Transcript Weight Loss and Ergogenic Aids

Weight Loss and Ergogenic Aids
Annie Laweryson, Erin Prasad, Merryl Landeck and Rebecca Levens
Introduction
Weight Loss
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Conjugated Linoleic Acid
Ephedra
PGX
Hoodia
Raspberry Ketones
Ergogenic Aids
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Creatine
Beta Alanine
Arginine
The Controversy…
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According to the FDA, weight loss supplements and
ergogenic aids are two of the three categories of
supplements that are most likely to have problems with
adulteration, toxicity and misbranding
GMP’s are critical to consider with these
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NSF for Sport for ergogenic supplements
Conjugated Linoleic Acid
Weight loss
Erin Prasad
Conjugated Linoleic Acid
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Scientific name: cis-9, trans-11 conjugated linoleic acid
trans-10, cis-12 conjugated linoleic acid
or octadecadienoate 18:2
Common name: CLA, Tonalin and Clarinol (brand names)
CLA:
A group of conjugated octadeadienoic acid isomers derived from linoleic acid
 A polyunsaturated fatty acid in which scientific interest was peaked in the 1980s when
scientific evidence support possible anti-cancer effects.
Food sources:
 Meat- beef and other ruminant animals
 Dairy products
 Eggs
 Vegetable oils
 Average daily intake (non veg/vegan) in ~150-220mg/d
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Suppelment sources:
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Safflower and Sunflower oils in which the CLA is made under alkaline conditions.
1, 2, 3, 4
Erin Prasad
Conjugated Linoleic Acid
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Typically used for conditions such as:
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Weight loss
Allergies, asthma, CVD, diabetes, cancer, exercise performance enhancement, hair loss,
hypercholerolemia, hypertension, immune function, and rheumatoid arthritis
Dosage:
 No proven safe or effective dose
 For weight loss/obesity:
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For all other conditions:
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1.8-7g/d has been administered
Doses greater than 3.4g/d do not offer additional benefit
2-6g/d with mixed results regarding efficacy
Mechanism of Action: Proposed
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CLA increases energy expenditure
CLA suppresses appetite
CLA decreases lipogenesis through apoptosis of adipocytes
CLA increases lipolysis
1, 3, 4
Erin Prasad
Conjugated Linoleic Acid
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Efficacy for weight loss:
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Natural standard
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Study 1 (2010): Overweight or obese children supplemented with CLA gained less weight
than the placebo group.
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Study 2 (2012): Chinese adults supplemented with CLA had an overall reduction in BMI, fat
mass, fat percentage, subcutaneous fat, and waist-to-hip ratio.
Safety:
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Considered generally safe for healthy individuals
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Adverse effects: nausea, diarrhea, and GI upset
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Cautionary use for:
 Children and breastfeeding women, CVD, inflammatory disorders, digestive
disorders, autoimmune diseases, dermatological disorders, diabetics, or those with
liver disease.
 DNIs: CLA should be taken with caution with medications used for blood thinning,
lowering blood pressure, cholesterol or blood sugar.
GMPs: All but one of 6 CLA supplements tested by Consumer Labs contained the claimed
amount of CLA (one had 86%), GRAS product.
3, 5, 6, 7
Erin Prasad
Conjugated Linoleic Acid
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What to look for when buying
Accessibility:
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Easily found at Super Supplement and drug stores in weight loss section (non-refrigerated)
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Price range 90 gel caps of 750mg CLA: $12.99-$22.99
Forms: Soft gels of 750mg, 800mg, 1000mg, or 1400mg all from sunflower or safflower oil
Dosing Instructions:
Varies among brands and is conflicting, one serving is 1-3 gel caps of 750mg
Other ingredients: D-alpha tocopherols
Excipients: gelatin, glycerin, color, (beeswax, soy lecithin)
Extras: Claims often stated are:
Supports body fat reduction
Retain lean body mass while burning fat
Clean Performance Product
Erin Prasad
Conjugated Linoleic Acid
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Overall Impressions and Recommendations
