Isotopic analysis of leucine and urea metabolism in exercising humans

Resistance exercise enhances long-term mTORC1 sensitivity to leucine

OBJECTIVE

Exercise enhances the sensitivity of mammalian target of rapamycin complex 1 (mTORC1) to amino acids, in particular leucine. How long this enhanced sensitivity lasts, and which mechanisms control enhanced leucine-mediated mTORC1 activation following exercise is currently unknown.

METHODS

C57BL/6J mice were exercised for one night in a resistance-braked running wheel after a 12-day acclimatization period. Mice were gavaged with a submaximal dose of l-leucine or saline acutely or 48 h after exercise cessation, following 3 h food withdrawal. Muscles were excised 30 min after leucine administration. To study the contribution of mTORC1, we repeated those experiments but blocked mTORC1 activation using rapamycin immediately before the overnight running bout and one hour before the first dose of leucine. mTORC1 signaling, muscle protein synthesis and amino acid sensing machinery were assessed using immunoblot and qPCR. Leucine uptake was measured using L-[14C(U)]-leucine tracer labeling.

RESULTS

When compared to sedentary conditions, leucine supplementation more potently activated mTORC1 and protein synthesis in acutely exercised muscle. This effect was observed in m. soleus but not in m. tibialis anterior nor m. plantaris. The synergistic effect in m. soleus was long-lasting as key downstream markers of mTORC1 as well as protein synthesis remained higher when leucine was administered 48 h after exercise. We found that exercise enhanced the expression of amino acid transporters and promoted uptake of leucine into the muscle, leading to higher free intramuscular leucine levels. This coincided with increased expression of activating transcription factor 4 (ATF4), a main transcriptional regulator of amino acid uptake and metabolism, and downstream activation of amino acid genes as well as leucyl-tRNA synthetase (LARS), a putative leucine sensor. Finally, blocking mTORC1 using rapamycin did not reduce expression and activation of ATF4, suggesting that the latter does not act downstream of mTORC1. Rather, we found a robust increase in eukaryotic initiation factor 2α (eIF2α) phosphorylation, suggesting that the integrated stress response pathway, rather than exercise-induced mTORC1 activation, drives long-term ATF4 expression in skeletal muscle after exercise.

CONCLUSIONS

The enhanced sensitivity of mTORC1 to leucine is maintained at least 48 h after exercise. This shows that the anabolic window of opportunity for protein ingestion is not restricted to the first hours immediately following exercise. Increased mTORC1 sensitivity to leucine coincided with enhanced leucine influx into muscle and higher expression of genes involved in leucine sensing and amino acid metabolism. Also, exercise induced an increase in ATF4 protein expression. Altogether, these data suggest that muscular contractions switch on a coordinated program to enhance amino acid uptake as well as intramuscular sensing of key amino acids involved in mTORC1 activation and the stimulation of muscle protein synthesis.

Tracing metabolic flux to assess optimal dietary protein and amino acid consumption

There is a general consensus that a dietary protein intake of 0.8 g protein/kg/day will prevent symptoms of protein deficiency in young, healthy individuals. However, individuals in many physiological circumstances may benefit from higher rates of dietary protein intake. Stable isotope tracer methodology enables a variety of approaches to assessing the optimal dietary protein intake in humans. In this paper, we present an overview of a variety of tracer methods, with a discussion of necessary assumptions, as well as the clinical circumstances in which different methods may be preferable. Although we discuss the nontracer method of nitrogen balance, which has historically been used to estimate dietary protein requirements, this paper primarily focuses on tracer methods for estimating dietary protein and essential amino acid requirements under different physiological conditions. We will explain the following approaches: isotopic measurement of urea production; the arterial-venous tracer balance method; measurement of the fractional synthetic and breakdown rates of muscle protein; the indicator and the direct amino acid oxidation methods; and different approaches to measuring whole-body protein synthesis and breakdown. The advantages and limitations of each method are discussed in the context of the optimal approaches for use under different circumstances.

Both clinical and practical considerations should inform how dietary protein intake is tracked in individuals. Little is known about optimal dietary protein intake in humans under different physiological conditions including disease states, prompting a review of current monitoring methods by Robert Wolfe at the University of Arkansas, Little Rock, USA, and co-workers. Monitoring nitrogen balance provides estimates of dietary protein and essential amino acid (EAA) levels, but requires several days of strict diet control. Various techniques monitor the uptake or fate of a specific tracer molecule in the body, but some are very invasive. The less invasive single EAA infusion methods provide rapid results and are valuable for monitoring immediate response to a meal, or in studies comparing protein intakes to a person’s baseline over time. Using two methods concurrently could improve accuracy of results.

Essential Amino Acid Ingestion Facilitates Leucine Retention and Attenuates Myofibrillar Protein Breakdown following Bodyweight Resistance Exercise in Young Adults in a Home-Based Setting

Home-based resistance exercise (RE) has become increasingly prevalent, but its effects on protein metabolism are understudied. We tested the effect of an essential amino acid formulation (EAA+: 9 g EAAs, 3 g leucine) and branched-chain amino acids (BCAAs: 6 g BCAAs, 3 g leucine), relative to a carbohydrate (CHO) placebo, on exogenous leucine retention and myofibrillar protein breakdown following dynamic bodyweight RE in a home-based setting. Twelve recreationally active adults (nine male, three female) participated in a double-blind, placebo-controlled, crossover study with four trial conditions: (i) RE and EAA+ (EX-EAA+); (ii) RE and BCAAs (EX-BCAA); (iii) RE and CHO placebo (EX-CHO); and (iv) rest and CHO placebo (REST-CHO). Total exogenous leucine oxidation and retention (estimates of whole-body anabolism) and urinary 3-methylhistidine:creatinine ratio (3MH:Cr; estimate of muscle catabolism) were assessed over 5 h post-supplement. Total exogenous leucine oxidation and retention in EX-EAA+ and EX-BCAA did not significantly differ (p = 0.116) but were greater than EX-CHO (p < 0.01). There was a main effect of condition on urinary 3MH:Cr (p = 0.034), with post hoc analysis revealing a trend (p = 0.096) for reduced urinary 3MH:Cr with EX-EAA+ (32%) compared to EX-CHO. By direct comparison, urinary 3MH:Cr was significantly lower (23%) in EX-EAA+ than EX-BCAA (p = 0.026). In summary, the ingestion of EAA+ or BCAA provided leucine that was ~60% retained for protein synthesis following home-based bodyweight RE, but EAA+ most effectively attenuated myofibrillar protein breakdown.

Role of Branched-chain Amino Acid Metabolism in Tumor Development and Progression

Branched-chain amino acids (BCAAs), isoleucine, leucine and valine, are essential amino acids with vital roles in protein synthesis and energy production. We reviewed the fundamentals of BCAA metabolism in advanced cancer patients. BCAAs and various catabolic products act as signalling molecules, which activate mechanisms ranging from protein synthesis to insulin secretion. Recently, BCAA metabolism has been suggested to contribute to cancer progression. Of particular interest is the modulation of the mTOR activity by BCAAs. There are likely multiple pathways involved in BCAA metabolism implicated in carcinogenesis. Understanding the mechanism(s) underlying altered BCAAs metabolism will significantly advance the current understanding of nutrient involvement in carcinogenesis and direct future studies to unravel the significance of BCCA metabolites in tumor development and progression.

Whole-body metabolic fate of branched-chain amino acids

Oxidation of branched-chain amino acids (BCAAs) is tightly regulated in mammals. We review here the distribution and regulation of whole-body BCAA oxidation. Phosphorylation and dephosphorylation of the rate-limiting enzyme, branched-chain α-ketoacid dehydrogenase complex directly regulates BCAA oxidation, and various other indirect mechanisms of regulation also exist. Most tissues throughout the body are capable of BCAA oxidation, and the flux of oxidative BCAA disposal in each tissue is influenced by three key factors: 1. tissue-specific preference for BCAA oxidation relative to other fuels, 2. the overall oxidative activity of mitochondria within a tissue, and 3. total tissue mass. Perturbations in BCAA oxidation have been implicated in many disease contexts, underscoring the importance of BCAA homeostasis in overall health.

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.

