Exercise training and protein metabolism: influences of contraction, protein intake, and sex-based differences

Injury Incidence, Severity, and Type Across the Menstrual Cycle in Female Footballers: A Prospective Three Season Cohort Study

PURPOSE

The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity, and type in elite female professional footballers over three seasons.

METHODS

Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorized into four phases using a standardized model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and premenstrual phase (phase 4; P4). Injury incidence rates (IIR) and ratios (IIRR) were calculated for overall injuries, injury severity, type, contact vs noncontact, and game/training.

RESULTS

A total of 593 cycles across 13,390 d were tracked during the study, and 74 injuries from 26 players were eligible for analysis. When comparing IIR between phases (reference: P1), overall injury rates were highest in P4 (IIRR, 2.30 (95% confidence interval, 0.99-5.34; P = 0.05)). When examining rates by injury severity and type, IIR values were also highest in P4 for ≤7 d' time-loss (4.40 (0.93-20.76; P = 0.06)), muscle-specific (6.07 (1.34-27.43; P = 0.02)), and noncontact (3.05 (1.10-8.50; P = 0.03)) injuries. Muscle-specific (IIRR P3/P1, 5.07 (1.16-22.07; P = 0.03)) and ≤7 d' time-loss (4.47 (1.01-19.68; P = 0.05)) injury risk was also significantly higher in P3. Muscle injuries were the most prevalent subtype ( n = 41). No anterior cruciate ligament injuries were recorded across the monitoring period.

CONCLUSIONS

Injury risk was significantly elevated during the luteal phase of the menstrual cycle (P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.

Plant-Based Proteins, Peptides and Amino Acids in Food Products Dedicated for Sportspeople-A Narrative Review of the Literature

Plant proteins are increasingly seen as critical nutrient sources for both amateur and professional athletes. The aim of the presented study was to review the inventions and experimental articles referring to the application of plant-based proteins, peptides and amino acids in food products dedicated to sportspeople and published in the period 2014-2023. The literature search was conducted according to PRISMA statementsacross several key databases, including Scopus and ISI Web of Science. Altogether, 106 patents and 35 original articles were found. The survey of patents and inventions described in the articles showed the use of 52 taxa (mainly annual herbaceous plants), creating edible seeds and representing mainly the families Fabaceae and Poaceae. The majority of inventions were developed by research teams numbering from two to five scientists, affiliated in China, The United States of America and Japan. The greatest number of inventions applied plant-based proteins (especially protein isolates), declared the nutritional activity and were prepared in liquid or solid consistency. According to the reviewed studies, the intake of soybean and potato proteins might provide better results than animal-based protein (excluding resistance training), whereas the consumption of pea and rice protein does not possess any unique anabolic properties over whey protein. The analysis of other investigations demonstrated the varied acceptability and consumption of food products, while the high rating of the tested food products presented in four articles seems to be an effect of their sensual values, as well as other elements, such as production method, health benefits and cost-effectiveness. Considering the great potential of useful plant species, it might be concluded that future investigations focusing on searching for novel plant protein sources, suitable for the preparation of food products dedicated to amateur and professional sportspeople, remain of interest.

Effects of Resistance Exercise and Essential Amino Acid Intake on Muscle Quality, Myokine, and Inflammation Factors in Young Adult Males

BACKGROUND

Recently, many studies have been devoted to discovering nutrients for exercise-like effects. Resistance exercise and the intake of essential amino acids (EAAs) are known to be factors that can affect muscle mass and strength improvement. The purpose of this study was to investigate changes in muscle quality, myokines, and inflammation in response to resistance exercise and EAA supplementation.

METHODS

Thirty-four males volunteered to participate in this study. They were assigned to four groups: (1) placebo (CO), (2) resistance exercise (RE), (3) EAA supplementation, and (4) RE + EAA supplementation. Body composition, muscle quality, myokines, and inflammation were measured at baseline and four weeks after treatment.

RESULTS

Lean body fat had decreased in both RE and RE + EAA groups. Lean body mass had increased in only the RE + EAA group. In all groups except for CO, irisin, myostatin A, and TNF-α levels had decreased. The grip strength of the right hand and trunk flexion peak torque increased in the RE group. The grip strength of the left hand, trunk flexion peak torque, and knee flexion peak torque of the left leg were increased in RE + EAA.

CONCLUSIONS

RE, EAA, and RE + EAA could effectively improve the muscle quality, myokine, and inflammation factors of young adult males. This finding highlights the importance of resistance exercise and amino acid intake.

Acute Microbial Protease Supplementation Increases Net Postprandial Plasma Amino Acid Concentrations After Pea Protein Ingestion in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial

BACKGROUND

Digestibility is a primary factor in determining the quality of dietary protein. Microbial protease supplementation may be a strategy for improving protein digestion and subsequent postprandial plasma amino acid availability.

OBJECTIVES

To assess the effect of co-ingesting a microbial protease mixture with pea protein on postprandial plasma amino acid concentrations.

DESIGN

A mixture of 3 microbial protease preparations (P3) was tested for proteolytic efficacy in an in vitro static simulation of gastrointestinal digestion. Subsequently, in a randomized, double-blind, placebo-controlled crossover trial, 24 healthy adults (27 ± 4 y; 12 females, 12 males) ingested 25 g pea protein isolate (20 g protein, 2.2 g fat) with either P3 or maltodextrin placebo (PLA). Blood samples were collected at baseline and throughout a 0‒5 h postprandial period and both the early (0-2 h) iAUC and total (0-5 h) iAUC were examined.

RESULTS

Plasma glucose concentrations decreased in both conditions (P < 0.001), with higher concentrations after P3 ingestion compared with PLA (P < 0.001). Plasma insulin concentrations increased for both conditions (P < 0.001) with no difference between conditions (P = 0.331). Plasma total amino acid (TAA) concentrations increased over time (P < 0.001) with higher concentrations observed for P3 compared with PLA (P = 0.010) during the 0‒5 h period. There was a trend for elevated essential amino acid (EAA) concentrations for P3 compared with PLA (P = 0.099) during the 0‒5 h postprandial period but not for leucine (P = 0.282) or branched-chain amino acids (BCAA, P = 0.410). The early net exposure (0‒2 h iAUC) to amino acids (leucine, BCAA, EAA, and TAA) was higher for P3 compared with PLA (all, P < 0.05).

CONCLUSIONS

Microbial protease co-ingestion increases plasma TAA concentrations (0-5 h) and leucine, BCAA, EAA, and TAA availability in the early postprandial period (0‒2 h) compared with ingesting pea protein with placebo in healthy adults.

Supplementation for Performance and Health in Patients with Phenylketonuria: An Exercise-Based Approach to Improving Dietary Adherence

Supplementation is crucial for improving performance and health in phenylketonuria (PKU) patients, who face dietary challenges. Proteins are vital for athletes, supporting muscle growth, minimizing catabolism, and aiding muscle repair and glycogen replenishment post-exercise. However, PKU individuals must limit phenylalanine (Phe) intake, requiring supplementation with Phe-free amino acids or glycomacropeptides. Tailored to meet nutritional needs, these substitutes lack Phe but fulfill protein requirements. Due to limited supplement availability, athletes with PKU may need higher protein intake. Various factors affect tolerated Phe levels, including supplement quantity and age. Adhering to supplement regimens optimizes performance and addresses PKU challenges. Strategically-timed protein substitutes can safely enhance muscle synthesis and sports performance. Individualized intake is essential for optimal outcomes, recognizing proteins' multifaceted role. Here, we explore protein substitute supplementation in PKU patients within the context of physical activity, considering limited evidence.

Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes

The dietary practices of athletes play a crucial role in shaping their body composition, influencing sports performance, training adaptations, and overall health. However, despite the widely acknowledged significance of dietary intake in athletic success, there exists a gap in our understanding of the intricate relationships between nutrition, body composition, and performance. Furthermore, emerging evidence suggests that many athletes fail to adopt optimal nutritional practices, which can impede their potential achievements. In response, this Special Issue seeks to gather research papers that delve into athletes' dietary practices and their potential impacts on body composition and sports performance. Additionally, studies focusing on interventions aimed at optimizing dietary habits are encouraged. This paper outlines the key aspects and points that will be developed in the ensuing articles of this Special Issue.

D-galactose might mediate some of the skeletal muscle hypertrophy-promoting effects of milk-A nutrient to consider for sarcopenia?

Sarcopenia is a process of progressive aging-associated loss of skeletal muscle mass (SMM) recognized as a serious global health issue contributing to frailty and increased all-cause mortality. Exercise and nutritional interventions (particularly intake of dairy products and milk) demonstrate good efficacy, safety, and broad applicability. Here, we propose that at least some of the well-documented favorable effects of milk and milk-derived protein supplements on SMM might be mediated by D-galactose, a monosaccharide present in large quantities in milk in the form of disaccharide lactose (milk sugar). We suggest that ingestion of dairy products results in exposure to D-galactose in concentrations metabolized primarily via the Leloir pathway with the potential to (i) promote anabolic signaling via maintenance of growth factor (e.g., insulin-like growth factor 1 [IGF-1]) receptor mature glycosylation patterns; and (ii) provide extracellular (liver glycogen) and intracellular substrates for short (muscle glycolysis) and long-term (muscle glycogen, intramyocellular lipids) energy availability. Additionally, D-galactose might optimize the metabolic function of skeletal muscles by increasing mitochondrial content and stimulating glucose and fatty acid utilization. The proposed potential of D-galactose to promote the accretion of SMM is discussed in the context of its therapeutic potential in sarcopenia.

Athletes' nutritional demands: a narrative review of nutritional requirements

Nutrition serves as the cornerstone of an athlete's life, exerting a profound impact on their performance and overall well-being. To unlock their full potential, athletes must adhere to a well-balanced diet tailored to their specific nutritional needs. This approach not only enables them to achieve optimal performance levels but also facilitates efficient recovery and reduces the risk of injuries. In addition to maintaining a balanced diet, many athletes also embrace the use of nutritional supplements to complement their dietary intake and support their training goals. These supplements cover a wide range of options, addressing nutrient deficiencies, enhancing recovery, promoting muscle synthesis, boosting energy levels, and optimizing performance in their respective sports or activities. The primary objective of this narrative review is to comprehensively explore the diverse nutritional requirements that athletes face to optimize their performance, recovery, and overall well-being. Through a thorough literature search across databases such as PubMed, Google Scholar, and Scopus, we aim to provide evidence-based recommendations and shed light on the optimal daily intakes of carbohydrates, protein, fats, micronutrients, hydration strategies, ergogenic aids, nutritional supplements, and nutrient timing. Furthermore, our aim is to dispel common misconceptions regarding sports nutrition, providing athletes with accurate information and empowering them in their nutritional choices.

The effect of fish oil supplementation on resistance training-induced adaptations

BACKGROUND

Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults.

METHODS

A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week^-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RM_SQT) and bench press (1RM_BP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES).

RESULTS

Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p< .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: -5.2%, PL: 0.0%, p = .092), and %BF (FOS: -5.9%, PL: -2.5%, p = .136) were observed, although, the between-group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]^-1) 1RM_BP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RM_SQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RM_SQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045).

CONCLUSIONS

When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.

Pre-sleep protein supplementation does not improve recovery from load carriage in British Army recruits (part 2)

British Army basic training (BT) is physically demanding with new recruits completing multiple bouts of physical activity each day with limited recovery. Load carriage is one of the most physically demanding BT activities and has been shown to induce acute exercise-induced muscle damage (EIMD) and impair muscle function. Protein supplementation can accelerate muscle recovery by attenuating EIMD and muscle function loss. This study investigated the impact of an additional daily bolus of protein prior to sleep throughout training on acute muscle recovery following a load carriage test in British Army recruits. Ninety nine men and 23 women (mean ± SD: age: 21.3 ± 3.5 yrs., height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg) were randomized to dietary control (CON), carbohydrate placebo (PLA), moderate (20 g; MOD) or high (60 g; HIGH) protein supplementation. Muscle function (maximal jump height), perceived muscle soreness and urinary markers of muscle damage were assessed before (PRE), immediately post (POST), 24-h post (24 h-POST) and 40-h post (40 h-POST) a load carriage test. There was no impact of supplementation on muscle function at POST (p = 0.752) or 40 h-POST (p = 0.989) load carriage but jump height was greater in PLA compared to HIGH at 24 h-POST (p = 0.037). There was no impact of protein supplementation on muscle soreness POST (p = 0.605), 24 h-POST (p = 0.182) or 40 h-POST (p = 0.333). All groups had increased concentrations of urinary myoglobin and 3-methylhistidine, but there was no statistical difference between groups at any timepoint (p > 0.05). We conclude that pre-sleep protein supplementation does not accelerate acute muscle recovery following load carriage in British Army recruits during basic training. The data suggests that consuming additional energy in the form of CHO or protein was beneficial at attenuating EIMD, although it is acknowledged there were no statistical differences between groups. Although EIMD did occur as indicated by elevated urinary muscle damage markers, it is likely that the load carriage test was not arduous enough to reduce muscle function, limiting the impact of protein supplementation. Practically, protein supplementation above protein intakes of 1.2 g⸱kg-1⸱day-1 following load carriage over similar distances (4 km) and carrying similar loads (15-20 kg) does not appear to be warranted.

A focus on leucine in the nutritional regulation of human skeletal muscle metabolism in ageing, exercise and unloading states

Muscle protein synthesis (MPS) and muscle protein breakdown (MPB) are influenced through dietary protein intake and physical (in)activity, which it follows, regulate skeletal muscle (SKM) mass across the lifespan. Following consumption of dietary protein, the bio-availability of essential amino acids (EAA), and primarily leucine (LEU), drive a transient increase in MPS with an ensuing refractory period before the next MPS stimulation is possible (due to the "muscle full" state). At the same time, MPB is periodically constrained via reflex insulin actions. Layering exercise on top of protein intake increases the sensitivity of SKM to EAA, therefore extending the muscle full set-point (∼48 h), to permit long-term remodelling (e.g., hypertrophy). In contrast, ageing and physical inactivity are associated with a premature muscle full set-point in response to dietary protein/EAA and contractile activity. Of all the EAA, LEU is the most potent stimulator of the mechanistic target of rapamycin complex 1 (mTORC1)-signalling pathway, with the phosphorylation of mTORC1 substrates increasing ∼3-fold more than with all other EAA. Furthermore, maximal MPS stimulation is also achieved following low doses of LEU-enriched protein/EAA, negating the need for larger protein doses. As a result, LEU supplementation has been of long term interest to maximise muscle anabolism and subsequent net protein accretion, especially when in tandem with resistance exercise. This review highlights current knowledge vis-à-vis the anabolic effects of LEU supplementation in isolation, and in enriched protein/EAA sources (i.e., EAA and/or protein sources with added LEU), in the context of ageing, exercise and unloading states.

Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions

Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.

