JMB lays the smack down on Caffeine

Training Bodybuilding
61

Professor X, based on your previous comments I went and did a little research and this is what I came up with. Epinephrine can increase glucose transport when insulin is absent, or can inhibit glucose transport when insulin is present (Am J Physiol 1998 Apr;274(4 pt 1):E700-7)(rat data) . Therefore, caffeine induced epinephrine release would lead to some insulin resistance in the presence of insulin but not in the presence of only epinephrine. Now if you were only taking caffeine during exercise and between meals you would be OK but that most likely is not the case with most as Free Ex pointed out. In addition, you seemed to make the assumption that epinephrine induces glucose uptake whenever it is released with this statement. “Anytime epi is released, glucose and blood is shuttled to muscle tissue. This is the flight or fight response and has been known for decades to occur whether you are lifting weights or not.” Based on the previous study glucose uptake is reduced by muscle tissue in the presence of insulin and epinephrine. Therefore, your assumption that “anytime epi is released, glucose and blood is shuttled to muscle tissue” is false. The effect of exercise induced glucose uptake into muscle cells has been shown to be independent of epinephrine release (J Appl Physiol 2000 Jul;89(1):176-81). Your primary argument appears to be that caffeine would not induce insulin resistance in normal, non-diabetic, actively trained individuals. Well, here is one study that disproves your assumption that healthy individuals with normal glucose tolerance experience normal glucose disposal in response to caffeine administration.

Diabetes Care 2002 Feb;25(2):364-9.

Caffeine can decrease insulin sensitivity in humans.

Keijzers GB, De Galan BE, Tack CJ, Smits P.

Department of Internal Medicine, University Medical Center Nijmegen, 6500 HB Nijmegen, the Netherlands.

OBJECTIVE: Caffeine is a central stimulant that increases the release of catecholamines. As a component of popular beverages, caffeine is widely used around the world. Its pharmacological effects are predominantly due to adenosine receptor antagonism and include release of catecholamines. We hypothesized that caffeine reduces insulin sensitivity, either due to catecholamines and/or as a result of blocking adenosine-mediated stimulation of peripheral glucose uptake. RESEARCH DESIGN AND METHODS: Hyperinsulinemic-euglycemic glucose clamps were used to assess insulin sensitivity. Caffeine or placebo was administered intravenously to 12 healthy volunteers in a randomized, double-blind, crossover design. Measurements included plasma levels of insulin, catecholamines, free fatty acids (FFAs), and hemodynamic parameters. Insulin sensitivity was calculated as whole-body glucose uptake corrected for the insulin concentration. In a second study, the adenosine reuptake inhibitor dipyridamole was tested using an identical protocol in 10 healthy subjects. RESULTS: Caffeine decreased insulin sensitivity by 15% (P < 0.05 vs. placebo). After caffeine administration, plasma FFAs increased (P < 0.05) and remained higher than during placebo. Plasma epinephrine increased fivefold (P < 0.0005), and smaller increases were recorded in plasma norepinephrine (P < 0.02) and blood pressure (P < 0.001). Dipyridamole did not alter insulin sensitivity and only increased plasma norepinephrine (P < 0.01). CONCLUSIONS: Caffeine can decrease insulin sensitivity in healthy humans, possibly as a result of elevated plasma epinephrine levels. Because dipyridamole did not affect glucose uptake, peripheral adenosine receptor antagonism does not appear to contribute to this effect.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 11815511 [PubMed - indexed for MEDLINE]

As far as exercising individuals are concerned I agree that they would not feel the negative effects of caffeine on insulin resistance as much as a inactive person or a diabetic would, primarily because resistance exercise increases Glut-4 activation and glucose uptake for 48 hours after the workout. However, there would be an effect it just wouldn’t be as pronounced. I am sure that you will still get great results using a thermogenic for energy or weight loss despite its negative effects it may have on glucose tolerance. I don’t believe it will cause diabetes, just short-term insulin resistance. Each individual needs to decide for him or herself if the loss of insulin sensitivity is worth the lipolytic, energy enhancing effects of caffeine. If you have any studies showing caffeine does not cause insulin resistance I would like to see them, Otherwise, I don’t need to hear anymore irrelevant details or any more of your life story. I am just interested in the facts.

