Nutrition to Support Recovery from Endurance Exercise

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.

Alcalase-Assisted Mytilus edulis Hydrolysate: A Nutritional Approach for Recovery from Muscle Atrophy

Muscle atrophy is a complex physiological condition caused by a variety of reasons, including muscle disuse, aging, malnutrition, chronic diseases, immobilization, and hormonal imbalance. Beyond its effect on physical appearance, this condition significantly reduces the quality of human life, thus warranting the development of preventive strategies. Although exercising is effective in managing this condition, it is applicable only for individuals who can engage in physical activities and are not bedridden. A combination of exercise and nutritional supplementation has emerged as a more advantageous approach. Here, we evaluated the effects of enzyme-assisted hydrolysates of Mytilus edulis prepared using Protamex (PMH), Alcalase (AMH), or Flavourzyme (FMH) in protecting against muscle atrophy in a dexamethasone (Dex)-induced muscular atrophy model in vitro and in vitro. Alcalase-assisted M. edulis hydrolysate (AMH) was the most efficient among the tested treatments and resulted in higher protein recovery (57.06 ± 0.42%) and abundant amino acid composition (43,158 mg/100 g; 43.16%). AMH treatment also escalated the proliferation of C2C12 cells while increasing the total number of nuclei, myotube coverage, and myotube diameter. These results were corroborated by a successful reduction in the levels of proteins responsible for muscle atrophy, including E3 ubiquitin ligases, and an increase in the expression of proteins associated with muscle hypertrophy, including myogenin and MyHC. These results were further solidified by the successful enhancement of locomotor ability and body weight in zebrafish following AMH treatment. Thus, these findings highlight the potential of AMH in recovery from muscle atrophy.

Potential health risks of foodborne performance-enhancing drugs in competitive sports

Athletes need to consume a significant amount of energy during prolonged training and in high-intensity competition. It is necessary for them to take nutritional foods that recharge their bodies. However, in sporting events of recent years, both domestic and international, many positive drug tests are found to be caused by the ingestion of foods that contain performance-enhancing drugs (PEDs). As a result, the prevention and control of PEDs in food supply have drawn increasing attention. For better prevention and control, the first step is to understand the food contaminants -- PEDs. This study has categorized PEDs through their presence in animal-derived foods, plant-derived foods, and synthetic nutritional supplements in competitive sports. It investigates the potential risks of foodborne doping using techniques such as external addition and endogenous component analysis. This research explored the causes of PEDs in food and their negative effects on athletes and proposed measures to ensure the safety of nutritional substances in competitive sports. PEDs in animal-derived foods include β-adrenergic agonists, anabolic steroids, and glucocorticoids, which can be found in meat and ox penis, amongst other food sources. In contrast, PEDs in plant-derived foods include alkaloids, higenamine, and zeranol, which can be found in coffee, tea, Sichuan pepper, custard apple, and cereal. Performance-enhancing drugs (PEDs) that are often added to synthetic supplements include creatine, traditional Chinese herbs, 1, 3-dimethylbutylamine (DMAA), sibutramine, ephedrine, and methylhexanamine. Targeted anti-doping training should be provided to athletes. In addition, the latest domestic and international standards and regulations regarding PEDs or prohibited and restricted ingredients in foods should be tracked in real-time. The control list for performance-enhancing drugs in food should be continually updated and refined. Research on detection methods for performance-enhancing drugs in food should also be advanced. Moreover, market surveillance and law enforcement should be strengthened to ensure that sports foods meet national safety standards before they enter the market. This paper provides workable solutions to clarify the types and scope of performance-enhancing drugs in food, aiming to improve the prevention and control of PEDs in animal-derived foods, plant-derived foods, and supplements in major sporting events.

