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Kviatkovsky SA, Hickner RC, Cabre HE, Small SD, Ormsbee MJ. Collagen peptides supplementation improves function, pain, and physical and mental outcomes in active adults. J Int Soc Sports Nutr 2023; 20:2243252. [PMID: 37551682 PMCID: PMC10411303 DOI: 10.1080/15502783.2023.2243252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Chronic pain affects 19% of adults in the United States, with increasing prevalence in active and aging populations. Pain can limit physical activity and activities of daily living (ADLs), resulting in declined mental and social health. Nutritional interventions for pain currently target inflammation or joint health, but few influence both. Collagen, the most abundant protein in the human body and constituent of the extra cellular matrix, is such a nutraceutical. While there have been reports of reductions in pain with short-term collagen peptide (CP) supplementation, there are no long-term studies specifically in healthy middle-aged active adults. PURPOSE To determine the effects of daily CP consumption over 3, 6, and 9 months on survey measures of pain, function, and physical and mental health using The Knee Injury & Osteoarthritis Outcomes Score (KOOS) and Veterans Rand 12 (VR-12) in middle-aged active adults. METHODS This study was a double-blind randomized control trial with three treatment groups (Placebo, 10 g/d CP, and 20 g/d CP). RESULTS Improvements in ADLs (p = .031, ηp2 = .096) and pain (p = .037, ηp2 = .164) were observed with 10 g/d CP over 6 months, although pain only improved in high frequency exercisers (>180 min/week). Additionally, VR-12 mental component scores (MCS) improved with 10 g/d of CP over 3-9 months (p = .017, ηp2 = .309), while physical component scores (PCS) improved with 20 g/d of CP over 3-9 months, but only in females (p = .013, ηp2= .582). CONCLUSION These findings suggest 10 to 20 g/d of CP supplementation over 6 to 9 months may improve ADLs, pain, MCS, and PCS in middle-aged active adults.
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Affiliation(s)
- Shiloah A. Kviatkovsky
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of Arkansas for Medical Sciences, Center for Aging and Longevity, Geriatrics, Little Rock, AR, USA
| | - Robert C. Hickner
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of KwaZulu-Natal, School of Health Sciences, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
| | - Hannah E. Cabre
- The University of North Carolina at Chapel Hill, Applied Physiology Lab, Department of Sport Science, Chapel Hill, NC, USA
| | - Stephanie D. Small
- University of Toronto, Faculty of Kinesiology & Physical Education, Toronto, ON, Canada
| | - Michael J. Ormsbee
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of KwaZulu-Natal, School of Health Sciences, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
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van Dam L, Terink R, Mensink M, de Vos RJ, Zwerver J. The JUMPFOOD study: additional effect of hydrolyzed collagen and vitamin C to exercise treatment for patellar tendinopathy (jumper's knee) in athletes-study protocol for a double-blind randomized controlled trial. Trials 2023; 24:768. [PMID: 38017500 PMCID: PMC10685530 DOI: 10.1186/s13063-023-07783-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Patellar tendinopathy (PT) is a common problem in jumping athletes. Management can be challenging and treatment outcome is not always successful. In combination with tendon loading exercises, hydrolyzed collagen/vitamin C supplementation appears to have a promising effect on the recovery of tendinopathy. The aim of this study is to evaluate whether the use of oral supplementation of hydrolyzed collagen and vitamin C in combination with progressive tendon loading exercises (PTLE) is superior to PTLE and placebo on VISA-P score (which rates pain, function, sports participation) after 24 weeks for athletes with PT. METHODS The JUMPFOOD study is a double-blinded, two-armed randomized controlled trial, in which the effectiveness of oral supplementation of hydrolyzed collagen/vitamin C combined with PTLE compared to PTLE with placebo on pain and recovery of function in athletes with PT will be investigated. Seventy-six athletes aged 16-40 years, with symptoms of PT for at least 12 weeks, who play sports at least once a week will be included. All participants will receive education, advice with regard to load management and a PTLE program according to the Dutch guidelines for anterior knee pain. In addition, the intervention group will receive daily 10 g hydrolyzed collagen and 40 mg vitamin C supplementation for 24 weeks whereas the control group receives 10 g maltodextrin placebo supplementation. Measurements will take place at baseline and at 12 and 24 weeks' follow-up. Primary outcome is the VISA-P score, which evaluates pain, function, and sports participation. For secondary outcome measures, data with regard to pain during functional tests, flexibility measurements, blood withdrawals, imaging characteristics of the tendon, and health questionnaires will be collected. During the follow-up period, participants will register sports participation, amount of training and tendon load, pain during sports, co-medication, and side-effects in a digital weekly diary. DISCUSSION The JUMPFOOD study is the first large RCT to study the effectiveness of hydrolyzed collagen/vitamin C supplementation in combination with the PTLE program in athletes with patellar tendinopathy. If supplementation of collagen/vitamin C appears to be effective, this treatment can be implemented in daily sports medicine practice to improve the treatment outcome of patients with PT. TRIAL REGISTRATION ClinicalTrials.gov NCT05407194. Registered on 7 June 2022.
