# 2.7: Exercise Supplement

### Multiplication of Whole Numbers

Exercise (PageIndex{1})

In the multiplication (5 imes 9 = 45), 5 and 9 are called and 45 is called the .

factors; product

Exercise (PageIndex{2})

In the multiplication (4 imes 8 = 32), 4 and 8 are called and 32 is called the .

### Concepts of Division of Whole Numbers

Exercise (PageIndex{3})

In the division (24 div 6 = 4), 6 is called the , and 4 is called the .

divisor; quotient

Exercise (PageIndex{4})

In the division (36 div 2 = 18), 2 is called the , and 18 is called the .

### Some Interesting Facts about Division

Exercise (PageIndex{5})

A number is divisible by 2 only if its last digit is .

an even digit (0, 2, 4, 6, or 8)

Exercise (PageIndex{6})

A number is divisible by 3 only if of its digits is divisible by 3.

Exercise (PageIndex{7})

A number is divisible by 4 only if the rightmost two digits form a number that is .

divisible by 4

Find each product or quotient.

Exercise (PageIndex{8})

(egin{array} {r} {24} {underline{ imes 3}} end{array})

Exercise (PageIndex{9})

(egin{array} {r} {14} {underline{ imes 8}} end{array})

112

Exercise (PageIndex{10})

(21 div 7)

Exercise (PageIndex{11})

(35 div 5)

7

Exercise (PageIndex{12})

(egin{array} {r} {36} {underline{ imes 22}} end{array})

Exercise (PageIndex{13})

(egin{array} {r} {87} {underline{ imes 35}} end{array})

3,045

Exercise (PageIndex{14})

(egin{array} {r} {117} {underline{ imes 42}} end{array})

Exercise (PageIndex{15})

(208 div 52)

4

Exercise (PageIndex{16})

(egin{array} {r} {521} {underline{ imes 87}} end{array})

Exercise (PageIndex{17})

(egin{array} {r} {1005} {underline{ imes 15}} end{array})

15,075

Exercise (PageIndex{18})

(1338 div 446)

Exercise (PageIndex{19})

(2814 div 201)

14

Exercise (PageIndex{20})

(egin{array} {r} {5521} {underline{ imes 8}} end{array})

Exercise (PageIndex{21})

(egin{array} {r} {6016} {underline{ imes 7}} end{array})

42,112

Exercise (PageIndex{22})

(576 div 24)

Exercise (PageIndex{23})

(3969 div 63)

63

Exercise (PageIndex{24})

(egin{array} {r} {5482} {underline{ imes 322}} end{array})

Exercise (PageIndex{25})

(egin{array} {r} {9104} {underline{ imes 115}} end{array})

1,046,960

Exercise (PageIndex{26})

(egin{array} {r} {6102} {underline{ imes 1000}} end{array})

Exercise (PageIndex{27})

(egin{array} {r} {10101} {underline{ imes 100000}} end{array})

101,010,000

Exercise (PageIndex{28})

(162,006 div 31)

Exercise (PageIndex{29})

(0 div 25)

0

Exercise (PageIndex{30})

(25 div 0)

Exercise (PageIndex{31})

(4280 div 10)

428

Exercise (PageIndex{32})

(2126000 div 100)

Exercise (PageIndex{33})

(84 div 15)

5 remainder 9

Exercise (PageIndex{34})

(126 div 4)

Exercise (PageIndex{35})

(424 div 0)

not defined

Exercise (PageIndex{36})

(1198 div 46)

Exercise (PageIndex{37})

(995 div 31)

32 remainder 3

Exercise (PageIndex{38})

(0 div 18)

Exercise (PageIndex{39})

(egin{array} {r} {2162} {underline{ imes 1421}} end{array})

3,072,202

Exercise (PageIndex{40})

(0 imes 0)

Exercise (PageIndex{41})

(5 imes 0)

0

Exercise (PageIndex{42})

(64 imes 1)

Exercise (PageIndex{43})

(1 imes 0)

0

Exercise (PageIndex{44})

(0 div 3)

Exercise (PageIndex{45})

(14 div 0)

not defined

Exercise (PageIndex{46})

(35 div 1)

Exercise (PageIndex{47})

(1 div 1)

1

### Properties of Multiplication

Exercise (PageIndex{48})

Use the commutative property of multiplication to rewrite (36 imes 128).

Exercise (PageIndex{49})

Use the commutative property of multiplication to rewrite (114 imes 226).

(226 imes 114)

Exercise (PageIndex{50})

Use the associative property of multiplication to rewrite ((5 cdot 4) cdot 8).

Exercise (PageIndex{51})

Use the associative property of multiplication to rewrite (16 cdot (14 cdot 0)).

