Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations

Protein requirements may be lower on a training compared to rest day but are not influenced by moderate training volumes in endurance trained males

The impact of training volume on protein requirements in endurance trained males was investigated with indicator amino acid oxidation (IAAO) methodology on a recovery day (REST) or after a 10 or 20 km run while consuming a single suboptimal protein intake (0.93 g/kg/day). Phenylalanine excretion (F13CO2; inverse proxy for whole body protein synthesis) was greatest and phenylalanine net balance was lowest on REST compared to post-exercise recovery with no difference between training volumes. Single point F13CO2 was indistinguishable from past IAAO studies using multiple protein intakes. Our results suggest that protein requirements may be greatest on recovery days but are not influenced by moderate training volumes in endurance athletes.

Protein Requirements Are Increased in Endurance-Trained Athletes but Similar between Females and Males during Postexercise Recovery

PURPOSE

This study aimed to determine the daily protein requirements of female and male endurance athletes in a home-based setting using noninvasive stable isotope methodology (i.e., indicator amino acid oxidation).

METHODS

Eight males (30 ± 3 yr; 78.6 ± 10.5 kg; 75.6 ± 7.5 mL·kgFFM-1·min-1; mean ± SD) and seven females (30 ± 4 yr; 57.7 ± 5.0 kg; 77.5 ± 7.1 mL·kgFFM-1·min-1) during the midluteal phase were studied. After 2 d of controlled diet (1.4 gprotein·kg-1·d-1) and training (10 and 5 km run·d-1, respectively), participants completed a 20-km run before an at-home indicator amino acid oxidation trial testing a suboptimal, a moderate, and an excess (i.e., 0.2, 1.2, and 2.0 g·kg-1·d-1, respectively) protein intake. Protein was consumed as a crystalline amino acid mixture containing [1-13C]phenylalanine to examine whole-body phenylalanine flux and phenylalanine oxidation (PheOx; the reciprocal of whole-body protein synthesis) through breath and urine sample collection. A modified biphasic linear regression determined the breakpoint in PheOx for each participant to generate an estimated average intake that would maximize whole-body protein synthesis for each sex.

RESULTS

PheOx was different (P < 0.01) between all protein intakes with no effect of sex (P = 0.63). Using a modified three-point curve resulted in a breakpoint that was not different (P = 0.94) between males and females (1.60 and 1.61 g·kg-1·d-1, respectively). The recommended intake (i.e., upper 95% confidence interval) was estimated to be 1.81 and 1.89 g·kg-1·d-1 for males and females, respectively.

CONCLUSIONS

Our findings indicate that endurance athletes consuming a daily protein intake toward the upper end of current consensus recommendations (~1.85 g·kg-1·d-1) will maximize whole-body protein synthesis during postexercise recovery regardless of sex.

Protein quality and the food matrix: defining optimal versus maximal meal-based protein intakes for stimulating muscle protein synthesis

This paper examines the opinion that we should aim to optimize, rather than maximize, protein intakes to avoid over-emphasizing muscle-centric protein requirements. An optimal eating approach strives to minimize amino acid oxidative waste and more efficiently stimulate postprandial muscle protein accretion. To do this, practitioners should acknowledge higher quality protein foods as better in delivering target amounts of amino acids into circulation, and the food matrix (e.g., nutrient-nutrient interactions) can be leveraged to potentiate essential amino acid incorporation into skeletal muscle protein.

Protein Requirements for Master Athletes: Just Older Versions of Their Younger Selves

It is established that protein requirements are elevated in athletes to support their training and post-exercise recovery and adaptation, especially within skeletal muscle. However, research on the requirements for this macronutrient has been performed almost exclusively in younger athletes, which may complicate their translation to the growing population of Master athletes (i.e. > 35 years old). In contrast to older (> 65 years) untrained adults who typically demonstrate anabolic resistance to dietary protein as a primary mediator of the ‘normal’ age-related loss of muscle mass and strength, Master athletes are generally considered successful models of aging as evidenced by possessing similar body composition, muscle mass, and aerobic fitness as untrained adults more than half their age. The primary physiology changes considered to underpin the anabolic resistance of aging are precipitated or exacerbated by physical inactivity, which has led to higher protein recommendations to stimulate muscle protein synthesis in older untrained compared to younger untrained adults. This review puts forth the argument that Master athletes have similar muscle characteristics, physiological responses to exercise, and protein metabolism as young athletes and, therefore, are unlikely to have protein requirements that are different from their young contemporaries. Recommendations for protein amount, type, and pattern will be discussed for Master athletes to enhance their recovery from and adaptation to resistance and endurance training.

Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review

This systematic literature review aimed to determine the protein requirements of pre-menopausal (e.g., 18-45 years) female athletes and identify if the menstrual cycle phase and/or hormonal contraceptive use influence protein requirements. Four databases were searched for original research containing pre-menopausal female athletes that ingested protein alongside exercise. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to determine study quality. Fourteen studies, which included 204 recreationally active or competitive females, met the eligibility criteria for inclusion in this review, and all were assessed as positive quality. The estimated average requirement (EAR) for protein intake of pre-menopausal recreational and/or competitive female athletes is similar for those undertaking aerobic endurance (1.28-1.63 g/kg/day), resistance (1.49 g/kg/day) and intermittent exercise (1.41 g/kg/day) of ~60-90 min duration. The optimal acute protein intake and influence of menstrual cycle phase or hormonal contraceptive use on protein requirements could not be determined. However, pre- and post-exercise protein intakes of 0.32-0.38 g/kg have demonstrated beneficial physiological responses in recreational and competitive female athletes completing resistance and intermittent exercise. The protein requirements outlined in this review can be used for planning and assessing protein intakes of recreational and competitive pre-menopausal female athletes.

