Cissus quadrangularis: one plant - many answers

Sometimes something comes along that is so good it’s hard to believe. Imagine a plant that has been in safe use for centuries. One that heals bones & joint problems, lessens pain without side effects can aid in the healing of overuse injuries, help solve gastrointestinal issues such as ulcers or acid reflux, is full of antioxidants & vitamins, can help with fat issues. Would you pay for a product like that? Of course you would & to be honest so would a lot of us.
Well you’re in luck because this isn’t some fantasy of an ideal supplement but a real plant that has been in use & is recorded in ancient Ayurvedic texts & has been shown by modern medicine to be completely safe. Cissus quadrangularis is that plant (we’ll call it Cissus from now on just to save the extra typing :-). The science gets a little tricky & much of the reasoning behind what it does is a little speculative, but it gets results, even if the science behind this wonder plant isn’t fully understood. First of all it gives pain relief & anti inflammatory effect at around the level of aspirin or ibuprofen, note the effect is slower to come on, but it lasts & without any side effects associated with these drugs (1,2).
The bulk of the studies on Cissus has been on the repair of bone & these have shown that bone is healed at a highly accelerated rate (3,4,5). Some studies have used cortisol to stimulate bone breakdown & Cissus appears to halt the effect of this hormone on the bones. So, interestingly if cortisol is halted in bone tissue, what about muscle tissue where it has a similar breakdown effect? So, far there are no studies on this possiblity as far I know, but it’s one I have got my eye out for as the implications of a totally safe, natural anti-cortisol product that is actually beneficial is a very real possibility.
One of the primary effects of Cissus is thought to be an increase in collagen turnover, so with increased synthesis & replacement you could expect quicker recover from overuse injuries, cartilage & tendon repair & this seems to be the case through anecdotal evidence although as yet no formal research has been done in this area beyond the probable finding in bone research studies that it seems to be increased collagen repair that seems to be a major factor (3,4,5).
As well as these benefits you also get a product that is packed full of antioxidants & antimicrobial substances (6)
Let’s look at the ‘side effects’ now. First off is fat control. Cissus tends to make you leaner (7,8) The treatment of ulcers & acid reflux (9), it will ease ulcers & reduce or relieve completely acid reflux. There is also anecodotal evidence that after 15-20 days continuous usage there is increased blood flow to the muscles & so bigger pumps. This effect isn’t universal, nor is it proven scientifically, but a certain proportion of users seems to be getting this result, enough reports to make it seem worth a mention.
So basically you get a product that will help control pain with no side effects (for the vast majority of users), will aid bone health, appears to help joints & connective tissue, is packed with usable nutrients, antioxidants & antimicrobials, can aid stomach issues, can make you leaner & might well give you massive pumps. Do you really want anything more from one supplement?
Dosage & type is the final issue I’d like to cover. First of all there are a selection of preparations available out there. The active ingredient is said to be Ketosterone & there are many amounts out there from 5% Ketosterone to up to 50% in some capsules. So, you’d think the higher the dose, the better. But in my view this is wrong. Cissus is a plant extract, like many such products there are a vast number of phytonutrients that work synergistically together to produce an effect much greater than the whole. The purer, higher grade ketosterone lacks many of these nutrients & so could possibly be less effective than the less pure alternative. I would aim at a product around the 6% ketosterone mark myself, it is levels around this purity that many studies have used & so the effects are known & there’s little guess work. As for dosage, between 3-6grams per day seems to have the desired effect (although the very small or very large may need to modify the dosage up or down slightly depending upon their need) . An average sized adult should be aiming at around the 5 gram mark. Take half first thing in the morning & half in the evening. You can take it with food or without. I tend to take it away from food, but I don’t know if there is any reason you should avoid food, but it fits my timing plan well.
Are there ANY downsides? Well, there is one obvious one, & that is taste. It takes a few days to adjust to the taste. Some of you might want to cap them yourselves (or buy pre-made capsules), but realistically if you stick with it for a few days you soon adjust. It smells worse than it tastes, so don’t sniff before you drink! I suppose the other possible bad effect could be you are a non-responder or maybe an allergy, but apart from that I can’t think of any reason not to give it a try.

