‘protein timing’).  The Cribb study did indeed show a significant effect of immediate PRE and POST training supplementation working quite well (i.e. increased lean body mass and type IIA and IIX muscle fiber cross-sectional areas) in comparison to a Morning and Evening consumption strategy.  So in this case, timing matters.  Dr. Cribb concluded that “supplement timing represents a simple but effective strategy that enhances the adaptations desired from RE-training.[2]”  On the other hand, Dr. Hoffman basically replicated this study design and found that the “time of protein-supplement ingestion in resistance-trained athletes during a 10-wk training program does not provide any added benefit to strength, power, or body-composition changes.[3]”  So it either helps or has no effect, right? If you answered yes, you get 5 extra credit points on your final exam.

A simple maxim that I teach my students to follow vis a vis sports nutrition strategies is as follows:  “If it helps or has a neutral effect, try it.” Or better yet, do it.  So if you go beyond the mere dotting of i’s and crossing of t’s, you’d ask yourself the following questions.  1)  Is there any advantage to NOT utilizing a protein timing strategy?  Answer: No.  2) Is there a potential benefit to using a protein timing strategy? If you answered ‘yes,’ then go to the head of the class.  There is no downside to protein timing as a strategy.  In fact, take the common scenario of eating every three hours.  Let’s say meal 1, 2, and 3 are at 6am, 9am and 12noon.  Then you train at 3pm-4pm.  Wouldn’t it make sense to consume a protein-containing meal immediately after training?  That would make your fourth meal of the day consumed at 4pm.  Not quite every three hours.  However imagine waiting four hours post-training?  Why on Earth would anyone do that?  Hence, follow my advice and consume your meal immediately post-training at 4pm.  Then eat your regular dinner (i.e. meal #5) around 6-7pm.  Then around 9-10pm, have another small casein-based protein meal.

To give the ‘advice’ that it is useless or ineffective is a bit of an untruth (that’s Washington DC political-speak if you get my drift).  Even if something is marginally helpful, it is still helpful.  If one’s goal is to promote muscle hypertrophy, why wouldn’t you employ every possible tactic to get to your goal?  From a purely pragmatic standpoint, you should employ protein timing.

Now getting back to ‘nutrient timing.’   Folks have summarily dismissed nutrient timing because of their confusion with protein timing as it relates to skeletal muscle hypertrophy.  Nutrient timing is a very effective strategy.  To wit:

Consuming caffeine (in the form of a chewing gum) enhances cycling performance when administered immediately prior to, but not 1 or 2 hours before cycling.[4]

A 20 gram bolus of whey protein consumed every three hours is superior to other temporal patterns of feeding for the purpose of stimulating muscle protein synthesis and thus “has the potential to maximize outcomes of resistance training for attaining peak muscle mass.[5]”whey-protein-drinks-06

Consuming a sports drink 30 minutes before exercise improved performance better than consuming it 120 minutes prior. “This study provides new evidence to suggest that timing of carbohydrate intake is important in short duration high-intensity exercise tasks, but a concentration effect requires further exploration.[6]”  Certainly, it is well known that consuming a sports drink during exercise is better than drinking water. Thus, a “carbohydrate-electrolyte drink can increase endurance performance as well as enhance lactate removal and thereby delaying the onset of fatigue.[7]”

Another study showed that casein “protein ingested immediately before sleep is effectively digested and absorbed, thereby stimulating muscle protein synthesis and improving whole-body protein balance during postexercise overnight recovery.[8]”

In overweight individuals, shifting more of your calories towards breakfast versus later in the day is better for weight loss.[9]

Heck, common sense tells you that drinking water during a half-marathon run in the heat is better for performance than drinking after the run.  That’s a simple example of nutrient timing.

Thus, it is virtually impossible to escape the fact that nutrient timing plays an important role in many circumstances vis a vis the acute and chronic response to exercise.

I’d posit that not eating is the worst thing you can do.  Let’s face, there is nothing anabolic about not eating for 4 hours after training.  When in doubt, consume a protein-containing meal.  A meal doesn’t have to be a Thanksgiving-size portion.  A protein shake of 200 kcals or so constitutes a meal.  In essence, nutrient timing incorporates the use of methodical planning and eating of whole foods, beverages and supplements with the express purpose of enhancing recovery, performance, or body composition.[10]

One last note.  Science often reminds me of the tale of the six blind men and the elephant.  The tale goes like this.  One blind man feels the trunk and says it’s a snake.  Another touches the tail and says it’s a rope.  Another touches the legs and says it’s a tree. Another touches the ear and says it’s a fan.  Another touches the side of the animal and says it’s a wall.  While another grabs the tusks and says it’s a spear.  All of them are right…and wrong.  Don’t lose sight of the forest for the trees.

