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Conlin LA, Aguilar DT, Rogers GE, Campbell BI. Flexible vs. rigid dieting in resistance-trained individuals seeking to optimize their physiques: A randomized controlled trial. J Int Soc Sports Nutr 2021; 18:52. [PMID: 34187492 PMCID: PMC8243453 DOI: 10.1186/s12970-021-00452-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract Background The purpose of this study was to compare a flexible vs. rigid diet on weight loss and subsequent weight regain in resistance-trained (RT) participants in a randomized, parallel group design. Methods Twenty-three males and females (25.6 ± 6.1 yrs; 170 ± 8.1 cm; 75.4 ± 10.3 kg) completed the 20-week intervention (consisting of a 10-week diet phase and a 10-week post-diet phase). Participants were randomized to a flexible diet (FLEX) comprised of non-specific foods or a rigid diet (RIGID) comprised of specific foods. Participants adhered to an ~20%kcal reduction during the first 10-weeks of the intervention and were instructed to eat ad libitum for the final 10-weeks. Body composition and resting metabolic rate were assessed 5 times: (baseline, 5, 10 [end of diet phase], 16, and 20 weeks). Results During the 10-week diet phase, both groups significantly reduced bodyweight (FLEX: baseline = 76.1 ± 8.4kg, post-diet = 73.5 ± 8.8 kg, ▲2.6 kg; RIGID: baseline = 74.9 ± 12.2 kg, post-diet = 71.9 ± 11.7 kg, ▲3.0 kg, p < 0.001); fat mass (FLEX: baseline = 14.8 ± 5.7 kg, post-diet = 12.5 ± 5.0 kg, ▲2.3 kg; RIGID: baseline = 18.1 ± 6.2 kg, post-diet = 14.9 ± 6.5 kg, ▲3.2 kg p < 0.001) and body fat% (FLEX: baseline = 19.4 ± 8.5%, post-diet = 17.0 ± 7.1%, ▲2.4%; RIGID: baseline = 24.0 ± 6.2%, post-diet = 20.7 ± 7.1%, ▲3.3%; p < 0.001). There were no significant differences between the two groups for any variable during the diet phase. During the post-diet phase, a significant diet x time interaction (p < 0.001) was observed for FFM with the FLEX group gaining a greater amount of FFM (+1.7 kg) in comparison with the RIGID group (−0.7 kg). Conclusions A flexible or rigid diet strategy is equally effective for weight loss during a caloric restriction diet in free-living, RT individuals. While post-diet FFM gains were greater in the FLEX group, there were no significant differences in the amount of time spent in resistance and aerobic exercise modes nor were there any significant differences in protein and total caloric intakes between the two diet groups. In the absence of a clear physiological rationale for increases in FFM, in addition to the lack of a standardized diet during the post-diet phase, we refrain from attributing the increases in FFM in the FLEX group to their diet assignment during the diet phase of the investigation. We recommend future research investigate additional physiological and psychological effects of flexible diets and weight regain in lean individuals.
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Affiliation(s)
- Laurin Alexandra Conlin
- Performance & Physique Enhancement Laboratory, Exercise Science Program, Department of Educational and Psychological Studies, University of South Florida, 4202 E. Fowler Ave., PED 214, Tampa, FL, 33620, USA
| | - Danielle Trina Aguilar
- Performance & Physique Enhancement Laboratory, Exercise Science Program, Department of Educational and Psychological Studies, University of South Florida, 4202 E. Fowler Ave., PED 214, Tampa, FL, 33620, USA
| | - Gavin Elliot Rogers
- Performance & Physique Enhancement Laboratory, Exercise Science Program, Department of Educational and Psychological Studies, University of South Florida, 4202 E. Fowler Ave., PED 214, Tampa, FL, 33620, USA
| | - Bill I Campbell
- Performance & Physique Enhancement Laboratory, Exercise Science Program, Department of Educational and Psychological Studies, University of South Florida, 4202 E. Fowler Ave., PED 214, Tampa, FL, 33620, USA.
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Kim HN, Song SW. Association between dietary protein intake and skeletal muscle mass in older Korean adults. Eur Geriatr Med 2021; 12:1221-1228. [PMID: 34156655 DOI: 10.1007/s41999-021-00530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE We investigated the association of low and high daily protein intakes on skeletal muscle mass status in Korean adults aged 60 years and older. METHODS This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey conducted between 2008 and 2011. The participants' dietary protein intake was assessed using the 24-h dietary recall method and was classified as low (< 0.8 g/kg body weight/day), moderate (0.8-1.2 g/kg/day), and high (> 1.2 g/kg/day). Amount of skeletal muscle mass was measured using whole-body dual-energy X-ray absorptiometry. Low skeletal muscle mass was defined as appendicular skeletal muscle mass index < 7.0 kg/m2 in men and < 5.4 kg/m2 in women. RESULTS The study included data from 4585 participants (2022 men and 2563 women). All skeletal muscle parameters in women and total lean mass in men decreased as the amount of protein consumed daily increased. However, there was no association between high or low protein intake and low skeletal muscle mass in men or women. CONCLUSIONS No association was found between the amount of daily protein intake and skeletal muscle mass status in older Korean adults. Gender-specific further studies focussing on the interactions of dietary protein intake under specific conditions including physical activity status and the daily distribution of protein intake and the quality and source of the protein are needed to evaluate the impact of protein intake status on muscle health in older Koreans.
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Affiliation(s)
- Ha-Na Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi, 16247, Republic of Korea
| | - Sang-Wook Song
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi, 16247, Republic of Korea.
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Roth C, Rettenmaier L, Behringer M. High-Protein Energy-Restriction: Effects on Body Composition, Contractile Properties, Mood, and Sleep in Active Young College Students. Front Sports Act Living 2021; 3:683327. [PMID: 34212136 PMCID: PMC8239143 DOI: 10.3389/fspor.2021.683327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/18/2021] [Indexed: 12/15/2022] Open
Abstract
Background: It is often advised to ensure a high-protein intake during energy-restricted diets. However, it is unclear whether a high-protein intake is able to maintain muscle mass and contractility in the absence of resistance training. Materials and Methods: After 1 week of body mass maintenance (45 kcal/kg), 28 male college students not performing resistance training were randomized to either the energy-restricted (ER, 30 kcal/kg, n = 14) or the eucaloric control group (CG, 45 kcal/kg, n = 14) for 6 weeks. Both groups had their protein intake matched at 2.8 g/kg fat-free-mass and continued their habitual training throughout the study. Body composition was assessed weekly using multifrequency bioelectrical impedance analysis. Contractile properties of the m. rectus femoris were examined with Tensiomyography and MyotonPRO at weeks 1, 3, and 5 along with sleep (PSQI) and mood (POMS). Results: The ER group revealed greater reductions in body mass (Δ -3.22 kg vs. Δ 1.90 kg, p < 0.001, partial η 2 = 0.360), lean body mass (Δ -1.49 kg vs. Δ 0.68 kg, p < 0.001, partial η 2 = 0.152), body cell mass (Δ -0.85 kg vs. Δ 0.59 kg, p < 0.001, partial η 2 = 0.181), intracellular water (Δ -0.58 l vs. Δ 0.55 l, p < 0.001, partial η 2 = 0.445) and body fat percentage (Δ -1.74% vs. Δ 1.22%, p < 0.001, partial η 2 = 433) compared to the CG. Contractile properties, sleep onset, sleep duration as well as depression, fatigue and hostility did not change (p > 0.05). The PSQI score (Δ -1.43 vs. Δ -0.64, p = 0.006, partial η 2 = 0.176) and vigor (Δ -2.79 vs. Δ -4.71, p = 0.040, partial η 2 = 0.116) decreased significantly in the ER group and the CG, respectively. Discussion: The present data show that a high-protein intake alone was not able to prevent lean mass loss associated with a 6-week moderate energy restriction in college students. Notably, it is unknown whether protein intake at 2.8 g/kg fat-free-mass prevented larger decreases in lean body mass. Muscle contractility was not negatively altered by this form of energy restriction. Sleep quality improved in both groups. Whether these advantages are due to the high-protein intake cannot be clarified and warrants further study. Although vigor was negatively affected in both groups, other mood parameters did not change.
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Affiliation(s)
- Christian Roth
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Lukas Rettenmaier
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt, Germany
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Williamson E, Moore DR. A Muscle-Centric Perspective on Intermittent Fasting: A Suboptimal Dietary Strategy for Supporting Muscle Protein Remodeling and Muscle Mass? Front Nutr 2021; 8:640621. [PMID: 34179054 PMCID: PMC8219935 DOI: 10.3389/fnut.2021.640621] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/19/2021] [Indexed: 01/04/2023] Open
Abstract
Muscle protein is constantly “turning over” through the breakdown of old/damaged proteins and the resynthesis of new functional proteins, the algebraic difference determining net muscle gain, maintenance, or loss. This turnover, which is sensitive to the nutritional environment, ultimately determines the mass, quality, and health of skeletal muscle over time. Intermittent fasting has become a topic of interest in the health community as an avenue to improve health and body composition primarily via caloric deficiency as well as enhanced lipolysis and fat oxidation secondary to attenuated daily insulin response. However, this approach belies the established anti-catabolic effect of insulin on skeletal muscle. More importantly, muscle protein synthesis, which is the primary regulated turnover variable in healthy humans, is stimulated by the consumption of dietary amino acids, a process that is saturated at a moderate protein intake. While limited research has explored the effect of intermittent fasting on muscle-related outcomes, we propose that infrequent meal feeding and periods of prolonged fasting characteristic of models of intermittent fasting may be counter-productive to optimizing muscle protein turnover and net muscle protein balance. The present commentary will discuss the regulation of muscle protein turnover across fasted and fed cycles and contrast it with studies exploring how dietary manipulation alters the partitioning of fat and lean body mass. It is our position that intermittent fasting likely represents a suboptimal dietary approach to remodel skeletal muscle, which could impact the ability to maintain or enhance muscle mass and quality, especially during periods of reduced energy availability.
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Affiliation(s)
- Eric Williamson
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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Coleman JL, Carrigan CT, Margolis LM. Body composition changes in physically active individuals consuming ketogenic diets: a systematic review. J Int Soc Sports Nutr 2021; 18:41. [PMID: 34090453 PMCID: PMC8180141 DOI: 10.1186/s12970-021-00440-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background To achieve ideal strength/power to mass ratio, athletes may attempt to lower body mass through reductions in fat mass (FM), while maintaining or increasing fat-free mass (FFM) by manipulating their training regimens and diets. Emerging evidence suggests that consumption of high-fat, ketogenic diets (KD) may be advantageous for reducing body mass and FM, while retaining FFM. Methods A systematic review of the literature was conducted using PubMed and Cochrane Library databases to compare the effects of KD versus control diets (CON) on body mass and composition in physically active populations. Randomized and non-randomized studies were included if participants were healthy (free of chronic disease), physically active men or women age ≥ 18 years consuming KD (< 50 g carbohydrate/d or serum or whole blood β-hydroxybutyrate (βhb) > 0.5 mmol/L) for ≥14 days. Results Thirteen studies (9 parallel and 4 crossover/longitudinal) that met the inclusion criteria were identified. Aggregated results from the 13 identified studies show body mass decreased 2.7 kg in KD and increased 0.3 kg in CON. FM decreased by 2.3 kg in KD and 0.3 kg in CON. FFM decreased by 0.3 kg in KD and increased 0.7 kg in CON. Estimated energy balance based on changes in body composition was − 339 kcal/d in KD and 5 kcal/d in CON. Risk of bias identified some concern of bias primarily due to studies which allowed participants to self-select diet intervention groups, as well as inability to blind participants to the study intervention, and/or longitudinal study design. Conclusion KD can promote mobilization of fat stores to reduce FM while retaining FFM. However, there is variance in results of FFM across studies and some risk-of-bias in the current literature that is discussed in this systematic review. Supplementary Information The online version contains supplementary material available at 10.1186/s12970-021-00440-6.
