Creatine: Helpful for Sports Performance Enhancement

Creatine is a naturally occurring substance that plays an important role in the production of energy in the body. The body converts it to phosphocreatine, a form of stored energy used by muscles.
Although the evidence for creatine is not definitive, it has the most evidence behind it among all the sports supplements. Numerous small double-blind studies suggest that it can increase athletic performance in sports that involve intense but short bursts of activity.
The theory behind its use is that supplemental creatine can build up a reserve of phosphocreatine in the muscles to help them perform on demand. Supplemental creatine may also help the body make new phosphocreatine faster when it has been used up by intense activity.
Sources
Although some creatine exists in the daily diet, it is not an essential nutrient because your body can make it from the amino acids L-arginine, glycine, and L-methionine. Provided you eat enough animal protein (the principal source of these amino acids), your body will make all the creatine you need for good health.
Meat (including chicken and fish) is the most important dietary source of creatine and its amino acid building blocks. For this reason, vegetarian athletes may potentially benefit most from creatine supplementation.
Therapeutic Dosages
For bodybuilding and exercise enhancement, a typical dosage schedule starts with a “loading dose” of 15 to 30 g daily (divided into 2 or 3 separate doses) for 3 to 4 days, followed by 2 to 5 g daily. Some authorities recommend skipping the loading dose. (By comparison, we typically get only about 1 g of creatine in the daily diet.)
Creatine’s ability to enter muscle cells can be increased by combining it with glucose, fructose, or other simple carbohydrates;^1,2 in addition, prior use of creatine might enhance the sports benefits of carbohydrate-loading.³
Caffeine may block the effects of creatine.⁴
Therapeutic Uses
Creatine is one of the best-selling and best documented supplements for enhancing athletic performance, but the scientific evidence that it works is far from complete. The best evidence we have points to potential benefits in forms of exercise that require repeated short-term bursts of high-intensity exercise; this has been seen more in artificial laboratory studies, though, rather than in studies involving athletes carrying out normal sports.^5-10,70-72 It might also be helpful for resistance exercise (weight training), although not all studies have found benefit.^{34,35,55,57,61,73-74}
Creatine has also been proposed as an aid to promote weight loss and to reduce the proportion of fat to muscle in the body, but there is little evidence that it is effective for this purpose.¹¹
Preliminary evidence suggests that creatine supplements may be able to reduce levels of triglycerides in the blood.¹² (Triglycerides are fats related to cholesterol that also increase risk of heart disease when elevated in the body.)
Creatine supplements might also help counter the loss of muscle strength that occurs when a limb is immobilized, such as following injury or surgery;^24,54,62 however, not all results have been positive.⁷⁵
Studies, including small, double-blind trials, inconsistently suggest that creatine might be helpful for reducing fatigue and increasing strength in various illnesses where muscle weakness occurs, including chronic obstructive pulmonary disease (COPD), congestive heart failure, dermatomyositis, Huntington’s disease, McArdle’s disease, mitochondrial illnesses, muscular dystrophy, and myotonic dystrophy.^{13,15-23,56,58,63,64,76,97,101,104}
One study claimed to find evidence that creatine supplements can reduce levels of blood sugar.⁹⁵ However, because dextrose (a form of sugar) was used as the “placebo” in this trial, the results are somewhat questionable.
Evidence from animal and open human trials suggested that creatine improved strength and slowed the progression of amyotrophic lateral sclerosis (ALS), and for this reason, many people with ALS have tried it.^14,15,20 However, these hopes were dashed in 2003 when the results of a 10-month, double-blind, placebo-controlled trial of 175 people with ALS were announced.⁵⁹ Use of creatine at a dose of 10 g daily failed to provide any benefit at all in terms of symptoms or disease progression. Negative results were also seen in a subsequent, slightly smaller studies.^65,106 Creatine also does not appear to strengthen muscles in people with wrist weakness due to nerve injury.⁷⁷
Long-term use of corticosteroid drugs can slow a child’s growth. One animal study suggests that use of supplemental creatine may help prevent this side effect.⁶⁰
Creatine has also shown some promise for improving mental function, particularly after sleep deprivation.^78-79 However, in one small study, it showed no similar benefit in young adult subjects who were not sleep deprived.¹⁰⁵
One study failed to find creatine helpful for maintaining muscle mass during treatment for colon cancer.⁸⁰ Another study found little to no benefits in Parkinson’s disease,⁹³ and another failed to find benefit in schizophrenia.⁹⁸
What Is the Scientific Evidence for Creatine?
Exercise Performance
Several small double-blind studies suggest that creatine can improve performance in exercises that involve repeated short bursts of high-intensity activity.^25,66
