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The 
Macronutrients 
– 
Protein 
By 
Ru 
Anderson 
The 
macronutrients 
are 
protein, 
fats 
and 
carbohydrates, 
with 
‘macro’ 
being 
given 
to 
the 
term 
as 
these 
nutrients 
make 
up 
the 
majority 
of 
energy 
obtained 
from 
our 
daily 
diet. 
This 
article 
will 
look 
at 
protein 
and 
provide 
you 
with 
a 
full 
understanding 
of 
this 
macro. 
Protein 
Protein 
is 
incredibly 
important, 
and 
without 
it 
our 
body 
composition 
and 
health 
greatly 
suffer 
as 
a 
result. 
Proteins 
are 
an 
essential 
nutrient 
and 
can 
be 
broken 
down 
into 
20 
building 
blocks 
known 
as 
amino 
acids. 
Out 
of 
these 
20 
amino 
acids, 
9 
are 
considered 
to 
be 
essential 
as 
the 
body 
cannot 
synthesize 
its 
own, 
meaning 
we 
must 
obtain 
these 
from 
animal 
and 
plant 
sources. 
The 
other 
11 
aminos 
can 
be 
synthesized 
by 
the 
body, 
making 
them 
non-­‐essential. 
The 
table 
below 
shows 
how 
protein 
can 
be 
broken 
down 
into 
its 
essential 
and 
non-­‐essential 
amino 
acids. 
Source: 
http://www.lifetime-­‐weightloss.com/blog/2012/8/11/performance-­‐enhancement-­‐part-­‐2-­‐essentials-­‐of-­‐repair-­‐ 
and-­‐reco.html 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
Within 
the 
9 
essential 
amino 
acids, 
there 
are 
3 
branch 
chain 
amino 
acids 
(BCAA’s): 
leucine, 
isoleucine 
and 
valine 
which 
are 
again 
different 
to 
the 
others 
as 
they 
do 
not 
require 
metabolizing 
by 
the 
liver, 
and 
are 
therefore 
taken 
up 
directly 
by 
skeletal 
muscle. 
Also, 
these 
3 
aminos 
are 
the 
most 
important 
for 
the 
manufacture, 
maintenance 
and 
repair 
of 
muscle 
tissue. 
Of 
the 
three, 
leucine 
has 
shown 
to 
be 
the 
most 
effective 
amino 
at 
stimulating 
protein 
synthesis 
(the 
process 
of 
building 
muscle 
protein 
and 
therefore 
growth), 
yet 
the 
three 
work 
better 
together 
to 
provide 
a 
host 
of 
benefits 
and 
even 
boost 
energy 
during 
workouts. 
(1) 
(2) 
Studies 
show 
that 
BCAA 
supplementation 
alone 
can 
blunt 
the 
catabolic 
hormone 
cortisol 
and 
decrease 
delayed-­‐onset 
muscle 
soreness. 
(3) 
Below 
is 
a 
table 
that 
shows 
the 
protein 
quantity 
in 
many 
of 
the 
common 
foods 
we 
eat: 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
Source: 
http://kpbodyreconstruction.com/personal-­‐diet-­‐nutrition/high-­‐protein-­‐foods-­‐list/ 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
Protein 
Quality 
When 
considering 
a 
protein 
source 
or 
determining 
its 
amino 
acid 
profile 
values, 
one 
of 
the 
most 
popular 
methods 
is 
classifying 
the 
food 
by 
its 
biological 
value 
(BV). 
The 
biological 
value 
of 
a 
protein 
is 
based 
on 
its 
quantity 
of 
the 
essential 
amino 
acids. 
So 
a 
food 
with 
a 
high 
BV 
(also 
known 
as 
a 
complete 
protein) 
contains 
all 
9 
essential 
aminos. 
This 
is 
commonly 
seen 
in 
animal 
and 
dairy 
products. 
A 
food 
with 
low 
to 
medium 
BV 
does 
not 
contain 
all 
of 
the 
essential 
amino 
acids. 
This 
is 
commonly 
seen 
in 
plant 
based 
protein 
sources, 
and 
it 
is 
only 
when 
these 
low 
BV 
foods 
are 
combined, 
that 
you 
can 
create 
a 
higher 
quality 
BV 
in 
meals. 