Our field is ultimately one governed by pragmatism.  Having done quite a bit of basic science (animal work particularly) research in my day, I can attest to its importance in understanding the underlying mechanisms that govern why things work the way they do.  However, our field is, when you get down to the nuts and bolts of it, an advice-driven one.  As scientists, we can argue over crossing t’s and dotting i’s, but in the end, we have to give the best advice we know based on the current data of the time.

If it helps or has a neutral effect, do it.


1.           Schoenfeld BJ, Aragon AA, Krieger JW: The effect of protein timing on muscle strength and hypertrophy: a meta-analysis. J Int Soc Sports Nutr 2013, 10:53.

2.           Cribb PJ, Hayes A: Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exerc 2006, 38:1918-1925.

3.           Hoffman JR, Ratamess NA, Tranchina CP, Rashti SL, Kang J, Faigenbaum AD: Effect of protein-supplement timing on strength, power, and body-composition changes in resistance-trained men. Int J Sport Nutr Exerc Metab 2009, 19:172-185.

4.           Ryan EJ, Kim CH, Fickes EJ, Williamson M, Muller MD, Barkley JE, Gunstad J, Glickman EL: Caffeine gum and cycling performance: a timing study. J Strength Cond Res 2013, 27:259-264.

5.           Areta JL, Burke LM, Ross ML, Camera DM, West DW, Broad EM, Jeacocke NA, Moore DR, Stellingwerff T, Phillips SM, et al: Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. J Physiol 2013, 591:2319-2331.

6.           Galloway SD, Lott MJ, Toulouse LC: Pre-Exercise Carbohydrate Feeding and High-Intensity Exercise Capacity: Effects of Timing of Intake and Carbohydrate Concentration. Int J Sport Nutr Exerc Metab 2013.

7.           Khanna GL, Manna I: Supplementary effect of carbohydrate-electrolyte drink on sports performance, lactate removal & cardiovascular response of athletes. Indian J Med Res 2005, 121:665-669.

8.           Res PT, Groen B, Pennings B, Beelen M, Wallis GA, Gijsen AP, Senden JM, LJ VANL: Protein ingestion before sleep improves postexercise overnight recovery. Med Sci Sports Exerc 2012, 44:1560-1569.

9.           Jakubowicz D, Barnea M, Wainstein J, Froy O: High Caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity (Silver Spring) 2013, 21:2504-2512.

10.         Kerksick C, Harvey T, Stout J, Campbell B, Wilborn C, Kreider R, Kalman D, Ziegenfuss T, Lopez H, Landis J, et al: International Society of Sports Nutrition position stand: nutrient timing. J Int Soc Sports Nutr 2008, 5:17.

About the Author – Jose Antonio is the CEO and Co-founder of the International Society of Sports Nutrition and the Editor-in-Chief of the JISSN (www.jissn.com).  Check out the latest ISSN Conferences at www.theissn.org. If you’re ever in South Florida, he’d be happy to take you outrigger paddling.




Interview with Stacy Sims PhD CISSN

SNI:  From the standpoint of rehydration, is there an ideal percentage of carbohydrate that is needed when consuming fluids?  Is there a combination of carbohydrates that is ideal?HE_sports-drinks_s4x3_lead
Stacy: In my experience working with athletes, they are so focused on calories that they don’t pay attention to the fact that what they are drinking contributes to FUELING, not HYDRATION.

Let me explain.

In science speak: During prolonged exercise, fluid and salt losses through sweating reduce plasma volume which leads to heart rate drift in association with hyperthermia and reductions in performance. Oral rehydration with water reduces the loss of plasma volume and lessens heart rate drift and hyperthermia. Moreover, the inclusion of sodium in the rehydration solution to levels that double those in sweat (i.e., around 90 mmol/l Na+) restores plasma volume when ingested during exercise, and expands plasma volume if ingested pre-exercise.

In real person speak: During exercise you lose water and salt through sweat. When you lose this water and salt, the watery part of your blood also drops. With less water in your blood, the blood is more viscous, thus you end up with a higher heart rate, lower power production, and a greater rise in core temperature->all leading to fatigue, reduced performance, and the dreaded power decline when it counts the most: at the end of a race.