Measuring Protein Turnover in the Field: Implications for Military Research

Protein turnover reflects the continual synthesis and breakdown of body proteins, and can be measured at a whole-body (i.e. aggregated across all body proteins) or tissue (e.g. skeletal muscle only) level using stable isotope methods. Evaluating protein turnover in free-living environments, such as military training, can help inform protein requirements. We undertook a narrative review of published literature with the aim of reviewing the suitability of, and advancements in, stable isotope methods for measuring protein turnover in field research. The 2 primary approaches for measuring protein turnover are based on precursor- and end-product methods. The precursor method is the gold-standard for measuring acute (over several hours) skeletal muscle protein turnover, whereas the end-product method measures chronic (over several weeks) skeletal muscle protein turnover and provides the opportunity to monitor free-living activities. Both methods require invasive procedures such as the infusion of amino acid tracers and muscle biopsies to assess the uptake of the tracer into tissue. However, the end-product method can also be used to measure acute (over 9-24 h) whole-body protein turnover noninvasively by ingesting 15N-glycine, or equivalent isotope tracers, and collecting urine samples. The end-product method using 15N-glycine is a practical method for measuring whole-body protein turnover in the field over short (24 h) time frames and has been used effectively in recent military field research. Application of this method may improve our understanding of protein kinetics during conditions of high physiological stress in free-living environments such as military training.

Nutrition for Female Soccer Players-Recommendations

Soccer is one of the most popular sports in the world. As its number of players is increasing, the number of female players is also on the rise. However, there are limited data about how the diets of female soccer players should be designed. Thus, the aim of our work is to deliver concise nutritional recommendations for women practicing this sport. Based on a literature review, we emphasize that individual adjustment of the energy value of the diet is the key factor for the physical performance of female soccer players. Appropriate macronutrient intake makes it possible to achieve the proper energy value of the diet (5-10 g/kg body mass/day carbohydrates; 1.2-1.7 g/kg body mass/day proteins; <30% fats from energy). The micronutrients should be consumed in amounts corresponding to individual values recommended in national standards. Soccer players should pay special attention to the proper consumption of such micronutrients, as well as vitamins such as iron, calcium, and vitamin D. The right amount of fluid intake, consistent with the player's needs, is crucial in maximizing exercise performance. The diet of a female practicing soccer is usually characterized with low energy values, which increases the risk of various health consequences related to low energy availability. Monitoring the diets of female soccer players is, therefore, necessary.

Heat alleviation strategies for athletic performance: A review and practitioner guidelines

International competition inevitably presents logistical challenges for athletes. Events such as the Tokyo 2020 Olympic Games require further consideration given historical climate data suggest athletes will experience significant heat stress. Given the expected climate, athletes face major challenges to health and performance. With this in mind, heat alleviation strategies should be a fundamental consideration. This review provides a focused perspective of the relevant literature describing how practitioners can structure male and female athlete preparations for performance in hot, humid conditions. Whilst scientific literature commonly describes experimental work, with a primary focus on maximizing magnitudes of adaptive responses, this may sacrifice ecological validity, particularly for athletes whom must balance logistical considerations aligned with integrating environmental preparation around training, tapering and travel plans. Additionally, opportunities for sophisticated interventions may not be possible in the constrained environment of the athlete village or event arenas. This review therefore takes knowledge gained from robust experimental work, interprets it and provides direction on how practitioners/coaches can optimize their athletes' heat alleviation strategies. This review identifies two distinct heat alleviation themes that should be considered to form an individualized strategy for the athlete to enhance thermoregulatory/performance physiology. First, chronic heat alleviation techniques are outlined, these describe interventions such as heat acclimation, which are implemented pre, during and post-training to prepare for the increased heat stress. Second, acute heat alleviation techniques that are implemented immediately prior to, and sometimes during the event are discussed. Abbreviations: CWI: Cold water immersion; HA: Heat acclimation; HR: Heart rate; HSP: Heat shock protein; HWI: Hot water immersion; LTHA: Long-term heat acclimation; MTHA: Medium-term heat acclimation; ODHA: Once-daily heat acclimation; RH: Relative humidity; RPE: Rating of perceived exertion; STHA: Short-term heat acclimation; TCORE: Core temperature; TDHA: Twice-daily heat acclimation; TS: Thermal sensation; TSKIN: Skin temperature; V̇O2max: Maximal oxygen uptake; WGBT: Wet bulb globe temperature.

Sport nutrition: the role of macronutrients and minerals in endurance exercises

Athletes’ nutrition optimization is very important for the nutritional support in all sport specializations. Macronutrients, as well as minerals and vitamins, are functionally active components that play an important role in nutrition of athletes especially in endurance sport. Optimal use of diets, including specialized sport nutrition, normalizes biochemical, immune, endocrine functions and restores athletes’ energy balance at different stages of sport exercises. Non-optimal athletes’ nutrition of different age groups, inadequate to their physiological needs, and no personalized approach to athletes’ diets, violate their right to adequate safe nutrition, according to international standards and criteria. Nutritional factors are one of the most important key factors in the risk prevention measures for a large number of diet-dependent diseases (e.g. digestive, liver, pancreas, cardiovascular system, endocrine system, and kidney diseases). The review presents the information on energy requirements, balance and availability, types and content of functional products for athletes. It also gives an overview of the specialized food market in Russia.

