Skeletal muscle responses to negative energy balance: effects of dietary protein

Physiological and psychological effects of testosterone during severe energy deficit and recovery: A study protocol for a randomized, placebo-controlled trial for Optimizing Performance for Soldiers (OPS)

BACKGROUND

The physiological consequences of severe energy deficit include hypogonadism and the loss of fat-free mass. Prolonged energy deficit also impacts physical performance, mood, attentiveness, and decision-making capabilities. This study will determine whether maintaining a eugonadal state during severe, sustained energy deficit attenuates physiological decrements and maintains mental performance. This study will also assess the effects of normalizing testosterone levels during severe energy deficit and recovery on gut health and appetite regulation.

METHODS

Fifty physically active men will participate in a 3-phase, randomized, placebo-controlled study. After completing a 14-d, energy-adequate, diet acclimation phase (protein: 1.6g∙kg^-1∙d^-1; fat: 30% total energy intake), participants will be randomized to undergo a 28-d, 55% energy deficit phase with (DEF+TEST: 200mg testosterone enanthate per week) or without (DEF) exogenous testosterone. Diet and physical activity will be rigorously controlled. Recovery from the energy deficit (ad libitum diet, no testosterone) will be assessed until body mass has been recovered within ±2.5% of initial body mass. Body composition, stable isotope methodologies, proteomics, muscle biopsies, whole-room calorimetry, molecular biology, activity/sleep monitoring, personality and cognitive function assessments, functional MRI, and comprehensive biochemistries will be used to assess physiological and psychological responses to energy restriction and recovery feeding while volunteers are in an expected hypogonadal versus eugonadal state.

DISCUSSION

The Optimizing Performance for Soldiers (OPS) study aims to determine whether preventing hypogonadism will mitigate declines in physical and mental function that typically occur during prolonged energy deficit, and the efficacy of testosterone replacement on recovery from severe underfeeding.

TRIAL REGISTRATION

NCT02734238.

Supplementing an energy adequate, higher protein diet with protein does not enhance fat-free mass restoration after short-term severe negative energy balance

Negative energy balance during military operations can be severe and result in significant reductions in fat-free mass (FFM). Consuming supplemental high-quality protein following such military operations may accelerate restoration of FFM. Body composition (dual-energy X-ray absorptiometry) and whole body protein turnover (single-pool [¹⁵N]alanine method) were determined before (PRE) and after 7 days (POST) of severe negative energy balance during military training in 63 male US Marines (means ± SD, 25 ± 3 yr, 84 ± 9 kg). After POST measures were collected, volunteers were randomized to receive higher protein (HIGH: 1,103 kcal/day, 133 g protein/day), moderate protein (MOD: 974 kcal/day, 84 g protein/day), or carbohydrate-based low protein control (CON: 1,042 kcal/day, 7 g protein/day) supplements, in addition to a self-selected, ad libitum diet, for the 27-day intervention (REFED). Measurements were repeated POST-REFED. POST total body mass (TBM; -5.8 ± 1.0 kg, -7.0%), FFM (-3.1 ± 1.6 kg, -4.7%), and net protein balance (-1.7 ± 1.1 g protein·kg^-1·day^-1) were lower and proteolysis (1.1 ± 1.9 g protein·kg^-1·day^-1) was higher compared with PRE (P < 0.05). Self-selected, ad libitum dietary intake during REFED was similar between groups (3,507 ± 730 kcal/day, 2.0 ± 0.5 g protein·kg^-1·day^-1). However, diets differed by protein intake due to supplementation (CON: 2.0 ± 0.4, MOD: 3.2 ± 0.7, and HIGH: 3.5 ± 0.7 g·kg^-1·day^-1; P < 0.05) but not total energy (4,498 ± 725 kcal/day). All volunteers, independent of group assignment, achieved positive net protein balance (0.4 ± 1.0 g protein·kg^-1·day^-1) and gained TBM (5.9 ± 1.7 kg, 7.8%) and FFM (3.6 ± 1.8 kg, 5.7%) POST-REFED compared with POST (P < 0.05). Supplementing ad libitum, energy-adequate, higher protein diets with additional protein may not be necessary to restore FFM after short-term severe negative energy balance.NEW & NOTEWORTHY This article demonstrates 1) the majority of physiological decrements incurred during military training (e.g., total and fat-free mass loss), with the exception of net protein balance, resolve and return to pretraining values after 27 days and 2) protein supplementation, in addition to an ad libitum, higher protein (~2.0 g·kg^-1·day^-1), energy adequate diet, is not necessary to restore fat-free mass following short-term severe negative energy balance.