This 
alone 
is 
a 
key 
reason 
as 
to 
why 
animal 
proteins 
(meat 
& 
dairy) 
are 
so 
important 
in 
our 
diets. 
Below 
is 
a 
table 
showing 
food 
sources 
that 
provide 
a 
complete 
and 
incomplete 
amino 
acid 
profile: 
Source: 
http://www.americancasein.com/wp-­‐content/uploads/2013/03/proteins-­‐chart.png 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
The 
role 
of 
protein 
When 
we 
do 
consume 
sufficient 
amounts 
of 
high 
quality 
and 
complete 
proteins, 
it 
has 
a 
whole 
host 
of 
benefits: 
Source: 
http://3.bp.blogspot.com/_tO5ykvLozeA/TTUyqvHrM9I/AAAAAAAAAB0/-­‐ 
oFTVTTnLA8/s1600/Protein+functions.jpg 
Note 
-­‐ 
protein 
provides 
the 
body 
energy, 
at 
a 
density 
of 
4kcals 
per 
gram. 
Protein 
metabolism 
There 
are 
around 
50 
000 
different 
protein 
containing 
compounds 
in 
the 
body, 
and 
65% 
of 
them 
are 
found 
in 
skeletal 
muscle. 
When 
we 
ingest 
more 
protein 
then 
we 
excrete 
(typically 
lost 
from 
urine, 
faeces 
or 
converted 
to 
fat/cholesterol) 
we 
are 
known 
to 
be 
in 
a 
positive 
nitrogen 
balance. 
This 
means 
we 
will 
have 
a 
high 
level 
of 
amino 
acids 
in 
our 
blood 
and 
body 
fluids. 
This 
process 
only 
occurs 
after 
regular 
protein 
intake. 
Before 
amino 
acids 
can 
enter 
the 
blood 
stream, 
protein 
must 
be 
digested 
in 
the 
stomach. 
This 
occurs 
when 
hydrochloric 
acid 
creates 
an 
active 
enzyme 
known 
as 
‘pepsin’. 
Structurally, 
proteins 
consist 
of 
various 
combinations 
of 
amino 
acids 
linked 
together 
by 
peptide 
bonds. 
Pepsin 
is 
the 
enzyme 
responsible 
for 
breaking 
down 
the 
peptide 
bonds 
to 
form 
smaller 
peptides 
and 
free 
form 
amino 
acids. 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
From 
here, 
the 
proteins 
are 
passed 
onto 
the 
small 
intestines, 
and 
are 
at 
this 
point 
finally 
digested 
to 
absorbable 
amino 
acids. 
From 
here 
then, 
the 
amino 
acids 
can 
enter 
the 
amino 
acid 
pool 
and 
will 
be 
used 
in 
a 
matter 
of 
two 
ways 
by 
the 
body: 
1. Protein 
synthesis 
will 
create 
new 
proteins 
for 
the 
body 
in 
terms 
of 
body 
tissue 
(muscle, 
liver, 
kidneys 
etc), 
hormones, 
enzymes 
and 
all 
the 
other 
previously 
mentioned 
functions 
of 
proteins. 
2. Excreted 
by 
urine 
as 
urea 
(nitrogen 
containing 
organic 
compound), 
or 
converted 
to 
fat 
and/or 
cholesterol. 
The 
table 
below 
summarizes 
this 
metabolic 
process: 
Source: 
http://mikestriathlon.com/nutrition-­‐the-­‐role-­‐of-­‐protein-­‐in-­‐sports-­‐performance/ 
Protein 
requirements 
The 
debate 
still 
continues 
on 
how 
much 
protein 
we 
should 
be 
taking 
daily, 
but 
there 
appears 
to 
be 
a 
general 
agreement 
that 
active 
individuals 
need 
a 
higher 
intake 
than 
sedentary 
people. 
The 
DRI 
(Dietary 
Reference 
Intake) 
suggests 
0.8 
grams 
of 
protein 
per 
kilogram 
of 
body 
weight, 
or 
0.36 
grams 
per 
pound. 
(4) 
This 
means 
an 
intake 
for 
a 
man 
weighing 
80kg 
is 
64g. 