Scope of Practice:
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With coordination of care with a physician, it is within the scope of a dietitian to
recommend CLA. Lab work for triglycerides, blood sugar, and cholesterol should be
monitored carefully
Overall impression: Yellow
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CLA is safe for general population, special populations for which it may be unsafe do
exist.
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It may reduce body fat, but has not been shown to increase lean body mass
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CLA may alter lipid profile in an unfavorable manner, especially a concern for those
with CVD or diabetes (large portion of obese population)
Erin Prasad
Ephedra
Weight Loss
Merryl Landeck
Ephedra
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Scientific Name ~ Ephedra sinica
Also known as Ma Huang in traditional Chinese medicine
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It is an evergreen shrub-like plant native to arid regions of China and Mongolia.
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There are approximately 40 species of ephedra (8)
Currently grow in China, northern India, Pakistan, Mongolia, and the southwestern United States
(8)
Traditional uses by Chinese herbalists dating back 5,000 years
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Treatment of respiratory infections, asthma, eczema, hay fever, cough, colds, chills,
shortness of breath, bone and joint pain, narcolepsy, and edema (8, 9)
Modern uses (prior to FDA ban)
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Weight loss, athletic performance enhancement, increase energy, sexual dysfunction,
hypotension. Still found over-the-counter for asthma and sinus congestion in a safer
form (8, 9, 10)
Merryl Landeck
Scientific Evidence for Uses of
Ephedra
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According to Natural Standard, some evidence exists suggesting
ephedra is successful as a supplement for weight loss, however,
the risks of taking ephedra alkaloids as a dietary supplement
outweigh the possible benefits.
Merryl Landeck
Ephedrine
Mechanism of Action
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Ephedra contains the alkaloids ephedrine and pseudoephedrine, which
have been found to induce CNS stimulation, bronchodilation, and
vasoconstriction (8)
Ephedrine alkaloids have sympathomimetic properties, simulating stimulated
sympathetic nerves which excite the CNS. They stimulate α-1, β-1, and β-2
receptors to increase blood pressure, heart rate, vascular resistance, and
cardiac contractibility (11, 12)
Suppresses appetite, increases energy expenditure/metabolic rate
(thermogenic), lypolitic (9)
Ergogenic properties marketed to reduce fatigue; increase strength, power,
and speed; decrease reaction time; and improve body composition.
Evidence is inconclusive (13)
Ephedrine, synthesized chemically is regulated by the FDA as a prescription
drug with weak amphetamine-like properties
Pseudoephedrine is a nonprescription product found in many cough and
cold products- causes vasoconstriction resulting in less fluid in nose, throat,
sinuses (11)
Merryl Landeck
Efficacy and Safety
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Studies show sufficient evidence to conclude that short-term use
of ephedrine at high doses, or ephedrine and caffeine, ephedra,
and ephedra with herbs containing caffeine promotes weight loss
(13)
Caffeine adds additional efficacy (0.9kg per month weight loss
above placebo) (11,13)
No data regarding weight loss beyond 6 months
Insufficient evidence to support ephedra supplementation for
enhancing athletic performance (11,12,13)
A meta-analysis found intervention groups to have a 2 to 3-fold
increase in psychiatric symptoms, autonomic symptoms, upper GI
symptoms, and heart palpitations compared to control (13)
Caused 64% of all adverse reactions reported in the U.S, despite
accounting for < 1% of all supplement sales (9, 11)
Merryl Landeck
Safety and Contraindications
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Adverse effects (11,14)
 Elevated BP
 Palpitations
 Headache
 Insomnia
 Anxiety
 Restlessness
 Psychiatric disturbances
 Seizure
 Heart attack
 Stroke
 Death
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DO NOT take ephedra with:
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MAO-inhibitors or other stimulant
drugs (9)
Should not be taken by persons
with:
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Heart disease
Cardiovascular disease
High BP
History of stroke
Diabetes
Hepatitis
Myocarditis
Diseases of the nervous system
Hyperthyroidism
High cholesterol
Heart rhythm abnormalities
Merryl Landeck
Accessibility
Dosage