((16 cdot 14) cdot 0)

Exercise (PageIndex{52})

A computer store is selling diskettes for $4 each. At this price, how much would 15 diskettes cost? Exercise (PageIndex{53}) Light travels 186,000 miles in one second. How far does light travel in 23 seconds? Answer 4,278,000 Exercise (PageIndex{54}) A dinner bill for eight people comes to exactly$112. How much should each person pay if they all agree to split the bill equally?

Exercise (PageIndex{55})

Each of the 33 students in a math class buys a textbook. If the bookstore sells $1089 worth of books, what is the price of each book? Answer$33

Asian herb astragalus may help boost endurance during exercise. Astragalus is a medicinal herb used to boost immunity, reduce inflammation, and help with specific conditions such as diabetes. It has also been claimed to improve workout performance by: Boosting endurance capacity. Astragalus has been shown to extend time until exhaustion during exercise in … [Read more. ]

## Do You Need Supplements?

The short answer is not really, however as mentioned above, you may want to consider certain supplements by the mere fact that they are suggestible for your gene type.

An example of this for me personally is a genetic predisposition to Vitamin D deficiency, which came up in my comprehensive DNA report. With this information in mind, I make an active effort to supplement Vitamin D, and get my butt into some sunlight as often as possible!

So in certain cases supplements may not be totally required, but highly advisable.

When I began losing weight several years back, many thoughts ran through my mind, from bogus weight loss supplements, to even considering the quick and easy liposuction of 40-50lbs.

However when I took a moment to listen to my own instinct and intuition, the truth about these ideologies is that they do not solve the root of the problem &ndash lifestyle choices.

My general opinion on supplementation for weight loss is that one need not focus on substances or external things in order to achieve weight loss.

When I was losing weight, after having gained it through silly lifestyle choices (to keep things short), my focus was not on supplements but on the consistent effort towards maximal weight loss and fat loss.

In order to maximize weight/fat loss &mdash I&rsquove discussed many times over the importance of incorporating Intermittent Fasting (Time-Restricted Eating), in conjunction with high activity levels throughout the week.

Simply put, you need to consider how you structure your eating, as well as the amount of exercise, effort, and overall exertion &ndash leading to daily caloric expenditure.

Get yourself in a healthy caloric deficit, not by starving yourself, but by exercising, eating healthy and within a Time-Restricted &ldquoeating window&rdquo.

## Decalcification of the Aortic Valve by Vitamin K2 (Menaquinone-7) (DECAV-K2)

Aortic Stenosis is a common but fatal disease when it becomes symptomatic, specially if not treated. Until now surgery remains the only reliable and effective treatment.

In this study, the investigators will examine the effect of high dose of Menaquinone-7 (MK-7) supplementation (1000 mcg)/day on the progression of the aortic valve disease. The investigators hypothesize that MK-7 supplementation may slow or even reverse the progression of the disease process.

Condition or disease Intervention/treatment Phase
Aortic Valve Disease Dietary Supplement: Vitamin K2 (Menaquinone 7) + Vitamin D3 Phase 2

The study is a randomized clinical trial that will use Cardiac Echography and multi-detector computed tomography to compare the changes in the Aortic Valve Calcification Score (AVCS) over 3 years when using:

1. 1000 mcg/d Vitamin K2 (menaquinone-7) + 5000 IU/d Vitamin D3
2. 5000 IU/d Vitamin D3 as a control group

Layout table for study information
 Study Type : Interventional (Clinical Trial) Estimated Enrollment : 150 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Decalcification of the Aortic Valve by Vitamin K2 (Menaquinone-7) Actual Study Start Date : January 2, 2018 Estimated Primary Completion Date : December 2020 Estimated Study Completion Date : December 2020

Resource links provided by the National Library of Medicine

## Pre-Workout Safety

### Are Pre-Workouts Safe?

There's no doubt that some supplement companies have made headlines for the wrong reasons in recent years. And pretty much every lifter can tell you a story about the time they took a stim-heavy pre-workout that was a bit more intense than they expected. However, as long as you follow a few straightforward rules, you can have a safe and productive training session after taking a pre-workout.

First and foremost, go in with your eyes open! Know what you're taking. Make sure you buy your pre-workout from a reputable, established company, preferably one whose products have been tested and approved by an independent third party. Informed-Choice is one such testing organization. Informed-Choice tests about 18,000 samples a year for contamination by banned substances, and to verify that what is on the label of your pre-workout matches exactly what's in the bottle.