This 
means 
an 
intake 
for 
a 
woman 
weighing 
60kg 
is 
48g. 
As 
you 
can 
see, 
this 
isn’t 
a 
lot 
of 
protein 
and 
we 
now 
know 
that 
for 
optimal 
body 
composition 
and 
health, 
we 
need 
a 
lot 
more. 
It’s 
difficult 
to 
put 
an 
exact 
figure 
on 
how 
much 
protein 
everyone 
should 
really 
be 
consuming, 
as 
it 
all 
depends 
on 
their 
goals, 
activity 
levels, 
caloric 
intake, 
muscle 
mass, 
training 
schedule 
and 
current 
health. 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
Therefore 
we 
must 
resort 
to 
the 
research 
that 
can 
help 
us 
make 
the 
right 
decisions, 
yet 
it 
too 
seems 
to 
vary 
from 
source 
to 
source. 
The 
average 
intake 
For 
a 
healthy 
person 
of 
a 
healthy 
weight 
who 
is 
mainly 
sedentary 
and 
is 
not 
seeking 
changes 
in 
body 
composition 
– 
then 
an 
intake 
of 
0.4 
– 
0.6 
grams 
of 
protein 
per 
pound 
bodyweight 
is 
sufficient. 
When 
losing 
body 
fat 
Protein 
has 
a 
high 
thermic 
effect, 
meaning 
it 
boosts 
our 
metabolic 
rate 
in 
the 
process 
(we 
burn 
more 
calories) 
and 
reduces 
our 
appetites 
(we 
eat 
less 
calories). 
(5) 
(6) 
This 
increase 
in 
metabolic 
effect 
has 
been 
shown 
to 
be 
most 
effective 
when 
protein 
is 
set 
to 
25-­‐30% 
of 
daily 
caloric 
intake. 
(7) 
(8) 
Having 
a 
high 
protein 
intake 
during 
a 
calorie 
deficit 
is 
also 
important, 
as 
it 
is 
very 
anabolic, 
meaning 
we 
are 
more 
likely 
to 
preserve 
lean 
body 
tissue 
in 
the 
process. 
(9) 
When 
building 
muscle 
The 
key 
to 
building 
muscle 
is 
protein 
synthesis. 
A 
higher 
protein 
diet 
will 
up 
regulate 
protein 
synthesis 
(providing 
you 
have 
evenly 
spaced 
meals), 
which 
creates 
a 
net 
positive 
protein 
balance, 
resulting 
in 
that 
anabolic 
(building) 
environment. 
(10) 
The 
studies 
that 
look 
at 
muscle 
mass 
and 
protein 
intake 
tend 
to 
vary 
from 
0.8-­‐ 
1.0+ 
gram 
per 
pound 
bodyweight, 
so 
it’s 
safe 
to 
say 
a 
balanced 
approach 
would 
be 
most 
beneficial, 
so 
around 
1g 
per 
pound 
bodyweight 
is 
highly 
effective. 
(11) 
(12) 
Active 
and 
elderly 
Body 
composition 
goals 
aside, 
you 
may 
find 
some 
clients 
are 
highly 
active, 
through 
their 
jobs 
or 
activities 
(such 
as 
endurance 
training). 
The 
research 
shows 
a 
daily 
intake 
of 
0.5-­‐0.65 
grams 
per 
pound 
bodyweight 
for 
these 
types 
of 
people. 
(13) 
Elderly 
people 
can 
also 
benefit 
from 
more 
protein 
to 
help 
prevent 
aging 
diseases 
such 
as 
osteoporosis 
and 
sarcopenia 
(reduced 
muscle 
mass). 
The 
research 
shows 
a 
daily 
intake 
of 
0.45-­‐0.6 
gram 
per 
pound 
bodyweight. 
(14) 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
Finally, 
those 
recovering 
from 
injuries 
may 
also 
benefit 
from 
a 
higher 
protein 
diet. 
Timing 
and 
type 
We 
have 
already 
discussed 
that 
we 
assess 
the 
quality 
of 
our 
protein 
sources 
via 
the 
biological 
value, 
therefore 
the 
type 
of 
protein 
we 
ingest 
will 
improve 
the 
results 
we 
see. 
