Welcome to the February 2025 issue of Research Extracts. “The Extracts” is designed to keep busy practitioners and savvy consumers up to date on the latest research on diet, nutrients, botanicals, the microbiome, the environment, and lifestyle approaches to good health and wellness. Our medical team, including NDs, RDs, MS biology, MS chemistry, an LAc, and a Certified Specialist in Sports Dietetics (CSSD), summarizes the essence of several interesting recent studies. With the addition of a CSSD to our team, we are launching a new column – the Movement Moment – which will feature a study focusing on athletic performance; in fact, we have two this month.

In this issue: (1) collagen for muscle and tendon support, (2) importance of breakfast for athletic performance, (3) metabolic benefits of okra, and (4) ultra-processed foods and insomnia risk.

Movement Moment: Collagen Supports Tendon and Muscular Strength 

Athletes, both recreational and professional, can experience soft tissue injuries, such as strains, sprains, or tears. Depending on the severity, these injuries can sideline athletes for weeks to months. Mechanical adaptations such as resistance training and nutritional adaptations such as proper supplementation can help decrease the risk of such injuries by maintaining muscular strength.  

Resistance exercises such as weightlifting, CrossFit, body weight exercises like push-ups and pull-ups, and plyometrics, promote collagen synthesis in muscles and tendons. This happens through the secretion of growth factors within the muscle, released during resistance exercise that are important for collagen formation. 

Collagen is a supplement consisting of amino acids, the building blocks for the body’s bones, muscles, ligaments, tendons, skin, and other connective tissues. Although collagen is made in the body through resistance exercise, supplementing collagen can ensure amino acids are available to maintain muscle and support connective tissue. 

The present double-blind, randomized, controlled trial assessed the impacts of a 30-g, 15-g, and 0-g dose of collagen, each with 50 mg of vitamin C, on collagen turnover over four resistance training sessions. Participants were asked to complete 10-RM (repetition maximum) back squats. The study included 10 young, healthy males actively participating in resistance training for at least 12 months and free from musculoskeletal injury.

Primary outcomes measured included blood procollagen type I N-terminal propeptide, amino acid concentrations, and plasma β-isomerized C-terminal telopeptide of type 1 collagen (markers of bone formation and collagen synthesis). Tests for these measures were completed at eight intervals throughout the day, including before collagen supplementation and resistance training, post-collagen supplementation, and post-resistance training. 

Results showed that when supplementing 30 g of collagen, individuals had significant increases in blood markers of collagen synthesis markers; increases were not significant with 15-g and 0-g collagen supplementation. Researchers concluded that this difference was due to the increased availability of amino acids from the higher-dose collagen supplementation. 

Note: Even if you are not performing resistance exercise, research has shown that daily collagen supplementation alone can support bone and cartilage health, through increased collagen synthesis.* 

Thorne’s NSF Certified for Sport® Collagen Fit provides 15 g of collagen peptides per serving along with nicotinamide riboside for healthy aging.* Thorne’s Collagen Plus has 13 g of collagen peptides per serving, in addition to ingredients that enhance hair, skin, and nail health.*  

Contributed by Maura Donovan, MS, RD, CSSD 

Reference

Movement Moment: Eating Breakfast – The Key to Unlocking Better Athletic Performance? 

Breakfast has always been coined, “the most important meal of the day,” where you break the fast and get your body ready for the day. However, diets like intermittent fasting are gaining increasing popularity, begging the question, “Do we need to eat breakfast?”

Breakfast is defined as eating at least 50 calories within two hours of waking. So, whether you’re having a clementine or a full English breakfast, either can count. Previous research has shown that eating breakfast is associated with lower BMI, improvements in health markers linked with diabetes and heart disease, and healthier habits; but how does it affect athletic performance? 

The present literature review aimed to see if consuming or omitting breakfast impacts acute resistance or endurance training performance, chronic adaptations to endurance or muscular performance, or changes in body composition. It also observed breakfast’s effect on exercise performance in the morning, afternoon, and evening, regardless of additional calories consumed throughout the day.

The authors made the following conclusions based on their review:

  • Consuming breakfast consistently improved morning endurance exercise lasting longer than one hour. 
  • Breakfast eaters saw an improvement in time-trial style performance later in the day regardless of additional meals consumed.  
  • Breakfast consumption had minimal effect on morning resistance training and no impact on afternoon or evening resistance training as long as total food consumption during the day was consistent. 
  • For exercise sessions lasting 30-60 minutes, the effects of breakfast consumption may be more psychological than physiological. 
  • Not having breakfast reduced body mass and body fat over 4-8 weeks, caused by an unintentional reduction in total daily calories. This could be advantageous for those trying to reduce body mass and/or fat; however, athletes’ under-consumption of calories can decrease overall performance. 
  • When skipping breakfast consistently, individuals' energy expended during an exercise session was decreased, likely related to the body’s instinct to conserve energy in a fasted state.  