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Affiliation(s)
- L van Dam
- Department of Sports Medicine, SportsValley, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands.
- Division of Human Nutrition and Health, Wageningen University & Research (WUR), Wageningen, The Netherlands.
| | - R Terink
- Department of Sports Medicine, SportsValley, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands
| | - M Mensink
- Division of Human Nutrition and Health, Wageningen University & Research (WUR), Wageningen, The Netherlands
| | - R J de Vos
- Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - J Zwerver
- Department of Sports Medicine, SportsValley, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Balshaw TG, Funnell MP, McDermott EJ, Maden-Wilkinson TM, Massey GJ, Abela S, Quteishat B, Edsey M, James LJ, Folland JP. The Effect of Specific Bioactive Collagen Peptides on Tendon Remodeling during 15 wk of Lower Body Resistance Training. Med Sci Sports Exerc 2023; 55:2083-2095. [PMID: 37436929 DOI: 10.1249/mss.0000000000003242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
PURPOSE Collagen peptide supplementation has been reported to enhance synthesis rates or growth in a range of musculoskeletal tissues and could enhance tendinous tissue adaptations to resistance training (RT). This double-blind placebo-controlled study aimed to determine if tendinous tissue adaptations, size (patellar tendon cross-sectional area (CSA) and vastus lateralis (VL) aponeurosis area), and mechanical properties (patellar tendon), after 15 wk of RT, could be augmented with collagen peptide (CP) versus placebo (PLA) supplementation. METHODS Young healthy recreationally active men were randomized to consume either 15 g of CP ( n = 19) or PLA ( n = 20) once every day during a standardized program of lower-body RT (3 times a week). Measurements pre- and post-RT included patellar tendon CSA and VL aponeurosis area (via magnetic resonance imaging), and patellar tendon mechanical properties during isometric knee extension ramp contractions. RESULTS No between-group differences were detected for any of the tendinous tissue adaptations to RT (ANOVA group-time, 0.365 ≤ P ≤ 0.877). There were within-group increases in VL aponeurosis area (CP, +10.0%; PLA, +9.4%), patellar tendon stiffness (CP, +17.3%; PLA, +20.9%) and Young's modulus (CP, +17.8%; PLA, +20.6%) in both groups (paired t -tests (all), P ≤ 0.007). There were also within-group decreases in patellar tendon elongation (CP, -10.8%; PLA, -9.6%) and strain (CP, -10.6%; PLA, -8.9%) in both groups (paired t -tests (all), P ≤ 0.006). Although no within-group changes in patellar tendon CSA (mean or regional) occurred for CP or PLA, a modest overall time effect ( n = 39) was observed for mean (+1.4%) and proximal region (+2.4%) patellar tendon CSA (ANOVA, 0.017 ≤ P ≤ 0.048). CONCLUSIONS In conclusion, CP supplementation did not enhance RT-induced tendinous tissue remodeling (either size or mechanical properties) compared with PLA within a population of healthy young men.
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Affiliation(s)
- Thomas G Balshaw
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Mark P Funnell
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Emmet J McDermott
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Thomas M Maden-Wilkinson
- Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, UNITED KINGDOM
| | - Garry J Massey
- School of Sport and Health Sciences, University of Exeter, UNITED KINGDOM
| | - Sean Abela
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Btool Quteishat
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Max Edsey
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Lewis J James
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
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Cuevas-Cervera M, Aguilar-Nuñez D, Aguilar-García M, García-Ríos MC, González-Muñoz A, Navarro-Ledesma S. Patellar Tendon Elasticity and Temperature Following after a 448 Kilohertz Radiofrequency Intervention on Active Healthy Subjects: An Open Controlled Clinical Trial. Diagnostics (Basel) 2023; 13:2976. [PMID: 37761343 PMCID: PMC10528375 DOI: 10.3390/diagnostics13182976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The purpose of this study was to analyze the changes in the elasticity and temperature of the patellar tendon produced by the application of a radiofrequency at 448 kHz (CRMR) just after and 7 days after the intervention. An open controlled clinical trial was used with participants being recruited from a private clinic. The experimental group (n = 22) received a 448 kHz CRMR treatment while the control group (n = 22) did not receive any type of intervention. Quantitative ultrasound strain elastography (SEL) and thermography were used to collect data from 4 different areas of the patellar tendon. These areas were measured at the start (T0), just after (T1), and seven days after (T2) the intervention. There were thermal changes immediately after the intervention (p < 0.001). In addition, when the measurements were collected just after the intervention and seven days after they were analyzed, significant changes (p < 0.001) in temperature were observed in the tendons of both groups. Finally, a low but significant association (r = 0.434, p < 0.04) was observed between the elastic properties of the tendon at its insertion in the patella and thermal changes just after the 448 kHz intervention.