We 
also 
know 
that 
animal 
proteins 
are 
better 
at 
improving 
strength 
and 
body 
composition 
compared 
to 
a 
plant 
based 
approach 
(vegetarian). 
Also, 
proteins 
that 
contain 
high 
levels 
of 
BCAA’s, 
particularly 
leucine, 
will 
produce 
greater 
protein 
synthesis, 
improve 
insulin 
signaling 
and 
spare 
glucose 
in 
muscle 
cells. 
Dangers 
of 
a 
high 
protein 
diet 
Many 
people 
will 
try 
and 
tell 
us 
that 
a 
high 
protein 
diet 
is 
bad 
for 
us, 
and 
that 
it 
is 
linked 
to 
cardiovascular 
disease, 
dehydration, 
calcium 
loss 
and 
damaged 
liver 
and 
kidney 
function. 
The 
question 
that 
must 
be 
asked 
is 
– 
show 
us 
the 
accurate 
research. 
The 
small 
amount 
of 
research 
that 
may 
support 
these 
dangers 
appears 
-­‐ 
just 
like 
many 
things 
in 
the 
nutritional 
world 
-­‐ 
to 
have 
been 
greatly 
exaggerated. 
Here’s 
what 
you 
need 
to 
know: 
1. There 
is 
no 
link 
to 
protein 
causing 
increased 
risk 
of 
coronary 
heart 
disease 
(15), 
2. There 
is 
no 
link 
to 
protein 
causing 
liver 
or 
kidney 
damage 
in 
healthy 
subjects 
(15), 
3. Recent 
studies 
show 
a 
positive 
relationship 
between 
protein 
intake 
and 
bone 
health. 
(16) 
Summary 
You 
should 
now 
understand 
the 
importance 
of 
protein 
in 
the 
human 
diet, 
how 
it 
is 
metabolized, 
how 
to 
measure 
quality, 
assess 
daily 
intake 
for 
various 
populations, 
compare 
protein 
types 
and 
de 
bunk 
some 
of 
the 
myths 
that 
surround 
it. 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com
References 
and 
further 
reading 
1. http://www.ncbi.nlm.nih.gov/pubmed/18056791 
2. http://www.ncbi.nlm.nih.gov/pubmed/21775557 
3. http://www.ncbi.nlm.nih.gov/pubmed/24195702 
4. http://www.nal.usda.gov/fnic/DRI/DRI_Energy/energy_full_report. 
pdf 
5. http://www.ncbi.nlm.nih.gov/pubmed/18448177 
6. http://www.ncbi.nlm.nih.gov/pubmed/8862477 
7. http://www.ncbi.nlm.nih.gov/pubmed/11838888 
8. http://www.ncbi.nlm.nih.gov/pubmed/20565999 
9. http://ajcn.nutrition.org/content/early/2012/01/17/ajcn.111.0263 
28 
10. http://www.jissn.com/content/9/1/42/abstract 
11. 
http://www.ncbi.nlm.nih.gov/pubmed/22150425 
12. 
http://www.ncbi.nlm.nih.gov/pubmed/19927027/ 
13. 
http://www.ncbi.nlm.nih.gov/pubmed/17213878 
14. 
http://www.ncbi.nlm.nih.gov/pubmed/16886097 
15. 
http://www.jissn.com/content/1/1/45 
16. 
