The effect of protein timing on muscle strength and hypertrophy: a meta-analysis

Comparative Meta-Analysis of the Effect of Concentrated, Hydrolyzed, and Isolated Whey Protein Supplementation on Body Composition of Physical Activity Practitioners

Whey protein (WP) is a dairy food supplement and, due to its effects on fat-free mass (FFM) gain and fat mass (FM) loss, it has been widely consumed by resistance training practitioners. This review analyzed the impact of WP supplementation in its concentrated (WPC), hydrolyzed (WPH) and isolated (WPI) forms, comparing it exclusively to isocaloric placebos. Random effect meta-analyses were performed from the final and initial body composition values of 246 healthy athletes undergoing 64.5 ± 15.3 days of training in eight randomized clinical trials (RCT) collected systematically from five scientific databases. The weighted mean difference (WMD) was statistically significant for FM loss (WMD = −0.96, 95% CI = −1.37, −0.55, p < 0.001) and, in the analysis of subgroups, this effect was maintained for the WPC (WMD = −0.63, 95% CI = −1.19, −0.06, p = 0.030), with protein content between 51% and 80% (WMD = −1.53; 95% CI = −2.13, −0.93, p < 0.001), and only for regular physical activity practitioners (WMD = −0.95; 95% CI = −1.70, −0.19, p = 0.014). There was no significant effect on FFM in any of the scenarios investigated (p > 0.05). Due to several and important limitations, more detailed analyses are required regarding FFM gain.

Effects of whey protein supplementation prior to, and following, resistance exercise on body composition and training responses: A randomized double-blind placebo-controlled study

PURPOSE

The composition of protein supplements, the consumption timing immedi¬ately before and after resistance exercise training (RET), and the quantity of protein supplementation may be important factors for the im-provement of muscle mass and function. Although these factors should be considered comprehensively for effective improvement of muscular function in protein supplementation, relatively few studies have focused on this area. Therefore, this study was designed to investigate whether a protein blend supplement before and after resistance exercise for 12 weeks would be effective in increasing muscular function.

METHODS

In total, 18 participants were randomly assigned to a placebo (PLA) or protein blend supplement (PRO) group. All subjects followed the same training routine 3 times per week for 12 weeks, taking placebo or protein supplements immediately before and after each exercise session. The protein supplement consisted of 40 g of blend protein, including hydrolyzed whey protein. The RET consisted of lower body (barbell squat, dead lift, seated leg extension, and lying leg curl) and upper body (bench press, barbell rowing, preacher bench biceps curl, and dumbbell shoulder press) exercises. A repetition was defined as three sets of 10-12 times with 80% of one repetition maximum (1RM).

RESULTS

Although the PRO group had a lower protein intake in terms of total food intake than the PLA group, the mean changes in muscle circumference, strength, and exercise volume increased, especially at week 12, compared to the PLA group.

CONCLUSION

These results suggest that the composition and timing of protein intake are more important than the total amount.

Nutrition Recommendations for Bodybuilders in the Off-Season: A Narrative Review

Many nutrition practices often used by bodybuilders lack scientific support and can be detrimental to health. Recommendations during the dieting phase are provided in the scientific literature, but little attention has been devoted to bodybuilders during the off-season phase. During the off-season phase, the goal is to increase muscle mass without adding unnecessary body fat. This review evaluated the scientific literature and provides nutrition and dietary supplement recommendations for natural bodybuilders during the off-season phase. A hyper-energetic diet (~10-20%) should be consumed with a target weight gain of ~0.25-0.5% of bodyweight/week for novice/intermediate bodybuilders. Advanced bodybuilders should be more conservative with the caloric surplus and weekly weight gain. Sufficient protein (1.6-2.2 g/kg/day) should be consumed with optimal amounts 0.40-0.55 g/kg per meal and distributed evenly throughout the day (3-6 meals) including within 1-2 hours pre- and post-training. Fat should be consumed in moderate amounts (0.5-1.5 g/kg/day). Remaining calories should come from carbohydrates with focus on consuming sufficient amounts (≥3-5 g/kg/day) to support energy demands from resistance exercise. Creatine monohydrate (3-5 g/day), caffeine (5-6 mg/kg), beta-alanine (3-5 g/day) and citrulline malate (8 g/day) might yield ergogenic effects that can be beneficial for bodybuilders.

Dietary Fuels in Athletic Performance

Focusing on daily nutrition is important for athletes to perform and adapt optimally to exercise training. The major roles of an athlete's daily diet are to supply the substrates needed to cover the energy demands for exercise, to ensure quick recovery between exercise bouts, to optimize adaptations to exercise training, and to stay healthy. The major energy substrates for exercising skeletal muscles are carbohydrate and fat stores. Optimizing the timing and type of energy intake and the amount of dietary macronutrients is essential to ensure peak training and competition performance, and these strategies play important roles in modulating skeletal muscle adaptations to endurance and resistance training. In this review, recent advances in nutritional strategies designed to optimize exercise-induced adaptations in skeletal muscle are discussed, with an emphasis on mechanistic approaches, by describing the physiological mechanisms that provide the basis for different nutrition regimens.

Efficacy and Safety of Whey Protein Supplements on Vital Sign and Physical Performance Among Athletes: A Network Meta-Analysis

Introduction: Athletes train physically to reach beyond their potential maximum aerobic threshold. Whey protein supplements (WPS) are often used in conjunction with physiotherapy and psychotherapy to regain better vital sign and physical performances. This review aimed to explore the clinical evidence on the efficacy and safety of WPS in sports performance and recovery among athletes.

Methodology: A comprehensive literature search was performed to identify relevant randomized control trials (RCTs) that investigated the efficacy and safety of WPS on the vital sign and physical performance among athletes. The Cochrane Risk of Bias (ROB) Assessment tools were used to assess the quality of the studies. Meta-analysis was conducted using the frequentist model with STATA version 14.2®.

Results: A total of 333,257 research articles were identified out of which 20 RCTs were included for qualitative synthesis and network meta-analysis with 351 participants. Among the studies, 7 had low ROB and 3 RCTs had high ROB. Of these 20 trials, 16 trials were randomized clinical trials which compared whey protein supplements (WPS) with various comparators i.e., L-alanine, bovine colostrum, carbohydrate, casein, leucine, maltodextrin, rice, protein + caffeine were compared with placebo. Analysis from the pairwise meta-analysis revealed that for respiratory exchange ratio (RER) WPS was found to be significantly improving compared to maltodextrin (WMD = 0.012; 95%CI = 0.001, 0.023). Similarity to RPE (Rate Perceived Exertion), slight difference between WPS and the comparators, however, when the estimation was favorable to the comparators, there was moderate-high heterogeneity. For VO_2max, high heterogeneity appeared when WPS compared to maltodextrin with the I² = 97.8% (WMD = 4.064; 95% CI = −4.230, 12.359), meanwhile bovine colostrum (WMD = −2.658; 95%CI = −6.180, 0.865) only comparator that was better than WPS. According to the estimated effect of the supplements on physical performance outcome results, maximum power (8 studies, 185 athletes), highest ranked was bovine colostrum (SUCRA = 70.7%) and the lowest ranked was placebo (SUCRA = 17.9%), yet all insignificant. Then again, on average power (nine studies, 187 athletes), WPS was the highest ranked (SUCRA = 75.4 %) about −112.00 watt (−187.91, −36.08) and most of the estimations were significant. Body mass was reported in 10 studies (171 athletes), carbohydrate may be at the highest ranked (SUCRA = 66.9%) but it is insignificant. Thought the second highest ranked was WPS (SUCRA = 64.7%) and it is significant (WMD = −6.89 kg; CI = −8.24, −5.54).

Conclusion: The findings of this review support the efficacy and safety of WPS as an ergogenic aid on athletes' sports performance and recovery. The overall quality of clinical evidence was found to be valid and reliable from the comprehensive search strategy and ROB assessment.

Effects of training, detraining, and retraining on strength, hypertrophy, and myonuclear number in human skeletal muscle

Previously trained mouse muscles acquire strength and volume faster than naïve muscles; it has been suggested that this is related to increased myonuclear density. The present study aimed to determine whether a previously strength-trained leg (mem-leg) would respond better to a period of strength training than a previously untrained leg (con-leg). Nine men and 10 women performed unilateral strength training (T1) for 10 wk, followed by 20 wk of detraining (DT) and a 5-wk bilateral retraining period (T2). Muscle biopsies were taken before and after each training period and analyzed for myonuclear number, fiber volume, and cross-sectional area (CSA). Ultrasound and one repetition of maximum leg extension were performed to determine muscle thickness (MT) and strength. CSA (~17%), MT (~10%), and strength (~20%) increased during T1 in the mem-leg. However, the myonuclear number and fiber volume did not change. MT and CSA returned to baseline values during DT, but strength remained elevated (~60%), supporting previous findings of a long-lasting motor learning effect. MT and strength increased similarly in the mem-leg and con-leg during T2, whereas CSA, fiber volume, and myonuclear number remained unaffected. In conclusion, training response during T2 did not differ between the mem-leg and con-leg. However, this does not discount the existence of human muscle memory, since no increase in the number of myonuclei was detected during T1 and no clear detraining effect was observed for cell size during DT; thus, the present data did not allow for a rigorous test of the muscle memory hypothesis. NEW & NOTEWORTHY If a long-lasting intramuscular memory exists in humans, this will affect strength-training advice for both athletes and the public. Based on animal experiments, we hypothesized that such a memory exists and that it is related to the myonuclear number. However, a period of unilateral strength training, followed by detraining, did not increase the myonuclear number. The training response, during a subsequent bilateral retraining period, was not enhanced in the previously trained leg.