There is a competition within the body when you start to exercise: Your muscles and your skin fight for your blood. Blood goes to the muscles for metabolic function. Blood goes to the skin to get rid of the heat produced by the working muscles. As body water drops, this competition becomes more fierce, and the skin blood flow will win out- Primarily because heat is a greater threat to the body than keeping the muscles working (which produces heat..).

The fatigue you experience is that drop in blood flow to the muscle- basically you have less metabolism functioning plus protein denaturing (the contractile proteins denature, aka stop working, in muscle temperatures >~39’C).

“Ok” you say, “But I’m drinking so I should be able to circumvent this blood volume problem.”

BUT here is where things go south. It’s what you’re drinking that’s making you dehydrated.

The mass market out there has the message that when you drink a 4-8% carbohydrate solution with sodium (~220mg sodium per liter) you are taking care of your hydration and fueling needs. The focus is always on carbohydrate availability and calories. (If you do a literature search on  hydration and carbohydrate for endurance exercise you will find the hydration research is really carbohydrate availability in the form of liquid calories.)

I’m here to tell you, as a physiologist that specializes in hydration, thermoregulation, and performance; this is a misleading and incorrect message.

Let’s look at two key factors needed to pull fluid into the body’s fluid spaces:
1) You need what you are drinking to have an osmolality below that of blood. (osmolality is the amount of solutes in a solution. The more active solutes in a fluid, the higher the osmolality. Blood sits ~285mOsm)
2) You want what you are drinking to meet the physiological needs of fluid absorption- this means that you want your fluid to have fluid co-transporters: the intestinal cell membranes use sucrose, glucose, and sodium (Na+) as facilitators to get fluid across the cells into the water spaces of the body.

Now let’s look at the nutritional aspects of a typical sports drink:
– 5-6% carbohydrate solution
– Osmolality of ~300-320mOsm
– Sugars: maltodextrin, fructose, sucrose
– Sodium: ~220mg per liter

With the higher osmolality than blood, the physiological response is to pull water from within the vascular spaces of the body to “dilute” higher osmolality. This creates a net gradient of water leaving the body into the digestive system. Problem: effective dehydration and GI distress.

The 5-6% solution provides exogenous carbohydrate but not in the levels needed to sustain longer term endurance exercise without energy fluctuations (you want 4-6 calories per pound of body weight of mixed macronutrient food- different rates of oxidation/breakdown means a greater time and titration of fuel to the body)

The maltodextrin and fructose are notorious for causing GI distress; free fructose (e.g. not from sucrose) has to go through the hepatic portal vein to the liver to be processed, and no rate limiting effect for this free fructose  will cause a “dumping” of fructose into the system,  leading to major GI distress. Maltodextrin exits the stomach quickly, but in the intestines, pulls water into the digestive tract =  GI distress (aka diarrhea!)

Sodium and sucrose- these are the only two potential “helpers” in fluid absorption, BUT by the nature of the osmolality of the 5-6% solution, the net gradient of fluid is to come from within the body into the gut, thus the sodium and sucrose work with this gradient to facilitate fluid movement through the intestinal cell membranes into the GI tract.

SNI: Should protein be in a rehydration drink? Yes, No, Maybe so?

Stacy: Post exercise is a key window for several things; primarily being maximum effect on muscle synthesis and glycogen recovery. The “critical” window for high quality protein intake is the 30 min post exercise; this is also part of the critical rehydration window- start rehydrating to decrease the negative effects on the immune system. I’m bending towards the question in a roundabout way to say Yes, protein is beneficial for rehydration just as it is essential for muscle reparation and synthesis. A small inclusion of protein in a low carbohydrate-concentration rehydration drink does facilitate plasma volume expansion, increases absorption of electrolytes and boosts levels of plasma proteins, which promote long term hydration after exercise. Keep in mind, however, rehydration post-exercise is different from rehydration from a long day at work, not drinking. The protein promotes muscle reparation, but also adds calories. Being cognate in the timing of your nutrients becomes critical for recovery and body composition changes.

SNI: What are your thoughts on caffeine?  It is commonly held that caffeine is a dehydrating agent.  What’s the science say?

