Please do not distribute without written consent of Dr. Cindy M. Howard

Cindy M. Howard, DC, DABCI, DACBN, FIAMA, FICC

March 1, 2019

The Good, The Bad and The Why A Look at Protein Bars, Powders and Gels

Professional Football Chiropractic Society

Please do not distribute or copy without permission

Dr. Cindy M. Howard drcindyhoward@msn.com 708-646-6561 ! Board Certified Chiropractic Internist and Nutritionist ! Fellowship International Academy of Medical Acupuncture ! Fellowship International College of Chiropractors ! Owner Innovative Health & Wellness Center ! DC Consulting, Owner ! Director of Functional Medicine Aligned Modern Health, Chicago, Illinois ! Director of Functional Nutrition for Neurosport Elite, Davie, Florida ! Illinois Delegate American Chiropractic Association ! ACA Committee member: Professional Development, Guidelines and Membership ! Past President of the Council on Diagnosis and Internal Disorders ! Medical Advisory Board Integrative Therapeutics ! Medical Advisory Board Functional Medicine University ! Executive Board member for The ACA College of Pharmacognosy & Toxicology ! Post graduate instructor for DABCI diplomate ! Executive Board Member Doc:s ! Board Member Before the Hit ! Team Chiropractic Physician for Dreamz Elite Cheer ! Board member Frankfort Falcons Youth Football Association ! Mom of 3 absolutely amazing kids

Objectives• Identify adverse ingredients in protein powders, bars and gels

• Understand why a product is beneficial or not

• What to look for so you can recommend a good product

Dietary Supplements

Product taken orally that contains a dietary ingredient “intended to supplement the diet”.

Available in capsules, tablets, liquids, soft gels, powders and bars

3 categories of supplements Supporting muscle mass growth

Supporting weight loss and fat burning Enhance performance and endurance

Most effective to support muscle mass growth: protein powders and drinks with more carbs than proteins (70-90%) (10-30%)

contain creatine essential amino acids

branched chain amino acids

Optimal intake is in the morning up to 30 minutes post exercise

3-6g of EAA and 5-10 g BCAA prior to and/or following exercise stimulates protein synthesis

Benefits of Protein supplementation

ISSN Position Statement related to intake of protein

• Exercise (resistance) and protein ingestion stimulate the building of muscle, synergistic when protein precedes or follows exercise

• 1.4-2.0 g/kg to build and maintain muscle mass

• Resistance-trained subjects on low calorie diets may need 2.3-3.1 g/kg/day

• Optimal protein per serving is .25g/kg or 20-40g.

• Acute protein dose should contain 700-3000 mg of leucine and balanced EAA

• Distribute proteins every 3-4 hours

• Optimal time to ingest is to individual tolerance

• Powder is practical to ensure intake while minimizing caloric intake

ISSN Position Statement related to intake of protein

Too much protein?

Over 35% of daily calories can cause nausea, cramps, fatigue, headaches and bloating

If kidneys have to work harder…increases calcium excretion leading to bone loss

Dehydration is potential risk factor

3 common forms of protein powders

• Protein concentrates: extract a protein from a whole food using heat and acid or enzymes ( supply 60-80% protein rest is fat and carbs

• Protein Isolates: filtering removes more fat and carbs ( contain 90-95% protein)

• Protein hydrolysates: further heating breaking the bond between amino acids ( absorbed more quickly)

• Raise insulin levels more than other forms

Comes from the watery part of milk Contains lactose

Isolate version contains less lactose Digests quickly Rich in BCAA

Builds and maintains muscle mass Helps with recovery from heavy

exercise Increases strength Reduces appetite

Negatives to Whey

Allergic reactions for those sensitive to milk, including goat’s milk and sheep’s milk May Cause:

Abnormal heart rhythms Changes in cholesterol levels

Headache Increased risk for DM

Increased fracture or osteoporosis Kidney dysfunction

Liver damage Acid reflux, bloating, constipation, cramps, gas

Lower blood sugar levels Increase risk of bleeding

Interferes with drugs using cytochrome P450 enzyme system Low blood pressure

Drowsiness

https://www.mayoclinic.org/drugs-supplements/whey-protein/safety/hrb-20060532

Casein

Found in Milk Slowly absorbed and digested

Forms a gel with stomach acid and delays absorption of aa More effective at increasing strength than soy and but less than whey