Association of Protein Intake in Three Meals with Muscle Mass in Healthy Young Subjects: A Cross-Sectional Study

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.

Protein timing has no effect on lean mass, strength and functional capacity gains induced by resistance exercise in postmenopausal women: A randomized clinical trial

BACKGROUND & AIMS

Short-term studies have shown that protein intake immediately post-exercise increases muscle protein synthesis. However, the effect of protein timing (comparing protein intake post-exercise vs. several hours after exercise) on lean mass and strength gains in long-term studies is still not fully elucidated. Thus, the aim of our study was to evaluate the effect of protein timing on lean mass, strength and functional capacity gains induced by resistance exercise in postmenopausal women.

METHODS

Thirty-four postmenopausal women (60.9 ± 6.7 years) participated in this double-blind, parallel-group, randomized clinical trial. All individuals performed the same resistance training protocol in the morning, 3 times a week, at 70% of 1-maximum repetition (1-RM), over 8 weeks. Participants were randomly assigned to protein-carbohydrate group (PC) (n = 17), that ingested 30 g of whey protein immediately after exercise and 30 g of maltodextrin in the afternoon; and to carbohydrate-protein group (CP) (n = 17), that ingested 30 g of maltodextrin immediately after exercise and 30 g of whey protein in the afternoon. Lean mass was assessed using dual-energy X-ray absorptiometry, handgrip strength by a dynamometer, and strength was evaluated by 1-RM of bench press and leg extension. One mile walk test was performed to assess the functional capacity.

RESULTS

Both the PC group (37.3 [35.0-39.7] to 38.1 [35.9-40.5] kg) and the CP group (38.2 [36.0-40.5] to 38.8 [36.5-41.3] kg) increased the total lean mass (p < 0.001). An increase was also observed in both groups for 1-RM bench press, 1-RM leg extension and handgrip strength (p < 0.001). In addition, the time of 1-mile walk test decreased in both groups (p = 0.019). No differences were noted for group and time interaction for these variables (p > 0.05).

CONCLUSION

Protein timing has no effect on lean mass, strength and functional capacity gains induced by resistance exercise in postmenopausal women. This trial was registered at ClinicalTrials.gov as NCT03372876.

Supplements with purported effects on muscle mass and strength

PURPOSE

Several supplements are purported to promote muscle hypertrophy and strength gains in healthy subjects, or to prevent muscle wasting in atrophying situations (e.g., ageing or disuse periods). However, their effectiveness remains unclear.

METHODS

This review summarizes the available evidence on the beneficial impacts of several popular supplements on muscle mass or strength.

RESULTS

Among the supplements tested, nitrate and caffeine returned sufficient evidence supporting their acute beneficial effects on muscle strength, whereas the long-term consumption of creatine, protein and polyunsaturated fatty acids seems to consistently increase or preserve muscle mass and strength (evidence level A). On the other hand, mixed or unclear evidence was found for several popular supplements including branched-chain amino acids, adenosine triphosphate, citrulline, β-Hydroxy-β-methylbutyrate, minerals, most vitamins, phosphatidic acid or arginine (evidence level B), weak or scarce evidence was found for conjugated linoleic acid, glutamine, resveratrol, tribulus terrestris or ursolic acid (evidence level C), and no evidence was found for other supplements such as ornithine or α-ketoglutarate (evidence D). Of note, although most supplements appear to be safe when consumed at typical doses, some adverse events have been reported for some of them (e.g., caffeine, vitamins, α-ketoglutarate, tribulus terrestris, arginine) after large intakes, and there is insufficient evidence to determine the safety of many frequently used supplements (e.g., ornithine, conjugated linoleic acid, ursolic acid).

CONCLUSION

 In summary, despite their popularity, there is little evidence supporting the use of most supplements, and some of them have been even proven ineffective or potentially associated with adverse effects.

EASL Clinical Practice Guidelines on nutrition in chronic liver disease

A frequent complication in liver cirrhosis is malnutrition, which is associated with the progression of liver failure, and with a higher rate of complications including infections, hepatic encephalopathy and ascites. In recent years, the rising prevalence of obesity has led to an increase in the number of cirrhosis cases related to non-alcoholic steatohepatitis. Malnutrition, obesity and sarcopenic obesity may worsen the prognosis of patients with liver cirrhosis and lower their survival. Nutritional monitoring and intervention is therefore crucial in chronic liver disease. These Clinical Practice Guidelines review the present knowledge in the field of nutrition in chronic liver disease and promote further research on this topic. Screening, assessment and principles of nutritional management are examined, with recommendations provided in specific settings such as hepatic encephalopathy, cirrhotic patients with bone disease, patients undergoing liver surgery or transplantation and critically ill cirrhotic patients.

CLAME: a new alignment-based binning algorithm allows the genomic description of a novel Xanthomonadaceae from the Colombian Andes

Background

Hot spring bacteria have unique biological adaptations to survive the extreme conditions of these environments; these bacteria produce thermostable enzymes that can be used in biotechnological and industrial applications. However, sequencing these bacteria is complex, since it is not possible to culture them. As an alternative, genome shotgun sequencing of whole microbial communities can be used. The problem is that the classification of sequences within a metagenomic dataset is very challenging particularly when they include unknown microorganisms since they lack genomic reference. We failed to recover a bacterium genome from a hot spring metagenome using the available software tools, so we develop a new tool that allowed us to recover most of this genome.

Results

We present a proteobacteria draft genome reconstructed from a Colombian’s Andes hot spring metagenome. The genome seems to be from a new lineage within the family Rhodanobacteraceae of the class Gammaproteobacteria, closely related to the genus Dokdonella. We were able to generate this genome thanks to CLAME. CLAME, from Spanish “CLAsificador MEtagenomico”, is a tool to group reads in bins. We show that most reads from each bin belong to a single chromosome. CLAME is very effective recovering most of the reads belonging to the predominant species within a metagenome.

Conclusions

We developed a tool that can be used to extract genomes (or parts of them) from a complex metagenome.

Electronic supplementary material

The online version of this article (10.1186/s12864-018-5191-y) contains supplementary material, which is available to authorized users.

The Effects of a High-Protein Diet on Bone Mineral Density in Exercise-Trained Women: A 1-Year Investigation

The effects of long-term high-protein consumption (i.e., >2.2 g/kg/day) are unclear as it relates to bone mineral content. Thus, the primary endpoint of this investigation was to determine if consuming a high-protein diet for one year affected various parameters of body composition in exercise-trained women. This investigation is a follow-up to a prior 6-month study. Subjects were instructed to consume a high-protein diet (>2.2 g/kg/day) for one year. Body composition was assessed via dual-energy X-ray absorptiometry (DXA). Subjects were instructed to keep a food diary (i.e., log their food ~three days per week for a year) via the mobile app MyFitnessPal^®. Furthermore, a subset of subjects had their blood analyzed (i.e., basic metabolic panel). Subjects consumed a high-protein diet for one year (mean ± SD: 2.3 ± 1.1 grams per kilogram body weight daily [g/kg/day]). There were no significant changes for any measure of body composition over the course of the year (i.e., body weight, fat mass, lean body mass, percent fat, whole body bone mineral content, whole body T-score, whole body bone mineral density, lumbar bone mineral content, lumbar bone mineral density and lumbar T-score). In addition, we found no adverse effects on kidney function. Based on this 1-year within-subjects investigation, it is evident that a diet high in protein has no adverse effects on bone mineral density or kidney function.

Is There a Postworkout Anabolic Window of Opportunity for Nutrient Consumption? Clearing up Controversies

Nutrient timing is a popular strategy for enhancing muscular adaptations and athletic performance. From the standpoint of muscle hypertrophy, the concept of a "postworkout anabolic window of opportunity" has been proposed, whereby a limited time exists after training to optimize accretion of muscle proteins. Some researchers have gone so far as to claim that the timing of nutritional consumption is even more critical to muscle development than the absolute daily consumption of nutrients. Thus, the purpose of this paper is to review the current literature as to the relevance of the anabolic window of opportunity, and draw evidence-based conclusions for application into practice. J Orthop Sports Phys Ther 2018;48(12):911-914. doi:10.2519/jospt.2018.0615.