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Affiliation(s)
- Maria Cuevas-Cervera
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (M.C.-C.); (M.A.-G.); (S.N.-L.)
- Biomedicine PhD Program, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071 Granada, Spain
| | - Daniel Aguilar-Nuñez
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain;
| | - María Aguilar-García
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (M.C.-C.); (M.A.-G.); (S.N.-L.)
| | - María Carmen García-Ríos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071 Granada, Spain;
| | - Ana González-Muñoz
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (M.C.-C.); (M.A.-G.); (S.N.-L.)
- Clinica Ana Gonzalez, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
| | - Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (M.C.-C.); (M.A.-G.); (S.N.-L.)
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5
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Burton I, McCormack A. Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review. J Sport Rehabil 2023:1-12. [PMID: 37146985 DOI: 10.1123/jsr.2022-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 01/02/2023] [Accepted: 02/24/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Tendinopathy has a high prevalence and incidence in the general population and among athletes, with a lack of consensus among medical practitioners on optimal management strategies. The objective of this scoping review was to evaluate current research on the use of nutritional supplements for treating tendinopathies, including what supplements have been used and what outcomes, outcome measures, and intervention parameters have been reported. METHODS Databases searched included Embase, SPORTDiscus, the Cochrane Library, MEDLINE, CINAHL, and AMED. This scoping review considered primary studies investigating nutritional supplements for tendinopathies and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. RESULTS A total of 1527 articles were identified with 16 included in the review. Studies investigated a range of nutritional supplements in the clinical management of various tendinopathies, including several commercially available proprietary blends of several ingredients. TendoActive (mucopolysaccharides, type I collagen, and vitamin C) was used in 2 studies, TENDISULFUR (methylsulfonylmethane, hydrolyzed collagen, L-arginine, L-lysine, vitamin C, bromelain, chondroitin, glucosamine, Boswellia, and myrrh) was used in 3 studies, and Tenosan (arginine-L-alpha ketoglutarate, hydrolyzed collagen type I, methylsulfonylmethane, vitamin C, bromelain, and vinitrox) was used in 2 studies. Collagen peptides were used in 2 studies, with omega-3 fatty acids, combined fatty acids and antioxidants, turmeric rhizome combined with Boswellia, β-hydroxy β-methylbutyric, vitamin C in isolation and combined with gelatin, and creatine investigated in one study each. CONCLUSION Despite a paucity of studies to date, findings from this review suggest that several nutritional compounds may be beneficial in the clinical management of tendinopathies, by exerting anti-inflammatory effects and improving tendon healing. Nutritional supplements may have potential as an adjunctive method to standard treatment methods such as exercise, where their pain-relieving, anti-inflammatory, and structural tendon effects may augment the positive functional outcomes gained from progressive exercise rehabilitation.
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Affiliation(s)
- Ian Burton
- Portlethen Medical Centre, Aberdeenshire, NHS Grampian, Aberdeen,United Kingdom
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6
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Balshaw TG, Funnell MP, McDermott E, Maden-Wilkinson TM, Abela S, Quteishat B, Edsey M, James LJ, Folland JP. The effect of specific bioactive collagen peptides on function and muscle remodeling during human resistance training. Acta Physiol (Oxf) 2023; 237:e13903. [PMID: 36433662 PMCID: PMC10078466 DOI: 10.1111/apha.13903] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
AIM Bioactive collagen peptides (CP) have been suggested to augment the functional, structural (size and architecture), and contractile adaptations of skeletal muscle to resistance training (RT), but with limited evidence. This study aimed to determine if CP vs. placebo (PLA) supplementation enhanced the functional and underpinning structural, and contractile adaptations after 15 weeks of lower body RT. METHODS Young healthy males were randomized to consume either 15 g of CP (n = 19) or PLA (n = 20) once every day during a standardized program of progressive knee extensor, knee flexor, and hip extensor RT 3 times/wk. Measurements pre- and post-RT included: knee extensor and flexor isometric strength; quadriceps, hamstrings, and gluteus maximus volume with MRI; evoked twitch contractions, 1RM lifting strength, and architecture (with ultrasound) of the quadriceps. RESULTS Percentage changes in maximum strength (isometric or 1RM) did not differ between-groups (0.684 ≤ p ≤ 0.929). Increases in muscle volume were greater (quadriceps 15.2% vs. 10.3%; vastus medialis (VM) 15.6% vs. 9.7%; total muscle volume 15.7% vs. 11.4%; [all] p ≤ 0.032) or tended to be greater (hamstring 16.5% vs. 12.8%; gluteus maximus 16.6% vs. 12.9%; 0.089 ≤ p ≤ 0.091) for CP vs. PLA. There were also greater increases in twitch peak torque (22.3% vs. 12.3%; p = 0.038) and angle of pennation of the VM (16.8% vs. 5.8%, p = 0.046), but not other muscles, for CP vs. PLA. CONCLUSIONS CP supplementation produced a cluster of consistent effects indicating greater skeletal muscle remodeling with RT compared to PLA. Notably, CP supplementation amplified the quadriceps and total muscle volume increases induced by RT.
