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Morton RW, Murphy KT, McKellar SR, Schoenfeld BJ, Henselmans M, Helms E, Aragon AA, Devries MC, Banfield L, Krieger JW, Phillips SM. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med 2017; 52:376-384. [PMID: 28698222 PMCID: PMC5867436 DOI: 10.1136/bjsports-2017-097608] [Citation(s) in RCA: 591] [Impact Index Per Article: 84.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We performed a systematic review, meta-analysis and meta-regression to determine if dietary protein supplementation augments resistance exercise training (RET)-induced gains in muscle mass and strength. DATA SOURCES A systematic search of Medline, Embase, CINAHL and SportDiscus. ELIGIBILITY CRITERIA Only randomised controlled trials with RET ≥6 weeks in duration and dietary protein supplementation. DESIGN Random-effects meta-analyses and meta-regressions with four a priori determined covariates. Two-phase break point analysis was used to determine the relationship between total protein intake and changes in fat-free mass (FFM). RESULTS Data from 49 studies with 1863 participants showed that dietary protein supplementation significantly (all p<0.05) increased changes (means (95% CI)) in: strength-one-repetition-maximum (2.49 kg (0.64, 4.33)), FFM (0.30 kg (0.09, 0.52)) and muscle size-muscle fibre cross-sectional area (CSA; 310 µm2 (51, 570)) and mid-femur CSA (7.2 mm2 (0.20, 14.30)) during periods of prolonged RET. The impact of protein supplementation on gains in FFM was reduced with increasing age (-0.01 kg (-0.02,-0.00), p=0.002) and was more effective in resistance-trained individuals (0.75 kg (0.09, 1.40), p=0.03). Protein supplementation beyond total protein intakes of 1.62 g/kg/day resulted in no further RET-induced gains in FFM. SUMMARY/CONCLUSION Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults. Increasing age reduces and training experience increases the efficacy of protein supplementation during RET. With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute RET-induced gains in FFM.
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Affiliation(s)
- Robert W Morton
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Kevin T Murphy
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Sean R McKellar
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Brad J Schoenfeld
- Department of Health Sciences, Lehman College of CUNY, Bronx, New York, USA
| | | | - Eric Helms
- Sport Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Alan A Aragon
- California State University, Northridge, California, USA
| | | | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Canada
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202
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Shao A, Campbell WW, Chen CYO, Mittendorfer B, Rivas DA, Griffiths JC. The emerging global phenomenon of sarcopenic obesity: Role of functional foods; a conference report. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.03.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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203
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Phillips SM. Current Concepts and Unresolved Questions in Dietary Protein Requirements and Supplements in Adults. Front Nutr 2017; 4:13. [PMID: 28534027 PMCID: PMC5420553 DOI: 10.3389/fnut.2017.00013] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/18/2017] [Indexed: 12/21/2022] Open
Abstract
Protein needs for otherwise healthy individuals older than 19 years are defined by the recommended dietary allowance (RDA) at 0.80 g protein/kg/day. There is no recommendation in the current RDA for subpopulations of older adults or people in various pathological situations. Despite the lack of a separate recommendation, there exists a growing body of evidence that is strongly suggestive of an increased need and/or benefit for protein in older persons. That is, intakes beyond the RDA are, in older persons, associated with benefits. In addition, a number of catabolic states including critical illness also result in a sharp elevation in the needs for protein and amino acids. An underappreciated issue in protein nutrition is the impact of protein quality on clinically relevant outcomes. The introduction of a new protein scoring system-the digestible indispensable amino acid score (DIAAS)-for protein quality has raised a forgotten awareness of protein quality. The DIAAS, which replaces the protein digestibility-corrected amino acid score (PDCAAS), is based on ileal digestibility of protein and a different test protein than PDCAAS and has values greater than 1.0. The aim of this article is a brief review and summary recommendations for protein nutrition and protein requirements in populations who would benefit from more protein than the RDA. The emphasis of the review is on muscle protein turnover, and there is a discussion of the impact of protein quality, particularly as it applies to commercially available protein sources. The evidence for more optimal protein intakes is considered in light of the potential health risks of consumption of protein at levels greater than the RDA.