Ingestion of mycoprotein, pea protein, and their blend support comparable postexercise myofibrillar protein synthesis rates in resistance-trained individuals

Pea protein is an attractive nonanimal-derived protein source to support dietary protein requirements. However, although high in leucine, a low methionine content has been suggested to limit its anabolic potential. Mycoprotein has a complete amino acid profile which, at least in part, may explain its ability to robustly stimulate myofibrillar protein synthesis (MyoPS) rates. We hypothesized that an inferior postexercise MyoPS response would be seen following ingestion of pea protein compared with mycoprotein, which would be (partially) rescued by blending the two sources. Thirty-three healthy, young [age: 21 ± 1 yr, body mass index (BMI): 24 ± 1 kg·m-2] and resistance-trained participants received primed, continuous infusions of l-[ring-2H5]phenylalanine and completed a bout of whole body resistance exercise before ingesting 25 g of protein from mycoprotein (MYC, n = 11), pea protein (PEA, n = 11), or a blend (39% MYC, 61% PEA) of the two (BLEND, n = 11). Blood and muscle samples were taken pre-, 2 h, and 4 h postexercise/protein ingestion to assess postabsorptive and postprandial postexercise myofibrillar protein fractional synthetic rates (FSRs). Protein ingestion increased plasma essential amino acid and leucine concentrations (time effect; P < 0.0001), but more rapidly in BLEND and PEA compared with MYC (time × condition interaction; P < 0.0001). From similar postabsorptive values (MYC, 0.026 ± 0.008%·h-1; PEA, 0.028 ± 0.007%·h-1; BLEND, 0.026 ± 0.006%·h-1), resistance exercise and protein ingestion increased myofibrillar FSRs (time effect; P < 0.0001) over a 4-h postprandial period (MYC, 0.076 ± 0.004%·h-1; PEA, 0.087 ± 0.01%·h-1; BLEND, 0.085 ± 0.01%·h-1), with no differences between groups (all; P > 0.05). These data show that all three nonanimal-derived protein sources have utility in supporting postexercise muscle reconditioning.NEW & NOTEWORTHY This study provides evidence that pea protein (PEA), mycoprotein (MYC), and their blend (BLEND) can support postexercise myofibrillar protein synthesis rates following a bout of whole body resistance exercise. Furthermore, these data suggest that a methionine deficiency in pea may not limit its capacity to stimulate an acute increase in muscle protein synthesis (MPS).

Transcriptomic Analysis of Human Skeletal Muscle in Response to Aerobic Exercise and Protein Intake

This study aimed to provide a more comprehensive molecular insight into the effects of aerobic exercise (AE), protein intake (PI), and AE combined with PI on human skeletal muscle by comparing their transcriptomic profiles. Fourteen published datasets obtained from the Gene Expression Omnibus (GEO) database were used. The hub genes were identified in response to acute AE (ACTB, IL6), training AE (UBB, COL1A1), PI (EZH2), acute AE combined with PI (DDIT3), and training AE combined with PI (MYC). Both FOS and MYC were upregulated in response to acute AE, and they were, respectively, downregulated by higher PI and a combination of AE and PI. COL1A1 was upregulated by training AE but was downregulated by higher PI. Results from the gene set enrichment analysis (p < 0.05 and FDR < 25%) showed that AE and PI delivered their impacts on human skeletal muscle in analogous pathways, including aerobic respiration, mitochondrial complexes, extracellular matrix (ECM) remodeling, metabolic process, and immune/inflammatory responses, whereas, PI may attenuate the response of immune/inflammation and ECM remodeling which would be promoted by AE, irrespective of its types. Compared to PI alone, acute AE combined with PI would further promote protein turnover and synthesis, but suppress skeletal muscle contraction and movement.

Daily Walking Accompanied with Intermittent Resistance Exercise Prevents Osteosarcopenia: A Large Cohort Study

BACKGROUND

This study aimed to analyze the effects of walking and resistance exercises on bone structure, bone mineral density (BMD), and skeletal muscle mass. We used data from the fourth Korean National Health and Nutrition Examination Survey (KNHANES).

METHODS

A total of 3,477 participants aged ≥19 years underwent hip structural analysis (HSA), BMD, and skeletal muscle index (SMI). All radiologic evaluations were performed using dual energy X-ray absorptiometry (DXA). The Korean short version of the International Physical Activity Questionnaire was used to measure physical activity status. The physical activity recommendations of the American College of Rheumatology Work Group Panel were used to evaluate the extent of activity.

RESULTS

The BMD and SMI in the group in which walking activity was performed 5 days or more per week for at least 30 min per day were significantly higher than those in the group in which walking activity was not performed. HSA and SMI in the group in which resistance exercise was performed 2 days or more per week for at least 30 min per day were found to be significantly higher than those in the group in which strengthening exercises were not performed.

CONCLUSIONS

If resistance exercise and walking are combined, bone loss and muscle loss are prevented maintaining cortical thickness in the elderly. Walking for more than 5 days a week and resistance exercise for more than 2 days a week will help to maintain the skeletal muscle as well as the cortex around the femur neck, thus helping to prevent fragility fractures in older individuals.

Live and Heat-Killed Probiotic Lactobacillus paracasei PS23 Accelerated the Improvement and Recovery of Strength and Damage Biomarkers after Exercise-Induced Muscle Damage

Excessive, high-intensity or inappropriate exercise may cause muscle damage. How to speed up recovery and reduce exercise discomfort are currently very important issues for athletes and sports people. Past research has shown that probiotics can improve inflammation and oxidative stress, as well as improve exercise performance and antifatigue. However, further research is needed to confirm the recovery benefits for muscle damage. In this double-blind design study, all subjects were randomly assigned to placebo, a live Lactobacillus paracasei group (L-PS23, 2 × 1010 colony forming unit (CFU)/day), or a heat-killed L. paracasei group (HK-PS23, 2 × 1010 cells/day), and supplemented for six consecutive weeks. Afterwards, subjects completed 100 maximal vertical jumps to bring about exercise-induced muscle damage (EIMD). Countermovement jump (CMJ), isometric mid-thigh pull (IMTP), and Wingate anaerobic test (WAnT), as well as blood tests for markers of muscle damage and inflammation were made pre-exercise and 3, 24, 48 h post exercise. The results show that both L-PS23 and HK-PS23 supplementation significantly slowed the loss of muscle strength after muscle injury, and they significantly reduced the production of markers of muscle damage and inflammation (p < 0.05). In addition, L-PS23 and HK-PS23 had the benefits of accelerating the recovery and improvement of muscle strength, the blood markers of muscle injury and inflammation, and slowing the decline in testosterone concentrations (p < 0.05). Especially in the HK-PS23 supplemented group, there was a better trend. In conclusion, we found that L-PS23 or HK-PS23 supplementation for six weeks prevented strength loss after muscle damage and improved blood muscle damage and inflammatory markers, with protective, accelerated recovery and anti-fatigue benefits.

The plasma amino acid response to blended protein beverages: a randomised crossover trial

Soya-dairy protein blends can extend post-exercise muscle synthesis in young people more than whey protein control. Older adults differ metabolically from young people, and their ability to absorb amino acids from dietary protein is important for muscle function. The objective was to determine how protein source affects postprandial plasma amino acid response and/or metabolomic profile in older adults via a single-blind randomised crossover trial (n 16, males 50-70 years), using three nutritionally equivalent meal replacement drinks containing 30 g protein, from a 1:1 (mass ratio) soya:dairy blend, a 1:2 soya:dairy blend or whey protein. The outcome measures were plasma amino acid concentrations at 0-300 min postprandially and urine metabolomic fingerprint. Soya:dairy drinks gave similar amino acid response in plasma over time and similar urinary metabolite fingerprints. However, there were significant differences in plasma amino acid concentrations and AUC values for the soya:dairy drinks v. the whey protein drink. AUC for Leu, Trp and Lys was lower and AUC for Phe and Pro was higher for the soya:dairy drinks. Differences partly reflected the amino acid profiles of the drinks, but overall plasma amino acid response patterns were qualitatively unchanged. Plasma amino acid differences between the whey protein drink and the soya:dairy blends were reflected in urine metabolite patterns. In conclusion, postprandial plasma amino acid responses were broadly similar, irrespective of protein source (and soya:dairy ratio). There were significant differences for some plasma amino acid concentrations, reflecting different amino acid profiles of the protein source and influencing urine metabolite fingerprints.