For example, a double-blind study investigated creatine and swimming performance in 18 men and 14 women.²⁶ Men taking the supplement had significant increases in speed when doing six bouts of 50-meter swims starting at 3-minute intervals, as compared with men taking placebo. However, their speed did not improve when swimming 10 sets of 25-yard lengths started at 1-minute intervals. It may be that the shorter rest time between laps was not enough for the swimmers’ bodies to resynthesize phosphocreatine.
Interestingly, none of the women enrolled in the study showed any improvement with the creatine supplement. The authors of this study noted that women normally have more creatine in their muscle tissue than men do, so perhaps creatine supplementation (at least at this level) is not of benefit to women, as it appears to be for men. Further research is needed to fully understand this gender difference in response to creatine.
In another double-blind study, 16 physical education students exercised 10 times for 6 seconds on a stationary cycle, alternating with a 30-second rest period.²⁷ The results showed that individuals who took 20 g of creatine for 6 days were better able to maintain cycle speed. Similar results were seen in many other studies of repeated high-intensity exercise, although generally benefits are minimal in studies involving athletes engaged in normal sports rather than contrived laboratory tests.^28-33,81-84
Isometric exercise capacity (pushing against a fixed resistance) also may improve with creatine, according to some, but not all studies.^{34,35,55,57,67,68,85-86}
In addition, two double-blind, placebo-controlled studies, each lasting 28 days, provide some evidence that creatine and creatine plus HMB (beta hydroxymethyl butyrate) can increase lean muscle and bone mass.36 The first study enrolled 52 college football players during off-season training, and the other followed 40 athletes engaged in weight training.
However, studies of endurance or nonrepeated exercise have not shown benefits.^37-40,87-88 Therefore, creatine probably won’t help you for marathon running or single sprints.⁶⁹
High Triglycerides
A 56-day, double-blind, placebo-controlled study of 34 men and women found that creatine supplementation can reduce levels of triglycerides in the blood by about 25%.⁴¹ Effects on other blood lipids such as total cholesterol were insignificant.
Congestive Heart Failure
Easy fatigability is one unpleasant symptom of congestive heart failure. Creatine supplementation has been tried as a treatment for this symptom, with some positive results.
A double-blind study examined 17 men with congestive heart failure who were given 20 g of creatine daily for 10 days.⁴² Exercise capacity and muscle strength increased in the creatine-treated group. Similarly, muscle endurance improved in a double-blind, placebo-controlled crossover study of 20 men with chronic heart failure.⁴³ Treatment with 20 g of creatine for 5 days increased the amount of exercise they could complete before they reached exhaustion.
These results are promising, but further study is needed.⁴⁴
Safety Issues
Creatine appears to be relatively safe.⁴⁵ No significant side effects have been found with the regimen of several days of a high dosage (15 g to 30 g daily) followed by 6 weeks of a lower dosage (2 g to 3 g daily). A study of 100 football players found no adverse consequences during 10 months to 5 years of creatine supplementation.⁴⁶ Contrary to early reports, creatine does not appear to adversely affect the body’s ability to exercise under hot conditions and might even be beneficial.^{47,89, 94,96,99}
Dividing the dose may help avoid gastrointestinal side effects (diarrhea, stomach upset, and belching). In one study of 59 male soccer players, two separate 5 g doses was associated with less diarrhea than a single 10 g dose.¹⁰³
However, there are some potential concerns with creatine. Because it is metabolized by the kidneys, fears have been expressed that creatine supplements could cause kidney injury, and there are two worrisome case reports.^48,49 However, evidence suggests that creatine is safe for people whose kidneys are healthy to begin with, and who don’t take excessive doses.^50,51,102 Furthermore, a 1-year, double-blind study of 175 people with amyotrophic lateral sclerosis found that use of 10 g of creatine daily did not adversely affect kidney function.⁹⁰ Nonetheless, prudence suggests that individuals with kidney disease, especially those on dialysis, should avoid creatine supplements.
Another concern revolves around the fact that creatine is metabolized in the body to the toxic substance formaldehyde.⁵² However, it is not clear whether the amount of formaldehyde produced in this way will cause any harm. Three deaths have been reported in individuals taking creatine, but other causes were most likely responsible.⁵³
It has also been suggested that use of oral creatine would increase urine levels of the carcinogen N-nitrososarcosine, but this does not seem to be the case.⁹¹
A few reports suggest that creatine could, at times, cause heart arrhythmias.⁹²
As with all supplements taken in very high doses, it is important to purchase a high-quality form of creatine, as contaminants present even in very low concentrations could conceivably build up and cause problems.