ISSN exercise & sports nutrition review update: research & recommendations

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.

Achieving Optimal Post-Exercise Muscle Protein Remodeling in Physically Active Adults through Whole Food Consumption

Dietary protein ingestion is critical to maintaining the quality and quantity of skeletal muscle mass throughout adult life. The performance of acute exercise enhances muscle protein remodeling by stimulating protein synthesis rates for several hours after each bout, which can be optimized by consuming protein during the post-exercise recovery period. To date, the majority of the evidence regarding protein intake to optimize post-exercise muscle protein synthesis rates is limited to isolated protein sources. However, it is more common to ingest whole food sources of protein within a normal eating pattern. Emerging evidence demonstrates a promising role for the ingestion of whole foods as an effective nutritional strategy to support muscle protein remodeling and recovery after exercise. This review aims to evaluate the efficacy of the ingestion of nutrient-rich and protein-dense whole foods to support post-exercise muscle protein remodeling and recovery with pertinence towards physically active people.

Increased Protein Requirements in Female Athletes after Variable-Intensity Exercise

PURPOSE

Protein requirements are primarily studied in the context of resistance or endurance exercise with little research devoted to variable-intensity intermittent exercise characteristic of many team sports. Further, female populations are underrepresented in dietary sports science studies. We aimed to determine a dietary protein requirement in active females performing variable-intensity intermittent exercise using the indicator amino acid oxidation (IAAO) method. We hypothesized that these requirements would be greater than current IAAO-derived estimates in nonactive adult males.

METHODS

Six females (21.2 ± 0.8 yr, 68.8 ± 4.1 kg, 47.1 ± 1.2 mL O2·kg·min; mean ± SE) completed five to seven metabolic trials during the luteal phase of the menstrual cycle. Participants performed a modified Loughborough Intermittent Shuttle Test before consuming eight hourly mixed meals providing the test protein intake (0.2-2.66 g·kg·d), 6 g·kg·d CHO and sufficient energy for resting and exercise-induced energy expenditure. Protein was provided as crystalline amino acid modeling egg protein with [C]phenylalanine as the indicator amino acid. Phenylalanine turnover (Q) was determined from urinary [C]phenylalanine enrichment. Breath CO2 excretion (FCO2) was analyzed using mixed effects biphase linear regression with the breakpoint and upper 95% confidence interval approximating the estimated average requirement and recommended dietary allowance, respectively.

RESULTS

Protein intake had no effect on Q (68.7 ± 7.3 μmol·kg·h; mean ± SE). FCO2 displayed a robust biphase response (R = 0.66) with an estimated average requirement of 1.41 g·kg·d and recommended dietary allowance of 1.71 g·kg·d.

CONCLUSIONS

The protein requirement estimate of 1.41 and 1.71 g·kg·d for females performing variable-intensity intermittent exercise is greater than the IAAO-derived estimates of adult males (0.93 and 1.2 g·kg·d) and at the upper range of the American College of Sports Medicine athlete recommendations (1.2-2.0 g·kg·d).

Nutritional Aspects of the Female Athlete

Athletes have specific needs based on sex, size, sport, exercise intensity, duration of activity, phase of training, and the season in which the sport is played. Nutritionally, the female athlete is unique, with needs that may vary based on hormonal fluctuations related to the menstrual cycle. This article provides an overview of the distinct nutritional needs and concerns of the physically active female, including energy availability, macronutrient needs, micronutrient needs, hydration, supplements, and other nutritional issues. Although there is some research focusing specifically on the female athlete and her exceptional nutritional concerns, further gender-specific exploration is needed in all areas.

Variable-Intensity Simulated Team-Sport Exercise Increases Daily Protein Requirements in Active Males

Protein requirements are generally increased in strength and endurance trained athletes relative to their sedentary peers. However, less is known about the daily requirement for this important macronutrient in individuals performing variable intensity, stop-and-go type exercise that is typical for team sport athletes. The objective of the present study was to determine protein requirements in active, trained adult males performing a simulated soccer match using the minimally invasive indicator amino acid oxidation (IAAO) method. After 2 days of controlled diet (1.2 g⋅kg⁻¹⋅day⁻¹ protein), seven trained males (23 ± 1 years; 177.5 ± 6.7 cm; 82.3 ± 6.1 kg; 13.5% ± 4.7% body fat; 52.3 ± 5.9 ml O₂⋅kg⁻¹⋅min^-1; mean ± SD) performed an acute bout of variable intensity exercise in the form of a modified Loughborough Intermittent Shuttle Test (4 × 15 min of exercise over 75 min). Immediately after exercise, hourly meals were consumed providing a variable amount of protein (0.2–2.6 g⋅kg⁻¹⋅day⁻¹) and sufficient energy and carbohydrate (6 g⋅kg⁻¹⋅day⁻¹). Protein was provided as a crystalline amino acids modeled after egg protein with the exception of phenylalanine and tyrosine, which were provided in excess to ensure the metabolic partitioning of the indicator amino acid (i.e., [1-¹³C]phenylalanine included within the phenylalanine intake) was directed toward oxidation when protein intake was limiting. Whole body phenylalanine flux and ¹³CO₂ excretion (F¹³CO₂) were determined at metabolic and isotopic steady state from urine and breath samples, respectively. Biphasic linear regression analysis was performed on F¹³CO₂ to determine the estimated average requirement (EAR) for protein with a safe intake defined as the upper 95% confidence interval. Phenylalanine flux was not impacted by protein intake (P = 0.45). Bi-phase linear regression (R² = 0.64) of F¹³CO₂ resulted in an EAR and safe intake of 1.20 and 1.40 g⋅kg⁻¹⋅day⁻¹, respectively. Variable intensity exercise increases daily protein requirements compared to the safe intake determined by nitrogen balance (0.83 g⋅kg⁻¹⋅day⁻¹) and IAAO (1.24 g⋅kg⁻¹⋅day⁻¹) but is within the range (i.e., 1.2–2.0 g⋅kg⁻¹⋅day⁻¹) of current consensus statements on general recommendations for athletes.