If you know what you're taking, the next step is to know yourself, and why you're taking a pre-workout in the first place. Is it to get a specific extra edge for your specific workouts, or is it just a way to try to motivate yourself into training? Are you comfortable with stimulants, or do you know they make you feel anxious and unpleasant, or struggle with insomnia? Is your training and nutrition in order, or are you hoping that a pre-workout will magically give you results? Answer these questions before you click "buy," and remember that a pre-workout is just the icing on the cake. Training consistently and eating right—those are the real keys.

More specifically to young athletes, there are no legal age limits for the use of pre-workouts nor for any other exercise-related supplement. And sure, a pre-workout may be "safe" for, say, a teen athlete, but that doesn't mean it's necessary or even helpful. A teen athlete or lifter would get more from simply eating right and training regularly than from taking any particular supplement—particularly one that can cause rapid heart rate and other side effects that could hinder an otherwise potentially productive workout.

And no matter what your age, if you have problems with your heart, be sure to consult a physician before taking a pre-workout or any other supplement.

### Are Some Pre-Workouts Better For Women?

More women are in the weight room than ever, training harder than ever, and that means more women than ever are taking supplements, too. We think it's high time this happened! But there are certain supplements, like pre-workouts, where the same rules and dosages that apply to one athlete may not always be the best for another.

Here's why: Research-recommended dosages of caffeine for athletic performance are generally based on body weight. The range that Douglas Kalman, Ph.D., RD, and co-founder of the International Society of Sports Nutrition, gives in Bodybuilding.com's Foundations of Fitness Nutrition course is 3-6 milligrams per kilogram of body weight, granting that it's highly personal—and that 6 milligrams is a serious dose that isn't appropriate for most people.

For a 55-kilogram (or 120-pound) woman, that's an "I feel it, but not too much" 165 milligrams of caffeine on the low end, or a "My eyes are bugging out of my head" 330 milligrams on the high end. And those are very different than for a 200-pound bodybuilder! Many popular pre-workouts, though, contain a fixed scoop of 300 or more milligrams per serving, regardless of how big you are.

This isn't necessarily a problem, but it's worth taking into consideration before you take a scoop of a random pre—and maybe end up feeling like your heart is beating out of your chest. Several companies on our list of the Best Women's Pre-Workouts make women-specific products with women's body size taken into account in the dosing.

"I always say, start small and then go up from there, just to see how well your body tolerates it," says Krissy Kendall, Ph.D. in the Bodybuilding.com Podcast episode "All About Caffeine: What Every Lifter Needs to Know." Translation: Try a half scoop, or even less, of popular pre-workouts to gauge your tolerance initially, and then customize subsequent doses.

As for the effectiveness of all the individual ingredients in pre-workouts, that doesn't change just because you use one locker room or the other. The increased energy, strength, endurance, and decreased muscle soreness that Jim Stoppani, Ph.D., creator of the Shortcut to Size program and others, says help caffeine make workouts better is just as true for women as for men. The same goes for common ingredients like citrulline malate and beta-alanine.

In one recent vote of support, A 2018 study published in the Journal of the International Society of Sports Nutrition confirms the fact that pre-workouts can "improve upper-body muscular endurance and anaerobic capacity [in women], while improving feelings of focus following high-intensity exercises."[8]

Sound familiar? Just figure out what dose works for you, and try for yourself.

### Can I Take Other Supplements If I Take Pre-Workouts?

Yes, of course! Pre-workout supplements are formulated with a specific purpose in mind: to give you extra energy or endurance so you can attack your workout with focus and purpose. Other supplements are formulated to accomplish other, equally specific goals.

For example, if you're not getting enough protein in your diet, all the pre-workouts in the world won't help you see lasting results. Eat up, and if you can't eat enough, have a shake post-workout, or even alongside your pre-workout.

On the flipside, if your pre-workout of choice is a little low in certain ingredients, as many are, it's OK to soup it up with a little extra. Here are a few to consider:

• Beta-alanine: This ingredient needs to be taken nearly daily in order to work effectively, so taking an additional 3 grams outside of your pre-workout is a no-brainer.
• Creatine: Similar to beta-alanine, creatine should be taken daily to provide muscular recover and other benefits.
• Nitric oxide boosters: Some companies make non-stimulant "pump" blends that can be stacked with a caffeinated pre-workout or energy drink.

If you're taking a caffeinated pre-workout, just be careful not to take other stimulants on top of it. The dose in most pre-workouts is strong enough without any extra caffeine!

### Should I Buy Or Make My Pre-Workout Supplement?

If you're someone who likes that extra level of control in your nutrition and supplementation, there's no reason you couldn't make your own pre-workout. Well, scratch that, there are a couple of reasons: It can end up being far more expensive, and depending on how you make it, you might miss out on a few key ingredients. And the taste is probably going to be terrible… Yeah, this is a pretty tall order for the average gym-goer.