Endocrine responses following exhaustive strength exercise with and without the use of protein and protein-carbohydrate supplements

The aim of this study was to determine the effect of carbohydrate-protein supplementation with whey protein (CHO-PROw) after resistance training, and casein protein (PROc) before bedtime on the concentration of growth hormone (GH), insulin (I) and insulin-like growth factor (IGF-1), as well as serum creatine kinase (CK) activity. Twelve strength trained male subjects (age: 25.8 ± 4.7 years; training experience 6.1 ± 0.79 years; body mass 75.9 ± 2.7 kg; body height 171.8 ± 13.3 cm) were recruited for the study. They were randomly divided into an experimental group (group E, n = 6) and a control group (group C, n = 6). All study participants completed full barbell squats with a constant external load of 90% one-repetition maximum (1RM) and a volume of 12 sets. In each set three repetitions were performed with 3 min rest periods after each set. Immediately after the exercise protocol, the subjects from the experimental group received a carbohydrate-protein complex (CHO-PROw) with a dose of 0.5 g/kg of body mass, while before bedtime they ingested a protein supplement (PROc) consisting of 90% casein protein with a dose of 0.3 g/kg of body weight The results indicate that a ignificant increase in GH concentration occurred in the experimental group between the pre-exercise level and after 24 h of recovery (p<0.01), as well as between 1 h and 24 hours of recovery (p<0.01). Significantly higher levels of GH were also found between the control group and the experimental group 24 hours after exercise (p<0.01). The results showed significantly higher levels of IGF-1 in the experimental than in the control group after 24 hours of recovery (p<0.05). In the case of insulin, no significant differences were observed when comparing levels before exercise, after exercise, after 1 hour of recovery and after 24 hours of recovery. The CHO-PROw and the PROc supplements did not reduce post-exercise muscle membrane damage as evidenced by serum CK activity. The intake of these supplements after high-intensity resistance exercise caused an increase in GH and IGF-1 concentration, which could stimulate muscle hypertrophy and inhibit proteolysis.

Effects of High Versus Low Protein Intake on Body Composition and Maximal Strength in Aspiring Female Physique Athletes Engaging in an 8-Week Resistance Training Program

Aspiring female physique athletes are often encouraged to ingest relatively high levels of dietary protein in conjunction with their resistance training programs. However, there is little to no research investigating higher versus lower protein intakes in this population. This study examined the influence of a high versus low-protein diet in conjunction with an 8-week resistance training program in this population. A total of 17 females (21.2 ± 2.1 years; 165.1 ± 5.1 cm; 61 ± 6.1 kg) were randomly assigned to a high-protein diet (HP: 2.5 g·kg^-1·day^-1; n = 8) or a low-protein diet (LP: 0.9 g·kg^-1·day^-1, n = 9) and were assessed for body composition and maximal strength prior to and after the 8-week protein intake and exercise intervention. Fat-free mass increased significantly more in the HP group as compared with the LP group (p = .009), going from 47.1 ± 4.5 to 49.2 ± 5.4 kg (+2.1 kg) and from 48.1 ± 2.7 to 48.7 ± 2 kg (+0.6 kg) in the HP and LP groups, respectively. Fat mass significantly decreased over time in the HP group (14.1 ± 3.6 to 13.0 ± 3.3 kg; p < .01), but no change was observed in the LP group (13.2 ± 3.7 to 12.5 ± 3.0 kg). Although maximal strength significantly increased in both groups, there were no differences in strength improvements between the two groups. In aspiring female physique athletes, a higher protein diet is superior to a lower protein diet in terms of increasing fat-free mass in conjunction with a resistance training program.

The effects of nutrient timing on training adaptations in resistance-trained females

OBJECTIVES

The purpose of this study was to determine the effects of pre- vs. post-workout nutrition on strength, body composition, and metabolism in trained females over 6 weeks of high intensity resistance training (HIRT).

DESIGN

Forty-three trained females (mean±SD; age: 20.5±2.2 yrs; height: 165.2±5.7cm; body mass: 66.5±11.4kg) were measured for strength, body composition, and metabolic variables before and after a HIRT intervention. Participants were randomized using a 2:2:1 matched block randomization scheme by baseline leg press strength into a group that consumed a 1:1.5 carbohydrate-protein supplement (16g CHO/25g PRO) pre-training (PRE), post-training (POST), or no supplement (CON).

METHODS

Dual-energy X-ray absorptiometry was used to evaluate fat mass (FM), lean mass (LM), and percent fat (%fat). Strength was analyzed using a one repetition max on the leg and bench press (LP1RM and BP1RM, respectively). Participants completed HIRT twice per week for 6 weeks. At the first and last trainings, metabolic variables [resting energy expenditure (REE) and respiratory exchange ratio, RER] were measured.

RESULTS

There were no significant differences between groups for any changes in body composition variables or LP1RM (p=0.170-0.959). There were significant differences for BP1RM (p=0.007), with PRE and POST experiencing greater increases than CON (p=0.010 and 0.015, respectively). REE changes were not significant between groups (p=0.058-0.643). PRE demonstrated greater fat oxidation (RER) at 30min post-exercise (p=0.008-0.035).

CONCLUSION

Peri-workout nutrition is potentially important for upper body strength and metabolism. PRE may be more effective for promoting fat utilization immediately post-workout.

Ingestion of Insect Protein Isolate Enhances Blood Amino Acid Concentrations Similar to Soy Protein in A Human Trial

Background: Increased amino acid availability stimulates muscle protein synthesis (MPS), which is critical for maintaining or increasing muscle mass when combined with training. Previous research suggests that whey protein is superior to soy protein in regard to stimulating MPS and muscle mass. Nevertheless, with respect to a future lack of dietary protein and an increasing need for using eco-friendly protein sources it is of great interest to investigate the quality of alternative protein sources, like insect protein. Objective: Our aim was to compare the postprandial amino acid (AA) availability and AA profile in the blood after ingestion of protein isolate from the lesser mealworm, whey isolate, and soy isolate. Design: Six healthy young men participated in a randomized cross-over study and received three different protein supplementations (25 g of crude protein from whey, soy, insect or placebo (water)) on four separate days. Blood samples were collected at pre, 0 min, 20 min, 40 min, 60 min, 90 min, and 120 min. Physical activity and dietary intake were standardized before each trial, and participants were instructed to be fasting from the night before. AA concentrations in blood samples were determined using ¹H NMR spectroscopy. Results: A significant rise in blood concentration of essential amino acids (EAA), branched-chain amino acids (BCAA) and leucine was detected over the 120 min period for all protein supplements. Nevertheless, the change in AA profile was significantly greater after ingestion of whey than soy and insect protein (p < 0.05). Area under the curve (AUC) analysis and AA profile revealed comparable AA concentrations for soy and insect protein, whereas whey promoted a ~97% and ~140% greater AUC value than soy and insect protein, respectively. A tendency towards higher AA concentrations beyond the 120 min period was observed for insect protein. Conclusion: We report that ingestion of whey, soy, and insect protein isolate increases blood concentrations of EAA, BCAA, and leucine over a 120 min period (whey > insect = soy). Insect protein induced blood AA concentrations similar to soy protein. However, a tendency towards higher blood AA concentrations at the end of the 120 min period post ingestion was observed for insect protein, which indicates that it can be considered a “slow” digestible protein source.

Effects of Protein Supplementation on Performance and Recovery in Resistance and Endurance Training

There is robust evidence which shows that consuming protein pre- and/or post-workout induces a significant rise in muscle protein synthesis. It should be noted, however, that total daily caloric and protein intake over the long term play the most crucial dietary roles in facilitating adaptations to exercise. However, once these factors are accounted for, it appears that peri-exercise protein intake, particularly in the post-training period, plays a potentially useful role in terms of optimizing physical performance and positively influencing the subsequent recovery processes for both resistance training and endurance exercise. Factors that affect the utility of pre- or post-workout feeding include but are not necessarily limited to: training status (e.g., novice vs. advanced, or recreational vs. competitive athlete), duration of exercise, the number of training sessions per day, the number of competitive events per day, etc. From a purely pragmatic standpoint, consuming protein post-workout represents an opportunity to feed; this in turn contributes to one's total daily energy and protein intake. Furthermore, despite recent suggestions that one does not “need” to consume protein during the immediate (1 h or less) post-training time frame, it should be emphasized that consuming nothing offers no advantage and perhaps even a disadvantage. Thus, based on performance and recovery effects, it appears that the prudent approach would be to have athletes consume protein post-training and post-competition.

Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies

The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity. We explore sex-specific hormonal changes, inflammatory pathways and myocellular mechanisms leading to the development of sarcopenic obesity. We discuss the evolution, controversies and challenges in defining sarcopenic obesity and present current body composition modalities used to assess this condition. Epidemiological surveys form the basis of defining its prevalence and consequences beyond comorbidity and mortality. Current treatment strategies, and the evidence supporting them, are outlined, with a focus on calorie restriction, protein supplementation and aerobic and resistance exercises. We also describe weight loss-induced complications in patients with sarcopenic obesity that are relevant to clinical management. Finally, we review novel and potential future therapies including testosterone, selective androgen receptor modulators, myostatin inhibitors, ghrelin analogues, vitamin K and mesenchymal stem cell therapy.