Transcriptional response of skeletal muscle to a low protein perinatal diet in rat offspring at different ages: The role of key enzymes of glucose-fatty acid oxidation

Skeletal muscle is a plastic tissue during development with distinctive acute and chronic response to maternal protein restriction. This study evaluated gene and protein expression of key-enzymes of glycolytic pathway (HK2, PFK, PDK4 and CS), and fatty acid oxidation (CPT1 and β-HAD) of two different types of skeletal muscle [soleus and extensor digitorium longus (EDL)] from offspring rats at 30 and 90 days of age, exposed to maternal isoenergetic low protein diet throughout gestation and lactation. Pups from dams fed 17% protein diet (n=5, normal protein, Np), and low protein pups from dams fed 8% casein diet (low protein, Lp, n=5) were evaluated. Offspring were sacrificed either 30 or 90 days old. Soleus and EDL were analyzed for mRNA and protein expression by quantitative PCR and western blotting, respectively. Soleus was more affected by Lp maternal diet at 90 days by down-regulation of key enzymes of glycolytic pathway, in particular HK2 and PDK4 with a concomitant reduction of β-HAD mRNA. For EDL, the effects of Lp maternal diet were more pronounced at 30 days, as the transcriptional key enzymes of glycolytic pathway were down-regulated. One important finding was that the observed acute (30 days) transcriptional changes did not remain in adult Lp rats (90 days), except for PDK4. The robust PDK4 mRNA down-regulation, observed in both soleus and EDL, and at both ages, and the consequent down-regulation of the PDK4 protein expression can be responsible for a state of reduced metabolic flexibility of skeletal muscle in response to maternal low protein diet.

Effect on Nitrogen Balance, Thermogenesis, Body Composition, Satiety, and Circulating Branched Chain Amino Acid Levels up to One Year after Surgery: Protocol of a Randomized Controlled Trial on Dietary Protein During Surgical Weight Loss

Background

Bariatric surgery (BS), the most effective treatment for severe obesity, typically results in 40-50 kg weight loss in the year following the surgery. Beyond its action on protein metabolism, dietary protein intake (PI) affects satiety, thermogenesis, energy efficiency, and body composition (BC). However, the required amount of PI after surgical weight loss is not known. The current daily PI recommendation for diet-induced weight loss is 0.8 g/kg ideal body weight (IBW) per day, but whether this amount is sufficient to preserve fat-free mass during active surgical weight loss is unknown.

Objective

To evaluate the effect of a 3-month dietary protein supplementation (PS) on nitrogen balance (NB), BC, energy expenditure, and satiety in women undergoing either gastric bypass or vertical sleeve gastrectomy.

Methods

In this randomized prospective study, participants will be randomized to a high protein supplementation group (1.2 g/kg IBW per day) or standard protein supplementation group (0.8 g/kg IBW per day) based on current guidelines. Outcome measures including NB, BC, circulating branched chain amino acids, and satiety, which will be assessed presurgery, and at 3-months and 12-months postsurgery.

Results

To date, no studies have examined the effect of dietary PS after BS. Current guidelines for PI after surgery are based on weak evidence.

Conclusions

The results of this study will contribute to the development of evidence-based data regarding the safe and optimal dietary PI and supplementation after BS.

Trial Registration

Clinicaltrials.gov NCT02269410; http://clinicaltrials.gov/ct2/show/NCT02269410 (Archived by WebCite at http://www.webcitation.org/6m2f2QLeg).