Endurance exercise and gut microbiota: A review

BACKGROUND

The physiological and biochemical demands of intense exercise elicit both muscle-based and systemic responses. The main adaptations to endurance exercise include the correction of electrolyte imbalance, a decrease in glycogen storage and the increase of oxidative stress, intestinal permeability, muscle damage, and systemic inflammatory response. Adaptations to exercise might be influenced by the gut microbiota, which plays an important role in the production, storage, and expenditure of energy obtained from the diet as well as in inflammation, redox reactions, and hydration status.

METHODS

A systematic and comprehensive search of electronic databases, including MEDLINE, Scopus, ClinicalTrials.gov, ScienceDirect, Springer Link, and EMBASE was done. The search process was completed using the keywords: "endurance", "exercise", "immune response", "microbiota", "nutrition", and "probiotics".

RESULTS

Reviewed literature supports the hypothesis that intestinal microbiota might be able to provide a measureable, effective marker of an athlete's immune function and that microbial composition analysis might also be sensitive enough to detect exercise-induced stress and metabolic disorders. The review also supports the hypothesis that modifying the microbiota through the use of probiotics could be an important therapeutic tool to improve athletes' overall general health, performance, and energy availability while controlling inflammation and redox levels.

CONCLUSION

The present review provides a comprehensive overview of how gut microbiota may have a key role in controlling the oxidative stress and inflammatory responses as well as improving metabolism and energy expenditure during intense exercise.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

Exercise-induced stress behavior, gut-microbiota-brain axis and diet: a systematic review for athletes

Fatigue, mood disturbances, under performance and gastrointestinal distress are common among athletes during training and competition. The psychosocial and physical demands during intense exercise can initiate a stress response activating the sympathetic-adrenomedullary and hypothalamus-pituitary-adrenal (HPA) axes, resulting in the release of stress and catabolic hormones, inflammatory cytokines and microbial molecules. The gut is home to trillions of microorganisms that have fundamental roles in many aspects of human biology, including metabolism, endocrine, neuronal and immune function. The gut microbiome and its influence on host behavior, intestinal barrier and immune function are believed to be a critical aspect of the brain-gut axis. Recent evidence in murine models shows that there is a high correlation between physical and emotional stress during exercise and changes in gastrointestinal microbiota composition. For instance, induced exercise-stress decreased cecal levels of Turicibacter spp and increased Ruminococcus gnavus, which have well defined roles in intestinal mucus degradation and immune function.

Diet is known to dramatically modulate the composition of the gut microbiota. Due to the considerable complexity of stress responses in elite athletes (from leaky gut to increased catabolism and depression), defining standard diet regimes is difficult. However, some preliminary experimental data obtained from studies using probiotics and prebiotics studies show some interesting results, indicating that the microbiota acts like an endocrine organ (e.g. secreting serotonin, dopamine or other neurotransmitters) and may control the HPA axis in athletes. What is troubling is that dietary recommendations for elite athletes are primarily based on a low consumption of plant polysaccharides, which is associated with reduced microbiota diversity and functionality (e.g. less synthesis of byproducts such as short chain fatty acids and neurotransmitters). As more elite athletes suffer from psychological and gastrointestinal conditions that can be linked to the gut, targeting the microbiota therapeutically may need to be incorporated in athletes’ diets that take into consideration dietary fiber as well as microbial taxa not currently present in athlete’s gut.

Nutritional Support for Exercise-Induced Injuries

Nutrition is one method to counter the negative impact of an exercise-induced injury. Deficiencies of energy, protein and other nutrients should be avoided. Claims for the effectiveness of many other nutrients following injuries are rampant, but the evidence is equivocal. The results of an exercise-induced injury may vary widely depending on the nature of the injury and severity. Injuries typically result in cessation, or at least a reduction, in participation in sport and decreased physical activity. Limb immobility may be necessary with some injuries, contributing to reduced activity and training. Following an injury, an inflammatory response is initiated and while excess inflammation may be harmful, given the importance of the inflammatory process for wound healing, attempting to drastically reduce inflammation may not be ideal for optimal recovery. Injuries severe enough for immobilization of a limb result in loss of muscle mass and reduced muscle strength and function. Loss of muscle results from reductions in basal muscle protein synthesis and the resistance of muscle to anabolic stimulation. Energy balance is critical. Higher protein intakes (2-2.5 g/kg/day) seem to be warranted during immobilization. At the very least, care should be taken not to reduce the absolute amount of protein intake when energy intake is reduced. There is promising, albeit preliminary, evidence for the use of omega-3 fatty acids and creatine to counter muscle loss and enhance hypertrophy, respectively. The overriding nutritional recommendation for injured exercisers should be to consume a well-balanced diet based on whole, minimally processed foods or ingredients made from whole foods. The diet composition should be carefully assessed and changes considered as the injury heals and activity patterns change.