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Affiliation(s)
- Thomas G Balshaw
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Mark P Funnell
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Emmet McDermott
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Thomas M Maden-Wilkinson
- Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, UK
| | - Sean Abela
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Btool Quteishat
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Max Edsey
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Lewis J James
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
| | - Jonathan P Folland
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK.,Versus Arthritis, Centre for Sport, Exercise and Osteoarthritis, Loughborough University, Leicestershire, UK
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Escaloni J, Mazloomdoost D, Young I. Novel Orthobiologic Preparation and Regenerative Rehabilitation of a Complex Shoulder Injury in a Competitive Adolescent Female Athlete. Int J Sports Phys Ther 2023; 18:240-252. [PMID: 36793563 PMCID: PMC9897030 DOI: 10.26603/001c.68143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/23/2022] [Indexed: 02/05/2023] Open
Abstract
Background Platelet-rich plasma (PRP) and prolotherapy have resulted in promising outcomes in patients with various types of shoulder injuries. However, there is a lack of preliminary evidence supporting preparation of PRP production, timely application of these therapies and regenerative rehabilitation protocols. The purpose of this case report is to describe the distinct method including orthobiologic preparation, tissue-specific treatment and regenerative rehabilitation of an athlete with a complex shoulder injury. Case Presentation A 15y/o competitive female wrestler with a complex shoulder injury presented to the clinic after unsuccessful conservative rehabilitation. Unique methods were incorporated to optimize PRP production, specific tissue healing and regenerative rehabilitation. Multiple injuries required different orthobiologic interventions at different time frames, in order to promote optimal healing and stability of the shoulder. Outcomes The described interventions resulted in successful outcomes including pain, disability, full return to sport, and regenerative tissue healing confirmed with diagnostic imaging. Level of Evidence 5.
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Affiliation(s)
- James Escaloni
- American Academy of Manipulative Therapy
- Wellward Regenerative Medicine
| | | | - Ian Young
- American Academy of Manipulative Therapy
- Tybee Wellness & Osteopractic
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Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr 2022; 19:474-504. [PMID: 35937777 PMCID: PMC9354648 DOI: 10.1080/15502783.2022.2104130] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Aveline Hijlkema
- Wageningen University and Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | | | - Marco Mensink
- Wageningen University and Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Johannes Zwerver
- Hospital Gelderse Vallei, Sports Valley, Department of Sports Medicine, Ede, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
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Wang K, Cheng L, He B. Therapeutic effects of asperosaponin VI in rabbit tendon disease. Regen Ther 2022; 20:1-8. [PMID: 35310016 PMCID: PMC8898761 DOI: 10.1016/j.reth.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 01/20/2023] Open
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Qiu F, Li J, Legerlotz K. Does Additional Dietary Supplementation Improve Physiotherapeutic Treatment Outcome in Tendinopathy? A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11061666. [PMID: 35329992 PMCID: PMC8950117 DOI: 10.3390/jcm11061666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
A systematic review and meta-analysis of randomized controlled trials was performed to evaluate the effects of dietary supplements in addition to physiotherapeutic treatment on pain and functional outcomes. PubMed, The Cochrane Library, Web of Science, and Embase were searched from inception to November 2021 (Prospero registration: CRD42021291951). Studies were eligible if the interventions consisted of physiotherapeutic approaches that were combined with dietary supplementation and if they reported measures of pain and/or function. Six studies were included in the meta-analysis. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated and analysed using a Review Manager software. Subgroup analysis was performed to explore possible associations between the study characteristics and the effectiveness of the intervention. Additional dietary supplementation during physiotherapeutic treatment significantly improved the reduction in pain score (SMD = −0.74, 95% CI, −1.37 to −0.10; p < 0.05), while it had no effect on functional outcomes (SMD = 0.29, 95% CI, 0.00 to 0.58; p > 0.05). This systematic review and meta-analysis suggests that additional nutritional interventions may improve physiotherapeutic treatment outcomes in the management of tendinopathies.