62

OK, now that I’ve almost caught up on my work,
and now that everyone has had a little time
to mellow out about the caffeine issue, I want
to address a few points with Professor X.

You wrote: "This is true, however, you have to realize something, everything can kill us. With everything you weigh the risks with the positives."

I completely agree with what I just quoted above. Everyone must weigh the risks and benefits of any substance or activity for himself. (More on this below.)

You wrote: "However, please, for the love of God, stop trying to make me put down my caffeine simply because YOU have diabetes."

First of all, as I've explained, I DON'T HAVE DIABETES. Are you illiterate an unable to read what I wrote above?

Second of all, I want to point out that I am not trying to tell you (or "force" you) or anyone else to not use caffeine, so please stop misinterpreting what I have been saying as that. You and every other adult are entirely capable of making your own choices, and facing the consequences of those choices. If you know anything about my views, you know that me telling other people what they should or should not put into their bodies is the antithesis of my values. I was simply making the *factual* argument that caffeine significantly adversely effects insulin sensitivity. I was also making the speculative assertion that a significant percentage of the population (*not* everyone) is at risk from those effects. Nothing more, nothing less. That's all I've been saying. But your perception seems to distort what I've said into something totally different. As a result of those facts, *I* weigh the drawbacks of caffeine use *for me* as outweighing the benefits. I absolutely am not trying to tell you that *you* (or anyone else) shouldn't use caffeine - as that is entirely up to you.

You wrote: "With all of the talk of anabolic steroids on this forum you would think that this was painfully clear."

Yes, I would agree; that is clear to me But are you sure it's clear to you?

You wrote: "it does slightly piss me off that people are now actually worried about this"

Why do you care about what worries other people or not, or what they decide for themselves to put into their own body? If you truly believe what you wrote above, then whether or not people consider caffeine to be a risk factor shouldn't concern you. Why not simply give people the facts and let them evaluate the evidence, and think and decide for themselves about caffeine. You getting pissed off serves no purpose but to make you miserable.

Now that we've gone through all that, I want to tie this back in with the debate about anabolic steroids that you and I had about a year ago. In that debate, our roles were reversed. You were up on your high horse criticizing everyone for using androgens, telling everyone they shouldn't use them, and you strongly advocated that they should be "illegal." You further asserted that androgens were very dangerous from a health risk point of view, almost to the point of telling people that they would destroy peoples' livers and cause all sorts of injection infections. I disagreed with all of those points, and gave rational reasons as to why. But now that the tables are turned, you don't like it very much when other people are (allegedely) "telling" *you* what you can or cannot put into your body. See? It's not much fun is it? If you want the freedom to put caffeine into your body, then you must accept that other people should have the freedom to use androgens if they choose. Otherwise, you are being logically inconsistent at best, or a hypocrite at worst. Fairness would mean that all drugs and all people are treated equally. Caffeine is a powerful drug (YES it *is*), just as anabolic steroids are drugs, just as codeine is a drug. Now since the tables are turned, I could take the approach that you took in that previous debate, and advocate that caffeine should be made "illegal" because it has the potential to harm people. But I won't do that because I think it is the wrong approach for both practical as well as moral reasons. So let's make a deal: you stop telling people they shouldn't use anabolic steroids, and stop advocating that they should be "illegal," and I'll stop "telling" people they shouldn't use caffeine, and I won't start lobbying my congressman to make caffeine "illegal." Deal? There's a relevant quote here that I can't quite think of at the moment. Something to the effect of: "Liberty has the unique property in that in order to possess it for oneself, one must give it away to others."

As a final parting thought, going back to the concept of weighing risks and benefits of various substances, and comparing our two debates, here is my evaluation of androgens vs caffeine *for me*. Since we had that debate, I have used high levels of androgens on a few occasions, ranging in duration from 1 to 6 weeks. Including both injectable and 17aa drugs. Funny, I've experienced absolutely no negative side effects from them, except for some suppression of natural T production for the first 2 weeks after the 6 week cycle. No liver problems (yup, I've had blood work done for liver function analysis). No injection problems or infections. In fact, the only effects I noticed was that I grew a lot of muscle and felt pretty damn good. So based upon *my* experience, for *me*, I can only conclude that your cautions were exaggerated or incorrect paranoia. Yet on the other hand, I used caffeine in a manner that you claim is harmless, and I experienced severe negative health consequences. So my relative risk benefit analysis between anabolic steroids and caffeine is that *I* will use the anabolic steroids because they have a strong benefit with almost no risk. On the other hand, *I* will avoid caffeine like it is poison (because for *me* it is). And you can choose the exact opposite if you perceive that is appropriate for you. See: we agree. Everyone needs to make those risk/benefit analysis based upon their own bodies and values. You can not effectively make those decisions for everyone via "laws". And some people might even argue that it is not appropriate for doctors to be making those decisions in place of patients making those decisions for themselves.