Intramuscular Mechanisms Mediating Adaptation to Low-Carbohydrate, High-Fat Diets during Exercise Training

Interest in low-carbohydrate, high-fat (LCHF) diets has increased over recent decades given the theorized benefit of associated intramuscular adaptations and shifts in fuel utilization on endurance exercise performance. Consuming a LCHF diet during exercise training increases the availability of fat (i.e., intramuscular triglyceride stores; plasma free fatty acids) and decreases muscle glycogen stores. These changes in substrate availability increase reliance on fat oxidation for energy production while simultaneously decreasing reliance on carbohydrate oxidation for fuel during submaximal exercise. LCHF diet-mediated changes in substrate oxidation remain even after endogenous or exogenous carbohydrate availability is increased, suggesting that the adaptive response driving changes in fat and carbohydrate oxidation lies within the muscle and persists even when the macronutrient content of the diet is altered. This narrative review explores the intramuscular adaptations underlying increases in fat oxidation and decreases in carbohydrate oxidation with LCHF feeding. The possible effects of LCHF diets on protein metabolism and post-exercise muscle remodeling are also considered.

Branched-Chain Amino Acids and Branched-Chain Keto Acids in Hyperammonemic States: Metabolism and as Supplements

In hyperammonemic states, such as liver cirrhosis, urea cycle disorders, and strenuous exercise, the catabolism of branched-chain amino acids (BCAAs; leucine, isoleucine, and valine) is activated and BCAA concentrations decrease. In these conditions, BCAAs are recommended to improve mental functions, protein balance, and muscle performance. However, clinical trials have not demonstrated significant benefits of BCAA-containing supplements. It is hypothesized that, under hyperammonemic conditions, enhanced glutamine availability and decreased BCAA levels facilitate the amination of branched-chain keto acids (BCKAs; α-ketoisocaproate, α-keto-β-methylvalerate, and α-ketoisovalerate) to the corresponding BCAAs, and that BCKA supplementation may offer advantages over BCAAs. Studies examining the effects of ketoanalogues of amino acids have provided proof that subjects with hyperammonemia can effectively synthesize BCAAs from BCKAs. Unfortunately, the benefits of BCKA administration have not been clearly confirmed. The shortcoming of most reports is the use of mixtures intended for patients with renal insufficiency, which might be detrimental for patients with liver injury. It is concluded that (i) BCKA administration may decrease ammonia production, attenuate cataplerosis, correct amino acid imbalance, and improve protein balance and (ii) studies specifically investigating the effects of BCKA, without the interference of other ketoanalogues, are needed to complete the information essential for decisions regarding their suitability in hyperammonemic conditions.

Coingestion of protein and carbohydrate in the early recovery phase, compared with carbohydrate only, improves endurance performance despite similar glycogen degradation and AMPK phosphorylation

Endurance athletes competing consecutive days need optimal dietary intake during the recovery period. We report that coingestion of protein and carbohydrate soon after exhaustive exercise, compared with carbohydrate only, resulted in better performance the following day. The better performance after coingestion of protein and carbohydrate was not associated with a higher rate of glycogen synthesis or activation of anabolic signaling compared with carbohydrate only. Importantly, nitrogen balance was positive after coingestion of protein and carbohydrate, which was not the case after intake of carbohydrate only, suggesting that protein synthesis contributes to the better performance the following day.

Metabolomic Response of Equine Skeletal Muscle to Acute Fatiguing Exercise and Training

The athletic horse, despite being over 50% muscle mass, remains understudied with regard to the effects of exercise and training on skeletal muscle metabolism. To begin to address this knowledge gap, we employed an untargeted metabolomics approach to characterize the exercise-induced and fitness-related changes in the skeletal muscle of eight unconditioned Standardbred horses (four male, four female) before and after a 12-week training period. Before training, unconditioned horses showed a high degree of individual variation in the skeletal muscle metabolome, resulting in very few differences basally and at 3 and 24 h after acute fatiguing exercise. Training did not alter body composition but did improve maximal aerobic and running capacities (p < 0.05), and significantly altered the skeletal muscle metabolome (p < 0.05, q < 0.1). While sex independently influenced body composition and distance run following training (p < 0.05), sex did not affect the skeletal muscle metabolome. Exercise-induced metabolomic alterations (p < 0.05, q < 0.1) largely centered on the branched-chain amino acids (BCAA), xenobiotics, and a variety of lipid and nucleotide-related metabolites, particularly in the conditioned state. Further, training increased (p < 0.05, q < 0.1) the relative abundance of almost every identified lipid species, and this was accompanied by increased plasma BCAAs (p < 0.0005), phenylalanine (p = 0.01), and tyrosine (p < 0.02). Acute exercise in the conditioned state decreased (p < 0.05, q < 0.1) the relative abundance of almost all lipid-related species in skeletal muscle by 24 h post-exercise, whereas plasma amino acids remained unaltered. These changes occurred alongside increased muscle gene expression (p < 0.05) related to lipid uptake (Cd36) and lipid (Cpt1b) and BCAA (Bckdk) utilization. This work suggests that metabolites related to amino acid, lipid, nucleotide and xenobiotic metabolism play pivotal roles in the response of equine skeletal muscle to vigorous exercise and training. Use of these and future data sets could be used to track the impact of training and fitness on equine health and may lead to novel predictors and/or diagnostic biomarkers.

A potent liver-mediated mechanism for loss of muscle mass during androgen deprivation therapy

CONTEXT

Androgen deprivation therapy (ADT) in prostate cancer results in muscular atrophy, due to loss of the anabolic actions of testosterone. Recently, we discovered that testosterone acts on the hepatic urea cycle to reduce amino acid nitrogen elimination. We now hypothesize that ADT enhances protein oxidative losses by increasing hepatic urea production, resulting in muscle catabolism. We also investigated whether progressive resistance training (PRT) can offset ADT-induced changes in protein metabolism.

OBJECTIVE

To investigate the effect of ADT on whole-body protein metabolism and hepatic urea production with and without a home-based PRT program.

DESIGN

A randomized controlled trial.

PATIENTS AND INTERVENTION

Twenty-four prostate cancer patients were studied before and after 6 weeks of ADT. Patients were randomized into either usual care (UC) (n = 11) or PRT (n = 13) starting immediately after ADT.

MAIN OUTCOME MEASURES

The rate of hepatic urea production was measured by the urea turnover technique using 15N2-urea. Whole-body leucine turnover was measured, and leucine rate of appearance (LRa), an index of protein breakdown and leucine oxidation (Lox), a measure of irreversible protein loss, was calculated.

RESULTS

ADT resulted in a significant mean increase in hepatic urea production (from 427.6 ± 18.8 to 486.5 ± 21.3; P < 0.01) regardless of the exercise intervention. Net protein loss, as measured by Lox/Lra, increased by 12.6 ± 4.9% (P < 0.05). PRT preserved lean body mass without affecting hepatic urea production.

CONCLUSION

As early as 6 weeks after initiation of ADT, the suppression of testosterone increases protein loss through elevated hepatic urea production. Short-term PRT was unable to offset changes in protein metabolism during a state of profound testosterone deficiency.

Branched Chain Amino Acids

Branched chain amino acids (BCAAs) are building blocks for all life-forms. We review here the fundamentals of BCAA metabolism in mammalian physiology. Decades of studies have elicited a deep understanding of biochemical reactions involved in BCAA catabolism. In addition, BCAAs and various catabolic products act as signaling molecules, activating programs ranging from protein synthesis to insulin secretion. How these processes are integrated at an organismal level is less clear. Inborn errors of metabolism highlight the importance of organismal regulation of BCAA physiology. More recently, subtle alterations of BCAA metabolism have been suggested to contribute to numerous prevalent diseases, including diabetes, cancer, and heart failure. Understanding the mechanisms underlying altered BCAA metabolism and how they contribute to disease pathophysiology will keep researchers busy for the foreseeable future.

