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Antonio J, Evans C, Ferrando AA, Stout JR, Antonio B, Cinteo H, Harty P, Arent SM, Candow DG, Forbes SC, Kerksick CM, Pereira F, Gonzalez D, Kreider RB. Common questions and misconceptions about protein supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2341903. [PMID: 38626029 PMCID: PMC11022925 DOI: 10.1080/15502783.2024.2341903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 04/07/2024] [Indexed: 04/18/2024] Open
Abstract
Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of "protein and exercise performance" reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming "excess" protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough protein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal muscle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily requirements of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scientific assessment of the literature concerning protein supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Arny A. Ferrando
- University of Arkansas for Medical Sciences, Department of Geriatrics, Little Rock, AR, USA
| | - Jeffrey R. Stout
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Harry Cinteo
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Patrick Harty
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Shawn M. Arent
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - Darren G. Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, Canada
| | - Scott C. Forbes
- Brandon University, Department of Physical Education, Faculty of Education, Brandon, MB, Canada
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Flavia Pereira
- Keiser University, Exercise and Sport Science, West Palm Beach Flagship Campus, West Palm Beach, FL, USA
| | - Drew Gonzalez
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
| | - Richard B. Kreider
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
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Liu X, Wu Y, Bennett S, Zou J, Xu J, Zhang L. The Effects of Different Dietary Patterns on Bone Health. Nutrients 2024; 16:2289. [PMID: 39064732 PMCID: PMC11280484 DOI: 10.3390/nu16142289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/05/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Bone metabolism is a process in which osteoclasts continuously clear old bone and osteoblasts form osteoid and mineralization within basic multicellular units, which are in a dynamic balance. The process of bone metabolism is affected by many factors, including diet. Reasonable dietary patterns play a vital role in the prevention and treatment of bone-related diseases. In recent years, dietary patterns have changed dramatically. With the continuous improvement in the quality of life, high amounts of sugar, fat and protein have become a part of people's daily diets. However, people have gradually realized the importance of a healthy diet, intermittent fasting, calorie restriction, a vegetarian diet, and moderate exercise. Although these dietary patterns have traditionally been considered healthy, their true impact on bone health are still unclear. Studies have found that caloric restriction and a vegetarian diet can reduce bone mass, the negative impact of a high-sugar and high-fat dietary (HSFD) pattern on bone health is far greater than the positive impact of the mechanical load, and the relationship between a high-protein diet (HPD) and bone health remains controversial. Calcium, vitamin D, and dairy products play an important role in preventing bone loss. In this article, we further explore the relationship between different dietary patterns and bone health, and provide a reference for how to choose the appropriate dietary pattern in the future and for how to prevent bone loss caused by long-term poor dietary patterns in children, adolescents, and the elderly. In addition, this review provides dietary references for the clinical treatment of bone-related diseases and suggests that health policy makers should consider dietary measures to prevent and treat bone loss.