1 Indian Journal of Pharmacology 1984 Vol 16, issue 3 pages 162-163. An experimental study of analgesic activity of Cissus quadrangularis. SP Singh, N Misra, KS Dixit, N Singh, RP Kohli
2 J Ethnopharmacol. 2007 Mar 21;110(2):264-70. Epub 2006 Sep 26. Analgesic, anti-inflammatory and venotonic effects of Cissus quadrangularis Linn. Panthong A, Supraditaporn W, Kanjanapothi D, Taesotikul T, Reutrakul V.
3 J Indian Med Assoc. 1962 Jun 1;38:590-3. Cissus quadrangularis in healing of fractures. A clinical study. Udupa KN, Prasad GC
4Indian J Med Res. 1975 Jun;63(6):824-8. Studies on Cissus quadrangularis in experimental fracture repair: effect on chemical parameters in blood. Chopra SS, Patel MR, Gupta LP, Datta IC.
5 Indian J Med Res. 1976 Sep;64(9):1365-8. Studies of Cissus quadrangularis in experimental fracture repair : a histopathological study. Chopra SS, Patel MR, Awadhiya RP.
6 J Med Food. 2003 Summer;6(2):99-105. Antioxidant and antimicrobial activity of Cissus quadrangularis L. Chidambara Murthy KN, Vanitha A, Mahadeva Swamy M, Ravishankar GA.
7 Lipids Health Dis. 2006 Sep 2;5:24. The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. Oben J, Kuate D, Agbor G, Momo C, Talla X.
8 Lipids Health Dis. 2008 Mar 31;7:12. The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study. Oben JE, Ngondi JL, Momo CN, Agbor GA, Sobgui CS.
9 Journal of Medicinal Food. September 1, 2004, 7(3): 372-376. doi:10.1089/jmf.2004.7.372. Mallika Jainu, C.S. Shyamala Devi.

Nutrient timing - ISSN position

here's some research pre-published on pubmed today stating the updated ISSN positon on nutrient timing. They pretty much lay down what we've talked about during our discussions on nutrient intake during & after training. We haven't really discussed pre-training nutrition, which is important. I'll have to get around to that, but it's mentioned here & I pretty much support the idea of carb/protein ingestion before training (exactly when depends on your digestive capabilities, but 1-2 hours before would be my advice if possible)
Here you can read for yourself:

J Int Soc Sports Nutr. 2008 Oct 3;5(1):17.

International society of sports nutrition position stand: nutrient timing.

Kerksick C, Stout J, Campbell B, Wilborn C, Kreider R, Kalman D, Ziegenfuss T, Lopez H, Landis J, Ivy J, Antonio J.

ABSTRACT: Position Statement: The position of the Society regarding nutrient timing and the intake of carbohydrates, proteins, and fats in reference to healthy, exercising individuals is summarized by the following eight points: 1.) Maximal endogenous glycogen stores are best promoted by following a high-glycemic, high-carbohydrate (CHO) diet (600 - 1000 grams CHO or ~ 8 - 10 g CHO/kg/d), and ingestion of free amino acids and protein (PRO) alone or in combination with CHO before resistance exercise can maximally stimulate protein synthesis. 2.) During exercise, CHO should be consumed at a rate of 30 - 60 grams of CHO/hour in a 6 - 8 % CHO solution (8 - 16 fluid ounces) every 10 - 15 minutes. Adding PRO to create a CHO:PRO ratio of 3 - 4:1 may increase endurance performance and maximally promotes glycogen re-synthesis during acute and subsequent bouts of endurance exercise. 3.) Ingesting CHO alone or in combination with PRO during resistance exercise increases muscle glycogen, offsets muscle damage, and facilitates greater training adaptations after either acute or prolonged periods of supplementation with resistance training. 4.) Post-exercise (within 30 minutes) consumption of CHO at high dosages (8 - 10 g CHO/kg/day) have been shown to stimulate muscle glycogen re-synthesis, while adding PRO (0.2 g - 0.5 g PRO/kg/day) to CHO at a ratio of 3 - 4:1 (CHO: PRO) may further enhance glycogen re-synthesis. 5.) Post-exercise ingestion (immediately to 3 h post) of amino acids, primarily essential amino acids, has been shown to stimulate robust increases in muscle protein synthesis, while the addition of CHO may stimulate even greater levels of protein synthesis. Additionally, pre-exercise consumption of a CHO + PRO supplement may result in peak levels of protein synthesis. 6.) During consistent, prolonged resistance training, post-exercise consumption of varying doses of CHO + PRO supplements in varying dosages have been shown to stimulate improvements in strength and body composition when compared to control or placebo conditions. 7.) The addition of creatine (Cr) (0.1 g Cr/kg/day) to a CHO + PRO supplement may facilitate even greater adaptations to resistance training. 8.) Nutrient timing incorporates the use of methodical planning and eating of whole foods, nutrients extracted from food, and other sources. The timing of the energy intake and the ratio of certain ingested macronutrients are likely the attributes which allow for enhanced recovery and tissue repair following high-volume exercise, augmented muscle protein synthesis, and improved mood states when compared with unplanned or traditional strategies of nutrient intake.

