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Chapman S, Chung HC, Rawcliffe AJ, Izard R, Smith L, Roberts JD. Does Protein Supplementation Support Adaptations to Arduous Concurrent Exercise Training? A Systematic Review and Meta-Analysis with Military Based Applications. Nutrients 2021; 13:1416. [PMID: 33922458 PMCID: PMC8145048 DOI: 10.3390/nu13051416] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022] Open
Abstract
We evaluated the impact of protein supplementation on adaptations to arduous concurrent training in healthy adults with potential applications to individuals undergoing military training. Peer-reviewed papers published in English meeting the population, intervention, comparison and outcome criteria were included. Database searches were completed in PubMed, Web of science and SPORTDiscus. Study quality was evaluated using the COnsensus based standards for the selection of health status measurement instruments checklist. Of 11 studies included, nine focused on performance, six on body composition and four on muscle recovery. Cohen's d effect sizes showed that protein supplementation improved performance outcomes in response to concurrent training (ES = 0.89, 95% CI = 0.08-1.70). When analysed separately, improvements in muscle strength (SMD = +4.92 kg, 95% CI = -2.70-12.54 kg) were found, but not in aerobic endurance. Gains in fat-free mass (SMD = +0.75 kg, 95% CI = 0.44-1.06 kg) and reductions in fat-mass (SMD = -0.99, 95% CI = -1.43-0.23 kg) were greater with protein supplementation. Most studies did not report protein turnover, nitrogen balance and/or total daily protein intake. Therefore, further research is warranted. However, our findings infer that protein supplementation may support lean-mass accretion and strength gains during arduous concurrent training in physical active populations, including military recruits.
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Affiliation(s)
- Shaun Chapman
- HQ Army Recruiting and Initial Training Command, UK Ministry of Defence, Upavon, Wiltshire SN9 6BE, UK;
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK; (H.C.C.); (L.S.); (J.D.R.)
| | - Henry C. Chung
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK; (H.C.C.); (L.S.); (J.D.R.)
| | - Alex J. Rawcliffe
- HQ Army Recruiting and Initial Training Command, UK Ministry of Defence, Upavon, Wiltshire SN9 6BE, UK;
| | - Rachel Izard
- Defence Science and Technology, Porton Down, UK Ministry of Defence, Salisbury, Wiltshire SP4 0JQ, UK;
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK; (H.C.C.); (L.S.); (J.D.R.)
| | - Justin D. Roberts
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK; (H.C.C.); (L.S.); (J.D.R.)
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Hackney KJ, English KL. Protein and Essential Amino Acids to Protect Musculoskeletal Health during Spaceflight: Evidence of a Paradox? Life (Basel) 2014; 4:295-317. [PMID: 25370374 PMCID: PMC4206848 DOI: 10.3390/life4030295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/19/2014] [Accepted: 06/23/2014] [Indexed: 11/17/2022] Open
Abstract
Long-duration spaceflight results in muscle atrophy and a loss of bone mineral density. In skeletal muscle tissue, acute exercise and protein (e.g., essential amino acids) stimulate anabolic pathways (e.g., muscle protein synthesis) both independently and synergistically to maintain neutral or positive net muscle protein balance. Protein intake in space is recommended to be 12%-15% of total energy intake (≤1.4 g∙kg-1∙day-1) and spaceflight is associated with reduced energy intake (~20%), which enhances muscle catabolism. Increasing protein intake to 1.5-2.0 g∙kg-1∙day-1 may be beneficial for skeletal muscle tissue and could be accomplished with essential amino acid supplementation. However, increased consumption of sulfur-containing amino acids is associated with increased bone resorption, which creates a dilemma for musculoskeletal countermeasures, whereby optimizing skeletal muscle parameters via essential amino acid supplementation may worsen bone outcomes. To protect both muscle and bone health, future unloading studies should evaluate increased protein intake via non-sulfur containing essential amino acids or leucine in combination with exercise countermeasures and the concomitant influence of reduced energy intake.
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Affiliation(s)
- Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58102, USA.
| | - Kirk L English
- Exercise Physiology and Countermeasures Laboratory, JES Tech, Houston, TX 77058, USA.
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Tipton KD, Elliott TA, Ferrando AA, Aarsland AA, Wolfe RR. Stimulation of muscle anabolism by resistance exercise and ingestion of leucine plus protein. Appl Physiol Nutr Metab 2009; 34:151-61. [DOI: 10.1139/h09-006] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Leucine is known to stimulate muscle protein synthesis and anabolism. However, evidence for the efficacy of additional leucine to enhance the response of muscle anabolism to resistance exercise and protein ingestion is unclear. Thus, we investigated the response of net muscle protein balance to ingestion of additional leucine with protein in association with resistance exercise. Two groups of untrained subjects performed an intense bout of leg resistance exercise following ingestion of 1 of 2 drinks: flavored water (PL); or 16.6 g of whey protein + 3.4 g of leucine (W+L). Arteriovenous amino acid balance across the leg was measured to assess the anabolic response of muscle in each group. Arterial amino acid concentrations increased in response to ingestion of W+L. Amino acid concentrations peaked between 60 and 120 min after ingestion, and then declined to baseline values. Valine concentration decreased to levels significantly lower than baseline. Net balance of leucine, threonine, and phenylalanine did not change following PL ingestion, but increased and remained elevated above baseline for 90–120 min following W+L ingestion. Leucine (138 ± 37 and –23 ± 23 mg), phenylalanine (58 ± 28 and –38 ± 14 mg), and threonine (138 ± 37 and –23 ± 23 mg) uptake was greater for W+L than for PL over the 5.5 h following drink ingestion. Our results indicate that the whey protein plus leucine in healthy young volunteers results in an anabolic response in muscle that is not greater than the previously reported response to whey protein alone.