Dietary protein supplementation in the elderly for limiting muscle mass loss

Supplementation with whey and other dietary protein, mainly associated with exercise training, has been proposed to be beneficial for the elderly to gain and maintain lean body mass and improve health parameters. The main objective of this review is to examine the evidence provided by the scientific literature indicating benefit from such supplementation and to define the likely best strategy of protein uptake for optimal objectified results in the elderly. Overall, it appears that an intake of approximately 0.4 g protein/kg BW per meal thus representing 1.2-1.6 g protein/kg BW/day may be recommended taking into account potential anabolic resistance. The losses of the skeletal muscle mass contribute to lower the capacity to perform activities in daily living, emphasizing that an optimal protein consumption may represent an important parameter to preserve independence and contribute to health status. However, it is worth noting that the maximal intake of protein with no adverse effect is not known, and that high levels of protein intake is associated with increased transfer of protein to the colon with potential deleterious effects. Thus, it is important to examine in each individual case the benefit that can be expected from supplementation with whey protein, taking into account the usual protein dietary intake.

n-3 Fatty acids preserve muscle mass and insulin sensitivity in a rat model of energy restriction

In obese subjects, the loss of fat mass during energy restriction is often accompanied by a loss of muscle mass. The hypothesis thatn-3 PUFA, which modulate protein homoeostasis via effects on insulin sensitivity, could contribute to maintain muscle mass during energy restriction was tested in rats fed a high-fat diet (4 weeks) rich in 18 : 1n-9 (oleic acid, OLE-R), 18 : 3n-3 (α-linolenic acid, ALA-R) orn-3 long-chain (LC-R) fatty acid and then energy restricted (8 weeks). A control group (OLE-ad libitum(AL)) was maintained with AL diet throughout the study. Rats were killed 10 min after an i.v. insulin injection. All energy-restricted rats lost weight and fat mass, but only the OLE-R group showed a significant muscle loss. TheGastrocnemiusmuscle was enriched with ALA in the ALA-R group and with LC-PUFA in the ALA-R and LC-R groups. The proteolytic ubiquitin–proteasome system was differentially affected by energy restriction, with MAFbx and muscle ring finger-1 mRNA levels being decreased in the LC-R group (−30 and −20 %, respectively). RAC-αserine/threonine-protein kinase and insulin receptor substrate 1 phosphorylation levels increased in the LC-R group (+70 %), together with insulin receptor mRNA (+50 %). The ALA-R group showed the same overall activation pattern as the LC-R group, although to a lesser extent. In conclusion, dietaryn-3 PUFA prevent the loss of muscle mass associated with energy restriction, probably by an improvement in the insulin-signalling pathway activation, in relation to enrichment of plasma membranes inn-3 LC-PUFA.

Weight Management for Athletes and Active Individuals: A Brief Review

Weight management for athletes and active individuals is unique because of their high daily energy expenditure; thus, the emphasis is usually placed on changing the diet side of the energy balance equation. When dieting for weight loss, active individuals also want to preserve lean tissue, which means that energy restriction cannot be too severe or lean tissue is lost. First, this brief review addresses the issues of weight management in athletes and active individuals and factors to consider when determining a weight-loss goal. Second, the concept of dynamic energy balance is reviewed, including two mathematical models developed to improve weight-loss predictions based on changes in diet and exercise. These models are now available on the Internet. Finally, dietary strategies for weight loss/maintenance that can be successfully used with active individuals are given. Emphasis is placed on teaching the benefits of consuming a low-ED diet (e.g., high-fiber, high-water, low-fat foods), which allows for the consumption of a greater volume of food to increase satiety while reducing energy intake. Health professionals and sport dietitians need to understand dynamic energy balance and be prepared with effective and evidence-based dietary approaches to help athletes and active individuals achieve their body-weight goals.

Dietary protein intake is associated with better physical function and muscle strength among elderly women

Dietary protein intake might be beneficial to physical function (PF) in the elderly. We examined the cross-sectional and prospective associations of protein intake of g/kg body weight (BW), fat mass (FM) and lean mass (LM) with PF in 554 women aged 65·3-71·6 years belonging to the Osteoporosis Risk Factor and Prevention Fracture Prevention Study. Participants filled a questionnaire on lifestyle factors and 3-d food record in 2002. Body composition was measured by dual-energy X-ray absorptiometry, and PF measures were performed at baseline and at 3-year follow-up. Sarcopaenia was defined using European Working Group on Sarcopenia in Older People criteria. At the baseline, women with higher protein intake (≥ 1·2 g/kg BW) had better performance in hand-grip strength/body mass (GS/BM) (P=0·001), knee extension/BM (P=0·003), one-leg stance (P=0·047), chair rise (P=0·043), squat (P=0·019), squat to the ground (P=0·001), faster walking speed for 10 m (P=0·005) and higher short physical performance battery score (P=0·004) compared with those with moderate and lower intakes (0·81-1·19 and ≤ 0·8 g/kg BW, respectively). In follow-up results, higher protein intake was associated with less decline in GS/BM, one-leg stance and tandem walk for 6 m over 3 years. Overall, results were no longer significant after controlling for FM. Associations were detected between protein intake and PF in non-sarcopaenic women but not in sarcopaenic women, except for change of GS (P=0·037). Further, FM but not LM was negatively associated with PF measures (P<0·050). This study suggests that higher protein intake and lower FM might be positively associated with PF in elderly women.