Effectiveness of current protein recommendations in adolescent athletes on a low-carbon diet

Adolescent athletes require adequate energy and nutrient supply to support growth, development, and the demands associated with exercise and training. However, they are susceptible to nutritional inadequacies affecting their health and physical performance. Food choices with nutrient adequacy and environmental protection is crucial for a sustainable diet. Therefore, we aimed to assess the adequacy of low-carbon diets to meet the protein requirements of adolescent athletes. Therefore, a cross-sectional observational study was conducted with 91 adolescent athletes from sports clubs in Rio de Janeiro who underwent anthropometric and food consumption assessments. To estimate the environmental impact of anthropogenic activities, the sustainability indicators carbon footprint (CF) and water footprint (WF) were used. The CF of the athlete's diet was compared with the benchmark of 1,571 g CO2eq/cap/d estimated by the World Wildlife Fund (WWF). Protein recommendations according to the American Dietetic Association (ADA) for athletes and protein food groups according to the low-carbon EAT-Lancet reference diet were used as references. The results were stratified by sport modality, age, sex, and income range. The Mann-Whitney test was performed, followed by the Kruskal-Wallis test with Dunn's post-hoc test to assess the differences between groups using the statistical program GraphPad PRISM® version 8.0. CF and WF were directly associated with total energy intake, total protein intake, animal-origin protein intake, and the food groups of meat and eggs. Significant differences were observed in the environmental impact of diet based on sports groups and gender. The athletes' profile with higher environmental impact was male, middle-income class, and of any age group. The quartiles of CF of the overall diets were above the 1,571 g CO2eq/cap/d benchmark. Additionally, ADA's recommended range of daily protein consumption was met by most athletes, even in the lowest quartile of CF. Thus, a diet with a lower environmental impact can meet protein recommendations in adolescent athletes. The results found are of interest to the sports and food industries. It could help in designing a balanced diet for athletes as well as ensure less negative environmental impacts of food production and consumption.

Continuous Glucose Monitoring in Healthy Adults—Possible Applications in Health Care, Wellness, and Sports

Introduction: Continuous glucose monitoring (CGM) systems were primarily developed for patients with diabetes mellitus. However, these systems are increasingly being used by individuals who do not have diabetes mellitus. This mini review describes possible applications of CGM systems in healthy adults in health care, wellness, and sports. Results: CGM systems can be used for early detection of abnormal glucose regulation. Learning from CGM data how the intake of foods with different glycemic loads and physical activity affect glucose responses can be helpful in improving nutritional and/or physical activity behavior. Furthermore, states of stress that affect glucose dynamics could be made visible. Physical performance and/or regeneration can be improved as CGM systems can provide information on glucose values and dynamics that may help optimize nutritional strategies pre-, during, and post-exercise. Conclusions: CGM has a high potential for health benefits and self-optimization. More scientific studies are needed to improve the interpretation of CGM data. The interaction with other wearables and combined data collection and analysis in one single device would contribute to developing more precise recommendations for users.

Coffee Increases Post-Exercise Muscle Glycogen Recovery in Endurance Athletes: A Randomized Clinical Trial

Coffee is one of the most widely consumed beverages worldwide and caffeine is known to improve performance in physical exercise. Some substances in coffee have a positive effect on glucose metabolism and are promising for post-exercise muscle glycogen recovery. We investigated the effect of a coffee beverage after exhaustive exercise on muscle glycogen resynthesis, glycogen synthase activity and glycemic and insulinemic response in a double-blind, crossover, randomized clinical trial. Fourteen endurance-trained men performed an exhaustive cycle ergometer exercise to deplete muscle glycogen. The following morning, participants completed a second cycling protocol followed by a 4-h recovery, during which they received either test beverage (coffee + milk) or control (milk) and a breakfast meal, with a simple randomization. Blood samples and muscle biopsies were collected at the beginning and by the end of recovery. Eleven participants were included in data analysis (age: 39.0 ± 6.0 years; BMI: 24.0 ± 2.3 kg/m²; VO_2max: 59.9 ± 8.3 mL·kg⁻¹·min⁻¹; PPO: 346 ± 39 W). The consumption of coffee + milk resulted in greater muscle glycogen recovery (102.56 ± 18.75 vs. 40.54 ± 18.74 mmol·kg dw⁻¹; p = 0.01; d = 0.94) and greater glucose (p = 0.02; d = 0.83) and insulin (p = 0.03; d = 0.76) total area under the curve compared with control. The addition of coffee to a beverage with adequate amounts of carbohydrates increased muscle glycogen resynthesis and the glycemic and insulinemic response during the 4-h recovery after exhaustive cycling exercise.