Dietary Manipulations Concurrent to Endurance Training

The role of an athlete's dietary intake (both timing and food type) goes beyond simply providing fuel to support the body's vital processes. Nutritional choices also have an impact on the metabolic adaptations to training. Over the past 20 years, research has suggested that strategically reducing carbohydrate (CHO) availability during an athlete's training can modify the metabolic responses in lieu of simply maintaining a high CHO diet. Several methods have been explored to manipulate CHO availability and include: Low-carb, high-fat (LCHF) diets, performing two-a-day training without glycogen restoration between sessions, and a "sleep-low" approach entailing a glycogen-depleting session in the evening without consuming CHO until after a morning training session performed in an overnight fasted state. Each of these methods can confer beneficial metabolic adaptations for the endurance athlete including increases in mitochondrial enzyme activity, mitochondrial content, and rates of fat oxidation, yet data showing a direct performance benefit is still unclear.

Molecular Regulation of Exercise-Induced Muscle Fiber Hypertrophy

Skeletal muscle hypertrophy is a widely sought exercise adaptation to counteract the muscle atrophy of aging and disease, or to improve athletic performance. While this desired muscle enlargement is a well-known adaptation to resistance exercise training (RT), the mechanistic underpinnings are not fully understood. The purpose of this review is thus to provide the reader with a summary of recent advances in molecular mechanisms-based on the most current literature-that are thought to promote RT-induced muscle hypertrophy. We have therefore focused this discussion on the following areas of fertile investigation: ribosomal function and biogenesis, muscle stem (satellite) cell activity, transcriptional regulation, mechanotransduction, and myokine signaling.

Daytime and nighttime casein supplements similarly increase muscle size and strength in response to resistance training earlier in the day: a preliminary investigation

BACKGROUND

Casein protein consumed before sleep has been suggested to offer an overnight supply of exogenous amino acids for anabolic processes. The purpose of this study was to compare supplemental casein consumed earlier in the day (DayTime, DT) versus shortly before bed (NightTime, NT) on body composition, strength, and muscle hypertrophy in response to supervised resistance training.

METHODS

Thirteen males participated in a 10-week exercise and dietary intervention while receiving 35 g casein daily. Isocaloric diets provided 1.8 g protein/kg body weight.

RESULTS

Both groups increased (p < 0.05) in lean soft tissue (DT Pre: 58.3 ± 10.3 kg; DT Post: 61.1 ± 11.1 kg; NT Pre: 58.3 ± 8.6 kg; NT Post: 60.3 ± 8.2 kg), cross-sectional area (CSA, DT Pre: 3.4 ± 1.5 cm2; DT Post: 4.1 ± 1.7 cm2; NT Pre: 3.3 ± 1.6 cm2; NT Post: 3.7 ± 1.6 cm2) and strength in the leg press (DT Pre: 341 ± 87.3 kg; DT Post: 421.1 ± 94.0 kg; NT Pre: 450.0 ± 180.3 kg; NT Post: 533.9 ± 155.4 kg) and bench press (DT Pre: 89.0 ± 27.0 kg; DT Post: 101.0 ± 24.0 kg; NT Pre 100.8 ± 32.4 kg; NT Post: 109.1 ± 30.4 kg) with no difference between groups in any variable (p > 0.05).

CONCLUSIONS

Both NT and DT protein consumption as part of a 24-h nutrition approach are effective for increasing strength and hypertrophy. The results support the strategy of achieving specific daily protein levels versus specific timing of protein ingestion for increasing muscle mass and performance.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03352583 .

Effect of Protein or Essential Amino Acid Supplementation During Prolonged Resistance Exercise Training in Older Adults on Body Composition, Muscle Strength, and Physical Performance Parameters: A Systematic Review

Objectives:

Loss of muscle mass and strength with aging, sarcopenia, burdens many older adults, making identification of strategies on how to counteract it very relevant—especially to health care providers working in rehabilitation. The aim of this systematic review was to determine the effect of protein or essential amino acid (EAA) supplementation during prolonged resistance exercise training (RT) in older adults. No known stimulants of muscle protein synthesis, or ingredients with an effect on muscle strength/physical function, were allowed with the supplementation, differentiating this systematic review from others.

Data sources and methods:

In January 2017, 4 electronic databases and reference lists were searched for randomized controlled trials investigating the effect of protein or EAA supplementation during RT in older adults (mean age >60 years) on outcomes of body composition, muscle strength, and physical performance. Study selection and data extraction were performed by 2 independent reviewers.

Results

Sixteen studies (1107 participants) fulfilled the eligibility criteria. Methodologic differences between the studies disallowed a meta-analysis. Of the 16 studies, 6 found significant effects on body composition (3 studies), muscle strength (3 studies), and physical performance (2 studies) measures.

Conclusions

The evidence is weak and inconsistent, as benefit of protein or EAA supplementation during RT in older adults is only shown in some studies. The findings indicate that frail/sarcopenic older adults might benefit more than healthy older adults. Further research is needed to allow an interpretation on the importance of study population and design.

Trial registration:

PROSPERO, Reg. no.: CRD42017063808. Registered April 14, 2017.

Effects of Insect Protein Supplementation during Resistance Training on Changes in Muscle Mass and Strength in Young Men

During prolonged resistance training, protein supplementation is known to promote morphological changes; however, no previous training studies have tested the effect of insect protein isolate in a human trial. The aim of this study was to investigate the potential effect of insect protein as a dietary supplement to increase muscle hypertrophy and strength gains during prolonged resistance training in young men. Eighteen healthy young men performed resistance training four day/week for eight weeks. Subjects were block randomized into two groups consuming either an insect protein isolate or isocaloric carbohydrate supplementation within 1 h after training and pre-sleep on training days. Strength and body composition were measured before and after intervention to detect adaptions to the resistance training. Three-day weighed dietary records were completed before and during intervention. Fat- and bone- free mass (FBFM) improved significantly in both groups (Mean (95% confidence interval (CI))), control group (Con): (2.5 kg (1.5, 3.5) p < 0.01), protein group (Pro): (2.7 kg (1.6, 3.8) p < 0.01) from pre- to post- leg and bench press one repetition maximum (1 RM) improved by Con: (42.0 kg (32.0, 52.0) p < 0.01) and (13.8 kg (10.3, 17.2) p < 0.01), Pro: (36.6 kg (27.3, 45.8) p < 0.01) and (8.1 kg (4.5, 11.8) p < 0.01), respectively. No significant differences in body composition and muscle strength improvements were found between groups. In young healthy men, insect protein supplementation did not improve adaptations to eight weeks of resistance training in comparison to carbohydrate supplementation. A high habitual protein intake in both Con and Pro may partly explain our observation of no superior effect of insect protein supplementation.

Protein Recommendations for Weight Loss in Elite Athletes: A Focus on Body Composition and Performance

There exists a large body of scientific evidence to support protein intakes in excess of the recommended dietary allowance (RDA) (0.8 g protein/kg/day) to promote the retention of skeletal muscle and loss of adipose tissue during dietary energy restriction. Diet-induced weight loss with as low as possible ratio of skeletal muscle to fat mass loss is a situation we refer to as high-quality weight loss. We propose that high-quality weight loss is often of importance to elite athletes in order to maintain their muscle (engine) and shed unwanted fat mass, potentially improving athletic performance. Current recommendations for protein intakes during weight loss in athletes are set at 1.6-2.4 g protein/kg/day. However, the severity of the caloric deficit and type and intensity of training performed by the athlete will influence at what end of this range athletes choose to be. Other considerations regarding protein intake that may help elite athletes achieve weight loss goals include the quality of protein consumed, and the timing and distribution of protein intake throughout the day. This review highlights the scientific evidence used to support protein recommendations for high-quality weight loss and preservation of performance in athletes. Additionally, the current knowledge surrounding the use of protein supplements, branched chain amino acids (BCAA), β-hydroxy β-methylbutyrate (HMB), and other dietary supplements with weight loss claims will be discussed.

High protein consumption in trained women: bad to the bone?

Background

It has been posited that the consumption of extra protein (> 0.8 g/kg/d) may be deleterious to bone mineral content. However, there is no direct evidence to show that consuming a high-protein diet results in a demineralization of the skeleton. Thus, the primary endpoint of this randomized controlled trial was to determine if a high-protein diet affected various parameters of whole body and lumbar bone mineral content in exercise-trained women.

Methods

Twenty-four women volunteered for this 6-month investigation (n = 12 control, n = 12 high-protein). The control group was instructed to consume their habitual diet; however, the high-protein group was instructed to consume ≥2.2 g of protein per kilogram body weight daily (g/kg/d). Body composition was assessed via dual-energy x-ray absorptiometry (DXA). Subjects were instructed to keep a food diary via the mobile app MyFitnessPal®. Exercise or activity level was not controlled. Subjects were asked to maintain their current levels of exercise.