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Affiliation(s)
- Fanji Qiu
- Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany;
| | - Jinfeng Li
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA;
| | - Kirsten Legerlotz
- Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany;
- Correspondence: ; Tel.: +49-(0)30-2093-46254
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Mienaltowski MJ, Gonzales NL, Beall JM, Pechanec MY. Basic Structure, Physiology, and Biochemistry of Connective Tissues and Extracellular Matrix Collagens. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1348:5-43. [PMID: 34807414 DOI: 10.1007/978-3-030-80614-9_2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The physiology of connective tissues like tendons and ligaments is highly dependent upon the collagens and other such extracellular matrix molecules hierarchically organized within the tissues. By dry weight, connective tissues are mostly composed of fibrillar collagens. However, several other forms of collagens play essential roles in the regulation of fibrillar collagen organization and assembly, in the establishment of basement membrane networks that provide support for vasculature for connective tissues, and in the formation of extensive filamentous networks that allow for cell-extracellular matrix interactions as well as maintain connective tissue integrity. The structures and functions of these collagens are discussed in this chapter. Furthermore, collagen synthesis is a multi-step process that includes gene transcription, translation, post-translational modifications within the cell, triple helix formation, extracellular secretion, extracellular modifications, and then fibril assembly, fibril modifications, and fiber formation. Each step of collagen synthesis and fibril assembly is highly dependent upon the biochemical structure of the collagen molecules created and how they are modified in the cases of development and maturation. Likewise, when the biochemical structures of collagens or are compromised or these molecules are deficient in the tissues - in developmental diseases, degenerative conditions, or injuries - then the ultimate form and function of the connective tissues are impaired. In this chapter, we also review how biochemistry plays a role in each of the processes involved in collagen synthesis and assembly, and we describe differences seen by anatomical location and region within tendons. Moreover, we discuss how the structures of the molecules, fibrils, and fibers contribute to connective tissue physiology in health, and in pathology with injury and repair.
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Affiliation(s)
| | - Nicole L Gonzales
- Department of Animal Science, University of California Davis, Davis, CA, USA
| | - Jessica M Beall
- Department of Animal Science, University of California Davis, Davis, CA, USA
| | - Monica Y Pechanec
- Department of Animal Science, University of California Davis, Davis, CA, USA
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12
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König D, Kohl J, Jerger S, Centner C. Potential Relevance of Bioactive Peptides in Sports Nutrition. Nutrients 2021; 13:3997. [PMID: 34836255 PMCID: PMC8622853 DOI: 10.3390/nu13113997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/27/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
Bioactive peptides are physiologically active peptides mostly derived from proteins following gastrointestinal digestion, fermentation or hydrolysis by proteolytic enzymes. It has been shown that bioactive peptides can be resorbed in their intact form and have repeatedly been shown to have a positive effect on health-related parameters such as hypertension, dyslipoproteinemia, inflammation and oxidative stress. In recent years, there has been increasing evidence that biologically active peptides could also play an important role in sports nutrition. Current studies have shown that bioactive peptides could have a positive impact on changes in body composition and muscular performance, reduce muscle damage following exercise and induce beneficial adaptions within the connective tissue. In the following overview, potential mechanisms as well as possible limitations regarding the sports-related effect of bioactive peptides and their potential mechanisms are presented and discussed. In addition, practical applications will be discussed on how bioactive peptides can be integrated into a nutritional approach in sports to enhance athletic performance as well as prevent injuries and improve the rehabilitation process.
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Affiliation(s)
- Daniel König
- Centre for Sports Science and University Sports, Institute for Nutrition, Exercise and Health, University of Vienna, Auf der Schmelz, 61150 Vienna, Austria
- Department for Nutritional Science, Institute for Nutrition, Exercise and Health, University of Vienna, 61150 Vienna, Austria
| | - Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
| | - Simon Jerger
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
- Praxisklinik Rennbahn, CH-4132 Muttenz, Switzerland
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13
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Zdzieblik D, Jendricke P, Oesser S, Gollhofer A, König D. The Influence of Specific Bioactive Collagen Peptides on Body Composition and Muscle Strength in Middle-Aged, Untrained Men: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094837. [PMID: 33946565 PMCID: PMC8125453 DOI: 10.3390/ijerph18094837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/18/2022]
Abstract
It has been shown that specific collagen peptides combined with resistance training (RT) improves body composition and muscle strength in elderly sarcopenic men. The main purpose of this RCT study was to investigate the efficacy of the identical specific collagen peptides combined with RT on body composition and muscle strength in middle-aged, untrained men. Furthermore, in the exploratory part of the study, these results were compared with another group that had received whey protein in addition to the RT. Ninety-seven men completed this study and participated in a 12-week RT program. They ingested 15 g of specific collagen peptides (n = 30; CP-G), placebo (n = 31; P-G), or whey protein (n = 36; WP-G) daily. Changes in fat free mass and fat mass were determined by dual-energy X-ray absorptiometry (DXA), and isometric leg strength was measured. All participants had significantly (p < 0.01) improved levels in fat free mass (ΔCP-G = 3.42 ± 2.54 kg; ΔP-G = 1.83 ± 2.09 kg; ΔWP-G = 2.27 ± 2.56 kg), fat mass (ΔCP-G = -5.28 ± 3.19 kg; ΔP-G = -3.39 ± 3.13 kg; ΔWP-G = -4.08 ± 2.80 kg) and leg strength (ΔCP-G = 163 ± 189 N; ΔP-G = 100 ± 154 N; ΔWP-G = 120 ± 233 N). The main analysis revealed a statistically significantly higher increase in fat free mass (p = 0.010) and decrease in fat mass (p = 0.023) in the CP-G compared with the P-G. The exploratory analysis showed no statistically significant differences between WP-G and CP-G or P-G, regarding changes of fat free mass and fat mass. In conclusion, specific collagen peptide supplementation combined with RT was associated with a significantly greater increase in fat free mass and a decrease in fat mass compared with placebo. RT combined with whey protein also had a positive impact on body composition, but the respective effects were more pronounced following the specific collagen peptide administration.