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Affiliation(s)
- Julie L Coleman
- U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Building 42, Natick, MA, 01760, USA.,Oak Ridge Institute of Science and Education, Belcamp, MD, USA
| | - Christopher T Carrigan
- U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Building 42, Natick, MA, 01760, USA
| | - Lee M Margolis
- U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Building 42, Natick, MA, 01760, USA.
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Karl JP, Margolis LM, Fallowfield JL, Child RB, Martin NM, McClung JP. Military nutrition research: Contemporary issues, state of the science and future directions. Eur J Sport Sci 2021; 22:87-98. [PMID: 33980120 DOI: 10.1080/17461391.2021.1930192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The importance of diet and nutrition to military readiness and performance has been recognized for centuries as dietary nutrients sustain health, protect against illness, and promote resilience, performance and recovery. Contemporary military nutrition research is increasingly inter-disciplinary with emphasis often placed on the broad topics of (1) determining operational nutrition requirements in all environments, (2) characterizing nutritional practices of military personnel relative to the required (role/environment) standards, and (3) developing strategies for improving nutrient delivery and individual choices. This review discusses contemporary issues shared internationally by military nutrition research programmes, and highlights emerging topics likely to influence future military nutrition research and policy. Contemporary issues include improving the diet quality of military personnel, optimizing operational rations, and increasing understanding of biological factors influencing nutrient requirements. Emerging areas include the burgeoning field of precision nutrition and its technological enablers.
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Affiliation(s)
- J Philip Karl
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Lee M Margolis
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Joanne L Fallowfield
- Environmental Medicine and Science Division, Institute of Naval Medicine, Alverstoke, Hampshire, UK
| | - Robert B Child
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Nicola M Martin
- New Zealand Army, New Zealand Defence Force, Upper Hutt, New Zealand
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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Greater protein intake at breakfast or as snacks and less at dinner is associated with cardiometabolic health in adults. Clin Nutr 2021; 40:4301-4308. [DOI: 10.1016/j.clnu.2021.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/08/2020] [Accepted: 01/11/2021] [Indexed: 11/18/2022]
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58
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Effects of intermittent fasting combined with resistance training on body composition: a systematic review and meta-analysis. Physiol Behav 2021; 237:113453. [PMID: 33984329 DOI: 10.1016/j.physbeh.2021.113453] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022]
Abstract
This systematic review and meta-analysis evaluated the influence of intermittent fasting (IF) in combination with resistance training (RT) on body composition outcomes. Studies examining IF vs. non-IF diets in individuals performing RT, published up to February 2021, were identified through PubMed, the Cochrane Library, Web of Science, Embase, and SCOPUS databases. Eight studies, including 221 participants were analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results indicated that IF had a significant effect on body mass (WMD = -2.08 kg; 95% CI: -3.04, -1.13), fat mass (WMD = -1.36 kg; 95% CI: -1.94, -0.78), body mass index (WMD = -0.52 kg/m2; 95% CI: -0.85, -0.19), and body fat percentage (WMD = -1.49%; 95% CI: -2.24, -0.74) relative to non-IF diets, without a significant effect for fat-free mass (WMD = -0.27 kg; 95% CI: -0.82, 0.28). The present systematic review and meta-analysis demonstrates potentially beneficial effects of IF in combination with RT for reducing body mass and body fat relative to non-IF control diets, with similar preservation of fat-free mass.
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59
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Kim JY. Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. J Obes Metab Syndr 2021; 30:20-31. [PMID: 33107442 PMCID: PMC8017325 DOI: 10.7570/jomes20065] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
Obesity has become one of the most important public health problems worldwide, which suggests the need for evidence-based dietary strategies for weight loss and its maintenance. Weight management depends upon complex factors such as amount of food eaten, type of food eaten, and timing of meals. In this review, we identified evidence-based dietary strategies for weight management based on these three components. An energy deficit is the most important factor in weight loss. A low-calorie diet with a low fat or carbohydrate content has been recommended; however, in some cases, a very-low-calorie diet is required for a short period. Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, could be considered in some cases, although the potential risks and long-term effectiveness remain unknown. Meal timing is also an important factor in weight management, and higher-calorie breakfasts in combination with overnight fasting may help to prevent obesity. Our review indicated that there is no single best strategy for weight management. Hence, strategies for weight loss and its maintenance should be individualized, and healthcare providers must choose the best strategy based on patient preferences.
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Affiliation(s)
- Ju Young Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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60
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Low Energy Availability with and without a High-Protein Diet Suppresses Bone Formation and Increases Bone Resorption in Men: A Randomized Controlled Pilot Study. Nutrients 2021; 13:nu13030802. [PMID: 33671093 PMCID: PMC8000240 DOI: 10.3390/nu13030802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022] Open
Abstract
Suppression of insulin-like growth factor 1 (IGF-1) and leptin secondary to low energy availability (LEA) may contribute to adverse effects on bone health. Whether a high-protein diet attenuates these effects has not been tested. Seven men completed three five-day conditions operationally defined as LEA (15 kcal kg fat-free mass (FFM)−1·day−1) with low protein (LEA-LP; 0.8 g protein·kg body weight (BW)−1), LEA with high protein (LEA-HP; 1.7 g protein·kg BW−1) and control (CON; 40 kcal·kg FFM−1·day−1, 1.7 g protein·kg BW−1). In all conditions, participants expended 15 kcal·kg FFM−1·day−1 during supervised cycling sessions. Serum samples were analyzed for markers of bone turnover, IGF-1 and leptin. The decrease in leptin during LEA-LP (−65.6 ± 4.3%) and LEA-HP (−54.3 ± 16.7%) was greater than during CON (−25.4 ± 11.4%; p = 0.02). Decreases in P1NP (p = 0.04) and increases in CTX-I (p = 0.04) were greater in LEA than in CON, suggesting that LEA shifted bone turnover in favour of bone resorption. No differences were found between LEA-LP and LEA-HP. Thus, five days of LEA disrupted bone turnover, but these changes were not attenuated by a high-protein diet.
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Ashtary-Larky D, Bagheri R, Asbaghi O, Tinsley GM, Kooti W, Abbasnezhad A, Afrisham R, Wong A. Effects of resistance training combined with a ketogenic diet on body composition: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021; 62:5717-5732. [PMID: 33624538 DOI: 10.1080/10408398.2021.1890689] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We evaluated the effects of ketogenic diets (KDs) on body mass (BM), fat mass (FM), fat-free mass (FFM), body mass index (BMI), and body fat percentage (BFP) compared to non-KDs in individuals performing resistance training (RT). Online electronic databases including PubMed, the Cochrane Library, Web of Science, Embase, SCOPUS, and Ovid were searched to identify initial studies until February 2021. Data were pooled using both fixed and random-effects methods and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). Out of 1372 studies, 13 randomized controlled trials (RCTs) that enrolled 244 volunteers were included. The pooled results demonstrated that KDs significantly decreased BM [(WMD = -3.67 kg; 95% CI: -4.44, -2.90, p < 0.001)], FM [(WMD = -2.21 kg; 95% CI: -3.09, -1.34, p < 0.001)], FFM [(WMD = -1.26 kg; 95% CI: -1.82, -0.70, p < 0.001)], BMI [(WMD = -1.37 kg.m-2; 95% CI: -2.14, -0.59, p = 0.022)], and BFP [(WMD = -2.27%; 95% CI: -3.63, -0.90, p = 0.001)] compared to non-KDs. We observed beneficial effects of KDs compared to non-KDs on BM and body fat (both FM and BFP) in individuals performing RT. However, adherence to KDs may have a negative effect on FFM, which is not ameliorated by the addition of RT.
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Affiliation(s)
- Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Omid Asbaghi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Wesam Kooti
- Lung Diseases & Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amir Abbasnezhad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Reza Afrisham
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, Texas, USA
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Jiang W, Huang S, Ma S, Gong Y, Fu Z, Zhou L, Hu W, Mao G, Ma Z, Yang L, Tang G, Sun X, Zhang P, Bai J, Chen L, Shi B, Ye X, Zhou H. Effectiveness of companion-intensive multi-aspect weight management in Chinese adults with obesity: a 6-month multicenter randomized clinical trial. Nutr Metab (Lond) 2021; 18:17. [PMID: 33536048 PMCID: PMC7856778 DOI: 10.1186/s12986-020-00511-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022] Open
Abstract
Background Obesity is a globally increasing health epidemic requiring early lifestyle intervention. Our main objective was to examine the effectiveness of companion-intensive multi-aspect weight management (CIMWM) in Chinese adults with obesity.
Methods In this 6-month, prospective, open-label, multicenter, randomized controlled clinical trial, we recruited 272 obese adults aged 18–50 years with a body mass index (BMI) ≥ 28.0 kg/m2 and capable of using smartphones. CIMWM (n = 136) offered both daily online instructions and monthly face-to-face guidance by physicians, dietitians, and health managers along with the provision of meal replacements in the first 3 months. Traditional multi-aspect weight management (TMWM, n = 136) provided monthly face-to-face guidance by the same panel of professionals and the same meal replacements as CIMWM group, but required subjects to complete daily self-monitoring instead of offering daily online instructions. Body composition and metabolic parameters were assessed at baseline, 1, 2, 3, and 6 months by physicians. The primary outcomes were clinically-significant weight loss and changes in BMI and body composition. Results Participants in both groups showed significantly reduced BMI, body fat mass (BFM), visceral fat area (VFA), and HOMA-IR (p < 0.05). CIMWM was shown to be superior to TMWM in the improvement of clinically-significant weight loss, BMI, total cholesterol (TC), the body composition parameters BFM and the skeletal muscle mass-to-visceral fat area ratio (S/V) (p < 0.05). The non-alcoholic fatty liver disease score (NFS) was negatively related to S/V at baseline. After weight management, NFS was lowered among individuals with levels in the highest tertile (p < 0.05). Metabolic memory in terms of the continuous reduction of BMI, BFM, and TC was retained up to 6 months in spite of participants transferring to self-monitoring assessment in the final 3 months. Conclusions The CIMWM strategy in obese Chinese adults is proved to be more effective than TMWM in weight loss, and motivates greater adherence to intervention and lifestyle reprogramming. Trial registration Chinese Clinical Trial Registry, ChiCTR1800017463, Registered July 31, 2018. http://www.chictr.org.cn/showproj.aspx?proj=29649.
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Affiliation(s)
- Wanzi Jiang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Shushu Huang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Department of Geriatrics, The Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Shuai Ma
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Yingyun Gong
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Zhenzhen Fu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Li Zhou
- Department of Endocrinology and Metabolism, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, 223001, China
| | - Wen Hu
- Department of Endocrinology, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, 223001, China
| | - Guofang Mao
- Department of Endocrinology, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou, 215000, China
| | - Zhimin Ma
- Department of Endocrinology, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou, 215000, China
| | - Ling Yang
- Department of Endocrinology, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, China
| | - Guangfeng Tang
- Department of Endocrinology, The First People's Hospital of Chuzhou, Chuzhou, 239000, China
| | - Xiaofang Sun
- Department of Endocrinology, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, 225000, China
| | - Ping Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116000, China
| | - Jianling Bai
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 210029, China
| | - Lei Chen
- Department of Endocrinology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, 215000, China
| | - Bimin Shi
- Department of Endocrinology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, China.
| | - Xinhua Ye
- Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213000, China.
| | - Hongwen Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.