β-glucan, "the knight of health sector": critical insights on physiochemical heterogeneities, action mechanisms and health implications

β-glucans, the class of biological response modifier has unceasing attention, not only for its immune stimulating but also for its role as prebiotics, modulator of physiological events etc. and is widely used in the treatment of cancer, diabetes, gastrointestinal disorders, cardiovascular diseases etc. However, β-glucan with different physiochemical properties is found to have discrete clinical functions and thus careful selection of the types of β-glucan plays pivotal role in providing significant and expected clinical outcome. Herein this review, we presented the factors responsible for diverse functional properties of β-glucan, their distinct mode of actions in regulating human health etc. Further, clinical aspects of different β-glucans toward the management of wound care, metabolic dysbiosis, fatty liver disorders and endurance training associated energy metabolism were compiled and exhibited in detail.

The importance of protein intake in master marathon runners

OBJECTIVES

The aim of this study was to investigate the relationships between protein intake (during the tapering period and the race), marathon performance, body composition, acute race-induced changes, and selected metabolic- and muscle damage-related blood biomarkers in recreational master runners.

METHODS

In 58 experienced master runners (58.28 y ± 1.07 y, 174.06 cm ± 0.72 cm, 78.51 kg ± 0.76 kg body mass, 21.38% ± 0.52% body fat, mean ± SEM), nutritional intake was evaluated 1 wk before the race and during the marathon. Body composition was evaluated before and 2 h after the race. Blood samples were collected at the same time points.

RESULTS

Body fat and lean body mass (LBM) were significantly reduced after the marathon (P < 0.01; η²: 0.311-0.888). Significant negative correlations were observed between energy intake from carbohydrates and proteins (expressed per LBM), marathon performance, and race-induced changes of blood metabolic-muscle damage indices (P < 0.05; r: -0.522 to -0.789). Positive correlations were observed between energy from carbohydrates and proteins per LBM, and body mass and LBM changes (P < 0.05; r: 0.485-0.814). The specific contribution of protein intakes per LBM (beta coefficient: -0.789 to 0.615) on race-induced changes of body composition and blood markers was the same as that of carbohydrate intakes per LBM (beta coefficient: -0.777 to 0.559).

CONCLUSIONS

Marathon-induced changes in body composition and metabolic blood indices are highly related to protein intake, either during the tapering period or during the race, with runners experiencing the lowest changes when consuming higher protein intakes.

Protein Timing Does Not Affect Next-Day Recovery of Strength or Power but May Enhance Aerobic Adaptations to Short-Term Variable Intensity Exercise Training in Recreationally Active Males: A Pilot Study

Background: Variable intensity training (VIT) characteristic of stop-and-go team sport exercise may reduce performance capacity when performed on successive days but also represent a strategy to induce rapid training-induced increases in exercise capacity. Although post-exercise protein enhances muscle protein synthesis, the timing of protein ingestion following variable intensity training (VIT) on next-day recovery and short-term performance adaptation is unknown. Purpose: To determine if immediate (IMM) as compared to delayed (DEL) protein ingestion supports greater acute recovery of exercise performance during successive days of VIT and/or supports chronic training adaptations. Methods: Sixteen habitually active men performed 5 consecutive days of variable intensity training (VIT) in the evening prior to consuming a beverage providing carbohydrate and whey protein (IMM; 0.7 g and 0.3 g/kg, respectively) or carbohydrates alone (DEL; 1 g/kg) with the reciprocal beverage consumed the following morning. Performance was assessed before each VIT (recovery) and 2 days after the final VIT (adaptation). Results: Five consecutive days of VIT progressively decreased anaerobic peak power (~7%) and muscle strength (MVC; ~8%) with no impact of protein timing. Following 2 days of recovery, VIT increased maximal voluntary contraction and predicted VO_2peak by ~10 and ~5%, respectively, with a moderate beneficial effect of IMM on predicted VO_2peak (ES = 0.78). Conclusion: Successive days of simulated team sport exercise decreases markers of next-day performance capacity with no effect of protein timing on acute recovery. However, practical VIT increases muscle strength and aerobic capacity in as little as 5 days with the latter potentially enhanced by immediate post-exercise protein consumption.