So, before you put on a lab coat and go deep into PubMed, make sure you have a rock-solid foundation of training and nutrition. Are you training 3-5 times a week consistently, and with good form? Are you eating adequate calories and protein, and having a solid pre-workout meal before intense training sessions? Check, check, check. OK, then maybe you're no longer an "average" gym-goer.

That said, before you start perusing the dark web for a discounted palette of pure African yohimbine, bear in mind that starting simple is almost always the best option. If you're going to make your own pre, keep it to the key ingredients that the best pre-workouts share: caffeine (if that's your thing), beta-alanine, and perhaps nitric oxide boosters for endurance and pumps. If you want to go down the rabbit hole of nootropics (i.e., brain-boosting supplements) or other highly goal-specific ingredients, go for it—but don't expect magic.

Remember, this isn't about cheating the process. It's only about reasonably enhancing what you can get out of it!

## Study Design: Part 2 (6-week Efficacy Study)

### Subjects

Healthy men and women aged 18-45 years (24.3 ± 2.9 years, 70.5 ± 3.1 inches, 83.8 ± 9.6 kg, 26.1 ± 2.7 kg/m 2 ) with body fat 10-25% and body mass index (BMI) 󖼮 kg/m 2 who had been undergoing resistance training regularly (defined as completing an average of three workouts/week) for 𕟴 years were eligible for inclusion. Exclusion criteria were the same as described for Part 1. The study was approved by a private IRB (Integreview, Austin, TX, Protocol # DS-CRZ-001, approval date: 6/8/2012 and Protocol # CHR-CRZ-001, approval date: 9/4/2012) and all subjects provided written informed consent to participate in this clinical trial prior to commencing any study-related activities.

Subjects recorded their dietary intake over a three-day period (two week days, one weekend day) according to instructions given by a licensed, registered dietician. Each subject's baseline diet was analyzed by NutriBase IV software (CyberSoft Inc., Phoenix, AR) to determine its energy and macronutrient contents. Follow-up three-day dietary records were collected and analyzed at weeks 3 and 6 to verify that eating habits remained consistent throughout the study.

### Supplementation

Subjects were randomized into two groups matched for age, weight, and resistance-training experience using a double-blind approach to ingest either a multi-ingredient performance product (MPP) or a comparator. As highlighted previously, the multi-ingredient performance product (MPP) was trademarked as Craze™ (Driven Sports, NY) and a copy of the supplement facts label is figure 1. The comparator was an isocaloric beverage of similar taste, color, smell, texture, caffeine content and packaging. All subjects ingested one serving of their prescribed supplement (MPP or comparator) and mixed it with eight fluid ounces (240 mL) of cold water 30 minutes prior to starting each training session. On non-training days, subjects took their allocated supplement in the mornings before or during breakfast hence subjects in both groups took MPP or comparator product every day throughout the 6-week duration of this study. Compliance was monitored by having participants complete a supplementation log while also being required to return their empty canisters. In addition, weekly text messages and emails were sent to remind study participants of all study requirements.

### Testing Protocol

Prior to pretesting, subjects were instructed not to do any strenuous exercise for 󖾤 hours and not consume any food or fluid with caloric contact past midnight the night before testing most participants observed a ten hour fast. Subjects were familiarized with the experimental procedures and practiced the exercise tests prior to pre-supplementation/baseline testing. Physical activity levels and health history were determined by a standardized questionnaire. Subjects were contacted every week to determine whether they had experienced any idiosyncratic responses to the supplementation protocol moreover, on weeks 3 and 6 subjects filled out a questionnaire to monitor individual changes in delayed-onset muscle soreness (DOMS), appetite, thirst, muscle cramping, stomach distress, and any other side effects. Additionally, vital signs such as blood pressure and heart rate were assessed at baseline and weeks 3 and 6. Fasting blood lipids (TC, LDL, HDL, and TG), whole blood cell counts, and serum markers of hepatic/renal function (AST, ALT, BUN, creatinine, total bilirubin, ALP) were recorded at baseline and end of study (week 6) (Quest Diagnostics, Pittsburgh, PA).

Lean mass, fat mass, and %fat were determined by dual-energy x-ray absorptiometry (DEXA General Electric Lunar DPX Pro) at baseline and weeks 3 and 6. All DEXA scans were performed by the same technician and analyzed by the manufacturer's software (enCORE version 13.31) reliability assessments using our device and protocol have been published previously [20]. Female subjects were measured during the early follicular phase of their menstrual cycle to control for diurnal changes in estrogen and its physiological effects (e.g., fluid retention, etc.). Briefly, subjects were positioned in the scanner according to standard procedures and remained motionless for approximately 15 minutes during scanning. DEXA segments for the upper and lower limbs and trunk were directed using standard anatomical landmarks. Percent fat was calculated by dividing fat mass by total scanned mass. Lean to fat mass ratio was computed using a simple ratio between the two values. Quality control calibration procedures were performed prior to all scans using a calibration block provided by the manufacturer. Prior to this study, we determined test-retest reliability for repeated measurements of lean mass, bone mineral content, and fat mass using this DEXA using intra-class correlation coefficients all values were ɬ.98 [20].