Stacy: Ah, “Black Gold”… Caffeine is a great addition to any endurance athlete’s arsenal for performance. There are three ways caffeine may provide ergogenic effects. First, the central nervous system is directly stimulated by caffeine (blocking receptors for adenosine and increasing plasma catecholamines), which helps reduce the sensation of fatigue, increases alertness, and increases muscle recruitment. Second, caffeine has been shown to improve endurance through the increased utilization of fat as a fuel and sparing carbohydrate utilization (a.k.a glycogen sparing effect); and most recently, it has been demonstrated that caffeine increases the calcium content of skeletal muscle, thus enhancing the strength of muscle contraction. Caffeine & Hydration –  Staying hydrated, while important for humans at all levels of activity, is especially important for athletes during vigorous exercise. Historically, athletes have been advised against consuming caffeine because of caffeine’s mild diuretic effect.  However, a point often missed is that any fluid, caffeine-coffee-beansincluding water, will also have a mild diuretic effect. In a review of hydration and caffeinated beverages, Lawrence Armstrong, PhD concluded that “it is unlikely that athletes and recreational enthusiasts will incur detrimental fluid-electrolyte imbalances if they consume caffeinated beverages in moderation and eat a well-balanced diet.” Contrary to popular belief, research has shown that caffeinated beverages can and do contribute to hydration.


SNI: For the endurance athlete who just ran, cycled or swam for 2 hours, what would YOU suggest they consume immediately post workout to promote fluid balance, glycogen repletion and skeletal muscle recovery? Do you have a ‘Stacy Sims recovery’ cocktail?

Stacy: There are two options here, one is nonfat greek yogurt with manuka honey within 30 min post exercise to address the nutritional needs of the muscle (yogurt is great for whey and casein, potassium, sodium, calcium, magnesium; manuka honey provides a bit of extra carbohydrate with natural immune boosting properties), then over the course of 2 hours, slowly rehydrate with a 1.5% glucose-sucrose solution with 200mg potassium and 100mg sodium per 16oz at a rate of 0.15oz per pound of body weight per hour.  The second option (and my “go-to”) is OsmoNutrition’s Acute Recovery. It is an organic, high quality (no hormones, non-GMO) protein recovery drink. It is unique as well as it doesn’t have any antioxidants in it and it has a wee bit of green tea extract for caffeine. As much hype as there is around antioxidants, you really don’t want them close to the end of exercise as antioxidants impede mitochondrial adaptations to endurance exercise stress. And the wee bit of caffeine helps facilitate glycogen repletion ~66% over protein+carbohydrate alone. In addition to this drink (again within 30 min post exercise), I recommend the same dosage of the 1.5% solution per above. Trying to cover both nutritional needs of the body with rehydration needs requires the separation of food and fluid.. Post exercise the first point to cover is protein and carbohydrate; the second aspect to cover is total fluid recovery. The window for muscle recovery is much smaller than fluid recovery; thus pay attention to the acute recovery needs first to maximize the adaptations induced from the exercise stress.
SNI: What do YOU personally consume pre, during and post-workout?

Stacy: Ah! I’m not training much right now as work and my new daughter take most of my time; but when I do head out, I usually have the pre covered by my most recent meal, during I use Osmo Active hydration with real food (I tend to like homemade protein bites or power cookies…) and post exercise, Osmo Acute recovery. 

SNI: What athlete do you admire the most and why?

Stacy: There are so many great role models and inspirational women out there, including some of my own clients; but I’m going to pull a name out of the past: Gabrielle Reece. She was my role model when I first discovered competitive sport and I still admire her for everything she has accomplished. Not only is she a world class athlete, she is a strong role model for athletic, career driven moms- not a super woman, but close enough!

BIO: Dr. Stacy Sims, MSc, PhD

Exercise Physiologist-Nutrition Scientist, CISSN
CRO-Research Scientist
Osmo Nutrition

Stacy served as an exercise physiologist and nutrition scientist at Stanford University from 2007-2012 where she worked as an environmental exercise physiologist and nutrition scientist specializing in recovery, and nutritional adaptations for health, body composition, and maximizing performance. During the past decade Stacy has worked as an environmental physiologist and nutrition specialist for top professional cyclists, ultraswimmer Jamie Patrick, the Garmin/Slipstream Pro Cycling Team, USA Cycling Olympic Team (BMX and women’s track cycling), Team Tibco, Flying Lizard Motorsports, and Team Leopard-Trek, among others. Stacy earned a BA from Purdue University, an MSc from Springfield College, a doctorate from University of Otago, and was a postdoctoral research fellow in cardiovascular disease prevention, thermoregulation, and women’s health at Stanford University. Stacy raced crew as an undergraduate at Purdue University, raced Ironman at an elite level in the early 2000s but now competes as a Cat 1 road cyclist and an elite XTerra triathlete.