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Prior to 2004 ban, FDA
recommended:
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Highest recommended dose
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8mg ephedrine every 6 hours
up to 7 days (11)
No more than 25 mg at one
time, not to exceed 100 mg/day
(9)
Typical marketed dose
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20 mg, 2-3 times daily (15)
Clinical weight loss trials
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50 mg, 3 times daily for 2
months (11)
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Before FDA ban on April 12,
2004 ephedra widely available
in stores and online
Cost avg. $1-$6/day
Reports from 1999 estimate 3
billion doses of ephedra sold
and 12 million users in the
U.S. (11)
GMPs questionable (15)
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Labels fail to list alkaloid
content
Actual alkaloid content
significantly different than
what’s listed
Contaminants
Merryl Landeck
EphREDra
Overall Impressions
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Ephedra is an example of how the current system for
regulation of dietary supplements can be challenging for
ensuring the protection and health of the general public
Should supplements with biological activity be evaluated
and regulated to the same degree as over-the-counter
medications? Or prescription drugs?
Are ephedra-free weight loss products, such as bitter
orange or caffeine, effective or any safer?
Merryl Landeck
PGX:
Functional Fiber Supplement
Weight Loss
Merryl Landeck
PolyGlycopleX
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Scientific Name (of main ingredient)
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Typical usage
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Amorphophallus konjac, native to Asia (16)
Konjac-mannan from the root is used
As a dietary supplement to reduce cholesterol levels, constipation,
blood sugar, and weight
Traditionally a source of food (jelly, tofu, noodles) and medicine in
Asian practices
Typical dosage (with 12-16 fl. oz. of water)
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Day 1-2: 1 softgel with each meal
***1.5g fiber in each softgel
Day 3-4: 2 softgels with each meal
Day 5-6: 3 softgels with each meal
Day 7 and beyond: 4-6 softgels with each meal
Merryl Landeck
Mechanism of Action
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PGX is a proprietary blend of konjac-mannan, sodium alginate,
xanthan gum, and MCTs (17)
Natural polysaccharide complex: α-D-glucurono-α-D-manno-β-Dmanno- β-D-gluco, α-L-gulurono-β-D mannurono, β-D-gluco-β- Dmannan
Highly viscous, soluble, fermentable fiber (18)
Upregulation of gut-satiety hormone gene expression (PYY, GLP-1)
via fermentation & production of SCFAs in large intestine (19)
“Volumetric effect”, gastric distension and delayed gastric emptying,
the “ileal brake” promotes earlier satiety, slower transit time
through small intestine (19,20)
Lowers glycemic index of foods, reduces post-meal spikes in blood
sugar
Lowers cholesterol levels by sequestration of bile acids
Aids in weight loss as fiber-rich meals tend to be less calorically
dense, lower in fat and added sugars.
Merryl Landeck
Natural Standard Scientific Evidence (16)
Merryl Landeck
Safety and Accessibility
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Generally well tolerated, low rate of adverse events (21)
Minor side effects in gas, bloating, and laxative effects (22)
Patent pending delayed viscosity process (17)
Caution with blood pressure and blood sugar lowering
medications-compounding effects (16)
Lack of safety information for pregnant and breastfeeding
woman.
Widely available online, in drugstores, natural-food stores, and
supplement stores.
Available in capsules, granules, shakes, and bars
Average cost is $30/ 120 softgels (approx. $2.5/day for an
average of 15g fiber/day)
 One can of organic garbanzo beans contains 19g fiber and
costs ~$1 – 1.50.
Merryl Landeck
GMPs and Overall Impression
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All manufacturing, processing and packaging steps
required for PGX meet or exceed government and
industry standards and Good Manufacturing Practices
are adhered to.
PGX has a USP Standard as of the 1st of March 2013
(17)
Green
light
May be a good alternative for people, overweight
or not, who are unable or unwilling to ↑ fiber
intake through food sources
 ↑ satiety on calorie-restricted diets
 Appropriate dosing
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Merryl Landeck
Hoodia
Weight Loss
Annie Laweryson
Hoodia
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Scientific name: Hoodia gordonii
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Traditionally used by San people of Namib desert as and