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204
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Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN, Kowalski A, Rabasa-Lhoret R, McCrimmon RJ, Hume C, Annan F, Fournier PA, Graham C, Bode B, Galassetti P, Jones TW, Millán IS, Heise T, Peters AL, Petz A, Laffel LM. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 2017; 5:377-390. [PMID: 28126459 DOI: 10.1016/s2213-8587(17)30014-1] [Citation(s) in RCA: 507] [Impact Index Per Article: 72.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 12/28/2022]
Abstract
Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
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Affiliation(s)
- Michael C Riddell
- Muscle Health Research Centre, York University, Toronto, ON, Canada.
| | - Ian W Gallen
- Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK
| | - Carmel E Smart
- Hunter Medical Research Institute, School of Health Sciences, University of Newcastle, Rankin Park, NSW, Australia
| | - Craig E Taplin
- Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Peter Adolfsson
- Department of Pediatrics, The Hospital of Halland, Kungsbacka, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alistair N Lumb
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
| | - Aaron Kowalski
- Juvenile Diabetes Research Foundation, New York, NY, USA
| | - Remi Rabasa-Lhoret
- Department of Nutrition and Institut de Recherches Cliniques de Montréal, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Rory J McCrimmon
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | | | - Francesca Annan
- Children and Young People's Diabetes Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Paul A Fournier
- School of Sport Science, Exercise, and Health, Perth, WA, Australia
| | | | - Bruce Bode
- Atlanta Diabetes Associates, Atlanta, GA, USA
| | - Pietro Galassetti
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA; AstraZeneca, Gaithersburg, MD, USA
| | - Timothy W Jones
- The University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Iñigo San Millán
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO, USA
| | | | - Anne L Peters
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Lori M Laffel
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA
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205
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Hrolfsdottir L, Halldorsson TI, Rytter D, Bech BH, Birgisdottir BE, Gunnarsdottir I, Granström C, Henriksen TB, Olsen SF, Maslova E. Maternal Macronutrient Intake and Offspring Blood Pressure 20 Years Later. J Am Heart Assoc 2017; 6:e005808. [PMID: 28438741 PMCID: PMC5533044 DOI: 10.1161/jaha.117.005808] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/22/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Results from 2 cohort studies in Scotland established in the 1940s and 1950s (Aberdeen and Motherwell) suggested that a high protein diet during pregnancy might adversely influence offspring blood pressure at adult age. Our objective was to examine this association in the Danish Fetal Origins Cohort (DaFO88). METHODS AND RESULTS This was a prospective birth cohort of 965 women who gave birth in 1988-1989 in Aarhus, Denmark, and whose offspring (n=434) participated in a clinical examination ≈20 years later. Macronutrient intake was assessed in gestational week 30. Multivariable adjusted linear regression was used to examine the relation between higher maternal protein intake, at the expense of carbohydrates, and offspring blood pressure (isocaloric substitution). Main analyses were adjusted for mother's age during pregnancy, prepregnancy body mass index, parity, smoking during pregnancy, educational level, and offspring's sex. The mean total energy intake was 8.7 MJ/day (SD 2.3 MJ/day). The mean energy from carbohydrate, fat, and protein intake was 51, 31, and 16 of total energy, respectively. The results showed that after adjustment, higher maternal protein intake was associated with slightly higher offspring diastolic blood pressure (highest compared with the lowest quintile of protein intake: ∆=2.4 mm Hg; 95% CI 0.4-4.4; P=0.03 for trend). Similar differences, although not significant, were found for systolic blood pressure (∆=2.6 mm Hg; 95% CI -0.0 to 5.3; P=0.08 for trend). CONCLUSIONS Higher maternal dietary protein intake at the expense of carbohydrates was associated with a modest increase in offspring blood pressure in young adulthood.