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What to do about Job-Related Weight Gain

It is a mantra you could repeat in your sleep: eat less, make healthier choices, and get more exercise. But let’s face it—you are busy, and even though you have sworn a thousand times that you will lose the ten pounds you have gained since you started your job, between the doughnuts at every meeting, the vending machine down the hall, and the long hours at the office, it feels like the deck is stacked against you. Here are some tips to help you regain control of your nutrition and your weight.
In general, the culprits behind weight gain at work are no different than those that trigger weight gain anywhere else. These include:

• Too much food or the wrong foods
• Too little exercise or physical activity

Too Much Food or the Wrong Foods

Grabbing fast food for lunch, or skipping it entirely? As you already know, these are dietary no-nos when it comes to your weight loss plan. But a busy lifestyle does not have to mean an unhealthy diet. Here are some tips to help:

• Eat breakfast! You may have more energy in the morning and you won’t be starving by lunchtime.
• Buy fresh produce and carry it with you so you always have a healthy snack on hand.
• Reduce butter use. Try substituting butter with extra virgin olive oil instead. A serving of extra virgin olive oil contains much less saturated fat (only two grams) than a serving of butter (eight grams), and extra virgin olive oil has no cholesterol, while butter has 33 milligrams of cholesterol per serving.
• Use nonfat or low-fat dairy products.
• Salad dressings are notoriously high in fat and calories. Try using just one tablespoon of dressing on your salad.
• When you buy meat, choose the leanest cuts. Trim any visible fat before cooking.
• Reduce your intake of fried foods. Try a baked potato, squash, or yam instead of fries. Or bake your chicken without the skin on.
• Reduce the portion size of your dessert, or better yet, try replacing it with fresh fruit.
• When eating in a fast food restaurant or cafeteria, try ordering a lean roast beef or grilled chicken sandwich, and no super-sizing! Also, order items without cheese, and omit or go light on the mayonnaise.
• Space your meals evenly throughout the day, approximately every 3-4 hours. Try switching that afternoon candy bar to one of the following:
  • Microwave light popcorn
  • Whole wheat crackers with peanut butter
  • Fresh fruit, plain or with reduced-fat cheese
  • Nonfat or low-fat yogurt
  • Carrot and pepper strips with a low-fat dressing or bean spread
  • Mixed nuts and dried fruit
  • A fresh fruit yogurt smoothie

Too Little Exercise or Physical Activity

You already know exercise is good for you, but between the demands at work and home, there’s simply no time, right? Wrong. Here are a few ways to work exercise into your workday:

• Park a little farther away from the office than you actually need to. Use the same trick when keeping appointments or running errands. A little extra walking every day can make a big difference.
• If you are tied to your desk because of your phone, get a headset or use your cell phone. This will allow you to walk around as you talk. But be courteous. Make sure you do not disrupt your coworkers’ activities.
• Have meetings on the run. Discuss business during an afternoon or noontime walk, run, or jog.
• Hand-deliver a message or document instead of using email or the phone. These few steps can help you accumulate more physical activity by the end of the day.
• If you have a sedentary job, take a break every hour to get up, move around, or stretch.
• If your office has or is near a gym, use it! Make it easy by keeping workout clothes and an extra towel at the office.
• Take “brain breaks.” Need a minute to think something through? Trying to compose a letter or an email? Take a short walk around the block or up one or two flights of stairs. Exercise helps improve blood flow to your brain, which can help you think.
• Tell your boss and your coworkers what you are doing. Don’t just disappear to go for a run or walk while at work. They will likely support your physical activity breaks when they see your improved energy level and productivity. Some of your coworkers might even join you!