The Effect of Fava Bean (Vicia faba L.) Protein Ingestion on Myofibrillar Protein Synthesis at Rest and after Resistance Exercise in Healthy, Young Men and Women: A Randomised Control Trial

The aim of the present study was to evaluate the effect of feeding fava bean (Vicia faba L.) protein (FBP) on resting and post-exercise myofibrillar fractional synthetic rate (myoFSR). In a parallel, double-blind, randomised control trial, sixteen young, healthy recreationally active adults (age = 25 (5) years, body mass = 70 (15) kg, stature = 1.72 (0.11) m, mean (SD)) ingested 0.33 g·kg⁻¹ FBP (n = 8) or a negative control (CON, i.e., EAA-free mixture) (n = 8), immediately after a bout of unilateral knee-extensor resistance exercise. Plasma, saliva, and m. vastus lateralis muscle samples were obtained pre-ingestion and 3 h post-ingestion. MyoFSR was calculated via deuterium labelling of myofibrillar-bound alanine, measured by gas chromatography–pyrolysis–isotope ratio mass spectrometry (GC-Pyr-IRMS). Resistance exercise increased myoFSR (p = 0.012). However, ingestion of FBP did not evoke an increase in resting (FBP 29 [−5, 63] vs. CON 12 [−25, 49]%, p = 0.409, mean % change [95% CI]) or post-exercise (FBP 78 [33, 123]% vs. CON 58 [9, 107]%, p = 0.732) myoFSR. Ingestion of 0.33 g·kg⁻¹ of FBP does not appear to enhance resting or post-exercise myoFSR in young, healthy, recreationally active adults.

Relationship Between Protein Intake in Each Traditional Meal and Physical Activity: Cross-sectional Study

Background

Protein intake plays an important role in the synthesis and maintenance of skeletal muscles for the prevention of health risks. It is also widely known that physical activity influences muscle function. However, no large-scale studies have examined the relationship between daily dietary habits, especially the timing of protein intake, and daily physical activity.

Objective

The purpose of this cross-sectional study was to investigate how protein intake and composition (involving the 3 major nutrients protein, fat, and carbohydrate) in the 3 traditional meals (breakfast, lunch, and dinner) are associated with physical activity.

Methods

Using daily dietary data accumulated in the smartphone food log app “Asken” and a web-based cross-sectional survey involving Asken users (N=8458), we analyzed nutrient intake and composition, as well as daily activity levels. As very few individuals skipped breakfast (1102/19,319 responses, 5.7%), we analyzed data for 3 meals per day.

Results

Spearman rank correlation analysis revealed that breakfast and lunch protein intakes had higher positive correlations with daily physical activity among the 3 major macronutrients (P<.001). These findings were confirmed by multivariate logistic regression analysis with confounding factors. Moreover, participants with higher protein intake and composition at breakfast or lunch tended to exhibit significantly greater physical activity than those with higher protein intake at dinner (P<.001).

Conclusions

Among the 3 macronutrients, protein intake during breakfast and lunch was closely associated with daily physical activity.

Isolated Soy Protein Supplementation Combined With Resistance Training Improves Muscle Strength, Mass, and Physical Performance of Aging Female Mice

Background/Purpose: In recent years, the aging population has gradually increased, and the aging process is accompanied by health-associated problems, such as loss of muscle mass and weakness. Therefore, it is important to explore alternative strategies for improving the health status and physical fitness of the aged population. In this study, we investigated the effect of soy protein supplementation combined with resistance training on changes in the muscle mass, muscle strength, and functional activity performance of aging mice.

Methods: Female Institute of Cancer Research (ICR) mice were divided into four groups (n = 8 per group): sedentary control (SC), isolated soy protein (ISP) supplementation, resistance training (RT), and a combination of ISP and RT (ISP + RT). The mice in designated groups received oral ISP supplementation (0.123 g/kg/day), RT (5 days/week for a period of 4 weeks), or a combination of both ISP plus RT for 4 weeks. Afterward, we assessed muscle strength, endurance, and anaerobic endurance performance and analyzed blood biochemical and pathological tissue sections to investigate whether there were adverse effects or not in mice.

Results: ISP supplementation effectively improved the muscle mass, muscle endurance, and endurance performance of aging female mice. The RT group not only showed similar results with ISP but also increased muscle strength and glycogen content. Nevertheless, the combination of ISP supplementation and RT had greater beneficial effects on muscle strength, physical performance, and glycogen levels (p < 0.05). In addition, the combination of ISP supplementation and RT had significantly increased type II muscle percentage and cross-sectional area (p < 0.05).

Conclusion: Although ISP or RT alone improved muscle mass and performance, the combination of ISP with RT showed greater beneficial effects in aging mice. Our findings suggest that regular exercise along with protein supplementation could be an effective strategy to improve overall health and physical fitness among the elderly.

Effects of Protein Supplementation Associated with Resistance Training on Body Composition and Muscle Strength in Older Adults: A Systematic Review of Systematic Reviews with Meta-analyses

BACKGROUND

There are some controversial findings regarding the benefits of combining protein supplementation with resistance training in order to optimize adaptations to training in older adults.

OBJECTIVE

The aim of this review was to summarize the evidence from meta-analyses assessing the effects of protein supplementation combined with resistance training on body composition and muscle strength in the older population.

METHODS

We included systematic reviews with meta-analyses of randomized clinical trials that examined the effects of protein and/or amino acid supplementation associated with resistance training compared with resistance training alone on lean body mass, muscle mass, and muscle strength in older people. The search was performed using the MEDLINE (PubMed), Embase, Cochrane Database of Systematic Reviews, Google Scholar, and OpenGrey databases. Methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist, and the quality of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation system. The pooled effect estimates were computed from the standardized mean difference and the 95% confidence interval achieved by each meta-analysis, using random effects models.

RESULTS

Five reviews were included, all of moderate methodological quality. In the analyses, protein supplementation combined with resistance training was associated with greater increases in lean body mass and muscle mass when compared with resistance training alone. However, no differences were observed between the interventions on muscle strength increases. The quality of evidence ranged from moderate to very low.

CONCLUSION

Protein supplementation associated with resistance training induces greater increases in lean body mass compared with resistance training alone. In addition, it is suggested that the use of protein supplementation enhances gains in muscle mass but does not promote greater increases in muscle strength.

Milk proteins: Processing, gastric coagulation, amino acid availability and muscle protein synthesis

It is well-known that the postprandial muscle protein synthetic response to protein ingestion is regulated on various levels, including dietary protein digestion and amino acid (AA) absorption, splanchnic AA retention, the availability of dietary protein-derived AA in the circulation, delivery of AA to the muscle, uptake of AA by the muscle, and intramuscular signaling. AA availability after consumption of dairy products is primarily determined by the rate of gastric emptying of milk proteins, which is mainly linked to coagulation of milk proteins in the stomach. Caseins form gastric coagula, which make their gastric emptying and subsequent postprandial aminoacidemia notably slower than that of whey proteins. Only recently, the role of processing, food structure, preservation and matrix on coagulation herein has been getting attention. In this review we describe various processes, that affect gastric coagulation of caseins and therewith control gastric emptying, such as the conversion to caseinate, heat treatment in the presence of whey proteins, conversion to stirred yoghurt and enzymatic hydrolysis. Modulating product characteristics by processing can be very useful to steer the gastric behavior of protein, and the subsequent digestion and AA absorption and muscle anabolic response to maintain or increase muscle mass.