Results

During the 6-month treatment period, there was a significant difference in protein intake between the control and high-protein groups (mean±SD; control: 1.5±0.3, high-protein: 2.8±1.1 g/kg/d); however, there were no differences in the consumption total calories, carbohydrate or fat. Whole body bone mineral density did not change in the control (pre: 1.22±0.08, post: 1.22±0.09 g/cm²) or high-protein group (pre: 1.25±0.11, post: 1.24±0.10 g/cm²). Similarly, lumbar bone mineral density did not change in the control (pre: 1.08±0.16, post: 1.05±0.13 g/cm²) or high-protein group (pre: 1.07±0.11, post: 1.08±0.12 g/cm²). In addition, there were no changes in whole body or lumbar T-Scores in either group. Furthermore, there were no changes in fat mass or lean body mass.

Conclusion

Despite an 87% higher protein intake (high-protein versus control), 6 months of a high-protein diet had no effect on whole body bone mineral density, lumbar bone mineral density, T-scores, lean body mass or fat mass.

Relationship between Dietary Protein or Essential Amino Acid Intake and Training-Induced Muscle Hypertrophy among Older Individuals

Dietary protein intake is critical for maintaining an optimal muscle mass, especially among older individuals. Although protein supplementation during resistance training (RT) has been shown to further augment training-induced muscle mass in older individuals, the impact of daily variations in protein intake on training-induced muscle mass has not been explored thus far. Therefore, this study aimed to investigate the relationship between the dietary protein and amino acid intake and RT-induced muscle hypertrophy among older individuals. Ten healthy older men (n=10; mean age=69±2 y; body weight (BW)=61.5±2.2 kg; height=1.65±0.02 m) participated in progressive RT performed 3 times/wk for 12 wk. Body composition (using DXA) and nutritional assessments (using a 3-d dietary record) were performed before and after the training period. Leg lean mass (LLM) increased significantly (15.0±0.8 vs. 15.4±0.8 kg, p<0.05) after RT, with no change in dietary nutrient intake. The average dietary protein intake was 1.62±0.11 g/kg BW/d, while essential amino acids was 600±51 mg/kg BW/d. Although the correlation between the increase in LLM and dietary protein intake was not significant, a significant correlation was found between the increase in LLM and dietary essential amino acid (EAA) intake. Furthermore, there were significant correlations between the increase in LLM and protein as well as EAA (especially leucine) intake at breakfast among subjects with suboptimal protein intake (p<0.05). Our study findings indicate that dietary protein as well as EAA intake may be significant contributing factors in muscle hypertrophic response during RT among healthy older men.

Protein Supplementation Does Not Affect Myogenic Adaptations to Resistance Training

It has been proposed that protein supplementation during resistance exercise training enhances muscle hypertrophy. The degree of hypertrophy during training is controlled in part through the activation of satellite cells and myonuclear accretion.

PURPOSE

This study aimed to determine the efficacy of protein supplementation (and the type of protein) during traditional resistance training on myofiber cross-sectional area, satellite cell content, and myonuclear addition.

METHODS

Healthy young men participated in supervised whole-body progressive resistance training 3 d·wk for 12 wk. Participants were randomized to one of three groups ingesting a daily 22-g macronutrient dose of soy-dairy protein blend (PB, n = 22), whey protein isolate (WP, n = 15), or an isocaloric maltodextrin placebo (MDP, n = 17). Lean mass, vastus lateralis myofiber-type-specific cross-sectional area, satellite cell content, and myonuclear addition were assessed before and after resistance training.

RESULTS

PB and the pooled protein treatments (PB + WP = PRO) exhibited a greater whole-body lean mass %change compared with MDP (P = 0.057 for PB) and (P = 0.050 for PRO), respectively. All treatments demonstrated similar leg muscle hypertrophy and vastus lateralis myofiber-type-specific cross-sectional area (P < 0.05). Increases in myosin heavy chain I and II myofiber satellite cell content and myonuclei content were also detected after exercise training (P < 0.05).

CONCLUSION

Protein supplementation during resistance training has a modest effect on whole-body lean mass as compared with exercise training without protein supplementation, and there was no effect on any outcome between protein supplement types (blend vs whey). However, protein supplementation did not enhance resistance exercise-induced increases in myofiber hypertrophy, satellite cell content, or myonuclear addition in young healthy men. We propose that as long as protein intake is adequate during muscle overload, the adaptations in muscle growth and function will not be influenced by protein supplementation.

Co-ingestion of protein or a protein hydrolysate with carbohydrate enhances anabolic signaling, but not glycogen resynthesis, following recovery from prolonged aerobic exercise in trained cyclists

PURPOSE

The effect of carbohydrate (CHO), or CHO supplemented with either sodium caseinate protein (CHO-C) or a sodium caseinate protein hydrolysate (CHO-H) on the recovery of skeletal muscle glycogen and anabolic signaling following prolonged aerobic exercise was determined in trained male cyclists [n = 11, mean ± SEM age 28.8 ± 2.3 years; body mass (BM) 75.0 ± 2.3 kg; VO_2peak 61.3 ± 1.6 ml kg^-1 min^-1].

METHODS

On three separate occasions, participants cycled for 2 h at ~ 70% VO_2peak followed by a 4-h recovery period. Isoenergetic drinks were consumed at + 0 and + 2 h of recovery containing either (1) CHO (1.2 g kg ^-1 BM), (2) CHO-C, or (3) CHO-H (1.04 and 0.16 g kg^-1 BM, respectively) in a randomized, double-blind, cross-over design. Muscle biopsies from the vastus lateralis were taken prior to commencement of each trial, and at + 0 and + 4 h of recovery for determination of skeletal muscle glycogen, and intracellular signaling associated with protein synthesis.

RESULTS

Despite an augmented insulin response following CHO-H ingestion, there was no significant difference in skeletal muscle glycogen resynthesis following recovery between trials. CHO-C and CHO-H co-ingestion significantly increased phospho-mTOR Ser²⁴⁴⁸ and 4EBP1 Thr^37/46 versus CHO, with CHO-H displaying the greatest change in phospho-4EBP1 Thr^37/46. Protein co-ingestion, compared to CHO alone, during recovery did not augment glycogen resynthesis.

CONCLUSION

Supplementing CHO with intact sodium caseinate or an insulinotropic hydrolysate derivative augmented intracellular signaling associated with skeletal muscle protein synthesis following prolonged aerobic exercise.

The short-term effect of high versus moderate protein intake on recovery after strength training in resistance-trained individuals

Background

Dietary protein intakes up to 2.9 g.kg⁻¹.d⁻¹ and protein consumption before and after resistance training may enhance recovery, resulting in hypertrophy and strength gains. However, it remains unclear whether protein quantity or nutrient timing is central to positive adaptations. This study investigated the effect of total dietary protein content, whilst controlling for protein timing, on recovery in resistance trainees.

Methods

Fourteen resistance-trained individuals underwent two 10-day isocaloric dietary regimes with a protein content of 1.8 g.kg⁻¹.d⁻¹ (PRO_MOD) or 2.9 g.kg⁻¹.d⁻¹ (PRO_HIGH) in a randomised, counterbalanced, crossover design. On days 8–10 (T1-T3), participants undertook resistance exercise under controlled conditions, performing 3 sets of squat, bench press and bent-over rows at 80% 1 repetition maximum until volitional exhaustion. Additionally, participants consumed a 0.4 g.kg⁻¹ whey protein concentrate/isolate mix 30 min before and after exercise sessions to standardise protein timing specific to training. Recovery was assessed via daily repetition performance, muscle soreness, bioelectrical impedance phase angle, plasma creatine kinase (CK) and tumor necrosis factor-α (TNF-α).

Results

No significant differences were reported between conditions for any of the performance repetition count variables (p > 0.05). However, within PRO_MOD only, squat performance total repetition count was significantly lower at T3 (19.7 ± 6.8) compared to T1 (23.0 ± 7.5; p = 0.006). Pre and post-exercise CK concentrations significantly increased across test days (p ≤ 0.003), although no differences were reported between conditions. No differences for TNF-α or muscle soreness were reported between dietary conditions. Phase angle was significantly greater at T3 for PRO_HIGH (8.26 ± 0.82°) compared with PRO_MOD (8.08 ± 0.80°; p = 0.012).

Conclusions

When energy intake and peri-exercise protein intake was controlled for, a short term PRO_HIGH diet did not improve markers of muscle damage or soreness in comparison to a PRO_MOD approach following repeated days of intensive training. Whilst it is therefore likely that moderate protein intakes (1.8 g.kg⁻¹.d⁻¹) may be sufficient for resistance-trained individuals, it is noteworthy that both lower body exercise performance and bioelectrical phase angle were maintained with PRO_HIGH. Longer term interventions are warranted to determine whether PRO_MOD intakes are sufficient during prolonged training periods or when extensive exercise (e.g. training twice daily) is undertaken.