Promotes fat loss during calorie restriction

Egg Protein

High quality protein Helps decrease appetite and stay full longer

Usually made from egg whites Provide all 9 essential AA

Second highest source of leucine needed for muscle health Good for those with dairy allergies

Easily digested

Pea Protein

Good for vegetarians, vegans or allergies to dairy or egg High fiber legume and has 8 essential aa

Promotes fullness Increases muscle growth

Hemp Protein

Plant based Contains trace amounts of THC

Rich in omega 3 fatty acids Low levels of lysine and leucine so not a complete protein

Well digested

Brown Rice Protein

Considered inferior for building muscle 9 essential aa

Low in lysine to be considered complete May have beneficial effects on body composition

Mixed Plant ProteinsUsually 2 or more types

brown rice pea

hemp alfalfa

chia seeds flax seeds artichoke

quinoa Digests slower

Limits the aa your body can use right after exercise Additional enzymes increases absorption and digestion

Dr. Tod Copperman Consumer Labs

• 20% of 22 products didn’t pass because there was more carbs, cholesterol or sugar than was on their label

• Whey and Casein: most popular from milk and contain all the amino acids needed

• Ratio of amino acids differ in the plant based proteins such as hemp, soy, pea and these give extra carbs and fiber

• Egg protein powder: more salty tasting

• Pea: mild vegetable taste

• When should you use…in conjunction with exercise

• Need up to 50 extra grams of protein if trying to build muscle

• Isolate: focuses on protein and gets rid of lactose

• Hydroxylate: break down protein: like it is digested for you, bitter taste

• May help with weight loss if taking after exercise

• Need extra fluid with protein

• Generally safe

• To get 20 grams of protein 37 cents to $5 per serving

Reproduced from purefoodcompany.com

Plant protein comparison

What to absolutely avoid!

Industrial Oils: Soybean, palm, Canola Dairy, gluten, soy

High Fructose corn syrup and other added sugars Chemicals and Additives:

guar gum sugar alcohols (xylitol, erythritol, sorbitol)

artificial sweeteners maltodextrin soy lecithin

Canola Oil

Canola oil linked to worsened memory and learning ability in Alzheimer's Date: December 7, 2017Source: Temple University Health SystemSummary: Canola oil is one of the most widely consumed vegetable oils, yet little is known about its health effects. Now, a study links canola oil consumption in the diet with worsened memory, worsened learning ability and weight gain in mice which model Alzheimer's disease. It's the first study to suggest that canola oil is more harmful than healthful for the brain.

Harmful for the brain Affects memory and learning ability

Contributes to weight gain

Causes obesity Contains contaminate including mercury not regulated

Marker of poor quality, nutrient poor food like substances

Related to cancers, fatty liver, hypercholesterolemia, Diabetes, HBP, leaky gut and heart disease

Leaves you craving more due to rise in leptin and insulin

High fructose corn syrup/sugars

Dairy

• Inflammatory

• Unable to digest

• Linked to prostate cancer

• High in saturated fat

• Inflammatory

• Increases vulnerability to Autoimmunity

• Damages gut biome

• Bloating, Stomach pain, bloating, Diarrhea, skin changes

Soy

Genetically modified

Glyphosate increases risk of cancer and high rates of birth defects

Chemicals/toxins

• 130+ toxins

• lead, arsenic, cadmium, mercury

• Bisphenol-A

• Pesticides

Consumer Reports tested 15 protein drinks for heavy metals and 3 had potentially harmful amounts.

ConsumerLab says nearly 1/3 of 24 protein supplements filled their quality assurance test. Two had potentially risky amounts of lead. Others had more cholesterol or sodium

than what was on the label.