Supplementation of Specific Collagen Peptides Following High-Load Resistance Exercise Upregulates Gene Expression in Pathways Involved in Skeletal Muscle Signal Transduction

Previous evidence suggests that resistance training in combination with specific collagen peptides (CP) improves adaptive responses of the muscular apparatus. Although beneficial effects have been repeatedly demonstrated, the underlying mechanisms are not well understood. Therefore, the primary objective of the present randomized trial was to elucidate differences in gene expression pathways related to skeletal muscle signal transduction following acute high-load resistance exercise with and without CP intake. Recreationally active male participants were equally randomized to high-load leg extension exercise in combination with 15 g CP or placebo (PLA) supplementation. Muscle biopsies from the vastus lateralis muscle were obtained at baseline as well as 1, 4 and 24 h post exercise to investigate gene expression using next generation sequencing analysis. Several important anabolic pathways including PI3K-Akt and MAPK pathways were significantly upregulated at 1 and 4 h post-exercise. Significant between-group differences for both pathways were identified at the 4 h time point demonstrating a more pronounced effect after CP intake. Gene expression related to the mTOR pathway demonstrated a higher visual increase in the CP group compared to PLA by trend, but failed to achieve statistically significant group differences. The current findings revealed a significantly higher upregulation of key anabolic pathways (PI3K-Akt, MAPK) in human skeletal muscle 4 h following an acute resistance training combined with intake of 15 g of specific collagen peptides compared to placebo. Further investigations should examine potential relationships between upregulated gene expression and changes in myofibrillar protein synthesis as well as potential long-term effects on anabolic pathways on the protein level.

(Dys)regulation of Protein Metabolism in Skeletal Muscle of Humans With Obesity

Studies investigating the proteome of skeletal muscle present clear evidence that protein metabolism is altered in muscle of humans with obesity. Moreover, muscle quality (i.e., strength per unit of muscle mass) appears lower in humans with obesity. However, relevant evidence to date describing the protein turnover, a process that determines content and quality of protein, in muscle of humans with obesity is quite inconsistent. This is due, at least in part, to heterogeneity in protein turnover in skeletal muscle of humans with obesity. Although not always evident at the mixed-muscle protein level, the rate of synthesis is generally lower in myofibrillar and mitochondrial proteins in muscle of humans with obesity. Moreover, alterations in the synthesis of protein in muscle of humans with obesity are manifested more readily under conditions that stimulate protein synthesis in muscle, including the fed state, increased plasma amino acid availability to muscle, and exercise. Current evidence supports various biological mechanisms explaining impairments in protein synthesis in muscle of humans with obesity, but this evidence is rather limited and needs to be reproduced under more defined experimental conditions. Expanding our current knowledge with direct measurements of protein breakdown in muscle, and more importantly of protein turnover on a protein by protein basis, will enhance our understanding of how obesity modifies the proteome (content and quality) in muscle of humans with obesity.

The Effects of Dietary Protein Supplementation on Acute Changes in Muscle Protein Synthesis and Longer-Term Changes in Muscle Mass, Strength, and Aerobic Capacity in Response to Concurrent Resistance and Endurance Exercise in Healthy Adults: A Systematic Review

BACKGROUND

Engaging in both resistance and endurance exercise within the same training program, termed 'concurrent exercise training,' is common practice in many athletic disciplines that require a combination of strength and endurance and is recommended by a number of organizations to improve muscular and cardiovascular health and reduce the risk of chronic metabolic disease. Dietary protein ingestion supports skeletal muscle remodeling after exercise by stimulating the synthesis of muscle proteins and can optimize resistance exercise-training mediated increases in skeletal muscle size and strength; however, the effects of protein supplementation on acute and longer-term adaptive responses to concurrent resistance and endurance exercise are unclear.

OBJECTIVES

The purpose of this systematic review is to evaluate the effects of dietary protein supplementation on acute changes in muscle protein synthesis and longer-term changes in muscle mass, strength, and aerobic capacity in responses to concurrent resistance and endurance exercise in healthy adults.

METHODS

A systematic search was conducted in five databases: Scopus, Embase, Medline, PubMed, and Web of Science. Acute and longer-term controlled trials involving concurrent exercise and protein supplementation in healthy adults (ages 18-65 years) were included in this systematic review. Main outcomes of interest were changes in skeletal muscle protein synthesis rates, muscle mass, muscle strength, and whole-body aerobic capacity (i.e., maximal/peak aerobic capacity [VO_2max/peak]). The quality of studies was assessed using the National Institute of Health Quality Assessment for Controlled Intervention Studies.

RESULTS

Four acute studies including 84 trained young males and ten longer-term studies including 167 trained and 391 untrained participants fulfilled the eligibility criteria. All included acute studies demonstrated that protein ingestion enhanced myofibrillar protein synthesis rates, but not mitochondrial protein synthesis rates during post-exercise recovery after an acute bout of concurrent exercise. Of the included longer-term training studies, five out of nine reported that protein supplementation enhanced concurrent training-mediated increases in muscle mass, while five out of nine studies reported that protein supplementation enhanced concurrent training-mediated increases in muscle strength and/or power. In terms of aerobic adaptations, all six included studies reported no effect of protein supplementation on concurrent training-mediated increases in VO_2max/peak.

CONCLUSION

Protein ingestion after an acute bout of concurrent exercise further increases myofibrillar, but not mitochondrial, protein synthesis rates during post-exercise recovery. There is some evidence that protein supplementation during longer-term training further enhances concurrent training-mediated increases in skeletal muscle mass and strength/power, but not whole-body aerobic capacity (i.e., VO_2max/peak).

Intermittent fasting and continuous energy restriction result in similar changes in body composition and muscle strength when combined with a 12 week resistance training program

Purpose

The objective of this study was to compare the effects of 12 weeks of resistance training combined with either 5:2 intermittent fasting or continuous energy restriction on body composition, muscle size and quality, and upper and lower body strength.

Methods

Untrained individuals undertook 12 weeks of resistance training plus either continuous energy restriction [20% daily energy restriction (CERT)] or 5:2 intermittent fasting [~ 70% energy restriction 2 days/week, euenergetic consumption 5 days/week (IFT)], with both groups prescribed a mean of ≥ 1.4 g of protein per kilogram of body weight per day. Participants completed 2 supervised resistance and 1 unsupervised aerobic/resistance training combination session per week. Changes in lean body mass (LBM), thigh muscle size and quality, strength and dietary intake were assessed.

Results

Thirty-four participants completed the study (CERT = 17, IFT = 17). LBM was significantly increased (+ 3.7%, p < 0.001) and body weight (− 4.6%, p < 0.001) and fat (− 24.1%, p < 0.001) were significantly reduced with no significant difference between groups, though results differed by sex. Both groups showed improvements in thigh muscle size and quality, and reduced intramuscular and subcutaneous fat assessed by ultrasonography and peripheral quantitative computed tomography (pQCT), respectively. The CERT group demonstrated a significant increase in muscle surface area assessed by pQCT compared to the IFT group. Similar gains in upper and lower body strength and muscular endurance were observed between groups.

Conclusion

When combined with resistance training and moderate protein intake, continuous energy restriction and 5:2 intermittent fasting resulted in similar improvements in body composition, muscle quality, and strength. ACTRN: ACTRN12620000920998, September 2020, retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-022-02804-3.