International society of sports nutrition position stand: nutrient timing

The International Society of Sports Nutrition (ISSN) provides an objective and critical review regarding the timing of macronutrients in reference to healthy, exercising adults and in particular highly trained individuals on exercise performance and body composition. The following points summarize the position of the ISSN:

Nutrient timing incorporates the use of methodical planning and eating of whole foods, fortified foods and dietary supplements. The timing of energy intake and the ratio of certain ingested macronutrients may enhance recovery and tissue repair, augment muscle protein synthesis (MPS), and improve mood states following high-volume or intense exercise.

Endogenous glycogen stores are maximized by following a high-carbohydrate diet (8–12 g of carbohydrate/kg/day [g/kg/day]); moreover, these stores are depleted most by high volume exercise.

If rapid restoration of glycogen is required (< 4 h of recovery time) then the following strategies should be considered:

aggressive carbohydrate refeeding (1.2 g/kg/h) with a preference towards carbohydrate sources that have a high (> 70) glycemic index

the addition of caffeine (3–8 mg/kg)

combining carbohydrates (0.8 g/kg/h) with protein (0.2–0.4 g/kg/h)

Extended (> 60 min) bouts of high intensity (> 70% VO₂max) exercise challenge fuel supply and fluid regulation, thus carbohydrate should be consumed at a rate of ~30–60 g of carbohydrate/h in a 6–8% carbohydrate-electrolyte solution (6–12 fluid ounces) every 10–15 min throughout the entire exercise bout, particularly in those exercise bouts that span beyond 70 min. When carbohydrate delivery is inadequate, adding protein may help increase performance, ameliorate muscle damage, promote euglycemia and facilitate glycogen re-synthesis.

Carbohydrate ingestion throughout resistance exercise (e.g., 3–6 sets of 8–12 repetition maximum [RM] using multiple exercises targeting all major muscle groups) has been shown to promote euglycemia and higher glycogen stores. Consuming carbohydrate solely or in combination with protein during resistance exercise increases muscle glycogen stores, ameliorates muscle damage, and facilitates greater acute and chronic training adaptations.

Meeting the total daily intake of protein, preferably with evenly spaced protein feedings (approximately every 3 h during the day), should be viewed as a primary area of emphasis for exercising individuals.

Ingestion of essential amino acids (EAA; approximately 10 g)either in free form or as part of a protein bolus of approximately 20–40 g has been shown to maximally stimulate muscle protein synthesis (MPS).

Pre- and/or post-exercise nutritional interventions (carbohydrate + protein or protein alone) may operate as an effective strategy to support increases in strength and improvements in body composition. However, the size and timing of a pre-exercise meal may impact the extent to which post-exercise protein feeding is required.

Post-exercise ingestion (immediately to 2-h post) of high-quality protein sources stimulates robust increases in MPS.

In non-exercising scenarios, changing the frequency of meals has shown limited impact on weight loss and body composition, with stronger evidence to indicate meal frequency can favorably improve appetite and satiety. More research is needed to determine the influence of combining an exercise program with altered meal frequencies on weight loss and body composition with preliminary research indicating a potential benefit.

Ingesting a 20–40 g protein dose (0.25–0.40 g/kg body mass/dose) of a high-quality source every three to 4 h appears to most favorably affect MPS rates when compared to other dietary patterns and is associated with improved body composition and performance outcomes.

Consuming casein protein (~ 30–40 g) prior to sleep can acutely increase MPS and metabolic rate throughout the night without influencing lipolysis.

Does nutrition play a role in the prevention and management of sarcopenia?

There is a growing body of evidence that links nutrition to muscle mass, strength and function in older adults, suggesting that it has an important role to play both in the prevention and management of sarcopenia. This review summarises the discussions of a working group [ESCEO working group meeting 8th September 2016] that met to review current evidence and to consider its implications for preventive and treatment strategies. The review points to the importance of 'healthier' dietary patterns that are adequate in quality in older age, to ensure sufficient intakes of protein, vitamin D, antioxidant nutrients and long-chain polyunsaturated fatty acids. In particular, there is substantial evidence to support the roles of dietary protein and physical activity as key anabolic stimuli for muscle protein synthesis. However, much of the evidence is observational and from high-income countries. Further high-quality trials, particularly from more diverse populations, are needed to enable an understanding of dose and duration effects of individual nutrients on function, to elucidate mechanistic links, and to define optimal profiles and patterns of nutrient intake for older adults.

A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults

OBJECTIVE

We performed a systematic review, meta-analysis and meta-regression to determine if dietary protein supplementation augments resistance exercise training (RET)-induced gains in muscle mass and strength.

DATA SOURCES

A systematic search of Medline, Embase, CINAHL and SportDiscus.

ELIGIBILITY CRITERIA

Only randomised controlled trials with RET ≥6 weeks in duration and dietary protein supplementation.

DESIGN

Random-effects meta-analyses and meta-regressions with four a priori determined covariates. Two-phase break point analysis was used to determine the relationship between total protein intake and changes in fat-free mass (FFM).

RESULTS

Data from 49 studies with 1863 participants showed that dietary protein supplementation significantly (all p<0.05) increased changes (means (95% CI)) in: strength-one-repetition-maximum (2.49 kg (0.64, 4.33)), FFM (0.30 kg (0.09, 0.52)) and muscle size-muscle fibre cross-sectional area (CSA; 310 µm² (51, 570)) and mid-femur CSA (7.2 mm² (0.20, 14.30)) during periods of prolonged RET. The impact of protein supplementation on gains in FFM was reduced with increasing age (-0.01 kg (-0.02,-0.00), p=0.002) and was more effective in resistance-trained individuals (0.75 kg (0.09, 1.40), p=0.03). Protein supplementation beyond total protein intakes of 1.62 g/kg/day resulted in no further RET-induced gains in FFM.

SUMMARY/CONCLUSION

Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults. Increasing age reduces and training experience increases the efficacy of protein supplementation during RET. With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute RET-induced gains in FFM.

Timing and pattern of postexercise protein ingestion affects whole-body protein balance in healthy children: a randomized trial

The dose and timing of postexercise protein ingestion can influence whole-body protein balance (WBPB) in adults, although comparable data from children are scarce. This study investigated how protein intake (both amount and distribution) postexercise can affect WBPB in physically active children. Thirty-five children (26 males; 9-13 years old) underwent a 5-day adaptation diet, maintaining a protein intake of 0.95 g·kg^-1·day^-1. Participants consumed [¹⁵N]glycine (2 mg·kg^-1) before performing 3 × 20 min of variable-intensity cycling, and whole-body protein kinetics were assessed over 6 and 24 h of recovery. Fifteen grams of protein was distributed across 2 isoenergetic carbohydrate-containing beverages (15 and 240 min postexercise) containing reciprocal amounts of protein (i.e., 0 + 15 g, 5 + 10 g, 10 + 5 g, and 15 + 0 g for Groups A-D, respectively). Over the 6 h that included the exercise bout and consumption of the first beverage at 15 min postexercise, WBPB (i.e., synthesis - breakdown) demonstrated a linear increase of 0.647 g·kg^-1·day^-1 per 1 g protein intake (P < 0.001). Over 24 h, robust regression revealed that WBPB was best modeled by a parabola (P < 0.05), suggesting that a maximum in WBPB was achieved between groups B and C. In conclusion, despite a dose response early in recovery, a periodized protein intake with multiple smaller doses after physical activity may be more beneficial than a single bolus dose in promoting daily WBPB in healthy active children.

International Society of Sports Nutrition Position Stand: protein and exercise

The International Society of Sports Nutrition (ISSN) provides an objective and critical review related to the intake of protein for healthy, exercising individuals. Based on the current available literature, the position of the Society is as follows:An acute exercise stimulus, particularly resistance exercise, and protein ingestion both stimulate muscle protein synthesis (MPS) and are synergistic when protein consumption occurs before or after resistance exercise.For building muscle mass and for maintaining muscle mass through a positive muscle protein balance, an overall daily protein intake in the range of 1.4-2.0 g protein/kg body weight/day (g/kg/d) is sufficient for most exercising individuals, a value that falls in line within the Acceptable Macronutrient Distribution Range published by the Institute of Medicine for protein.Higher protein intakes (2.3-3.1 g/kg/d) may be needed to maximize the retention of lean body mass in resistance-trained subjects during hypocaloric periods.There is novel evidence that suggests higher protein intakes (>3.0 g/kg/d) may have positive effects on body composition in resistance-trained individuals (i.e., promote loss of fat mass).Recommendations regarding the optimal protein intake per serving for athletes to maximize MPS are mixed and are dependent upon age and recent resistance exercise stimuli. General recommendations are 0.25 g of a high-quality protein per kg of body weight, or an absolute dose of 20-40 g.Acute protein doses should strive to contain 700-3000 mg of leucine and/or a higher relative leucine content, in addition to a balanced array of the essential amino acids (EAAs).These protein doses should ideally be evenly distributed, every 3-4 h, across the day.The optimal time period during which to ingest protein is likely a matter of individual tolerance, since benefits are derived from pre- or post-workout ingestion; however, the anabolic effect of exercise is long-lasting (at least 24 h), but likely diminishes with increasing time post-exercise.While it is possible for physically active individuals to obtain their daily protein requirements through the consumption of whole foods, supplementation is a practical way of ensuring intake of adequate protein quality and quantity, while minimizing caloric intake, particularly for athletes who typically complete high volumes of training. Rapidly digested proteins that contain high proportions of essential amino acids (EAAs) and adequate leucine, are most effective in stimulating MPS. Different types and quality of protein can affect amino acid bioavailability following protein supplementation. Athletes should consider focusing on whole food sources of protein that contain all of the EAAs (i.e., it is the EAAs that are required to stimulate MPS). Endurance athletes should focus on achieving adequate carbohydrate intake to promote optimal performance; the addition of protein may help to offset muscle damage and promote recovery. Pre-sleep casein protein intake (30-40 g) provides increases in overnight MPS and metabolic rate without influencing lipolysis.