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Affiliation(s)
- Xiaohua Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Yangming Wu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Samuel Bennett
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Jun Zou
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Lingli Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China
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Larrosa M, Gil-Izquierdo A, González-Rodríguez LG, Alférez MJM, San Juan AF, Sánchez-Gómez Á, Calvo-Ayuso N, Ramos-Álvarez JJ, Fernández-Lázaro D, Lopez-Grueso R, López-León I, Moreno-Lara J, Domínguez-Balmaseda D, Illescas-Quiroga R, Cuenca E, López T, Montoya JJ, Rodrigues-de-Souza DP, Carrillo-Alvarez E, Casado A, Rodriguez-Doñate B, Porta-Oliva M, Santiago C, Iturriaga T, De Lucas B, Solaesa ÁG, Montero-López MDP, Benítez De Gracia E, Veiga-Herreros P, Muñoz-López A, Orantes-Gonzalez E, Barbero-Alvarez JC, Cabeza-Ruiz R, Carnero-Diaz Á, Sospedra I, Fernández-Galván LM, Martínez-Sanz JM, Martín-Almena FJ, Pérez M, Guerra-Hernández EJ, López-Samanes Á, Sánchez-Oliver AJ, Domínguez R. Nutritional Strategies for Optimizing Health, Sports Performance, and Recovery for Female Athletes and Other Physically Active Women: A Systematic Review. Nutr Rev 2024:nuae082. [PMID: 38994896 DOI: 10.1093/nutrit/nuae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
CONTEXT Despite the progress toward gender equality in events like the Olympic Games and other institutionalized competitions, and the rising number of women engaging in physical exercise programs, scientific studies focused on establishing specific nutritional recommendations for female athletes and other physically active women are scarce. OBJECTIVE This systematic review aimed to compile the scientific evidence available for addressing the question "What dietary strategies, including dietary and supplementation approaches, can improve sports performance, recovery, and health status in female athletes and other physically active women?" DATA SOURCES The Pubmed, Web of Science, and Scopus databases were searched. DATA EXTRACTION The review process involved a comprehensive search strategy using keywords connected by Boolean connectors. Data extracted from the selected studies included information on the number of participants and their characteristics related to sport practice, age, and menstrual function. DATA ANALYSIS A total of 71 studies were included in this review: 17 focused on the analysis of dietary manipulation, and 54 focused on the effects of dietary supplementation. The total sample size was 1654 participants (32.5% categorized as competitive athletes, 30.7% as highly/moderately trained, and 37.2% as physically active/recreational athletes). The risk of bias was considered moderate, mainly for reasons such as a lack of access to the study protocol, insufficient description of how the hormonal phase during the menstrual cycle was controlled for, inadequate dietary control during the intervention, or a lack of blinding of the researchers. CONCLUSION Diets with high carbohydrate (CHO) content enhance performance in activities that induce muscle glycogen depletion. In addition, pre-exercise meals with a high glycemic index or rich in CHOs increase CHO metabolism. Ingestion of 5-6 protein meals interspersed throughout the day, with each intake exceeding 25 g of protein favors anabolism of muscle proteins. Dietary supplements taken to enhance performance, such as caffeine, nitric oxide precursors, β-alanine, and certain sport foods supplements (such as CHOs, proteins, or their combination, and micronutrients in cases of nutritional deficiencies), may positively influence sports performance and/or the health status of female athletes and other physically active women. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD480674.
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Affiliation(s)
- Mar Larrosa
- Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Angel Gil-Izquierdo
- Research Group on Food and Nutrition (ALINUT), University of Alicante, 03690 Alicante, Spain
- Quality, Safety, and Bioactivity of Plant Foods Group, Department of Food Science and Technology, CEBAS-CSIC, University of Murcia, 30100 Murcia, Spain
| | - Liliana Guadalupe González-Rodríguez
- Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain
| | - María José Muñoz Alférez
- Department of Physiology (Faculty of Pharmacy, Cartuja University Campus), Institute of Nutrition and Food Technology "José Mataix", University of Granada, 18071 Granada, Spain
| | - Alejandro F San Juan
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences (INEF), Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Natalia Calvo-Ayuso
- Departamento de Enfermería y Fisioterapia, Campus de Ponferrada, Universidad de León, 24401 Ponferrada, Spain
| | - Juan José Ramos-Álvarez
- School of Sport Medicine, Department of Radiology, Rehabilitation and Physiotherapy, Complutense University Madrid, 28040 Madrid, Spain
| | - Diego Fernández-Lázaro
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Raúl Lopez-Grueso