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Raw Chocolate Almond Butter

Photo Credit to Ricki Heller of Diet, Desserts and Dogs Blog

When I saw a recipe for Raw Chocolate Almond Butter from Ricki, the creator of the Diet, Desserts and Dogs Blog, I knew I had to share it with you. While you can go to most health and specialty grocery stores and pick up a jar of any variety of nut or seed butter these days, isn’t it sometimes better to make something and know where the ingredients come from? Click here to see the original recipe post.

Ricki was also kind enough to let me repost her Brilliantly Beet Smoothie recipe, which you can see here. When you get a chance, be sure to pay a visit to Diet, Desserts and Dogs because it is a blog that is focused on whole food recipes that are primarily sugar-free and/or gluten-free as well as helpful for anti-candida living. Some of her tasty recipes includes one for Smoked Salmon Sushi Pizza and another for African Sweet Potato Stew. But for now, I hope you enjoy Ricki’s newest creation.

Raw Chocolate Almond Butter(Please note that brands listed below are iHerb suggestions and not necessarily endorsed by the recipe author)

2 cups Now Foods, Almonds, Natural, Unblanched

3 Tbs Navitas Naturals, Cacao Powder, Raw Chocolate Powder

pinch of Le Saunier de Camargue, Fleur de Sel, Sea Salt

2 tsp whole vanilla bean powder or 1 tsp Simply Organic, Madagascar Pure Vanilla Extract (see instructions)

3 Tbs Nutiva, Organic Extra Virgin Coconut Oil

70-80 drops or about 1-1/4 tsp of NuNaturals, Clear Stevia or NuNaturals, Vanilla Stevia, With Singing Dog Vanilla Extract

Place the almonds, cacao powder, salt and vanilla bean powder in the bowl of a food processor (if using liquid vanilla extract, don’t add it yet, but save it to add with the stevia instead). Process until the mixture looks like a powder, with no pieces of almond visible.
Add the coconut oil and stevia (and liquid vanilla, if using) and continue to process until a ball forms, which will then roll around for a bit before breaking up into a paste; continue to process for another 3-5 minutes, scraping sides occasionally, until the butter is almost liquid and very smooth. (This may require some patience; if you just can’t wait, you’ll still enjoy a somewhat grainier nut butter.).
Pour into a clean jar or container and store in the refrigerator until ready to use. It will firm up in the fridge; for a softer, pourable nut butter, allow to come to room temperature before using. Makes about 1-1/4 cups (300 ml). Store, covered, in refrigerator up to 2 weeks.

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Caring for a Newborn: When to Call a Doctor

If you’re a new mom or dad, you probably have only one main concern—the health of your newborn. It’s only natural to worry. But, one way you can decrease any worries is to arm yourself with information. Learn what symptoms to be on alert for and when to get medical care.

First Things First
Get accustomed to your newborn’s usual routine. For example, how often does he eat and sleep? How many times do you usually need to change his diaper in one day? How does he normally respond to you? Your baby’s typical behavior will help you to determine if he is feeling fine or if something is wrong.
Also, go with your instinct. If you think your baby may be ill, call the doctor right away. It is common for parents of newborns to call the pediatrician with questions and concerns. So, don’t hesitate to get expert advice.

Be Prepared
You will feel more in control if you already have the following medical information close at hand:

• The name of your newborn’s doctor and the phone number
• The doctor’s office hours and on-call hours
• Instructions as to what to do during after-hours
• Location of the hospital that the doctor is affiliated with
• The name, phone number, and location of the pharmacy that you use

If you do need to call the doctor, be prepared for any questions that you may be asked, such as:

• What are your newborn’s symptoms?
• What is his temperature? (Note: Rectal thermometers are typically used with newborns.)
• How many bowel movements has he had? Does he have loose stools? How many wet diapers has he had?
• What vaccines has your newborn had? Are they up-to-date?
• Does he have any allergies or conditions?
• Does your newborn take any medicine? If so, what kind of medicine and what is the dose?

Also, keep in mind that you may need to write down any instructions that the nurse or doctor gives you. So, have a pen and paper handy.

Another way you can be prepared is by learning first aid and CPR for infants. The hospital may offer these classes or you can check online (eg, American Red Cross or the American Heart Association).