Nutritional considerations during prolonged exposure to a confined, hyperbaric, hyperoxic environment: recommendations for saturation divers

Saturation diving is an occupation that involves prolonged exposure to a confined, hyperoxic, hyperbaric environment. The unique and extreme environment is thought to result in disruption to physiological and metabolic homeostasis, which may impact human health and performance. Appropriate nutritional intake has the potential to alleviate and/or support many of these physiological and metabolic concerns, whilst enhancing health and performance in saturation divers. Therefore, the purpose of this review is to identify the physiological and practical challenges of saturation diving and consequently provide evidence-based nutritional recommendations for saturation divers to promote health and performance within this challenging environment. Saturation diving has a high-energy demand, with an energy intake of between 44 and 52 kcal/kg body mass per day recommended, dependent on intensity and duration of underwater activity. The macronutrient composition of dietary intake is in accordance with the current Institute of Medicine guidelines at 45-65 % and 20-35 % of total energy intake for carbohydrate and fat intake, respectively. A minimum daily protein intake of 1.3 g/kg body mass is recommended to facilitate body composition maintenance. Macronutrient intake between individuals should, however, be dictated by personal preference to support the attainment of an energy balance. A varied diet high in fruit and vegetables is highly recommended for the provision of sufficient micronutrients to support physiological processes, such as vitamin B12 and folate intake to facilitate red blood cell production. Antioxidants, such as vitamin C and E, are also recommended to reduce oxidised molecules, e.g. free radicals, whilst selenium and zinc intake may be beneficial to reinforce endogenous antioxidant reserves. In addition, tailored hydration and carbohydrate fueling strategies for underwater work are also advised.

Metabolic advantages of higher protein diets and benefits of dairy foods on weight management, glycemic regulation, and bone

The Inst. of Medicine and World Health Organization have determined that 0.8 to 0.83 g protein·kg(-1) ·d(-1) is the quantity of protein required to establish nitrogen balance in nearly all healthy individuals. However, consuming higher protein diets may be metabolically advantageous, particularly for overweight and obese adults attempting weight loss, and for physically active individuals such as athletes and military personnel. Studies have demonstrated that higher protein diets may spare lean body mass during weight loss, promote weight management, enhance glycemic regulation, and increase intestinal calcium absorption, which may result in long-term improvements in bone health. The extent to which higher protein diets are beneficial is largely attributed to the digestive and absorptive properties, and also to the essential amino acid (EAA) content of the protein. Proteins that are rapidly digested and absorbed likely contribute to the metabolic advantages conferred by consuming higher protein diets. The EAA profiles, as well as the digestive and absorptive properties of dairy proteins, such as whey protein and casein, are particularly advantageous because they facilitate a rapid, robust, and sustained delivery of EAAs to the periphery. This article reviews the scientific literature assessing metabolic advantages associated with higher protein diets on weight management, glycemic regulation, and bone, with emphasis given to studies evaluating the potential benefits associated with dairy.

The effects of protein supplements on muscle mass, strength, and aerobic and anaerobic power in healthy adults: a systematic review

BACKGROUND

Protein supplements are frequently consumed by athletes and recreationally active adults to achieve greater gains in muscle mass and strength and improve physical performance.

OBJECTIVE

This review provides a systematic and comprehensive analysis of the literature that tested the hypothesis that protein supplements accelerate gains in muscle mass and strength resulting in improvements in aerobic and anaerobic power. Evidence statements were created based on an accepted strength of recommendation taxonomy.

DATA SOURCES

English language articles were searched through PubMed and Google Scholar using protein and supplements together with performance, exercise, strength, and muscle, alone or in combination as keywords. Additional articles were retrieved from reference lists found in these papers.