- Facultad de Ciencias de la Salud, Universidad Isabel I, 09003 Burgos, Spain
| | - Inmaculada López-León
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Javier Moreno-Lara
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Diego Domínguez-Balmaseda
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Román Illescas-Quiroga
- Departamento de Enfermería y Fisioterapia, University of Alcala, 28805 Alcalá de Henares, Spain
| | - Eduardo Cuenca
- Academia de Guardias y Suboficiales de la Guardia Civil, 23440 Baeza, Spain
| | - Teba López
- Academia de Guardias y Suboficiales de la Guardia Civil, 23440 Baeza, Spain
| | - Juan José Montoya
- School of Sport Medicine, Department of Radiology, Rehabilitation and Physiotherapy, Complutense University Madrid, 28040 Madrid, Spain
| | - Daiana Priscila Rodrigues-de-Souza
- Departamento de Enfermería, Farmacología y Fisioterapia, 14004 Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - Elena Carrillo-Alvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences, University Ramon Llull, 08025 Barcelona, Spain
| | - Arturo Casado
- Centro de Investigación en Ciencias del Deporte, Universidad Rey Juan Carlos, 28943 Fuenlabrada, Spain
| | | | - Mireia Porta-Oliva
- Faculty of Food Technology, Autonomous University of Barcelona (UAB), Bellaterra, Spain
- FC Barcelona Medical Department, FC Barcelona, 08028 Barcelona, Spain
- Catalan School of Kinanthropometry, INEFC, 0838 Barcelona, Spain
| | - Catalina Santiago
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Támara Iturriaga
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Beatriz De Lucas
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | | | | | - Elvira Benítez De Gracia
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio, 28691 Villanueva de la Cañada, Spain
| | - Pablo Veiga-Herreros
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio, 28691 Villanueva de la Cañada, Spain
| | - Alejandro Muñoz-López
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Eva Orantes-Gonzalez
- Department of Sports and Computer Science, Faculty of Sports, University of Pablo de Olavide, 41013 Seville, Spain
| | | | - Ruth Cabeza-Ruiz
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Ángel Carnero-Diaz
- Departamento de Educación Física y Deportiva, University of Seville, 41013 Seville, Spain
| | - Isabel Sospedra
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | - José Miguel Martínez-Sanz
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | - Margarita Pérez
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences (INEF), Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Eduardo J Guerra-Hernández
- Departamento de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Granada, 18011 Granada, Spain
| | - Álvaro López-Samanes
- Faculty of Human and Social Sciences, Universidad Pontificia Comillas, 28049 Madrid, Spain
| | - Antonio Jesús Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, 37203-202 Lavras, Brazil
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, 37203-202 Lavras, Brazil
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Peng Y, Zhong Z, Huang C, Wang W. The effects of popular diets on bone health in the past decade: a narrative review. Front Endocrinol (Lausanne) 2024; 14:1287140. [PMID: 38665424 PMCID: PMC11044027 DOI: 10.3389/fendo.2023.1287140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/14/2023] [Indexed: 04/28/2024] Open
Abstract
Bone health encompasses not only bone mineral density but also bone architecture and mechanical properties that can impact bone strength. While specific dietary interventions have been proposed to treat various diseases such as obesity and diabetes, their effects on bone health remain unclear. The aim of this review is to examine literature published in the past decade, summarize the effects of currently popular diets on bone health, elucidate underlying mechanisms, and provide solutions to neutralize the side effects. The diets discussed in this review include a ketogenic diet (KD), a Mediterranean diet (MD), caloric restriction (CR), a high-protein diet (HP), and intermittent fasting (IF). Although detrimental effects on bone health have been noticed in the KD and CR diets, it is still controversial, while the MD and HP diets have shown protective effects, and the effects of IF diets are still uncertain. The mechanism of these effects and the attenuation methods have gained attention and have been discussed in recent years: the KD diet interrupts energy balance and calcium metabolism, which reduces bone quality. Ginsenoside-Rb2, metformin, and simvastatin have been shown to attenuate bone loss during KD. The CR diet influences energy imbalance, glucocorticoid levels, and adipose tissue, causing bone loss. Adequate vitamin D and calcium supplementation and exercise training can attenuate these effects. The olive oil in the MD may be an effective component that protects bone health. HP diets also have components that protect bone health, but their mechanism requires further investigation. In IF, animal studies have shown detrimental effects on bone health, while human studies have not. Therefore, the effects of diets on bone health vary accordingly.