In-Depth Analyses of the Effects of a Diet and Resistance Exercise Intervention in Older Adults: Who Benefits Most From ProMuscle in Practice?

BACKGROUND

The ProMuscle in Practice intervention, comprising resistance exercise and an increased protein intake, was effective in improving muscle strength, lean body mass, and physical functioning in older adults aged 65 years and older (N = 168). However, a heterogeneous response to such interventions is common. Therefore, we explored the differences in responsiveness to the intervention in subgroups based on demographic characteristics and mobility-impairing disorders.

METHOD

Multiple regression analyses were performed to study mean changes between baseline and 12 weeks on the Short Physical Performance Battery, chair rise test, lean body mass, knee extension strength, leg press strength, and leg extension strength. The interaction term Treatment × Subgroup was included to study differences in effects between subgroups. Subgroups comprised age (≤75 vs >75 years), sex (men vs women), presence of frailty, presence of sarcopenia, and presence of osteoarthritis.

RESULTS

A significant interaction effect including age was found on lean body mass (β = -0.8; 95% CI: -1.5, -0.2), favoring participants aged 75 years and younger. A significant interaction effect including sex was found on leg press strength (β = 15.5; 95% CI: 0.6, 30.3), favoring women. Participants with or without frailty, sarcopenia, or osteoarthritis responded equally to the intervention in terms of absolute effects.

CONCLUSIONS

Participants aged 75 years and younger and women benefited to a great extent from the intervention, as they improved significantly on nearly every outcome. Effects in participants with and without a mobility-impairing disorder were comparable, indicating that the intervention is suitable for both groups.

Does branched-chain amino acid supplementation improve pulmonary rehabilitation effect in COPD?

BACKGROUND

Muscle wasting is frequent in chronic obstructive lung disease (COPD) and associated with low branched-chain amino acids (BCAA). We hypothesized that BCAA supplementation could potentiate the effect of a pulmonary rehabilitation program (PRP) by inducing muscular change.

MATERIALS AND METHODS

Sixty COPD patients (GOLD 2-3) were involved in an ambulatory 4-week PRP either with BCAA oral daily supplementation or placebo daily supplementation in a randomized double-blind design. Maximal exercise test including quadriceps oxygenation measurements, functional exercise test, muscle strength, lung function tests, body composition, dyspnea and quality of life were assessed before and after PRP.

RESULTS

Fifty-four patients (64.9 ± 8.3 years) completed the protocol. In both groups, maximal exercise capacity, functional and muscle performances, quality of life and dyspnea were improved after 4-week PRP (p ≤ 0.01). Changes in muscle oxygenation during the maximal exercise and recovery period were not modified after 4-week PRP in BCAA group. Contrarily, in the placebo group the muscle oxygenation kinetic of recovery was slowed down after PRP.

CONCLUSION

This study demonstrated that a 4-week PRP with BCAA supplementation is not more beneficial than PRP alone for patients. A longer duration of supplementation or a more precise targeting of patients would need to be investigated to validate an effect on muscle recovery and to demonstrate other beneficial effects.

Protein status of people with phenylketonuria: a scoping review protocol

INTRODUCTION

Phenylketonuria (PKU) is a disorder of protein metabolism resulting in an accumulation of phenylalanine in the body. Dietary management consists of altering the sources of ingested protein to limit phenylalanine intake. Current dietary protein guidelines for PKU are based on limited scientific evidence, thus it remains unclear whether current practice leads to optimal protein status in people with PKU. To date, no attempt has been made to systematically evaluate the protein status of people with PKU, using a combination of validated anthropometric, biochemical and functional measurement tools. Furthermore, factors known to influence protein status in the general population warrant consideration when determining protein status in individuals with PKU, alongside factors unique to PKU such as the type of protein substitute consumed. Understanding the impact of these variables on protein status is crucial to developing a personalised approach to protein recommendations for optimising health and functional outcomes in people with PKU. Therefore, the aim of this scoping review is to examine existing evidence regarding the protein status of people with PKU, and to investigate the nutritional and lifestyle variables that influence protein status.

METHODS AND ANALYSIS

This review will be guided by Arksey and O'Malley's framework, along with guidance from Levac et al, Pawliuk et al and the Joanna Briggs Institute. The following databases will be searched: MEDLINE (Ovid), Embase, CENTRAL, Web of Science and Scopus, alongside grey literature. Identified literature will be assessed by two independent reviewers for inclusion. Descriptive numerical analysis will be performed and a narrative summary will accompany the tabulated results describing how study findings relate to the review questions.

ETHICS AND DISSEMINATION

This review protocol does not require ethical approval. Findings will be disseminated through peer-reviewed publication, presented at relevant conferences, and shared with a patient research advisory group to inform discussions on future research.

The Effect of a Multi-ingredient Supplement on Resistance Training-induced Adaptations

INTRODUCTION

Resistance exercise training (RET) induces muscle hypertrophy that, when combined with co-temporal protein ingestion, is enhanced. However, fewer studies have been conducted when RET is combined with multi-ingredient supplements.

PURPOSE

We aimed to determine the effect of a high-quality multi-ingredient nutritional supplement (SUPP) versus an isonitrogenous (lower protein quality), isoenergetic placebo (PL) on RET-induced gains in lean body mass (LBM), muscle thickness, and muscle cross-sectional area (CSA). We hypothesized that RET-induced gains in LBM and muscle CSA would be greater in SUPP versus PL.

METHODS

In a double-blind randomized controlled trial, 26 (13 male, 13 female) healthy young adults (mean ± SD, 22 ± 2 yr) were randomized to either the SUPP group (n = 13; 20 g whey protein, 2 g leucine, 2.5 g creatine monohydrate, 300 mg calcium citrate, 1000 IU vitamin D) or the PL group (n = 13; 20 g collagen peptides, 1.4 g alanine, 0.6 g glycine) groups, ingesting their respective supplements twice daily. Measurements were obtained before and after a 10-wk linear progressive RET program.

RESULTS

Greater increases in LBM were observed for SUPP versus PL (SUPP: +4.1 ± 1.3 kg, PL: +2.8 ± 1.7 kg, P < 0.05). No additive effect of the supplement could be detected on vastus lateralis muscle CSA, but SUPP did result in increased biceps brachii muscle CSA and thickness (P < 0.05).

CONCLUSIONS

We conclude that when combined with RET, the consumption of SUPP increased LBM and upper-body CSA and thickness to a greater extent than to that observed in the PL group of healthy young adults.

A systematic review and meta-analysis: Effects of protein hydrolysate supplementation on fat-free mass and strength in resistance-trained individuals

The quality of the existing evidence on the effects of protein hydrolysate supplementation on fat-free mass (FFM) and upper and lower body strength under resistance exercise intervention has not been evaluated. We conducted a structured literature search in PubMed, Web of Science, Cochrane Library, and Scopus database. A random effect model was used with continuous data of FFM and upper and lower body strength for healthy participants over 18 years old who received resistance training for ≥4 weeks and took protein hydrolysate or equivalent control supplements. Sensitivity and subgroup analyses were also conducted. Data from 330 participants in eight studies showed that supplemental protein hydrolysate had a positive effect on the FFM (n = 13, SMD = 0.36, 95% confidence interval (CI): 0.16-0.56, P = 0.000) and lower (n = 7, SMD = 0.43, 95% CI: 0.16-0.69, P = 0.001) and upper (n = 5, SMD = 0.17, 95% CI: -0.06-0.41, P = 0.145) body strength of resistance-trained individuals compared with placebo, showing an increase in physical fitness and muscle strength. However, the current evidence is insufficient to establish ingestion recommendations.

Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis

Older adults with knee osteoarthritis (KOA) are at high risk of sarcopenia. Protein-rich nutritional composition supplementation (PS) combined with resistance exercise training (RET) improves muscle gains and facilitates physical activity in older adults. However, whether PS augments the effects of RET on muscle mass and PA in patients with KOA remains unclear. Therefore, this study identified the effects of PS on sarcopenic indices and PA in older women with KOA subjected to an RET program. Eligible older women aged 60–85 years and diagnosed as having KOA were randomly assigned to either the experimental group (EG) or the control group (CG). Both groups performed RET twice a week for 12 weeks. The EG received additional PS during this period. Outcome measures included appendicular lean mass index, walking speed, physical activity, and scores on the Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC). All measures were tested at baseline and after intervention. With participant characteristics and baseline scores as covariates, analysis of variance was performed to identify between-group differences in changes in all outcome measures after intervention. Statistical significance was defined as p < 0.05. Compared with the CG, the EG achieved greater changes in appendicular lean mass index (adjusted mean difference (aMD) = 0.19 kg/m², p < 0.01), physical activity (aMD = 30.0 MET-hour/week, p < 0.001), walking speed (aMD = 0.09 m/s, p < 0.05), and WOMAC global function (aMD = −8.21, p < 0.001) after intervention. In conclusion, PS exerted augmentative effects on sarcopenic indices, physical activity, and perceived global WOMAC score in older women with KOA through 12 weeks of RET.

Wheel running improves fasting-induced AMPK signaling in skeletal muscle from tumor-bearing mice

Disruptions to muscle protein turnover and metabolic regulation contribute to muscle wasting during the progression of cancer cachexia. The initiation of cachexia is also associated with decreased physical activity. While chronic muscle AMPK activation occurs during cachexia progression in ApcMin/+ (MIN) mice, a preclinical cachexia model, the understanding of muscle AMPK's role during cachexia initiation is incomplete. Therefore, we examined if voluntary wheel exercise could improve skeletal muscle AMPK signaling in pre-cachectic MIN mice. Next, we examined muscle AMPK's role in aberrant catabolic signaling in response to a 12-h fast in mice initiating cachexia. Male C57BL/6 (B6: N = 26) and MIN (N = 29) mice were subjected to ad libitum feeding, 12-h fast, or 4 wks. of wheel access and then a 12-h fast during the initiation of cachexia. Male tamoxifen-inducible skeletal muscle AMPKα1 α2 (KO) knockout mice crossed with ApcMin/+ and floxed controls were examined (WT: N = 8, KO: N = 8, MIN: N = 10, MIN KO: N = 6). Male mice underwent a 12-h fast and the gastrocnemius muscle was analyzed. MIN gastrocnemius mass was reduced compared to B6 mice. A 12-h fast induced MIN muscle AMPKT172 , FOXOS413 , and ULK-1S555 phosphorylation compared to B6. Wheel running attenuated these inductions. A 12-h fast induced MIN muscle MuRF-1 protein expression compared to B6 and was suppressed by wheel running. Additionally, fasting induced muscle autophagy signaling and disrupted mitochondrial quality protein expression in the MIN, which was prevented in the MIN KO. We provide evidence that increased skeletal muscle AMPK sensitivity to a 12-h fast is an adverse event in pre-cachectic MIN mice, and exercise can improve this regulation.

Basal and resistance exercise-induced increase in protein synthesis is impaired in skeletal muscle of iron-deficient rats

OBJECTIVES

We aimed to investigate the effect of iron deficiency on basal- and contraction-induced increases in muscle protein synthesis.

METHODS

Four-wk-old male Sprague-Dawley rats were divided into three groups. The rats in two of the three groups had free access to a control diet (AD) or iron-deficient diet (ID) for 4 wk. The rats in the third group (CON) were pair-fed the control diet to the mean intake of the ID group.

RESULTS

In comparison with the CON group, the ID group showed significantly lower hematocrit and hemoglobin concentrations, iron-containing protein levels, and total iron content in skeletal muscle, but non-iron-containing protein levels did not show any differences between the groups. Protein synthesis, measured by puromycin-labeled peptides, was lower in the ID group compared with the CON group in both basal- and contraction-stimulated states. The ID diet impaired the activation levels of signaling pathways involved in protein synthesis, such as ribosomal protein S6 and eukaryotic translation initiation factor 4E-binding protein 1. Furthermore, dietary iron deficiency decreased autophagy capacity, but did not affect the ubiquitinated protein content.

CONCLUSIONS

These results suggest that severe iron deficiency decreases not only basal but also muscle contraction-induced increases in protein synthesis due to, at least in part, downregulation of the protein synthesis signaling pathway in the skeletal muscle.

Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4-8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.

Plant Proteins and Exercise: What Role Can Plant Proteins Have in Promoting Adaptations to Exercise?

Adequate dietary protein is important for many aspects of health with current evidence suggesting that exercising individuals need greater amounts of protein. When assessing protein quality, animal sources of protein routinely rank amongst the highest in quality, largely due to the higher levels of essential amino acids they possess in addition to exhibiting more favorable levels of digestibility and absorption patterns of the amino acids. In recent years, the inclusion of plant protein sources in the diet has grown and evidence continues to accumulate on the comparison of various plant protein sources and animal protein sources in their ability to stimulate muscle protein synthesis (MPS), heighten exercise training adaptations, and facilitate recovery from exercise. Without question, the most robust changes in MPS come from efficacious doses of a whey protein isolate, but several studies have highlighted the successful ability of different plant sources to significantly elevate resting rates of MPS. In terms of facilitating prolonged adaptations to exercise training, multiple studies have indicated that a dose of plant protein that offers enough essential amino acids, especially leucine, consumed over 8–12 weeks can stimulate similar adaptations as seen with animal protein sources. More research is needed to see if longer supplementation periods maintain equivalence between the protein sources. Several practices exist whereby the anabolic potential of a plant protein source can be improved and generally, more research is needed to best understand which practice (if any) offers notable advantages. In conclusion, as one considers the favorable health implications of increasing plant intake as well as environmental sustainability, the interest in consuming more plant proteins will continue to be present. The evidence base for plant proteins in exercising individuals has seen impressive growth with many of these findings now indicating that consumption of a plant protein source in an efficacious dose (typically larger than an animal protein) can instigate similar and favorable changes in amino acid update, MPS rates, and exercise training adaptations such as strength and body composition as well as recovery.

Performance demands in the endurance rider

Endurance is one of the fastest growing equestrian disciplines worldwide. Races are long distance competitions (40-160 km), organised into loops, over variable terrain usually within one day. Horse and rider combinations in endurance races have to complete the course in good condition whilst also aiming to win. Horse welfare is paramount within the sport and horses are required to ‘pass’ a veterinary check prior to racing, after each loop of the course and at the end of the race. Despite the health, fitness and welfare of both athletes within the horse-rider dyad being essential to achieve success, few equivalent measures assessing the wellbeing of the endurance rider are implemented. This review considers evidence from ultra-endurance sports and rider performance in other equestrian disciplines, to consider physiological and psychological strategies the endurance rider could use to enhance their competition performance. Successful endurance riding requires an effective partnership to be established between horse and rider. Within this partnership, adequate rider health and fitness are key to optimal decision-making to manage the horse effectively during training and competition, but just as importantly riders should manage themselves as an athlete. Targeted management for superior rider performance can underpin more effective decision-making promoting ethical equitation practices and optimising competition performance. Therefore, the responsible and competitive endurance rider needs to consider how they prepare themselves adequately for participation in the sport. This should include engaging in appropriate physiological training for fitness and musculoskeletal strength and conditioning. Alongside planning nutritional strategies to support rider performance in training and within the pre-, peri- and post-competition periods to promote superior physical and cognitive performance, and prevent injury. By applying an evidence informed approach to self-management, the endurance athlete will support the horse and rider partnership to achieve to their optimal capacity, whilst maximising both parties physical and psychological wellbeing.