Additives

• Fractionated palm kernel oil: saturated fat

• Soy Lecithin: prevents sticking , helps mixing, increases shelf life

• Food dyes; brain and behavior issues, cancer, chromosomal damage

• Carrageenan: from seaweed and enhances smoothness, causes digestive problems, ulcers and bleeding

1 https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm557424.htm2 https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/With-No-Amount-of-Lead-Exposure-Safe-for-Children,-American-Academy-of-Pediatrics-Calls-For-Stricter-Regulations.aspx

• Water run off from industries that smelt copper and prepare nuclear fuels causes contamination

• Elevated Cadmium: heart and digestive system • Lead: lower IQ scores and academic performance, inattention, impulsivity, aggression

and hyperactivity • Arsenic found in foods from run off in soil, rice m/c • Mercury causes damage to GI tract, nervous system and kidneys

Clean label project

What to look for.

• Real whole food ingredients

• Natural, unrefined sugars

• Quality protein

• Quality fat sources

Natural unrefined sugars• Honey

• Pure Maple syrup

• Molasses

• Coconut sugar

• Sucanat

• Brown Rice Syrup

• Date Sugar

Quality protein

Quality fat sources

What is best?For Muscle gain: Whey

For Weight loss: Casein, whey or combo For vegetarians and vegans: single or mixed

Products to avoid

Muscle Milk •Dairy •Sunflower Oil •Maltodextrin •Canola Oil

Quest Protein •Dairy •Cellulose and Xanthan gum •Sucralose

BSN® SYNTHA-6 ISOLATE™ •Dairy •Sunflower solids •Corn syrup solids •Soy Lecithin •Cellulose Gum

Ingredients

GNC Total Lean •Dairy •Soy •Cellulose and Xanthan gum •Corn syrup solids •Artificial flavors •Long list of unrecognizable additives

OPTIMUM Nutrition Gold Standard 100% WHEY™ •Dairy •Artificial flavors •Soy lecithin

GNC AMP Sustained Protein Blend •Dairy •Artificial flavors •Gum Blend •Sucralose •Red #40

Body Fortress • Maltodextrin • Cocoa (Processed With Alkali) • Artificial Flavors • Soy Lecithin • Cellulose Gum • Artifical sweeteners (Sucralose and Acesulfame Potassium)

• ISOPURE Natural Flavor • Second ingredient is cane sugar • Soy lecithin • High sodium 240mg • Synthetic additives

• Adaptogen Tasty Whey • Partial hydrogenated coconut oil • Corny syrup solids • Sugar • Fructose • Guar gum • Artificial flavors and many additives

JYM® PRO JYM PROTEIN •Gum Blend (Cellulose Gum, Xanthan Gum,

Carrageenan) • Artifical sweeteners (Sucralose and Acesulfame Potassium) • Silicon Dioxide additive

• Pure Protein • Maltodextrin • Artifical Flavors • Cellulose and Xanthan gum • Soy Lecithin • Artifical sweeteners • (Sucralose and Acesulfame Potassium)

Multi level powders

Herbal Life •Fillers and gums •Corn based ingredients •Fructose, cane sugar •Canola Oil •Sunflower lecithin •Not certified organic

Complete Juice Plus + •Soy protein blend •High in sugar (10g) •Gums (gum arabic, guar gum, xanthan gum) •Lecithin •Not certified organic

Multi level powders

Arbonne •Cane sugar •Xanthan, guar, and acacia gum •High in sodium 360 mg •Sunflower oil •Contains soy •Not certified organic

Usana- Vanilla Nutrimeal •18g sugar, 470 mg sodium •Soy protein isolate •Crystalline fructose •High oleic sunflower oil •Maltodextrin •Gums •Not certified organic

There are different protein bars on the market.

What do I pick?