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's, and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert.

Cumulative Muscle Protein Synthesis and Protein Intake Requirements

Muscle protein synthesis (MPS) fluctuates widely over the course of a day and is influenced by many factors. The time course of MPS responses to exercise and the influence of training and nutrition can only be pieced together from several different investigations and methods, many of which create unnatural experimental conditions. Measurements of cumulative MPS, the sum synthesis over an extended period, using deuterium oxide have been shown to accurately reflect muscle responses and may allow investigations of the response to exercise, total protein intake requirements, and interaction with protein timing in free-living experimental conditions; these factors have yet to be carefully integrated. Such studies could include clinical and athletic populations to integrate nutritional and exercise recommendations and help guide their revisions to optimize the skeletal muscle function that is so important to overall health.

Females have a blunted cardiovascular response to one year of intensive supervised endurance training

Cross-sectional studies in athletes suggest that endurance training augments cardiovascular structure and function with apparently different phenotypes in athletic males and females. It is unclear whether the longitudinal response to endurance training leads to similar cardiovascular adaptations between sexes. We sought to determine whether males and females demonstrate similar cardiovascular adaptations to 1 yr of endurance training, matched for training volume and intensity. Twelve previously sedentary males (26 ± 7, n = 7) and females (31 ± 6, n = 5) completed 1 yr of progressive endurance training. All participants underwent a battery of tests every 3 mo to determine maximal oxygen uptake (V̇o2max) and left ventricle (LV) function and morphology (cardiac magnetic resonance imaging). Pulmonary artery catheterization was performed before and after 1 yr of training, and pressure-volume and Starling curves were constructed during decreases (lower-body negative pressure) and increases (saline infusion) in cardiac volume. Males progressively increased V̇o2max, LV mass, and mean wall thickness, before reaching a plateau from month 9 to 12 of training. In contrast, despite exactly the same training, the response in females was markedly blunted, with V̇o2max, LV mass, and mean wall thickness plateauing after only 3 mo of training. The response of LV end-diastolic volume was not influenced by sex (males +20% and females +18%). After training Starling curves were shifted upward and left, but the effect was greatest in males (interaction P = 0.06). We demonstrate for the first time clear sex differences in response to 1 yr of matched endurance training, such that the development of ventricular hypertrophy and increase in V̇o2max in females is markedly blunted compared with males.

Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis

BACKGROUND

The dietary content of advice in men's lifestyle magazines has not been closely scrutinised.

METHODS

We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control.

RESULTS

Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on fat-burning, good fats and consumption of single foods, with relatively little mention of dietary restriction.

CONCLUSIONS

Despite the widespread use of scientific information to endorse dietary advice, the content, format and scientific basis of dietary content of MH leaves much to be desired. The dietary advice as provided may not be conducive to public health.

Beyond muscle hypertrophy: why dietary protein is important for endurance athletes

Recovery from the demands of daily training is an essential element of a scientifically based periodized program whose twin goals are to maximize training adaptation and enhance performance. Prolonged endurance training sessions induce substantial metabolic perturbations in skeletal muscle, including the depletion of endogenous fuels and damage/disruption to muscle and body proteins. Therefore, increasing nutrient availability (i.e., carbohydrate and protein) in the post-training recovery period is important to replenish substrate stores and facilitate repair and remodelling of skeletal muscle. It is well accepted that protein ingestion following resistance-based exercise increases rates of skeletal muscle protein synthesis and potentiates gains in muscle mass and strength. To date, however, little attention has focused on the ability of dietary protein to enhance skeletal muscle remodelling and stimulate adaptations that promote an endurance phenotype. The purpose of this review is to critically discuss the results of recent studies that have examined the role of dietary protein for the endurance athlete. Our primary aim is to consider the results from contemporary investigations that have advanced our knowledge of how the manipulation of dietary protein (i.e., amount, type, and timing of ingestion) can facilitate muscle remodelling by promoting muscle protein synthesis. We focus on the role of protein in facilitating optimal recovery from, and promoting adaptations to strenuous endurance-based training.

Increased net muscle protein balance in response to simultaneous and separate ingestion of carbohydrate and essential amino acids following resistance exercise

Relative to essential amino acids (EAAs), carbohydrate (CHO) ingestion stimulates a delayed response of net muscle protein balance (NBAL). We investigated if staggered ingestion of CHO and EAA would superimpose the response of NBAL following resistance exercise, thus resulting in maximal anabolic stimulation. Eight recreationally trained subjects completed 2 trials: combined (COMB - drink 1, CHO+EAA; drink 2, placebo) and separated (SEP - drink 1, CHO; drink 2, EAA) post-exercise ingestion of CHO and EAA. Drink 1 was administered 1 h following an acute exercise bout and was followed 1 h later by drink 2. A primed, continuous infusion of l-[ring-(13)C6]-phenylalanine was combined with femoral arteriovenous sampling and muscle biopsies for the determination of muscle protein kinetics. Arterial amino acid concentrations increased following ingestion of EAA in both conditions. No difference between conditions was observed for phenylalanine delivery to the leg (COMB: 167 ± 23 μmol·min(-1)·(100 mL leg vol)(-1) × 6 h; SEP: 167 ± 21 μmol·min(-1)·(100 mL leg vol)(-1) × 6 h, P > 0.05). In the first hour following ingestion of the drink containing EAA, phenylalanine uptake was 50% greater for the SEP trial than the COMB trial. However, phenylalanine uptake was similar for COMB (110 ± 19 mg) and SEP (117 ± 24 mg) over the 6 h period. These data suggest that whereas separation of CHO and EAA ingestion following exercise may have a transient physiological impact on NBAL, this response is not reflected over a longer period. Thus, separation of CHO and EAA ingestion is unnecessary to optimize post-exercise muscle protein metabolism.