Acute and Long-Term Impact of High-Protein Diets on Endocrine and Metabolic Function, Body Composition, and Exercise-Induced Adaptations

BACKGROUND

High-protein diets have been shown to improve body composition through alterations in satiety, muscle protein synthesis, and the thermic effect of food.

AIM

Given these findings, the purpose of this review is to discuss the integration of the specific hormonal and metabolic effects of high-protein diets following both acute and long-term usage, especially with regard to body composition.

METHODS

Full-text articles were obtained through PubMed by using the terms "high-protein diet and body composition," "high-protein diet and exercise," "high-protein diet risk," "high-protein diet side effects," "protein quality PDCAAS," "RDA for protein," and "daily protein recommendation." Articles were initially screened according to their title and abstract; careful evaluation of the full manuscripts was then used to identify relevant articles.

RESULTS

The higher satiety exerted by high-protein diets is generated through increments in anorexigenic, as well as decrements in orexigenic hormones. Improvements in muscle mass are achieved by activation of muscle protein synthesis acting through the mTOR pathway. High thermic effect of food is caused due to necessary deamination, gluconeogenesis, and urea synthesis caused by high-protein diets. Interestingly, high-protein diets in both hypo- and normocaloric conditions have shown to improve body composition, whereas in combination with hypercaloric conditions does not seem to increase fat mass, when the excess energy comes from protein.

CONCLUSIONS

High protein diets effectively improve body composition by acting through different pathways.

Pre- versus post-exercise protein intake has similar effects on muscular adaptations

The purpose of this study was to test the anabolic window theory by investigating muscle strength, hypertrophy, and body composition changes in response to an equal dose of protein consumed either immediately pre- versus post-resistance training (RT) in trained men. Subjects were 21 resistance-trained men (>1 year RT experience) recruited from a university population. After baseline testing, participants were randomly assigned to 1 of 2 experimental groups: a group that consumed a supplement containing 25 g protein and 1 g carbohydrate immediately prior to exercise (PRE-SUPP) (n = 9) or a group that consumed the same supplement immediately post-exercise (POST-SUPP) (n = 12). The RT protocol consisted of three weekly sessions performed on non-consecutive days for 10 weeks. A total-body routine was employed with three sets of 8–12 repetitions for each exercise. Results showed that pre- and post-workout protein consumption had similar effects on all measures studied (p > 0.05). These findings refute the contention of a narrow post-exercise anabolic window to maximize the muscular response and instead lends support to the theory that the interval for protein intake may be as wide as several hours or perhaps more after a training bout depending on when the pre-workout meal was consumed.

Timing, Optimal Dose and Intake Duration of Dietary Supplements with Evidence-Based Use in Sports Nutrition

[Purpose]

The aim of the present narrative review was to consider the evidence on the timing, optimal dose and intake duration of the main dietary supplements in sports nutrition, i.e. β-alanine, nitrate, caffeine, creatine, sodium bicarbonate, carbohydrate and protein.

[Methods]

This review article focuses on timing, optimal dose and intake duration of main dietary supplements in sports nutrition.

[Results]

This paper reviewed the evidence to determine the optimal time, efficacy doses and intake duration for sports supplements verified by scientific evidence that report a performance enhancing effect in both situation of laboratory and training settings.

[Conclusion]

Consumption of the supplements are usually suggested into 5 specific times, such as pre-exercise (nitrate, caffeine, sodium bicarbonate, carbohydrate and protein), during exercise (carbohydrate), post-exercise (creatine, carbohydrate, protein), meal time (β-alanine, creatine, sodium bicarbonate, nitrate, carbohydrate and protein), and before sleep (protein). In addition, the recommended dosing protocol for the supplements nitrate and β-alanine are fixed amounts irrespective of body weight, while dosing protocol for sodium bicarbonate, caffeine and creatine supplements are related to corrected body weight (mg/kg bw). Also, intake duration is suggested for creatine and β-alanine, being effective in chronic daily time < 2 weeks while caffeine, sodium bicarbonate are effective in acute daily time (1-3 hours). Plus, ingestion of nitrate supplement is required in both chronic daily time < 28 days and acute daily time (2- 2.5 h) prior exercise.

Pre-Sleep Protein Ingestion to Improve the Skeletal Muscle Adaptive Response to Exercise Training

Protein ingestion following resistance-type exercise stimulates muscle protein synthesis rates, and enhances the skeletal muscle adaptive response to prolonged resistance-type exercise training. As the adaptive response to a single bout of resistance exercise extends well beyond the first couple of hours of post-exercise recovery, recent studies have begun to investigate the impact of the timing and distribution of protein ingestion during more prolonged recovery periods. Recent work has shown that overnight muscle protein synthesis rates are restricted by the level of amino acid availability. Protein ingested prior to sleep is effectively digested and absorbed, and thereby stimulates muscle protein synthesis rates during overnight recovery. When applied during a prolonged period of resistance-type exercise training, protein supplementation prior to sleep can further augment gains in muscle mass and strength. Recent studies investigating the impact of pre-sleep protein ingestion suggest that at least 40 g of protein is required to display a robust increase in muscle protein synthesis rates throughout overnight sleep. Furthermore, prior exercise allows more of the pre-sleep protein-derived amino acids to be utilized for de novo muscle protein synthesis during sleep. In short, pre-sleep protein ingestion represents an effective dietary strategy to improve overnight muscle protein synthesis, thereby improving the skeletal muscle adaptive response to exercise training.

Evidence inconclusive - comment on article by Schoenfeld et al

This article comments on the study by Schoenfeld, et al. entitled “The effect of protein timing on muscle strength and hypertrophy: a meta-analysis” and discusses how the methodology led to inconclusive results.

The Effect of a Moderately Low and High Carbohydrate Intake on Crossfit Performance

CrossFit is a metabolically demanding strength and conditioning method which performance may benefit from a carbohydrate (CHO)-rich diet. This study investigated the effect of three consecutive days of high CHO intake on CrossFit performance and corresponding metabolically -related variables in strength trained individuals. Eighteen subjects with a CHO intake of <6 g/kg/day were randomly assigned into a CHO (n = 9) or control (C) group (n =9) and underwent a 9-day training protocol. During days 1, 5, and 9, performance was measured as repetitions completed during a 12 minute CrossFit workout. Oxygen consumption (VO₂), respiratory exchange ratio (RER), and blood lactate (BL) were also measured. Days 6-8, the CHO group increased CHO intake from <6 g/kg/day to 6-8 g/kg/day; the C group maintained their current intake of <6 g/kg/day. On days 6 and 7 both groups performed CrossFit workouts followed by a day of rest prior to day 9. There was a significant increase in repetitions completed in both groups in day 9 (vs. means score of day 1 + 5) (p = 0.002), but no differences between C and CHO groups (p = 0.111). However, the CHO group displayed a 15.2 repetition increase (+10.9%) in day 9, compared to 5.7 (+4.2%) by the C group. VO₂, RER, and BL were not influenced by the experimental intervention. Our results suggest that the CrossFit-embraced practice of moderately-low CHO diets may be adequate in CHO during short periods of training, however, given the noted trend, extended training periods may be effected.

The impact of protein quality on the promotion of resistance exercise-induced changes in muscle mass

Protein supplementation during resistance exercise training augments hypertrophic gains. Protein ingestion and the resultant hyperaminoacidemia provides the building blocks (indispensable amino acids - IAA) for, and also triggers an increase in, muscle protein synthesis (MPS), suppression of muscle protein breakdown (MPB), and net positive protein balance (i.e., MPS > MPB). The key amino acid triggering the rise in MPS is leucine, which stimulates the mechanistic target of rapamycin complex-1, a key signalling protein, and triggers a rise in MPS. As such, ingested proteins with a high leucine content would be advantageous in triggering a rise in MPS. Thus, protein quality (reflected in IAA content and protein digestibility) has an impact on changes in MPS and could ultimately affect skeletal muscle mass. Protein quality has been measured by the protein digestibility-corrected amino acid score (PDCAAS); however, the digestible indispensable amino acid score (DIAAS) has been recommended as a better method for protein quality scoring. Under DIAAS there is the recognition that amino acids are individual nutrients and that protein quality is contingent on IAA content and ileal (as opposed to fecal) digestibility. Differences in protein quality may have important ramifications for exercise-induced changes in muscle mass gains made with resistance exercise as well as muscle remodelling. Thus, the purpose of this review is a critical appraisal of studies examining the effects of protein quality in supplementation on changes in muscle mass and strength as well as body composition during resistance training.