Strategic Ingestion of High-Protein Dairy Milk during a Resistance Training Program Increases Lean Mass, Strength, and Power in Trained Young Males

BACKGROUND

We evaluated the effects of high-protein dairy milk ingestion on changes in body composition, strength, power, and skeletal muscle regulatory markers following 6 weeks of resistance training in trained young males.

METHODS

Thirty resistance-trained young males (age: 27 ± 3 years; training experience: 15 ± 2 months) were randomly assigned to one of two groups: high-protein dairy milk (both whey and casein) + resistance training (MR; n = 15) or isoenergetic carbohydrate (maltodextrin 9%) + resistance training (PR; n = 15). Milk and placebo were ingested immediately post-exercise (250 mL; 30 g protein) and 30 min before sleep (250 mL; 30 g protein). Before and after 6 weeks of linear periodized resistance training (4 times/week), body composition (bioelectrical impedance), strength, power, and serum levels of skeletal muscle regulatory markers (insulin-like growth factor 1 (IGF-1), growth hormone, testosterone, cortisol, follistatin, myostatin, and follistatin-myostatin ratio) were assessed.

RESULTS

The MR group experienced a significantly higher (p < 0.05) increase in lean mass, strength, and power (upper- and lower-body) than the PR group. Further, IGF-1, growth hormone, testosterone, follistatin, and follistatin-myostatin ratio were significantly increased, while cortisol and myostatin significantly decreased in the MR group than the PR group (p < 0.05).

CONCLUSIONS

The strategic ingestion of high-protein dairy milk (post-exercise and pre-sleep) during 6 weeks of resistance training augmented lean mass, strength, power, and altered serum concentrations of skeletal muscle regulatory markers in trained young males compared to placebo.

Subcellular localization- and fibre type-dependent utilization of muscle glycogen during heavy resistance exercise in elite power and Olympic weightlifters

AIM

Glycogen particles are found in different subcellular localizations, which are utilized heterogeneously in different fibre types during endurance exercise. Although resistance exercise typically involves only a moderate use of mixed muscle glycogen, the hypothesis of the present study was that high-volume heavy-load resistance exercise would mediate a pattern of substantial glycogen depletion in specific subcellular localizations and fibre types.

METHODS

10 male elite weightlifters performed resistance exercise consisting of four sets of five (4 × 5) repetitions at 75% of 1RM back squats, 4 × 5 at 75% of 1RM deadlifts and 4 × 12 at 65% of 1RM rear foot elevated split squats. Muscle biopsies (vastus lateralis) were obtained before and after the exercise session. The volumetric content of intermyofibrillar (between myofibrils), intramyofibrillar (within myofibrils) and subsarcolemmal glycogen was assessed by transmission electron microscopy.

RESULTS

After exercise, biochemically determined muscle glycogen decreased by 38 (31:45)%. Location-specific glycogen analyses revealed in type 1 fibres a large decrement in intermyofibrillar glycogen, but no or only minor changes in intramyofibrillar or subsarcolemmal glycogen. In type 2 fibres, large decrements in glycogen were observed in all subcellular localizations. Notably, a substantial fraction of the type 2 fibres demonstrated near-depleted levels of intramyofibrillar glycogen after the exercise session.

CONCLUSION

Heavy resistance exercise mediates a substantial utilization of glycogen from all three subcellular localization in type 2 fibres, while mostly taxing intermyofibrillar glycogen stores in type 1 fibres. Thus, a better understanding of the impact of resistance training on myocellular metabolism and performance requires a focus on compartmentalized glycogen utilization.

When your brain looks older than expected: combined lifestyle risk and BrainAGE

Lifestyle may be one source of unexplained variance in the great interindividual variability of the brain in age-related structural differences. While physical and social activity may protect against structural decline, other lifestyle behaviors may be accelerating factors. We examined whether riskier lifestyle correlates with accelerated brain aging using the BrainAGE score in 622 older adults from the 1000BRAINS cohort. Lifestyle was measured using a combined lifestyle risk score, composed of risk (smoking, alcohol intake) and protective variables (social integration and physical activity). We estimated individual BrainAGE from T1-weighted MRI data indicating accelerated brain atrophy by higher values. Then, the effect of combined lifestyle risk and individual lifestyle variables was regressed against BrainAGE. One unit increase in combined lifestyle risk predicted 5.04 months of additional BrainAGE. This prediction was driven by smoking (0.6 additional months of BrainAGE per pack-year) and physical activity (0.55 less months in BrainAGE per metabolic equivalent). Stratification by sex revealed a stronger association between physical activity and BrainAGE in males than females. Overall, our observations may be helpful with regard to lifestyle-related tailored prevention measures that slow changes in brain structure in older adults.

Breakfast before resistance exercise lessens urinary markers of muscle protein breakdown in young men: A crossover trial

OBJECTIVES

Skipping breakfast prolongs the fasting state initiated after the last meal consumed the previous day and can have negative effects on muscle protein balance. The aim of this crossover trial was to examine the effects of skipping breakfast before a single bout of resistance exercise (RE) on muscle protein breakdown (MPB), as assessed using the urinary 3-methylhistidine/creatinine ratio (3-MH/Cr).

METHODS

Thirteen healthy young men, who habitually consumed breakfast (21.8 ± 1.1 y of age), were assigned to eating breakfast (EB) and skipping breakfast (SB) conditions. Participants consumed meat-free diets throughout the 5-d experiment. On day 5, individuals in the EB group consumed breakfast (497 kcal) 2.5 h before RE (75% repetition maximum), whereas those in the SB group consumed the same meal after dinner.

RESULTS

In the two-way analysis of variance, significant interactions were observed with blood insulin and free fatty acid levels, and the 3-MH/Cr ratio (P < 0.05). We confirmed a significantly greater decrease in the insulin level pre-RE (P < 0.001; d = 3.281), and increases in the free fatty acid level pre-RE (P < 0.001; d = 1.437) and post-RE (P = 0.013; d = 0.811) and the 3-MH/Cr ratio 6 (P < 0.001; d = 0.878) and 8 h (P < 0.001; d = 0.634) post-RE in the SB condition than in the EB condition.

CONCLUSION

Eating breakfast before RE can be beneficial for MPB suppression. The importance of breakfast consumption in terms of positive muscle protein balance is emphasized on sports fields.

Sex differences in health and disease: A review of biological sex differences relevant to cancer with a spotlight on glioma

The influence of biological sex differences on human health and disease, while being increasingly recognized, has long been underappreciated and underexplored. While humans of all sexes are more alike than different, there is evidence for sex differences in the most basic aspects of human biology and these differences have consequences for the etiology and pathophysiology of many diseases. In a disease like cancer, these consequences manifest in the sex biases in incidence and outcome of many cancer types. The ability to deliver precise, targeted therapies to complex cancer cases is limited by our current understanding of the underlying sex differences. Gaining a better understanding of the implications and interplay of sex differences in diseases like cancer will thus be informative for clinical practice and biological research. Here we review the evidence for a broad array of biological sex differences in humans and discuss how these differences may relate to observed sex differences in various diseases, including many cancers and specifically glioblastoma. We focus on areas of human biology that play vital roles in healthy and disease states, including metabolism, development, hormones, and the immune system, and emphasize that the intersection of sex differences in these areas should not go overlooked. We further propose that mathematical approaches can be useful for exploring the extent to which sex differences affect disease outcomes and accounting for those in the development of therapeutic strategies.