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Affiliation(s)
- Yue Peng
- China Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zikang Zhong
- China Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Cheng Huang
- Department of Orthopaedic Surgery, China Japan Friendship Hospital, Beijing, China
| | - Weiguo Wang
- Department of Orthopaedic Surgery, China Japan Friendship Hospital, Beijing, China
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Active Women Across the Lifespan: Nutritional Ingredients to Support Health and Wellness. Sports Med 2022; 52:101-117. [PMID: 36173598 PMCID: PMC9521557 DOI: 10.1007/s40279-022-01755-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Women are the largest consumers of dietary supplements. Dietary supplements can play a role in health and performance, particularly for women. Growing evidence and innovations support the unique physiological and nutrient timing needs for women. Despite the need for more nutrition and exercise-specific research in women, initial data and known physiological differences between sexes related to the brain, respiration, bone, and muscle support new product development and evidence-based education for active women regarding the use of dietary supplements. In this narrative review, we discuss hormonal and metabolic considerations with the potential to impact nutritional recommendations for active women. We propose four potential areas of opportunity for ingredients to help support the health and well-being of active women, including: (1) body composition, (2) energy/fatigue, (3) mental health, and (4) physical health.
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Ooi DSQ, Ling JQR, Sadananthan SA, Velan SS, Ong FY, Khoo CM, Tai ES, Henry CJ, Leow MKS, Khoo EYH, Tan CS, Lee YS, Chong MFF. Branched-Chain Amino Acid Supplementation Does Not Preserve Lean Mass or Affect Metabolic Profile in Adults with Overweight or Obesity in a Randomized Controlled Weight Loss Intervention. J Nutr 2021; 151:911-920. [PMID: 33537760 DOI: 10.1093/jn/nxaa414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/18/2020] [Accepted: 12/01/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Branched-chain amino acid (BCAA) supplementation has been shown to increase muscle mass or prevent muscle loss during weight loss. OBJECTIVE We aimed to investigate the effects of a BCAA-supplemented hypocaloric diet on lean mass preservation and insulin sensitivity. METHODS A total of 132 Chinese adults (63 men and 69 women aged 21-45 y, BMI 25-36 kg/m2) were block randomly assigned by gender and BMI into 3 hypocaloric diet (deficit of 500 kcal/d) groups: standard-protein (14%) with placebo (control, CT) or BCAA supplements at 0.1 g · kg-1 body weight · d-1 (BCAA) or high-protein (27%) with placebo (HP). The subjects underwent 16 wk of dietary intervention with provision of meals and supplements, followed by 8 wk of weight maintenance with provision of supplements only. One-way ANOVA analysis was conducted to analyze the primary (lean mass and insulin sensitivity) and secondary outcomes (anthropometric and metabolic parameters) among the 3 groups. Paired t-test was used to analyze the change in each group. RESULTS The 3 groups demonstrated similar significant reductions in body weight (7.97%), fat mass (13.8%), and waist circumference (7.27%) after 16 wk of energy deficit. Lean mass loss in BCAA (4.39%) tended to be lower than in CT (5.39%) and higher compared with HP (3.67%) (P = 0.06). Calf muscle volume increased 3.4% in BCAA and intramyocellular lipids (IMCLs) decreased in BCAA (17%) and HP (18%) (P < 0.05) over 16 wk. During the 8 wk weight maintenance period, lean mass gain in BCAA (1.03%) tended to be lower compared with CT (1.58%) and higher than in HP (-0.002%) (P = 0.04). Lean mass gain differed significantly between CT and HP (P = 0.03). Insulin sensitivity and metabolic profiles did not differ among the groups throughout the study period. CONCLUSIONS BCAA supplementation does not preserve lean mass or affect insulin sensitivity in overweight and obese adults during weight loss. A higher protein diet may be more advantageous for lean mass preservation.