STUDY SELECTION

Studies recruiting healthy adults between 18 and 50 years of age that evaluated the effects of protein supplements alone or in combination with carbohydrate on a performance metric (e.g., one repetition maximum or isometric or isokinetic muscle strength), metrics of body composition, or measures of aerobic or anaerobic power were included in this review. The literature search identified 32 articles which incorporated test metrics that dealt exclusively with changes in muscle mass and strength, 5 articles that implemented combined resistance and aerobic training or followed participants during their normal sport training programs, and 1 article that evaluated changes in muscle oxidative enzymes and maximal aerobic power.

STUDY APPRAISAL AND SYNTHESIS METHODS

All papers were read in detail, and examined for experimental design confounders such as dietary monitoring, history of physical training (i.e., trained and untrained), and the number of participants studied. Studies were also evaluated based on the intensity, frequency, and duration of training, the type and timing of protein supplementation, and the sensitivity of the test metrics.

RESULTS

For untrained individuals, consuming supplemental protein likely has no impact on lean mass and muscle strength during the initial weeks of resistance training. However, as the duration, frequency, and volume of resistance training increase, protein supplementation may promote muscle hypertrophy and enhance gains in muscle strength in both untrained and trained individuals. Evidence also suggests that protein supplementation may accelerate gains in both aerobic and anaerobic power.

LIMITATIONS

To demonstrate measureable gains in strength and performance with exercise training and protein supplementation, many of the studies reviewed recruited untrained participants. Since skeletal muscle responses to exercise and protein supplementation differ between trained and untrained individuals, findings are not easily generalized for all consumers who may be considering the use of protein supplements.

CONCLUSIONS

This review suggests that protein supplementation may enhance muscle mass and performance when the training stimulus is adequate (e.g., frequency, volume, duration), and dietary intake is consistent with recommendations for physically active individuals.

Implications of exercise training and distribution of protein intake on molecular processes regulating skeletal muscle plasticity

To optimize its function, skeletal muscle exhibits exceptional plasticity and possesses the fundamental capacity to adapt its metabolic and contractile properties in response to various external stimuli (e.g., external loading, nutrient availability, and humoral factors). The adaptability of skeletal muscle, along with its relatively large mass and high metabolic rate, makes this tissue an important contributor to whole body health and mobility. This adaptational process includes changes in the number, size, and structural/functional properties of the myofibers. The adaptations of skeletal muscle to exercise are highly interrelated with dietary intake, particularly dietary protein, which has been shown to further potentiate exercise training-induced adaptations. Understanding the molecular adaptation of skeletal muscle to exercise and protein consumption is vital to elicit maximum benefit from exercise training to improve human performance and health. In this review, we will provide an overview of the molecular pathways regulating skeletal muscle adaptation to exercise and protein, and discuss the role of subsequent timing of nutrient intake following exercise.

Deep body composition phenotyping during weight cycling: relevance to metabolic efficiency and metabolic risk

Weight cycling may lead to adverse effects on metabolic efficiency (i.e. adaptive thermogenesis or 'metabolic slowing') and metabolic risks (e.g. increased risk for insulin resistance and the metabolic syndrome). In order to investigate these topics, the partitioning of fat and lean mass (i.e. the change in the proportion of both compartments) needs to be extended to the organ and tissue level because metabolic risk differs between adipose tissue depots and lean mass is metabolically heterogeneous being composed of organs and tissues differing in metabolic rate. Contrary to data obtained with severe weight loss and regain in lean people, weight cycling most likely has no adverse effects on fat distribution and metabolic risk in obese patients. There is even evidence for an increased ability of fat storage in subcutaneous fat depots (at the trunk in men and at the limbs in women) with weight cycling that may provide a certain protection from ectopic lipid deposition and thus explain the preservation of a favourable metabolic profile despite weight regain. On the other hand, the mass-specific metabolic rate of lean mass may increase with weight gain and decrease with weight loss mainly because of an increase and respective decrease in the proportion (and/or activity) of metabolically active organ mass. Obese people could therefore have a higher slope of the regression line between resting energy expenditure (REE) and fat-free mass that leads to an overestimation of metabolic efficiency when applied to normalize REE data after weight loss. Furthermore, in addressing the impact of macronutrient composition of the diet on partitioning of lean and fat mass, and the old controversy about whether a calorie is a calorie, we discuss recent evidence in support of a low glycaemic weight maintenance diet in countering weight regain and challenge this concept for weight loss by proposing the opposite.