Medical Concerns
Call the doctor if your newborn:

• Has a cough
• Has any eye problems (eg, mucus or redness)
• Has a runny nose, which can make it difficult for your newborn to breath
  • Note: You can use a rubber bulb aspirator to clear the mucus from his nose.
• Is vomiting
• Is eating less than usual or is having problems with breastfeeding (eg, difficulty latching onto the nipple)
• Is not moving his bowels
• Has stools that are looser than normal
• Is crying more than usual and is unable to be soothed
• Has problems sleeping
• Has blood or pus on his navel or penis
• Has a rash
• Has drainage coming from his ear
• Is not responding to sounds

If your newborn has any of the following, call your doctor immediately:

• Rectal temperature above 100.4°F (38°C)
• Rectal temperature below 97.8°F (36.5°C)
• Any breathing problems, like difficulty breathing or fast breathing
• Other signs of not getting enough oxygen, like blue lips or fingernails
• Extreme tiredness or drowsiness, difficulty awakening
• Is limp
• Signs of dehydration (wetting less than six diapers in 24 hours, sunken eyes, sunken soft spot, no tears when crying)
• Soft spot on the top of the head looks swollen
• Seizure
• Yellowish skin or eyes
• Bloody urine, stool, or vomit
• Injury to any part of the body, especially the head

If you are extremely concerned and you think the situation is an emergency, call 911 to have an ambulance come.
You can care for your newborn’s health by knowing which symptoms to watch out for and by being prepared if medical care is needed. Remember that many moms and dads have felt the same way you do and have reached out for help and guidance from doctors and nurses. If at any time you feel concerned about your little one’s health, call the doctor.

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Is it Heartburn or a Heart Attack?

The pain experienced during a heart attack and during a severe heartburn episode can be difficult to distinguish. It is not unusual for people to mistake symptoms of heart disease (such as angina and even a heart attack) for heartburn. Similarly, many people go to the emergency room each year out of fear that they are having a heart attack, only to find out they have severe heartburn. In fact, it often takes medical testing to make the determination.

Pain May Be Difficult to Distinguish
In addition to some similar symptoms, both heartburn and heart attacks are more likely to occur in people over the age of 40. Here are some possible differences between the two conditions.
Possible Signs of Heartburn

• A sharp, burning sensation below the breastbone or ribs
• Burning sensation may move up toward the throat
• Pain usually does not radiate to the shoulders, arms, or neck (although it can)
• Pain often occurs after eating, particularly when lying down
• Pain that increases when bending over, lying down, exercising, or lifting heavy objects
• Bitter or sour taste at the back of the throat
• Symptoms tend to respond quickly to antacids

Note: Call 911 if you have any chest pain, even if you think it may be heartburn.
Possible Signs of Angina or Heart Attack

• A feeling of uncomfortable fullness, pressure, squeezing, tightness, or pain in the center of the chest that lasts for more than a few minutes, or goes away and comes back
• Pain or discomfort that spreads to one or both arms, the back, stomach, neck, or jaw
• Pain often responds quickly to nitroglycerin
• Shortness of breath
• Other symptoms such as:
  • Breaking out in a cold sweat
  • Nausea
  • Lightheadedness
  • Fainting
  • Palpitations (feeling a rapid heart beat)

Other Causes of Chest Pain
Other problems that can cause chest pain include:

• Other heart conditions, such as:
  • Pericarditis—inflammation of the sac surrounding the heart
  • Aortic dissection—rare, but dangerous condition in which the inner layers of the aorta separate
  • Coronary spasm—arteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart muscle
• Panic attack—periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
• Pleurisy—inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathing
• Costochondritis—inflammation of the rib cage cartilage
• Pulmonary embolism—a blood clot lodged in the artery of the lung
• Other lung conditions, such as
  • Collapsed lung
  • Pulmonary hypertension
  • Severe asthma
  • Pneumonia
• Muscle-related chest pain—often accompanies fibromyalgia and other chronic pain syndromes
• Injured ribs, pinched nerves—can cause localized chest pain
• Shingles—infection of a nerve root, caused by reactivation of the chickenpox virus
• Gallbladder or pancreas problems—gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain, which can radiate to the chest
• Disorders of the esophagus—swallowing disorders such as esophageal spasms and achalasia (failure of esophageal muscle to relax)
• Cancer—cancer involving the chest or that has spread from another part of the body

Seeking Medical Attention for Chest Pain
Chest pain can be difficult to interpret. Get emergency medical attention if you have any chest pain, especially if you have other signs and symptoms of a heart attack. A visit to the emergency room could save your life.