Protein intake in the early recovery period after exhaustive exercise improves performance the following day

The aim of the present study was to investigate the effect of protein and carbohydrate ingestion during early recovery from exhaustive exercise on performance after 18-h recovery. Eight elite cyclists (V̇o2max: 74.0 ± 1.6 ml·kg−1·min−1) completed two exercise and diet interventions in a double-blinded, randomized, crossover design. Participants cycled first at 73% of V̇o2max (W73%) followed by 1-min intervals at 90% of V̇o2max until exhaustion. During the first 2 h of recovery, participants ingested either 1.2 g carbohydrate·kg−1·h−1 (CHO) or 0.8 g carbohydrate + 0.4 g protein·kg−1·h−1 (CHO + PROT). The diet during the remaining recovery period was similar for both interventions and adjusted to body weight. After an 18-h recovery, cycling performance was assessed with a 10-s sprint test, 30 min of cycling at W73%, and a cycling time trial (TT). The TT was 8.5% faster (41:53 ± 1:51 vs. 45:26 ± 1:32 min; P < 0.03) after CHO + PROT compared with CHO. Mean power output during the sprints was 3.7% higher in CHO + PROT compared with CHO (1,063 ± 54 vs. 1,026 ± 53 W; P = 0.01). Nitrogen balance in the recovery period was negative in CHO and neutral in CHO + PROT (−82.4 ± 11.5 vs. 7.0 ± 15.4 mg/kg; P < 0.01). In conclusion, TT and sprint performances were improved 18 h after exhaustive cycling by CHO + PROT supplementation during the first 2 h of recovery compared with isoenergetic CHO supplementation. Our results indicate that intake of carbohydrate plus protein after exhaustive endurance exercise more rapidly converts the body from a catabolic to an anabolic state than carbohydrate alone, thus speeding recovery and improving subsequent cycling performance.

NEW & NOTEWORTHY Prolonged high intensity endurance exercise depends on glycogen utilization and high oxidative capacity. Still, exhaustion develops and effective recovery strategies are required to compete in multiday stage races. We show that coingestion of protein and carbohydrate during the first 2 h of recovery is superior to isoenergetic intake of carbohydrate to stimulate recovery, and improves both endurance time-trial and 10-s sprint performance the following day in elite cyclists.

Beta-hydroxy-beta-methylbutyrate supplementation and skeletal muscle in healthy and muscle-wasting conditions

Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the essential amino acid leucine that has been reported to have anabolic effects on protein metabolism. The aims of this article were to summarize the results of studies of the effects of HMB on skeletal muscle and to examine the evidence for the rationale to use HMB as a nutritional supplement to exert beneficial effects on muscle mass and function in various conditions of health and disease. The data presented here indicate that the beneficial effects of HMB have been well characterized in strength-power and endurance exercise. HMB attenuates exercise-induced muscle damage and enhances muscle hypertrophy and strength, aerobic performance, resistance to fatigue, and regenerative capacity. HMB is particularly effective in untrained individuals who are exposed to strenuous exercise and in trained individuals who are exposed to periods of high physical stress. The low effectiveness of HMB in strength-trained athletes could be due to the suppression of the proteolysis that is induced by the adaptation to training, which may blunt the effects of HMB. Studies performed with older people have demonstrated that HMB can attenuate the development of sarcopenia in elderly subjects and that the optimal effects of HMB on muscle growth and strength occur when it is combined with exercise. Studies performed under in vitro conditions and in various animal models suggest that HMB may be effective in treatment of muscle wasting in various forms of cachexia. However, there are few clinical reports of the effects of HMB on muscle wasting in cachexia; in addition, most of these studies evaluated the therapeutic potential of combinations of various agents. Therefore, it has not been possible to determine whether HMB was effective or if there was a synergistic effect. Although most of the endogenous HMB is produced in the liver, there are no reports regarding the levels and the effects of HMB supplementation in subjects with liver disease. Several studies have suggested that anabolic effects of HMB supplementation on skeletal muscle do not occur in healthy, non-exercising subjects. It is concluded that (i) HMB may be applied to enhance increases in the mass and strength of skeletal muscles in subjects who exercise and in the elderly and (ii) studies examining the effects of HMB administered alone are needed to obtain conclusions regarding the specific effectiveness in attenuating muscle wasting in various muscle-wasting disorders.

Testosterone prevents protein loss via the hepatic urea cycle in human

CONTEXT

The urea cycle is a rate-limiting step for amino acid nitrogen elimination. The rate of urea synthesis is a true indicator of whole-body protein catabolism. Testosterone reduces protein and nitrogen loss. The effect of testosterone on hepatic urea synthesis in humans has not been studied.

OBJECTIVE

To determine whether testosterone reduces hepatic urea production.

DESIGN

An open-label study.

PATIENTS AND INTERVENTION

Eight hypogonadal men were studied at baseline, and after two weeks of transdermal testosterone replacement (Testogel, 100 mg/day).

MAIN OUTCOMES MEASURES

The rate of hepatic urea synthesis was measured by the urea turnover technique using stable isotope methodology, with ¹⁵N₂-urea as tracer. Whole-body leucine turnover was measured, from which leucine rate of appearance (LRa), an index of protein breakdown and leucine oxidation (Lox), a measure of irreversible protein loss, were calculated.

RESULTS

Testosterone administration significantly reduced the rate of hepatic urea production (from 544.4 ± 71.8 to 431.7 ± 68.3 µmol/min; P < 0.01), which was paralleled by a significant reduction in serum urea concentration. Testosterone treatment significantly reduced net protein loss, as measured by percent Lox/LRa, by 19.3 ± 5.8% (P < 0.05). There was a positive association between Lox and hepatic urea production at baseline (r² = 0.60, P < 0.05) and after testosterone administration (r² = 0.59, P < 0.05).

CONCLUSION

Testosterone replacement reduces protein loss and hepatic urea synthesis. We conclude that testosterone regulates whole-body protein metabolism by suppressing the urea cycle.

Riboflavin Deficiency in Rats Decreases de novo Formate Production but Does Not Affect Plasma Formate Concentration

Background: The one-carbon metabolism pathway is highly dependent on a number of B vitamins in order to provide one-carbon units for purine and thymidylate biosynthesis as well as homocysteine remethylation. Previous studies have examined folate and vitamin B-12 deficiency and their effects on formate metabolism; as of yet, to our knowledge, no studies on the effects of riboflavin deficiency on formate metabolism have been published.Objective: Our objective was to determine the effects of riboflavin deficiency on formate metabolism.Methods: Weanling male rats were randomly assigned either to control, riboflavin-replete (RR) or to experimental, riboflavin-deficient (RD) versions of the AIN-93G diet for 13 d, at which time a constant infusion of [¹³C]-formate was carried out to ascertain the effects of deficiency on formate production. Gas chromatography-mass spectrometry was used to measure plasma formate concentration and [¹³C]-formate enrichment. HPLC, LC-mass spectrometry (MS)/MS, and enzymatic assays were used for the measurement of one-carbon precursors and other metabolites.Results: RD rats had significantly lower rates of formate production (15%) as well as significantly reduced hepatic methylenetetrahydrofolate reductase activity (69%) and protein concentration (54%) compared with RR rats. There was no difference in plasma formate concentrations between the groups. Plasma serine, a potential one-carbon precursor, was significantly higher in RD rats (467 ± 73 μM) than in RR rats (368 ± 52 μM).Conclusions: Although deficiencies in folate and vitamin B-12 lead to major changes in plasma formate concentrations, riboflavin deficiency results in no significant difference; this disagrees with the prediction of a published mathematical model. Our observation of a lower rate of formate production is consistent with a role for flavoproteins in this process.

Intake of Protein Plus Carbohydrate during the First Two Hours after Exhaustive Cycling Improves Performance the following Day

Intake of protein immediately after exercise stimulates protein synthesis but improved recovery of performance is not consistently observed. The primary aim of the present study was to compare performance 18 h after exhaustive cycling in a randomized diet-controlled study (175 kJ·kg^-1 during 18 h) when subjects were supplemented with protein plus carbohydrate or carbohydrate only in a 2-h window starting immediately after exhaustive cycling. The second aim was to investigate the effect of no nutrition during the first 2 h and low total energy intake (113 kJ·kg^-1 during 18 h) on performance when protein intake was similar. Eight endurance-trained subjects cycled at 237±6 Watt (~72% VO_2max) until exhaustion (TTE) on three occasions, and supplemented with 1.2 g carbohydrate·kg^-1·h^-1 (CHO), 0.8 g carbohydrate + 0.4 g protein·kg^-1·h^-1 (CHO+PRO) or placebo without energy (PLA). Intake of CHO+PROT increased plasma glucose, insulin, and branch chained amino acids, whereas CHO only increased glucose and insulin. Eighteen hours later, subjects performed another TTE at 237±6 Watt. TTE was increased after intake of CHO+PROT compared to CHO (63.5±4.4 vs 49.8±5.4 min; p<0.05). PLA reduced TTE to 42.8±5.1 min (p<0.05 vs CHO). Nitrogen balance was positive in CHO+PROT, and negative in CHO and PLA. In conclusion, performance was higher 18 h after exhaustive cycling with intake of CHO+PROT compared to an isocaloric amount of carbohydrate during the first 2 h post exercise. Intake of a similar amount of protein but less carbohydrate during the 18 h recovery period reduced performance.