Pros and Cons

Quick Easy to store and take with you

Can find raw ingredients and organic Alternative to higher calorie snacks Pre packages with nutritional info

Could be a meal substitute Many have a good source of fiber

Most are loaded with sugar Not as healthy as whole food

May be too low in protein May be very high in fat contributing to weight gain

Contain artificial sweeteners, preservatives Contain GMO soy, casein or milk

Most nut bars have been heated and aren’t raw Must have them on hand since most convenient stores have junk

Issues with bars and quality

Steve Hertzler, PhD, RD Ohio State University

Ironman PR Bar increase blood sugar levels that remained steady = might enhance endurance performance

40%carb, 30% fat, 30% protein “Consuming a little bit of carb every so often increases endurance”

PowerBar produced a quick increase in blood sugar with rapid decline = similar to a Snickers bar

“Anything that provides calories will give you some energy “ “Bananas give energy, Energy bars give energy, Twinkies give energy,

because they all provide calories” Nancy Clark, MS, RD

What to look for

•Real whole food ingredients

•Natural, unrefined sugars

•Quality protein

•Quality fat sources

What to avoid

Cellulose and Xantham gum

• Insoluble fiber

• Not digestable

•May cause GI distress

• Reacts for those with severe allergies

Corn Syrup Solids

• Dried and solidified corn Syrup

• Corn syrup (100% glucose) is dehydrated until it is 10% water

• Metabolized by the body in a way that may contribute to obesity, diabetes and liver disease

Maltodextrin• White powder, tasteless and dissolves in water

• Improves texture, flavor and shelf life

• Made from corn ( usually GM) , potato, wheat, tapioca or rice

• hydrolysis used to break starch into smaller molecules of sugar

• Increases risk of hypercholesterolemia, weight gain and DM type 2 and insulin resistance, flatulence, bloating

• Higher glycemic index than table sugar

• Increases the activity of E. Coli….IBD and Crohn’s

• Helps salmonella survive

• But it is cheap and a rapid source of energy

Soy Lecithin• Derived from sunflower kernels, rapeseed, mild, soy and egg yolks

• Soybean oil is extracted using hexane and is then gummed to separate lecithin from the oil. It is then dried and sometimes bleached with hydrogen peroxide.

• Pesticides can remain in the oil

• Protein content varies so hard to know if it will cause an allergic reaction

• Probably GMO so if Organic…OK

• Used as an emulsifier

• Diarrhea, nausea, abdominal pain, bloating

• Usually indicate a lower quality food

• Can come from anything inedible

• Side effects: dizziness, nausea, mental confusion, seizures, depression, DNA damage, allergies, fatigue, anxiety, high blood pressure, kidney disfunction

• Natural flavors might not be much better

Artificial Flavors

Red Dye #40• Comes from petroleum or coal

• Banned in 1990 but can be used until supplies run out

• Australia and Europe

• Correlated to thyroid cancer and chromosomal damage in lab animals

• Interferes with brain nerve transmission

• Stomach aches, migraines, jitteriness, nervousness, inability to concentrate, eczema, hives

Sunflower oil• High in omega-6 fatty acids up to 70%

• Exacerbates inflammation

• Imbalance in omega 6 can contribute to cardiovascular disease

• If allergic to ragweed, daisies, marigolds and chrysanthemums do not use

• Increase fasting insulin and blood sugar

Over 1/3 of protein bars have more saturated fat than a glazed donut from Krispy Kreme

Protein bars to avoid• Protein edition*- 12g added sugars, unnatural

flavors, palm oil, soy protein isolate • Energy edition*- 26g added sugars,

maltodextrin, soy protein isolate, fructose

• Soy protein isolate • palm kernel oil • 21g sugar

• Fractionated palm kernel oil • artificial sweeteners • disodium phosphate • sugar alcohols

• 13g sugar • milk powder • fractionated palm kernel oil

• Soy Protein-isolate • vegetable glycerin • xanthan gum

• Palm oil • xanthan gum • sunflower lecithin • cellulose gum • Zero grams sugar but all sugar alcohols

Protein bars to avoid

Protein bars to avoid • Soy and whey protein isolate • malitol • glycerin • soy lecithin

• Soy protein isolate and palm oil

• 340 calories • 29g sugar

• Palm and vegetable oil • whey protein isolate • corn syrup • vegetable shortening • caramel • modified corn starch • soy lecithin

Protein Bars to Love

• 15g Pro, 11g Fiber, 14g Quality Fats, 10g Net Carb, 8g Sugar • Some ingredients: bone broth protein concentrate, grass fed

whey protein concentrate, chicory root fiber, cassava root fiber, organic almond butter, Organic Clover Honey, Organic Coconut Nectar, Organic Dates, Stevia