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Amini MR, Aminianfar A, Naghshi S, Larijani B, Esmaillzadeh A. The effect of ketogenic diet on body composition and anthropometric measures: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2021; 62:3644-3657. [PMID: 33443451 DOI: 10.1080/10408398.2020.1867957] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study aimed to summarize earlier randomized controlled trials on the effects of ketogenic diet (KD) on body composition and anthropometric measures. Four databases were searched from inception to May 2020 using relevant keywords. All clinical trials investigating the effects of KD on body weight (BW), body mass index (BMI), waist circumference (WC), fat mass (FM), fat-free mass (FFM), lean body mass (LBM), visceral adipose tissue (VAT) and percentage body fat (PBF) in adults were included. Overall, 18 trials were included in the review. Pooled effect sizes revealed a significant effect of KD on BW (weighted mean differences [WMD]: -2.87 kg, 95% confidence interval [CI]: -3.84 to -1.89), BMI (WMD: -1.44 kg/m2, 95% CI: -2.07, -0.81), FM (WMD: -1.40 kg, 95% CI: -2.50, -0.30), FFM (WMD: -0.81 kg, 95% CI: -1.32, -0.30), LBM (WMD: -0.63 kg, 95% CI: -1.21, -0.06), WC (WMD: -3.23 cm, 95% CI: -4.38, -2.09), VAT (WMD: -28.91 g, 95% CI: -50.57, -7.24) and PBF (WMD: -2.81 kg, 95% CI: -3.82, -1.80), respectively. Taken together, the data suggest that KD has beneficial effects on BW, BMI, FM, FFM, LBM, WC, VAT, and PBF. However, the effectiveness of the long term effect of this dietary pattern is unclear.
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Affiliation(s)
- Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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64
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Hsu KJ, Chien KY, Tsai SC, Tsai YS, Liao YH, Chen JJ, Chen YR, Chen CN. Effects of Exercise Alone or in Combination with High-Protein Diet on Muscle Function, Aerobic Capacity, and Physical Function in Middle-Aged Obese Adults: A Randomized Controlled Trial. J Nutr Health Aging 2021; 25:727-734. [PMID: 34179925 DOI: 10.1007/s12603-021-1599-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Obesity accelerates and exacerbates the age-related changes on muscle function and exercise capacity. In addition, the middle-aged population is often overlooked when talking about the prevention of sarcopenia. This study investigated the effects of exercise alone or in combination with a high-protein diet on muscle function and physical fitness in middle-aged obese adults. MATERIALS AND METHODS Sixty-nine middle-aged (50-64 years old) obese adults were randomly assigned to one of the following groups: control group (C; n=23), exercise group (E; n=23) or exercise plus high-protein group (EP; n=23). Individuals within the E and EP groups received 12 weeks of exercise training; whereas, the individuals in the EP group also received a high-protein diet intervention (1.6g/kg/day). Individuals within the C group were asked to maintain their lifestyle for 12 weeks. Participants were evaluated before and after the intervention. Outcome measures included maximal exercise capacity, muscle function and functional physical performance. Analysis of covariance was used to determine the effects of the intervention. RESULTS After the intervention, the E and EP groups had greater maximal work rate, peak oxygen consumption, and muscle power during muscle contractions at 180°/sec than that in the C group (P<0.05). The EP group, but not the E group, showed significant improvement in the sit-to-stand test and climbing stairs test than the C group after the intervention (P<0.05). Within group comparisons showed that the anaerobic threshold only increased in the EP group (+12% from pre-test). CONCLUSIONS For middle-aged obese adults, exercise with a high-protein diet not only improved muscle power and exercise capacity but also enhanced their functional physical performance.
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Affiliation(s)
- K-J Hsu
- Chiao-Nan Chen, PhD, PT, Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, 155, Sec. 2, Li-nong St., Taipei 112, Taiwan, Phone: 886-2-28267164, E-mail:
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65
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Ardavani A, Aziz H, Smith K, Atherton PJ, Phillips BE, Idris I. The Effects of Very Low Energy Diets and Low Energy Diets with Exercise Training on Skeletal Muscle Mass: A Narrative Review. Adv Ther 2021; 38:149-163. [PMID: 33211298 PMCID: PMC7854408 DOI: 10.1007/s12325-020-01562-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/04/2020] [Indexed: 12/25/2022]
Abstract
In recent years, very-low-energy diets (VLEDs) have been recognised as a viable strategy for improving the extent of weight loss and cardio-metabolic outcomes in people who are either overweight or obese. However, concerns exist regarding the reductions in lean body mass (LBM) during VLEDs, particularly in vulnerable demographic groups, such as middle-aged and older adults already prone to developing sarcopenia. Sarcopenia is itself associated with multiple adverse outcomes, including frailty, cardio-metabolic deterioration and increased mortality. Therefore, a number of studies investigating strategies to ameliorate this detrimental effect of VLEDs have attempted to address this concern. This narrative review explores the potential benefits and limitations of exercise and/or protein supplementation for LBM retention during VLEDs based on the available evidence. Current studies suggest that both protein supplementation and exercise training may result in improved LBM retention (and skeletal muscle function) during VLEDs. However, uncertainty remains concerning the interactions between intervention types, based on discordant outcomes reported in the literature and the heterogeneity of exercise modalities in achieving this particular outcome.
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Affiliation(s)
- Arash Ardavani
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Hariz Aziz
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Ken Smith
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Philip J Atherton
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Bethan E Phillips
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Iskandar Idris
- Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.
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Pearson AG, Alexander L, Witard OC, Coughlin TE, Tipton KD, Walshe IH. A hypoenergetic diet with decreased protein intake does not reduce lean body mass in trained females. Eur J Appl Physiol 2020; 121:771-781. [PMID: 33258997 PMCID: PMC7892501 DOI: 10.1007/s00421-020-04555-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/07/2020] [Indexed: 12/21/2022]
Abstract
Purpose Increasing protein intake during energy restriction (ER) attenuates lean body mass (LBM) loss in trained males. However, whether this relationship exists in trained females is unknown. This study examined the impact of higher compared to lower protein intakes (35% versus 15% of energy intake) on body composition in trained females during 2 weeks of severe ER. Methods Eighteen well-trained females completed a 1-week energy balanced diet (HD100), followed by a 2-week hypoenergetic (40% ER) diet (HD60). During HD60, participants consumed either a high protein (HP; 35% protein, 15% fat) or lower protein (CON; 15% protein, 35% fat) diet. Body composition, peak power, leg strength, sprint time, and anaerobic endurance were assessed at baseline, pre-HD60, and post-HD60. Results Absolute protein intake was reduced during HD60 in the CON group (from 1.6 to 0.9 g·d·kgBM−1) and maintained in the HP group (~ 1.7 g·d·kgBM−1). CON and HP groups decreased body mass equally during HD60 (− 1.0 ± 1.1 kg; p = 0.026 and − 1.1 ± 0.7 kg; p = 0.002, respectively) and maintained LBM. There were no interactions between time point and dietary condition on exercise performance. Conclusion The preservation of LBM during HD60, irrespective of whether absolute protein intake is maintained or reduced, contrasts with findings in trained males. In trained females, the relationship between absolute protein intake and LBM change during ER warrants further investigation. Future recommendations for protein intake during ER should be expressed relative to body mass, not total energy intake, in trained females.
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Affiliation(s)
- Alice G Pearson
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Lee Alexander
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, UK
| | - Oliver C Witard
- Centre of Human and Applied Physiological Research, King's College London, London, UK
| | - Thomas E Coughlin
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, UK
| | - Kevin D Tipton
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Ian H Walshe
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK.
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Zhang Y, Chen X, Allison DB, Xun P. Efficacy and safety of a specific commercial high-protein meal-replacement product line in weight management: meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2020; 62:798-809. [PMID: 33938779 DOI: 10.1080/10408398.2020.1829539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Protein is suggested to be the nutrient providing the most satiety and is frequently used in meal-replacement products to achieve weight loss. Commercial products such as Herbalife high-protein (HP) products have been studied in various clinical trials, but controversy remains regarding their efficacy and safety. METHODS We searched the PubMed, Center for Clinical and Translational Research (CCTR), and Google Scholar databases for randomized controlled trials of Herbalife HP products used as meal replacement (MR) published through July 2019 in peer-reviewed journals. We reviewed changes in efficacy and safety-related outcomes in treatment and control groups, and we estimated the pooled standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) with a DerSimonian and Laird random-effects method. RESULTS By pooling data from nine identified studies (934 participants: 463 in treatment groups and 471 in control groups), we found that participants who consumed HP products experienced significantly larger decreases in body weight (SMD = -0.24; 95% CI: -0.37 to -0.10), body mass index (SMD = -0.31; 95% CI: -0.50 to -0.11), and fat mass (SMD = -0.37; 95% CI: -0.65 to -0.09) than did individuals consuming control diets. Concerning safety outcomes, the participants in the treatment group had a significantly larger decrease in aspartate aminotransferase (SMD = -0.23; 95% CI: -0.42 to -0.03). There were no significant between-group differences in alanine aminotransferase or creatinine. However, blood urea nitrogen levels increased in both groups, with a significantly larger increase in the treatment group (SMD = 0.53; 95% CI: 0.15 to 0.92). CONCLUSIONS Herbalife HP MR products appear effective and do not evidence significant risk in reducing body weight.
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Affiliation(s)
- Yijia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, Indiana, USA
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Ross JA, Thomas DT, Winters JD, Royer SD, Halagarda CJ, Sheppard R, Abt J, Heebner NR. Military Protein Intake Related to Strength and Fat Mass Independent of Energy Intake. Mil Med 2020; 185:e1671-e1678. [PMID: 32633753 DOI: 10.1093/milmed/usaa151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Kinetic military units operate in austere training environments and deprivation not commonly experienced by competitive athletes. Nutritional strategies to protect against decrements in performance and potential injury risk may differ for these two groups. A cross sectional analysis was conducted to determine energy and macronutrient characteristics associated with performance metrics. MATERIALS AND METHODS 78 male subjects (age: 28.4 ± 6.0 years, height: 178.3 ± 6.7 cm, mass: 84.3 ± 9.4 kg, 8.5 ± 5.8 years of service) assigned to Marine Corps Forces Special Operations Command completed a 1-day performance assessment. Body mass, lean body mass, fat mass (FM), aerobic capacity (VO2max), lactate inflection point (LT), anaerobic power, anaerobic capacity, knee flexion strength, knee extension strength, peak knee flexion strength, and peak knee extension strength outcome values were recorded. Dietary intake was collected using automated self-administered 24-hour dietary recall (ASA24). Performance assessment scores were compared with macronutrient intake and controlled for energy intake using analysis of covariance. RESULTS Differences in knee flexion strength, knee extension strength, peak knee flexion strength, and peak knee extension strength were significant across low (LPRO), medium (MPRO), and high (HPRO) protein intake groups (p < 0.05) with LPRO performance metrics significantly lower than both MPRO and HPRO and MPRO significantly lower than HPRO. FM was significantly higher in LPRO than MPRO or HPRO (p < 0.05). Low carbohydrate intake (LCHO) was associated with greater body mass and FM compared with high (HCHO) (p < 0.05). There was no association between fat intake and any variable. CONCLUSIONS Increases in protein intake may have beneficial performance effects independent of total energy intake, while moderate increases in carbohydrate intake may not be sufficient to enhance physical performance in a special operations population.