The applicability of the dimeric heterosynthon concept to molecules with equivalent binding sites. A DFT study of crystalline urea–H2O2

The limited applicability of the dimeric heterosynthon concept to a two-component urea–H₂O₂crystal is reported.

In vivo kinetics of formate metabolism in folate-deficient and folate-replete rats

It is now established that the mitochondrial production of formate is a major process in the endogenous generation of folate-linked one-carbon groups. We have developed an in vivo approach involving the constant infusion of [(13)C]formate until isotopic steady state is attained to measure the rate of endogenous formate production in rats fed on either a folate-replete or folate-deficient diet. Formate was produced at a rate of 76 μmol·h(-1)·100 g of body weight(-1) in the folate-replete rats, and this was decreased by 44% in folate-deficient rats. This decreased formate production was confirmed in isolated rat liver mitochondria where formate production from serine, the principal precursor of one-carbon groups, was decreased by 85%, although formate production from sarcosine and dimethylglycine (choline metabolites) was significantly increased. We attribute this unexpected result to the demonstrated production of formaldehyde by sarcosine dehydrogenase and dimethylglycine dehydrogenase from their respective substrates in the absence of tetrahydrofolate and subsequent formation of formate by formaldehyde dehydrogenase. Comparison of formate production with the ingestion of dietary formate precursors (serine, glycine, tryptophan, histidine, methionine, and choline) showed that ∼75% of these precursors were converted to formate, indicating that formate is a significant, although underappreciated end product of choline and amino acid oxidation. Ingestion of a high protein diet did not result in increased production of formate, suggesting a regulation of the conversion of these precursors at the mitochondrial level to formate.

Effects of Chinese herbal medicine on plasma glucose, protein and energy metabolism in sheep

BACKGROUND

The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in the past two decades and played an increasingly important role in livestock production. The present study was carried out to assess the feeding effects of a traditional nourishing Chinese herbal medicine mixture on kinetics of plasma glucose, protein and energy metabolism in sheep. Ruminal fermentation characteristics were also determined.

METHODS

Four sheep were fed on either mixed hay (MH-diet) or MH-diet supplemented with 2% of Chinese herbal medicine (mixture of Astragalus root, Angelica root and Atractylodes rhizome; CHM-diet) over two 35-day periods using a crossover design. The turnover rate of plasma glucose was measured with an isotope dilution method using [U-13C]glucose. The rates of plasma leucine turnover and leucine oxidation, whole body protein synthesis (WBPS) and metabolic heat production were measured using the [1-13C]leucine dilution and open circuit calorimetry.

RESULTS

Body weight gain of sheep was higher (P = 0.03) for CHM-diet than for MH-diet. Rumen pH was lower (P = 0.02), concentration of rumen total volatile fatty acid tended to be higher (P = 0.05) and acetate was higher (P = 0.04) for CHM-diet than for MH-diet. Turnover rates of plasma glucose and leucine did not differ between diets. Oxidation rate of leucine tended to be higher (P = 0.06) for CHM-diet than for MH-diet, but the WBPS did not differ between diets. Metabolic heat production tended to be greater (P = 0.05) for CHM-diet than for MH-diet.

CONCLUSIONS

The sheep fed on CHM-diet had a higher body weight gain and showed positive impacts on rumen fermentation and energy metabolism without resulting in any adverse response. Therefore, these results suggested that the Chinese herbal medicine mixture should be considered as a potential feed additive for sheep.

Changes in body composition in triathletes during an Ironman race

PURPOSE

Triathletes lose body mass during an Ironman triathlon. However, the associated body composition changes remain enigmatic. Thus, the purpose of this study was to investigate Ironman-induced changes in segmental body composition, using for the first time dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT).

METHODS

Before and after an Ironman triathlon, segmental body composition and lower leg tissue mass, areas and densities were assessed using DXA and pQCT, respectively, in eight non-professional male triathletes. In addition, blood and urine samples were collected for the determination of hydration status.

RESULTS

Body mass decreased by 1.9 ± 0.8 kg. This loss was due to 0.4 ± 0.3 and 1.4 ± 0.8 kg decrease in fat and lean mass, respectively (P < 0.01). Calf muscle density was reduced by 1.93 ± 1.04 % (P < 0.01). Hemoglobin, hematocrit, and plasma [K(+)] remained unchanged, while plasma [Na(+)] (P < 0.05), urine specific gravity and plasma and urine osmolality increased (P < 0.01).

CONCLUSIONS

The loss in lean mass was explained by a decrease in muscle density, as an indicator of glycogen loss, and increases in several indicators for dehydration. The measurement of body composition with DXA and pQCT before and after an Ironman triathlon provided exact values for the loss in fat and lean mass. Consequently, these results yielded more detailed insights into tissue catabolism during ultra-endurance exercise.

Diurnal variation of phenylalanine and tyrosine concentrations in adult patients with phenylketonuria: subcutaneous microdialysis is no adequate tool for the determination of amino acid concentrations

BACKGROUND

Metabolic control and dietary management of patients with phenylketonuria (PKU) are based on single blood samples obtained at variable intervals. Sampling conditions are often not well-specified and intermittent variation of phenylalanine concentrations between two measurements remains unknown. We determined phenylalanine and tyrosine concentrations in blood over 24 hours. Additionally, the impact of food intake and physical exercise on phenylalanine and tyrosine concentrations was examined. Subcutaneous microdialysis was evaluated as a tool for monitoring phenylalanine and tyrosine concentrations in PKU patients.

METHODS

Phenylalanine and tyrosine concentrations of eight adult patients with PKU were determined at 60 minute intervals in serum, dried blood and subcutaneous microdialysate and additionally every 30 minutes postprandially in subcutaneous microdialysate. During the study period of 24 hours individually tailored meals with defined phenylalanine and tyrosine contents were served at fixed times and 20 min bicycle-ergometry was performed.

RESULTS

Serum phenylalanine concentrations showed only minor variations while tyrosine concentrations varied significantly more over the 24-hour period. Food intake within the patients' individual diet had no consistent effect on the mean phenylalanine concentration but the tyrosine concentration increased up to 300% individually. Mean phenylalanine concentration remained stable after short-term bicycle-exercise whereas mean tyrosine concentration declined significantly. Phenylalanine and tyrosine concentrations in dried blood were significantly lower than serum concentrations. No close correlation has been found between serum and microdialysis fluid for phenylalanine and tyrosine concentrations.

CONCLUSIONS

Slight diurnal variation of phenylalanine concentrations in serum implicates that a single blood sample does reliably reflect the metabolic control in this group of adult patients. Phenylalanine concentrations determined by subcutaneous microdialysis do not correlate with the patients' phenylalanine concentrations in serum/blood.

Suppression in growth hormone during overeating ameliorates the increase in insulin resistance and cardiovascular disease risk

Previously, we reported that overeating for only a few days markedly suppressed the secretion of growth hormone (GH). The purpose of the present study was to determine the role of this reduction in GH concentration on key metabolic adaptations that occur during 2 wk of overeating. Nine nonobese, healthy adults were admitted to the hospital for 2 wk, during which time they ate ∼4,000 kcal/day (70 kcal·kg fat-free mass(-1)·day(-1); 50% carbohydrate, 35% fat, and 15% protein), and their plasma GH concentration was allowed to decline naturally (control). An additional eight subjects underwent the same overeating intervention and received exogenous GH treatment (GHT) administered in four daily injections to mimic physiological GH secretion throughout the 2-wk overeating period. We measured plasma insulin and glucose concentrations in the fasting and postprandial state as well as fasting lipolytic rate, proteolytic rate, and fractional synthetic rate (FSR) using stable-isotope tracer methods. GHT prevented the fall in plasma GH concentration, maintaining plasma GH concentration at baseline levels (1.2 ± 0.2 ng/ml), which increased fasting and postprandial assessments of insulin resistance (P < 0.05) and increased fasting lipidemia (all P < 0.05 vs. control). In addition, preventing the suppression in GH with overeating also blunted the increase in systemic proteolysis (P < 0.05 GHT vs. control). However, GHT did not alter lipolysis or FSR in response to overeating. In conclusion, our main findings suggest that the suppression in GH secretion that naturally occurs during the early stages of overeating may help attenuate the insulin resistance and hyperlipidemia that typically accompany overeating.