Sensory Analysis of Post-Exercise Coffee or Cocoa Milk Beverages for Endurance Athletes

Beverage strategies with balanced carbohydrate and protein supply are important for athletes’ recovery. Cow’s milk with added bioactive compounds present in coffee and cocoa facilitates glucose metabolism and may help post-workout glycogen recovery. Home-prepared beverages are cost and nutritionally effective strategies. Thus, the objectives were: (1) To develop home-prepared beverages containing nonfat powdered milk and sugar combined with filtered coffee or cocoa powder in balanced amounts for recovery after endurance exercise; and (2) to perform sensory analysis. Sensory evaluation was conducted by an acceptance test, applying nine-point hedonic scale and descriptive analysis, using the check-all-that-apply method (CATA). McNemar’s test and logistic regression with the proportional odds model were employed. The sample included 44 triathletes and 56 runners, of both sexes, 31–70 years old. Both beverages were well accepted by runners and triathletes, with higher acceptance of the coffee beverage (odds ratio coffee vs cocoa 5.232, p=0.0038). There was no significant difference between acceptance of triathletes and runners for the two beverages. The descriptive sensory analysis (CATA) resulted in slightly different characterizations between the two beverages. Both beverages were well accepted and characterized by the athletes, who can supply different options of post-workout beverages according to individual tastes, composition, and characteristics.

The Effect of Athletes' Probiotic Intake May Depend on Protein and Dietary Fiber Intake

Studies investigating exercise-induced gut microbiota have reported that people who exercise regularly have a healthy gut microbial environment compared with sedentary individuals. In contrast, recent studies have shown that high protein intake without dietary fiber not only offsets the positive effect of exercise on gut microbiota but also significantly lowers the relative abundance of beneficial bacteria. In this study, to resolve this conundrum and find the root cause, we decided to narrow down subjects according to diet. Almost all of the studies had subjects on an ad libitum diet, however, we wanted subjects on a simplified diet. Bodybuilders who consumed an extremely high-protein/low-carbohydrate diet were randomly assigned to a probiotics intake group (n = 8) and a placebo group (n = 7) to find the intervention effect. Probiotics, comprising Lactobacillus acidophilus, L. casei, L. helveticus, and Bifidobacterium bifidum, were consumed for 60 days. As a result, supplement intake did not lead to a positive effect on the gut microbial environment or concentration of short-chain fatty acids (SCFAs). It has been shown that probiotic intake is not as effective as ergogenic aids for athletes such as bodybuilders with extreme dietary regimens, especially protein and dietary fiber. To clarify the influence of nutrition-related factors that affect the gut microbial environment, we divided the bodybuilders (n = 28) into groups according to their protein and dietary fiber intake and compared their gut microbial environment with that of sedentary male subjects (n = 15). Based on sedentary Korean recommended dietary allowance (KRDA), the bodybuilders′ intake of protein and dietary fiber was categorized into low, proper, and excessive groups, as follows: high-protein/restricted dietary fiber (n = 12), high-protein/adequate dietary fiber (n = 10), or adequate protein/restricted dietary fiber (n = 6). We found no significant differences in gut microbial diversity or beneficial bacteria between the high-protein/restricted dietary fiber and the healthy sedentary groups. However, when either protein or dietary fiber intake met the KRDA, gut microbial diversity and the relative abundance of beneficial bacteria showed significant differences to those of healthy sedentary subjects. These results suggest that the positive effect of exercise on gut microbiota is dependent on protein and dietary fiber intake. The results also suggest that the question of adequate nutrition should be addressed before supplementation with probiotics to derive complete benefits from the intervention.

The effect of low dose marine protein hydrolysates on short-term recovery after high intensity performance cycling: a double-blinded crossover study

Background

Knowledge of the effect of marine protein hydrolysate (MPH) supplementation to promote recovery after high intensity performance training is scarce. The aim of this study was to examine the effect of MPH supplementation to whey protein (WP) and carbohydrate (CHO): (CHO-WP-MPH), on short-term recovery following high intensity performance, compared to an isoenergetic and isonitrogenous supplement of WP and CHO: (CHO-WP), in male cyclists.

Methods

This was a double-blinded crossover study divided into three phases. Fourteen healthy men participated. In phase I, an incremental bicycle exercise test was performed for establishment of intensities used in phase II and III. In phase II (9–16 days after phase 1), the participants performed first one high intensity performance cycling session, followed by nutrition supplementation (CHO-WP-MPH or CHO-WP) and 4 hours of recovery, before a subsequent high intensity performance cycling session. Phase III (1 week after phase II), was similar to phase II except for the nutrition supplementation, where the participants received the opposite supplementation compared to phase II. Primary outcome was difference in time to exhaustion between the cycling sessions, after nutrition supplementations containing MPH or without MPH. Secondary outcomes were differences in heart rate (HR), respiratory exchange ratio (RER), blood lactate concentration and glucose.