The reason I took the time to write such a long damn response to you is because I think highly of you, not because I want to bash you. You are sharp, motivated, and ethical. But in the past you have also greatly frightened me with your overzealous self righteousness of telling people what to do with their bodies when they don't want your "help." (Eg, anabolic steroids) I hope that maybe now that you've had the tables turned, you might adopt more of a "live and let live" perspective, and understand that there is a line to be drawn between your good will as a doctor to help your patients (who want your help) on one side, and everyone else (who may not want your "help") on the other side.

Good luck with med school.

63

Ken Stark: “In addition, you seemed to make the assumption that epinephrine induces glucose uptake whenever it is released with this statement. “Anytime epi is released, glucose and blood is shuttled to muscle tissue. This is the flight or fight response and has been known for decades to occur whether you are lifting weights or not.” Based on the previous study glucose uptake is reduced by muscle tissue in the presence of insulin and epinephrine. Therefore, your assumption that “anytime epi is released, glucose and blood is shuttled to muscle tissue” is false”

Exactly how is that false? Glucose UPTAKE would be a result of a need for the energy. That doesn’t stop the fact that blood and glucose is moved to muscle tissue in preparation for its immediate use. There is a difference between applied knowledge and read knowledge. This is what sets a doctor apart from a guy who reads biology books. Look, I don’t know how much free time you have to do random research on the computer, but my time is limited. Since I do not have the time to go through every study you have listed, let me put it like this so that you can understand what has already been said. Caffeine is not the only thing that increases epi release. It was used in these studies simply because one of the scientists thought that would be a good place to start as far as inducing an insulin response. That means that ephedrine causes the same response as well as any activity or experience in your life that increase your heart rate. Since it wouldn’t be prudent to go around scaring the test subjects on a regular basis to produce the same results, caffeine was used because it is relatively harmless and most of the people being tested have probably had their fair share of it. That is why worrying about any of what you have written is not warranted unless you plan on starting a regimen of Beta blockers just so that your heart rate never increases. Understand?

64

Free Ex: “First of all, as I’ve explained, I DON’T HAVE DIABETES. Are you illiterate an unable to read what I wrote above? “

Previously, you wrote, “By the end of that five year period I had developed borderline type 2 diabetes”. Excuse me if I took that as meaning that you are showing the symptoms of diabetes to some degree. If you are not showing the symptoms, then what is the diagnosis based on if you don’t mind me asking. Of course, that is if I can manage to read your response considering how illiterate I am.

Free Ex: “Why do you care about what worries other people or not, or what they decide for themselves to put into their own body? If you truly believe what you wrote above, then whether or not people consider caffeine to be a risk factor shouldn’t concern you. Why not simply give people the facts and let them evaluate the evidence, and think and decide for themselves about caffeine. You getting pissed off serves no purpose but to make you miserable. “

Why do I care? Sorry, I thought I was in school to help people. My mistake. I will now pack up my bags and drop out of school as no doctor should give a damn about others. It must be that illiteracy of mine acting up again. Sorry.

Free Ex: “Now that we’ve gone through all that, I want to tie this back in with the debate about anabolic steroids that you and I had about a year ago. “

No, please. Why the hell would you bring up an argument we had an entire year ago? Are you getting enough sex at home?