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.

Impact of protein coingestion on muscle protein synthesis during continuous endurance type exercise

This study investigates the impact of protein coingestion with carbohydrate on muscle protein synthesis during endurance type exercise. Twelve healthy male cyclists were studied during 2 h of fasted rest followed by 2 h of continuous cycling at 55% W(max). During exercise, subjects received either 1.0 g·kg(-1)·h(-1) carbohydrate (CHO) or 0.8 g·kg(-1)·h(-1) carbohydrate with 0.2 g·kg(-1)·h(-1) protein hydrolysate (CHO+PRO). Continuous intravenous infusions with l-[ring-(13)C(6)]phenylalanine and l-[ring-(2)H(2)]tyrosine were applied, and blood and muscle biopsies were collected to assess whole body protein turnover and muscle protein synthesis rates at rest and during exercise conditions. Protein coingestion stimulated whole body protein synthesis and oxidation rates during exercise by 22 ± 3 and 70 ± 17%, respectively (P < 0.01). Whole body protein breakdown rates did not differ between experiments. As a consequence, whole body net protein balance was slightly negative in CHO and positive in the CHO+PRO treatment (-4.9 ± 0.3 vs. 8.0 ± 0.3 μmol Phe·kg(-1)·h(-1), respectively, P < 0.01). Mixed muscle protein fractional synthetic rates (FSR) were higher during exercise compared with resting conditions (0.058 ± 0.006 vs. 0.035 ± 0.006%/h in CHO and 0.070 ± 0.011 vs. 0.038 ± 0.005%/h in the CHO+PRO treatment, respectively, P < 0.05). FSR during exercise did not differ between experiments (P = 0.46). We conclude that muscle protein synthesis is stimulated during continuous endurance type exercise activities when carbohydrate with or without protein is ingested. Protein coingestion does not further increase muscle protein synthesis rates during continuous endurance type exercise.

Whole-body CO2 production as an index of the metabolic response to sepsis

Whole-body carbon dioxide (CO2) production (RaCO2) is an index of substrate oxidation and energy expenditure; therefore, it may provide information about the metabolic response to sepsis. Using stable isotope techniques, we determined RaCO2 and its relationship to protein and glucose metabolism in medical patients with sepsis and septic shock. Whole-body CO2 production, an index of basal metabolic rate, was measured in 13 patients with sepsis or septic shock and 7 healthy controls using an i.v. infusion of 13C-sodium bicarbonate. Endogenous leucine flux, leucine oxidation, and nonoxidative disposal, indices of whole-body protein breakdown, catabolism, and synthesis, were measured with an infusion of 1-13C-leucine, and glucose production and clearance were measured with an infusion of 2H2-glucose. There was no difference in mean RaCO2 between the patients and controls, but the patients had a wider range of values. The four patients with the lowest RaCO2 died. Protein breakdown and synthesis and glucose production were significantly faster in patients than in controls (P < 0.05). Whole-body CO2 production was positively correlated with protein breakdown (P = 0.001), protein synthesis (P < 0.01), and glucose clearance (P = 0.01). Patients with low metabolic rates (mean-2 SDs of controls) had slower protein breakdown and decreased glucose clearance compared with patients with high metabolic rates (mean + 2 SDs of controls). Septic patients were both hypometabolic and hypermetabolic. The correlation between RaCO2 and protein breakdown and synthesis as well as glucose clearance suggests that RaCO2 can provide information about substrate metabolism in septic patients. Because hypometabolism was associated with mortality and changes in protein and glucose metabolism in septic patients, it may be a useful clinical indicator of an inadequate metabolic response.

Amino Acid-Based Peritoneal Dialysis Solutions for Malnutrition: New Perspectives

Protein and energy malnutrition is frequently found in patients on maintenance dialysis and is associated with an increased risk of death. Among a variety of factors involved in the development of protein and energy malnutrition, such as acidosis, insulin resistance, inflammation, and dialysate protein losses, insufficient intake of proteins and energy as a result of anorexia plays a prominent role.

Amino acid (AA)-based peritoneal dialysis (PD) solutions can induce an anabolic response in malnourished patients on continuous ambulatory PD if enough calories are ingested simultaneously. Poor appetite, however, may impede the intake of sufficient calories. Peritoneal dialysis solutions containing a mixture of AAs and glucose in a proper ratio can serve as a source of proteins and calories. Such a dialysis solution can be used in fasting patients on nocturnal automated PD as part of a regular dialysis schedule. Using a sophisticated technique involving stable isotopes, this dialysis mixture has been found to induce acute anabolic changes in whole body protein metabolism. Such a metabolic response is similar to that induced by food. Intraperitoneal AAs, in common with ingested proteins, can induce generation of hydrogen ions and urea through oxidation of specific AAs. Supplying AAs together with calories could bring about utilization of AAs for the synthesis of proteins rather than the oxidation of AAs, thereby limiting production of acid and urea. Using dialysis solutions with a buffer concentration of 40 mmol/L further contributes to maintaining acid–base homeostasis.

We advocate consideration of usage of AA/glucose dialysate when PD patients cannot comply with dietary requirements. To evaluate the long-term effects of this approach on morbidity and mortality, clinical trials with large groups of patients are needed.

Protein coingestion stimulates muscle protein synthesis during resistance-type exercise

In contrast to the effect of nutritional intervention on postexercise muscle protein synthesis, little is known about the potential to modulate protein synthesis during exercise. This study investigates the effect of protein coingestion with carbohydrate on muscle protein synthesis during resistance-type exercise. Ten healthy males were studied in the evening after they consumed a standardized diet throughout the day. Subjects participated in two experiments in which they ingested either carbohydrate or carbohydrate with protein during a 2-h resistance exercise session. Subjects received a bolus of test drink before and every 15 min during exercise, providing 0.15 g x kg(-1) x h(-1) carbohydrate with (CHO + PRO) or without (CHO) 0.15 g x kg(-1) x h(-1) protein hydrolysate. Continuous intravenous infusions with l-[ring-(13)C(6)]phenylalanine and l-[ring-(2)H(2)]tyrosine were applied, and blood and muscle biopsies were collected to assess whole body and muscle protein synthesis rates during exercise. Protein coingestion lowered whole body protein breakdown rates by 8.4 +/- 3.6% (P = 0.066), compared with the ingestion of carbohydrate only, and augmented protein oxidation and synthesis rates by 77 +/- 17 and 33 +/- 3%, respectively (P < 0.01). As a consequence, whole body net protein balance was negative in CHO, whereas a positive net balance was achieved after the CHO + PRO treatment (-4.4 +/- 0.3 vs. 16.3 +/- 0.4 micromol phenylalanine x kg(-1) x h(-1), respectively; P < 0.01). In accordance, mixed muscle protein fractional synthetic rate was 49 +/- 22% higher after protein coingestion (0.088 +/- 0.012 and 0.060 +/- 0.004%/h in CHO + PRO vs. CHO treatment, respectively; P < 0.05). We conclude that, even in a fed state, protein coingestion stimulates whole body and muscle protein synthesis rates during resistance-type exercise.

Urea-nitrogen production and salvage are modulated by protein intake in fed humans: results of an oral stable-isotope-tracer protocol and compartmental modeling

BACKGROUND

The influence of protein source on postprandial urea kinetics is poorly understood, despite its nutritional significance with respect to nitrogen homeostasis. Furthermore, traditional tracer infusion studies underestimate acute postprandial change in urea kinetics.

