Hookah - A Healthier Option?

According to the Cancer Council of Australia, in 1945, approximately 72% of Australian men smoked. Since then, the rate has dropped significantly, with 2010 survey data indicating that only 16.4% of Australian males and 13.8% of Australian females smoke cigarettes. Regardless, smoking is the largest preventable cause of death and disease in Australia, with a tobacco-related death occurring about once every 28 minutes.

While some of those intending to quit manage to turn away from cigarettes entirely, many turn to other addictive behaviours to fill the void left in their lives. One alternative is smoking tobacco preparations in a water pipe (hookah, shisha). This practice is widespread in many places of the world and is perceived by many as a relatively safe alternative to cigarettes. I myself have, in the past, experimented with smoking water pipe, lulled under a false sense of security.

However, a recent comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking found evidence to explain where added concerns may lie with the former.

The researchers ascertained that, when smoking an average of 3 water pipe sessions compared with smoking 11 cigarettes per day, water pipe use was associated with a significantly lower intake of nicotine however, a greater exposure to carbon monoxide, and a different pattern of carcinogen exposure compared with cigarette smoking, which included greater exposure to benzene and high molecular weight polycyclic aromatic hydrocarbon. 

On the other hand, there was less exposure to tobacco-specific nitrosamines, 1,3-butadiene, acrolein, ethylene oxide, and low molecular weight polyciclic aromatic hydrocarbons.

In short, it appears that water pipe smoking is not benign but, rather that use of the hookah may result in a different pattern of carcinogen exposure which may result in a entirely different cancer risk profile. For example, high levels of benzene exposure have been associated with leukemia.

Another reason to shun smoking entirely is the research suggesting that water pipe smoking negatively affects lung function and could be as harmful as cigarette smoking in this regard. As such, it is likely to be a cause of COPD (chronic obstructive pulmonary disease), which is the fourth leading cause of mortality in the United States.

Reference:

Jacob III, P., et al. (2013). Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking, Cancer Epidemiol Biomarkers Prv, 22, 765.

Raad, D., et al. (2011). Effects of water-pipe smoking on lung function: A systematic review and meta-analysis, Chest, 139(4), 737-738.

Increasing Post-Workout Protein Turnover

One does not need to be an athlete to see the beneficial effects that increased protein can provide to a nutrition plan. It is recommended that adult women consume 0.75g and adult men consume 0.84g per kilogram of bodyweight. So, for example - a 75kg adult male would need a measly 63g of protein per day. 

As an individual who engages in both resistance training and martial arts, I find that the government regulations leave me with drastically increased DOMS (delayed onset muscle soreness) and impact my ability to recovery from exercise. As such, I subscribe to the recommendations of Dr 'Protein' Peter Lemon, of the University of Western Ontario who has advised that "the RDA for those engaged in strength training should be about 1.7 - 1.8g of protein per kilogram of body mass per day."

That being said, what is the best way to consume this quantity. Is there any appreciable difference between living the bodybuilding lifestyle of 6 smaller, protein-based meals spread throughout the day or a single bolus dose of steak eaten at dinner?

Researchers from Switzerland and Canada attempted to test just that question and to investigate the effects of the intervals at which protein is ingested.

The Study

They performed experiments with 24 young men, all of whom performed strength training 4 - 6 times a week (finally, a study relevant to the non-couch potato). The individuals performed leg extension exercises in the laboratory prior to breakfast. Warm-ups were performed with 5 sets at 60-70% of their 1RM, followed by 4 sets of 10 reps at 80% 1RM.

In the 12 hours following this session, the individuals were administered a TOTAL of 80g whey isolate. The three groups were separated as such:

• BOLUS group: 2 servings of 40g whey (1 portion per 6 hours)
• INT group: 4 servings of 20g whey (1 portion per 3 hours)
• PULSE group: 8 servings of 10g whey (1 portion per 1.5 hours)

Interestingly, protein synthesis was highest in those who spread their intake out during the day. While the difference in net muscle increase between the three groups was subtle, a trend was apparent where net protein balance was highest in the INT group. While protein synthesis was higher in the PULSE group, protein breakdown was also higher in the same individuals.

Notably, the differences were not statistically significant. However, the study was also 'under powered'. The researchers claimed that with a larger number of subjects, the sought after significance values may have emerged.

Implications

Given that whole-body protein balance appeared to be greatest with moderate 20g feedings every 3 hours, this has implications for individuals attempting to enhance their anabolism and lean mass accrual through the use of strength training.

Indeed, the bodybuilder paradigm of separating the day into 6 meals may be the ideal way to provide yourself with the slight increase in anabolism that is required to push an aspiring athlete into the next stage of their training.

Reference:

Moore, D.R., Areta, J., Coffey, V.G., et al. (2012). Daytime pattern of post-exercise protein intake affects whole-body protein turnover in resistance-trained males. Nutr Metabolism (London), 16(9), 91.

Acne: Pathways, Causes and Cures

And ... We're back! To my readers, I'd like to extend my sincerest apologies about the recent lack of articles. As the stresses and pressures of life built up, I found myself needing a short hiatus to collect and compose myself so that I could keep churning out quality information to those of you who read it!

However, that doesn't mean I've been sitting on my hands. The first article off the bat is one suggested to me by a friend and aims to debunk and clarify the myths behind the causes of acne.