Free Ex:”You further asserted that androgens were very dangerous from a health risk point of view, almost to the point of telling people that they would destroy peoples’ livers and cause all sorts of injection infections. I disagreed with all of those points, and gave rational reasons as to why. But now that the tables are turned, you don’t like it very much when other people are (allegedely) “telling” you what you can or cannot put into your body. See? It’s not much fun is it? “

I listed the negatives but did not state them as being deadly or anything like that. Why didn’t you quote exactly what I wrote instead of twisting what was said? My only true judgment during that steroid debate is that most people have no clue what they are doing and are simply listening to some unknown person over the internet when it comes to playing with their body chemistry. If you are educated, do whatever the hell you want to do. That doesn’t change the fact that most of the people that log into the other forum I participate on who ask about steroids are in high school and don’t even know what a testicle is, let alone testosterone.

Free Ex: “Now since the tables are turned, I could take the approach that you took in that previous debate, and advocate that caffeine should be made “illegal” because it has the potential to harm people.”

Since when have the tables turned? If caffeine should be made illegal, then so should anything else that increases your heart rate and increases the release of epinephrine, like sex, standing in long lines and prostate exams. Ouch, that last sentence was a little hard to type with this chronic illiteracy problem I have. I am done with this topic because I have a life to get back to. As soon as you get one, hit me back

65

Yes, I am done with this topic too, as I don’t
have any more time to waste on people like
you.

That is what is so pathetic about you, Prof X, is that you can't make a coherent rational argument for your case, so all you can do is resort to childish name calling and completely unsubstantiated character attacks. Pathetic. You are apparently unable to even comprehend any of the important points I wrote above. Even more pathetic. Like I said, I won't waste any more of my time on immature children like you. What I've written stands on it's own. What you've written doesn't.

66

Professor X, I am not just a guy who reads biology books. Otherwise I would not have been able to provide you with the references I did. I have a B.S. in nutritional science and now am enrolled in pharmacy school. I understand there is a difference between applied knowledge and read knowledge; however, I believe if you dig down deep enough you will find a strong correlation between the two. I think you missed the point of my argument. I was not stating that glucose would not be taken up into muscle cells during the flight or fight response. I was stating that when insulin release is high (like after a meal) caffeine or epinephrine would inhibit glucose uptake into muscle cells (post-prandial insulin resistance). During the flight or fight response glucose would be taken up into muscle cells but it would not primarily be due to epinephrine release. It is primarily due to changes in the energy status of the cell and through activation of AMPK (contraction induced glucose uptake). Epinephrine will definitely increase blood flow to muscles and glucose release form liver but it has very little effect on the uptake of glucose into muscle cells. If you are stuck in traffic and experiencing a lot of stress your body would be releasing epinephrine to provide glucose to the muscles but the need for glucose uptake would be low because you would just be sitting in your car. I would be impractical for the body to start pumping glucose into the muscle cells in that situation because energy stores are not being compromised and the AMPK system is not being activated. The body is more complex than the thought that any activity that increases your heart rate will cause a significant glucose uptake into muscle cells. Therefore, your statement that “ephedrine causes the same response as well as any activity or experience in your life that increase your heart rate” would be false because as I have explained epinephrine has little responsibility for glucose uptake into muscle cells. High epinephrine levels with inactivity would lead to high blood glucose and insulin resistance. There are some studies that show that epinephrine alone can increase glucose uptake slightly but this would not be enough to offset the heavy release of glucose into the blood by the liver. If you compound this problem with high insulin levels you are due to experience some seriously high blood sugar. If we could all avoid stressful situations it would be ideal but we cannot. So why would someone want to self-induce physiologic stress by taking caffeine? Perhaps taking beta-blockers would be useful during periods of stressful inactivity. My main point is that if you take caffeine on a regular basis, especially before meals like many people do you will be impairing insulin mediated glucose uptake. This would not be much of a concern for active people but it would be a concern nonetheless. If you are just taking caffeine a couple of hours before a workout you are probably going to be fine but it may still affect your post-workout drink. Like I have said before you still have not provided me with any evidence that caffeine does not affect insulin sensitivity where I have. My time is limited too but I just don’t want you spreading unsubstantiated information on how caffeine won’t affect blood sugar. If you really want to be a MD and help people I would think you would look into it more before making your statements. You can do whatever you want but as a health professional you need obtain accurate information before passing judgements. I guess this is what sets a pharmacy student apart from a medical student. Oh wait, you already consider yourself a doctor whereas I am just a guy who reads biology texts.