appetite suppressor on long hunts and in times of harsh
conditions (16,17)
Soft middle of cactus root is chewed
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Has been used for 1000’s of years (16,17)
Laweryson, Annie
Hoodia
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Mechanism of action (16,17,18)
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P57, exact mechanism unknown
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Increased ATP production in nerve cells of hypothalamus when
injected into brain of rats
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Tricks brain into thinking the body is full
Rats consumed 40-60% less kcal
Human studies (16,17,19)
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One study showed 18 obese people who took Hoodia for 15 days
consumed 1000 kcal daily less than the control group
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Study has never been replicated and never published in a peer reviewed
journal
Another study showed that overweight women who consumed 1110
mg of hoodia per day did not consume fewer kcal than the control
group
Laweryson, Annie
Hoodia
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Typical dosage: 800 mg bid, 3000-4000 mg/d
Accessibility: Easy to get
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Natures Way: $13.50 60 caps
Source Naturals: $21.49 60 capsules
Used in teas, patches, capsules, etc.
Laweryson, Annie
Hoodia
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GMP’s
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Safety concerns
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No scientific standard for assessing quality of hoodia (16)
Consumer Lab unable to perform desired testing
More Hoodia is being sold than exists (16,17)
Products may contain similar species to hoodia or no hoodia at
all (16)
Contraindications
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One study showed women receiving 1110 mg bid experienced
side effects including nausea, vomiting, skin sensations, elevated
BP, increased HR (16,19)
Laweryson, Annie
Hoodia
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Scope of practice
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Within scope to recommend supplements for weight loss
however, would advise against recommending Hoodia
Overall impression
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No real research that supports the use of Hoodia in
supplemental form
Possibilities? May have better weight loss properties if used
similar to how San people use it
Laweryson, Annie
Raspberry Ketones
Weight Loss
Annie Laweryson
Raspberry Ketones
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1995 Japanese scientist noticed RK are similar to
Capsaicin and Synephrin (20, 21)
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Capsaicin- increased metabolism thus causing a reduction in
adipose tissue and TG
Synephrine- found in citrus fruits and exerts a lypolytic
property on fat cells
Food sources: phenolic compounds in
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raspberries
cranberries,
blackberries
kiwi fruit
Laweryson, Annie
Raspberry Ketones
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Mechanism of action:
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Antiobese action conducted
during fat decomposition (20,21)
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RK at 1% and 2% have shown
antiobese affects
Reported that RK at 5%
suppressed weight gain despite
over consumption of fructose
and glucose
Lipolytic effects shown both in
vivo & in vitro (20,21)
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Failed to stimulate lypolysis in
the absence of norepinephrine
Laweryson, Annie
Raspberry Ketones
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Accessibility:
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Nature Made: $10.74 60 caps
Bio Nutrition: 13.99 60 caps
Typical dosage: varies 100-500 mg
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One study showed 100 mg RK taken 30 min prior to a high fat
meal showed some evidence for reducing arteriosclerosis (22)
1-4 mg RK derived from 1 kg of red raspberries (22)
Laweryson, Annie
Raspberry Ketones
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GMP: No standardizations for testing RK (22)
Safety Concerns: GRAS, lack of research
Contraindications (22):
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Use cautiously with antidiabetic agents, anti-inflammatory
agents, antiobesity agents, certain cancers, cardiac dysrhythmia
Insufficient evidence regarding use by children, pregnant or
lactating women, allergies, hypersensitivity
Possible DNI: Antiandrogens, anticoagulants, antidiabetics, antiinflammatories, antilipemics, antineoplastics, antiobesity, CNS