Nutrition for adventure racing

Adventure racing requires competitors to perform various disciplines ranging from, but not limited to, mountain biking, running, kayaking, climbing, mountaineering, flat- and white-water boating and orienteering over a rugged, often remote and wilderness terrain. Races can vary from 6 hours to expedition-length events that can last up to 10-consecutive days or more. The purpose of this article is to provide evidence-based nutritional recommendations for adventure racing competitors. Energy expenditures of 365-750 kcal/hour have been reported with total energy expenditures of 18 000-80 000 kcal required to complete adventure races, and large negative energy balances during competitions have been reported. Nutrition, therefore, plays a major role in the successful completion of such ultra-endurance events. Conducting research in these events is challenging and the limited studies investigating dietary surveys and nutritional status of adventure racers indicate that competitors do not meet nutrition recommendations for ultra-endurance exercise. Carbohydrate intakes of 7-12 g/kg are needed during periods of prolonged training to meet requirements and replenish glycogen stores. Protein intakes of 1.4-1.7 g/kg are recommended to build and repair tissue. Adequate replacement of fluid and electrolytes are crucial, particularly during extreme temperatures; however, sweat rates can vary greatly between competitors. There is considerable evidence to support the use of sports drinks, gels and bars, as they are a convenient and portable source of carbohydrate that can be consumed during exercise, in training and in competition. Similarly, protein and amino acid supplements can be useful to help meet periods of increased protein requirements. Caffeine can be used as an ergogenic aid to help competitors stay awake during prolonged periods, enhance glycogen resynthesis and enhance endurance performance.

Dietary intakes and eating habits of college athletes: are female college athletes following the current sports nutrition standards?

OBJECTIVE

The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards.

PARTICIPANTS

Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May 2010.

METHODS

Participants completed anthropometric measurements and dietary assessment using a 3-day food record, a 24-hour recall, and a nutrition questionnaire.

RESULTS

t tests indicated the energy and carbohydrate intakes were below the minimum recommended amount (p<.001), with only 9% of the participants meeting their energy needs. Seventy-five percent of the participants failed to consume the minimum amount of carbohydrates that is required to support training. The majority of the participants reported no regular breakfast, 36% consumed<5 meals/day, and only 16% monitored their hydration status.

CONCLUSIONS

Effective nutrition interventions are needed to improve dietary intakes and eating habits of female college athletes.

Nutrition for adventure racing

Adventure racing requires competitors to perform various disciplines ranging from, but not limited to, mountain biking, running, kayaking, climbing, mountaineering, flat- and white-water boating and orienteering over a rugged, often remote and wilderness terrain. Races can vary from 6 hours to expedition-length events that can last up to 10-consecutive days or more. The purpose of this article is to provide evidence-based nutritional recommendations for adventure racing competitors. Energy expenditures of 365-750 kcal/hour have been reported with total energy expenditures of 18 000-80 000 kcal required to complete adventure races, and large negative energy balances during competitions have been reported. Nutrition, therefore, plays a major role in the successful completion of such ultra-endurance events. Conducting research in these events is challenging and the limited studies investigating dietary surveys and nutritional status of adventure racers indicate that competitors do not meet nutrition recommendations for ultra-endurance exercise. Carbohydrate intakes of 7-12 g/kg are needed during periods of prolonged training to meet requirements and replenish glycogen stores. Protein intakes of 1.4-1.7 g/kg are recommended to build and repair tissue. Adequate replacement of fluid and electrolytes are crucial, particularly during extreme temperatures; however, sweat rates can vary greatly between competitors. There is considerable evidence to support the use of sports drinks, gels and bars, as they are a convenient and portable source of carbohydrate that can be consumed during exercise, in training and in competition. Similarly, protein and amino acid supplements can be useful to help meet periods of increased protein requirements. Caffeine can be used as an ergogenic aid to help competitors stay awake during prolonged periods, enhance glycogen resynthesis and enhance endurance performance.

Protein turnover, amino acid requirements and recommendations for athletes and active populations

Skeletal muscle is the major deposit of protein molecules. As for any cell or tissue, total muscle protein reflects a dynamic turnover between net protein synthesis and degradation. Noninvasive and invasive techniques have been applied to determine amino acid catabolism and muscle protein building at rest, during exercise and during the recovery period after a single experiment or training sessions. Stable isotopic tracers (¹³C-lysine, ¹⁵N-glycine, ²H₅-phenylalanine) and arteriovenous differences have been used in studies of skeletal muscle and collagen tissues under resting and exercise conditions. There are different fractional synthesis rates in skeletal muscle and tendon tissues, but there is no major difference between collagen and myofibrillar protein synthesis. Strenuous exercise provokes increased proteolysis and decreased protein synthesis, the opposite occurring during the recovery period. Individuals who exercise respond differently when resistance and endurance types of contractions are compared. Endurance exercise induces a greater oxidative capacity (enzymes) compared to resistance exercise, which induces fiber hypertrophy (myofibrils). Nitrogen balance (difference between protein intake and protein degradation) for athletes is usually balanced when the intake of protein reaches 1.2 g·kg⁻¹·day⁻¹ compared to 0.8 g·kg⁻¹·day⁻¹ in resting individuals. Muscular activities promote a cascade of signals leading to the stimulation of eukaryotic initiation of myofibrillar protein synthesis. As suggested in several publications, a bolus of 15-20 g protein (from skimmed milk or whey proteins) and carbohydrate (± 30 g maltodextrine) drinks is needed immediately after stopping exercise to stimulate muscle protein and tendon collagen turnover within 1 h.