• No trans fats, hydrogenated oils or canola oil • Gluten free, soy free, no artificial flavors

• **also have protein powder

• 12g protein, 5g fiber • Clean whole food ingredients • 4 main ingredients:

• 3 egg whites, almonds, cashews, 2 dates • Gluten free • No artificial flavors or added sugars

• 12g Pro, 14g Fat, 2g sugar • Gluten-Free • Grass-fed collagen • Some ingredients:

• Brain octane ( oil ), collagen, chicory root fiber, stevia

• 15g Pro, 3g Sugar, 6-8g Fiber • Gluten-free, soy-free, dairy-free and whey free • Paleo • Some ingredients:

• Nuts, grass-fed collagen, pre-biotic fiber, • honey, monk fruit

• 15g Pro, 12g Sugar, 13g Fat, • organic, soy-free, gluten-free, • no artificial sweeteners or sugar alcohols • no preservatives • 4 natural ingredients:

• Organic cashews, organic coconut nectar, • pea protein, and organic lemon extract

•No artificial ingredients •14g Pro, 11g Fiber, 4g Sugar, 11g Fat •Vegan, USDA organic •gluten-free, dairy free, stevia free, soy-free

•Some ingredients: •Protein blend (brown rice and pumpkin seed protein), •tapioca powder, cashew butter, dark chocolate, •vegetable glycerin, sunflower butter, lecithin*, •monk fruit extract

• USDA organic, gluten-free, vegan, soy-free • 15g Pro, 4g Sugar, 9g Fiber, 4g Fat • Some ingredients:

• organic brown rice protein, organic tapioca fiber • organic tapioca syrup, organic virgin olive oil • organic stevia

• *also have protein powders

• 13g Pro, 2g Sugar, 13g Fat, 11g Fiber • (full ingredient list) Cookie Dough flavor:

• Organic Pea Protein, Organic Prebiotic Fiber • Organic Cashews, Organic Chocolate Chips • Organic Palm Oil (Certified Sustainable) • Organic Coconut Flour, Water • Organic Tapioca Flour, Organic Vanilla • Sea Salt, Monk Fruit

• **Debatable sugar wise • first two ingredients are brown rice syrup • dark chocolate)

• USDA organic, Vegan, Gluten-free • 12G Plant-based protein, 3g fiber, 14g sugar • Antioxidant rich

• **Debatable sugar wise ingredient • (first ingredient is brown rice syrup)

• 11g Pro, 14g Sugar, 11g Fat • Gluten-free, dairy-free, vegan, organic • kosher, soy free, • R.A.W., C.L.E.A.N

ConsumerLab.com announced the findings of its independent laboratory tests of 30 nutrition bars, 18 did not meet the claims of ingredient levels on the label. More than any other misrepresentation, about one-half of the nutrition bars exceeded the carbohydrate levels stated on the wrapper (one bar promoted as a low-carbohydrate diet product claimed it had just 2 grams of carbohydrates, but testing showed it actually contained 22 grams).

Things to watch for

Less than 5 grams of fat 3-5 grams of fiber

Watch calories meal replacement should have 15 grams of protein or more

and fiber Limit to no more than 1 bar a day

Gels

Why Use a Gel?• To replenish carbohydrate stores that get depleted with running

• But…the glycogen from gels don’t always get to working muscles

• So….. carbohydrate is stored in muscle and blood

• Gels may wake you up because our brain runs on glucose stored in blood

• Glycogen has to be digested first through the intestinal wall and then absorbed by muscles and takes time

• Not efficient as a simple replacement so timing and frequency are important

• As muscles absorb more brain gets less leading to a hazy feeling especially if you didn’t eat enough ahead of time.

When should you take them?

• Can feel effects in 3-15 minutes

• Timing depends on absorption rate

• When running hard body diverts blood away from digestion leading to shut down or slow digestion

• Taking a gel early prevents duress and you can process sugar faster with out GI issues.

• 45-60 minutes before running

How often should you take gels?