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Affiliation(s)
- Jeremy A Ross
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Dr. Lexington, KY 40506
| | - D Travis Thomas
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Dr. Lexington, KY 40506
| | - Joshua D Winters
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Dr. Lexington, KY 40506
| | - Scott D Royer
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Dr. Lexington, KY 40506
| | | | - Ryan Sheppard
- United States Marine Forces Special Operations Command, SC Box 20116 Camp Lejeune, NC 28542
| | - John Abt
- Children's Health Andrews Institute for Orthopaedics and Sports Medicine, 7211 Preston Rd. Suite T1200, Plano, TX 75024
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Dr. Lexington, KY 40506
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Murphy NE, Carrigan CT, Margolis LM. High-Fat Ketogenic Diets and Physical Performance: A Systematic Review. Adv Nutr 2020; 12:223-233. [PMID: 32865567 PMCID: PMC7850028 DOI: 10.1093/advances/nmaa101] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/13/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022] Open
Abstract
Use of high-fat, ketogenic diets (KDs) to support physical performance has grown in popularity over recent years. While these diets enhance fat and reduce carbohydrate oxidation during exercise, the impact of a KD on physical performance remains controversial. The objective of this work was to assess the effect of KDs on physical performance compared with mixed macronutrient diets [control (CON)]. A systematic review of the literature was conducted using PubMed and Cochrane Library databases. Randomized and nonrandomized studies were included if participants were healthy (free of chronic disease), nonobese [BMI (kg/m2) <30], trained or untrained men or women consuming KD (<50 g carbohydrate/d or serum or whole-blood β-hydroxybutyrate >0.5 mmol/L) compared with CON (fat, 12-38% of total energy intake) diets for ≥14 d, followed by a physical performance test. Seventeen studies (10 parallel, 7 crossover) with 29 performance (13 endurance, 16 power or strength) outcomes were identified. Of the 13 endurance-type performance outcomes, 3 (1 time trial, 2 time-to-exhaustion) reported lower and 10 (4 time trials, 6 time-to-exhaustion) reported no difference in performance between the KD compared with CON. Of the 16 power or strength performance outcomes, 3 (1 power, 2 strength) reported lower, 11 (4 power, 7 strength) no difference, and 2 (power) enhanced performance in the KD compared with the CON. Risk of bias identified some concern of bias primarily due to studies allowing participants to self-select diet intervention groups and the inability to blind participants to the study intervention. Overall, the majority of null results across studies suggest that a KD does not have a positive or negative impact on physical performance compared with a CON diet. However, discordant results between studies may be due to multiple factors, such as the duration consuming study diets, training status, performance test, and sex differences, which will be discussed in this systematic review.
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Affiliation(s)
- Nancy E Murphy
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Christopher T Carrigan
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
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Gwin JA, Church DD, Wolfe RR, Ferrando AA, Pasiakos SM. Muscle Protein Synthesis and Whole-Body Protein Turnover Responses to Ingesting Essential Amino Acids, Intact Protein, and Protein-Containing Mixed Meals with Considerations for Energy Deficit. Nutrients 2020; 12:nu12082457. [PMID: 32824200 PMCID: PMC7469068 DOI: 10.3390/nu12082457] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Protein intake recommendations to optimally stimulate muscle protein synthesis (MPS) are derived from dose-response studies examining the stimulatory effects of isolated intact proteins (e.g., whey, egg) on MPS in healthy individuals during energy balance. Those recommendations may not be adequate during periods of physiological stress, specifically the catabolic stress induced by energy deficit. Providing supplemental intact protein (20–25 g whey protein, 0.25–0.3 g protein/kg per meal) during strenuous military operations that elicit severe energy deficit does not stimulate MPS-associated anabolic signaling or attenuate lean mass loss. This occurs likely because a greater proportion of the dietary amino acids consumed are targeted for energy-yielding pathways, whole-body protein synthesis, and other whole-body essential amino acid (EAA)-requiring processes than the proportion targeted for MPS. Protein feeding formats that provide sufficient energy to offset whole-body energy and protein-requiring demands during energy deficit and leverage EAA content, digestion, and absorption kinetics may optimize MPS under these conditions. Understanding the effects of protein feeding format-driven alterations in EAA availability and subsequent changes in MPS and whole-body protein turnover is required to design feeding strategies that mitigate the catabolic effects of energy deficit. In this manuscript, we review the effects, advantages, disadvantages, and knowledge gaps pertaining to supplemental free-form EAA, intact protein, and protein-containing mixed meal ingestion on MPS. We discuss the fundamental role of whole-body protein balance and highlight the importance of comprehensively assessing whole-body and muscle protein kinetics when evaluating the anabolic potential of varying protein feeding formats during energy deficit.
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Affiliation(s)
- Jess A. Gwin
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA;
- Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA
| | - David D. Church
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.D.C); (R.R.W.); (A.A.F.)
| | - Robert R. Wolfe
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.D.C); (R.R.W.); (A.A.F.)
| | - Arny A. Ferrando
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.D.C); (R.R.W.); (A.A.F.)
| | - Stefan M. Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA;
- Correspondence: ; Tel.: +1-508-206-2353
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Minderis P, Fokin A, Dirmontas M, Ratkevicius A. Hypocaloric Low-Carbohydrate and Low-Fat Diets with Fixed Protein Lead to Similar Health Outcomes in Obese Mice. Obesity (Silver Spring) 2020; 28:1494-1502. [PMID: 32639096 DOI: 10.1002/oby.22872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE It is controversial whether low-carbohydrate diets are better suited for weight control and metabolic health than high-carbohydrate diets. This study examined whether these diets induce different improvements in body composition and glucose tolerance in obese mice during caloric restriction (CR). METHODS Male C57BL/6J mice were fed an obesogenic diet ad libitum for 18 weeks and then subjected to 6-week progressive CR of up to 40%, using either a low-fat or low-carbohydrate diet with equal protein content. Mice fed a regular chow diet ad libitum served as controls. Body mass, hindlimb muscle mass, fat mass, energy expenditure, and glucose tolerance were compared between the groups. RESULTS Initially low-fat and low-carbohydrate groups had similar body mass, which was 30% greater compared with controls. CR induced similar weight loss in low-fat and low-carbohydrate groups. This weight loss was mainly due to fat loss in both groups. Energy expenditure of freely moving mice did not differ between the groups. Glucose tolerance improved compared with the values before CR and in controls but did not differ between the diets. CONCLUSIONS Dietary carbohydrate or fat content does not affect improvements in body composition and metabolic health in obese mice exposed to CR with fixed energy and protein intake.
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Affiliation(s)
- Petras Minderis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Andrej Fokin
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Mantas Dirmontas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Aivaras Ratkevicius
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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72
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Protein Intake and Exercise-Induced Skeletal Muscle Hypertrophy: An Update. Nutrients 2020; 12:nu12072023. [PMID: 32646013 PMCID: PMC7400877 DOI: 10.3390/nu12072023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/29/2022] Open
Abstract
Skeletal muscle mass is critical for sport performance and in many pathological conditions. The combination of protein intake and resistance exercise is the most efficient strategy to promote skeletal muscle hypertrophy and remodeling. However, to be really efficient, certain conditions need to be considered. The amount, type and source of proteins do all matter as well as the timing of ingestion and spreading over the whole day. Optimizing those conditions favor a positive net protein balance, which in the long term, may result in muscle mass accretion. Last but not least, it is also essential to take the nutritional status and the exercise training load into consideration when looking for maintenance or gain of skeletal muscle mass.
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Yasuda J, Tomita T, Arimitsu T, Fujita S. Evenly Distributed Protein Intake over 3 Meals Augments Resistance Exercise-Induced Muscle Hypertrophy in Healthy Young Men. J Nutr 2020; 150:1845-1851. [PMID: 32321161 PMCID: PMC7330467 DOI: 10.1093/jn/nxaa101] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/14/2019] [Accepted: 03/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although daily protein intake (PI) has been reported to be essential for regulating muscle mass, the distribution of daily PI in individuals is typically the lowest at breakfast and skewed toward dinner. Skewed protein intake patterns and inadequate PI at breakfast were reported to be negative factors for muscle maintenance. OBJECTIVES This study examined whether a protein-enriched meal at breakfast is more effective for muscle accretion compared with the typical skewed PI pattern. METHODS This 12-wk, parallel-group, randomized clinical trial included 26 men (means ± SEs; age: 20.8 ± 0.4 y; BMI: 21.8 ± 0.4 kg/m2). The "high breakfast" (HBR) group (n = 12) consumed a protein-enriched meal at breakfast providing a PI of 0.33 g/kg body weight (BW); their PI at lunch (0.46 g/kg BW) and dinner (0.48 g/kg BW) provided an adequate overall daily PI (1.30 g/kg BW/d). The "low breakfast" (LBR) group (n = 14) consumed 0.12 g protein/kg BW at breakfast; intakes at lunch (0.45 g/kg BW) and dinner (0.83 g/kg BW) yielded the same daily PI as in the HBR group. The participants performed supervised resistance training (RT) 3 times per week (75-80% 1-repetition maximum; 3 sets × 10 repetitions). DXA was used to measure the primary outcome variable, that is, total lean soft tissue mass (LTM). RESULTS The total LTM at baseline did not differ between the HBR (52.4 ± 1.3 kg) and LBR (53.4 ± 1.2 kg) groups. After the intervention, increases in total LTM were significant in both groups, with that in the HBR group (2.5 ± 0.3 kg) tending to be greater than that in the LBR group (1.8 ± 0.3 kg) (P = 0.06), with a large effect size (Cohen d = 0.795). CONCLUSIONS For RT-induced muscle hypertrophy in healthy young men, consuming a protein-enriched meal at breakfast and less protein at dinner while achieving an adequate overall PI is more effective than consuming more protein at dinner.This study was registered at University hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000037583 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042763).
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Affiliation(s)
- Jun Yasuda
- Faculty of Sport and Health Science, Ritsumeikan University, Nojihigashi, Kusatsu, Shiga, Japan
| | - Toshiki Tomita
- Faculty of Sport and Health Science, Ritsumeikan University, Nojihigashi, Kusatsu, Shiga, Japan
| | - Takuma Arimitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Nojihigashi, Kusatsu, Shiga, Japan
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Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis. Br J Nutr 2020; 124:1121-1132. [DOI: 10.1017/s000711452000224x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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75
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The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial. Br J Nutr 2020; 124:1044-1051. [PMID: 32513334 DOI: 10.1017/s0007114520002019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Normal-weight obesity (NWO) syndrome is associated with metabolic diseases. The present study aimed to investigate the effects of 12 weeks of a high-protein (HP) v. a standard protein (SP) diet on appetite, anthropometry and body composition in NWO women. In this clinical trial, fifty NWO women were randomly allocated to HP (n 25) or SP (n 25) diet groups. Women in the HP and SP groups consumed 25 and 15 % of their total energy intake from protein for 12 weeks. Weight, fat mass (FM), lean body mass (LBM), waist circumference (WC) and appetite were evaluated at baseline and following their 3-month intervention. After 12 weeks, the LBM was higher in HP compared with no significant changes in the SP group (mean between-group difference = 1·5 kg; 95 % CI 3·1, 0·01; effect size (d) = 0·4). Furthermore, the HP group had lower FM (mean between-group difference -1·1 kg; 95 % CI 1, -3·3; d = -0·2), body fat percentage (BFP) (mean between-group difference -2 %; 95 % CI 0·7, -5·2; d = -0·3) and WC (mean between-group difference -1·4 cm; 95 % CI 0·6, -3·6; d = -0·2) at the end of the study in comparison with the SP group. In both groups, weight and appetite were unchanged over time without significant differences between groups. Twelve weeks of euenergetic diets with different dietary protein contents resulted in no significant weight loss in women with NWO. However, an HP diet significantly improved body composition (LBM, FM, BFP and WC) in this population.