It can be hard to believe that acne is yet another health outcome that we may have greater control over than social norms dictate. When we're teenagers, we shut up and put up with the aptly named acne vulgaris and hope that it will pass quickly. As adults, we dread it's return - petrified by dormant memories of social exclusion and stigma.

Diet and Acne - The Hypothetical Association

It is believed that the hypothetical association between diet and acne lies in the stimulation of Insulin-like Growth Factor (IGF-1) that occurs when the body is placed in a hyperinsulinemic state. Simply put, spikes in insulin caused by High GI foods would cause an increase in IGF-1 which would then increase the amount of circulating androgens in the blood, decrease sex hormone binding protein and increase 'sebum synthesis' (which is crucial in acne development). 

*Sebum keeps skin and hair soft and supple. Like anything, it requires balance. Too much sebum and you'll be battling acne; too little and you'll be fighting dry and cracked skin.

Thus, it could be suggested that a typical 'Western' diet rich in high glycaemic index foods such as pasta, flour, bread, sugar, etc may contribute to the formation of acne by causing hormonal variations in the body.

Acne & It's Recognised Causes

There is a progressive increase in acne from pre-adolescence to early adulthood which coincides with the pubertal androgenic spurt. As we learned above, greater circulating androgens contribute to sebum synthesis. Indeed, the density of acne has been found to be positively correlated with the sebum excretion rate.

With regard to diet, a number of studies have determined that dietary factors particularly high glycaemic foods and diets with a high glycemic load (GL), as well as greater dairy intake are positively associated with the development of acne.

A study of over 1,200 individuals from two non-Western societies found that there was an absence of acne in these populations. Interestingly, epidemiological studies of the Inuit Eskimo population, have observed that this culture had not presented with the symptoms of acne until the introduction of Westernized food habits.

With regard to the ingestion of milk, the paradox lies in the fact that, although lactose is a low-GI nutrient, milk increases levels of IGF-1 in the body. Ironically, for all of you 'skim milk' or 'fat free' drinkers - the aggravation of acne is more severe with the ingestion of fat-free milk than the regular variety.

The following image summarises the above quite succinctly -

Chocolate & Acne

Bad news for choc-a-holics! The theory of association between acne and chocolate is almost entirely confirmed by various clinical findings. 

For those who wonder about the mechanism behind it; it is postulated that chocolate is rich in various biologically active compounds including caffeine, teobromine, serotonin, phenylethylamine, etc which increase secretion of and resistance to insulin. At the same time, it contains insulinogenic amino acids including arginine and leucine which, when igested with carbohydrates and the artificial sugars within chocolate can contribute to acne formation.

Caffeine & Acne?

Unfortunately, little scientific evidence exists to directly link caffeine consumption of the development of acne. Once again, the theoretical tie-in is that caffeine consumption is purported to increase androgen levels in the blood, leading to the sebum synthesis slippery slope. However, a recent study into the effects of caffeinated and decaffeinated coffee on sex hormone-binding globulin and other sex hormone levels was unable to find a consistent effect of caffeinated coffee consumption on SHBG in participants.

One could surmise that caffeine may contribute to the development of acne by -

• disrupting sleep patterns
• causing adrenal fatigue (in chronic consumption)
• slow down kidney function, thus inhibiting the body's ability to release it's toxins

Treating Acne?

Given what we've just learned about the formation and causes of acne, it seems illogical that prescription medication and harsh creams are the only possible pathway for treating the condition.

Some tips for keeping those nasty pimples away include:

• Ensure that your Omega 3, Zinc and Vitamin A levels are adequate: All three of these nutrients help to reduce inflammation and zinc serves the double purpose of boosting immunity.
• De-Stress: Stress raises cortisol which increases the production of oil in the skin.
• Avoid High GI foods: for the reasons stated in the ENTIRE ARTICLE.
• Keep your Kidney Happy (& I don't mean through a Lemon Detox): having appropriate detoxification pathways that aren't clogged by junk can assist your body in moving toxins where they need to go (rather than to your skin). So, cut the junk and give your kidney the much needed break it deserves.
• Watch the Wheat & Grains: many people are sensitive to wheat gluten. Sensitivities can aggravate acne as it is a signal of a heightened immune response in reaction to a nutrient that the body has difficulty in processing. 
• Drink plenty of water and keep regular: You heard me ... The kidney can detox your body but your physical excretion of waste matter is one of the best ways you have of ridding yourself of unwanted toxins. So go and grab some Psyllium Husk and let the good times flow.

References:

Wedick, N.M., et al. (2012). The effects of caffeinated and decaffeinated coffee on sex hormone binding globulin and endogenous sex hormone levels: a randomized controlled trial. Nutr J., 11 (86), 1475-2891.

Taylor, M., et al. (2011). Pathways to inflammation: acne pathophysiology. European Journal of Dermatology, 21(3), 323-33.

Reynolds, R.C., et al. (2010). Effects of the Glycemic Index of Cabohydrates on acne vulgaris. Nutrients, 2(10), 1060-1072.

Costa, A., Lage, D., & Moises, T.A. (2010). Acne and Diet: Truth of myth? Anais Brasilieros de Dermatologia, 83(3), 346-53.

Ismail, N. H., Manaf, Z. A., & Azizan, N. Z. (2012). High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatol., 12(13), doi: 10.1186/1471-5945-12-13.

Magin, P., et al. (2004). A systematic review of the evidence for 'myths and misconceptions' in acne management: diet, face-washing and sunlight. Family Practice, 22(1), 62-70.