Written by Anssi Manninen, MHS
12 July 2006

”To repeat what others have said, requires education; to challenge it, requires brains.” —Mary Pettibone Poole


Editor´s Note: Every month MD gives you get the most accurate, scientifically based information on building muscle and burning fat— from drugs and supplements to training and diet— from the top medical experts. This month we're lauching a new column, Sports Supplement Product Review, to give you cutting-edge insight into products that can benefit your training and give you the extra "boost" you've been looking for.

Legislation regarding sports supplements is minimal in most countries, allowing unsupported claims to flourish. However, some nutritional supplements offer scientifically documented advantages to the athlete. Some products work by producing a direct ergogenic effect (e.g., creatine). Other products can be used by athletes to meet their nutritional goals (e.g., meal replacements) and as an indirect outcome, to achieve optimal performance.

mhpMaximum Human Performance (MHP) was born out of a friendship between world class bodybuilder, Gerard Dente, and Vincent Giampapa, MD, a specialist in hormone replacement therapy and age management medicine. Although MHP is a relatively fresh player in the field of sports supplements, they have produced many innovative products for serious athletes. In this article, I will discuss their TRAC® Extreme-NO product, which represents the next generation of pre-workout nitric oxide/creatine formulas. The main actives of this product are creatine, arginine and Metafolin.


Creatine is a nitrogenous amine. Normal daily dietary intake of creatine from an omnivorous diet approximates one gram. Exogenous dietary sources of creatine include meat, fish and other animal products, but it may also be formed endogenously in the liver, kidney and pancreas from the amino acids glycine, arginine and methionine. One-half kilogram of fresh, uncooked steak contains about two grams of creatine.

Creatine has become an extremely popular dietary supplement among strength-power athletes. In 1998, about $200 million was spent on creatine monohydrate. Of the approximate 320 studies evaluating the potential ergogenic value of creatine supplementation, about 70 percent of these studies report statistically significant results, while remaining studies generally report non-significant gains in performance. However, studies reporting no significant benefit of creatine supplementation often have low statistical power, have evaluated performance tests with large test-to-test variability, and/or haven’t incorporated appropriate experimental controls. Short-term creatine supplementation has been reported to improve:

·       Maximum power/strength (five to 15 percent)

·       Work performed during sets of maximum effort muscle contractions (five to 15 percent)

·       Single-effort sprint performance (one to five percent)

·       Work performed during repetitive sprint performance (five to 15 percent)

·       Body composition, i.e., creatine supplementation during training promotes greater gains in fat-free mass

Creatine supplementation isn’t banned by the International Olympic Committee (IOC) and, with the exception of a small increase in body mass (approximately one kilogram) over the initial three to six days, doesn’t appear to have any adverse side effects, at least with short-term use. Few scientific data are available for more prolonged use, but considering the large numbers of athletes using creatine over the past 10 years and the absence of reported problems, it’s likely that the purported long term adverse effects are being overestimated. In fact, creatine supplementation has been, and continues to be, investigated as a possible therapeutic approach for the treatment of muscular, neurological and neuromuscular diseases (arthritis, congestive heart failure, disuse atrophy, gyrate atrophy, McArdle’s disease, etc.).


Arginine is classified as a conditionally essential amino acid. Although it has numerous important physiological functions, gym rats have taken arginine supplements for two main reasons: 1) to increase growth hormone secretion; and 2) to augment nitric oxide (NO) synthesis. However, it’s now clear that oral arginine supplementation alone has little, if any, effect on growth hormone secretion. However, one study reported that the ingestion of arginine (1.5 grams) and lysine (1.5 grams) resulted in a 2.7-fold increase in growth hormone concentration in strength-trained athletes. So, the argine plus lysine combo appears to be a somewhat effective “GH booster.”

As noted above, another possible ergogenic potential of arginine is its role in the synthesis of nitric oxide (NO). NO acts as a signaling molecule to faciliate the dilation of blood vessels; its main effect on muscle metabolism is to increase the delivery and uptake of nutrients via its vasodilating effects. Recently, nitric oxide boosters (i.e., arginine, arginine alpha-ketoglutarate [AAKG]) have become popular among serious gym rats. It’s been suggested that these products enhance blood flow to muscle, in turn leading to greater gains in muscle mass and strength during training.

A recent study at the Baylor University´s Exercise & Sports Nutrition Lab examined the effects of AAKG supplementation during training on body composition and training adaptations in experienced gym rats. Thirty-five resistance-trained males were matched according to fat-free mass and randomly assigned to ingest supplements containing either a placebo (fake supplement) or commercial AAKG supplement in a double-blind manner (an experimental procedure in which neither the subjects nor the experimenters know which subjects are in the test and control groups during the actual course of the experiments).

Subjects took four grams of the supplements three times daily (12 grams per day) for eight weeks during standardized training. No significant differences were observed between groups in terms of changes in body mass, fat-free mass, fat mass, or percent body fat. However, changes in bench press one repetition maximum were significantly greater in the AAKG group. It’s mystery how AAKG supplementation added an average of more than 13 pounds to bench press max over placebo without a concomitant increase in muscle mass. This seems to suggest that the changes are neural in origin.

In patients with stable angina pectoris (a disease marked by brief attacks of chest pain precipitated by deficient oxygenation of the heart muscles), ingestion of six grams of arginine per day for three days has been shown to improve exercise workload during a treadmill stress test. The vasodilatory properties of arginine may facilitate an increase in oxygen delivery, which helps meet the increased demands caused by exercise.


Metafolin™, L-methylfolate, is the pure crystalline synthetic derivative of the naturally occurring predominant form of folate. Folates are water-soluble vitamins. Folate is a generic term comprising all the various chemical forms including folic acid. Now you may ask what the heck does folic acid have to do with bodybuilding? Well, let me tell you something about nitric oxide biochemistry.

It’s now well-established that tetrahydrobiopterin (BH4) is an essential co-factor required for the activation of nitric oxide synthase (NOS; the enzyme that produces NO from arginine). Importantly, in the presence of inadequate levels of BH4, NOS becomes “uncoupled” from the production of NO, producing harmful superoxide radicals rather than NO.

A recent study Dr. Mathew Hydman and colleagues was designed to investigate the interaction between 5-methyltetrahydrofolate (the physiological form of folate) and BH4. The investigators hypothesized that 5-methyltetrahydrofolate interacts with NOS in a fashion analogous to, yet independent of, BH4. Interestingly, this study demonstrated that 5-methyltetrahydrofolate binds the active site of NOS and mimics the orientation of BH4. The results also indicated that 5-methyltetrahydrofolate attenuates superoxide production. Dr. Hydman et al. suggested that 5-methyltetrahydrofolate directly interacts with NOS to promote NO production. Now you should realize why MHP included Metafolin in their NO boosting formula.


Other Ingredients
TRAC Extreme-NO also contains green tea, guarana, vanadium, tyrosine, chromium and a host of other ingredients. For more information on MHP products, visit their website at www.maxperformance.com.


The author of this article has no financial relationship with MHP.


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