On the same day as blood sampling and body composition assessment, upper body muscle strength was estimated by 1-RM bench press protocol that was adapted from standard NSCA protocols [21]. Only upper-body was assessed due to previous experience indicating that greater stability and reliability of the data is present when assessing upper body vs. lower body activities [22]. After a general warm-up of 3-5 minutes light activity (upper body ergometry) and static stretching exercises of the involved musculature, the subject performed a warm-up set of eight repetitions at approximately 50% of the perceived 1-RM followed by a set of three repetitions at 70% of the perceived 1-RM. Thereafter, the subject performed single lifts at progressively heavier weights until failure. At failure, a single lift of a weight approximately midway between the last successful and failed lift was attempted and this process was repeated until the 1-RM was determined. No more than five maximal attempts were completed in one testing session. Upper body muscle endurance was estimated by the total number of repetitions completed (repetitions to failure RTF) during three successive sets (separated by 1-minute rest intervals) of isotonic bench press at a load equal to 100% of subjects' pretesting body weight. The aggregate or total number of repetitions performed were used for statistical determination of muscular endurance. Upper body power production (average power [AP], average velocity [AV], peak power [PP], peak velocity [PV]) was assessed during the bench press exercise using a Tendo unit. Previous studies have incorporated the use of a Tendo into their study design [23] and Stock and colleagues [24] recently published data to indicate it is a reliable means of assessment. The unit consists of a position transducer that measures the rate of linear displacement providing velocity and acceleration in addition to power production.

Subjective levels of fatigue, energy, focus, and concentration were assessed by visual analog scale (VAS) immediately before commencing each workout. Using VAS, subjects were asked to mark their feelings on a 15-cm straight line anchored with verbal cues such as "high" and "low" at each end. The validity and reliability of VAS to assess fatigue and energy have been previously established [25].

### Statistical Analyses

All statistical analyses were completed while group assignments were still blinded. All collected data were first screened to meet normality and sphericity assumptions. Between-group differences in body composition, muscular performance, and safety markers were assessed by analysis of covariance (ANCOVA) using baseline scores as the covariate. When significant interaction effects were found, main effects were decomposed using independent samples t-test for between group determinations and paired sample t-tests for within-group assessments. In all analyses, a statistically significant difference was assumed when the probability of a type I error was ɘ.05 (Pɘ.05). Statistical analyses were carried out using SPSSv21.0 software.

## Should I use creatine supplements?

Creatine is a nitrogenous organic acid that helps supply energy to cells throughout the body, particularly muscle cells.

It occurs naturally in red meat and fish, it is made by the body, and it can also be obtained from supplements.

Supplements are used by athletes to improve their performance, by older adults to increase muscle mass, and to treat problems that result when a body cannot metabolize creatine fully.

Some evidence suggests that it might prevent skin aging, treat muscle diseases, help people with multiple sclerosis (MS) to exercise, enhance cognitive ability, and more. Additional evidence is needed to confirm these uses.

This article will look at the uses of creatine, how it works, and how safe and effective it is.

Share on Pinterest Creatine is a common ingredient muscle-building supplements and sports drinks.

Creatine is formed of three amino acids: L-arginine, glycine, and L-methionine. It makes up about 1 percent of the total volume of human blood.

Around 95 percent of creatine in the human body is stored in skeletal muscle, and 5 percent is in the brain.

Between 1.5 and 2 percent of the body’s creatine store is converted for use each day by the liver, the kidneys, and the pancreas.

It is transported through the blood and used by parts of the body that have high energy demands, such as skeletal muscle and the brain.

Different forms of creatine are used in supplements, including creatine monohydrate and creatine nitrate.

No creatine supplement has yet been approved for use by the United States (U.S.) Food and Drug Administration (FDA). There are dangers associated with use of unrestricted supplements.

A person needs between 1 and 3 grams (g) of creatine a day. Around half of this comes from the diet, and the rest is synthesized by the body. Food sources include red meat and fish. One pound of raw beef or salmon provides 1 to 2 grams (g) of creatine.

Creatine can supply energy to parts of the body where it is needed. Athletes use supplements to increase energy production, improve athletic performance, and to allow them to train harder.