• 60 minutes between gels if you take more than 1

• Not often because it is a simple sugar and is first absorbed as glucose

• Training your digestive system to “need” less so the body learns to keep it running to digest more easily if you fuel regularly at proper intervals

• Always take with water for better absorption

• Do not take with sports drink….too much sugar at once

DURATION AND INTENSITY OF EXERCISE CARBOHYDRATE NEEDED

less than 45 minutes none

1 - 2.5 hrs 30 - 60 grams per hr

more than 2.5 hrs, low-to-moderate intensity 30 grams per hr

more than 2.5 hrs, moderate-to-high intensity 60 - 90 grams per hr

• Quick energy and electrolytes • Natural fruit flavors and colors • no artificial coloring, no HFCS • no artificial sweeteners • no caffeine, dairy-free, gluten-free • soy-free, and vegan

Quick entry and electrolytes Natural fruit flavor

• All natural ingredients (3)- Fruit Puree. Chia Seeds. Brown Rice Syrup

• Vegan and gluten-free • 21g of carbs • Some flavors contain caffeine

• *Also have Huma Plus (with electrolytes)

GELS

•Vegan, organic, gluten-free, paleo, •No artificial ingredients •5 main ingredients: •raw cacao, raw almond butter •raw coconut palm nectar, blackstrap molasses •Pink Himalayan salt

•Gluten-free, USDA organic •Organic honey, tapioca syrup •fruit juice concentrates •100% RDA Vitamin C •24g of carbs

Thank you PCFS!

Dr. Cindy M. Howard708-646-6561

drcindyhoward@msn.com

https://www.glukosenergy.com/products/energy-products.html https://humagel.com/pages/nutrition-info https://www.honeystinger.com/strawberry-organic-chew https://muirenergy.com/pages/flavors https://store.draxe.com/collections/proteins https://www.rxbar.com/shop/rxbar.html/ https://www.amazinggrass.com/store/green-superfood-energy-bars-chocolate-peanut-butter.html https://www.primalkitchen.com/products/coconut-cashew-bar https://www.bulletproof.com/food-drink/quality-snacks https://aloha.com/products/chocolate-fudge-brownie-protein-bar https://risebar.com/products/lemon-cashew-protein-bars https://www.22daysnutrition.com/discover-bars https://www.amazinggrass.com/store/green-superfood-energy-bars-chocolate-peanut-butter.html https://www.bhufoods.com/protein-bar-ingredients/ https://www.gomacro.com/dietary-considerations/

References for products

References for recommended products: https://www.glukosenergy.com/products/energy-products.html https://humagel.com/pages/nutrition-info https://www.honeystinger.com/strawberry-organic-chew https://muirenergy.com/pages/flavors https://store.draxe.com/collections/proteins https://www.rxbar.com/shop/rxbar.html/ https://www.amazinggrass.com/store/green-superfood-energy-bars-chocolate-peanut-butter.html https://www.primalkitchen.com/products/coconut-cashew-bar https://www.bulletproof.com/food-drink/quality-snacks https://aloha.com/products/chocolate-fudge-brownie-protein-bar https://risebar.com/products/lemon-cashew-protein-bars https://www.22daysnutrition.com/discover-bars https://www.amazinggrass.com/store/green-superfood-energy-bars-chocolate-peanut-butter.html https://www.bhufoods.com/protein-bar-ingredients/ https://www.gomacro.com/dietary-considerations/

References

Kreider RB, Wilborn CD, Taylor L, Campbell B, Almanda AL, Collins R. et al. ISSN exercise & sport nutrition review: research & recommendations. J Internat Soc Sports Nutr. 2010;7:7–49.

Koopman R, Pennemans DLE, Jeukendrup AE, et al. Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise. Am J Physiol Endo Metab 2004;287:E712-E720. Abstract

Petroczi A, Naughton DP, Mazanov J, Holloway A, Bingham J. Performance enhancement with supplements: incongruence between rationale and practice. J Internat Soc Sports Nutr. 2007;4:19–26.

Phillips SM. Protein requirements and supplementation in strength sports. Nutrition. 2004;20:689–95.

Manninen AH. Protein hydrolysates in sports nutrition. Nutr Metab. 2009;6:38–42.