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Paoli A. Advances in Sport and Performance Nutrition. Nutrients 2019; 11:nu11030538. [PMID: 30832303 PMCID: PMC6471132 DOI: 10.3390/nu11030538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Antonio Paoli
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy.
- Faculty of Sport Sciences, UCAM, Catholic University of Murcia, 30107 Murcia, Spain.
- European Sport Nutrition Society, 43126 Parma, Italy.
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153
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Chu L, Timmons BW. Nutritional Considerations for Sport Participation in Children and Adolescents With Obesity. Am J Lifestyle Med 2019; 13:129-137. [PMID: 30800016 PMCID: PMC6378498 DOI: 10.1177/1559827617751684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is a high prevalence of children with obesity who are participating in sports. Appropriate nutritional considerations are important to optimize health and training adaptations. This review focuses on macronutrient recommendations and their effect on weight management and/or benefits for athletic training for children ages 5 to 18 years. Equal distribution of protein intake throughout the day (~25-30 g/meal) and during postexercise recovery is recommended. Special attention should be given to increasing protein intake during breakfast because it is often the meal with the least protein intake. Both postexercise recommendations for protein (~0.3 g/kg of body weight) and carbohydrate (~1.0-1.2 g/kg/h) were not determined in children with obesity, and require future verification. Individual carbohydrate needs of training to meet fuel costs are recommended, but ~200 to 500 g/day of carbohydrate may be required depending on a child's level of sport participation and competition. Fat intake should follow general recommendations to meet the accepted macronutrient distribution range in children (25% to 35%) and reduce saturated fat intake. No evidence suggests that additional dietary fat modifications would improve training adaptations in children. Longitudinal studies are required to further our understanding of age and sex effects and confirm the appropriate quantity of macronutrients for active children with obesity.
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Affiliation(s)
- Lisa Chu
- Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Brian W. Timmons
- Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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154
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Steell L, Sillars A, Welsh P, Iliodromiti S, Wong SC, Pell JP, Sattar N, Gill JMR, Celis-Morales CA, Gray SR. Associations of dietary protein intake with bone mineral density: An observational study in 70,215 UK Biobank participants. Bone 2019; 120:38-43. [PMID: 30292817 DOI: 10.1016/j.bone.2018.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE Adequate dietary protein intake is important for the maintenance of bone health; however, data in this area is ambiguous with some suggestion that high protein intake can have deleterious effects on bone health. The aim of the current study was to explore the associations of protein intake with bone mineral density (BMD). METHODS We used baseline data from the UK Biobank (participants aged 40-69 years) to examine the association of protein intake with BMD (measured by ultrasound). These associations were examined, in women (n = 39,066) and men (n = 31,149), after adjustment for socio-demographic and lifestyle confounders and co-morbidities. RESULTS Protein intake was positively and linearly associated with BMD in women (β-coefficient 0.010 [95% CI 0.005; 0.015, p < 0.0001]) and men (β-coefficient 0.008 [95% CI 0.000; 0.015, p = 0.044]); per 1.0 g/kg/day increment in protein intake, independently of socio-demographics, dietary factors and physical activity. CONCLUSIONS The current data have demonstrated that higher protein intakes are positively associated with BMD in both men and women. This indicates that higher protein intakes may be beneficial for both men and women.
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Affiliation(s)
- L Steell
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK
| | - A Sillars
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - P Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - S Iliodromiti
- Department of Obstetrics and Gynaecology, School of Medicine, University of Glasgow, UK
| | - S C Wong
- Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK
| | - J P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - J M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - C A Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - S R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
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155
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Gillis C, Wischmeyer PE. Pre-operative nutrition and the elective surgical patient: why, how and what? Anaesthesia 2019; 74 Suppl 1:27-35. [PMID: 30604414 DOI: 10.1111/anae.14506] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2018] [Indexed: 01/04/2023]
Abstract
Pre-operative nutrition therapy is increasingly recognised as an essential component of surgical care. The present review has been formatted using Simon Sinek's Golden Circle approach to explain 'why' avoiding pre-operative malnutrition and supporting protein anabolism are important goals for the elective surgical patient, 'how' peri-operative malnutrition develops leading in part to a requirement for pre-operative anabolic preparation, and 'what' can be done to avoid pre-operative malnutrition and support anabolism for optimal recovery.
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Affiliation(s)
- C Gillis
- Peri-Operative Program, McGill University, Montreal, QC, Canada
| | - P E Wischmeyer
- Director of Peri-operative Research, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
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156
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Dietary Protein for Training Adaptation and Body Composition Manipulation in Track and Field Athletes. Int J Sport Nutr Exerc Metab 2019; 29:165-174. [PMID: 30507259 DOI: 10.1123/ijsnem.2018-0267] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Track and field athletes engage in vigorous training that places stress on physiological systems requiring nutritional support for optimal recovery. Of paramount importance when optimizing recovery nutrition are rehydration and refueling which are covered in other papers in this volume. Here, we highlight the benefits for dietary protein intake over and above requirements set out in various countries at ∼0.8-1.0 g·kg body mass (BM)-1·day-1 for training adaptation, manipulating body composition, and optimizing performance in track and field athletes. To facilitate the remodeling of protein-containing structures, which are turning over rapidly due to their training volumes, track and field athletes with the goal of weight maintenance or weight gain should aim for protein intakes of ∼1.6 g·kg BM-1·day-1. Protein intakes at this level would not necessarily require an overemphasis on protein-containing foods and, beyond convenience, does not suggest a need to use protein or amino acid-based supplements. This review also highlights that optimal protein intakes may exceed 1.6 g·kg BM-1·day-1 for athletes who are restricting energy intake and attempting to minimize loss of lean BM. We discuss the underpinning rationale for weight loss in track and field athletes, explaining changes in metabolic pathways that occur in response to energy restriction when manipulating protein intake and training. Finally, this review offers practical advice on protein intakes that warrant consideration in allowing an optimal adaptive response for track and field athletes seeking to train effectively and to lose fat mass while energy restricted with minimal (or no) loss of lean BM.
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157
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Systematic review and meta-analysis of the effect of protein and amino acid supplements in older adults with acute or chronic conditions. Br J Nutr 2019; 119:527-542. [PMID: 29508691 DOI: 10.1017/s0007114517003816] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The loss of lean body mass, muscle strength and physical function causes significant problems in older adults. Protein and amino acid supplements can preserve muscle strength but the effect on function is variable. We conducted a systematic literature review and meta-analysis to investigate the effect of protein and amino acid supplementation on fat-free mass, muscle strength and physical function in malnourished, frail, sarcopenic, dependent or elderly with acute or chronic conditions, with or without rehabilitation exercise. Databases searched included Medline, BIOSIS, CINAHL, Cochrane Library, EBM Reviews, Embase, Pre-Medline, ProQuest, PubMed and Scopus. Retrieved articles were assessed by two reviewers using the Cochrane Risk of Bias (ROB) Tool. In all, thirty nine randomised controlled trails (n 4274) were included. The studies used a range of protein or essential amino acid (EAA) supplements in a variety of settings, including hospital, community and long-term care. Only seven studies had low ROB and no effect of supplementation was found on any outcomes. Analysis of all thirty-nine studies suggest protein and EAA supplements may improve fat-free mass, muscle strength and physical function (standardised mean difference 0·21-0·27, all P<0·005), but significant heterogeneity and ROB was evident. Predetermined subgroup analysis found undernourished elderly benefitted most; EAA were the most effective supplements and small beneficial effects were seen without rehabilitation exercise. The high heterogeneity and few studies with low ROB limits the conclusions and more high quality studies are needed to determine the best nutritional strategies for the maintenance of strength and function with increasing age.
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158
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Burd NA, Beals JW, Martinez IG, Salvador AF, Skinner SK. Food-First Approach to Enhance the Regulation of Post-exercise Skeletal Muscle Protein Synthesis and Remodeling. Sports Med 2019; 49:59-68. [PMID: 30671904 PMCID: PMC6445816 DOI: 10.1007/s40279-018-1009-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Protein recommendations are provided on a daily basis as defined by the recommended dietary allowance (RDA) at 0.80 g protein/kg/day. However, meal-based, as opposed to daily, dietary protein recommendations are likely more informative given the role of the daily protein distribution pattern in modulating the post-exercise muscle protein synthetic response. Current protein meal recommendations to plateau post-exercise muscle protein synthesis rates are based on the ingestion of isolated protein sources, and not protein-rich whole foods. It is generally more common to eat whole food sources of dietary protein within a normal eating pattern to meet dietary protein requirements. Yet, there is a need to define how dietary protein action on muscle protein synthesis rates can be modulated by other nutrients within a food matrix to achieve protein requirements for optimal muscle adaptations. Recent developments suggest that the identification of an "optimal" protein source should likely consider the characteristics of the protein and the food matrix in which it is consumed. This review aims to discuss recent concepts related to protein quality, and the potential interactive effects of the food matrix, to achieve optimal protein requirements and elicit a robust postprandial muscle protein synthetic response with an emphasis on the post-exercise recovery window.
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Affiliation(s)
- Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL, 61801, USA.