Metabolomics – the complementary field in systems biology: a review on obesity and type 2 diabetes

This paper highlights the metabolomic roles in systems biology towards the elucidation of metabolic mechanisms in obesity and type 2 diabetes.

Effects of winter military training on energy balance, whole-body protein balance, muscle damage, soreness, and physical performance

Physiological consequences of winter military operations are not well described. This study examined Norwegian soldiers (n = 21 males) participating in a physically demanding winter training program to evaluate whether short-term military training alters energy and whole-body protein balance, muscle damage, soreness, and performance. Energy expenditure (D218O) and intake were measured daily, and postabsorptive whole-body protein turnover ([15N]-glycine), muscle damage, soreness, and performance (vertical jump) were assessed at baseline, following a 4-day, military task training phase (MTT) and after a 3-day, 54-km ski march (SKI). Energy intake (kcal·day−1) increased (P < 0.01) from (mean ± SD (95% confidence interval)) 3098 ± 236 (2985, 3212) during MTT to 3461 ± 586 (3178, 3743) during SKI, while protein (g·kg−1·day−1) intake remained constant (MTT, 1.59 ± 0.33 (1.51, 1.66); and SKI, 1.71 ± 0.55 (1.58, 1.85)). Energy expenditure increased (P < 0.05) during SKI (6851 ± 562 (6580, 7122)) compared with MTT (5480 ± 389 (5293, 5668)) and exceeded energy intake. Protein flux, synthesis, and breakdown were all increased (P < 0.05) 24%, 18%, and 27%, respectively, during SKI compared with baseline and MTT. Whole-body protein balance was lower (P < 0.05) during SKI (–1.41 ± 1.11 (–1.98, –0.84) g·kg−1·10 h) than MTT and baseline. Muscle damage and soreness increased and performance decreased progressively (P < 0.05). The physiological consequences observed during short-term winter military training provide the basis for future studies to evaluate nutritional strategies that attenuate protein loss and sustain performance during severe energy deficits.

Effects of short-term energy deficit on muscle protein breakdown and intramuscular proteolysis in normal-weight young adults

The effects of short-term energy deficit (ED) on direct measures of muscle proteolysis and the intracellular mechanisms by which muscle proteins are degraded at rest and following aerobic exercise are not well described. This study evaluated the effects of a short-term diet-induced ED, on muscle fractional breakdown rate (FBR), intramuscular 26S proteasome activity, caspase-3 activation, and PSMA2 and MAFbx expression at rest, in the postabsorptive state, and following a single bout of moderate aerobic exercise (45 min at 65% peak oxygen uptake). Six men and 4 women participated in two 10-day diet interventions: weight maintenance (WM) followed by ED (80% estimated energy requirements). Dietary protein (1.5 g·kg−1·day−1) intake was constant for WM and ED. Mixed muscle FBR, proteasome activity, and intracellular proteolytic factor expression were measured using stable isotope methodology, fluorescent enzyme activity assays, and Western blotting, respectively. Overall, FBR and caspase-3 activation increased 60% and 11%, respectively, in response to ED (P < 0.05), but were not influenced by exercise. During ED, 26S proteasome α-subunit PSMA2 expression was 25% higher (P < 0.05) after exercise compared with rest. Exercise did not influence PSMA2 expression during WM, and MAFbx expression and 26S proteasome activity were not affected by ED or exercise. These data illustrate the effects of short-term, moderate ED on muscle protein degradation. In the context of skeletal muscle integrity during weight loss interventions, this work demonstrates a need for further investigations aimed at mitigating muscle loss associated with energy deficit imposed for intentional reduction of total body weight.

Decreased rate of protein synthesis, caspase-3 activity, and ubiquitin–proteasome proteolysis in soleus muscles from growing rats fed a low-protein, high-carbohydrate diet