stimulants, dermatologic agents, heart rate-regulating agents,
hepatoprotective agents, hormonal agents, warfarin
Laweryson, Annie
Raspberry Ketones
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Scope of practice
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Within scope to recommend supplements for weight loss
Natural Standard grade C for weight loss
Overall impressions
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Appears to be promising
Fairly safe
Lack of research
Laweryson, Annie
Creatine
Ergogenic Aid
Rebecca Levens
Creatine
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Scientific name (30)
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N-amidinosarcosine
N-(aminoiminomethyl)-N methyl glycine.
Types
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Creatine monohydrate (88%) (31)
Creatine ethyl ester (86%) (31, 32, 33, 34)
Creatine HCl (79%) (31)
Dicreatine malate and tricreatine malate (70%) (31)
Creatine ester phosphate (62%) (31)
Creatine AKG (47.5%) (31, 35)
Rebecca Levens
Food Sources
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Food sources (30,36, 37)
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Red meat, poultry, and fish
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350 mg per 3.5 ounce of red meat
Only animal protein sources so may have additional effects for
vegetarians
Rebecca Levens
Usage
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Usage (30)
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A- Athletic performance enhancement for muscle mass and
muscle strength
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C- performance enhancement for cyclists, high intensity
endurance, rowers, runners, sport specific, sprinters, swimmers
Rebecca Levens
Mechanism of Action
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Synthesized in the body from dietary amino acids in liver,
kidneys and pancreas (30, 37)
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This is in addition to what we get from food sources
Gets stored in skeletal muscles as creatine phosphate (30, 37,
38)
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High energy substrate to create ATP
Increased levels of creatine enhance
the ability to regenerate ATP for
short energy bursts
Improved resynthesis of
creatine phosphate during recovery
Rebecca Levens
Dosage
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Orally (31)
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Start with a “loading” dose (30,37)
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2-5 grams of creatine per day.
Results in gradual increase in creatine storage in muscles (30,37)
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15-20 grams of creatine per day for 5-14 days
Followed a “maintenance” dose (30, 37)
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Powder
Capsule
Liquid
Should occur within 2-4 weeks
Mixed evidence of whether the loading dose is actually more beneficial
than just taking a constant dose
Cycling on and off is recommended (39)
Rebecca Levens
Safety
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Avoid with renal patients due to difficulty removing waste
product creatinine (38)
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Little is known about the potential long terms effects, may
impact renal function (38)
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High doses of 20 grams/day long term may impact kidneys and
cardiovascular system
Possible DNI with nephrotoxic drugs
Can cause slight weight gain due to water retention (38)
Some people may also experience muscle cramping,
diarrhea, and dehydration (38)
Caution with caffeine, may decrease effectiveness (38)
Rebecca Levens
Purchasing Creatine
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Be cautious when purchasing of liquid creatine (31)
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Differing amounts of usable creatine (31)
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Creatine breaks down in water
Powders and tablets are better
Monohydrate form has the most (88%) (31)
Be mindful of proprietary blends that do not disclose the
amount of creatine
Excipients may include carbohydrates (31)
Things to note on label:
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NSF certified for sport
GMP
Purity assured by HPLC
Rebecca Levens
Brand
Source
Dosage
ALL Max
Super
Supplements
Bioplex
Nutrition
Creatine
Serving
s
Cost
Cost per
month
1 teaspoon
80
(yields 5 grams
creatine
monohydrate)
$18.99
$0.23 per
serving
$11.27
Super
Supplements
1 scoop (yields 65
7 grams
creatine
monohydrate)
$26.50
$0.40 per
serving
$14.00
Twin Labs
Super
Supplements
3 capsules
(yields 2,100
mg creatine
monohydrate)
20
$9.09
$0.45 per
serving
$49.00
Jarrow
Formulas
Super
Supplements
1 capsule