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76
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Chow LS, Manoogian ENC, Alvear A, Fleischer JG, Thor H, Dietsche K, Wang Q, Hodges JS, Esch N, Malaeb S, Harindhanavudhi T, Nair KS, Panda S, Mashek DG. Time-Restricted Eating Effects on Body Composition and Metabolic Measures in Humans who are Overweight: A Feasibility Study. Obesity (Silver Spring) 2020; 28:860-869. [PMID: 32270927 PMCID: PMC7180107 DOI: 10.1002/oby.22756] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/14/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE In contrast to intentionally restricting energy intake, restricting the eating window may be an option for treating obesity. By comparing time-restricted eating (TRE) with an unrestricted (non-TRE) control, it was hypothesized that TRE facilitates weight loss, alters body composition, and improves metabolic measures. METHODS Participants (17 women and 3 men; mean [SD]: 45.5 [12.1] years; BMI 34.1 [7.5] kg/m2 ) with a prolonged eating window (15.4 [0.9] hours) were randomized to TRE (n = 11: 8-hour window, unrestricted eating within window) versus non-TRE (n = 9: unrestricted eating) for 12 weeks. Weight, body composition (dual x-ray absorptiometry), lipids, blood pressure, 2-hour oral glucose tolerance, 2-week continuous glucose monitoring, and 2-week physical activity (actigraphy assessed) were measured during the pre- and end-intervention periods. RESULTS The TRE group significantly reduced the eating window (end-intervention window: 9.9 [2.0] hours) compared with the non-TRE group (end-intervention window: 15.1 [1.1] hours) (P < 0.01). Compared with non-TRE, TRE decreased the number of eating occasions, weight, lean mass, and visceral fat (all P ≤ 0.05). Compared with preintervention measures, the TRE group reduced the number of eating occasions (-21.9% [30.1%]) and reduced weight (-3.7% [1.8%]), fat mass (-4% [2.9%]), lean mass (-3.0% [2.7%]), and visceral fat (-11.1% [13.4%]) (all P ≤ 0.05). Physical activity and metabolic measures remained unchanged. CONCLUSIONS In the setting of a randomized trial, TRE presents a simplified view of food intake that reduces weight.
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Affiliation(s)
- Lisa S Chow
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Alison Alvear
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Honoree Thor
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katrina Dietsche
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | - Qi Wang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - James S Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nicholas Esch
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | - Samar Malaeb
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tasma Harindhanavudhi
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
| | - K Sreekumaran Nair
- Division of Endocrinology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | | | - Douglas G Mashek
- Division of Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, Minnesota, USA
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77
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Øfsteng SJ, Garthe I, Jøsok Ø, Knox S, Helkala K, Knox B, Ellefsen S, Rønnestad BR. No effect of increasing protein intake during military exercise with severe energy deficit on body composition and performance. Scand J Med Sci Sports 2020; 30:865-877. [DOI: 10.1111/sms.13634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
| | - Ina Garthe
- Norwegian Olympic Sport Center Oslo Norway
| | - Øyvind Jøsok
- Inland Norway University of Applied Sciences Lillehammer Norway
- Norwegian Defence Cyber Academy Lillehammer Norway
| | - Silje Knox
- Norwegian Defence Cyber Academy Lillehammer Norway
| | | | - Ben Knox
- Norwegian Defence Cyber Academy Lillehammer Norway
| | - Stian Ellefsen
- Inland Norway University of Applied Sciences Lillehammer Norway
- Innlandet Hospital Trust Brumunddal Norway
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78
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Tinline-Goodfellow CT, West DWD, Malowany JM, Gillen JB, Moore DR. An Acute Reduction in Habitual Protein Intake Attenuates Post Exercise Anabolism and May Bias Oxidation-Derived Protein Requirements in Resistance Trained Men. Front Nutr 2020; 7:55. [PMID: 32391374 PMCID: PMC7188927 DOI: 10.3389/fnut.2020.00055] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/02/2020] [Indexed: 02/06/2023] Open
Abstract
Protein recommendations for resistance-trained athletes are generally lower than their habitual intakes. Excess protein consumption increases the capacity to oxidize amino acids, which can attenuate post-exercise anabolism and may impact protein requirements determined by stable isotope techniques predicated on amino acid tracer oxidation. We aimed to determine the impact of an acute (5d) reduction in dietary protein intake on post-exercise anabolism in high habitual consumers using the indicator amino acid oxidation (IAAO) technique. Resistance trained men [n = 5; 25 ± 7 y; 73.0 ± 5.7 kg; 9.9 ± 2.9% body fat; 2.69 ± 0.38 g·kg−1·d−1 habitual protein intake) consumed a high (H; 2.2 g·kg−1·d−1) and moderate (M; 1.2 g·kg−1·d−1) protein diet while training every other day. During the High protein phase, participants consumed a 2d controlled diet prior to determining whole body phenylalanine turnover, net balance (NB), and 13CO2 excretion (F13CO2) after exercise via oral [13C]phenylalanine. During the Moderate phase, participants consumed 2.2 g protein·kg−1·d−1 for 2d prior to consuming 1.2 g protein·kg−1·d−1 for 5d. Phenylalanine metabolism was measured on days 1, 3, and 5 (M1, M3, and M5, respectively) of the moderate intake. F13CO2, the primary outcome for IAAO, was ~72 and ~55% greater on the 1st day (M1, P < 0.05) and the third day of the moderate protein diet (M3, P = 0.07), respectively, compared to the High protein trial. Compared to the High protein trial, NB was ~25% lower on the 1st day (M1, P < 0.01) and 15% lower on the third day of the moderate protein diet (M3, P = 0.09). High habitual protein consumption may bias protein requirements determined by traditional IAAO methods that use only a 2d pre-trial controlled diet. Post-exercise whole body anabolism is attenuated following a reduction in protein intake in resistance trained men and may require ~3–5d to adapt. This trial is registered at clinicaltrials.gov as NCT03845569.
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Affiliation(s)
| | - Daniel W D West
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Julia M Malowany
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Jenna B Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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79
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Hennigar SR, Berryman CE, Kelley AM, Anderson BJ, Young AJ, McClung JP, Pasiakos SM. High-Altitude Acclimatization Suppresses Hepcidin Expression During Severe Energy Deficit. High Alt Med Biol 2020; 21:232-236. [PMID: 32316799 DOI: 10.1089/ham.2019.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hennigar, Stephen R., Claire E. Berryman, Alyssa M. Kelley, Bradley J. Anderson, Andrew J. Young, James P. McClung, and Stefan M. Pasiakos. High-altitude acclimatization suppresses hepcidin expression during severe energy deficit. High Alt Med Biol. 21:232-236, 2020. Background: The erythropoietic cells in the bone marrow require iron to synthesize heme for incorporation into hemoglobin. Exposure to hypoxic conditions, such as extended sojourns to high altitude (HA), results in increased erythropoiesis and an increased physiological requirement for iron. In addition to increasing iron requirements, hypoxic conditions suppress appetite and often lead to decreased energy intake. The objective of this study was to determine the combined effects of severe energy deficit and hypoxia on hepcidin and measures of iron status in lowlanders sojourning to HA. Methods: Iron status indicators and hepcidin were determined in 17 healthy male volunteers (mean ± standard deviation, age 23 ± 6 years, body mass index 27 ± 4 kg/m2) fed a controlled diet (12 ± 1.2 mg iron/day) during a 20-day sojourn to 4300 m above sea level. Results: Chronic exposure to HA during severe energy deficit increased hematocrit by 12% (p < 0.01) and decreased serum hepcidin by 37% (p < 0.01) compared with baseline. Ferritin declined by 18% (p = 0.02) and transferrin saturation and soluble transferrin receptor increased by 55% and 83%, respectively (p < 0.01 for both) compared with baseline. Conclusions: HA acclimatization suppresses hepcidin expression to increase iron availability during severe energy deficit. Registered at ClinicalTrials.gov as NCT02731066.
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Affiliation(s)
- Stephen R Hennigar
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, Florida, USA.,Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - Claire E Berryman
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, Florida, USA.,Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - Alyssa M Kelley
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - Bradley J Anderson
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - Andrew J Young
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - James P McClung
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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80
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Caloric restriction induces anabolic resistance to resistance exercise. Eur J Appl Physiol 2020; 120:1155-1164. [PMID: 32236752 PMCID: PMC8233264 DOI: 10.1007/s00421-020-04354-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/21/2020] [Indexed: 12/21/2022]
Abstract
Purpose Weight loss can result in the loss of muscle mass and bone mineral density. Resistance exercise is commonly prescribed to attenuate these effects. However, the anabolic endocrine response to resistance exercise during caloric restriction has not been characterized. Methods Participants underwent 3-day conditions of caloric restriction (15 kcal kg FFM−1) with post-exercise carbohydrate (CRC) and with post-exercise protein (CRP), and an energy balance control (40 kcal kg FFM−1) with post-exercise carbohydrate (CON). Serial blood draws were taken following five sets of five repetitions of the barbell back squat exercise on day 3 of each condition. Results In CRC and CRP, respectively, growth hormone peaked at 2.6 ± 0.4 and 2.5 ± 0.9 times the peak concentrations observed during CON. Despite this, insulin-like growth factor-1 concentrations declined 18.3 ± 3.4% in CRC and 27.2 ± 3.8% in CRP, which was greater than the 7.6 ± 3.6% decline in CON, over the subsequent 24 h. Sclerostin increased over the first 2 days of each intervention by 19.2 ± 5.6% in CRC, 21.8 ± 6.2% in CRP and 13.4 ± 5.9% in CON, but following the resistance exercise bout, these increases were attenuated and no longer significant. Conclusion During caloric restriction, there is considerable endocrine anabolic resistance to a single bout of resistance exercise which persists in the presence of post-exercise whey protein supplementation. Alternative strategies to restore the sensitivity of insulin-like growth factor-1 to growth hormone need to be explored. Electronic supplementary material The online version of this article (10.1007/s00421-020-04354-0) contains supplementary material, which is available to authorized users.