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Joseph W Beals
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Isabel G Martinez
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL, 61801, USA
| | - Amadeo F Salvador
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL, 61801, USA
| | - Sarah K Skinner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL, 61801, USA
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159
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Tomlinson DJ, Erskine RM, Morse CI, Onambélé GL. Body Fat Percentage, Body Mass Index, Fat Mass Index and the Ageing Bone: Their Singular and Combined Roles Linked to Physical Activity and Diet. Nutrients 2019; 11:E195. [PMID: 30669348 PMCID: PMC6356293 DOI: 10.3390/nu11010195] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/20/2018] [Accepted: 01/16/2019] [Indexed: 12/17/2022] Open
Abstract
This study took a multi-analytical approach including group differences, correlations and unit-weighed directional z-score comparisons to identify the key mediators of bone health. A total of 190 participants (18⁻80 years) were categorized by body fat%, body mass index (BMI) and fat mass index (FMI) to examine the effect of differing obesity criteria on bone characteristics. A subset of 50 healthy-eating middle-to-older aged adults (44⁻80 years) was randomly selected to examine any added impact of lifestyle and inflammatory profiles. Diet was assessed using a 3-day food diary, bone mineral density (BMD) and content (BMC) by dual energy x-ray absorptiometry in the lumbar, thoracic, (upper and lower) appendicular and pelvic areas. Physical activity was assessed using the Baecke questionnaire, and endocrine profiling was assessed using multiplex luminometry. Obesity, classed via BMI, positively affected 20 out of 22 BMC- and BMD-related outcome measures, whereas FMI was associated with 14 outcome measures and adiposity only modulated nine out of 22 BMC- and BMD-related outcome measures. Whilst bivariate correlations only linked vitamin A and relative protein intake with BMD, the Z-score composite summary presented a significantly different overall dietary quality between healthy and osteopenic individuals. In addition, bivariate correlations from the subset revealed daily energy intake, sport-based physical activity and BMI positive mediators of seven out of 10 BMD sites with age and body fat% shown to be negative mediators of bone characteristics. In conclusion, whilst BMI is a good indicator of bone characteristics, high body fat% should also be the focus of osteoporosis risk with ageing. Interestingly, high BMI in conjunction with moderate to vigorous activity supplemented with an optimal diet (quality and quantity) are identified as positive modulators of bone heath.
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Affiliation(s)
- David J Tomlinson
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
- Institute of Sport, Exercise and Health, University College London, London W1T 7HA, UK.
| | - Christopher I Morse
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
| | - Gladys L Onambélé
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
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160
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de Branco FMS, Carneiro MAS, Rossato LT, Nahas PC, Teixeira KRC, de Oliveira GN, Orsatti FL, de Oliveira EP. Protein timing has no effect on lean mass, strength and functional capacity gains induced by resistance exercise in postmenopausal women: A randomized clinical trial. Clin Nutr 2019; 39:57-66. [PMID: 30691866 DOI: 10.1016/j.clnu.2019.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 12/18/2018] [Accepted: 01/09/2019] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Flávia M S de Branco
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Marcelo A S Carneiro
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil; Department of Sport Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Luana T Rossato
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Paula C Nahas
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Kely R C Teixeira
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Gersiel N de Oliveira
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil; Department of Sport Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Fábio L Orsatti
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil; Department of Sport Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Erick P de Oliveira
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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161
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Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes 2019. [PMID: 31372016 DOI: 10.2147/dmso.s186600[publishedonlinefirst:2019/08/03]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the age-related loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter- and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Barbora De Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, VIC, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
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162
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Ross M, Lithgow H, Hayes L, Florida-James G. Potential Cellular and Biochemical Mechanisms of Exercise and Physical Activity on the Ageing Process. Subcell Biochem 2019; 91:311-338. [PMID: 30888658 DOI: 10.1007/978-981-13-3681-2_12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Exercise in young adults has been consistently shown to improve various aspects of physiological and psychological health but we are now realising the potential benefits of exercise with advancing age. Specifically, exercise improves cardiovascular, musculoskeletal, and metabolic health through reductions in oxidative stress, chronic low-grade inflammation and modulating cellular processes within a variety of tissues. In this this chapter we will discuss the effects of acute and chronic exercise on these processes and conditions in an ageing population, and how physical activity affects our vasculature, skeletal muscle function, our immune system, and cardiometabolic risk in older adults.
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Affiliation(s)
- Mark Ross
- School of Applied Science, Edinburgh Napier University, Edinburgh, Scotland, UK.
| | - Hannah Lithgow
- School of Applied Science, Edinburgh Napier University, Edinburgh, Scotland, UK
| | - Lawrence Hayes
- Active Ageing Research Group, University of Cumbria, Lancaster, UK
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163
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Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes 2019; 12:1057-1072. [PMID: 31372016 PMCID: PMC6630094 DOI: 10.2147/dmso.s186600] [Citation(s) in RCA: 278] [Impact Index Per Article: 55.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/07/2019] [Indexed: 12/05/2022] Open
Abstract
The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the age-related loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter- and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Correspondence: Jakub MesinovicDepartment of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, Victoria3068, AustraliaTel + 6 138 572 2919Fax + 6 139 594 6495Email
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Barbora De Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, VIC, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
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164
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Apweiler E, Wallace D, Stansfield S, Allerton DM, Brown MA, Stevenson EJ, Clifford T. Pre-Bed Casein Protein Supplementation Does Not Enhance Acute Functional Recovery in Physically Active Males and Females When Exercise is Performed in the Morning. Sports (Basel) 2018; 7:sports7010005. [PMID: 30597848 PMCID: PMC6359469 DOI: 10.3390/sports7010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/21/2018] [Accepted: 12/24/2018] [Indexed: 01/17/2023] Open
Abstract
This study examined whether consuming casein protein (CP) pre-sleep could accelerate acute recovery following muscle-damaging exercise. Thirty-nine active males and females performed 100 drop jumps in the morning, consumed their habitual diet during the day, and then within 30 min pre-bed consumed either ~40 g of CP (n = 19) or ~40 g of a carbohydrate-only control (CON) (n = 20). Maximal isometric voluntary contractions (MIVC), countermovement jumps (CMJ), pressure-pain threshold (PPT), subjective muscle soreness and the brief assessment of mood adapted (BAM+) were measured pre, 24 and 48 h following the drop jumps. MIVC decreased in CP and CON post-exercise, peaking at 24 h post (CP: -8.5 ± 3.5 vs. CON: -13.0 ± 2.9%, respectively); however, no between-group differences were observed (p = 0.486; ηp² =0.02). There were also no group differences in the recovery of CMJ height, PPT and BAM+ (p > 0.05). Subjective muscle soreness increased post-exercise, but no group differences were present at 24 h (CP: 92 ± 31 mm vs. CON: 90 ± 46 mm) or 48 h (CP: 90 ± 44 mm vs. CON: 80 ± 58 mm) (p > 0.05). These data suggest that pre-bed supplementation with ~40 g of CP is no more beneficial than CON for accelerating the recovery following muscle-damaging exercise.
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Affiliation(s)
- Eva Apweiler
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands.
| | - David Wallace
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands.
| | - Sarah Stansfield
- School of Biomedical Sciences, Newcastle University, Newcastle NE2 4HH, UK.
| | - Dean M Allerton
- School of Biomedical Sciences, Newcastle University, Newcastle NE2 4HH, UK.
| | - Meghan A Brown
- School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK.
| | - Emma J Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle NE2 4HH, UK.
| | - Tom Clifford
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle NE2 4HH, UK.
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Roberts J, Zinchenko A, Mahbubani K, Johnstone J, Smith L, Merzbach V, Blacutt M, Banderas O, Villasenor L, Vårvik FT, Henselmans M. Satiating Effect of High Protein Diets on Resistance-Trained Subjects in Energy Deficit. Nutrients 2018; 11:nu11010056. [PMID: 30597865 PMCID: PMC6356668 DOI: 10.3390/nu11010056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 11/16/2022] Open
Abstract
Short-term energy deficit strategies are practiced by weight class and physique athletes, often involving high protein intakes to maximize satiety and maintain lean mass despite a paucity of research. This study compared the satiating effect of two protein diets on resistance-trained individuals during short-term energy deficit. Following ethical approval, 16 participants (age: 28 ± 2 years; height: 1.72 ± 0.03 m; body-mass: 88.83 ± 5.54 kg; body-fat: 21.85 ± 1.82%) were randomly assigned to 7-days moderate (PROMOD: 1.8 g·kg-1·d-1) or high protein (PROHIGH: 2.9 g·kg-1·d-1) matched calorie-deficit diets in a cross-over design. Daily satiety responses were recorded throughout interventions. Pre-post diet, plasma ghrelin and peptide tyrosine tyrosine (PYY), and satiety ratings were assessed in response to a protein-rich meal. Only perceived satisfaction was significantly greater following PROHIGH (67.29 ± 4.28 v 58.96 ± 4.51 mm, p = 0.04). Perceived cravings increased following PROMOD only (46.25 ± 4.96 to 57.60 ± 4.41 mm, p = 0.01). Absolute ghrelin concentration significantly reduced post-meal following PROMOD (972.8 ± 130.4 to 613.6 ± 114.3 pg·mL-1; p = 0.003), remaining lower than PROHIGH at 2 h (-0.40 ± 0.06 v -0.26 ± 0.06 pg·mL-1 normalized relative change; p = 0.015). Absolute PYY concentration increased to a similar extent post-meal (PROMOD: 84.9 ± 8.9 to 147.1 ± 11.9 pg·mL-1, PROHIGH: 100.6 ± 9.5 to 143.3 ± 12.0 pg·mL-1; p < 0.001), but expressed as relative change difference was significantly greater for PROMOD at 2 h (+0.39 ± 0.20 pg·mL-1 v -0.28 ± 0.12 pg·mL-1; p = 0.001). Perceived hunger, fullness and satisfaction post-meal were comparable between diets (p > 0.05). However, desire to eat remained significantly blunted for PROMOD (p = 0.048). PROHIGH does not confer additional satiating benefits in resistance-trained individuals during short-term energy deficit. Ghrelin and PYY responses to a test-meal support the contention that satiety was maintained following PROMOD, although athletes experiencing negative symptoms (i.e., cravings) may benefit from protein-rich meals as opposed to over-consumption of protein.