OBJECTIVE

We investigated postprandial, non-steady state urea kinetics and their modulation by qualitative and quantitative factors of protein intake by the combined use of robust clinical data on nitrogen postprandial distribution and mathematical modeling.

DESIGN

In healthy subjects standardized to a normal protein intake for 7 d, dietary and total nitrogen kinetics were measured for 8 h in plasma proteins, body, and urinary urea after the ingestion of a (15)N-labeled milk (n = 8), soy (n = 8), or wheat (n = 8) protein meal. In subjects who received the soy protein meal, these postprandial measurements were repeated after a further 7-d adaptation to a high protein intake. A 4-compartment model was developed to calculate from these data the postprandial kinetics of production, urinary excretion, and intestinal hydrolysis of urea nitrogen from both dietary and endogenous sources.

RESULTS

Urinary urea excretion was not influenced by the protein source in the meal but was influenced by the protein level in the diet. By contrast, urea production and hydrolysis were higher when ingesting plant versus animal protein, together with a higher efficiency of urea hydrolysis (50-60% versus 25% of the urea produced being hydrolyzed, respectively).

CONCLUSIONS

We conclude that urea hydrolysis is an acute nitrogen-sparing mechanism that can counterbalance a postprandial higher urea production, and the efficiency of this recycling is higher when the usual protein intake is lower.

Alternative equations for whole-body protein synthesis and for fractional synthetic rates of proteins

In a constant infusion study of a mass isotope of leucine, two alternative equations are commonly available to calculate amino acid oxidation rate and, thence, whole-body protein synthesis. One, developed by Matthews et al (Am J Physiol Endocrinol Metab. 1980;238:E473-E479), is shown here to require assuming a tracee steady state (TSS), namely, that tracee (unlabeled) amino acid concentrations and fluxes (rates of oxidation and incorporation into protein) are unaltered compared with the preinfusion state. The other, developed by Garlick and coworkers (Melville et al, Metabolism 1989;38:248-255), stems from a protein steady state (PSS) assumption, namely, that protein synthesis is unaffected by the tracer infusion. We derive here a simple expression for the relative difference in whole-body protein synthesis computed from the two assumptions, and a simple test of the validity of TSS in the form of an equality that must be satisfied by plasma measurements at all times. We also propose two experiments to discriminate between the two assumptions. Theoretical reasons and experimental evidence from the literature are offered to support PSS. The two assumptions result in different expressions for fractional synthetic rates (FSRs) of individual or organ proteins-TSS requires the use of tracer-to-tracee ratios and PSS the use of enrichments. An expression is derived here for the relative difference in FSR with TSS vs PSS. For both whole-body synthesis and for FSR, the TSS assumption consistently results in an underestimate, the relative bias roughly equal to the precursor amino acid enrichment.

Postexercise Whole-Body Protein Turnover Response to Three Levels of Protein Intake

PURPOSE

This investigation examined the effect of variations in protein intake on whole-body protein turnover (WBPTO) after exercise in endurance-trained males.

METHODS

Five male runners (21.3 +/- 0.3 yr, 179 +/- 2 cm, 70.6 +/- 0.1 kg, 8.7 +/- 0.4% body fat, 70.6 +/- 0.1 VO2peak) participated in a randomized, crossover-design diet intervention, where they consumed either a low- (0.8 g.kg(-1); LP), moderate- (1.8 g.kg(-1); MP), or high-protein (3.6 g.kg(-1); HP) diet for 4 wk. WBPTO (Ra, leucine rate of appearance; NOLD, nonoxidative leucine disposal; and Ox, leucine oxidation) were assessed after a 75-min run at 70% VO2peak after each diet-intervention period.

RESULTS

Leucine Ra (indicator of protein breakdown) and leucine Ox were greater on the HP diet than on the LP diet (Ra, 123.4 +/- 6.9 vs 97.9 +/- 6.0 micromol.kg(-1).h(-1); Ox, 23.9 +/- 0.5 vs 17.0 +/- 0.8 micromol.kg(-1).h(-1), P < 0.05). No differences were noted in NOLD (an indicator of protein synthesis) across diets. Plasma branched chain amino acids (BCAA) at rest were greater for MP and HP than for LP, and nonessential amino acids (NEAA) were greater for LP than MP at rest and greater than MP and HP after exercise.

CONCLUSION

Findings from this study show that variations in protein intake can alter plasma amino acid levels and modulate rates of WBPTO after exercise. Additionally, a lower protein intake was associated with decreased rates of WBPTO after exercise.

Influence of branched-chain amino acid supplementation on urinary protein metabolite concentrations after swimming

OBJECTIVE

The influence of branched-chain amino acid (BCAA) supplementation on urinary urea nitrogen, hydroxyproline (HP), and 3-methylhistidine (3MH) concentrations after 25 min of breast stroke exercise (65-70% maximum heart rate reserved, 65-70% HRRmax) followed by a 600 m crawl stroke competition was investigated in a double-blind, counter-balanced study.

METHODS

Male university students (19-22 years old) majoring in physical education participated in the study. Based on the previous swimming time of a 600 m crawl stroke, the participants were divided into two groups: placebo (n = 9, BMI = 24.2 +/- 2.1 kg/m2; 12 g of glucose/day; in capsules) and BCAA (n = 10, BMI = 22.7 +/- 1.5 kg/m2; 12 g of BCAAs/day; in capsules: leucine 54%, isoleucine 19%, valine 27%) groups. The participants maintained a regular dietary intake (except the prescribed breakfast on day 15) and exercise activity at a moderate/low intensity (60-70% HRRmax, swimming and rowing, approximately 1.5 hour/day) during the 15-day study. A prescribed exercise program was performed on day 15. Urinary and blood samples were collected before, during, and after the prescribed exercise for the measurements of the urinary urea nitrogen, HP, and 3MH concentrations in urine, as well as the glucose, lactate, glutamine, alanine, and BCAA concentrations in plasma.

RESULTS

Two weeks of dietary supplementation did not induce any changes in the plasma glucose and total BCAA concentrations of either group, nor in the urinary urea nitrogen, HP, and 3MH concentrations in urine. On day 15, after 25 min of breast stroke exercise and a 600 m crawl stroke competition, plasma glucose concentration decreased significantly (p < 0.05) whereas plasma lactate concentration increased significantly (p < 0.05) in both groups. The exercise program prescribed in the study did not affect urinary urea nitrogen, HP, and 3MH concentrations. Twenty hours after the competition, however, a significant increase in the concentrations of urinary urea nitrogen, HP, and 3MH was found in the placebo group (p < 0.05), but not in the BCAA group.

CONCLUSIONS

The results obtained in this study suggest that swimming induced muscle proteolysis was prevented by BCAA supplementation. The mechanism could be attributed to the availability of ammonia provided by the oxidation of supplemented BCAAs during exercise.

Level of dietary protein impacts whole body protein turnover in trained males at rest

The current investigation examined the effect of variations in protein intake on Whole body protein turnover (WBPTO) at rest in endurance-trained males. Whole body protein turnover is influenced by both diet and exercise. Whether endurance athletes require more protein than the non-exerciser remains equivocal. Five male runners (21.3 +/- 0.3 years, 179 +/- 2 cm, 70.6 +/- 0.1 kg, 8.7% +/- 0.4% body fat, 70.6 +/- 0.1 VO(2)max) participated in a randomized, crossover design diet intervention where they consumed either a low-protein (LP; 0.8 g/kg), moderate-protein (MP; 1.8 g/kg), or high-protein (HP; 3.6 g/kg) diet for 3 weeks. Whole body protein turnover (Ra, leucine rate of appearance; NOLD, nonoxidative leucine disposal; and Ox, leucine oxidation), nitrogen balance, and substrate oxidation were assessed at rest following each dietary intervention period. The HP diet increased leucine Ra (indicator of protein breakdown; 136.7 +/- 9.3, 129.1 +/- 7.4, and 107.8 +/- 3.1 micromol/[kg . h] for HP, MP, and LP diets, respectively) and leucine Ox (31.0 +/- 3.6, 26.2 +/- 4.3, and 18.3 +/- 0.6 micromol/[kg . h] for HP, MP, and LP diets, respectively) compared with LP diet (P < .05). No differences were noted in nonoxidative leucine disposal (an indicator of protein synthesis) across diets. Nitrogen balance was greater for HP diet than for MP and LP diets (10.2 +/- 0.7, 1.8 +/- 0.6, and -0.3 +/- 0.5 for HP, MP, and LP diets, respectively). Protein oxidation increased with increasing protein intake (54% +/- 6%, 25% +/- 1%, and 14% +/- 2% for HP, MP, and LP diets, respectively). Findings from this study show that variations in protein intake can modulate WBPTO and that protein intake approximating the current recommended dietary allowance was not sufficient to achieve nitrogen balance in the endurance-trained males in this investigation. Our results suggest that a protein intake of 1.2 g/kg or 10% of total energy intake is needed to achieve a positive nitrogen balance. This is not a concern for most endurance athletes who routinely consume protein at or above this level.