Effects of Whey Protein Alone or as Part of a Multi-ingredient Formulation on Strength, Fat-Free Mass, or Lean Body Mass in Resistance-Trained Individuals: A Meta-analysis

BACKGROUND

Even though the positive effects of whey protein-containing supplements for optimizing the anabolic responses and adaptations process in resistance-trained individuals have been supported by several investigations, their use continues to be controversial. Additionally, the administration of different multi-ingredient formulations where whey proteins are combined with carbohydrates, other protein sources, creatine, and amino acids or derivatives, has been extensively proposed as an effective strategy to maximize strength and muscle mass gains in athletes.

OBJECTIVE

We aimed to systematically summarize and quantify whether whey protein-containing supplements, administered alone or as a part of a multi-ingredient, could improve the effects of resistance training on fat-free mass or lean body mass, and strength in resistance-trained individuals when compared with other iso-energetic supplements containing carbohydrates or other sources of proteins.

METHODS

A structured literature search was conducted on PubMed, Science Direct, Web of Science, Cochrane Libraries, US National Institutes of Health clinicaltrials.gov, SPORTDiscus, and Google Scholar databases. Main inclusion criteria comprised randomized controlled trial study design, adults (aged 18 years and over), resistance-trained individuals, interventions (a resistance training program for a period of 6 weeks or longer, combined with whey protein supplementation administered alone or as a part of a multi-ingredient), and a calorie equivalent contrast supplement from carbohydrates or other non-whey protein sources. Continuous data on fat-free mass and lean body mass, and maximal strength were pooled using a random-effects model.

RESULTS

Data from nine randomized controlled trials were included, involving 11 treatments and 192 participants. Overall, with respect to the ingestion of contrast supplements, whey protein supplementation, administered alone or as part of a multi-ingredient, in combination with resistance training, was associated with small extra gains in fat-free mass or lean body mass, resulting in an effect size of g = 0.301, 95% confidence interval (CI) 0.032-0.571. Subgroup analyses showed less clear positive trends resulting in small to moderate effect size g = 0.217 (95% CI -0.113 to 0.547) and g = 0.468 (95% CI 0.003-0.934) in favor of whey and multi-ingredient, respectively. Additionally, a positive overall extra effect was also observed to maximize lower (g = 0.316, 95% CI 0.045-0.588) and upper body maximal strength (g = 0.458, 95% CI 0.161-0.755). Subgroup analyses showed smaller superiority to maximize strength gains with respect to the contrast groups for lower body (whey protein: g = 0.343, 95% CI -0.016 to 0.702, multi-ingredient: g = 0.281, 95% CI -0.135 to 0.697) while in the upper body, multi-ingredient (g = 0.612, 95% CI 0.157-1.068) seemed to produce more clear effects than whey protein alone (g = 0.343, 95% CI -0.048 to 0.735).

LIMITATIONS

Studies involving interventions of more than 6 weeks on resistance-training individuals are scarce and account for a small number of participants. Furthermore, no studies with an intervention longer than 12 weeks have been found. The variation regarding the supplementation protocol, namely the different doses criteria or timing of ingestion also add some concerns to the studies comparison.

CONCLUSIONS

Whey protein alone or as a part of a multi-ingredient appears to maximize lean body mass or fat-free mass gain, as well as upper and lower body strength improvement with respect to the ingestion of an iso-energetic equivalent carbohydrate or non-whey protein supplement in resistance-training individuals. This enhancement effect seems to be more evident when whey proteins are consumed within a multi-ingredient containing creatine.

Protein Supplementation Has Minimal Effects on Muscle Adaptations during Resistance Exercise Training in Young Men: A Double-Blind Randomized Clinical Trial

BACKGROUND

To our knowledge the efficacy of soy-dairy protein blend (PB) supplementation with resistance exercise training (RET) has not been evaluated in a longitudinal study.

OBJECTIVE

Our aim was to determine the effect of PB supplementation during RET on muscle adaptation.

METHODS

In this double-blind randomized clinical trial, healthy young men [18-30 y; BMI (in kg/m(2)): 25 ± 0.5] participated in supervised whole-body RET at 60-80% 1-repetition maximum (1-RM) for 3 d/wk for 12 wk with random assignment to daily receive 22 g PB (n = 23), whey protein (WP) isolate (n = 22), or an isocaloric maltodextrin (carbohydrate) placebo [(MDP) n = 23]. Serum testosterone, muscle strength, thigh muscle thickness (MT), myofiber cross-sectional area (mCSA), and lean body mass (LBM) were assessed before and after 6 and 12 wk of RET.

RESULTS

All treatments increased LBM (P < 0.001). ANCOVA did not identify an overall treatment effect at 12 wk (P = 0.11). There tended to be a greater change in LBM from baseline to 12 wk in the PB group than in the MDP group (0.92 kg; 95% CI: -0.12, 1.95 kg; P = 0.09); however, changes in the WP and MDP groups did not differ. Pooling data from combined PB and WP treatments showed a trend for greater change in LBM from baseline to 12 wk compared with MDP treatment (0.69 kg; 95% CI: -0.08, 1.46 kg; P = 0.08). Muscle strength, mCSA, and MT increased (P < 0.05) similarly for all treatments and were not different (P > 0.10) between treatments. Testosterone was not altered.

CONCLUSIONS

PB supplementation during 3 mo of RET tended to slightly enhance gains in whole-body and arm LBM, but not leg muscle mass, compared with RET without protein supplementation. Although protein supplementation minimally enhanced gains in LBM of healthy young men, there was no enhancement of gains in strength. This trial was registered at clinicaltrials.gov as NCT01749189.

Muscles provide protection during microbial infection by activating innate immune response pathways in Drosophila and zebrafish

Muscle contraction brings about movement and locomotion in animals. However, muscles have also been implicated in several atypical physiological processes including immune response. The role of muscles in immunity and the mechanism involved has not yet been deciphered. In this paper, using Drosophila indirect flight muscles (IFMs) as a model, we show that muscles are immune-responsive tissues. Flies with defective IFMs are incapable of mounting a potent humoral immune response. Upon immune challenge, the IFMs produce anti-microbial peptides (AMPs) through the activation of canonical signaling pathways, and these IFM-synthesized AMPs are essential for survival upon infection. The trunk muscles of zebrafish, a vertebrate model system, also possess the capacity to mount an immune response against bacterial infections, thus establishing that immune responsiveness of muscles is evolutionarily conserved. Our results suggest that physiologically fit muscles might boost the innate immune response of an individual.

Summary: Using fruit fly and zebrafish models, we show that skeletal muscles are immune responsive tissues; they mount innate immune responses during bacterial infection – an evolutionarily conserved defense mechanism.

Role of Ingested Amino Acids and Protein in the Promotion of Resistance Exercise-Induced Muscle Protein Anabolism

The goal of this critical review is to comprehensively assess the evidence for the molecular, physiologic, and phenotypic skeletal muscle responses to resistance exercise (RE) combined with the nutritional intervention of protein and/or amino acid (AA) ingestion in young adults. We gathered the literature regarding the translational response in human skeletal muscle to acute exposure to RE and protein/AA supplements and the literature describing the phenotypic skeletal muscle adaptation to RE and nutritional interventions. Supplementation of protein/AAs with RE exhibited clear protein dose-dependent effects on translational regulation (protein synthesis) through mammalian target of rapamycin complex 1 (mTORC1) signaling, which was most apparent through increases in p70 ribosomal protein S6 kinase 1 (S6K1) phosphorylation, compared with postexercise recovery in the fasted or carbohydrate-fed state. These acute findings were critically tested via long-term exposure to RE training (RET) and protein/AA supplementation, and it was determined that a diminishing protein/AA supplement effect occurs over a prolonged exposure stimulus after exercise training. Furthermore, we found that protein/AA supplements, combined with RET, produced a positive, albeit minor, effect on the promotion of lean mass growth (when assessed in >20 participants/treatment); a negligible effect on muscle mass; and a negligible to no additional effect on strength. A potential concern we discovered was that the majority of the exercise training studies were underpowered in their ability to discern effects of protein/AA supplementation. Regardless, even when using optimal methodology and large sample sizes, it is clear that the effect size for protein/AA supplementation is low and likely limited to a subset of individuals because the individual variability is high. With regard to nutritional intakes, total protein intake per day, rather than protein timing or quality, appears to be more of a factor on this effect during long-term exercise interventions. There were no differences in strength or mass/muscle mass on RET outcomes between protein types when a leucine threshold (>2 g/dose) was reached. Future research with larger sample sizes and more homogeneity in design is necessary to understand the underlying adaptations and to better evaluate the individual variability in the muscle-adaptive response to protein/AA supplementation during RET.