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Affiliation(s)
- Justin Roberts
- School of Psychology and Sport Science, Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK.
| | - Anastasia Zinchenko
- Department of Biochemistry, Kings College, University of Cambridge, Kings Parade, Cambridge CB2 1ST, UK.
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
| | | | - James Johnstone
- School of Psychology and Sport Science, Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK.
| | - Lee Smith
- School of Psychology and Sport Science, Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK.
| | - Viviane Merzbach
- School of Psychology and Sport Science, Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK.
| | - Miguel Blacutt
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
| | - Oscar Banderas
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
| | - Luis Villasenor
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
| | - Fredrik T Vårvik
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
| | - Menno Henselmans
- International Scientific Research Foundation for Fitness and Nutrition, 1073 LC Amsterdam, The Netherlands.
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Lynch H, Johnston C, Wharton C. Plant-Based Diets: Considerations for Environmental Impact, Protein Quality, and Exercise Performance. Nutrients 2018; 10:E1841. [PMID: 30513704 PMCID: PMC6316289 DOI: 10.3390/nu10121841] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/23/2018] [Accepted: 11/27/2018] [Indexed: 12/19/2022] Open
Abstract
Plant-based diets provide well-established physical and environmental health benefits. These benefits stem in part from the degree of restriction of animal-derived foods. Historically, meat and other animal-derived proteins have been viewed as an integral component of athletes' diets, leading some to question the adequacy of vegetarian or vegan diets for supporting athletic performance. The purpose of this review is to examine the impact of plant-based diets on human physical health, environmental sustainability, and exercise performance capacity. Based on currently available literature, it is unlikely that plant-based diets provide advantages, but do not suffer from disadvantages, compared to omnivorous diets for strength, anaerobic, or aerobic exercise performance. However, plant-based diets typically reduce the risk of developing numerous chronic diseases over the lifespan and require fewer natural resources for production compared to meat-containing diets. As such, plant-based diets appear to be viable options for adequately supporting athletic performance while concurrently contributing to overall physical and environmental health. Given the sparse literature comparing omnivore, vegetarian, and vegan athletes, particularly at the elite level, further research is warranted to ascertain differences that might appear at the highest levels of training and athletic performance.
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Affiliation(s)
- Heidi Lynch
- Point Loma Nazarene University, San Diego, CA 92106, USA.
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167
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Oliveira CL, Dionne IJ, Prado CM. Are Canadian protein and physical activity guidelines optimal for sarcopenia prevention in older adults? Appl Physiol Nutr Metab 2018; 43:1215-1223. [DOI: 10.1139/apnm-2018-0141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Aging is characterized by physiological and morphological changes that affect body composition, strength, and function, ultimately leading to sarcopenia. This condition results in physical disability, falls, fractures, poor quality of life, and increased health care costs. Evidence suggests that increased consumption of dietary protein and physical activity levels, especially resistance exercise, can counteract the trajectory of sarcopenia. Canadian guidelines for protein intake and physical activity were last updated in 2005 and 2011, respectively, and new evidence on sarcopenia diagnosis, prevention, and treatment is rapidly evolving. Protein recommendations are set as “one-size-fits-all” for both young and older adults. Recent evidence demonstrates that current recommendations are insufficient to meet the minimum protein requirement to counteract muscle loss and to stimulate hypertrophy in healthy older adults. Beyond quantity, protein quality is also essential to benefit muscle anabolism in older adults. In terms of physical activity, resistance exercise training is a potential strategy to counteract age-related effects, as it can elicit muscle hypertrophic response in addition to increases in muscle strength and function in older adults. Canadian physical activity guidelines lack details on how this modality of training should be performed. Current guidelines for protein intake and physical activity do not reflect recent knowledge on sarcopenia prevention. The gap between guidelines and the latest evidence on the maintenance and promotion of older adult’s health highlight the need for updated protein and physical activity recommendations.
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Affiliation(s)
- Camila L.P. Oliveira
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, 2-004 Li Ka Shing Center for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Isabelle J. Dionne
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, CIUSS de l’Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
| | - Carla M. Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, 2-004 Li Ka Shing Center for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada
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168
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Granic A, Mendonça N, Sayer AA, Hill TR, Davies K, Adamson A, Siervo M, Mathers JC, Jagger C. Low protein intake, muscle strength and physical performance in the very old: The Newcastle 85+ Study. Clin Nutr 2018; 37:2260-2270. [PMID: 29191494 PMCID: PMC6295979 DOI: 10.1016/j.clnu.2017.11.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/28/2017] [Accepted: 11/09/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Low protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength. AIMS To investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old. METHODS The analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex. RESULTS At baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status. CONCLUSIONS Intake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Avan Aihie Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom
| | - Ashley Adamson
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Devries MC, Sithamparapillai A, Brimble KS, Banfield L, Morton RW, Phillips SM. Changes in Kidney Function Do Not Differ between Healthy Adults Consuming Higher- Compared with Lower- or Normal-Protein Diets: A Systematic Review and Meta-Analysis. J Nutr 2018; 148:1760-1775. [PMID: 30383278 PMCID: PMC6236074 DOI: 10.1093/jn/nxy197] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/01/2017] [Accepted: 07/24/2018] [Indexed: 01/09/2023] Open
Abstract
Background Higher-protein (HP) diets are advocated for several reasons, including mitigation of sarcopenia, but their effects on kidney function are unclear. Objective This meta-analysis was conducted to determine the effect of HP intakes on kidney function in healthy adults. Methods We conducted a systematic review and meta-analysis of trials comparing HP (≥1.5 g/kg body weight or ≥20% energy intake or ≥100 g protein/d) with normal- or lower-protein (NLP; ≥5% less energy intake from protein/d compared with HP group) intakes on kidney function. Medline and EMBASE databases were searched. Randomized controlled trials comparing the effects of HP with NLP (>4 d duration) intakes on glomerular filtration rate (GFR) in adults without kidney disease were included. Results A total of 2144 abstracts were reviewed, with 40 articles selected for full-text review; 28 of these were analyzed and included data from 1358 participants. Data were analyzed using random-effects meta-analysis (RevMan 5; The Cochrane Collaboration), meta-regression (STATA; StataCorp), and dose-response analysis (Prism; GraphPad). Analyses were conducted using postintervention (post) GFR and the change in GFR from preintervention to post. The post-only comparison showed a trivial effect for GFR to be higher after HP intakes [standardized mean difference (SMD): 0.19; 95% CI: 0.07, 0.31; P = 0.002]. The change in GFR did not differ between interventions (SMD: 0.11; 95% CI: -0.05, 0.27; P = 0.16). There was a linear relation between protein intake and GFR in the post-only comparison (r = 0.332, P = 0.03), but not between protein intake and the change in GFR (r = 0.184, P = 0.33). The main limitation of the current analysis is the unclear risk of selection bias of the included trials. Conclusions Postintervention GFR comparisons indicate that HP diets result in higher GFRs; however, when changes in GFR were compared, dietary protein had no effect. Our analysis indicates that HP intakes do not adversely influence kidney function on GFR in healthy adults.
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Affiliation(s)
- Michaela C Devries
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada
| | | | | | - Laura Banfield
- Health Sciences Library, Faculty of Health Sciences, McMaster University, Hamilton, Canada
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170
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Tomlinson DJ, Erskine RM, Morse CI, Onambélé GL. Impact of Above-Average Proanabolic Nutrients Is Overridden by High Protein and Energy Intake in the Muscle-Tendon Unit Characteristics of Middle- to Older-Aged Adults. J Nutr 2018; 148:1776-1785. [PMID: 30247586 PMCID: PMC6209810 DOI: 10.1093/jn/nxy185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/19/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022] Open
Abstract
Background The impact, within a single cohort, of independent modulators of skeletal muscle quality, including age, adiposity and obesity, habitual nutritional intake, and physical activity (PA), is unclear. Objective We examined the bivariate associations between age, adiposity, habitual nutritional intake, and PA against 11 key intrinsic muscle-tendon unit (MTU) characteristics to identify the strongest predictors. We also compared overall profile differences between MTU categories with the use of z scores shown in radar graphs. Methods Fifty untrained independently living men (n = 15) and women (n = 35) aged 43-80 y (mean ± SD: 64 ±9 y) were categorized by adiposity [men: normal adiposity (NA) <28%, high adiposity (HA) ≥28%; women: NA <40%, HA ≥40%] and body mass index [BMI (in kg/m2); normal: 18 to <25; overweight: ≥25 to <30; and obese: ≥30]. Group differences were examined by body composition assessed with the use of dual-energy X-ray absorptiometry, habitual nutritional intake through a 3-d food diary, PA (work, leisure, sport) using the Baecke questionnaire, 14 serum cytokine concentrations using multiplex luminometry, and 11 MTU characteristics of the gastrocnemius medialis using a combination of isokinetic dynamometry, electromyography, and ultrasonography. Results Interestingly, classification by BMI highlighted differences between normal and obese individuals in 6 of 11 MTU characteristics (P < 0.001 to P = 0.043). No significant differences were reported in serum cytokine concentrations between adiposity and BMI classifications. BMI predicted 8 of 11 (r = 0.62-0.31, P < 0.001 to P = 0.032), daily energy intake predicted 7 of 11 (r = 0.45-0.34, P = 0.002-0.036), age predicted 5 of 11 (r = -0.49-0.32, P < 0.001 to P = 0.032), work-based PA predicted 5 of 11 (r = 0.43-0.32, P = 0.003-0.048), and adiposity predicted 4 of 11 (r = 0.51-0.33, P < 0.001 to P = 0.022) MTU characteristics. Mathematical z scores and radar graphs showed how endocrine and dietary profiles, but not PA, differed between the top and bottom ∼20% of muscle unit size and specific force. Conclusions Given the number of factors associated with MTU, education should be targeted to both adequate food quantity and quality (especially protein intake) and increasing habitual moderate to vigorous PA while decreasing sedentary behavior. Specific endocrine variables are also proposed as key pharmaceutical targets.