A critical review of recommendations to increase dietary protein requirements in the habitually active

Some scientists and professional organisations have called for an increase in dietary protein for those who reach a threshold level of exercise, i.e. endurance athletes. But there are individual scientists who question this recommendation. Limitations in the procedures used to justify changing the recommended daily allowance (RDA) are at issue. N balance has been used to justify this increase; but it is limiting even when measured in a well-controlled clinical research centre. Experimental shortcomings are only exacerbated when performed in a sports or exercise field setting. Another laboratory method used to justify this increase, the isotope infusion procedure, has methodological problems as well. Stable isotope infusion data collected during and after exercise cannot account for fed-state gains that counterbalance those exercise losses over a 24 h dietary period. The present review concludes that an adaptive metabolic demand model may be needed to accurately study the protein health of the active individual.

Efficacy and consequences of very-high-protein diets for athletes and exercisers

Athletes and exercisers have utilised high-protein diets for centuries. The objective of this review is to examine the evidence for the efficacy and potential dangers of high-protein diets. One important factor to consider is the definition of a ‘high-protein diet’. There are several ways to consider protein content of a diet. The composition of the diet can be determined as the absolute amount of the protein (or other nutrient of interest), the % of total energy (calories) as protein and the amount of protein ingested per kg of body weight. Many athletes consume very high amounts of protein. High-protein diets most often are associated with muscle hypertrophy and strength, but now also are advocated for weight loss and recovery from intense exercise or injuries. Prolonged intake of a large amount of protein has been associated with potential dangers, such as bone mineral loss and kidney damage. In otherwise healthy individuals, there is little evidence that high protein intake is dangerous. However, kidney damage may be an issue for individuals with already existing kidney dysfunction. Increased protein intake necessarily means that overall energy intake must increase or consumption of either carbohydrate or fat must decrease. In conclusion, high protein intake may be appropriate for some athletes, but there are potential negative consequences that must be carefully considered before adopting such a diet. In particular, care must be taken to ensure that there is sufficient intake of other nutrients to support the training load.

Nutrition for acute exercise-induced injuries

BACKGROUND/AIMS

Injuries are an unavoidable aspect of participation in physical activity. Little information about nutritional support for injuries exists.

REVIEW

Immediately following injury, wound healing begins with an inflammatory response. Excessive anti-inflammatory measures may impair recovery. Many injuries result in limb immobilization. Immobilization results in muscle loss due to increased periods of negative muscle protein balance. Oxidative capacity of muscle is also decreased. Nutrient and energy deficiencies should be avoided. Energy expenditure may be reduced during immobilization, but inflammation, wound healing and the energy cost of ambulation limit the reduction of energy expenditure. There is little rationale for increasing protein intake during immobilization. There is a theoretical rationale for leucine and omega-3 fatty acid supplementation to help reduce muscle atrophy. During rehabilitation and recovery from immobilization, increased activity, in particular resistance exercise will increase muscle protein synthesis and restore sensitivity to anabolic stimuli. Ample, but not excessive, protein and energy must be consumed to support muscle growth. During rehabilitation and recovery, nutritional needs are very much like those for any athlete desiring muscle growth.

CONCLUSION

Nutrition is important for optimal wound healing. The most important consideration is to avoid malnutrition and to apply a risk/benefit approach.

Effects of high-whey-protein intake and resistance training on renal, bone and metabolic parameters in rats

Consumption of high-protein (HP) diets is postulated to exert a negative influence on bone and renal health. However, no conclusive evidence has been presented related to this issue or to the potential protective action of resistance training on HP-induced systemic effects. We examined the effects of HP diet consumption on food intake, body-weight gain, body composition, and renal, bone and metabolic parameters of rats performing resistance training. A total of ninety-six adult male Wistar rats were randomly distributed in twelve experimental groups (n 8): normal-protein (10 %) or HP (45 %) diets, with or without resistance training, killed for experimental periods of 1, 2 or 3 months. Diets were based on a commercial whey protein hydrolysate. Consumption of HP diets and resistance training significantly affected food intake, body weight and body composition, as well as the plasma levels of total cholesterol, HDL-cholesterol and TAG. The buffering action of resistance training on such diet-induced alterations was especially evident in the levels of plasma TAG. Consumption of HP diets led to a considerable increase in kidney weight, urinary volume and acidity, as well as in the urinary excretion of Ca, with a parallel reduction in the urinary excretion of citrate (P < 0·05). No apparent deleterious effect on bone mineral content was found. In conclusion, consumption of HP diets caused alterations in renal health status and some metabolic parameters, but did not seem to affect bone status. Resistance training had a protective action against alterations of renal health status and some metabolic parameters such as plasma TAG.