The aim of this study was to investigate the changes in the rates of both protein synthesis and breakdown, and the activation of intracellular effectors that control these processes in soleus muscles from growing rats fed a low-protein, high-carbohydrate (LPHC) diet for 15 days. The mass and the protein content, as well as the rate of protein synthesis, were decreased in the soleus from LPHC-fed rats. The availability of amino acids was diminished, since the levels of various essential amino acids were decreased in the plasma of LPHC-fed rats. Overall rate of proteolysis was also decreased, explained by reductions in the mRNA levels of atrogin-1 and MuRF-1, ubiquitin conjugates, proteasome activity, and in the activity of caspase-3. Soleus muscles from LPHC-fed rats showed increased insulin sensitivity, with increased levels of insulin receptor and phosphorylation levels of AKT, which probably explains the inhibition of both the caspase-3 activity and the ubiquitin–proteasome system. The fall of muscle proteolysis seems to represent an adaptive response that contributes to spare proteins in a condition of diminished availability of dietary amino acids. Furthermore, the decreased rate of protein synthesis may be the driving factor to the lower muscle mass gain in growing rats fed the LPHC diet.

High-intensity interval training and β-hydroxy-β-methylbutyric free acid improves aerobic power and metabolic thresholds

BACKGROUND

Previous research combining Calcium β-hydroxy-β-methylbutyrate (CaHMB) and running high-intensity interval training (HIIT) have shown positive effects on aerobic performance measures. The purpose of this study was to examine the effect of β-hydroxy-β-methylbutyric free acid (HMBFA) and cycle ergometry HIIT on maximal oxygen consumption (VO2peak), ventilatory threshold (VT), respiratory compensation point (RCP) and time to exhaustion (Tmax) in college-aged men and women.

METHODS

Thirty-four healthy men and women (Age: 22.7 ± 3.1 yrs ; VO2peak: 39.3 ± 5.0 ml · kg(-1) · min(-1)) volunteered to participate in this double-blind, placebo-controlled design study. All participants completed a series of tests prior to and following treatment. A peak oxygen consumption test was performed on a cycle ergometer to assess VO2peak, Tmax, VT, and RCP. Twenty-six participants were randomly assigned into either a placebo (PLA-HIIT) or 3 g per day of HMBFA (BetaTor™) (HMBFA-HIIT) group. Eight participants served as controls (CTL). Participants in the HIIT groups completed 12 HIIT (80-120% maximal workload) exercise sessions consisting of 5-6 bouts of a 2:1 minute cycling work to rest ratio protocol over a four-week period. Body composition was measured with dual energy x-ray absorptiometry (DEXA). Outcomes were assessed by ANCOVA with posttest means adjusted for pretest differences.

RESULTS

The HMBFA-HIIT intervention showed significant (p < 0.05) gains in VO2peak, and VT, versus the CTL and PLA-HIIT group. Both PLA-HIIT and HMBFA-HIIT treatment groups demonstrated significant (p < 0.05) improvement over CTL for Tmax, and RCP with no significant difference between the treatment groups. There were no significant differences observed for any measures of body composition. An independent-samples t-test confirmed that there were no significant differences between the training volumes for the PLA-HIIT and HMBFA-HIIT groups.

CONCLUSIONS

Our findings support the use of HIIT in combination with HMBFA to improve aerobic fitness in college age men and women. These data suggest that the addition of HMBFA supplementation may result in greater changes in VO2peak and VT than HIIT alone.

STUDY REGISTRATION

The study was registered on ClinicalTrials.gov (ID NCT01941368).

A time-efficient reduction of fat mass in 4 days with exercise and caloric restriction

To determine whether a fast reduction in fat mass can be achieved in 4 days by combining caloric restriction (CR: 3.2 kcal/kg body weight per day) with exercise (8-h walking + 45-min arm cranking per day) to induce an energy deficit of ∼5000 kcal/day, 15 overweight men underwent five experimental phases: pretest, exercise + CR for 4 days (WCR), control diet + reduced exercise for 3 days (DIET), and follow-up 4 weeks (POST1) and 1 year later (POST2). During WCR, the diet consisted solely of whey protein (n = 8) or sucrose (n = 7) (0.8 g/kg body weight per day). After WCR, DIET, POST1, and POST2, fat mass was reduced by a mean of 2.1, 2.8, 3.8, and 1.9 kg (P < 0.05), with two thirds of this loss from the trunk; and lean mass by 2.8, 1.0, 0.5, and 0.4 kg, respectively. After WCR, serum glucose, insulin, homeostatic model assessment, total and low-density lipoprotein cholesterol and triglycerides were reduced, and free fatty acid and cortisol increased. Serum leptin was reduced by 64%, 50%, and 33% following WCR, DIET, and POST1, respectively (P < 0.05). The effects were similar in both groups. In conclusion, a clinically relevant reduction in fat mass can be achieved in overweight men in just 4 days by combining prolonged exercise with CR.