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Affiliation(s)
- David J Tomlinson
- Health, Exercise, and Active Living Research Center, Manchester Metropolitan University, Crewe, United Kingdom
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Institute of Sport, Exercise, and Health, University College London, London, United Kingdom
| | - Christopher I Morse
- Health, Exercise, and Active Living Research Center, Manchester Metropolitan University, Crewe, United Kingdom
| | - Gladys L Onambélé
- Health, Exercise, and Active Living Research Center, Manchester Metropolitan University, Crewe, United Kingdom
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172
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Mazzulla M, Volterman KA, Packer JE, Wooding DJ, Brooks JC, Kato H, Moore DR. Whole-body net protein balance plateaus in response to increasing protein intakes during post-exercise recovery in adults and adolescents. Nutr Metab (Lond) 2018; 15:62. [PMID: 30258470 PMCID: PMC6154919 DOI: 10.1186/s12986-018-0301-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/14/2018] [Indexed: 01/27/2023] Open
Abstract
Background Muscle protein synthesis and muscle net balance plateau after moderate protein ingestion in adults. However, it has been suggested that there is no practical limit to the anabolic response of whole-body net balance to dietary protein. Moreover, limited research has addressed the anabolic response to dietary protein in adolescents. The present study determined whether whole-body net balance plateaued in response to increasing protein intakes during post-exercise recovery and whether there were age- and/or sex-related dimorphisms in the anabolic response. Methods Thirteen adults [7 males (M), 6 females (F)] and 14 adolescents [7 males (AM), 7 females (AF) within ~ 0.4 y from peak height velocity] performed ~ 1 h variable intensity exercise (i.e., Loughborough Intermittent Shuttle Test) prior to ingesting hourly mixed meals that provided a variable amount of protein (0.02-0.25 g·kg- 1·h- 1) as crystalline amino acids modeled after egg protein. Steady-state protein kinetics were modeled noninvasively with oral L-[1-13C]phenylalanine. Breath and urine samples were taken at plateau to determine phenylalanine oxidation and flux (estimate of protein breakdown), respectively. Whole-body net balance was determined by the difference between protein synthesis (flux - oxidation) and protein breakdown. Total amino acid oxidation was estimated from the ratio of urinary urea/creatinine. Results Mixed model biphasic linear regression explained a greater proportion of net balance variance than linear regression (all, r 2 ≥ 0.56; P < 0.01), indicating an anabolic plateau. Net balance was maximized at ~ 0.15, 0.12, 0.12, and 0.11 g protein·kg- 1·h- 1 in M, F, AM, and AF, respectively. When collapsed across age, the y-intercept (net balance at very low protein intake) was greater (overlapping CI did not contain zero) in adolescents vs. adults. Urea/creatinine excretion increased linearly (all, r ≥ 0.76; P < 0.01) across the range of protein intakes. At plateau, net balance was greater (P < 0.05) in AM vs. M. Conclusions Our data suggest there is a practical limit to the anabolic response to protein ingestion within a mixed meal and that higher intakes lead to deamination and oxidation of excess amino acids. Consistent with a need to support lean mass growth, adolescents appear to have greater anabolic sensitivity and a greater capacity to assimilate dietary amino acids than adults.
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Affiliation(s)
- Michael Mazzulla
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
| | - Kimberly A Volterman
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
| | - Jeff E Packer
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
| | - Denise J Wooding
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
| | - Jahmal C Brooks
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
| | - Hiroyuki Kato
- 2Frontier Research Laboratories, Institute for Innovation, Ajinomoto Co., Inc, Kawasaki, Japan
| | - Daniel R Moore
- 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON Canada
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173
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Wiggins AKA, Anderson GH, House JD. Research and regulatory gaps for the substantiation of protein content claims on foods. Appl Physiol Nutr Metab 2018; 44:95-98. [PMID: 30138570 DOI: 10.1139/apnm-2018-0429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Protein claims provide guidance to consumers seeking protein-rich foods. Protein claim regulations differ globally, and both Canada and the United States require protein quality assessments. A tripartite workshop identified the need to (i) harmonize, (ii) update existing amino acid composition and digestibility databases, (iii) develop non-animal bioassays, and (iv) evaluate the impact of protein claims on human health. The Protein-Digestibility Corrected Amino Acid Score method is recommended for current regulatory use in Canada.
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Affiliation(s)
- Ashleigh K A Wiggins
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - G Harvey Anderson
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.,b Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - James D House
- c Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Kerksick CM, Wilborn CD, Roberts MD, Smith-Ryan A, Kleiner SM, Jäger R, Collins R, Cooke M, Davis JN, Galvan E, Greenwood M, Lowery LM, Wildman R, Antonio J, Kreider RB. ISSN exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr 2018; 15:38. [PMID: 30068354 PMCID: PMC6090881 DOI: 10.1186/s12970-018-0242-y] [Citation(s) in RCA: 399] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/17/2018] [Indexed: 12/18/2022] Open
Abstract
Background Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words ‘sport nutrition’. Consequently, staying current with the relevant literature is often difficult. Methods This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation and oversight; 2.) How dietary supplements are legally regulated in the United States; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of nutritional approaches to augment skeletal muscle hypertrophy and the potential ergogenic value of various dietary and supplemental approaches. Conclusions This updated review is to provide ISSN members and individuals interested in sports nutrition with information that can be implemented in educational, research or practical settings and serve as a foundational basis for determining the efficacy and safety of many common sport nutrition products and their ingredients.
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Affiliation(s)
- Chad M Kerksick
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, USA.
| | - Colin D Wilborn
- Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, TX, USA
| | | | - Abbie Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Rick Collins
- Collins Gann McCloskey and Barry PLLC, Mineola, NY, USA
| | - Mathew Cooke
- Department of Health and Medical Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jaci N Davis
- Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, TX, USA
| | - Elfego Galvan
- University of Texas Medical Branch, Galveston, TX, USA
| | - Mike Greenwood
- Exercise & Sports Nutrition Lab, Human Clinical Research Facility, Texas A&M University, College Station, TX, USA
| | - Lonnie M Lowery
- Department of Human Performance & Sport Business, University of Mount Union, Alliance, OH, USA
| | | | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
| | - Richard B Kreider
- Exercise & Sports Nutrition Lab, Human Clinical Research Facility, Texas A&M University, College Station, TX, USA.
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175
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Berryman CE, Lieberman HR, Fulgoni VL, Pasiakos SM. Protein intake trends and conformity with the Dietary Reference Intakes in the United States: analysis of the National Health and Nutrition Examination Survey, 2001-2014. Am J Clin Nutr 2018; 108:405-413. [PMID: 29931213 DOI: 10.1093/ajcn/nqy088] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/04/2018] [Indexed: 11/12/2022] Open
Abstract
Background Systematic analysis of dietary protein intake may identify demographic groups within the American population that are not meeting the Dietary Reference Intakes (DRIs). Objective This cross-sectional study analyzed protein intake trends (2001-2014) and evaluated recent conformity to the DRIs (2011-2014) according to age, sex, and race or ethnicity in the US population. Design Protein intakes and trends during 2-y cycles of NHANES 2001-2014 (n = 57,980; ≥2 y old) were calculated as absolute (grams per day) and relative [grams per kilogram of ideal body weight (IBW) per day] intakes and as a percentage of total energy. Sex and race or ethnicity [Asian, Hispanic, non-Hispanic black (NHB), and non-Hispanic white (NHW)] differences were determined for protein intake and percentage of the population below the Estimated Average Requirement (EAR) and Recommended Dietary Allowance, and above and below the Acceptable Macronutrient Distribution Range (AMDR). Results Usual protein intakes (mean ± SE) averaged from 55.3 ± 0.9 (children aged 2-3 y) to 88.2 ± 1.1 g/d (adults aged 19-30 y). Protein comprised 14-16% of total energy intakes. Relative protein intakes averaged from 1.10 ± 0.01 (adults aged ≥71 y) to 3.63 ± 0.07 g · kg IBW-1 · d-1 (children aged 2-3 y), and were above the EAR in all demographic groups. Asian and Hispanic populations aged >19 y consumed more relative protein (1.32 ± 0.02 and 1.32 ± 0.02 g · kg IBW-1 · d-1, respectively) than did NHB and NHW (1.18 ± 0.01 g · kg IBW-1 · d-1). Relative protein intakes did not differ by race or ethnicity in the 2-18 y population. Adolescent (aged 14-18 y) females and older (aged ≥71 y) NHB men had the largest population percentages below the EAR (11% and 13%, respectively); <1% of any demographic group had intakes above the AMDR. Conclusions The majority of the US population exceeds minimum recommendations for protein intake. Protein intake remains well below the upper end of the AMDR, indicating that protein intake, as a percentage of energy intake, is not excessive in the American diet. This trial was registered at www.isrctn.com as ISRCTN76534484.