The authors conclude that choosing to have or not have breakfast should be based on individual needs, preferences, and goals. However, if breakfast is not consumed, individuals should still aim to meet their daily calorie and nutrient requirements throughout the rest of the day. As a disclaimer, skipping breakfast would not be recommended for athletes who need to increase body mass or have difficulty maintaining their calorie needs. 

Note: Although eating breakfast before exercise can benefit your performance, if you can’t eat within two hours of waking, try having a snack with carbohydrates and protein before bed, particularly if you plan to exercise the next morning. Check out Thorne’s RecoveryPro® for a protein-rich option. 

Contributed by Maura Donovan, MS, RD, CSSD

Reference 

Okra – Healthy Goodness Beyond Gumbo! Metabolic Benefits for Diabetes

Okra (Abelmoschus esculentus), also known as lady’s finger, is a flowering plant native to East Africa that is widely known primarily for its edible green pods. Commonly used in cuisines around the world, okra is a staple ingredient in dishes like gumbo in the Southern United States, stir-fry in Asian cooking, and different stews in African and Middle Eastern cuisine. Its distinct mucilaginous texture makes it an excellent natural thickener for soups and sauces. Beyond its culinary versatility, okra is also valued for its potential health benefits. Rich in fiber, vitamins C and K, and antioxidants, okra has been linked to improved digestion, heart health, and blood sugar regulation. Emerging research suggests that okra-based treatments may support glycemic control and lipid metabolism, making it a promising dietary addition for individuals with diabetes and other cardiometabolic conditions.

A recent systematic review and meta-analysis examined the effects of okra-based treatments on cardiometabolic risk factors in individuals with pre-diabetes and diabetes. The analysis included data from multiple randomized controlled trials to assess the impact of okra consumption on various health parameters.

Key findings

  • Lipid profile improvements: Okra intake was associated with significant reductions in total- and LDL-cholesterol levels. However, changes in triglycerides and HDL-cholesterol were not statistically significant.
  • Glycemic control enhancements: Consumption of okra led to notable decreases in fasting blood sugar and hemoglobin A1c (HbA1c) levels, indicating improved blood sugar management.
  • Blood pressure and anthropometric measures: The analysis found no significant effects of okra on systolic blood pressure, diastolic blood pressure, body weight, or body mass index.

Subgroup analyses

  • Dosage impact: Doses of okra at or below 3,000 mg per day were particularly effective in reducing triglycerides, total- and LDL-cholesterol, and HbA1c levels, and in increasing HDL-cholesterol.
  • Intervention duration: Interventions lasting longer than eight weeks resulted in more pronounced reductions in triglycerides and HbA1c levels.

The findings suggest that okra-based treatments can beneficially affect certain cardiometabolic risk factors, particularly lipid profiles and glycemic control, in individuals with pre-diabetes and diabetes. Further research is recommended to determine the optimal dosage and duration of okra interventions for maximum health benefits.

Contributed by Mario Roxas, ND

Reference

Ultra-Processed Food Consumption Increases Insomnia Risk

Insomnia is one of the most common sleep disorders and is characterized by difficulties falling asleep, staying asleep, and waking feeling rested. Many factors influence insomnia risk including age, gender, stress or anxiety, and diet quality. The Mediterranean diet has been linked previously with reducing insomnia symptoms. This systematic review and meta-analysis of seven observational studies explored the associations between ultra-processed food consumption and insomnia risk in adolescent and adult populations.

Overall, the results showed a significant positive association between higher intake of ultra-processed foods and insomnia risk. Across the studies, the NOVA food classification system – which categorizes foods based on their level of processing – and snack food intake measurements demonstrated positive relationships of ultra-processed food consumption with insomnia risk. Increased frequency of consumption of ultra-processed foods from weekly to daily also showed a greater risk of insomnia. Between sexes, females showed stronger positive correlations with insomnia risk compared to males. The positive association was also stronger in adolescents than adults, potentially due to the larger proportion of processed foods in adolescent diets.

The researchers noted that the intake of ultra-processed foods may disrupt the gut microbiome, contributing to decreased production of beneficial metabolites from gut microbiota including tryptophan. This amino acid is used in the body to synthesize melatonin, a hormone that helps us fall asleep. While these results suggest significant associations between ultra-processed food intake and insomnia, further precision is needed to eliminate variabilities in the definitions and assessment methods of ultra-processed food consumption.

Note: To evaluate your own sleep health, Thorne’s at-home Sleep Test tracks hormone fluctuations that regulate the sleep-wake cycle and provides a personalized health plan including diet, supplement, and lifestyle recommendations based on your results. 

Contributed by Carly Duffy, MPH, RD

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