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Affiliation(s)
- Delicia S Q Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Jennifer Q R Ling
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Suresh Anand Sadananthan
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - S Sendhil Velan
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Fang Yi Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - E Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Melvin K S Leow
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore
| | - Eric Y H Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Mary F F Chong
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Hruby A, Jacques PF. Protein Intake and Human Health: Implications of Units of Protein Intake. Adv Nutr 2021; 12:71-88. [PMID: 32879937 PMCID: PMC7850043 DOI: 10.1093/advances/nmaa097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Understanding the health effects of protein intake is bedeviled by a number of factors, including protein quality and source. In addition, different units, including grams, grams per kilogram body weight (g/kg BW), and percent energy, may contribute to confusion about protein's effects on health, especially BW-based units in increasingly obese populations. We aimed to review the literature and to conduct a modeling demonstration of various units of protein intake in relation to markers of cardiometabolic health. Data from the Framingham Heart Study Offspring (n = 1847; 60.3 y; 62.5% women) and Third Generation (n = 2548; 46.2 y; 55.3% women) cohorts and the NHANES 2003-04 (n = 1625; 46.2 y; 49.7% women) and 2005-06 (n = 1347; 43.7 y; 49.5% women) cycles were used to model cross-sectional associations between 7 protein units (grams, percent energy, g/kg ideal BW, g/kg actual BW, BW-adjusted g/kg actual BW, g/kg lean BW, and g/kg fat-free BW) and 9 cardiometabolic outcomes (fasting glucose, systolic and diastolic blood pressure, total and HDL cholesterol, triglycerides, BMI, waist circumference, and estimated glomerular filtration rate). The literature review indicated the use of myriad units of protein intake, with differential results on cardiometabolic outcomes. The modeling demonstration showed units expressed in BW were confounded by BW, irrespective of outcome. Units expressed in grams, percent energy, and ideal BW showed similar results, with or without adjustment for body size. After adjusting for BW, results of units expressed in BW aligned with results of grams, percent energy, and ideal BW. In conclusion, protein intake in cardiometabolic health appears to depend on protein's unit of expression. Authors should be specific about the use of WHO (g/kg ideal BW) compared with US (g/kg actual BW) units, and ideally use gram or percent energy in observational studies. In populations where overweight/obesity are prevalent, intake based on actual BW should be reevaluated.
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Affiliation(s)
- Adela Hruby
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, MA, USA
| | - Paul F Jacques
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Nutritional Epidemiology, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Wawrzyniak N, Suliburska J. Nutritional and health factors affecting the bioavailability of calcium: a narrative review. Nutr Rev 2021; 79:1307-1320. [PMID: 33491051 DOI: 10.1093/nutrit/nuaa138] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Calcium is responsible for the effectiveness of various processes, and its supply in the diet is necessary for the normal function of the human body. Apart from being an important component of the skeleton, calcium also helps maintain the structure of cell organelles and regulates intracellular and extracellular fluid homeostasis. This review presents the nutritional and health factors that affect the bioavailability of calcium. Physiological conditions and factors such as pregnancy, infancy, menopause, old age, hormones, growth factors associated with calcium metabolism, diseases limiting its absorption, and intestinal microbiota are distinguished among endogenous factors. Although the calcium supply in the body is genetically conditioned and specific to each person, its qualitative and quantitative composition can be modified by external factors. The exogenous factors include dietary modifications with particular nutrients and pharmacological treatment. Adequate calcium levels increase bone protection and prevent osteoporosis, a disease involving low mineral bone mass.