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81
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Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial. J Funct Morphol Kinesiol 2020; 5:jfmk5010019. [PMID: 33467235 PMCID: PMC7739314 DOI: 10.3390/jfmk5010019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/26/2022] Open
Abstract
There is a lack of research into how lean, resistance trained (RT) individuals respond to intermittent energy restricted diets. Therefore, we investigated body composition changes in RT-individuals during continuous energy restriction or intermittent restriction. A total of 27 males and females (25 ± 6.1 years; 169 ± 9.4 cm; 80 ± 15.6 kg) were randomized to a ~25% caloric restricted diet Refeed (RF; n = 13) or Continuous group (CN; n = 14) in conjunction with 4-days/week resistance training for 7-weeks. RF implemented two consecutive days of elevated carbohydrate (CHO) intake, followed by 5-days of caloric restriction each week. CN adhered to a continuous 7-week caloric restriction. Body mass (BM), fat mass (FM), fat-free mass (FFM), dry fat-free mass (dFFM), and resting metabolic rate (RMR) were assessed pre/post-diet. Both groups significantly reduced BM (RF: baseline = 76.4 ± 15.6 kg, post-diet = 73.2 ± 13.8 kg, Δ3.2 kg; CN: baseline = 83.1 ± 15.4 kg, post-diet = 79.5 ± 15 kg, Δ3.6 kg) and FM (RF: baseline = 16.3 ± 4 kg, post-diet = 13.5 ± 3.6 kg, Δ2.8 kg; CN: baseline = 16.7 ± 4.5 kg, post-diet = 14.4 ± 4.9 kg, Δ2.3 kg) with no differences between groups. FFM (RF: baseline = 60.1 ± 13.8 kg, post-diet = 59.7 ± 13.0 kg, 0.4 kg; CN: baseline = 66.4 ± 15.2 kg, post-diet = 65.1 ± 15.2 kg, Δ1.3 kg p = 0.006), dFFM (RF: baseline = 18.7 ± 5.0 kg, post-diet = 18.5 ± 4.5 kg, Δ0.2 kg; CN: baseline =21.9 ± 5.7 kg, post-diet = 20.0 ± 5.7 kg, Δ1.9 kg), and RMR (RF: baseline = 1703 ± 294, post-diet = 1665 ± 270, Δ38 kcals; CN: baseline = 1867 ± 342, post-diet = 1789 ± 409, Δ78 kcals) were better maintained in the RF group. A 2-day carbohydrate refeed preserves FFM, dryFFM, and RMR during energy restriction compared to continuous energy restriction in RT-individuals.
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Saghebjoo M, Kargar-Akbariyeh N, Mohammadnia-Ahmadi M, Saffari I. How to exercise to increase lipolysis and insulin sensitivity: Fasting or following a single high-protein breakfast. J Sports Med Phys Fitness 2020; 60:625-633. [PMID: 32043347 DOI: 10.23736/s0022-4707.20.10403-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the lipolysis response and insulin sensitivity to high-intensity interval exercise (HIIE) upon fasting (HIIEFAST) and following the intake of a high-protein breakfast (HIIEHPFED). METHODS Overweight men participated in two sessions of HIIE after an overnight fast and post-HPFED with an interval of one week. Metabolic biomarkers were assessed before, immediately after, and 3h postexercise. To evaluate the metabolic effects of HIIE, two-way repeated-measures ANOVA was used. RESULTS Glycerol levels increased immediately after HIIEFAST and HIIEHPFED (P=0.0001) and decreased 3h after exercise in both states (P=0.001). There were no significant changes in free fatty acid (FFA) levels immediately after exercise, but a significant increase was observed 3h after exercise compared to the baseline and immediately after exercise in HIIEFAST and HIIEHPFED (P=0.0001). Insulin sensitivity was increased for 3h after HIIEHPFED compared to the baseline and immediately after exercise (P=0.04). CONCLUSIONS These findings suggest that fasting during exercise is not necessary for the greater stimulation of lipolysis and an increase in insulin sensitivity and that exercise following a high-protein breakfast can have a similar effect in overweight young men.
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Affiliation(s)
- Marziyeh Saghebjoo
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Birjand, Birjand, Iran -
| | - Nasrin Kargar-Akbariyeh
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Birjand, Birjand, Iran
| | | | - Iman Saffari
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Birjand, Birjand, Iran
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83
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Energy Expenditure and Changes in Body Composition during Submarine Deployment-An Observational Study "DasBoost 2-2017". Nutrients 2020. [PMID: 31952273 DOI: 10.3390/nu12010226.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present study was designed to objectively assess the effects of 3-months submarine deployment on behavioural and metabolic determinants of metabolic health. In 13 healthy, non-obese volunteers, we using stable isotope dilution, and plasma and urinary biochemistry to characterize metabolic health before and after a 3-month submarine deployment. Volunteers worked in 6-h shifts. After deployment, we observed reduced fat-free mass (mean ± SD, -4.1 ± 3.3 kg, p = 0.003) and increased adiposity (21.9 ± 3.2% fat mass to 24.4 ± 4.7%, p = 0.01). Changes in fat-free mass were positively associated with physical activity (+0.8 kg per 0.1 increase in PAL, p = 0.03). The average physical activity level was 1.64 ± 0.26 and total energy expenditure during deployment was 2937 ± 498 kcal/d, while energy intake was 3158 ± 786 kcal/d. Fasting glucose (p = 0.03), and triglycerides (p = 0.01) declined, whereas fasting free fatty acids increased (p = 0.04). Plasma vitamin D and B12 concentrations decreased (-14%, p = 0.04, and -44%, p = 0.001, respectively), and plasma calcium, and magnesium increased (+51%, p = 0.01, and +5%, p = 0.02). Haemoglobin was unchanged, but haematocrit decreased (-2.2 ± 2.1%, p = 0.005). In conclusion, submarine deployment impairs fat-free mass maintenance and promotes adiposity. High physical activity may prevent the decline in fat-free mass. Our study confirms the need to counteract Vitamin D and B12 deficiencies, and suggests impairments in erythrocyte metabolism.
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84
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Rietjens G, Most J, Joris PJ, Helmhout P, Plasqui G. Energy Expenditure and Changes in Body Composition during Submarine Deployment-An Observational Study "DasBoost 2-2017". Nutrients 2020; 12:nu12010226. [PMID: 31952273 PMCID: PMC7019715 DOI: 10.3390/nu12010226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 12/12/2022] Open
Abstract
The present study was designed to objectively assess the effects of 3-months submarine deployment on behavioural and metabolic determinants of metabolic health. In 13 healthy, non-obese volunteers, we using stable isotope dilution, and plasma and urinary biochemistry to characterize metabolic health before and after a 3-month submarine deployment. Volunteers worked in 6-h shifts. After deployment, we observed reduced fat-free mass (mean ± SD, −4.1 ± 3.3 kg, p = 0.003) and increased adiposity (21.9 ± 3.2% fat mass to 24.4 ± 4.7%, p = 0.01). Changes in fat-free mass were positively associated with physical activity (+0.8 kg per 0.1 increase in PAL, p = 0.03). The average physical activity level was 1.64 ± 0.26 and total energy expenditure during deployment was 2937 ± 498 kcal/d, while energy intake was 3158 ± 786 kcal/d. Fasting glucose (p = 0.03), and triglycerides (p = 0.01) declined, whereas fasting free fatty acids increased (p = 0.04). Plasma vitamin D and B12 concentrations decreased (−14%, p = 0.04, and −44%, p = 0.001, respectively), and plasma calcium, and magnesium increased (+51%, p = 0.01, and +5%, p = 0.02). Haemoglobin was unchanged, but haematocrit decreased (−2.2 ± 2.1%, p = 0.005). In conclusion, submarine deployment impairs fat-free mass maintenance and promotes adiposity. High physical activity may prevent the decline in fat-free mass. Our study confirms the need to counteract Vitamin D and B12 deficiencies, and suggests impairments in erythrocyte metabolism.
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Affiliation(s)
- Gerard Rietjens
- Training Medicine and Training Physiology, Army Command/Directory of Personnel, Royal Netherlands Army, Ministry of Defence, Herculeslaan 1, 3584 AB Utrecht, The Netherlands; (G.R.); (P.H.)
- Department of Human Physiology and Sports Medicine, Vrije Universiteit Brussel, Pleinlaan 2, U-Residence, Verd. 1, 1050 Etterbeek, Brussels, Belgium
| | - Jasper Most
- Training Medicine and Training Physiology, Army Command/Directory of Personnel, Royal Netherlands Army, Ministry of Defence, Herculeslaan 1, 3584 AB Utrecht, The Netherlands; (G.R.); (P.H.)
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands; (P.J.J.); (G.P.)
- Correspondence: ; Tel.: +31-43-38-81-506
| | - Peter J. Joris
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands; (P.J.J.); (G.P.)
| | - Pieter Helmhout
- Training Medicine and Training Physiology, Army Command/Directory of Personnel, Royal Netherlands Army, Ministry of Defence, Herculeslaan 1, 3584 AB Utrecht, The Netherlands; (G.R.); (P.H.)
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands; (P.J.J.); (G.P.)
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Osaka T, Hashimoto Y, Okamura T, Fukuda T, Yamazaki M, Hamaguchi M, Fukui M. Reduction of Fat to Muscle Mass Ratio Is Associated with Improvement of Liver Stiffness in Diabetic Patients with Non-Alcoholic Fatty Liver Disease. J Clin Med 2019; 8:jcm8122175. [PMID: 31835362 PMCID: PMC6947171 DOI: 10.3390/jcm8122175] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 12/31/2022] Open
Abstract
Body weight reduction leads to improvement of nonalcoholic fatty liver disease (NAFLD), but the contributions of body composition modification on its improvement have not been clarified yet. We performed a retrospective cohort study in a Japanese university hospital to clarify the effect of body fat reduction on the improvement of hepatic stiffness as well as hepatic steatosis. The skeletal muscle mass index (SMI, kg/m2), fat to muscle mass ratio, and the change in fat to muscle mass ratio after 1 year from baseline were calculated. Controlled attenuation parameter (CAP, dB/m) and liver stiffness measurement (LSM, kPa) were evaluated by elastography. Primary outcome was set as the association of the change of fat to muscle mass ratio after 1 year from baseline with the change of liver stiffness measurement. One hundred and seventeen patients (59 men and 58 women) completed the study. The average age was 63.5 years, and baseline CAP and LSM were 273.4 ± 53.5 dB/m and 6.3 ± 3.4 kPa, respectively. After 1 year, body mass index (BMI), SMI, and LSM decreased. Multiple regression analyses demonstrated that change in fat to muscle mass ratio was associated with the change in CAP (ß = 0.38, p < 0.001) or LSM (ß = 0.21, p = 0.026). The reduction of fat to muscle mass ratio was associated with improvement in liver stiffness, but the reduction of BMI was not.
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Affiliation(s)
- Takafumi Osaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
- Department of Endocrinology and Diabetology, Ayabe City Hospital, Ayabe 623-0011, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
| | - Takuya Fukuda
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan; (T.O.); (Y.H.); (T.O.); (T.F.); (M.Y.); (M.H.)