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Achieving and Maintaining a Healthy Weight

You may have heard that losing weight is as easy as eating less and exercising more. Well it is true—taking in fewer calories than you use each day is the simplest way to lose weight. Never mind the fad diets, weight-loss pills, and herbal remedies—it all comes down to a balanced diet and a regular exercise program.
Using the Body Mass Index
The first step is determining your current weight status: Are you underweight, normal weight, overweight, or obese?
A good measure for this is the Body Mass Index (BMI), a standardized method used by health professionals to evaluate weight and body fat. BMI is calculated by dividing weight in kilograms by height in meters squared. You can also use pounds and inches squared, and multiply the value by 703. It gives you an indication of whether you are at risk of health problems that are related to being overweight or obese. If your BMI is 25 or higher, you are at risk for a number of serious health problems, including high blood pressure, high cholesterol, heart disease, stroke, type 2 diabetes, pregnancy-related disorders, and osteoarthritis.
To find your weight in kilograms, multiply your weight in pounds by 0.45. For example:
If your weight is 130 pounds: 130 x 0.45 = 58.5. Your weight in kilograms is 58.5.
To find your height in meters, multiply your height in inches by 0.0254. For example:
If your height is 5’6″, that is 66 inches: 66 x 0.0254 = 1.6764. Your height in meters is 1.6764.
To square the number, multiply it by itself: 1.6764 x 1.6764 = 2.81
For the example above, the BMI is: 58.97 divided by 2.81 = 20.98
BMI values are interpreted as follows:

• 18.4 or less = underweight
• 18.5-24.9 = normal weight
• 25-29.9 = overweight
• 30 and over = obese

Although this is a reliable method, it is not foolproof. Because muscle tissue weighs more than fat tissue, heavily muscled people may fall into the obese range when they are not obese.
Eating a Healthful Diet
To lose weight, you need to take in fewer calories than you use. This is where your diet comes in; which may be in need of an overhaul. But, you do not want to lower your calories at the expense of nutrition. Try not to think of your new eating habits as “going on a diet,” instead, think of it as a lifestyle change. Adding more fruits, vegetables, and whole grains to your diet and cutting back on animal protein, saturated fat, and cholesterol are good for you no matter what your age. Creating a healthful diet that you can stick to throughout your life will help you achieve and maintain your desired weight, and losing even 10% of your body weight may lower your blood pressure and reduce your risk of diabetes.
It may also be a good idea to keep track of how much you eat and drink. When sitting at a meal, you should consume only small portions. Eating smaller portions has been linked to weight loss and maintenance over time. And of all the meals, breakfast is important. Skipping breakfast has been associated with increased body weight. But of course, make sure your breakfast is packed with fruits and whole grains—think oatmeal with slices of apple, not bacon and eggs.
Getting Regular Exercise
To lose weight, you need to use more calories than you take in; this is where exercise comes in. Not only does regular exercise help you get to an ideal weight, it can help you stay there too. Additionally, muscle burns more calories than fat, so building up your muscles will allow you to eat more while maintaining your weight. If you do not exercise already, it is time to get started.
There are several different types of exercise that you can do. An ideal exercise program combines four types of exercise:

• Aerobic
• Weight-bearing
• Strength training
• Stretching

A good goal for many people to work up to is exercising 4-6 times a week for 30-60 minutes at a time. Some guidelines suggest that to achieve and maintain a healthy weight, one should consider doing 150 minutes of moderate to intense aerobic activity weekly. But it is always a good idea to talk with your doctor before beginning any kind of exercise program. She can help you develop an exercise routine that will meet your weight and health goals.
No Time Like Today
Now that you have the tools, getting started is up to you. Start slowly, have carrots or an apple for a snack, instead of a bag of chips. And take a walk around the block before or after work today. Just remember, the sooner you begin working toward your ideal weight, the sooner you can reap the healthful benefits.

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Can Diet Shakes and Meal Replacements Really Help You Lose Weight?