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Affiliation(s)
- Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Dorte Rytter
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Charlotta Granström
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Pediatric Department, Aarhus University Hospital, Skejby, Denmark
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Ekaterina Maslova
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Primary Care and Public Health, Imperial College, London, United Kingdom
- Danish Diabetes Academy, Odense, Denmark
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206
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Meyer N, Reguant-Closa A. "Eat as If You Could Save the Planet and Win!" Sustainability Integration into Nutrition for Exercise and Sport. Nutrients 2017; 9:E412. [PMID: 28430140 PMCID: PMC5409751 DOI: 10.3390/nu9040412] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 04/10/2017] [Accepted: 04/14/2017] [Indexed: 12/11/2022] Open
Abstract
Today's industrial food production contributes significantly to environmental degradation. Meat production accounts for the largest impact, including greenhouse gas emissions, land and water use. While food production and consumption are important aspects when addressing climate change, this article focuses predominantly on dietary change that promotes both health for planet and people with focus on athletes. Healthy, sustainable eating recommendations begin to appear in various governmental guidelines. However, there remains resistance to the suggested reductions in meat consumption. While food citizens are likely to choose what is good for them and the planet, others may not, unless healthy eating initiatives integrate creative food literacy approaches with experiential learning as a potential vehicle for change. This concept paper is organized in three sections: (1) Environmental impact of food; (2) health and sustainability connections; and (3) application in sports and exercise. For active individuals, this article focuses on the quantity of protein, highlighting meat and dairy, and quality of food, with topics such as organic production and biodiversity. Finally, the timing of when to integrate sustainability principles in sport nutrition is discussed, followed by practical applications for education and inclusion in team, institutional, and event operations.
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Affiliation(s)
- Nanna Meyer
- Health Sciences Department, University of Colorado, Colorado Springs, CO 80918, USA.
| | - Alba Reguant-Closa
- International Doctoral School, University of Andorra, Principality of Andorra, Sant Julià de Lòria AD600, Andorra.
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207
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Scott D, de Courten B, Ebeling PR. Sarcopenia: a potential cause and consequence of type 2 diabetes in Australia's ageing population? Med J Aust 2017; 205:329-33. [PMID: 27681976 DOI: 10.5694/mja16.00446] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/01/2016] [Indexed: 12/23/2022]
Abstract
The incidence of type 2 diabetes is increasing in Australia's older adult population. Sarcopenia, the age-related decline in skeletal muscle mass, quality and function, may make a significant but under-appreciated contribution to increasing the risk of type 2 diabetes. As skeletal muscle is the largest insulin-sensitive tissue in the body, low muscle mass in sarcopenia likely results in reduced capacity for glucose disposal. Age-related declines in muscle quality, including increased mitochondrial dysfunction and fat infiltration, are also implicated in skeletal muscle inflammation and subsequent insulin resistance. Prospective studies have shown that low muscle mass and strength are associated with increased risk of incident type 2 diabetes. Prevalent type 2 diabetes also appears to exacerbate progression of sarcopenia in older adults. Recently developed operational definitions and the inclusion of sarcopenia in the International classification of diseases, 10th revision, clinical modification, provide impetus for clinicians to diagnose and treat sarcopenia in older patients. Simple assessments to diagnose sarcopenia can potentially play a role in primary and secondary prevention of type 2 diabetes in older patients. Lifestyle modification programs for older adults with type 2 diabetes, particularly for those with sarcopenia, should incorporate progressive resistance training, along with adequate intakes of protein and vitamin D, which may improve both functional and metabolic health and prevent undesirable decreases in muscle mass associated with weight loss interventions. As some older adults with type 2 diabetes have a poor response to exercise, clinicians must ensure that lifestyle modification programs are appropriately prescribed, regularly monitored and modified if necessary.