Hardest email in a while

Before I start I would like to say I will not put up anyone’s private issues without first asking permission, so I have asked to put this up before I published.
I got an email the other day from a person who had suffered from anaphylactic shock due to eating a nut coated cereal & as a result had lost the ability to produce saliva & a host of new allergies. They had been through the medical system, trying doctors & nutritionists with no success. They had been forced to eat liquidised food & chocolate (which they sucked), their weight had plummeted due to lack of calories & limited nutrition. One nutritionist suggested they add cream to their liquidised cream, but when informed they had developed an allergy to all dairy products was told they couldn’t help them & to go away! (I was personally shocked that anyone calling themselves a nutritionist was so limited they couldn’t devise a liquid based eating plan without the option of dairy!).
So, our emailer was left with nowhere to turn for help by the medical system so they turned to the internet.
Anyway, I’m not sure how many people they approached before they found our pages, but hopefully we could offer some help. As it happens the ‘bodybuilding’ side of came in very useful for this. When you get a dieting bodybuilder they often ingest a fare amount of calories as liquid, so we have a range of liquid options in place for people to ingest. Also knowing & working with those in the raw food market we also have a keen eye on ‘super foods’ available on the market like algae’s & wholefood powders that would work in a liquid diet.
Obviously living on a liquid diet wasn’t a long term solution, but our first job had to be to get their immediate nutrition sorted out. This is also a time I suggested keeping IN an animal product as they could eat liquidised chicken soup & I had real concerns that if they dropped the chicken out of the soup they might die! If they decided they didn’t need the chicken later, then they could remove it at a later date, but until they were on the mend I suggested they keep it in.
They also believed that artificial sweeteners had made the illness much worse. I’m not sure if the research is out there to back up that particular claim, but I certainly advice against the use artificial sweeteners where possible as they have been implied in quite a few conditions & it appears only the power of the companies backing these products that keeps them from being investigated thoroughly, if not banned.
So, we have a person here with no saliva & on an inadequate liquidised diet, suffering dangerous weightloss & multiple allergies, so here’s what I offered in the way of advice. Hopefully if anyone else out there is suffering related problems this might help you too:
~~~~
As you suggested I can't actually diagnose. I am a qualified sports
nutritionist & personal trainer & I am taking a nutritional
consultancy course, which, when completed would allow me to recommend
food stuffs for you directly, but to recommend what you could do at
the moment could lead to barring as both a trainer & failing my course
(for diagnosing without a qualification). However, what I can do is
suggest what I could do. The first thing I would do is look towards
the raw food market & natural body building fields as they've brought
out some interesting stuff:
Vega by Brenden Brazier http://www.myvega.com/ is a protein powder
plus it contains quite a few other nutrients
Raw power is another product you might want to look into www.rawpower.com/
Here's a few others from vegan essentials to look at
http://store.nexternal.com/shared/StoreFront/products.asp?CS=vegane&CategoryID=112&Refresh=True

OK there's a couple of complete food replacements. Let's look at what
else I'd need if I had your condition:

For just protein/calories I would consider a simple protein powder.
There are many out there. Like Soya protein, pea protein, rice
protein, hemp protein I've got a list of supplement sellers on this
page many of whom sell various protein powders
http://www.veganbodybuilding.org/supps.htm ). To those I would add
certain things:

EFA's - these are essential fatty acids. One of the reasons you
probably aren't thinking too well is lack of calories, but also lack of
EFA's. The brain is predominantly made of fat, cutting off this fat
makes thinking pretty hard (as you imagine), so you will need to find a
source you can tolerate. Udo's blend is available in most places
around the world in the fridge of your local health food store. It
can be mixed with a shake or taken off the spoon, but you do need this
daily. I would aim at a couple of tablespoons a day, that could be
split over several meals if necessary.

B-complex (containing B12) - I would find a capsule that contains this
(I think vegan essentials sells some? www.veganessentials.com ) &
either add these to your shakes, or open the capsule & swill the
powder around in your mouth for 1 minute before swallowing.

Spirulina or algae - I would consider investing in some form of algae
that can be added to your food. These foods have loads of nutrients
for the amount you take, so it may cost a bit, but you'll probably