Final report of the safety assessment of Urea

Although Urea is officially described as a buffering agent, humectant, and skin-conditioning agent-humectant for use in cosmetic products, there is a report stating that Urea also is used in cosmetics for its desquamating and antimicrobial action. In 2001, the Food and Drug Administration (FDA) reported that Urea was used in 239 formulations. Concentrations of use for Urea ranged from 0.01% to 10%. Urea is generally recognized as safe by FDA for the following uses: side-seam cements for food contact; an inhibitor or stabilizer in pesticide formulations and formulations applied to animals; internal sizing for paper and paperboard and surface sizing and coating of paper and paper board that contact water-in-oil dairy emulsions, low-moisture fats and oils, moist bakery products, dry solids with surface containing no free fats or oil, and dry solids with the surface of fat or oil; and to facilitate fermentation of wine. Urea is the end product of mammalian protein metabolism and the chief nitrogenous compound of urine. Urea concentrations in muscle, liver, and fetuses of rats increased after a subcutaneous injection of Urea. Urea diffused readily through the placenta and into other maternal and fetal organs. The half-life of Urea injected into rabbits was on the order of several hours, and the reutilization rate was 32.2% to 88.8%. Urea given to rats by a bolus injection or continuous infusion resulted in distribution to the following brain regions: frontal lobe, caudate nucleus, hippocampus, thalamus plus hypothalamus, pons and white matter (corpus callosum). The permeability constant after treatment with Urea of whole skin and the dermis of rabbits was 2.37 +/- 0.13 (x 10(6)) and 1.20 +/- 0.09 (x10(3)) cm/min, respectively. The absorption of Urea across normal and abraded human skin was 9.5% +/- 2.3% and 67.9% +/- 5.6%, respectively. Urea increased the skin penetration of other compounds, including hydrocortisone. No toxicity was observed for Urea at levels as high as 2000 mg/kg in acute oral studies using female rats or mice. No signs of toxicity were observed in male piglets dosed orally with up to 4 g/kg Urea for 5 days. Dogs dosed orally with 5 to 30 g/L Urea for 4 to 10 days had signs of toxicity, including weakness, anorexia, vomiting and retching, diarrhea and a decreased body temperature, which led to a deep torpor or coma. No significant microscopic changes were observed in the skin of male nude mice dermally exposed to 100% Urea for 24 h. No observable effect on fetal development was seen in rats and mice dosed orally with an aqueous solution of Urea (2000 mg/kg) on days 10 and 12 of gestation. The mean number of implants, live fetuses, percent fetal resorptions, mean fetal weight, and percent fetuses malformed were comparable to control group. A detergent containing 15% Urea was injected into pregnant ICR-JCl mice and dams and fetuses had no significant differences when compared to control animals. Urea given orally did not enhance the developmental toxicity of N-nitrosomethylurea. Female Sprague-Dawley rats injected in the uterine horn with 0.05 ml Urea on day 3 (preimplantation) or on day 7 (post implantation) exhibited no maternal mortality or morbidity; a dose-dependent reduction in embryo survival was seen with preimplantation treatment. Urea injected intra-amniotically induces mid-trimester abortions in humans. Urea was not genotoxic in several bacterial and mammalian assays; although in assays where Urea was used at a high concentration, genotoxicity was found, many in in vitro assays. Urea is commonly used in studies of DNA because it causes uncoiling of DNA molecules. Urea was not carcinogenic in Fisher 344 rats or C57B1/6 mice fed diets containing up to 4.5% Urea. Exposure of normal human skin to 60% Urea produced no significant irritation in one study, but 5% Urea was slightly irritating and 20% Urea was irritating in other reports. Burning sensations are the most frequently reported effect of Urea used alone or with other agents in treatment of diseased skin. Overall, there are few reports of sensitization among the many clinical studies that report use of Urea in treatment of diseased skin. The Cosmetic Ingredient Review (CIR) Expert Panel determined the data provided in this report to be sufficient to assess the safety of Urea. The Panel did note that Urea can cause uncoiling of DNA, a property used in many DNA studies, but concluded that this in vitro activity is not linked to any in vivo genotoxic activity. Although noting that formulators should be aware that Urea can increase the percutaneous absorption of other chemicals, the CIR Expert Panel concluded that Urea is safe as used in cosmetic products.

Dietary protein intake impacts human skeletal muscle protein fractional synthetic rates after endurance exercise

This investigation evaluated the physiological impact of different dietary protein intakes on skeletal muscle protein synthesis postexercise in endurance runners. Five endurance-trained, male runners participated in a randomized, crossover design diet intervention, where they consumed either a low (0.8 g/kg; LP)-, moderate (1.8 g/kg; MP)-, or high (3.6 g/kg; HP)-protein diet for 4 wk. Diets were designed to be eucaloric with carbohydrate, fat, and protein approximating 60, 30, and 10%; 55, 30, and 15%; and 40, 30, and 30% for LP, MP, and HP, respectively. Substrate oxidation was assessed via indirect calorimetry at 3 wk of the dietary interventions. Mixed-muscle protein fractional synthetic rate (FSR) was measured after an endurance run (75 min at 70% V(O2 peak)) using a primed, continuous infusion of [(2)H(5)]phenylalanine. Protein oxidation increased with increasing protein intake, with each trial being significantly different from the other (P < 0.01). FSR after exercise was significantly greater for LP (0.083%/h) and MP (0.078%/h) than for HP (0.052%/h; P < 0.05). There was no difference in FSR between LP and MP. This is the first investigation to establish that habitual dietary protein intake in humans modulates skeletal muscle protein synthesis after an endurance exercise bout. Future studies directed at mechanisms by which level of protein intake influences skeletal muscle turnover are needed.

Interrelationship between physical activity and branched-chain amino acids

Some athletes can have quite high intakes of branched-chain amino acids (BCAAs) because of their high energy and protein intakes and also because they consume protein supplements, solutions of protein hydrolysates, and free amino acids. The requirement for protein may actually be higher in endurance athletes than in sedentary individuals because some amino acids, including the BCAAs, are oxidized in increased amounts during exercise compared with rest, and they must therefore be replenished by the diet. In the late 1970s, BCAAs were suggested to be the third fuel for skeletal muscle after carbohydrate and fat. However, the majority of later studies, using various exercise and treatment designs and several forms of administration of BCAAs (infusion, oral, and with and without carbohydrates), have failed to find a performance-enhancing effect. No valid scientific evidence supports the commercial claims that orally ingested BCAAs have an anticatabolic effect during and after exercise in humans or that BCAA supplements may accelerate the repair of muscle damage after exercise. The recommended protein intakes for athletes (1.2 to 1.8 g . kg body mass(-1) . d(-1)) do not seem to be harmful. Acute intakes of BCAA supplements of about 10-30 g/d seem to be without ill effect. However, the suggested reasons for taking such supplements have not received much support from well-controlled scientific studies.