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208
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Bechshøft RL, Malmgaard-Clausen NM, Gliese B, Beyer N, Mackey AL, Andersen JL, Kjær M, Holm L. Improved skeletal muscle mass and strength after heavy strength training in very old individuals. Exp Gerontol 2017; 92:96-105. [PMID: 28363433 DOI: 10.1016/j.exger.2017.03.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/12/2017] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
Age-related loss of muscle mass and function represents personal and socioeconomic challenges. The purpose of this study was to determine the adaptation of skeletal musculature in very old individuals (83+ years) performing 12weeks of heavy resistance training (3×/week) (HRT) compared to a non-training control group (CON). Both groups received similar protein supplementations. We studied 26 participants (86.9±3.2 (SD) (83-94, range) years old) per-protocol. Quadriceps cross-sectional area (CSA) differed between groups at post-test (P<0.05) and increased 1.5±0.7cm2 (3.4%) (P<0.05) in HRT only. The increase in CSA is correlated inversely with the baseline level of CSA (R2=0.43, P<0.02). Thigh muscle isometric strength, isokinetic peak torque and power increased significantly only in HRT by 10-15%, whereas knee extension one-repetition maximum (1 RM) improved by 91%. Physical functional tests, muscle fiber type distribution and size did not differ significantly between groups. We conclude that in protein supplemented very old individuals, heavy resistance training can increase muscle mass and strength, and that the relative improvement in mass is more pronounced when initial muscle mass is low.
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Affiliation(s)
- Rasmus Leidesdorff Bechshøft
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Nikolaj Mølkjær Malmgaard-Clausen
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Bjørn Gliese
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Nina Beyer
- Musculoskeletal Rehabilitation Research Unit, Dept. of Physical and Occupational Therapy, Bispebjerg Hospital, Denmark
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Jesper Løvind Andersen
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Michael Kjær
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Lars Holm
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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209
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Phillips SM, Dickerson RN, Moore FA, Paddon-Jones D, Weijs PJM. Protein Turnover and Metabolism in the Elderly Intensive Care Unit Patient. Nutr Clin Pract 2017; 32:112S-120S. [PMID: 28388378 DOI: 10.1177/0884533616686719] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Many intensive care unit (ICU) patients do not achieve target protein intakes particularly in the early days following admittance. This period of iatrogenic protein undernutrition contributes to a rapid loss of lean, in particular muscle, mass in the ICU. The loss of muscle in older (aged >60 years) patients in the ICU may be particularly rapid due to a perfect storm of increased catabolic factors, including systemic inflammation, disuse, protein malnutrition, and reduced anabolic stimuli. This loss of muscle mass has marked consequences. It is likely that the older patient is already experiencing muscle loss due to sarcopenia; however, the period of stay in the ICU represents a greatly accelerated period of muscle loss. Thus, on discharge, the older ICU patient is now on a steeper downward trajectory of muscle loss, more likely to have ICU-acquired muscle weakness, and at risk of becoming sarcopenic and/or frail. One practice that has been shown to have benefit during ICU stays is early ambulation and physical therapy (PT), and it is likely that both are potent stimuli to induce a sensitivity of protein anabolism. Thus, recommendations for the older ICU patient would be provision of at least 1.2-1.5 g protein/kg usual body weight/d, regular and early utilization of ambulation (if possible) and/or PT, and follow-up rehabilitation for the older discharged ICU patient that includes rehabilitation, physical activity, and higher habitual dietary protein to change the trajectory of ICU-mediated muscle mass loss and weakness.