- Correspondence: ; Tel.: +81-75-251-5505
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86
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Moore DR. Maximizing Post-exercise Anabolism: The Case for Relative Protein Intakes. Front Nutr 2019; 6:147. [PMID: 31552263 PMCID: PMC6746967 DOI: 10.3389/fnut.2019.00147] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/23/2019] [Indexed: 01/03/2023] Open
Abstract
Maximizing the post-exercise increase in muscle protein synthesis, especially of the contractile myofibrillar protein fraction, is essential to facilitate effective muscle remodeling, and enhance hypertrophic gains with resistance training. MPS is the primary regulated variable influencing muscle net balance with dietary amino acid ingestion representing the single most important nutritional variable enhancing post-exercise rates of muscle protein synthesis. Dose-response studies in average (i.e., ~80 kg) males have reported an absolute 20 g dose of high quality, rapidly digested protein maximizes mixed, and myofibrillar protein synthetic rates. However, it is unclear if these absolute protein intakes can be viewed in a “one size fits all” solution. Re-analysis of published literature in young adults suggests a relative single meal intake of ~0.31 g/kg of rapidly digested, high quality protein (i.e., whey) should be considered as a nutritional guideline for individuals of average body composition aiming to maximize post-exercise myofibrillar protein synthesis while minimizing irreversible amino acid oxidative catabolism that occurs with excessive intakes of this macronutrient. This muscle-specific bolus intake is lower than that reported to maximize whole body anabolism (i.e., ≥0.5 g/kg). Review of the available literature suggests that potential confounders such as the co-ingestion of carbohydrate, sex, and amount of active muscle mass do not represent significant barriers to the translation of this objectively determined relative protein intake. Additional research is warranted to elucidate the effective dose for proteins with suboptimal amino acid compositions (e.g., plant-based), and/or slower digestion rates as well as whether recommendations are appreciably affected by other physiological conditions such endurance exercise, high habitual daily protein ingestion, aging, obesity, and/or periods of chronic negative energy balance.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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87
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Hsu KJ, Liao CD, Tsai MW, Chen CN. Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients 2019; 11:nu11092163. [PMID: 31505890 PMCID: PMC6770949 DOI: 10.3390/nu11092163] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 12/29/2022] Open
Abstract
People with sarcopenic obesity (SO) are characterized by both low muscle mass (sarcopenia) and high body fat (obesity); they have greater risks of metabolic diseases and physical disability than people with sarcopenia or obesity alone. Exercise and nutrition have been reported to be effective for both obesity and sarcopenia management. Thus, we aimed to investigate the effects of exercise and nutrition on body composition, metabolic health, and physical performance in individuals with SO. Studies investigating the effects of exercise and nutrition on body composition, metabolic health, and physical performance in SO individuals were searched from electronic databases up to April 2019. Fifteen studies were included in the meta-analysis. Aerobic exercise decreased body weight and fat mass (FM). Resistance exercise (RE) decreased FM and improved grip strength. The combination of aerobic exercise and RE decreased FM and improved walking speed. Nutritional intervention, especially low-calorie high-protein (LCHP) diet, decreased FM but did not affect muscle mass and grip strength. In addition to exercise training, nutrition did not provide extra benefits in outcome. Exercise, especially RE, is essential to improve body composition and physical performance in individuals with SO. Nutritional intervention with LCHP decreases FM but does not improve physical performance.
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Affiliation(s)
- Kuo-Jen Hsu
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming University, Taipei 11221, Taiwan.
| | - Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
| | - Mei-Wun Tsai
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming University, Taipei 11221, Taiwan.
| | - Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming University, Taipei 11221, Taiwan.
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88
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Ahmed M, Mandic I, Lou W, Goodman L, Jacobs I, L'Abbé MR. Comparison of dietary intakes of Canadian Armed Forces personnel consuming field rations in acute hot, cold, and temperate conditions with standardized infantry activities. Mil Med Res 2019; 6:26. [PMID: 31416472 PMCID: PMC6696676 DOI: 10.1186/s40779-019-0216-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/06/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dietary Reference Intakes are used to guide the energy intake of the Canadian Armed Forces (CAF) field rations provided to military personnel deployed for training or operations. However, the high energy expenditures likely to occur under harsh environmental/metabolically challenging deployment conditions may not be adequately considered. This study examined the Ad libitum energy and nutrient intakes of CAF personnel (n = 18) consuming field rations in a resting thermoneutral environment and during a day of standardized strenuous infantry activities at varying environmental temperatures. METHODS Dietary intake was assessed using a measured food intake/food waste method during the experimental treatment and for 6 h after treatment. Four treatments were administered in a randomized counterbalanced design: exercise (as standardized infantry activities) in the heat (30 °C), exercise in the cold (- 10 °C), exercise in temperate thermoneutral (21 °C) air temperatures and a resting (sedentary) trial (21 °C). RESULTS The average Ad libitum consumption of field rations was 70% of the provided total energy (2776 ± 99 kcal/8 h) during all treatments. Even with an acute challenge of increased energy expenditure and temperature stress in the simulated field conditions, participants' energy intakes (1985 ± 747 kcal/8 h) under hot, cold and temperate treatments did not differ from energy intake during the sedentary condition (1920 ± 640 kcal/8 h). Participants' energy intakes (1009 ± 527 kcal/6 h) did not increase during the 6 h posttreatment period when the stresses of the strenuous physical activities and the harsh environmental temperatures had subsided. CONCLUSION These results should be considered when planning the provision of field rations for CAF personnel expected to be engaged in strenuous physical activities with prolonged exposure to temperature extremes.
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Affiliation(s)
- Mavra Ahmed
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, Ontario, M5S 1A8, Canada
| | - Iva Mandic
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, M5S 2W6, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M2, Canada
| | - Len Goodman
- Defence Research and Development Canada - Toronto Research Centre, Toronto, M3K 2C9, Canada
| | - Ira Jacobs
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, M5S 2W6, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, Ontario, M5S 1A8, Canada.
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89
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Willert S, Weissenfels A, Kohl M, von Stengel S, Fröhlich M, Kleinöder H, Schöne D, Teschler M, Kemmler W. Effects of Whole-Body Electromyostimulation on the Energy-Restriction-Induced Reduction of Muscle Mass During Intended Weight Loss. Front Physiol 2019; 10:1012. [PMID: 31456693 PMCID: PMC6699561 DOI: 10.3389/fphys.2019.01012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose: Overweight and obesity are an increasing problem worldwide. However, most studies that focus on weight reduction by energy restriction and/or aerobic exercise reported considerable loss of muscle mass as well. Increased protein intake and/or resistance exercise might inhibit this detrimental effect during a negative energy balance. Whole-body electromyostimulation (WB-EMS), a time effective, joint-friendly, and highly customizable training technology, showed similar hypertrophic effects compared with high-intensity resistance training. The aim of this study is to evaluate the effect of WB-EMS on body composition during negative energy balance with maintained/increased protein intake in overweight premenopausal women. Patients and Methods: Ninety premenopausal, 25–50-year-old, overweight women were randomly assigned to three groups (n = 30 each). (1) Negative energy balance (−500 kcal/day) by energy restriction with compensatory protein intake (CG). (2) Negative energy balance (−500 kcal/day) by energy restriction (−250 kcal/day) and increased physical activity (−250 kcal/day) with increased protein intake (PA). (3) Negative energy balance (−500 kcal/day) due to energy restriction and increased physical activity with increased protein intake plus WB-EMS. The duration of the intervention was 16 weeks. Participants underwent restrictions in kcal per days and supplementation of protein (CG: 1.2 or PA/WB-EMS: 1.7 g/kg body mass/day) where needed. Bipolar WB-EMS was applied 1.5× week for 20 min (85 Hz; 350 μs; intermittent 6 s impulse, 4 s rest; rectangular). The primary study endpoint “lean body mass” (LBM) and secondary endpoint body fat mass (BFM) were assessed by bio-impedance analysis (BIA). Results: LBM decreased in the CG and PA group (CG: −113 ± 1,872 g; PA: −391 ± 1,832 g) but increased in the WB-EMS group (387 ± 1,769 g). However, changes were not significant (p > 0.05). Comparing the groups by ANOVA, no significant differences were observed (p = 0.070). However, pairwise adjusted comparisons determined significant differences between WB-EMS and PA (p = 0.049). BFM decreased significantly (p < 0.001) in all groups (CG: −2,174 ± 4,331 g; PA: −3,743 ± 4,237 g; WB-EMS: −3,278 ± 4,023 g) without any significant difference between the groups (ANOVA: p = 0.131). Conclusion: WB-EMS is an efficient, joint-friendly, and highly customizable training technology for maintaining muscle mass during energy restriction and can thus be considered as an alternative to more demanding resistance exercise protocols.
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Affiliation(s)
- Sebastian Willert
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Anja Weissenfels
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Fröhlich
- Department of Sports Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Heinz Kleinöder
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Daniel Schöne
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Marc Teschler
- Institute of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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90
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91
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Effects of testosterone supplementation on body composition and lower-body muscle function during severe exercise- and diet-induced energy deficit: A proof-of-concept, single centre, randomised, double-blind, controlled trial. EBioMedicine 2019; 46:411-422. [PMID: 31358477 PMCID: PMC6711889 DOI: 10.1016/j.ebiom.2019.07.059] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Severe energy deficits during military operations, produced by significant increases in exercise and limited dietary intake, result in conditions that degrade lean body mass and lower-body muscle function, which may be mediated by concomitant reductions in circulating testosterone. METHODS We conducted a three-phase, proof-of-concept, single centre, randomised, double-blind, placebo-controlled trial (CinicalTrials.gov, NCT02734238) of non-obese men: 14-d run-in, free-living, eucaloric diet phase; 28-d live-in, 55% exercise- and diet-induced energy deficit phase with (200 mg testosterone enanthate per week, Testosterone, n = 24) or without (Placebo, n = 26) exogenous testosterone; and 14-d recovery, free-living, ad libitum diet phase. Body composition was the primary end point; secondary endpoints included lower-body muscle function and health-related biomarkers. FINDINGS Following energy deficit, lean body mass increased in Testosterone and remained stable in Placebo, such that lean body mass significantly differed between groups [mean difference between groups (95% CI), 2.5 kg (3.3, 1.6); P < .0001]. Fat mass decreased similarly in both treatment groups [0.2 (-0.4, 0.7), P = 1]. Change in lean body mass was associated with change in total testosterone (r = 0.71, P < .0001). Supplemental testosterone had no effect on lower-body muscle function or health-related biomarkers. INTERPRETATION Findings suggest that supplemental testosterone may increase lean body mass during short-term severe energy deficit in non-obese, young men, but it does not appear to attenuate lower-body functional decline. FUNDING Collaborative Research to Optimize Warfighter Nutrition projects I and II, Joint Program Committee-5, funded by the US Department of Defence.
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92
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Church DD, Gwin JA, Wolfe RR, Pasiakos SM, Ferrando AA. Mitigation of Muscle Loss in Stressed Physiology: Military Relevance. Nutrients 2019; 11:nu11081703. [PMID: 31344809 PMCID: PMC6724061 DOI: 10.3390/nu11081703] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022] Open
Abstract
Military personnel may be exposed to circumstances (e.g., large energy deficits, sleep deprivation, cognitive demands, and environmental extremes) of external stressors during training and combat operations (i.e., operational stressors) that combine to degrade muscle protein. The loss of muscle protein is further exacerbated by frequent periods of severe energy deficit. Exposure to these factors results in a hypogonadal state that may contribute to observed decrements in muscle mass. In this review, lessons learned from studying severe clinical stressed states and the interventions designed to mitigate the loss of muscle protein are discussed in the context of military operational stress. For example, restoration of the anabolic hormonal status (e.g., testosterone, insulin, and growth hormone) in stressed physiological states may be necessary to restore the anabolic influence derived from dietary protein on muscle. Based on our clinical experiences, restoration of the normal testosterone status during sustained periods of operational stress may be advantageous. We demonstrated that in severe burn patients, pharmacologic normalization of the anabolic hormonal status restores the anabolic stimulatory effect of nutrition on muscle by improving the protein synthetic efficiency and limiting amino acid loss from skeletal muscle. Furthermore, an optimal protein intake, and in particular essential amino acid delivery, may be an integral ingredient in a restored anabolic response during the stress state. Interventions which improve the muscle net protein balance may positively impact soldier performance in trying conditions.