According to the International Society of Sports Nutrition (ISSN), larger athletes who train intensely “may need to consume between 5 and 10 g of creatine a day” to maintain their stores.

People who cannot synthesize creatine because of a health condition may need to take 10 to 30 g a day to avoid health problems.

Creatine is one of the most popular supplements in the U.S., especially among men who participate in ice hockey, football, baseball, lacrosse, and wrestling.

It is also the most common supplement found in sports nutrition supplements, including sports drinks.

There are claims for a number of uses, some of which are supported by research evidence.

### Improving athletic performance

Athletes commonly use creatine supplements, because there is some evidence that they are effective in high-intensity training.

The idea is that creatine allows the body to produce more energy. With more energy, athletes can work harder and achieve more.

For some participants in some kinds of exercise, boosting the body’s creatine pool appears to enhance performance.

In 2003, a meta-analysis published in the Journal of Sports Science and Medicine concluded that creatine “may improve performance involving short periods of extremely powerful activity, especially during repeated bouts.”

The researchers added that not all studies had reported the same benefits.

In 2012, a review concluded that creatine:

• boosts the effects of resistance training on strength and body mass
• increases the quality and benefits of high-intensity intermittent speed training
• improves endurance performance in aerobic exercise activities that last more than 150 seconds
• may improve strength, power, fat-free mass, daily living performance and neurological function

It seems to benefit athletes participating in anaerobic exercise, but not in aerobic activity.

It appears to be useful in short-duration, high-intensity, intermittent exercises, but not necessarily in other types of exercise.

However, a study published in 2017 found that creatine supplementation did not boost fitness or performance in 17 young female athletes who used it for 4 weeks.

### Increased body mass

Increased creatine content in muscles has been associated with greater body mass.

However, according to the U.S. National Library of Medicine, creatine does not build muscle. The increase in body mass occurs because creatine causes the muscles to hold water.

One review, published in 2003, notes that “The gains in body weigh observed are likely due to water retention during supplementation.”

It is also possible that muscle mass builds as a result of working harder during exercise.

### Repairing damage after injury

Research suggests that creatine supplements may help prevent muscle damage and enhance the recovery process after an athlete has experienced an injury.

Creatine may also have an antioxidant effect after an intense session of resistance training, and it may help reduce cramping. It may have a role in rehabilitation for brain and other injuries.

### Creatine and deficiency syndromes

Creatine is a natural substance and essential for a range of body functions.

An average young male weighing 70 kilograms (kg) has a store, or pool, of creatine of around 120 to 140 g . The amount varies between individuals, and it depends partly on a person’s muscle mass and their muscle fiber type.

Creatine deficiency is linked to a wide range of conditions, including, but not limited to:

• chronic obstructive pulmonary disease (COPD)
• congestive heart failure (CHF)
• depression
• multiple sclerosis (MS)
• muscle atrophy
• Parkinson’s disease
• osteoarthritis

Oral creatine supplements may relieve these conditions, but there is not yet enough evidence to prove that this is an effective treatment for most of them.

Supplements are also taken to increase creatine in the brain. This can help relieve seizures, symptoms of autism, and movement disorders.

Taking creatine supplements for up to 8 years has been shown to improve attention, language and academic performance in some children. However, it does not affect everyone in the same way.

While creatine occurs naturally in the body, creatine supplements are not a natural substance. Anyone considering using these or other supplements should do so only after researching the company that provides them.

### Creatine and muscular dystrophy

Creatine may help improve the strength of people with muscular dystrophy.

A review of 14 studies, published in 2013, found that people with muscular dystrophy who took creatine experienced an increase in muscle strength of 8.5 percent compared with those who did not take the supplement.

“ Short- and medium-term creatine treatment improves muscle strength in people with muscular dystrophies and is well-tolerated.”

Dr. Rudolf Kley, of Ruhr University Bochum, Germany

Using creatine every day for 8 to 16 weeks may improve muscle strength and reduce fatigue in people with muscular dystrophy, but not all studies have produced the same results.

### Parkinson’s disease

In mouse models of Parkinson’s disease, creatine was able to prevent the loss of cells that are typically affected by the condition.

An animal study involving a combined treatment of coenzyme Q(10) and creatine concluded that this might help treat neurodegenerative diseases such as Parkinson’s disease and Huntington’s disease.

However, research published in JAMA, with over 1,700 human participants, noted that: “Treatment with creatine monohydrate for at least 5 years, compared with placebo did not improve clinical outcomes.”

Similarly, a systematic review published in Cochrane found that there was no strong evidence for the use of creatine in Parkinson’s.

### Depression

In South Korea, 52 women with depression added a 5-gram creatine supplement to their daily antidepressant. They experienced improvements in their symptoms as early as 2 weeks, and the improvement continued up to weeks 4 and 8.