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Affiliation(s)
- Stuart M Phillips
- 1 McMaster University, Department of Kinesiology, Hamilton, Ontario, Canada
| | - Roland N Dickerson
- 2 Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Frederick A Moore
- 3 Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Douglas Paddon-Jones
- 4 Nutrition and Metabolism, University of Texas Medical Branch, Galveston, Texas, USA
| | - Peter J M Weijs
- 5 Nutrition and Dietetics, Department of Internal Medicine, Department of Intensive Care Medicine, and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,6 Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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210
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Peterson SJ, Mozer M. Differentiating Sarcopenia and Cachexia Among Patients With Cancer. Nutr Clin Pract 2016; 32:30-39. [PMID: 28124947 DOI: 10.1177/0884533616680354] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Patients with cancer are at an increased risk for muscle loss via 2 distinct mechanisms: sarcopenia, defined as the age-associated decrease in muscle mass related to changes in muscle synthesis signaling pathways, and/or cachexia, defined as cytokine-mediated degradation of muscle and adipose depots. Both wasting disorders are prevalent; among patients with cancer, 15%-50% are sarcopenic and 25%-80% are cachectic. Muscle mass may be difficult to quantify in overweight/obese individuals. Often, overweight/obese patients with cancer are assumed to be normally nourished when in fact severe muscle depletion may be present. No universally accepted treatment exists for preventing or reversing sarcopenia or cachexia in patients with cancer. Current treatment options are limited to nutrition therapy and exercise, which may lead to difficulties in adherence during cancer treatment. Future treatments may provide pharmaceutical therapy that targets muscle degradation and synthesis pathways. There is a need to determine a multimodal treatment plan for muscle depletion to improve quality of life, survival, and therapy complications in patients with cancer.
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Affiliation(s)
- Sarah J Peterson
- 1 Department of Clinical Nutrition/Department of Food and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | - Marisa Mozer
- 1 Department of Clinical Nutrition/Department of Food and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
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211
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Gibson AA, Franklin J, Pattinson AL, Cheng ZGY, Samman S, Markovic TP, Sainsbury A. Comparison of Very Low Energy Diet Products Available in Australia and How to Tailor Them to Optimise Protein Content for Younger and Older Adult Men and Women. Healthcare (Basel) 2016; 4:healthcare4030071. [PMID: 27657150 PMCID: PMC5041072 DOI: 10.3390/healthcare4030071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/24/2016] [Accepted: 09/08/2016] [Indexed: 12/21/2022] Open
Abstract
Very low energy diets (VLED) are efficacious in inducing rapid weight loss but may not contain adequate macronutrients or micronutrients for individuals with varying nutritional requirements. Adequate protein intake during weight loss appears particularly important to help preserve fat free mass and control appetite, and low energy and carbohydrate content also contributes to appetite control. Therefore, the purpose of this study was to compare the nutritional content (with a focus on protein), nutritional adequacy and cost of all commercially-available VLED brands in Australia. Nutritional content and cost were extracted and compared between brands and to the Recommended Dietary Intake (RDI) or adequate intake (AI) of macronutrients and micronutrients for men and women aged 19-70 years or >70 years. There was wide variability in the nutritional content, nutritional adequacy and cost of VLED brands. Most notably, even brands with the highest daily protein content, based on consuming three products/day (KicStart™ and Optislim(®), ~60 g/day), only met estimated protein requirements of the smallest and youngest women for whom a VLED would be indicated. Considering multiple options to optimise protein content, we propose that adding pure powdered protein is the most suitable option because it minimizes additional energy, carbohydrate and cost of VLEDs.
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Affiliation(s)
- Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown 2050, Australia.