Energy Drink Dumba$$es

By Jose Antonio PhD FISSN, FNSCA, CSCS.  There are some things that are just annoying.  Stepping on chewing gum.   Emails from Nigeria asking for $1,000 so they can transfer a $1,000,000 to your bank (Really?  What dope falls for this?).  Hitting every red light as you make your way home.  Celebrity confessions.  Having to actually watch a TV show with the commercials (thank god for TiVo!).  And reading the numbskull articles written by the mainstream press on pretty much all things related to sports nutrition.  Runner’s World, a magazine that I actually enjoy reading (yeah, don’t tell anyone), posted on their website an article entitled “Sports Nutrition Group Doubts Claims of Energy Drink Makers.” http://www.runnersworld.com/drinks-hydration/sport-nutrition-group-doubts-claims-energy-drink-makers  I’m thinking; hey, I wonder who that group is.  Inquiring minds need to know.  And guess what, it’s the International Society of Sports Nutrition!  The ISSN is the leading academic society that studies sports nutrition and supplements and I’m the head honcho.  I’ll at least give Runner’s World credit for citing the Position Paper that we recently published.  But that’s pretty much where the credit ends.

The Runner’s World interpretation of our article is so wrong.  Why?  Because my colleagues and I wrote the dang thing.  I think we’d know BETTER than anyone what the correct interpretation is!  To wit:  Here’s the headline – “Sports Nutrition Group Doubts the Claims of Energy Drink Makers.”  Uh no.  In fact, if you read #3 of the Position Paper’s abstract it says the following:  “Consuming ED 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance.”  That my friends is THE most important point.  The drinks work!  We can argue over the why and whether it’s the ingredients or combination thereof, but the bottom line is that as an ergogenic aid, the stuff will help you perform better.

And then we have the Dawn Report which states that the number of emergency room visits involving energy drinks has increased.  The implication is that energy drinks must be hurting thousands of people, right?  Well as they say in Alabama, shitfire Bubba, that ain’t no proof!

http://www.samhsa.gov/data/2k13/DAWN126/sr126-energy-drinks-use.htm Since when did emergency room visits become a substitute for scientific studies?  Did I miss something in my years of studying the frickin’ scientific method?  To fall for the moronic trap that sensational headlines are a substitute for honest-to-goodness critical thinking would be like judging a fish by its ability to climb trees.  As I tell my super-smart students at Nova Southeastern University in beautiful South Florida, read the data.  Read the science.  Whenever you see headlines such as this, instead of believing it hook, line and sinker, instead immerse yourself in the actual studies and decide for yourself.  Because one day you’ll write a scientific paper and then some journalist with about as much science training as your pet Beagle will tell you how it should be interpreted.  Ok enough of this.  Time to consume copious quantities of caffeine-filled java.

Reference: The 2013 International Society of Sports Nutrition position stand: energy drinks http://www.jissn.com/content/10/1/1



Surviving An Ultra

By Michelle Adams M.P.H., CISSN, CSCS, IFBB Pro.

Ultra- endurance events are defined as any event longer than a marathon (26.2 miles or 42.16km).  These events are a challenge to every aspect of the human body.  Preparation for such an event is undoubtedly a demanding process.  Months of training logging hundreds of miles in preparation for one 30 or 50 mile race will simply NOT happen, or at least not SUCCESSFULLY happen, without a carefully laid out nutrition and supplementation plan.  Most people know the basics of nutrition as far as macronutrients go: carbohydrate (CHO), protein (PRO), fat, and water. Unfortunately, that is usually where the knowledge stops. Often times runners’ nutrition strategy is as simple as “I am a runner, I eat carbs.” Protein is usually an after thought and fat sometimes happens on accident- or as a late night ice cream binge after a long day with an even longer run.  What is usually completely omitted is any type of supplement plan.  “Supplements? I’m not a bodybuilder. Why would I need supplements?”  The answer is: to perform better, or at the very least to not suck.

So what are the top supplements I would recommend?

1. Fluids (water, electrolyte, and CHO delivery)

2. CHO


4. Caffeine

5. Creatine


Fluids may seem like a no brainer.  But optimizing your hydration with regards to how much, when, and what type can take some careful preparation.  Your body is composed of 60-80% water.  Body temperature regulation, blood volume, and heart rate are all affected by hydration status. Showing up to a race not optimally hydrated will start you off behind the eight ball.  This is something you will not be able to make up. Fluid intake during the event should be about 5-6 ounces every 15 minutes. Fluid should be comprised of 8-10% carbohydrate solution to allow for optimal gastric emptying and absorption rates and should contain electrolytes as well.