Diet shakes are called meal replacements by nutritionists and weight-loss experts because, in theory, drinking one shake is intended to replace one whole meal. Other types of meal replacements are nutritional bars and pre-packaged entrees. But do meal replacements work?
According to a scientific study led by Steven Heymsfield, MD from Columbia University, they do. Heymsfield and colleagues pooled data from six separate studies of different types of meal replacements and found that the overall weight loss for the 249 people on meal replacements was greater than for the 238 people in the comparison groups who followed low-calorie diets.
One study with United States Army volunteers found that soldiers started on a meal replacement program, when added to education based weight management, had greater weight loss over a 6 month period. However, only 59% of the volunteers in this study continued with the diet for the study period.
Another study also found that meal replacements resulted in more pounds shed than a food-based diet. The study involved 90 obese men and women who were randomized to either a meal replacement program, which included 3-5 meal replacements plus one meal daily, or a 1,000 kcal/daily food diet. Researchers found that rate of weight loss was greater in the group who were on meal replacements (93%) compared to the group on the food-based diet (55%) after 16 weeks. However, many people in the study dropped the diet and only the people that continued the diet were counted.
Losing Weight
Weight loss on paper is very easy. You really only need to eat 500 fewer calories every day to lose a pound a week. The trick is that weight loss in the real world, with busy schedules and abundant food choices, is hard. Meal replacements work on the premise that few of us know how many calories we eat each day. Packaged foods may list calorie content but most meals we eat don’t. Many of our meals may reach 700-800 calories without us realizing it. Three meals a day at 750 calories each equals 2250 calories. An average woman needs only about 1,800- 2,200 calories per day. The average man requires about 2,000-2,500 calories per day. If you add in snacks and the occasional sweets, not to mention alcohol or other calorie beverages like soda, most of us consume far more calories than we need.
Replacing one or two meals per day with a known quantity of calories will necessarily reduce the number of calories you consume. In other words, instead of eating a meal that might have 750 calories, you drink a shake with 250 calories then you will have reduced the usual number of calories you take in by 500. Doing that every day for a week and you will lose one pound as long as nothing else changes.
David Allison, PhD, an obesity researcher at the University of Alabama at Birmingham has studied the use of meal replacements to lose weight.
“I think they are a reasonable approach and can play a valuable role in weight loss,” he says. Allison evaluated the use of a soy-based meal replacement in 100 people who were randomized to use the meal replacement or follow a low-calorie diet for three months. He found that those on meal replacements lost more weight and had a greater reduction in waist circumference than those on a low-calorie diet.
Another study by Dana Rothacker, PhD followed women using diet shakes for weight loss for one year to assess their long-term effectiveness. At three months the women who drank diet shakes lost about the same amount of weight as women on low-calorie diets. But after one year the women who continued to follow the meal replacement plan maintained their weight loss, whereas women continuing on the low-calorie diet had regained much of their weight.
No Magic Bullet
Meal replacements are no magic bullet. As with most diets, the reason people who stop using meal replacements regain their weight is because they return to a higher caloric intake. Plus, critics argue, using meal replacements don’t teach people how to make healthy choices about the rest of the food they eat.
According to Allison, “People [on meal replacements] haven’t learned how to deal with real food.” So when they stop using the meal replacements, they often return to an unhealthy diet. In general, maintaining a normal weight requires learning lifelong healthy eating habits or staying on the meal replacement indefinitely. Few people want to do that.
Buyer Beware
Because meal replacements are dietary supplements, they are not regulated by the United States Food and Drug Administration (FDA). Therefore, advertisements for meal replacements may make claims about their effectiveness that are not supported by any scientific research. Also, there are no standards for the ingredients of meal replacements. Some diet shakes may be nutritionally sound with necessary vitamins and minerals included. Others may contain few healthful nutrients and are about as healthy as replacing your meal with a can of coke.
Allison recommends that anyone considering meal replacements should talk with a knowledgeable healthcare provider and get some nutritional advice. Then you will be savvy about your choice of meal replacement and what it can do for you. One of the challenges of meal replacement is that your reliance on a manufactured product may deprive you of the variety that we commonly experience in our day-to-day meal planning. Meal replacement may give you a high intake of foods that you might otherwise eat rarely or in moderation. You may, for example, want to be particularly wary about soy-based meal replacements because scientists still don’t know whether and how heavy consumption of soy may influence the development of some cancers. There is data suggesting both increased and decreased risk, so the jury is definitely still “out” on this topic.
For many people, using diet shakes or meal replacements will jumpstart their weight loss. Reaching a short-term weight-loss goal can be very satisfying and may encourage the perseverance needed to make permanent changes in the way you eat. Meal replacements can have a successful role in promoting weight loss especially when incorporated into the goal of learning lifelong healthy eating choices.

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