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Affiliation(s)
- Natalia Wawrzyniak
- N. Wawrzyniak and J. Suliburska are with the Department of Human Nutrition and Dietetics, Faculty of Food and Nutrition Science, Poznań University of Life Sciences, Poznań, Poland
| | - Joanna Suliburska
- N. Wawrzyniak and J. Suliburska are with the Department of Human Nutrition and Dietetics, Faculty of Food and Nutrition Science, Poznań University of Life Sciences, Poznań, Poland
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Antonio J, Candow DG, Forbes SC, Ormsbee MJ, Saracino PG, Roberts J. Effects of Dietary Protein on Body Composition in Exercising Individuals. Nutrients 2020; 12:E1890. [PMID: 32630466 PMCID: PMC7353221 DOI: 10.3390/nu12061890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/26/2022] Open
Abstract
Protein is an important component of a healthy diet and appears to be integral to enhancing training adaptations in exercising individuals. The purpose of this narrative review is to provide an evidence-based assessment of the current literature examining increases in dietary protein intake above the recommended dietary allowance (RDA: 0.8 g/kg/d) in conjunction with chronic exercise on body composition (i.e., muscle, fat and bone). We also highlight acute and chronic pre-sleep protein studies as well as the influence of exercise timing on body composition. Overall, a high-protein diet appears to increase muscle accretion and fat loss and may have beneficial effects on bone when combined with exercise. Pre-sleep protein is a viable strategy to help achieve total daily protein goals. Importantly, there appears to be no deleterious effects from a high-protein diet on muscle, fat or bone in exercising individuals.
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Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL 33314, USA
| | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada;
| | - Scott C. Forbes
- Faculty of Education, Department of Physical Education, Brandon University, Brandon, MB R7A6A9, Canada;
| | - Michael J. Ormsbee
- Department of Nutrition, Food & Exercise Sciences, Institute of Sports Sciences & Medicine, Florida State University, Tallahassee, FL 32313, USA; (M.J.O.); (P.G.S.)
- Discipline of Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Patrick G. Saracino
- Department of Nutrition, Food & Exercise Sciences, Institute of Sports Sciences & Medicine, Florida State University, Tallahassee, FL 32313, USA; (M.J.O.); (P.G.S.)
| | - Justin Roberts
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB11PT, UK;
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The Effects of a High-Protein Diet on Bone Mineral Density in Exercise-Trained Women: A 1-Year Investigation. J Funct Morphol Kinesiol 2018; 3:jfmk3040062. [PMID: 33466990 PMCID: PMC7737008 DOI: 10.3390/jfmk3040062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022] Open
Abstract
The effects of long-term high-protein consumption (i.e., >2.2 g/kg/day) are unclear as it relates to bone mineral content. Thus, the primary endpoint of this investigation was to determine if consuming a high-protein diet for one year affected various parameters of body composition in exercise-trained women. This investigation is a follow-up to a prior 6-month study. Subjects were instructed to consume a high-protein diet (>2.2 g/kg/day) for one year. Body composition was assessed via dual-energy X-ray absorptiometry (DXA). Subjects were instructed to keep a food diary (i.e., log their food ~three days per week for a year) via the mobile app MyFitnessPal®. Furthermore, a subset of subjects had their blood analyzed (i.e., basic metabolic panel). Subjects consumed a high-protein diet for one year (mean ± SD: 2.3 ± 1.1 grams per kilogram body weight daily [g/kg/day]). There were no significant changes for any measure of body composition over the course of the year (i.e., body weight, fat mass, lean body mass, percent fat, whole body bone mineral content, whole body T-score, whole body bone mineral density, lumbar bone mineral content, lumbar bone mineral density and lumbar T-score). In addition, we found no adverse effects on kidney function. Based on this 1-year within-subjects investigation, it is evident that a diet high in protein has no adverse effects on bone mineral density or kidney function.