Energy and macronutrient requirements for physical fitness in exercising subjects

Optimal nutritional intakes are critical for health- and skill-related physical fitness. This review details the effect of energy restriction and supplementation on physical fitness, discusses the optimal chronic macronutrient intakes for physical fitness in exercising subjects and finally overviews the impact of short-term intakes of carbohydrate and protein, before, during and after exercise, on physical fitness of athletes. The present standings highlight that it is essential that health care givers personalize nutritional advice to meet the specific needs of exercising individuals while applying the described recommendations. It reminds the difficulty of providing straight nutritional recommendations for physical fitness on the basis of evidence-based medicine.

Position of the American Dietetic Association: vegetarian diets

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence- based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their needs.

Blood oxidative stress biomarkers: influence of sex, exercise training status, and dietary intake

BACKGROUND

Sex and lifestyle factors are known to influence the oxidation of protein, lipids, and DNA. Biomarkers such as protein carbonyls (PC), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) have been commonly used in an attempt to characterize the oxidative status of human subjects.

OBJECTIVE

This study compared resting blood oxidative stress biomarkers, in relation to exercise training status and dietary intake, between men and women.

METHODS

Exercise-trained and sedentary men and women (with normal menstrual cycles; reporting during the early follicular phase) were recruited from the University of Memphis, Tennessee, campus and surrounding community via recruitment flyers and word of mouth. Participants were categorized by sex and current exercise training status (ie, trained or untrained). Each completed a detailed 5-day food record of all food and drink consumed. Diets were analyzed for kilocalories and macro- and micronutrient (vitamins C, E, A) intake. Venous blood samples were obtained at rest and analyzed for PC, MDA, and 8-OHdG.

RESULTS

In the 131 participants (89 men, of whom 74 were exercise trained and 15 untrained, and 42 women, of whom 22 were exercise trained and 20 untrained; mean [SD] age, 24 [4] years), PC did not differ significantly between trained men and women or between untrained men and women. However, trained participants had significantly lower plasma PC (measured in nmol . mg protein(-1)) (mean [SEM] 0.0966 [0.0055]) than did untrained participants (0.1036 [0.0098]) (P < 0.05). MDA levels (measured in micromol . L(-1)) were significantly lower in trained women (0.4264 [0.0559]) compared with trained men (0.6959 [0.0593]); in trained men and women combined (0.5621 [0.0566]) compared with untrained men and women combined (0.7397 [0.0718]); and in women combined (0.5665 [0.0611]) compared with men combined (0.7338 [0.0789]) (P < 0.05 for all comparisons). No significant differences were noted between any groups for 8-OHdG. Neither PC nor 8-OHdG were correlated to any dietary variable, with the exception of PC and percent of protein in untrained men (r = 0.552; P = 0.033). MDA was positively correlated to protein intake and negatively correlated to percent of carbohydrate and vitamin C intake, primarily in trained men (P < or = 0.03).

CONCLUSIONS

In this sample of young healthy adults, oxidative stress was lower in women than in men and in trained compared with untrained individuals, particularly regarding MDA. With the exception of MDA primarily in trained men, dietary intake did not appear to be correlated to biomarkers of oxidative stress.

mVps34 is activated following high-resistance contractions

Following resistance exercise in the fasted state, both protein synthesis and degradation in skeletal muscle are increased. The addition of essential amino acids potentiates the synthetic response suggesting that an amino acid sensor, which is involved in both synthesis and degradation, may be activated by resistance exercise. One such candidate protein is the class 3 phosphatidylinositol 3OH-kinase (PI3K) Vps34. To determine whether mammalian Vps34 (mVps34) is modulated by high-resistance contractions, mVps34 and S6K1 (an index of mTORC1) activity were measured in the distal hindlimb muscles of rats 0.5, 3, 6 and 18 h after acute unilateral high-resistance contractions with the contralateral muscles serving as a control. In the lengthening tibialis anterior (TA) muscle, S6K1 (0.5 h = 366.3 +/- 112.08%, 3 h = 124.7 +/- 15.96% and 6 h = 129.2 +/- 0%) and mVps34 (3 h = 68.8 +/- 15.1% and 6 h = 36.0 +/- 8.79%) activity both increased, whereas in the shortening soleus and plantaris (PLN) muscles the increase was significantly lower (PLN S6K1 0.5 h = 33.1 +/- 2.29% and 3 h = 47.0 +/- 6.65%; mVps34 3 h = 24.5 +/- 7.92%). HPLC analysis of the TA demonstrated a 25% increase in intramuscular leucine concentration in rats 1.5 h after exercise. A similar level of leucine added to C2C12 cells in vitro increased mVps34 activity 3.2-fold. These data suggest that, following high-resistance contractions, mVps34 activity is stimulated by an influx of essential amino acids such as leucine and this may prolong mTORC1 signalling and contribute to muscle hypertrophy.

Symposium on ‘Performance, exercise and health’ Practical aspects of nutrition in performance

The importance of nutrition in sport has been recognised since the ancient Olympians, and its role in improving both health and sports performance has widespread acceptance. However, in sporting circles nutritional knowledge, beliefs and practices are extremely varied. Within any sporting organisation the sports dietitian or nutritionist must be able to work with athletes, their family, coaches and other support staff to develop and monitor realistic and practical strategies that work best for each performer, contributing to a positive and sustained outcome on performance. The present review examines the practical application of current key issues in performance nutrition, highlighting the advantages of early intervention in youth development and comprehensive and integrated nutrition services.