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Affiliation(s)
- David D Church
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Jess A Gwin
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
- Oak Ridge Institute for Science and Education Supporting the Military Nutrition Division of the US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Robert R Wolfe
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Arny A Ferrando
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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Batsis JA, Zagaria AB, Halter RJ, Boateng GG, Proctor P, Bartels SJ, Kotz D. Use of Amulet in behavioral change for geriatric obesity management. Digit Health 2019; 5:2055207619858564. [PMID: 31258927 PMCID: PMC6589988 DOI: 10.1177/2055207619858564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 05/30/2019] [Indexed: 02/05/2023] Open
Abstract
Background Obesity in older adults is a significant public health concern. Weight-loss interventions are known to improve physical function but risk the development of sarcopenia. Mobile health devices have the potential to augment existing interventions and, if designed accordingly, could improve one’s physical activity and strength in routine physical activity interventions. Methods and results We present Amulet, a mobile health device that has the capability of engaging patients in physical activity. The purpose of this article is to discuss the development of applications that are tailored to older adults with obesity, with the intention to engage and improve their health. Conclusions Using a team-science approach, Amulet has the potential, as an open-source mobile health device, to tailor activity interventions to older adults.
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Affiliation(s)
- John A Batsis
- Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, United States of America.,Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, United States of America.,Dartmouth Centers for Health and Aging, Dartmouth College, United States of America.,Health Promotion Research Center at Dartmouth, United States of America.,Section of Weight & Wellness, Dartmouth-Hitchcock Medical Center, United States of America
| | - Alexandra B Zagaria
- Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, United States of America.,Dartmouth Centers for Health and Aging, Dartmouth College, United States of America
| | - Ryan J Halter
- Thayer School of Engineering, Dartmouth College, United States of America.,Department of Surgery, Geisel School of Medicine, Dartmouth College, United States of America
| | - George G Boateng
- Thayer School of Engineering, Dartmouth College, United States of America.,Department of Computer Science, Dartmouth College, United States of America
| | - Patrick Proctor
- Thayer School of Engineering, Dartmouth College, United States of America.,Department of Computer Science, Dartmouth College, United States of America
| | - Stephen J Bartels
- Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, United States of America.,Dartmouth Centers for Health and Aging, Dartmouth College, United States of America.,Health Promotion Research Center at Dartmouth, United States of America
| | - David Kotz
- Department of Computer Science, Dartmouth College, United States of America
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Alexandrino EG, Marçal DFDS, Antunes MD, Oliveira LPD, Massuda EM, Bertolini SMMG. Physical activity level and lifestyle perception in prebariatric surgery patients. EINSTEIN-SAO PAULO 2019; 17:eAO4619. [PMID: 31271609 PMCID: PMC6611082 DOI: 10.31744/einstein_journal/2019ao4619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/20/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine sociodemographic characteristics, lifestyle perception and physical activity levels in obese prebariatric surgery patients. METHODS A quantitative, cross-sectional study. The sample comprised 96 male and female morbidly obese prebariatric surgery patients. Questionnaires addressing sociodemographic profile, lifestyle perception and physical activity levels were applied. RESULTS Patients were aged 40.3±11.45 years. Inadequate levels of physical activity were reported by 47.8% of patients; most respondents (79.2%) attributed scores defined as inadequate to the physical activity domain of the lifestyle questionnaire. Time spent on physical activity practice per week differed significantly between patients reporting being physically active or physically inactive in adolescence (p=0.046). CONCLUSION Most obese prebariatric surgery patients perceive their lifestyle as inadequate, in spite of eligibility for bariatric surgery. Results also indicate that physical activity practice and nutrition are the domains with greatest impacts on patient lifestyle, and that physical activity practice in adolescence may contribute to adoption of a more active behavior in adulthood, which may represent a vital tool for health promotion in patients undergoing bariatric surgery.
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95
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Beals JW, Burd NA, Moore DR, van Vliet S. Obesity Alters the Muscle Protein Synthetic Response to Nutrition and Exercise. Front Nutr 2019; 6:87. [PMID: 31263701 PMCID: PMC6584965 DOI: 10.3389/fnut.2019.00087] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/23/2019] [Indexed: 12/17/2022] Open
Abstract
Improving the health of skeletal muscle is an important component of obesity treatment. Apart from allowing for physical activity, skeletal muscle tissue is fundamental for the regulation of postprandial macronutrient metabolism, a time period that represents when metabolic derangements are most often observed in adults with obesity. In order for skeletal muscle to retain its capacity for physical activity and macronutrient metabolism, its protein quantity and composition must be maintained through the efficient degradation and resynthesis for proper tissue homeostasis. Life-style behaviors such as increasing physical activity and higher protein diets are front-line treatment strategies to enhance muscle protein remodeling by primarily stimulating protein synthesis rates. However, the muscle of individuals with obesity appears to be resistant to the anabolic action of targeted exercise regimes and protein ingestion when compared to normal-weight adults. This indicates impaired muscle protein remodeling in response to the main anabolic stimuli to human skeletal muscle tissue is contributing to poor muscle health with obesity. Deranged anabolic signaling related to insulin resistance, lipid accumulation, and/or systemic/muscle inflammation are likely at the root of the anabolic resistance of muscle protein synthesis rates with obesity. The purpose of this review is to discuss the impact of protein ingestion and exercise on muscle protein remodeling in people with obesity, and the potential mechanisms underlining anabolic resistance of their muscle.
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Affiliation(s)
- Joseph W Beals
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, United States
| | - Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Stephan van Vliet
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
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96
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Bellissimo MP, Licata AD, Nucci A, Thompson W, Benardot D. Relationships Between Estimated Hourly Energy Balance and Body Composition in Professional Cheerleaders. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42978-019-0004-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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97
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Michael MK, Joubert L, Witard OC. Assessment of Dietary Intake and Eating Attitudes in Recreational and Competitive Adolescent Rock Climbers: A Pilot Study. Front Nutr 2019; 6:64. [PMID: 31134207 PMCID: PMC6523393 DOI: 10.3389/fnut.2019.00064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/23/2019] [Indexed: 12/03/2022] Open
Abstract
The dietary intake and eating attitudes of adolescent climbers has not previously been studied. To fill this knowledge gap, we administered three surveys to 22 rock climbers (13 males, 9 females, age 14.2 ± 1.9 years): climbing ability, three-day dietary recall, and Eating Attitude Test-26 (EAT-26). The majority (82%) of climbers did not meet their target energy intake (target = 2,471 ± 493 kcal·day−1; actual = 1,963 ± 581 kcal·day−1) (p = 0.003) and 86% of climbers consumed below their target carbohydrate intake (target = 283 ± 67 g·day−1; actual intake = 226 ± 72 g·day−1) (p = 0.009). Average dietary protein intake was 95 ± 51 g·day−1, with the majority of climbers meeting their target intake of 88 ± 21 g (p = 0.580). Seventy-three percent of climbers consumed below their target dietary fat intake (target = 90 ± 21 g·day−1; actual = 69 ± 20 g·day−1) (p = 0.001). Average EAT-26 scores were 5.3 ± 4.1, indicating minimal risk of disordered eating attitudes/behaviors. There were no significant differences in boulderers vs. top rope climbers for energy/macronutrient intake, BMI, and EAT-26 score. There were no associations between energy intake and EAT-26 score (R2 = 0.245, p = 0.271) or climbing ability and EAT-26 score (R2 = p = 0.217). These data suggest that, with the exception of dietary protein intake, adolescent climbers fail to meet target dietary intakes, and exhibit minimal risk of disordered eating.
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Affiliation(s)
- Marisa K Michael
- Department of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Lanae Joubert
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
| | - Oliver C Witard
- Department of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
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Case Study: Extreme Weight Making Causes Relative Energy Deficiency, Dehydration, and Acute Kidney Injury in a Male Mixed Martial Arts Athlete. Int J Sport Nutr Exerc Metab 2019; 29:331-338. [DOI: 10.1123/ijsnem.2018-0029] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Effect of the Health Tourism weight loss programme on body composition and health outcomes in healthy and excess-weight adults. Br J Nutr 2019; 119:1133-1141. [PMID: 29759101 DOI: 10.1017/s0007114518000582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Excess weight loss while minimising fat-free mass (FFM) loss is important for health. Travel is a particular period at risk for weight gain and for which the effects of a short-term intensive weight loss programme have not been studied. Therefore, we studied the effect of a novel, 1-week supervised health travel programme combining high volume, low-to-moderate intensity exercise and energy intake restriction on weight, body composition and health outcomes in adults. Weight was also monitored for 12 weeks after the programme. In all, thirty-six subjects (nineteen men, seventeen women) consisting of sixteen excess-weight (BMI: 27·1 (sd 1·7) kg/m2) and twenty healthy-weight (BMI: 22·3 (sd 1·8) kg/m2) individuals participated. Subjects performed 1 h of slow-paced intermittent jogging three times per d and other leisure activities, whereas consuming only provided foods without water restriction. Body mass significantly decreased from pre- to post-intervention in excess-weight and healthy-weight individuals (-3·5 (sd 1·5) and -3·5 (sd 1·3) %, respectively; P<0·001 for both), and losses were maintained at 12 weeks post-intervention in both groups (-6·3 (sd 3·8) and -1·7 (sd 4·0) %, respectively; P<0·01 for both). Fat mass also significantly decreased in both groups (excess weight: -9·2 (sd 4·6) %: healthy weight: -13·4 (sd 9·0) %; P<0·01 for both), whereas FFM was maintained. Similar improvements were observed for blood biochemistry and pressure in both groups. This short-term weight loss intervention yielded favourable outcomes in both excess- and healthy-weight adults, particularly a 3·5 % weight loss with no significant change to FFM. In addition, participants maintained weight loss for at least 12 weeks. Of multiple programme choices, the Health Tourism weight loss programme's results indicate that it is a viable option.
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100
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Association of Protein Intake in Three Meals with Muscle Mass in Healthy Young Subjects: A Cross-Sectional Study. Nutrients 2019; 11:nu11030612. [PMID: 30871197 PMCID: PMC6471574 DOI: 10.3390/nu11030612] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/03/2019] [Accepted: 03/08/2019] [Indexed: 12/25/2022] Open
Abstract
Protein intake of >0.24 g/kg of body weight (BW) at a single meal is necessary to maximize muscle protein synthesis in a young population. However, the association between the protein intake rate for three meals and muscle mass in the young population has not been evaluated. We hypothesized that a protein intake of >0.24 g/kg BW at all three meals is effective for maintaining muscle mass. Therefore, we cross-sectionally examined the association between protein intake at all three meals with muscle mass in 266 healthy young subjects (aged 21.4 ± 2.4 years). Subjects were divided into the AP group, which achieved protein intake >0.24 g/kg BW at all three meals; and the NP group, which did not. We calculated total fat-free mass (FFM) and appendicular fat-free mass (AppFFM) with dual-energy X-ray absorptiometry, and the percentage of total FFM (TotalFFM%) and appendicular FFM (AppFFM%) were calculated as the percentage of BW (%BW). We demonstrated that TotalFFM% (77.0 ± 0.5 vs. 75.2 ± 0.4%, p = 0.008) and AppFFM% (34.7 ± 0.3 vs. 34.1 ± 0.2%, p = 0.058) were higher in the AP than in the NP group. This finding suggests that achieving protein intake of >0.24 g/kg BW at all three meals is important for muscle mass maintenance in young populations.
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