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Affiliation(s)
- Claire E Berryman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Oak Ridge Institute for Science and Education, Belcamp, MD
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | | | - Stefan M Pasiakos
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
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176
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Gillis C, Buhler K, Bresee L, Carli F, Gramlich L, Culos-Reed N, Sajobi TT, Fenton TR. Effects of Nutritional Prehabilitation, With and Without Exercise, on Outcomes of Patients Who Undergo Colorectal Surgery: A Systematic Review and Meta-analysis. Gastroenterology 2018; 155:391-410.e4. [PMID: 29750973 DOI: 10.1053/j.gastro.2018.05.012] [Citation(s) in RCA: 294] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Although there have been meta-analyses of the effects of exercise-only prehabilitation on patients undergoing colorectal surgery, little is known about the effects of nutrition-only (oral nutritional supplements with and without counseling) and multimodal (oral nutritional supplements with and without counseling and with exercise) prehabilitation on clinical outcomes and patient function after surgery. We performed a systemic review and meta-analysis to determine the individual and combined effects of nutrition-only and multimodal prehabilitation compared with no prehabilitation (control) on outcomes of patients undergoing colorectal resection. METHODS We searched Medline, EMBASE, CINAHL, CENTRAL, and ProQuest for cohort and randomized controlled studies of adults awaiting colorectal surgery who received at least 7 days of nutrition prehabilitation with or without exercise. We performed a random-effects meta-analysis to estimate the pooled risk ratio for categorical data and the weighted mean difference for continuous variables. The primary outcome was length of hospital stay; the secondary outcome was recovery of functional capacity based on results of a 6-minute walk test. RESULTS We identified 9 studies (5 randomized controlled studies and 4 cohort studies) composed of 914 patients undergoing colorectal surgery (438 received prehabilitation and 476 served as controls). Receipt of any prehabilitation significantly decreased days spent in the hospital compared with controls (weighted mean difference of length of hospital stay = -2.2 days; 95% confidence interval = -3.5 to -0.9). Only 3 studies reported on functional outcomes but could not be pooled owing to methodologic heterogeneity. In the individual studies, multimodal prehabilitation significantly improved results of the 6-minute walk test at 4 and 8 weeks after surgery compared with standard Enhanced Recovery Pathway care and at 8 weeks compared with standard Enhanced Recovery Pathway care with added rehabilitation. The 4 observational studies had a high risk of bias. CONCLUSIONS In a systematic review and meta-analysis, we found that nutritional prehabilitation alone or combined with an exercise program significantly decreased length of hospital stay by 2 days in patients undergoing colorectal surgery. There is some evidence that multimodal prehabilitation accelerated the return to presurgical functional capacity.
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Affiliation(s)
- Chelsia Gillis
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
| | - Katherine Buhler
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lauren Bresee
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University Health Center, Montreal, Quebec, Canada
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology and Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Tolulope T Sajobi
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Tanis R Fenton
- Department of Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Nutrition Services, Alberta Health Services, Calgary, Canada
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177
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Niccoli S, Kolobov A, Bon T, Rafilovich S, Munro H, Tanner K, Pearson T, Lees SJ. Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial. J Nutr Gerontol Geriatr 2018; 36:149-165. [PMID: 29252150 DOI: 10.1080/21551197.2017.1391732] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Whey protein supplementation (WPS) has been shown to improve functional outcomes in populations that are able to participate in high-intensity resistance training. The purpose of the study was to evaluate the efficacy of WPS on rehabilitation outcomes in a frail, hospitalized elderly population. Men and women (n = 47) were randomly assigned to either a control group or WPS group for the length of their hospital stay. Several functional and serum measures were determined pre- and post-intervention. WPS significantly increased average daily protein intake and was well tolerated. The WPS group exhibited significant improvements in grip strength and knee extensor force over the control group, and a significant positive correlation was found between change in prealbumin and percent-increase knee extensor force. These findings support the use of WPS to improve protein nutritional status and rehabilitation outcomes in a clinical setting involving a frail, elderly population.
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Affiliation(s)
- Sarah Niccoli
- a Medical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Anton Kolobov
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Trevor Bon
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Seda Rafilovich
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Heather Munro
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Kim Tanner
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Trina Pearson
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Simon J Lees
- a Medical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada.,d Department of Biology , Lakehead University , Thunder Bay , Ontario , Canada.,e Health and Exercise Science , Colorado State University , Fort Collins , Colorado , USA
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178
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Franzke B, Neubauer O, Cameron-Smith D, Wagner KH. Dietary Protein, Muscle and Physical Function in the Very Old. Nutrients 2018; 10:E935. [PMID: 30037048 PMCID: PMC6073115 DOI: 10.3390/nu10070935] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
There is an ongoing debate as to the optimal protein intake in older adults. An increasing body of experimental studies on skeletal muscle protein metabolism as well as epidemiological data suggest that protein requirements with ageing might be greater than many current dietary recommendations. Importantly, none of the intervention studies in this context specifically investigated very old individuals. Data on the fastest growing age group of the oldest old (aged 85 years and older) is very limited. In this review, we examine the current evidence on protein intake for preserving muscle mass, strength and function in older individuals, with emphasis on data in the very old. Available observational data suggest beneficial effects of a higher protein intake with physical function in the oldest old. Whilst, studies estimating protein requirements in old and very old individuals based on whole-body measurements, show no differences between these sub-populations of elderly. However, small sample sizes preclude drawing firm conclusions. Experimental studies that compared muscle protein synthetic (MPS) responses to protein ingestion in young and old adults suggest that a higher relative protein intake is required to maximally stimulate skeletal muscle MPS in the aged. Although, data on MPS responses to protein ingestion in the oldest old are currently lacking. Collectively, the data reviewed for this article support the concept that there is a close interaction of physical activity, diet, function and ageing. An attractive hypothesis is that regular physical activity may preserve and even enhance the responsiveness of ageing skeletal muscle to protein intake, until very advanced age. More research involving study participants particularly aged ≥85 years is warranted to better investigate and determine protein requirements in this specific growing population group.
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Affiliation(s)
- Bernhard Franzke
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
| | - Oliver Neubauer
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
- School of Biomedical Sciences, Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
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179
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Abstract
Sarcopenia refers to the age-related loss of muscle mass, muscle strength, and physical function. With an increase in the number and proportion of elderly in the population, sarcopenia is a growing global health concern due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains underrecognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. This article provides the general practitioner or rheumatologist an overview of the pathophysiology, diagnosis, and management of this complex and critical entity.
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Affiliation(s)
- Sarthak Gupta
- Lupus Clinical Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Room Number 3-2340, Bethesda, MD 20892, USA
| | - Robinder J S Dhillon
- Lupus Clinical Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Room Number 3-2340, Bethesda, MD 20892, USA
| | - Sarfaraz Hasni
- Lupus Clinical Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Room Number 3-2340, Bethesda, MD 20892, USA.
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180
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Karagounis LG, Volterman KA, Breuillé D, Offord EA, Emady-Azar S, Moore DR. Protein Intake at Breakfast Promotes a Positive Whole-Body Protein Balance in a Dose-Response Manner in Healthy Children: A Randomized Trial. J Nutr 2018; 148:729-737. [PMID: 30053279 DOI: 10.1093/jn/nxy026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/30/2018] [Indexed: 01/05/2023] Open
Abstract
Background Protein ingestion promotes whole-body net protein balance (NB) in children, which is a prerequisite for growth. Determining how much protein is required at breakfast to promote a positive NB, which may be negative after the traditional overnight fast in children, has yet to be determined. Objective We determined the impact of incremental doses of milk protein at breakfast as well as the impact of daily dietary protein distribution on NB in children. Methods A total of 28 children [14 boys, 14 girls; age range: 7-11 y; body mass index (mean ± SD, in kg/m2): 16.0 ± 1.9] completed 2 intervention trials. During the breakfast meal, participants consumed an isoenergetic beverage with different amounts of protein (0, 7, 14, or 21 g for Groups A-D, respectively) and [15N]-glycine to measure whole body protein metabolism. Whole-body nitrogen turnover, protein synthesis (PS), protein breakdown, and NB were measured over 9 and 24 h. Results Following an overnight fast, children were in negative NB (-64.5 mg · kg-1 · h-1). Protein ingestion at breakfast induced a stepwise increase in NB over 9 h [Groups A (6.2 mg · kg-1 · h-1) < B (27.9 mg · kg-1 · h-1) < C (46.9 mg · kg-1 · h-1) < D (66.0 mg · kg-1 · h-1)] with all conditions different from each other (all P < 0.01). PS was 42% greater in Group D than in Group A over 9 h (P < 0.05). Conclusions Consuming ≥7 g of the total daily protein intake at breakfast attenuates the observed overnight protein losses in children during the subsequent 9 h following breakfast consumption. The dose-dependent increase in NB over a daytime fed period, inclusive of breakfast and lunch, highlights the importance of breakfast protein intake on acute anabolism in healthy active children. This trial was registered at clinicaltrials.gov as NCT02465151.