67

Free Ex: “That is what is so pathetic about you, Prof X, is that you can’t make a coherent rational argument for your case, so all you can do is resort to childish name calling and completely unsubstantiated character attacks. Pathetic.”

Uh, didn’t you call me illiterate first? You are accusing me of everything you have done. Odd.

68

Be careful what you label as Decaf. Most major coffee labels actually blend decaf with regular beans to reduce the cost. Get your decaf from an independent source, ie… your local coffee house.

and to answer an earlier question about flavoured coffee. Flavoured coffee is simply a standard meduim grade bean with a flavour additive mixed in and allowed to absorb. This is done after the roast and before the grind. You can actually buy the syrup yourself from several online coffee companies (not ours, but others. While I’m sure if you drank the bottle of syrup it would be caloric, I don’t think it is going to add much to your standard 16oz cup of joe…

69

It’s amazing how two intelligent people could have spent so much time in school yet have no class. It just goes to show how some things can’t be taught.

70

I think just about everyone has had enough
of this crap on caffeine. Everyone PLEASE
just let these caffeine messages drop into
the forum ether.

71

prof, while I agree with yoiu on ALMOST all your points I must dissagree with you on this, "I doubt a 300lbs 60 year old woman who think that deadlifts involve a burial will respond to carbs the same way I do. " YES they will (unless they have another prob.) we all respond the same to the same things.If we were all soooo different we would need dif. heart surg. diff. lung transplant surg. diff. root canal, etc… we are not that diff… none of this matters to most people. blaablaaablaaablaablaaaa

72

I don’t know, I kind of enjoyed it. Learned something, too…

73

Rev. I:“we all respond the same to the same things”


I will have to remember that the next time someone claims they are allergic to penicillin. I can see it now, “don’t worry Mrs. Henderson, I was told on the internet that we all respond the same to the same things so regardless of how close to death you were the last time you were given this antibiotic, it must have all been in your head.” Are we done with this topic now?

74

Great discussion! Very informative. And in my opinion prof X wins hands down. Free ex you ought to be ashamed of yourself for insulting prof X just because he gave you the smack down in the debate. Now go sit in a corner and read some Tom Paine. Perhaps he can convince you to not engage in such unethical behaviour

75

LOL. Huh? Believe whatever you want, dude. I
really don’t care. I’m done with this topic.

76

Dan, I do not know what thread you were reading but Free Ex and I provided evidence in the form of studies that demonstrated caffeine induces insulin resistance whereas Proffessor X didn’t.

77

Can somebody please tell me what happened to MD6??? When did Biotest stop making it…are they making a newer version of it??? I must have missed something because I’ve been reading all the articles and I didn’t read anything about them stopping production of MD6. Anybody have info about this? What is in the new formula if they are making a new one?

Thanks…

78

Tim Patterson explained the MD6 situation a couple of weeks ago, sparking much discussion. Where you been? Look up his name in the search engine and you’ll probably find it. You may have to hit the button twice to get it to work.

79


Diabetes 2001 Oct;50(10):2349-54

Caffeine ingestion decreases glucose disposal during a hyperinsulinemic-euglycemic clamp in sedentary humans.

Greer F, Hudson R, Ross R, Graham T.

Ohio University Eastern, St. Clairsville, Ohio 43950, USA.

----------------------

Eur J Clin Nutr 1998 Nov;52(11):846-9

Effects of caffeine on glucose tolerance: a placebo-controlled study.

Pizziol A, Tikhonoff V, Paleari CD, Russo E, Mazza A, Ginocchio G, Onesto C, Pavan L, Casiglia E, Pessina AC.

Department of Clinical and Experimental Medicine, University of Padova, Italy.

------------------------------

Can J Physiol Pharmacol 2001 Jul;79(7):559-65

Caffeine ingestion elevates plasma insulin response in humans during an oral glucose tolerance test.

Graham TE, Sathasivam P, Rowland M, Marko N, Greer F, Battram D.

Human Biology and Nutritional Sciences, University of Guelph, ON, Canada.

--------------------------------

J Appl Physiol. 2002 Jun;92(6):2347-52.

Caffeine-induced impairment of glucose tolerance is abolished by beta-adrenergic receptor blockade in humans.

Thong FS, Graham TE.

----------------------------

Diabetes. 2002 Mar;51(3):583-90.