http://www.ncbi.nlm.nih.gov/pubmed/21102327 
The 
Exceed 
Nutrition 
Certification 
/ 
www.ExceedNutrition.com

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Protein: An Essential Macronutrient for Health and Performance

  • 1. The Macronutrients – Protein By Ru Anderson The macronutrients are protein, fats and carbohydrates, with ‘macro’ being given to the term as these nutrients make up the majority of energy obtained from our daily diet. This article will look at protein and provide you with a full understanding of this macro. Protein Protein is incredibly important, and without it our body composition and health greatly suffer as a result. Proteins are an essential nutrient and can be broken down into 20 building blocks known as amino acids. Out of these 20 amino acids, 9 are considered to be essential as the body cannot synthesize its own, meaning we must obtain these from animal and plant sources. The other 11 aminos can be synthesized by the body, making them non-­‐essential. The table below shows how protein can be broken down into its essential and non-­‐essential amino acids. Source: http://www.lifetime-­‐weightloss.com/blog/2012/8/11/performance-­‐enhancement-­‐part-­‐2-­‐essentials-­‐of-­‐repair-­‐ and-­‐reco.html The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 2. Within the 9 essential amino acids, there are 3 branch chain amino acids (BCAA’s): leucine, isoleucine and valine which are again different to the others as they do not require metabolizing by the liver, and are therefore taken up directly by skeletal muscle. Also, these 3 aminos are the most important for the manufacture, maintenance and repair of muscle tissue. Of the three, leucine has shown to be the most effective amino at stimulating protein synthesis (the process of building muscle protein and therefore growth), yet the three work better together to provide a host of benefits and even boost energy during workouts. (1) (2) Studies show that BCAA supplementation alone can blunt the catabolic hormone cortisol and decrease delayed-­‐onset muscle soreness. (3) Below is a table that shows the protein quantity in many of the common foods we eat: The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 4. Protein Quality When considering a protein source or determining its amino acid profile values, one of the most popular methods is classifying the food by its biological value (BV). The biological value of a protein is based on its quantity of the essential amino acids. So a food with a high BV (also known as a complete protein) contains all 9 essential aminos. This is commonly seen in animal and dairy products. A food with low to medium BV does not contain all of the essential amino acids. This is commonly seen in plant based protein sources, and it is only when these low BV foods are combined, that you can create a higher quality BV in meals. This alone is a key reason as to why animal proteins (meat & dairy) are so important in our diets. Below is a table showing food sources that provide a complete and incomplete amino acid profile: Source: http://www.americancasein.com/wp-­‐content/uploads/2013/03/proteins-­‐chart.png The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 5. The role of protein When we do consume sufficient amounts of high quality and complete proteins, it has a whole host of benefits: Source: http://3.bp.blogspot.com/_tO5ykvLozeA/TTUyqvHrM9I/AAAAAAAAAB0/-­‐ oFTVTTnLA8/s1600/Protein+functions.jpg Note -­‐ protein provides the body energy, at a density of 4kcals per gram. Protein metabolism There are around 50 000 different protein containing compounds in the body, and 65% of them are found in skeletal muscle. When we ingest more protein then we excrete (typically lost from urine, faeces or converted to fat/cholesterol) we are known to be in a positive nitrogen balance. This means we will have a high level of amino acids in our blood and body fluids. This process only occurs after regular protein intake. Before amino acids can enter the blood stream, protein must be digested in the stomach. This occurs when hydrochloric acid creates an active enzyme known as ‘pepsin’. Structurally, proteins consist of various combinations of amino acids linked together by peptide bonds. Pepsin is the enzyme responsible for breaking down the peptide bonds to form smaller peptides and free form amino acids. The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 6. From here, the proteins are passed onto the small intestines, and are at this point finally digested to absorbable amino acids. From here then, the amino acids can enter the amino acid pool and will be used in a matter of two ways by the body: 1. Protein synthesis will create new proteins for the body in terms of body tissue (muscle, liver, kidneys etc), hormones, enzymes and all the other previously mentioned functions of proteins. 