Nutritional strategies for the preservation of fat free mass at high altitude

Exposure to extreme altitude presents many physiological challenges. In addition to impaired physical and cognitive function, energy imbalance invariably occurs resulting in weight loss and body composition changes. Weight loss, and in particular, loss of fat free mass, combined with the inherent risks associated with extreme environments presents potential performance, safety, and health risks for those working, recreating, or conducting military operations at extreme altitude. In this review, contributors to muscle wasting at altitude are highlighted with special emphasis on protein turnover. The article will conclude with nutritional strategies that may potentially attenuate loss of fat free mass during high altitude exposure.

Protein supplementation in U.S. military personnel

Protein supplements (PSs) are, after multivitamins, the most frequently consumed dietary supplement by U.S. military personnel. Warfighters believe that PSs will improve health, promote muscle strength, and enhance physical performance. The estimated prevalence of regular PS use by military personnel is nearly 20% or more in active-duty personnel, which is comparable to collegiate athletes and recreationally active adults, but higher than that for average U.S. civilians. Although the acute metabolic effects of PS ingestion are well described, little is known regarding the benefits of PS use by warfighters in response to the metabolic demands of military operations. When dietary protein intake approaches 1.5 g · kg(-1) · d(-1), and energy intake matches energy expenditure, the use of PSs by most physically active military personnel may not be necessary. However, dismounted infantry often perform operations consisting of long periods of strenuous physical activity coupled with inadequate dietary energy and protein intake. In these situations, the use of PSs may have efficacy for preserving fat-free mass. This article reviews the available literature regarding the prevalence of PS use among military personnel. Furthermore, it highlights the unique metabolic stressors affecting U.S. military personnel and discusses potential conditions during which protein supplementation might be beneficial.

Training table to the battlefield: protein recommendations for warfighters

Warfighters represent a population of athletes for whom routine training and physical expectations for military operations parallel, and very often exceed, those of their civilian counterparts. Like athletes, warfighters require nutrition support to optimize physical condition to maintain training, sustain performance, speed recovery, and prevent injury and illness. Specifically, energy and protein requirements have been tailored for these populations. Like athletes, warfighters consider protein a critical component of their diet and often incorporate protein supplements into daily diet plans. This article highlights sports nutrition principles that target energy and protein needs of athletes, considers the basis of these recommendations in the context of protein supplementation, and asserts that translating these recommendations to the warfighter is appropriate and necessary. The recommended range of protein intake of 1.2-1.8 g · kg (- 1) · d (- 1) can be extended to the warfighter. Because energy balance is pivotal to optimal protein utilization, adequate energy intake or lack thereof such that a state of negative energy balance exists, should be given particular consideration for the warfighter. Routine protein supplementation is recommended to reduce protein breakdown, support protein synthesis, and promote a positive net protein balance throughout various deployment situations and when energy intake is insufficient.

Considerations for protein supplementation in warfighters

Ingestion of dietary protein stimulates the synthesis of numerous body proteins. This effect is manifest via hyperaminoacidemia with insulin as a permissive factor. In a sedentary person in energy balance, it is possible to maintain nitrogen balance while consuming protein at an intake of 0.8 g protein · kg(-1) · d(-1). What is unclear is whether being in nitrogen balance is optimal for protein synthesis and not merely adequate and representative of adaptive strategies that could lead to accommodation in "stressed" physiological states. It is clear that being in negative energy balance results in reductions in lean mass and reduced rates of protein synthesis, which can be mitigated by consumption of higher (i.e., 2-3 times the RDA) dietary protein. That long-term practice of inadequate protein intake leads to reduced metabolic, physiological, and physical function provides the basic rationale for the consumption of more than merely adequate protein to prevent not only adaptation but accommodation. Warfighters engaged in combat have been shown to have high daily physical activity energy expenditure, engage in voluntary energy restriction, and are under high metabolic and mental stress. Thus, as a group warfighters would be at risk of consuming suboptimal protein intakes and therefore may benefit from higher amounts of dietary protein intake. Balanced against the potential risk of consuming higher protein, the scientific documentation for which is lacking, there is a strong rationale for the recommendation of higher protein intakes in warfighters who are engaged in field operations.