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Affiliation(s)
- Kevin D. Tipton
- Metabolism Unit, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Tabatha A. Elliott
- Metabolism Unit, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Arny A. Ferrando
- Metabolism Unit, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Asle A. Aarsland
- Metabolism Unit, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Robert R. Wolfe
- Metabolism Unit, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Hansen M, Miller BF, Holm L, Doessing S, Petersen SG, Skovgaard D, Frystyk J, Flyvbjerg A, Koskinen S, Pingel J, Kjaer M, Langberg H. Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissue in young women. J Appl Physiol (1985) 2008; 106:1435-43. [PMID: 18845777 DOI: 10.1152/japplphysiol.90933.2008] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Women are at greater risk than men for certain kinds of diseases and injuries, which may at least partly be caused by sex hormonal differences. We aimed to test the influence of estradiol in vivo on collagen synthesis in tendon, bone, and muscle. Two groups of young, healthy women similar in age, body composition, and exercise-training status were included. The two groups were either habitual users of oral contraceptives exposed to a high concentration of synthetic estradiol and progestogens (OC, n = 11), or non-OC-users tested in the follicular phase of the menstrual cycle characterized by low concentrations of estradiol and progesterone (control, n = 12). Subjects performed 1 h of one-legged kicking exercise. The next day collagen fractional synthesis rates (FSR) in tendon and muscle connective tissue were measured after a flooding dose of [(13)C]proline followed by biopsies from the patellar tendon and vastus lateralis in both legs. Simultaneously, microdialysis catheters were inserted in vastus lateralis and in front of the patellar tendon for measurement of insulin-like growth factor I (IGF-I) and its binding proteins. Serum NH(2)-terminal propeptide of type I collagen (PINP) and urine COOH-terminal telopeptides of type-I collagen (CTX-I) were measured as markers for bone synthesis and breakdown, respectively. Tendon FSR and PINP were lower in OC compared with control. An increase in muscle collagen FSR postexercise was only observed in control (P < 0.05). Furthermore, the results indicate a lower bioavailability of IGF-I in OC. In conclusion, synthetic female sex hormones administered as OC had an inhibiting effect on collagen synthesis in tendon, bone, and muscle connective tissue, which may be related to a lower bioavailability of IGF-I.
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Affiliation(s)
- M Hansen
- Institute of Sports Medicine, Bispebjerg Hospital and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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Hansen M, Koskinen SO, Petersen SG, Doessing S, Frystyk J, Flyvbjerg A, Westh E, Magnusson SP, Kjaer M, Langberg H. Ethinyl oestradiol administration in women suppresses synthesis of collagen in tendon in response to exercise. J Physiol 2008; 586:3005-16. [PMID: 18420709 DOI: 10.1113/jphysiol.2007.147348] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Women are at greater risk than men of sustaining certain kinds of injury and diseases of collagen-rich tissues. To determine whether a high level of oestradiol has an acute influence on collagen synthesis in tendons at rest and in response to exercise, one-legged kicking exercise was performed for 60 min at 67% of maximum power by healthy, young oral contraceptive (OC) users when circulating synthetic (ethinyl) oestradiol was high (n = 11, HE-OC) and compared to similar women who had never used OCs when circulating endogenous oestrogen was low (n = 12, LE-NOC). Interstitial fluid was collected 24 h post-exercise through microdialysis catheters placed anterior to the patellar tendon in both legs and subsequently analysed for the amino-terminal propeptide of type I collagen (PINP), a marker of tendon collagen synthesis. To determine the long-term effect of OC usage, patellar tendon cross-sectional area (CSA) was measured by magnetic resonance imaging (MRI). A lower exercise-induced increase in tendon collagen synthesis was observed in HE-OC than in LE-NOC (DeltaPINP (mean +/- s.e.m.) 1.5 +/- 5.3 versus 24.2 +/- 9.4 ng ml(-1), P < 0.05). Furthermore, serum and the interstitial peritendinous tissue concentrations of insulin-like growth factor I (IGF-I) and IGF-binding proteins showed a reduced bioavailability in HE-OC compared with results in LE-NOC. No difference in patellar tendon CSA was observed between groups. In conclusion, the selective increase in tendon collagen synthesis in LE-NOC but not HE-OC 24 h post-exercise is consistent with the hypothesis that oestradiol inhibits exercise-induced collagen synthesis in human tendon. The mechanism behind this is either a direct effect of oestradiol, or an indirect effect via a reduction in levels of free IGF-I. However, the data did not indicate any long-term effect on tendon size associated with chronic OC use.
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Affiliation(s)
- Mette Hansen
- Institute of Sports Medicine, Copenhagen, Build. 8, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
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Tipton KD, Witard OC. Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations. Clin Sports Med 2007; 26:17-36. [DOI: 10.1016/j.csm.2006.11.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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