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Affiliation(s)
- Leonidas G Karagounis
- Institute of Nutritional Science, Nestlé Research Centre, Lausanne, Switzerland.,Experimental Myology and Integrative Physiology Cluster, Plymouth Marjon University, Plymouth, United Kingdom
| | - Kimberly A Volterman
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Denis Breuillé
- Institute of Nutritional Science, Nestlé Research Centre, Lausanne, Switzerland
| | - Elizabeth A Offord
- Institute of Nutritional Science, Nestlé Research Centre, Lausanne, Switzerland
| | - Shahram Emady-Azar
- Institute of Nutritional Science, Nestlé Research Centre, Lausanne, Switzerland
| | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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181
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Smith GI, Commean PK, Reeds DN, Klein S, Mittendorfer B. Effect of Protein Supplementation During Diet-Induced Weight Loss on Muscle Mass and Strength: A Randomized Controlled Study. Obesity (Silver Spring) 2018; 26:854-861. [PMID: 29687650 PMCID: PMC5918424 DOI: 10.1002/oby.22169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE High protein (particularly leucine-rich whey protein) intake is recommended to mitigate the adverse effect of weight loss on muscle mass. The effectiveness of this approach is unknown. METHODS Seventy middle-aged (50-65 years old) postmenopausal women with obesity were randomized to (1) weight maintenance (WM), (2) weight loss and the recommended daily allowance for protein (0.8 g/kg/d) (WL group), or (3) weight loss plus whey protein supplementation (total protein: 1.2 g/kg/d) (WL-PS group). Thigh muscle volume and strength were assessed at baseline and after 5% and 10% weight loss in the weight-loss groups and after matched time periods (∼3 and 6 months, respectively) in the WM group. RESULTS A 5% weight loss caused a greater decrease in thigh muscle volume in the WL group than the WL-PS group (4.7% ± 0.7% vs. 2.8% ± 0.8%, respectively; P < 0.05). After 10% weight loss, there was no statistically significant difference in muscle mass loss in the two groups, and the total loss was small in both groups (5.5% ± 0.8% and 4.5% ± 0.7%, respectively). The dietary interventions did not affect muscle strength. CONCLUSIONS Whey protein supplementation during diet-induced weight loss does not have clinically important therapeutic effects on muscle mass or strength in middle-aged postmenopausal women with obesity.
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Affiliation(s)
- Gordon I Smith
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Paul K Commean
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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182
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Phillips SM. Higher Dietary Protein During Weight Loss: Muscle Sparing? Obesity (Silver Spring) 2018; 26:789. [PMID: 29687646 DOI: 10.1002/oby.22186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/14/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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183
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Traylor DA, Gorissen SHM, Phillips SM. Perspective: Protein Requirements and Optimal Intakes in Aging: Are We Ready to Recommend More Than the Recommended Daily Allowance? Adv Nutr 2018; 9:171-182. [PMID: 29635313 PMCID: PMC5952928 DOI: 10.1093/advances/nmy003] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/08/2018] [Indexed: 12/17/2022] Open
Abstract
The Dietary Reference Intakes set the protein RDA for persons >19 y of age at 0.8 g protein ⋅ kg body weight-1 ⋅ d-1. A growing body of evidence suggests, however, that the protein RDA may be inadequate for older individuals. The evidence for recommending a protein intake greater than the RDA comes from a variety of metabolic approaches. Methodologies centered on skeletal muscle are of paramount importance given the age-related decline in skeletal muscle mass and function (sarcopenia) and the degree to which dietary protein could mitigate these declines. In addition to evidence from short-term experimental trials, observational data show that higher protein intakes are associated with greater muscle mass and, more importantly, better muscle function with aging. We are in dire need of more evidence from longer-term intervention trials showing the efficacy of protein intakes that are higher than the RDA in older persons to support skeletal muscle health. We propose that it should be recommended that older individuals consume ≥1.2 g protein · kg-1 · d-1 and that there should be an emphasis on the intake of the amino acid leucine, which plays a central role in stimulating skeletal muscle anabolism. Critically, the often-cited potential negative effects of consuming higher protein intakes on renal and bone health are without a scientific foundation in humans.
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Affiliation(s)
- Daniel A Traylor
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stefan H M Gorissen
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada,Address correspondence to SMP (e-mail: )
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184
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Abstract
The ability of athletes to train day after day depends in large part on adequate restoration of muscle glycogen stores, a process that requires the consumption of sufficient dietary carbohydrates and ample time. Providing effective guidance to athletes and others wishing to enhance training adaptations and improve performance requires an understanding of the normal variations in muscle glycogen content in response to training and diet; the time required for adequate restoration of glycogen stores; the influence of the amount, type, and timing of carbohydrate intake on glycogen resynthesis; and the impact of other nutrients on glycogenesis. This review highlights the practical implications of the latest research related to glycogen metabolism in physically active individuals to help sports dietitians, coaches, personal trainers, and other sports health professionals gain a fundamental understanding of glycogen metabolism, as well as related practical applications for enhancing training adaptations and preparing for competition.
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Affiliation(s)
- Bob Murray
- Sports Science Insights, LLC, Crystal Lake, Illinois, USA
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185
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Lonnie M, Hooker E, Brunstrom JM, Corfe BM, Green MA, Watson AW, Williams EA, Stevenson EJ, Penson S, Johnstone AM. Protein for Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients 2018; 10:E360. [PMID: 29547523 PMCID: PMC5872778 DOI: 10.3390/nu10030360] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/12/2018] [Accepted: 03/14/2018] [Indexed: 12/27/2022] Open
Abstract
With an ageing population, dietary approaches to promote health and independence later in life are needed. In part, this can be achieved by maintaining muscle mass and strength as people age. New evidence suggests that current dietary recommendations for protein intake may be insufficient to achieve this goal and that individuals might benefit by increasing their intake and frequency of consumption of high-quality protein. However, the environmental effects of increasing animal-protein production are a concern, and alternative, more sustainable protein sources should be considered. Protein is known to be more satiating than other macronutrients, and it is unclear whether diets high in plant proteins affect the appetite of older adults as they should be recommended for individuals at risk of malnutrition. The review considers the protein needs of an ageing population (>40 years old), sustainable protein sources, appetite-related implications of diets high in plant proteins, and related areas for future research.
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Affiliation(s)
- Marta Lonnie
- Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Ashgrove Road West, Aberdeen AB25 2ZD, UK.
| | - Emma Hooker
- Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Ashgrove Road West, Aberdeen AB25 2ZD, UK.
| | - Jeffrey M Brunstrom
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
| | - Bernard M Corfe
- Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
- Insigneo Institute for in silico medicine, The Pam Liversidge Building, Mappin Street, Sheffield S1 3JD, UK.
| | - Mark A Green
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Liverpool L69 7ZT, UK.
| | - Anthony W Watson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Medical School, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Elizabeth A Williams
- Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
| | - Emma J Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Medical School, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Simon Penson
- Campden BRI, Station Rd, Chipping Campden, Gloucestershire GL55 6LD, UK.
| | - Alexandra M Johnstone
- Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Ashgrove Road West, Aberdeen AB25 2ZD, UK.
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186
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Moreno-Pérez D, Bressa C, Bailén M, Hamed-Bousdar S, Naclerio F, Carmona M, Pérez M, González-Soltero R, Montalvo-Lominchar MG, Carabaña C, Larrosa M. Effect of a Protein Supplement on the Gut Microbiota of Endurance Athletes: A Randomized, Controlled, Double-Blind Pilot Study. Nutrients 2018; 10:E337. [PMID: 29534465 PMCID: PMC5872755 DOI: 10.3390/nu10030337] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 12/24/2022] Open
Abstract
Nutritional supplements are popular among athletes to improve performance and physical recovery. Protein supplements fulfill this function by improving performance and increasing muscle mass; however, their effect on other organs or systems is less well known. Diet alterations can induce gut microbiota imbalance, with beneficial or deleterious consequences for the host. To test this, we performed a randomized pilot study in cross-country runners whose diets were complemented with a protein supplement (whey isolate and beef hydrolysate) (n = 12) or maltodextrin (control) (n = 12) for 10 weeks. Microbiota, water content, pH, ammonia, and short-chain fatty acids (SCFAs) were analyzed in fecal samples, whereas malondialdehyde levels (oxidative stress marker) were determined in plasma and urine. Fecal pH, water content, ammonia, and SCFA concentrations did not change, indicating that protein supplementation did not increase the presence of these fermentation-derived metabolites. Similarly, it had no impact on plasma or urine malondialdehyde levels; however, it increased the abundance of the Bacteroidetes phylum and decreased the presence of health-related taxa including Roseburia, Blautia, and Bifidobacterium longum. Thus, long-term protein supplementation may have a negative impact on gut microbiota. Further research is needed to establish the impact of protein supplements on gut microbiota.
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Affiliation(s)
- Diego Moreno-Pérez
- Departamento de Educación, Métodos de Investigación y Evaluación, Universidad Pontificia de Comillas, ICAI-ICADE, Cantoblanco, Madrid 28015, Spain.
| | - Carlo Bressa
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - María Bailén
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - Safa Hamed-Bousdar
- Escuela de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - Fernando Naclerio
- Department of Life and Sports Sciences, University of Greenwich, Kent ME4 4TB, UK.
| | - Manuel Carmona
- Escuela de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - Margarita Pérez
- Escuela de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - Rocío González-Soltero
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | | | - Claudia Carabaña
- Escuela de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
| | - Mar Larrosa
- Escuela de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain.
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Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations. Nutr Res Rev 2018; 31:204-224. [DOI: 10.1017/s0954422418000045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.
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Stevenson EJ, Watson AW, Brunstrom JM, Corfe BM, Green MA, Johnstone AM, Williams EA. Protein for Life: Towards a focussed dietary framework for healthy ageing. NUTR BULL 2018; 43:97-102. [PMID: 29540996 PMCID: PMC5838517 DOI: 10.1111/nbu.12312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
'Ageing well' has been highlighted as an important research area by the World Health Organization. In the UK, healthy ageing has been identified as a priority research area by multiple Research Councils and is a key NHS priority. Sarcopaenia, the decline of muscle mass/strength and a key component of healthy ageing, can have a major impact on quality of life and is associated with premature mortality. Increasing protein intake at all stages of the life course may help to reduce the rate of muscle decline and the onset of associated health conditions. However, there is a lack of understanding of the social, demographic and psychological drivers of food choices surrounding protein intake. This report describes the multidisciplinary approach that has been adopted by the Protein for Life project to create a framework for the development of palatable, cost-effective higher-protein foods suitable for an ageing population.