(yields 800 mg
creatine
monohydrate)
120
$9.07
$0.08 per
serving
$24.50
Rebecca Levens
Brand
Source
Dosage
ALL Max
Super
Supplements
Axis Labs
Creatine
Ethyl Ester
Now Foods
Serving
s
Cost
Cost per
month
1 teaspoon
80
(yields 5 grams
creatine
monohydrate)
$18.99
$0.23 per
serving
$11.27
Supper
Supplements
3 capsules
(yields 2,250
mg creatine
ethyl ester)
$24.95
$0.62 per
serving
$67.51
Supper
Supplements
2 capsules
120
(yields 1.5
grams buffered
creatine
monohydrate)
$49.99
$0.42 per
serving
$68.60
40
Rebecca Levens
Overall Impression
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Within scope of practice, especially for sports dietician
Green light
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When taken in appropriate doses for 1-5 years
Effect of long-term, high doses of creatine has yet to be
established
Rebecca Levens
Beta Alanine
Ergogenic Aid
Rebecca Levens
Beta Alanine
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Scientific name
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Also called carnosine or CarnoSyn (40)
Food sources
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3 aminopropanoic acid (40)
Naturally occurring beta amino acid (41)
Poultry, beef, pork and fish (40)
Usage
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Exercise performance enhancement (C) (41)
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Used for exercise that requires power and strength
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High intensity, anaerobic, strength training and weight lifting
Goal is to increase time to exhaustion and improve muscular
endurance
Rebecca Levens
Mechanism of Action
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Works to increase the carnosine levels in the fibers of all
types of muscles
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Increases buffer to decrease effects of pH changes from lactic
acid production (40,41)
Results in decreased fatigue and increased power (40)
Note that carnosine levels can be increased with training
alone (41)
Rebecca Levens
Dosage and Safety
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Orally (40,41)
 Capsule
 Powder
There is some variation in the research for dosage
 2.4 – 6.4 grams/day (41)
 4.8 grams/day for 30 days (40)
 Increase dosage for 8 weeks starting with 2 grams/day and gradually
increasing to 4 grams/day (40)
Greater than 10-20 mg/kg body weight may cause parasthesia (40)
Caution with allergy (40)
No known interactions with drugs, herbs or food (40)
Little information for pregnant and lactating women (40)
Rebecca Levens
Purchasing Beta Alanine
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There is no standardization (41)
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Can find a variety of excipients/added ingredients
NSF certified for sport
Easily accessible
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Online
Super Supplements
Rebecca Levens
Brand
Source
Dosage
# Servings
Cost
Now Foods
Supper
Supplements
3 capsules
(2.5 grams
beta-alanine)
40
$29.99
$0.75 per
serving
ALL Max
Nutrition
Supper
Supplements
1 teaspoon
(3.2 grams
beta-alanine)
31
$18.99
Rebecca Levens
Overall Impression
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Within scope of practice for sports dietician
Yellow light (natural standard)
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GRAS
Possibly safe with appropriate short term use
Additional research is necessary due to varied results
Rebecca Levens
Synergy of Supplements
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Mixed evidence (42,43)
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Some suggests increased benefit of supplementing with
both creatine and beta-alanine due the supplements acting
differently in one’s body
Others note no difference with stacking of supplements
Can easily find supplements that contain multiple
ergogenic aids
Rebecca Levens
Arginine
Ergogenic Aid
Erin Prasad
Arginine
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Scientific name: 2-amino-5-guanidinopentanoic acid
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Common name: L-arginine
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Conditionally essential amino acid first isolated in 1886
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Food sources:
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Nuts (brazil, almonds, cashews)
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Seeds (sesame, sunflower)
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Whole grains (oats, barley, buckwheat)
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Poultry
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Red meat
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Dairy products
Functions in the body:

cell division, wound healing, removing ammonia from body,

immune function, release of hormones, lean body mass,

blood sugar regulation.
44, 45
Erin Prasad
Arginine



Typically used for conditions such as:

CHF, Intermittent claudication, angina, impotence,

sexual dysfunction in women, wasting syndrome in AIDS

decreased inflammation in infants, improved wound healing, faster recover after
surgery
 And as and ERGOGENIC AID in increased exercise endurance and body
building.
Dosage:
 No upper intake established
 Supplemental: 2-8g/d
 CHF: 6-20g/d, Angina: 3-6g/d
 Infants: 261mg/kg for first 28 days of life
Mechanism of Action:
 L-arginine is a substrate for nitric oxide synthase therefore necessary for the
formation of nitric oxide
 Nitric oxide is a vasodialator and contributes to increased blood flow
 Proposed theory: Increased blood flow to the tissues=increased O2 to muscles=
Improved athletic performance.
44, 45, 46, 49
Erin Prasad
Arginine

Efficacy as an Ergogenic Aid

Study 1 (2014): Runners-No significant change in running time.
 “…L-arginine supplementation did not cause beneficial changes in metabolic and hormonal
parameters beyond those achieved with exercise alone.”
Study 2 (2012): Strength trainers did not show increase in their strength resistance exercise
performance.
 “It is still premature to recommend nutrition supplements containing L-arginine as an ergogenic
aid”

Safety:








Considered safe in doses up to 20g/d
Adverse reactions:
Capsule- abdominal pain, bloating, diarrhea, gout, airway inflammation (asthma)
IV: urticaria, periorbital edema, pruritis
Interactions with medications:
Caution with anti-hypertensive drugs or nitrates: blood pressure can drop too low
GMPs:

All of the L-arginine containing supplements that Consumer Lab selected for review passed.
46, 47, 48
Erin Prasad
Arginine

What to look for when buying
Accessibility:

L-arginine can be found at any supplement store (AA Section), online, or at drug/grocery
store

Price range: $9.50 (100 capsules)-$31.99 (1lb)
Forms: 500mg or 1000mg tablets or capsules
Powder (free form): 1/2tsp contains 1500mg
Dosing Instructions:
Varies from brand to brand but all fall within recommended dose of 2-8g/d.
Excipients: gelatin, magnesium, stearate, and silica
Extras: L-arginine is in the form of hydrochloride and often combined with an ornithine or
citrulline complex to “support protein synthesis” or “support peak performance”
Erin Prasad
Arginine
Overall Impressions and Recommendations
Scope of Practice:





Safe and relevant for a RDN to suggest for someone who may be in periods of
growth, recovering from surgery or a wound, and lacking dietary sources.
Coordination of care with physician should be considered, and necessary in the
case of children.
Relatively safe

Exceptions: When combined with blood pressure meds or nitrates
Large doses in infants
Yet, it has not been proven effective as an ergogenic aid
Erin Prasad
Overall Recommendations

Green Light



Yellow Light





PGX
Creatine
Conjugated Linoleic Acid
Raspberry Ketones
Beta-alanine
L-arginine
Red Light


Epherdra
Hoodia
References
1, Consumer Labs: Review of CLA (Conjugated Linoleic Acid) Supplements for
slimming.
http://www.consumerlab.com.buproxy.bastyr.edu:2048/reviews/CLA_Conjugated_Linol
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2. Natural Standard: Conjugated Linoleic Acid (CLA) professional monograph.
http://www.naturalstandard.com.buproxy.bastyr.edu:2048/databases/herbssupplements/
conjugatedlinoleicacid.asp?. Accessed 2/4/2014.
3. Natural Methods Comprehensive Database: Conjugated Linoleic Acid.
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4. Kennedy et al. Antiobesity mechanism action of conjugated linoleic acid. Journal of
Nutrition and Biochemistry, 2010; 21 (3): 171-79.
5. Chen SC et al. Effect of conjugated linoleic acid supplementation on weight loss and
body fat composition in a Chinese population. Nutrition, 2012; 28(5): 559-65.
6. Racine NM et al. Effect of conjugated linoleic acid on body fat accretion in
overweight and obese children. American Journal of Clinical Nutrition, 2010; 91: 1157-64.
7. Onakpoyaa IJ et al. The efficacy of long-term conjugated linoleic acid (CLA)
supplementation on body composition in overweight and obese individuals: a
systematic review and meta-analysis of randomized clinical trials. European Journal of
Nutrition (systematic review); 51 (20): 127-34.
References:
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