| | - Andrea L Pattinson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Zilvia G Y Cheng
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Samir Samman
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Tania P Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown 2050, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
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212
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Egan B. Protein intake for athletes and active adults: Current concepts and controversies. NUTR BULL 2016. [DOI: 10.1111/nbu.12215] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- B. Egan
- School of Health and Human Performance; Dublin City University; Dublin Ireland
- Food for Health Ireland; University College Dublin; Dublin Ireland
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213
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Arciero PJ, Edmonds RC, Bunsawat K, Gentile CL, Ketcham C, Darin C, Renna M, Zheng Q, Zhang JZ, Ormsbee MJ. Protein-Pacing from Food or Supplementation Improves Physical Performance in Overweight Men and Women: The PRISE 2 Study. Nutrients 2016; 8:nu8050288. [PMID: 27187451 PMCID: PMC4882701 DOI: 10.3390/nu8050288] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 12/26/2022] Open
Abstract
We recently reported that protein-pacing (P; six meals/day @ 1.4 g/kg body weight (BW), three of which included whey protein (WP) supplementation) combined with a multi-mode fitness program consisting of resistance, interval sprint, stretching, and endurance exercise training (RISE) improves body composition in overweight individuals. The purpose of this study was to extend these findings and determine whether protein-pacing with only food protein (FP) is comparable to WP supplementation during RISE training on physical performance outcomes in overweight/obese individuals. Thirty weight-matched volunteers were prescribed RISE training and a P diet derived from either whey protein supplementation (WP, n = 15) or food protein sources (FP, n = 15) for 16 weeks. Twenty-one participants completed the intervention (WP, n = 9; FP, n = 12). Measures of body composition and physical performance were significantly improved in both groups (p < 0.05), with no effect of protein source. Likewise, markers of cardiometabolic disease risk (e.g., LDL (low-density lipoprotein) cholesterol, glucose, insulin, adiponectin, systolic blood pressure) were significantly improved (p < 0.05) to a similar extent in both groups. These results demonstrate that both whey protein and food protein sources combined with multimodal RISE training are equally effective at improving physical performance and cardiometabolic health in obese individuals.
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Affiliation(s)
- Paul J Arciero
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Rohan C Edmonds
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Kanokwan Bunsawat
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Christopher L Gentile
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA.
| | - Caitlin Ketcham
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Christopher Darin
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Mariale Renna
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Qian Zheng
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Jun Zhu Zhang
- Human Nutrition and Metabolism Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, NY 12866, USA.
| | - Michael J Ormsbee
- Florida State University, Institute of Sports Sciences & Medicine, Department of Nutrition, Food and Exercise Sciences, Tallahassee, FL 32304, USA.
- Discipline of Biokinetics, Exercise, and Leisure Studies, University of KwaZulu-Natal, Durban 4041, South Africa.
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214
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Bertolo RF, Ma DW. Advances in Protein Nutrition Across the Lifespan. Appl Physiol Nutr Metab 2016; 41:563. [DOI: 10.1139/apnm-2016-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Robert F. Bertolo
- Department of Biochemistry, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - David W.L. Ma
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
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215
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Pencharz PB, Elango R, Wolfe RR. Recent developments in understanding protein needs - How much and what kind should we eat? Appl Physiol Nutr Metab 2016; 41:577-80. [PMID: 27109436 DOI: 10.1139/apnm-2015-0549] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A novel method has been developed to determine protein requirements, which is called indicator amino acid oxidation (IAAO). This technique has been validated by comparison with the "gold standard" nitrogen balance. Using IAAO we have shown that minimum protein requirements have been underestimated by 30%-50%. The National Academy of Sciences has for macro-nutrients proposed "Acceptable Macronutrient Distribution Ranges", which for protein is 10% to 35% of total energy. In practice, we suggest 1.5-2.2 g/(kg·day) of a variety of high-quality proteins.
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Affiliation(s)
- Paul B Pencharz
- a Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.,b Department of Paediatrics and Nutritional Sciences, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Rajavel Elango
- c Department of Pediatrics, University of British Columbia, Vancouver, BC V6T 1Z9, Canada.,d School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,e Child and Family Research Institute, BC Children's Hospital, Room 170A, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Robert R Wolfe
- f Department of Geriatrics, Center for Translational Research in Aging and Longevity, Reynolds Institute on Aging, University of Arkansas for Medical Sciences, 4301 W Markham Street, #806, Little Rock, AR 72205, USA
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