A small-scale study found that creatine appeared to help treat depression in 14 females with both depression and an addiction to methamphetamine.

The results suggested that: “Creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence.”

Further research is needed.

### Cognitive ability

In 2003, researchers published evidence that creatine can boost mental performance.

After taking a 5-g supplement each day for 6 weeks, 45 participants scored better on working memory and intelligence tests, specifically tasks taken under time pressure, than other people who took a placebo.

A study published in 2007, concluded that “creatine supplementation aids cognition in the elderly.” Participants took a 5-g supplement four times a day for a week and then carried out some number and spatial tests. Those who took the supplement did better than those who took only a placebo.

At recommended doses, creatine is considered “likely safe” to consume.

In high doses, it is “possibly safe.” It is expected that it could affect the liver, kidneys, or heart, although these effects have not been proven.

Other possible effects include:

People with kidney disease are advised not to use creatine, and caution is recommended for those with diabetes and anyone taking blood sugar supplements.

The safety of creatine supplements has not been confirmed during pregnancy or breastfeeding, so women are advised to avoid it at this time.

Use of creatine can lead to weight gain. While this may be mostly due to water, it can have a negative impact on athletes aiming at particular weight categories. It may also affect performance in activities where the center of gravity is a factor.

In 2003, a review of 14 studies on creatine supplementation and exercise performance, published in Cochrane concluded that it:

“Appears to pose no serious health risks when taken at doses described in the literature and may enhance exercise performance in individuals that require maximal single effort and/or repetitive sprint bouts.”

In 2007, the ISSN described the use of creatine as, “safe, effective, and ethical.” They recommended it as a way for athletes to obtain extra creatine without increasing their intake of fat or protein.

Updating their statement in 2017, they conclude that creatine supplementation is acceptable within recommended doses, and for short-term use for competitive athletes who are eating a proper diet.

Overall, creatine, used appropriately, seems to be relatively safe.

However, one study, published in 2012, cautioned that the “safe and ethical” status of creatine supplements could change.

“The perception of safety cannot be guaranteed,” the authors add, “Especially when administered for long periods of time to different populations.”

## Details on Active PK and Weight Loss

Active-PK is primarily a weight loss pill claiming to take advantage of the body’s enzyme balance to induce weight loss via a natural and biochemical process. It is formulated with an AMPK activator to increase the AMPK levels in the body.

In turn, the AMPK increase helps break down fat, which then produces energy by speeding up the body’s fat breakdown.

What’s more? Clinical trials reveal how AMPK can slow down the rate of response to appetite. Thus, making dieting relatively easier as dieters can now take it slow on caloric intake.

## Tips for reducing thigh cellulite at home

Cellulite refers to dimples or other textural changes in skin that develop when fat cells push through the second layer of skin, called the dermis. Cellulite often affects the buttocks, thighs, and abdomen.

More than 85 percent of females older than 21 have cellulite, but males rarely develop it. Cellulite can develop regardless of age or weight, though it becomes more common with increasing age. The medical term for it is gynoid lipodystrophy.

Invasive procedures, noninvasive techniques, certain products, and lifestyle changes may each reduce the appearance of cellulite.

However, the effects of procedures and tools are likely to be temporary. Results tend to last between a few days and 2 years.

This article describes remedies, exercises, and other methods that may reduce the appearance of cellulite. We also describe possible causes and the role of the diet.

While it may not be possible to completely eliminate cellulite, a few products and lifestyle changes may help reduce its appearance, including:

### Staying hydrated

Share on Pinterest A person can drink water to help the skin maintain a plump appearance.

Skin cells, like the rest of the body’s cells, need water to function. Water also helps the skin maintain a plump appearance.

The American Council on Exercise (ACE) note that the layer of fat involved in cellulite retains water — dehydration can contribute to its dimpled appearance.

Everyone has different hydration needs, depending on factors such as:

• age
• gender
• health status
• activity levels
• pregnancy and breastfeeding

Some recommendations state that most healthy adult females need around 2.7 liters of water each day, including water from foods.

### Maintaining a healthy weight

A person with any weight can get cellulite. However, having more fatty tissue in the body increases the likelihood of developing it.

Also, having extra weight can make cellulite more apparent, according to the American Academy of Dermatology (AAD).

For some people, losing weight gradually and consistently may help reduce the appearance of cellulite. However, losing a lot of weight, especially quickly, can lead to loose skin. This may make cellulite more visible.

### Using creams or lotions

Many creams and lotions claim to reduce the appearance of cellulite, and a person can find a range in pharmacies, spas, and online stores.

Several compounds in these products may subtly minimize the appearance of cellulite when a person uses them daily, though none change the skin’s structure.