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Affiliation(s)
- Denise Zdzieblik
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
| | - Patrick Jendricke
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
- Correspondence: ; Tel.: +49-761-20354240
| | - Steffen Oesser
- CRI, Collagen Research Institute, Schauenburgerstr 116, 24118 Kiel, Germany;
| | - Albert Gollhofer
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
| | - Daniel König
- Centre of Sports Science, Department for Nutrition, Exercise and Health, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria;
- Department for Nutrition, Exercise and Health, Faculty of Life Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
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14
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Mersmann F, Laube G, Marzilger R, Bohm S, Schroll A, Arampatzis A. A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players. Front Physiol 2021; 12:626225. [PMID: 33776790 PMCID: PMC7987778 DOI: 10.3389/fphys.2021.626225] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/18/2021] [Indexed: 01/31/2023] Open
Abstract
Imbalances of muscle strength and tendon stiffness may increase the risk for patellar tendinopathy in growing athletes. The present study investigated if a functional high-load exercise intervention, designed to facilitate tendon adaptation and reduce muscle-tendon imbalances, may prevent patellar tendon pain in adolescent male handball players (12–14 years). Tendon pain prevalence (using VISA-P scores), knee extensor strength, vastus lateralis (VL) architecture and patellar tendon mechanical properties were measured at four measurement time points (M1–M4) over a season. The control group (CON; n = 18; age 13.1 ± 0.7 yrs, height 170 ± 8 cm, mass 58 ± 10 kg) followed the usual strength training plan, including muscular endurance and explosive strength components. In the experimental group (EXP; n = 16; 13.1 ± 0.6 yrs, 169 ± 11 cm, 58 ± 16 kg), two sessions per week with functional high-load exercises for the patellar tendon were integrated in the strength training schedule, aiming to provide repetitive high-intensity loading of at least 3 s loading duration per repetition. While in the control group 30% of the athletes reported a clinically significant aggravation of symptoms, all players in the experimental group remained or became pain-free at M2 until the end of the season. There was a similar increase of strength (normalized to body mass; CON: 3.1%, d = 0.22; EXP: 6.8%, d = 0.47; p = 0.04) and VL thickness (CON: 4.8%, d = 0.28; EXP: 5.7%, d = 0.32; p < 0.001) in both groups, but no significant changes of tendon stiffness or maximum tendon strain. Further, both groups demonstrated similar fluctuations of tendon strain over time. We conclude that functional high-load exercises can reduce the prevalence of patellar tendon pain in adolescent athletes even without a reduction of tendon strain.
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Affiliation(s)
- Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gunnar Laube
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Marzilger
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Arno Schroll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
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15
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Abstract
The aim of this study was to assess the possibility of using collagen protein hydrolysate in the production of milk fermented by Bifidobacterium animalis ssp. lactis Bb-12 and Lactobacillusrhamnosus. Physicochemical and organoleptic properties were studied and microbiological analysis of fermented milk was performed on days 1 and 21 of storage. Milk with the addition of 3% collagen protein hydrolysate was pasteurized (85 °C/30 min), divided into two groups, cooled to 37 °C and inoculated: the first group with Bifidobacteriumanimalis ssp. lactis Bb-12, second with Lactobacillus rhamnosus. Incubation was carried out at 37 °C/10 h. After 21 days of refrigerated storage, the pH value decreased in all analyzed milk samples. Collagen protein hydrolysate was a good milk additive to increase gel hardness and reduce syneresis. Moreover, its addition did not change the taste and odour of milk fermented with the use of Bifidobacterium Bb-12 and Lactobacillus rhamnosus. Collagen protein hydrolysate favourably stimulated the survival of Bifidobacterium Bb-12 during 21 days of storage. After 21 days of cold storage in milk with collagen, the number of Lactobacillus rhamnosus cells was reduced by 0.11 log cfu g−1.