Caffeine-induced impairment of insulin action but not insulin signaling in human skeletal muscle is reduced by exercise.

Thong FS, Derave W, Kiens B, Graham TE, Urso B, Wojtaszewski JF, Hansen BF, Richter EA.

-------------------------

Diabetes Care. 2002 Feb;25(2):364-9.

Caffeine can decrease insulin sensitivity in humans.

Keijzers GB, De Galan BE, Tack CJ, Smits P.

80

Ken Stark: " Dan, I do not know what thread you were reading but Free Ex and I
provided evidence in the form of studies that demonstrated caffeine
induces insulin resistance whereas Proffessor X didn’t."

I wasn’t aware that this was a competition. What, is this a race for who can find a scientific journal the fastest? My goal was, and is, not to continue an argument but to get to the truth, not jump in on one side of the debate. Enough about me though, huh? Let’s stick with the info. You wanted studies so let’s talk studies…starting with this one:


Caffeine-Induced Impairment of Insulin Action
but Not Insulin Signaling in Human Skeletal
Muscle Is Reduced by Exercise
(Farah S.L. Thong1, Wim Derave2, Bente Kiens3, Terry E. Graham1,
Birgitte Ursø4, Jørgen F.P. Wojtaszewski3, Bo F. Hansen4, and
Erik A. Richter3)

The whole purpose of this study was to test the effects of caffeine ingestion on skeletal muscle glucose uptake (glycogen synthase activity). It was found that 1) caffeine impairs insulin-stimulated glucose uptake and GS activity in rested and exercised human skeletal muscle;this, you were correct about 2) caffeine-induced impairment of insulin-stimulated muscle glucose uptake and downregulation of GS activity are not accompanied by alterations in IRTK,
PI 3-kinase, PKB/Akt, or GSK-3 but may be associated with increases in epinephrine and intramuscular cAMP concentrations; and finally, 3) exercise reduces the detrimental effects of caffeine on insulin action in muscle. In fact, exercise not only increase insulin sensitivity in the caffeine group, but also in the placebo group. This means that exercise plays a large part in how much concern someone should give this caffeine paranoia. With all of the talk of insulin resistance, you would swear that everyone logging in had the disease, however, this disease is largely associated with increased intra-abdominal fat and/or increased subcutaneous fat deposition (yes, in lean individuals as well). This means that if you are out of shape, don’t you think that should be the first place you start? For instance, the study, The Concurrent Accumulation of
Intra-Abdominal and Subcutaneous Fat Explains
the Association Between Insulin Resistance and
Plasma Leptin Concentrations

Distinct Metabolic Effects of Two Fat Compartments

(Miriam Cnop1, Melinda J. Landchild1, Josep Vidal1, Peter J. Havel3, Negar G. Knowles1,
Darcy R. Carr2, Feng Wang1, Rebecca L. Hull1, Edward J. Boyko1, Barbara M. Retzlaff1,
Carolyn E. Walden4, Robert H. Knopp1, and Steven E. Kahn1) found that accumulation of intra-abdominal fat correlates with insulin resistance, whereas subcutaneous fat deposition correlates with circulating leptin levels (which is associated with increase subcutaneous fat deposition). They concluded that the
concurrent increase in these two metabolically distinct fat compartments is a major explanation for the association between insulin resistance and elevated circulating leptin concentrations in lean and obese subjects. This basically implies that insulin resistance is largely based on the deposition of fat whether the person on “obese” or not. This also implies that exercise can reduce the negative impact of this problem…again, not hindered by caffeine use.
But hey, maybe after all of that, we are still not looking at weight and fat deposition as the culprit because we would much rather blame caffeine for the problem. Let’s look at “Diet and Exercise in the Treatment of Obesity” effects of 3 interventions on insulin resistance (Ruth S. Weinstock, MD, PhD; Huiliang Dai, MD; Thomas A. Wadden, PhD)
This study showed that weight reduction alone decreased hyperinsulinemia to a mean of 61.8% of baseline associated with a mean of 13.8kgs loss in weight. Taking into account the first study which shows that any negative effects of caffeine are reduced with training, could someone tell me why I, a healthy resistance training, non-fat or obese bodybuilder, need to eject caffeine from my diet? I know I sure can’t see it.