benefit.
Again I'll give you a vegan essentials link, but if you look around
there are many companies selling these sorts of things, so look around
& try out a few, then I'd find things I like
http://store.nexternal.com/shared/StoreFront/products.asp?CS=vegane&CategoryID=134&Refresh=True

The soups are a good idea. I would stick with those, but I would also
invest in a juicer. I wouldn't so much juice the sweet fruits, but
things like green leafy vegetables, carrots, etc - basically all the
vegetables you have on the side of a plate in a normal meal. I would
need to buy more than the average consumer as there will be a lot of
waste (you throw away a good deal when you juice), but it will get
some nutrition into me. I would have as at least one juice with every
meal. I would have one sweet juiced drink per day only, the others
all savoury type juices based around leafy vegetables.

I'm not sure how often you eat right now, but I would be planning on
upping your eating to around 6-8 times a day. You wouldn't need to
eat much, a soup with juice, a shake with juice, but basically every 2
hours I would plan on getting nutrition down me. It is possible to
pre-prepare juices, by juicing a lot of stuff AM & putting a days
worth of juice in the fridge, then drinking as its needed, shakes take
about 5 minutes to put together, get a stick mixer & a large container
(like a shaker they sell to mix protein drinks in your health food
store) & just whiz them up with the added oil &/ algae etc if they are
required that day.

Simple things you can add to shakes that bump up the calories. I
assume you had your problems with PEANUTS? but there are other nuts
out there. In your health food store there are nut butters, tahini &
I would invest in those & consider adding some of those to a shake,
also wheatgerm oil is a cheap oil you might want to add, debittered
brewers yeast is packed with nutrients.

If a person isn't producing saliva they are also not producing the
enzyme that first works on food on the way down to the stomach, so I
would invest in some digestive enzymes. Yes, they are a tablet, so no
good for you, but you can whiz then up in the food, so they completely
break up (something that could also be done with vitamin/mineral
pills by the way).

I would plan on only eating chocolate after a meal. I would get what
I NEED first, before I have what I want. The shakes, soups & juices
would be my nutritional safety net. Next the chocolate will add some
calories, but little else really. You can buy dairy-free chocolate
that gives you more antioxidants & without the bad effects of the milk
(milk is an allergen & some nutritionists say it heightens any allergic
response), most supermarkets & healthfood stores now sell a variety of
dark chocolate that is nutritionally far superior to the dairy bars
out there. Chicken probably isn't an allergen, so won't make the
problem any worse. There are other options like adding beans, tofu,
tempeh etc, but I wouldn't like to shrink your food intake anymore
than it already is at the moment, so I would consider adding those in
as other options, rather than just having chicken soup all the time.
You can always lose the chicken once you've got your eating sorted
out.

Once I was up to eating 6-8 times a day. My next course would be to
begin introducing solid food. Basically I would follow a weaning
plan, just like you do with a baby. Start with things like mashed
banana & steamed mashed carrot etc & work up, just like you do with a
small child. There is no reason your body cannot, given time re-learn
to produce saliva. Everything is there, it's just shut down.
Anaphylactic shock cannot destroy the salivary ducts or production
centres, just close them down, so it should be possible to get them to
switch back on given time & patience.
The EFA's will help remove damaging chemicals, heavy metals etc & the
extra nutrition by eating regularly would help a lot. After all that
was in place & I was comfortable with that eating plan I would begin
weaning. One meal would start with a little mashed banana or steamed
mashed carrot before the meal & slowly increase from there. I would
swill it around my mouth for a bit, try & remind the saliva glands to
do their thing :-) It will probably take time, but hopefully things
would slowly return to normal.

That would be my basic plan that I'd use towards recovery. My aim
would be to reactivate my saliva glands & get back to solid food. I
wouldn't rush the process, but I would head in that direction over
time.
Once I felt I was on track for recovery I would also consider some
weight training as I would have lost a lot of muscle mass & strength.
Obviously I wouldn't be lifting massive weights, but most people male
or female in show-business or modelling use weights these days to keep
in shape & the fat low. Obviously I'd have to get the nutrition in
place first & feel ready before I started that though, at the moment,
in your position, I would focus on getting the nutrition in place

Hopefully looking at what I would do in your position has given you a
few ideas of your own & anything else just let me know.