Aerobic Exercise Training Decreases Leucine Oxidation at Rest in Healthy Adults

Both exercise and dietary protein intake affect whole-body protein turnover (WBPTO). Few studies have investigated the effect of aerobic exercise training on WBPTO [leucine rate of appearance (Ra), oxidation (Ox), and nonoxidative leucine disposal (NOLD)] in untrained individuals consuming a specified level of protein. This study examined the effect of aerobic exercise training on WBPTO in untrained men and women during a controlled diet intervention providing 0.88 g protein/(kg . d). After a 2-wk adaptation to the study diet, 7 subjects [3 men, 4 women; 76.1 +/- 5.8 kg, 164.7 +/- 4.4 cm, 30.7 +/- 4.5% body fat, 39.1 +/- 2.8 VO(2max) (maximal oxygen uptake) mL/(kg . min)] participated in 4 wk of aerobic exercise training (running and walking 4-5 times/wk at 65-85% maximal heart rate). WBPTO (determined via constant infusion of 1-[(13)C] leucine), nitrogen balance, and body composition were determined at baseline and after 4 wk of training. Nitrogen balance (-1.0 +/- 0.7 vs. 0.9 +/- 1.1 g N/24 h, P = 0.03) improved with exercise training, whereas body mass and composition did not change. Leucine Ra did not change, Ox decreased [18 +/- 2 to 15 +/- 2 micromol/(kg . h), P </= 0.001], and NOLD tended to increase [128 +/- 18 to 151 +/- 19 micromol/(kg . h), P = 0.09] in response to training. These data indicate improved protein utilization in response to exercise training in weight-stable subjects. This study emphasizes the importance of dietary control, with specific regard to energy and protein intakes, in the characterization of protein utilization in response to an exercise intervention.

Postprandial intestinal and whole body nitrogen kinetics and distribution in piglets fed a single meal

Our aim was to characterize the postprandial total and dietary N fluxes in the portal drained viscera (PDV) and whole body after administration of a single meal in young pigs. Seven 4-wk-old piglets, implanted with a portal flow probe and portal, arterial and venous catheters, received a primed constant [(18)O]urea intravenous infusion and were studied for 8 h after a bolus mixed meal ingestion (46 mmol N/kg body wt) intrinsically labeled with (15)N to trace dietary N fluxes. The real cecal digestibility of the formula was 94.3% (SD 1.8). PDV output of dietary N was found principally in the pool of circulating protein (51% of the measured dietary N PDV output), in the free alpha-amino N pool (44%), and to a lesser extent in ammonia (5%). Dietary N release in alpha-amino N and ammonia mainly occurred during the first 3 h. Total and exogenous postprandial urea productions were 5.8 and 2.0 mmol N/kg body wt, respectively. At the end of the postprandial period, losses of dietary N amounted to 10.3% of the dose: 5.7% through ileal losses and 4.6% by deamination and transfer to urea. Net postprandial retention of dietary N was 90.4% (SD 1.3), of which 20% was found in splanchnic zone (small intestine 10%, liver 5%, and plasma protein 3%) and 42% in peripheral zone (muscle 31%, skin 6%). In conclusion, our results show a high efficiency of dietary N utilization for muscular uptake and anabolic utilization. However, the results obtained point out the necessity to further explore the form of dietary N released into the portal blood.

Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise

The aims of this study were to compare different tracer methods to assess whole body protein turnover during 6 h of prolonged endurance exercise when carbohydrate was ingested throughout the exercise period and to investigate whether addition of protein can improve protein balance. Eight endurance-trained athletes were studied on two different occasions at rest (4 h), during 6 h of exercise at 50% of maximal O2 uptake (in sequential order: 2.5 h of cycling, 1 h of running, and 2.5 h of cycling), and during subsequent recovery (4 h). Subjects ingested carbohydrate (CHO trial; 0.7 g CHO.kg(-1.)h(-1)) or carbohydrate/protein beverages (CHO + PRO trial; 0.7 g CHO.kg(-1).h(-1) and 0.25 g PRO.kg(-1).h(-1)) at 30-min intervals during the entire study. Whole body protein metabolism was determined by infusion of L-[1-13C]leucine, L-[2H5]phenylalanine, and [15N2]urea tracers with sampling of blood and expired breath. Leucine oxidation increased from rest to exercise [27 +/- 2.5 vs. 74 +/- 8.8 (CHO) and 85 +/- 9.5 vs. 200 +/- 16.3 mg protein.kg(-1).h(-1) (CHO + PRO), P < 0.05], whereas phenylalanine oxidation and urea production did not increase with exercise. Whole body protein balance during exercise with carbohydrate ingestion was negative (-74 +/- 8.8, -17 +/- 1.1, and -72 +/- 5.7 mg protein.kg(-1).h(-1)) when L-[1-13C]leucine, L-[2H5]phenylalanine, and [15N2]urea, respectively, were used as tracers. Addition of protein to the carbohydrate drinks resulted in a positive or less-negative protein balance (-32 +/- 16.3, 165 +/- 4.6, and 151 +/- 13.4 mg protein.kg(-1).h(-1)) when L-[1-13C]leucine, L-[2H5]phenylalanine, and [15N2]urea, respectively, were used as tracers. We conclude that, even during 6 h of exhaustive exercise in trained athletes using carbohydrate supplements, net protein oxidation does not increase compared with the resting state and/or postexercise recovery. Combined ingestion of protein and carbohydrate improves net protein balance at rest as well as during exercise and postexercise recovery.

In vivo muscle amino acid transport involves two distinct processes

We have tested the hypothesis that transit through the interstitial fluid, rather than across cell membranes, is rate limiting for amino acid uptake from blood into muscle in human subjects. To quantify muscle transmembrane transport of naturally occurring amino acids, we developed a novel 4-pool model that distinguishes between the interstitial and intracellular fluid compartments. Transport kinetics of phenylalanine, leucine, lysine, and alanine were quantified using tracers labeled with stable isotopes. The results indicate that interstitial fluid is a functional compartment insofar as amino acid kinetics are concerned. In the case of leucine and alanine, transit between blood and interstitial fluid was potentially rate limiting for muscle amino acid uptake and release in the postabsorptive state. For example, in the case of leucine, the rate of transport between blood and interstitial fluid compared with the corresponding rate between interstitial fluid and muscle was 247 +/- 36 vs. 610 +/- 95 nmol.min(-1).100 ml leg(-1), respectively (P < 0.05). Our results are consistent with the process of diffusion governing transit from blood to interstitial fluid without selectivity, and of specific amino acid transport systems with varying degrees of efficiency governing transit from interstitial fluid to muscle. These results imply that changes in factors that affect the transit of amino acids from blood through interstitial fluid, such as muscle blood flow or edema, could play a major role in controlling the rate of muscle amino acid uptake.

Effect of lifestyle changes on whole-body protein turnover in obese adolescents

OBJECTIVE

To investigate the effect of lifestyle changes on whole-body protein turnover (WBPT) in obese adolescents.

DESIGN/METHODS

Randomized and controlled nonpharmacological intervention study of WBPT in obese adolescents using stable isotope dilution techniques.

SUBJECTS AND MEASUREMENTS

We studied a total of 21 adolescents (11 boys and 10 girls, matched for their pubertal status) of which 15 were obese (age=15.8+/-0.4 y old and BMI=38.6+/-3.3 kg/m(2)) and six were lean controls (age=16.0+/-0.4 y old and BMI=21.3+/-1.2 kg/m(2)). The obese subjects were subjected to a randomized controlled lifestyle intervention program that involved moderate physical activity and diet changes for 3 months. A group of lean age-matched subjects was also studied at baseline to compare the WBPT in obese and lean adolescents. The studies were performed during a primed, continuous infusion of L-[1-(13)C]leucine. Leucine appearance rate (Leu Ra) was used as an index of whole protein breakdown and the nonoxidative portion of leucine disposal (NOLD) as an index of whole-body protein synthesis.

RESULTS

The obese groups showed significantly higher body mass index (BMI), fat mass (FM), percent body fat (%BF), fat-free mass (FFM), resting energy expenditure (REE) and WBPT compared to the lean controls. The intervention program resulted in a redistribution of the parameters of body composition without apparent changes in BMI or body weight. There was a significant decrease in WBPT in the obese intervention group, but not in the obese control group. Insulin levels also decreased significantly in the obese group after intervention but not in the obese control group, whereas the glucose concentrations remained normal in all groups at baseline and also after intervention/or control.

CONCLUSIONS

Results from the current study suggest: (i). abonormalities of protein metabolism occur early in the clinical course of obesity and (ii). these abnormalities are modifiable by moderate lifestyle changes in obese adolescents. The mechanism for these changes in WBPT in obese adolescents as well as their impact on specific cardiovascular risk factors and turnover of specific proteins will require further investigation.