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16
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Alcock RD, Shaw GC, Tee N, Burke LM. Plasma Amino Acid Concentrations After the Ingestion of Dairy and Collagen Proteins, in Healthy Active Males. Front Nutr 2019; 6:163. [PMID: 31681789 PMCID: PMC6803522 DOI: 10.3389/fnut.2019.00163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 09/27/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction: Recent evidence suggests that the consumption of essential amino acids (AA) and/or those abundantly present in collagen may have the capacity to influence the synthesis of new collagen in ligaments and tendons, when tissue perfusion is optimized (e.g., during exercise). However, little is currently known about the bioavailability of these AAs in blood after the consumption of various collagen and diary protein sources: such information is needed to develop potentially useful dietary and supplement intake strategies. Objectives: The aim of the current study was to characterize blood AA concentrations in response to consumption of collagen and dairy protein sources; specifically, maximum concentrations, the timing of maximum concentration, and total (area under the curve) exposure above baseline. Methods: A 20 g serve of various dairy and collagen proteins, and a 300 mL serve of bone broth were consumed by healthy, recreationally active males after an overnight fast. Blood samples were drawn every 20 min for a total of 180 min, for analysis of plasma AA concentrations. Total AA, essential AA and collagen specific AAs were analyzed for maximum concentration, timing of peak, and area under the curve. Results: In general, protein intake was associated with a similar increase in total and collagen specific AAs, except for collagen proteins being a superior source of glycine (683 ± 166 μmol/L) compared to 260 ± 65 μmol/L for dairy proteins (P < 0.0001), whilst dairy proteins were a superior source of leucine (267 ± 77 μmol/L) compared to 189 ± μmol/L for collagen proteins (P < 0.04). Although there were several differences in the bioavailability of hydrolysed compared to non-hydrolysed proteins, this only reached statistical significance within the dairy proteins, but not for collagen proteins. Conclusions: The intake of collagen proteins result in higher plasma peaks of glycine, whilst the intake of dairy proteins result in higher plasma peaks of leucine. This information may support further investigations, and identification of key AAs that may support exercise in the synthesis of collagen.
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Affiliation(s)
- Rebekah D Alcock
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.,Australian Institute of Sport, Australian Sports Commission, Canberra, ACT, Australia
| | - Gregory C Shaw
- High Performance Unit, Swimming Australia, Brisbane, QLD, Australia
| | - Nicolin Tee
- Australian Institute of Sport, Australian Sports Commission, Canberra, ACT, Australia
| | - Louise M Burke
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.,Australian Institute of Sport, Australian Sports Commission, Canberra, ACT, Australia
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17
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Kirmse M, Oertzen-Hagemann V, de Marées M, Bloch W, Platen P. Prolonged Collagen Peptide Supplementation and Resistance Exercise Training Affects Body Composition in Recreationally Active Men. Nutrients 2019; 11:nu11051154. [PMID: 31126103 PMCID: PMC6566878 DOI: 10.3390/nu11051154] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/13/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Abstract
We aimed to determine the effects of long-term collagen peptide (CP) supplementation and resistance exercise training (RET) on body composition, strength, and muscle fiber cross-sectional area (fCSA) in recreationally active men. Fifty-seven young men were randomly and double-blinded divided into a group receiving either collagen peptides (COL, 15 g/day) or a placebo (PLA). Strength testing, bioimpedance analysis, and muscle biopsies were used prior to and after an RET intervention. Food record protocols were performed during the RET intervention. The groups trained three times a week for 12 weeks. Baseline parameters showed no differences between groups, and the external training load and dietary food intake were also similar. COL showed a significant increase in fat-free mass (FFM) compared with the placebo group (p < 0.05). Body fat mass (BFM) was unchanged in COL, whereas a significant increase in BFM was observed in PLA. Both groups showed significant increases in all strength tests, with a trend for a slightly more pronounced effect in COL. The fCSA of type II muscle fibers increased significantly in both groups without differences between the two groups. We firstly demonstrated improved body composition in healthy, recreationally active men subsequent to prolonged CP supplementation in combination with RET. As the observed increase in FFM was not reflected in differences in fCSA hypertrophy between groups, we assume enhanced passive connective tissue adaptations in COL due to CP intake.
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Affiliation(s)
- Marius Kirmse
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Gesundheitscampus Nord 10, 44801 Bochum, Germany.
| | - Vanessa Oertzen-Hagemann
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Gesundheitscampus Nord 10, 44801 Bochum, Germany.
| | - Markus de Marées
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Gesundheitscampus Nord 10, 44801 Bochum, Germany.
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Gesundheitscampus Nord 10, 44801 Bochum, Germany.
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18
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Paul C, Leser S, Oesser S. Significant Amounts of Functional Collagen Peptides Can Be Incorporated in the Diet While Maintaining Indispensable Amino Acid Balance. Nutrients 2019; 11:E1079. [PMID: 31096622 PMCID: PMC6566836 DOI: 10.3390/nu11051079] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
The results of twenty years of research indicate that the inclusion of collagen peptides in the diet can lead to various improvements in health. According to the current protein quality evaluation method PDCAAS (Protein Digestibility-corrected Amino Acid Score), collagen protein lacks one indispensable amino acid (tryptophan) and is therefore categorized as an incomplete protein source. Collagen protein displays a low indispensable amino acid profile, yet as a functional food, collagen is a source of physiologically active peptides and conditionally indispensable amino acids that have the potential to optimize health and address physiological needs posed by aging and exercise. The objective of this study was to determine the maximum level of dietary collagen peptides that can be incorporated in the Western pattern diet while maintaining its indispensable amino acid balance. Iterative PDCAAS calculations showed that a level as high as 36% of collagen peptides can be used as protein substitution in the daily diet while ensuring indispensable amino acid requirements are met. This study suggests that the effective amounts of functional collagen peptides (2.5 to 15 g per day) observed in the literature are below the maximum level of collagen that may be incorporated in the standard American diet.