Carbohydrates are synonymous with endurance events. Unfortunately athletes are all too often focused on carbohydrate intake BEFORE the event with little attention paid to intake during the event.  The longer the duration of the event, the more your body relies on blood glucose for fuel.  Muscle glycogen stores may be depleted in a rather short time frame (1-2 hours). Races longer than this (pretty much ANY ultra-endurance event) will rely heavily on blood glucose as well as free fatty acids for fuel.  Exogenous carbohydrates ingested during an event can generally be oxidized at a rate of approximately 1g/min or more.  (Some studies show that mixing sources of carbohydrates may yield higher oxidation rates [1].) This means that ingesting carbohydrates at a rate of 45-60g/hour would be ideal in terms of providing a continuous source of exogenous CHO for oxidation. Taking in high glycemic index carbohydrates during the event will stave off the ‘hitting of the wall’ phenomenon that can occur when inadequate energy substrate is unavailable.  Popular carbohydrate supplements such as gels or GU typically contain 23-25g of high glycemic carbohydrates per serving. Trying to stomach nothing but GU or gel for 5, 6, 7 hours or more would be a feat in and of itself.  Most ultra events will require the athlete to eat some amount of solid food during the event.  Pretzels, power bars, cookies and candy are all commonly found at aid stations during such events.  It is wise to stick with lower fat, lower fiber choices as they will tend to be higher glycemic index and more readily available to your body for fuel.

Protein/Amino Acids

If there is one thing that most endurance athletes are deficient in, it is protein.  Protein, especially essential amino acids and branched chain amino acids, can be a great help not only during the training period, but also during an ultra event.  Many studies have shown that adding even a small amount of protein to a carbohydrate solution enhances glycogen replenishment post exercise.  Those same amino acids may also be used as an energy substrate during the event as well.  Branched chain amino acids (BCAAs), unlike other amino acids, may be used directly by the skeletal muscle for fuel.  They do not need to be transported to the liver to be broken down.  BCAAs can comprise up to 20% or more of the fuel used by the working muscles during exercise.  In addition to providing energy directly to working muscles, BCAAs are also an important player in helping to synthesize glucose (gluconeogenesis) thereby increasing time to exhaustion. Another benefit to BCAAs is their ability to delay central fatigue and mental exhaustion by way of blocking tryptophan transport to the brain.  The bottom line – to keep your muscles and your brain going strong take your BCAAs. Ten to twenty grams would be a great place to start when adding BCAAs to your race day hydration, especially as the hours wear on.


Caffeine often gets a bad rap, although I am not sure why since it has so many benefits. No, it will not dehydrate you.  In fact it is likely to enhance your performance.  Taking 3-6mg/kg of bodyweight about 15 minutes prior to an endurance event can not only increase central nervous system excitement, but also promote increased utilization of free fatty acids for fuel.  This increase in free fatty acid usage actually helps to spare muscle glycogen, leaving more in the tank for later in the race.


Creatine isn’t just for bodybuilders.  In fact, some of the first studies done with creatine were conducted on endurance athletes measuring its effect on sprint times and anaerobic threshold (2, 3).  Increasing numbers of studies continue to demonstrate the positive impact creatine has on endurance athletes.  Beis et al. demonstrated creatine’s ability to help maintain a lower heart rate as well as core temperature with its ability to aid in hydration states, especially in hot environments, without affecting running economy (4).

Athletes should remember though that creatine must be taken at a minimum dose of 3g/d for at least 28 days before optimal intra-muscular creatine levels will be achieved.  Simply throwing creatine into race day nutrition will have little impact on performance or hydration.

So there you have it, the top five supplements to ensure your survival of an ultra endurance event.  You cannot shirk your training or proper nutrition during the training period and expect these supplements to carry you through. However when used properly they can help make the difference between a good race day performance and a great one.  Do your homework, train smart, recover, arrive well rested, well hydrated, stocked and ready to run.


1. Jentjens RLPG, Achten J, Jeukendrup A. High oxidation rates from combined carbohydrates ingested during exercise. Medicine & Science in Sport & Exercise 2004;36:9 1551-1558

2. Harris RC, Viru M, Greenhaff PL, Hultman E. The effect of oral creatine     supplementation on running performance during maximal short term exercise in man. J Physiol 1993;467:74P.