One of these compounds is caffeine, which can dehydrate fat cells and make cellulite less visible.

Also, according to the AAD, products with 0.3% retinol, a vitamin A derivative, may help thicken the skin, leading to a reduction in the appearance of cellulite. However, a person may have to use these products for 6 months or longer before seeing results.

Other common ingredients in cellulite creams may have similar effects and benefit skin health. These ingredients include:

All skin products can cause an allergic reaction. It is essential to test new products on a small area of skin. If no reaction occurs within 48 hours, it may be safe to use the product on a larger area.

It is important to note that some creams contain aminophylline, which can cause anxiety, a racing heart, and breathing problems. People who use asthma inhalers should refrain from using any product with this ingredient.

### Taking collagen peptides

Various manufacturers market supplements, including caffeine extract, grape seed extract, and gingko biloba, as cellulite-busters.

Some research does suggest that certain bioactive collagen peptide supplements may have this effect in some people.

In a 2015 study , researchers separated 105 female participants aged 24–50 with moderate cellulite into two groups. One group took 2.5 grams (g) of specific bioactive collagen peptides daily for 6 months. The other group took a placebo.

Participants in the supplement group who weighed within a healthy range experienced a reduction in cellulite and an increase in skin thickness.

Cellulite damages collagen bands within the skin. Taking supplementary collagen may help repair these and other structures and boost metabolism within dermal cells.

However, more research is needed to determine whether and to what extent collagen supplementation may reduce cellulite.

### Trying massage

Share on Pinterest Massage may reduce the most advanced type of cellulite.

Certain devices deliver a deep tissue massage to help stretch underlying skin tissues, improve blood flow, and improve lymphatic drainage.

Some research indicates that manual and mechanical lymphatic drainage — which some consider a form of massage — may reduce the most advanced type of cellulite in as few as 2 weeks. However, the participants in this study also underwent cervical stimulation.

Several at-home devices claim to reduce cellulite by encouraging blood flow and tissue regeneration. These devices include dry brushes, mechanical massagers, and foam rollers, available for purchase online.

However, according to ACE, while devices, such as foam rollers, may help break up collagen adhesions and loosen tight connective tissues, they do not eliminate cellulite.

## Physical activity

### Should I exercise during cancer treatment and recovery?

Research strongly suggests that exercise is not only safe during cancer treatment, but it can also improve physical functioning and many aspects of quality of life. Moderate exercise has been shown to improve fatigue (extreme tiredness), anxiety, and self-esteem. It also helps heart and blood vessel fitness, muscle strength, and body composition (how much of your body is made up of fat, bone, or muscle).

People getting chemotherapy and radiation who already exercise may need to do so at a lower intensity and build up more slowly than people who are not getting cancer treatment. The main goal should be to stay as active as possible and slowly increase your level of activity over time after treatment.

### Are there special precautions survivors should consider?

Certain issues for cancer survivors may prevent or affect their ability to exercise. Some effects of treatment may increase the risk for exercise-related problems. For instance:

• People with severe anemia (low red blood cell counts) should delay activity until the anemia is better.
• Those with weak immune systems should avoid public gyms and other public places until their white blood cell counts return to safe levels.
• People getting radiation should avoid swimming pools because chlorine may irritate the skin at the treatment area.

If you were not active before diagnosis, you should start with low-intensity activities and then slowly increase your activity level. Certain people should use extra caution to reduce their risk of falls and injuries:

• Older people
• Those with bone disease (cancer in the bones or thinning bones, such as osteoporosis)
• People with arthritis
• Anyone with nerve damage (peripheral neuropathy)

### Can regular exercise reduce the risk of cancer coming back?

This has not been looked at for all types of cancer, but there have been studies of survivors of breast, colorectal, prostate, and ovarian cancers. In these studies, people with higher levels of physical activity after diagnosis lived longer and had less chance of the cancer coming back. Still, more studies are needed to see if exercise has a direct effect on cancer growth.

In the meantime, since physical activity is known to prevent heart and blood vessel disease, diabetes, and osteoporosis, cancer survivors should try to have a physically active lifestyle.

### Is yoga helpful to cancer survivors?

Most of the studies of yoga in cancer have been in breast cancer patients. They have found that yoga can be helpful in terms of anxiety, depression, distress, and stress. It didn’t seem to be as helpful for more physical outcomes, such as body composition, fitness, and muscle strength.

More research is needed, but to get the most benefit, it may be best to combine yoga with aerobic exercise and resistance (weight) training.

## How to Increase Bone Density

This article was co-authored by Laura Marusinec, MD. Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.

There are 25 references cited in this article, which can be found at the bottom of the page.