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Abstract
The United States (US) recommended dietary allowance (RDA) for protein is 0.8 grams per kilogram body weight per day (g/kg/d). The International Society of Sports Nutrition (ISSN) recently recommended an intake of 1.4-2.0 g/kg/d whereas the United States and Canadian Dietetic Association typically recommend a lower range of 1.2 to 1.7 g/kg/d. It is clear that the US RDA for protein is grossly inadequate for exercising individuals; thus, athletes are typically advised to consume twice the RDA. This falls within the range commonly recommended by academic societies. The effect of protein consumption that exceeds these aforementioned guidelines is not entirely known. This review examines the current literature as it pertains to the influence of very high protein intakes in trained individuals (i.e., humans). It is the scientific opinion of the author that athletes should consume at least 2.2 g/kg/d of protein.
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Affiliation(s)
- Jose Antonio
- a Department of Health and Human Performance , Nova Southeastern University , Davie , FL , USA
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12
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Agostini D, Zeppa Donati S, Lucertini F, Annibalini G, Gervasi M, Ferri Marini C, Piccoli G, Stocchi V, Barbieri E, Sestili P. Muscle and Bone Health in Postmenopausal Women: Role of Protein and Vitamin D Supplementation Combined with Exercise Training. Nutrients 2018; 10:nu10081103. [PMID: 30115856 PMCID: PMC6116194 DOI: 10.3390/nu10081103] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/11/2018] [Accepted: 08/13/2018] [Indexed: 12/25/2022] Open
Abstract
Menopause is an age-dependent physiological condition associated with a natural decline in oestrogen levels, which causes a progressive decrease of muscle mass and strength and bone density. Sarcopenia and osteoporosis often coexist in elderly people, with a prevalence of the latter in elderly women. The profound interaction between muscle and bone induces a negative resonance between the two tissues affected by these disorders worsening the quality of life in the postmenopausal period. It has been estimated that at least 1 in 3 women over age 50 will experience osteoporotic fractures, often requiring hospitalisation and long-term care, causing a large financial burden to health insurance systems. Hormonal replacement therapy is effective in osteoporosis prevention, but concerns have been raised with regard to its safety. On the whole, the increase in life expectancy for postmenopausal women along with the need to improve their quality of life makes it necessary to develop specific and safe therapeutic strategies, alternative to hormonal replacement therapy, targeting both sarcopenia and osteoporosis progression. This review will examine the rationale and the effects of dietary protein, vitamin D and calcium supplementation combined with a specifically-designed exercise training prescription as a strategy to counteract these postmenopausal-associated disorders.
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Affiliation(s)
- Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Sabrina Zeppa Donati
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Marco Gervasi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giovanni Piccoli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Vilberto Stocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
- Interuniversity Institute of Myology (IIM), University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Piero Sestili
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
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13
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Abstract
Bone health is determined by the rate of accrual in early life, followed by the rate of age-associated bone loss. Dietary protein intake might have a role in bone health across both of these phases via pleiotropic mechanistic pathways. Herein we summarise the pathways through which protein may exert either a positive or negative influence on bone. In the introduction, we describe the acid-ash hypothesis, which states that a high-protein intake may lead to an acidic residue that must be neutralised through the leaching of calcium and other minerals from the bone, subsequently leading to demineralisation and bone weakening. Conversely, and as described in the 'Against: mechanisms through which protein may negatively impact bone' section, protein intake may act to strengthen the bone by stimulating the activity of various anabolic hormones and growth factors, or by optimising muscle mass and functionality, which itself has an osteogenic influence. The net effect of these contrasting pathways is described in the 'For: mechanisms through which protein may positively impact bone' section, where a number of meta-analyses have demonstrated that higher protein intakes have a small positive impact on bone mass and fracture risk. Sometimes higher than recommended protein intakes are advised, e.g. during the earlier and later phases of the lifespan or during reduced energy availability. We conclude that protein is an essential nutrient for bone health, although further research is required to clarify the mechanistic pathways through which it exerts its influence, along with the clarification of the quantities, food sources and timing to allow for the optimisation of this protective influence and ultimately a reduction in fracture risk.
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