3. Smith JC, Stephens DP, Hall EL, Jackson AW, Earnest CP. Effect of oral creatine ingestion on parameters of the work-time relationship and time to exhaustion in high-intensity cycling. Eur J Appl Physiol 1998;77:360-365.

4. Beis LY, Polyviou T, Malkova D, Pitsiladis YP. The effects of creatine and glycerol hyperhydration on runnin economy in well trained endurance runners. JISSN 2011, 8:24


Michelle Adams BS, MPH, CISSN, CSCS. Originally hailing from western Massachusetts, Michelle Adams received both her Bachelor’s degree and Master of Public Health degree from the University of South Carolina.  With over 13 years’ experience in personal training, Michelle is a certified strength and conditioning specialist with the National Strength and Conditioning Association (NSCA CSCS), certified Sports Nutritionist with the International Society of Sports Nutrition (CISSN), certified sports performance coach with USA weightlifting as well as a kettlebell instructor.  Michelle is a competitive athlete herself having competed as a professional figure athlete in the IFBB with career highlights including a first place finish at the 2006 IFBB Toronto Figure Championships.  More recent endeavors have included marathon and ultra-marathon running.  Michelle currently lives in Florida but may also be seen throughout the United States serving as a spokesperson for General Nutrition Centers.




Coffee Rocks!

by Jose Antonio PhD FISSN.  Has your doctor told you to lay off the coffee? Well if he or she did, then clearly they’re dummies.  Coffee is one of the best drinks for you! Drink more coffee and the risk of death from heart disease goes down.  And besides, that caffeine fix in the morning is better than bad sex or a good donut.  Okay, maybe not.  But you get my drift.

Here’s the super cool study.

BACKGROUND: Caffeine is the world’s most widely used central nervous system stimulant, with approximately 80% consumed in the form of coffee. However, studies that analyze prospectively the relationship between coffee or caffeine consumption and depression risk are scarce.
METHODS:  A total of 50 739 US women (mean age, 63 years) free of depressive symptoms at baseline (in 1996) were prospectively followed up through June 1, 2006. Consumption of caffeine was measured from validated questionnaires completed from May 1, 1980, through April 1, 2004, and computed as cumulative mean consumption with a 2-year latency period applied. Clinical depression was defined as self-reported physician-diagnosed depression and antidepressant use. Relative risks of clinical depression were estimated using Cox proportional hazards regression models.
RESULTS:  During 10 years of follow-up (1996-2006), 2607 incident cases of depression were identified. Compared with women consuming 1 or less cup of caffeinated coffee per week, the multivariate relative risk of depression was 0.85 (95% confidence interval, 0.75-0.95) for those consuming 2 to 3 cups per day and 0.80 (0.64-0.99; P for trend <.001) for those consuming 4 cups per day or more. Multivariate relative risk of depression was 0.80 (95% confidence interval, 0.68-0.95; P for trend = .02) for women in the highest (≥550 mg/d) vs lowest (<100 mg/d) of the 5 caffeine consumption categories. Decaffeinated coffee was not associated with depression risk.
CONCLUSIONS: In this large longitudinal study, we found that depression risk decreases with increasing caffeinated coffee consumption. Further investigations are needed to confirm this finding and to determine whether usual caffeinated coffee consumption can contribute to depression prevention.

The moral of the story:  Coffee is good for you.

Arch Intern Med. 2011 Sep 26;171(17):1571-8.
Coffee, caffeine, and risk of depression among women.
Lucas M, Mirzaei F, Pan A, Okereke OI, Willett WC, O’Reilly EJ, Koenen K, Ascherio A.


Love Affair with Caffeine


By: Jose Antonio PhD, CSCS, FACSM

The Ubiquitous Pick Me Up!

We love caffeine ‘cause it gives your brain a kick start! Let’s face it. You could be moving slower than a fat chick on Xanax, but with a little help from your trimethylxanthine friend (i.e. caffeine), you’ll have more energy than Paris Hilton’s videographer. Here’s the proof!

One study examined one hundred and forty-four volunteers (72 male, 72 female, mean age 21 years) and had them consume breakfast (cereal versus no breakfast) and caffeine (caffeinated versus decaffeinated coffee). They found that those who consumed breakfast cereal had a more positive mood at the start of the test sessions, performed better on a spatial memory task, and felt calmer at the end of the test session than those in the no breakfast condition (lesson: don’t skip breakfast.). Consuming caffeine improved the “encoding of new information and counteracted the fatigue that developed over the test session.”(1) Blah blah blah…translation: that means your brain works better. Bottom line: drink coffee as you eat that delicious bowl of oatmeal (or is it Captain Crunch you prefer?).