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Affiliation(s)
- Cristiana Paul
- Independent Nutrition Researcher, Los Angeles, CA 91344, USA.
| | - Suzane Leser
- GELITA AG, Uferstrasse 7, 69412 Eberbach, Germany.
| | - Steffen Oesser
- CRI, Collagen Research Institute GmbH, Schauenburgerstrasse 116, 24118 Kiel, Germany.
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19
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Skov K, Oxfeldt M, Thøgersen R, Hansen M, Bertram HC. Enzymatic Hydrolysis of a Collagen Hydrolysate Enhances Postprandial Absorption Rate-A Randomized Controlled Trial. Nutrients 2019; 11:nu11051064. [PMID: 31086034 PMCID: PMC6566347 DOI: 10.3390/nu11051064] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 01/16/2023] Open
Abstract
Collagen is characterized by its high content of glycine, proline and hydroxyproline, and is found to exert beneficial effects on joint pain related to activity and osteoarthritis. However, to exert any beneficial effects it is essential that collagen is optimally absorbed. This study aimed to investigate the postprandial absorption of collagen and elucidate the impact of an exogenous enzymatic hydrolysis on absorption rate and bioavailability. A randomized, blinded, cross-over study was conducted where ten healthy male subjects received either 35 g enzymatically hydrolyzed collagen protein (EHC), 35 g non-enzymatically hydrolyzed collagen protein (NC) or placebo (250 mL water) on three nonconsecutive days. Blood samples were drawn before, and up to 240 min following, ingestion and the blood metabolome was characterized by nuclear magnetic resonance (NMR)-based metabolomics. A significant increase in the plasma concentration of nearly all amino acids (AAs) was observed over a 240 min period for both EHC and NC. In addition, the absorption rate and bioavailability of glycine, proline and hydroxyproline were significantly higher for EHC (p < 0.05). In conclusion, ingestion of collagen hydrolysates increases postprandial plasma concentrations of AAs over a period of 240 min, and an enzymatic hydrolysis increases the absorption rate and bioavailability of the collagen-rich AAs glycine, proline and hydroxyproline.
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Affiliation(s)
- Kathrine Skov
- Department of Food Science, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
| | - Mikkel Oxfeldt
- Section for Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus, Denmark.
| | - Rebekka Thøgersen
- Department of Food Science, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
| | - Mette Hansen
- Section for Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus, Denmark.
| | - Hanne Christine Bertram
- Department of Food Science, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
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20
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Shaw G, Serpell B, Baar K. Rehabilitation and nutrition protocols for optimising return to play from traditional ACL reconstruction in elite rugby union players: A case study. J Sports Sci 2019; 37:1794-1803. [PMID: 30967011 DOI: 10.1080/02640414.2019.1594571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Current nutrition and exercise focus during rehabilitation periods has been on reducing muscle atrophy associated with immobilisation. This case report outlines a best practice anterior cruciate ligament (ACL) rehabilitation programme undertaken by two professional rugby athletes, with the addition of an evidence-based supplementation (gelatine and vitamin C) and exercise protocol focused on collagenous tissue. Both players ruptured their left ACL and were repaired with a traditional hamstring graft. Players undertook a structured rehabilitation programme for 34 weeks before being clinically assessed ready to play. Players saw minimal changes in body composition in the early rehabilitation period (P1 - 0.8 kg; P2 - 0.4 kg). Leg lean mass reduced in both legs of Player 1 (Injured - 0.8 kg, Non-injured - 0.6 kg) at 17 weeks, with Player 2 only experiencing a loss of 0.3 kg of lean tissue in the injured leg. Both players returned to baseline body compositions after 24 weeks. Leg strength returned to a maximum at 24 and 15 weeks, respectively, with knee function returning to baseline by 30 weeks. This case report provides evidence that nutrition and rehabilitation programmes targeted at minimising the effects of disuse in both muscle and connective tissue may assist return to play after ACL injury.
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Affiliation(s)
- Gregory Shaw
- a High Performance Unit , Swimming Australia , Brisbane , Australia
| | | | - Keith Baar
- c Department of Neurobiology, Physiology, and Behaviour , University of California Davis , Davis, CA , USA.,d Department of Physiology and Membrane Biology , University of California Davis , Davis , CA , USA.,e High Performance Unit , VA Northern California Health Care System , Mather , CA , USA
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