2. Excreted by urine as urea (nitrogen containing organic compound), or converted to fat and/or cholesterol. The table below summarizes this metabolic process: Source: http://mikestriathlon.com/nutrition-­‐the-­‐role-­‐of-­‐protein-­‐in-­‐sports-­‐performance/ Protein requirements The debate still continues on how much protein we should be taking daily, but there appears to be a general agreement that active individuals need a higher intake than sedentary people. The DRI (Dietary Reference Intake) suggests 0.8 grams of protein per kilogram of body weight, or 0.36 grams per pound. (4) This means an intake for a man weighing 80kg is 64g. This means an intake for a woman weighing 60kg is 48g. As you can see, this isn’t a lot of protein and we now know that for optimal body composition and health, we need a lot more. It’s difficult to put an exact figure on how much protein everyone should really be consuming, as it all depends on their goals, activity levels, caloric intake, muscle mass, training schedule and current health. The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 7. Therefore we must resort to the research that can help us make the right decisions, yet it too seems to vary from source to source. The average intake For a healthy person of a healthy weight who is mainly sedentary and is not seeking changes in body composition – then an intake of 0.4 – 0.6 grams of protein per pound bodyweight is sufficient. When losing body fat Protein has a high thermic effect, meaning it boosts our metabolic rate in the process (we burn more calories) and reduces our appetites (we eat less calories). (5) (6) This increase in metabolic effect has been shown to be most effective when protein is set to 25-­‐30% of daily caloric intake. (7) (8) Having a high protein intake during a calorie deficit is also important, as it is very anabolic, meaning we are more likely to preserve lean body tissue in the process. (9) When building muscle The key to building muscle is protein synthesis. A higher protein diet will up regulate protein synthesis (providing you have evenly spaced meals), which creates a net positive protein balance, resulting in that anabolic (building) environment. (10) The studies that look at muscle mass and protein intake tend to vary from 0.8-­‐ 1.0+ gram per pound bodyweight, so it’s safe to say a balanced approach would be most beneficial, so around 1g per pound bodyweight is highly effective. (11) (12) Active and elderly Body composition goals aside, you may find some clients are highly active, through their jobs or activities (such as endurance training). The research shows a daily intake of 0.5-­‐0.65 grams per pound bodyweight for these types of people. (13) Elderly people can also benefit from more protein to help prevent aging diseases such as osteoporosis and sarcopenia (reduced muscle mass). The research shows a daily intake of 0.45-­‐0.6 gram per pound bodyweight. (14) The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 8. Finally, those recovering from injuries may also benefit from a higher protein diet. Timing and type We have already discussed that we assess the quality of our protein sources via the biological value, therefore the type of protein we ingest will improve the results we see. We also know that animal proteins are better at improving strength and body composition compared to a plant based approach (vegetarian). Also, proteins that contain high levels of BCAA’s, particularly leucine, will produce greater protein synthesis, improve insulin signaling and spare glucose in muscle cells. Dangers of a high protein diet Many people will try and tell us that a high protein diet is bad for us, and that it is linked to cardiovascular disease, dehydration, calcium loss and damaged liver and kidney function. The question that must be asked is – show us the accurate research. The small amount of research that may support these dangers appears -­‐ just like many things in the nutritional world -­‐ to have been greatly exaggerated. Here’s what you need to know: 1. There is no link to protein causing increased risk of coronary heart disease (15), 2. There is no link to protein causing liver or kidney damage in healthy subjects (15), 3. Recent studies show a positive relationship between protein intake and bone health. (16) Summary You should now understand the importance of protein in the human diet, how it is metabolized, how to measure quality, assess daily intake for various populations, compare protein types and de bunk some of the myths that surround it. The Exceed Nutrition Certification / www.ExceedNutrition.com
  • 9. References and further reading 1. http://www.ncbi.nlm.nih.gov/pubmed/18056791 2. http://www.ncbi.nlm.nih.gov/pubmed/21775557 3. http://www.ncbi.nlm.nih.gov/pubmed/24195702 4. http://www.nal.usda.gov/fnic/DRI/DRI_Energy/energy_full_report. pdf 5. http://www.ncbi.nlm.nih.gov/pubmed/18448177 6. http://www.ncbi.nlm.nih.gov/pubmed/8862477 7. http://www.ncbi.nlm.nih.gov/pubmed/11838888 8. http://www.ncbi.nlm.nih.gov/pubmed/20565999 9. http://ajcn.nutrition.org/content/early/2012/01/17/ajcn.111.0263 28 10. http://www.jissn.com/content/9/1/42/abstract 11. http://www.ncbi.nlm.nih.gov/pubmed/22150425 12. http://www.ncbi.nlm.nih.gov/pubmed/19927027/ 13. http://www.ncbi.nlm.nih.gov/pubmed/17213878 14. http://www.ncbi.nlm.nih.gov/pubmed/16886097 15. http://www.jissn.com/content/1/1/45 16. http://www.ncbi.nlm.nih.gov/pubmed/21102327 The Exceed Nutrition Certification / www.ExceedNutrition.com