Fat Blaster!!

Perhaps one of the more idiotic things I’ve ever heard about caffeine is that it helps you gain fat! Listen up now. If anybody (i.e. your trainer, strength coach, nutritionist, boyfriend, girlfriend, wife, or any of the above) says that, than I’d suggest you put on your Nikes and run faster than a cheetah on amphetamines. Why? Because anyone who says that is a moron. Anyhow, here’s some data (i.e. evidence) for you.

Scientists studied 18,417 men and 39,740 women from 1986 to 1998. Caffeine intake was assessed repeatedly every 2-4 years. Weight change was calculated as the difference between the self-reported weight in 1986 and in 1998. What did these self-professed science nerds discover? “Age-adjusted models showed a lower mean weight gain in participants who increased their caffeine consumption than in those who decreased their consumption…” In English, that means those who consumed the most caffeine, gained the least amount of weight. That is, an increase in coffee and tea consumption was also associated with less weight gain.(2)


Yes, caffeine can ratchet up your body’s furnace such that you burn more calories.(3-11) And the cool part is that you oxidize or burn more fat in the process. An oft-used technique by fitness competitors is to down a strong cup-a-Joe or a caffeine pill prior to exercise. You’ll exercise harder, longer, and burn more fat in the process. What about consuming caffeine at rest?

A recent study looked at energy expenditure, fat oxidation or burning, and norepinephrine (NE) kinetics (i.e. how ‘adrenaline’ like hormones are metabolized) after caffeine or placebo ingestion using placebo-controlled double-blind conditions. The dose administered was 5 mg of caffeine per kilogram of fat-free mass (note: fat-free mass or FFM is mainly muscle and bone). Translation: For the young men, they consumed about 350 mg while the old men consumed about 295 mg. (Therefore, the young men had more FFM than the old men).

They studied 10 older (65-80 yr) and 10 younger (19-26 yr) men who were moderate consumers of caffeine. Caffeine ingestion resulted in similar increases in both the old and young men for plasma caffeine levels; thus both young and old absorb caffeine equally well. Metabolic rate or energy expenditure increased similarly by 11% in young and 9.5% in the older men. According to the scientists, “older and younger men show a similar thermogenic response to caffeine ingestion…” (6) Bottom line: young and old can benefit from the thermogenic effect of caffeine.

Performance Enhancer

Known to fitness enthusiasts as well as Olympians, caffeine is the most versatile and effective ergogenic aid (i.e. something that enhances exercise performance).(12-32) A prominent exercise physiologist, David Costill, Ph.D., performed the ground-breaking study on caffeine and exercise 26 years ago! He took nine competitive cyclists (two females and seven males) and had them bike until exhaustion at 80% of V02 max.

(Note: V02 max, also known as maximal oxygen uptake, is a measure of how well your cardiopulmonary system functions).

Each subject consumed coffee containing 330 mg of caffeine 60 min before the exercise or a placebo (decaffeinated coffee). Following the ingestion of caffeine, the subjects were able to perform an average of 90 minutes of cycling as compared to an average of 76 minutes in the placebo trial. This reflects an 18% increase! They also found that subjects burned more fat (aka lipolysis) as shown by measurements of plasma free fatty acids, glycerol and respiratory exchange ratios. In fact, fat oxidation or burning was significantly higher (107% greater) during the caffeine trial (118 g or 1.31 g/min) than in the placebo trial (57 g or 0.75 g/min). Also, the perception of effort was much less in subjects after consuming subjects indicating that exercise felt easier.(32)


Don’t be fooled by the nonsense about caffeine being bad for your health. It is so far from reality that you need the Hubble telescope to see even a kernel of truth in it. Caffeine not only works, it’s one of the safest ingredients in existence. For instance, one study concluded that caffeine consumption is “not associated with adverse effects such as general toxicity, cardiovascular effects, effects on bone status and calcium balance (with consumption of adequate calcium), changes in adult behaviour, increased incidence of cancer and effects on male fertility.”(33) And a study published in May of 2006 found that no evidence that coffee consumption increases the risk of heart disease.(34)

Take home message:

  • Caffeine helps you burn fat.
  • Caffeine helps you lose weight or alleviate weight gain.
  • Caffeine improves athletic performance.
  • Caffeine improves brain function.

About the Author:

Juan and JA at NSCAJose Antonio is an author, speaker, radio show host, sports nutrition scientist, and avid outrigger paddler.  www.theissn.org





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