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Affiliation(s)
- E. J. Stevenson
- Human Nutrition Research CentreInstitute of Cellular MedicineNewcastle UniversityNewcastle Upon‐TyneUK
| | - A. W. Watson
- Human Nutrition Research CentreInstitute of Cellular MedicineNewcastle UniversityNewcastle Upon‐TyneUK
| | - J. M. Brunstrom
- School of Experimental PsychologyUniversity of BristolBristolUK
| | - B. M. Corfe
- Department of OncologyUniversity of SheffieldSheffieldUK
| | - M. A. Green
- School of Environmental SciencesUniversity of LiverpoolLiverpoolUK
| | | | - E. A. Williams
- Department of OncologyUniversity of SheffieldSheffieldUK
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Protein Recommendations for Weight Loss in Elite Athletes: A Focus on Body Composition and Performance. Int J Sport Nutr Exerc Metab 2018; 28:170-177. [PMID: 29182451 DOI: 10.1123/ijsnem.2017-0273] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
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.
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Differences in muscle adaptation to a 12-week mixed power training in elderly men, depending on usual protein intake. Exp Gerontol 2018; 104:78-85. [PMID: 29421607 DOI: 10.1016/j.exger.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Normal aging is often associated with a decline of muscle mass (MM), strength (MS) and quality (MQ: MS/MM), leading to functional incapacities. This aging-related deterioration of muscles may involve a decreased protein intake. Mixed power training has been recently shown to induce positive effects on MM, MS and MQ. However, to our knowledge, no study has examined if muscle adaptations following mixed power training could be influenced by the daily amount of protein ingested in elderly men. METHODS Twenty-one men completed the intervention and were divided into 2 groups based on their usual protein intake: PROT 1.1- (<1.1 g·kg-1·d-1 [n = 10; 73 ± 3 years]) and PROT 1.2+ (>1.2 g·kg-1·d-1 [n = 11; 73 ± 3 years]). Body composition (DXA: lean and fat masses), MS (1-maximal repetition on leg-press and handgrip strength), MQ (MS/body mass and MS/lower limb lean mass), functional capacities (Short Physical Performance Battery/Senior Fitness Test), dietary intake (3-day food record) and energy expenditure (accelerometer; 7 days) were measured. Mixed power training intervention consisted in power and functional exercises (12 weeks; 3 times/week; 1 h/session). RESULTS Lower limb MS increase in the PROT 1.2+ group was greater from that of the PROT 1.1- group when normalized to lower limbs lean mass (p = 0.036). In addition, a trend for greater gain in lower limb MS normalized to body mass (p = 0.053) was observed in the PROT 1.2+. CONCLUSION To optimize mixed power training effects on muscle function, healthy older men should ingest daily at least 1.2 g·kg-1·d-1 of protein. These beneficial effects of a higher usual protein intake were observed especially for MQ, which is one of the best predictors of functional capacities in older adults.
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Abstract
Sarcopenia represents a loss of muscle strength and mass in older individuals. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training. There are no pharmacologic agents for the treatment of sarcopenia.
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Affiliation(s)
- Robinder J S Dhillon
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Room Number 3-2340, Bethesda, MD 20892, USA
| | - Sarfaraz Hasni
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Room Number 3-2340, Bethesda, MD 20892, USA.
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Mishra S, Goldman JD, Sahyoun NR, Moshfegh AJ. Association between dietary protein intake and grip strength among adults aged 51 years and over: What We Eat in America, National Health and Nutrition Examination Survey 2011-2014. PLoS One 2018; 13:e0191368. [PMID: 29364939 PMCID: PMC5783368 DOI: 10.1371/journal.pone.0191368] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/03/2018] [Indexed: 01/16/2023] Open
Abstract
Introduction Distributing daily protein intake evenly across meals (∼25–30g/meal) has been suggested to improve muscle mass. The aim of this research is to examine the association between grip strength, total protein intake and its distribution across day’s meals in older adults. Methods Nationally representative dietary intake data of adults aged 51 years and older (n = 4,123) who participated in What We Eat in America, NHANES 2011–2014 were analyzed. Protein intake per day and per eating occasion (breakfast, lunch, dinner, and snack) were determined. Combined grip strength was calculated and expressed in kilograms. Grip strength of individuals consuming ≥25g protein at 1 eating occasion was compared with those consuming same level of protein at 2 and 3 or more eating occasions. Grip strength of individuals in quartile 1 of daily protein intake was compared to those in the other quartiles. All associations were examined without and with adjustment for age, race/ethnicity, physical activity, health status, and smoking status. The comparison involving eating occasions and protein intake quartiles were further adjusted for daily protein intake and energy intake, respectively. Results Only 33% of men and 19% of women had protein intake of ≥25g at 2 or more eating occasions. These individuals also had higher grip strength and daily protein intake. Grip strength was positively associated with consumption of ≥25g protein at 2 eating occasions as compared to consumption of same level of protein at 1 eating occasion (p<0.05) in unadjusted model, but not when adjusted. Grip strength was positively associated with daily protein intake among women in quartiles 3 and 4 (p<0.05) of protein intake in both unadjusted and adjusted models compared to lowest protein intake. Among men, grip strength was associated with daily protein intake in quartiles 3 and 4 (p<0.05) in the unadjusted model, but not when adjusted. Conclusion In a nationally representative sample of older adults, consuming ≥25g protein at 2 or more eating occasions was not associated with grip strength. However, higher daily protein intake was positively associated with grip strength in women.
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Affiliation(s)
- Suruchi Mishra
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, United States of America
- * E-mail:
| | - Joseph D. Goldman
- United States Department of Agriculture, ARS, Beltsville Human Nutrition Research Center, Beltsville, Maryland, United States of America
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, United States of America
| | - Alanna J. Moshfegh
- United States Department of Agriculture, ARS, Beltsville Human Nutrition Research Center, Beltsville, Maryland, United States of America
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Fanelli Kuczmarski M, Pohlig RT, Stave Shupe E, Zonderman AB, Evans MK. Dietary Protein Intake and Overall Diet Quality Are Associated with Handgrip Strength in African American and White Adults. J Nutr Health Aging 2018; 22:700-709. [PMID: 29806859 PMCID: PMC5984956 DOI: 10.1007/s12603-018-1006-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the association of handgrip strength (HS) with protein intake, diet quality, and nutritional and cardiovascular biomarkers in African American and White adults. DESIGN Cross-sectional wave 3 (2009-2013) of the cohort Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. PARTICIPANTS Socioeconomically diverse urban population of 2,468 persons aged 33 to 71 years. MEASUREMENTS Socio-demographic correlates, dietary intakes and biomarkers, HS, physical performance measures were collected. HS was measured using a dynamometer with the dominant hand. Functional measures included chair, tandem, and single leg stands. Two 24-hour recalls were collected using the US Department of Agriculture Automated Multiple Pass Method. The total protein intake and diet quality, evaluated by adherence to the DASH eating plan and Healthy Eating Index-2010, were calculated. Biomarkers included nutritional anemia, and serum levels of albumin, cholesterol, magnesium, and glucose. RESULTS The mean ±SE age of the sample was 52.3±0.2 years. Approximately 61% were African American and 57% were women. The mean ±SE HS of women was 29.1±0.2kg and for men was 45.9±0.4 kg. Protein, gm, per kg body weight for the women was 0.94±0.02 compared to 1.16 ±0.02 for men. After adjusting for socio-demographic factors, hypertension, and diabetes, HS/BMI ratio was significantly associated with protein intake per kg body weight (p<0.001) and diet quality, assessed by either the DASH adherence (p=0.009) or Health Eating Index-2010 (p=0.031) scores. For both men and women, participants in the upper tertile of HS maintained a single leg and tandem stances longer and completed 5 and 10 chair stands in shorter time compared to individuals in the lower HS tertile. Of the nutritional status indicators, the percent of men in the upper HS tertile with low serum magnesium and albumin, was significantly lower than those in the lower HS tertile [magnesium,7.4% vs 16.1%; albumin, 0.4% vs 4.5%]. The only difference observed for women was a lower percent of diabetes (14.4% for the upper HS tertile compared to 20.5% for the lower HS tertile. CONCLUSIONS The findings confirm the role of protein and a healthful diet in the maintenance of muscle strength. In this community sample, HS was significantly associated with other physical performance measures but did not appear to be strongly associated with indicators of nutritional risk. These findings support the use of HS as a proxy for functional status and indicate the need for research to explore its role as a predictor of nutritional risk.
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Affiliation(s)
- M Fanelli Kuczmarski
- Marie Fanelli Kuczmarskia, University of Delaware, Department of Behavioral Health and Nutrition, 206C McDowell Hall, Newark, DE 19716, United States, , Ph: +1-302-831-8765; Fax: +1-302-831-4261,
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Protein and Peptides for Elderly Health. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2018; 112:265-308. [DOI: 10.1016/bs.apcsb.2018.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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195
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Mishra S, Goldman JD, Sahyoun NR, Moshfegh AJ. Dietary protein intake by meal types in adults aged 51 years and over: WWEIA, NHANES 2011–2012. J Food Compost Anal 2017. [DOI: 10.1016/j.jfca.2017.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Churchward-Venne TA, Pinckaers PJM, van Loon JJA, van Loon LJC. Consideration of insects as a source of dietary protein for human consumption. Nutr Rev 2017; 75:1035-1045. [DOI: 10.1093/nutrit/nux057] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Ispoglou T, Deighton K, King RF, White H, Lees M. Novel essential amino acid supplements enriched with L-leucine facilitate increased protein and energy intakes in older women: a randomised controlled trial. Nutr J 2017; 16:75. [PMID: 29183324 PMCID: PMC5704600 DOI: 10.1186/s12937-017-0298-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/20/2017] [Indexed: 12/27/2022] Open
Abstract
Background Inadequate protein intake (PI), containing a sub-optimal source of essential amino acids (EAAs), and reduced appetite are contributing factors to age-related sarcopenia. The satiating effects of dietary protein per se may negatively affect energy intake (EI), thus there is a need to explore alternative strategies to facilitate PI without compromising appetite and subsequent EI. Methods Older women completed two experiments (EXP1 and EXP2) where they consumed either a Bar (565 kJ), a Gel (477 kJ), both rich in EAAs (7.5 g, 40% L-leucine), or nothing (Control). In EXP1, participants (n = 10, 68 ± 5 years, mean ± SD) consumed Bar, Gel or Control with appetite sensations and appetite-related hormonal responses monitored for one hour, followed by consumption of an ad libitum breakfast (ALB). In EXP2, participants (n = 11, 69 ± 5 years) ingested Bar, Gel or Control alongside an ALB. Results In EXP1, EI at ALB was not different (P = 0.674) between conditions (1179 ± 566, 1254 ± 511, 1206 ± 550 kJ for the Control, Bar, and Gel respectively). However, total EI was significantly higher in the Bar and Gel compared to the Control after accounting for the energy content of the supplements (P < 0.0005). Analysis revealed significantly higher appetite Area under the Curve (AUC) (P < 0.007), a tendency for higher acylated ghrelin AUC (P = 0.087), and significantly lower pancreatic polypeptide AUC (P = 0.02) in the Control compared with the Bar and Gel. In EXP2, EI at ALB was significantly higher (P = 0.028) in the Control (1282 ± 513 kJ) compared to the Bar (1026 ± 565 kJ) and Gel (1064 ± 495 kJ). However, total EI was significantly higher in the Bar and Gel after accounting for the energy content of the supplements (P < 0.007). Conclusions Supplementation with either the Bar or Gel increased total energy intake whether consumed one hour before or during breakfast. This may represent an effective nutritional means for addressing protein and total energy deficiencies in older women. Trial registration Clinical trial register: retrospectively registered, ISRCTN12977929 on.
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Affiliation(s)
- Theocharis Ispoglou
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK. .,Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK.
| | - Kevin Deighton
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
| | - Roderick Fgj King
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
| | - Helen White
- School of Applied and Clinical Sciences, Leeds Beckett University, CL413 Calverley Building Civic Quarter, Leeds, LS1 3HE, UK
| | - Matthew Lees
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
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Burd NA, De Lisio M. Skeletal Muscle Remodeling: Interconnections Between Stem Cells and Protein Turnover. Exerc Sport Sci Rev 2017; 45:187-191. [PMID: 28419002 DOI: 10.1249/jes.0000000000000117] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nutrition and exercise are important components of a healthy lifestyle to improve rates of hypertrophic and nonhypertrophic skeletal muscle remodeling. We provide evidence to support the hypothesis that muscle stem cells and protein turnover are collaborative, not separate, mechanisms supporting muscle remodeling by facilitating protein, nuclear, and cellular turnover in response to the ingestion of protein dense foods and exercise.
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Affiliation(s)
- Nicholas A Burd
- 1Department of Kinesiology and Community Health, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, IL; and 2School of Human Kinetics, Brain and Mind Institute, Centre for Neuromuscular Disease, and Regenerative Medicine Program, University of Ottawa, Ottawa, ON, Canada
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Mycoprotein represents a bioavailable and insulinotropic non-animal-derived dietary protein source: a dose–response study. Br J Nutr 2017; 118:673-685. [DOI: 10.1017/s0007114517002409] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AbstractThe anabolic potential of a dietary protein is determined by its ability to elicit postprandial rises in circulating essential amino acids and insulin. Minimal data exist regarding the bioavailability and insulinotropic effects of non-animal-derived protein sources. Mycoprotein is a sustainable and rich source of non-animal-derived dietary protein. We investigated the impact of mycoprotein ingestion, in a dose–response manner, on acute postprandial hyperaminoacidaemia and hyperinsulinaemia. In all, twelve healthy young men completed five experimental trials in a randomised, single-blind, cross-over design. During each trial, volunteers consumed a test drink containing either 20 g milk protein (MLK20) or a mass matched (not protein matched due to the fibre content) bolus of mycoprotein (20 g; MYC20), a protein matched bolus of mycoprotein (40 g; MYC40), 60 g (MYC60) or 80 g (MYC80) mycoprotein. Circulating amino acid, insulin and uric acid concentrations, and clinical chemistry profiles, were assessed in arterialised venous blood samples during a 4-h postprandial period. Mycoprotein ingestion resulted in slower but more sustained hyperinsulinaemia and hyperaminoacidaemia compared with milk when protein matched, with overall bioavailability equivalent between conditions (P>0·05). Increasing the dose of mycoprotein amplified these effects, with some evidence of a plateau at 60–80 g. Peak postprandial leucine concentrations were 201 (sem 24) (30 min), 118 (sem 10) (90 min), 150 (sem 14) (90 min), 173 (sem 23) (45 min) and 201 (sem 21 (90 min) µmol/l for MLK20, MYC20, MYC40, MYC60 and MYC80, respectively. Mycoprotein represents a bioavailable and insulinotropic dietary protein source. Consequently, mycoprotein may be a useful source of dietary protein to stimulate muscle protein synthesis rates.
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200
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Rossato LT, Nahas PC, de Branco FMS, Martins FM, Souza AP, Carneiro MAS, Orsatti FL, de Oliveira EP. Higher Protein Intake Does Not Improve Lean Mass Gain When Compared with RDA Recommendation in Postmenopausal Women Following Resistance Exercise Protocol: A Randomized Clinical Trial. Nutrients 2017; 9:nu9091007. [PMID: 28895933 PMCID: PMC5622767 DOI: 10.3390/nu9091007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to evaluate the effect of a higher protein intake on lean body mass (LBM) gain in postmenopausal women practicing resistance exercise and compare it to the Recommended Dietary Allowance (RDA) recommendation. Twenty-three postmenopausal women (63.2 ± 7.8 years) were randomized into two groups. The group with higher protein intake (n = 11) (HP) received a dietary plan with ~1.2 g·kg-1·day-1 of protein, while the normal protein (NP) group (n = 12) was instructed to ingest ~0.8 g·kg-1·day-1 of protein (RDA recommendation). Both groups performed the same resistance training protocol, 3 times a week, with progression of the number of sets (from 1 to 6 sets) and 8-12 repetitions. The intervention occurred over 10 weeks. Body composition evaluation was performed by dual-energy X-ray absorptiometry. The diet was evaluated by nine 24-h food recall summaries over the course of the study. During the intervention period, the HP group presented a higher protein (1.18 ± 0.3 vs. 0.87 ± 0.2 g·kg-1·day-1, p = 0.008) and leucine (6.0 ± 1.4 vs. 4.3 ± 0.9 g/day, p < 0.001) intake than the NP group, respectively. At the end of the intervention, there were increases in LBM both in HP (37.1 ± 6.2 to 38.4 ± 6.5 kg, p = 0.004) and in NP (37.6 ± 6.2 to 38.8 ± 6.4 kg, p < 0.001), with no differences between the groups (p = 0.572). In conclusion, increased protein intake did not promote higher LBM gain when compared to RDA recommendation in postmenopausal women performing resistance exercise during 10 weeks. This trial was registered at ClinicalTrials.gov as NCT03024125.
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Affiliation(s)
- Luana T Rossato
- School of Medicine, Federal University of Uberlandia (UFU), Av. Pará, n° 1720, Bloco 2U, Campus Umuarama, Uberlandia 38400-902, Minas Gerais, Brazil.
| | - Paula C Nahas
- School of Medicine, Federal University of Uberlandia (UFU), Av. Pará, n° 1720, Bloco 2U, Campus Umuarama, Uberlandia 38400-902, Minas Gerais, Brazil.
| | - Flávia M S de Branco
- School of Medicine, Federal University of Uberlandia (UFU), Av. Pará, n° 1720, Bloco 2U, Campus Umuarama, Uberlandia 38400-902, Minas Gerais, Brazil.
| | - Fernanda M Martins
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba 38061-500, Minas Gerais, Brazil.
| | - Aletéia P Souza
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba 38061-500, Minas Gerais, Brazil.
| | - Marcelo A S Carneiro
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba 38061-500, Minas Gerais, Brazil.
| | - Fábio L Orsatti
- Exercise Biology Research Group (BioEx), Federal University of Triangulo Mineiro (UFTM), Uberaba 38061-500, Minas Gerais, Brazil.
- Department of Sport Sciences, Federal University of Triangulo Mineiro (UFTM), Uberaba 38061-500, Minas Gerais, Brazil.
| | - Erick P de Oliveira
- School of Medicine, Federal University of Uberlandia (UFU), Av. Pará, n° 1720, Bloco 2U, Campus Umuarama, Uberlandia 38400-902, Minas Gerais, Brazil.
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