Results

The mean age of the participants was 45.6 years (range 40–58). The maximal oxygen uptake (mean ± SD) measured at baseline was 54.7 ± 4.1 ml∙min^− 1∙kg^− 1. There were no significant differences between the two nutrition supplementations measured by time to exhaustion at the cycling sessions (mean_diff = 0.85 min, p = 0.156, 95% confidence interval (CI), − 0.37, 2.06), HR (mean_diff = 0.8 beats pr.min, p = 0.331, 95% CI, − 0.9, 2.5), RER (mean_diff = − 0.05, p = 0.361, 95% CI -0.07 – 0.17), blood lactate concentration (mean_diff = − 0.24, p = 0.511, 95% CI, − 1.00, 0.53) and glucose (mean_diff = 0.23, p = 0.094, 95% CI, − 0.05, 0.51).

Conclusions

A protein supplement with MPH showed no effects on short-term recovery in middle-aged healthy male cyclists compared to a protein supplement without MPH.

Trial registration

The study was registered 02.05.2017 at ClinicalTrials.gov (Protein Supplements to Cyclists, NCT03136133, https://clinicaltrials.gov/ct2/show/NCT03136133?cond=marine+peptides&rank=1.

Whey Protein Hydrolysate Increases Amino Acid Uptake, mTORC1 Signaling, and Protein Synthesis in Skeletal Muscle of Healthy Young Men in a Randomized Crossover Trial

BACKGROUND

Muscle protein synthesis (MPS) can be stimulated by ingestion of protein sources, such as whey, casein, or soy. Protein supplementation can enhance muscle protein synthesis after exercise and may preserve skeletal muscle mass and function in aging adults. Therefore, identifying protein sources with higher anabolic potency is of high significance.

OBJECTIVE

The aim of this study was to determine the anabolic potency and efficacy of a novel whey protein hydrolysate mixture (WPH) on mechanistic target of rapamycin complex 1 (mTORC1) signaling and skeletal MPS in healthy young subjects.

METHODS

Ten young men (aged 28.7 ± 3.6 y, 25.2 ± 2.9 kg/m2 body mass index [BMI]) were recruited into a double-blind two-way crossover trial. Subjects were randomized to receive either 0.08 g/kg of body weight (BW) of WPH or an intact whey protein (WHEY) mixture during stable isotope infusion experiments. Fractional synthetic rate, leucine and phenylalanine kinetics, and markers of amino acid sensing were assessed as primary outcomes before and 1-3 h after protein ingestion using a repeated measures mixed model.

RESULTS

Blood leucine concentration, delivery of leucine to muscle, transport of leucine from blood into muscle and intracellular muscle leucine concentration significantly increased to a similar extent 1 h after ingestion of both mixtures (P < 0.05). Phosphorylation of S6K1 (i.e. a marker of mTORC1 activation) increased equally by ∼20% 1-h postingestion (P < 0.05). Ingestion of WPH and WHEY increased mixed MPS similarly in both groups by ∼43% (P < 0.05); however, phenylalanine utilization for synthesis increased in both treatments 1-h postingestion but remained elevated 3-h postingestion only in the WPH group (P < 0.05).

CONCLUSIONS

We conclude that a small dose of WPH effectively increases leucine transport into muscle, activating mTORC1 and stimulating MPS in young men. WPH anabolic potency and efficacy for promoting overall muscle protein anabolism is similar to WHEY, an intact protein source. This trial was registered at clinicaltrials.gov as NCT03313830.

Cherry Gel Supplementation Does Not Attenuate Subjective Muscle Soreness or Alter Wellbeing Following a Match in a Team of Professional Rugby Union players: A Pilot Study

This study examined the effects of sour tart cherry juice (TC) on muscle soreness (MS) and wellbeing following a rugby union match in professional players. In a crossover design, 10 players from a senior squad in the top tier of England consumed either 2 × 30 mL servings of TC or an isocaloric cherry-flavoured control gel (CON) two days before, the day of, and two days following an 80 min match. Subjective wellbeing and MS were measured before the match (Pre), and for three days following the match (M+1, M+2, and M+3, respectively). MS was elevated from Pre at M+1 (CON, 111 ± 37 mm vs. TC 94 ± 41 mm) and M+2 (CON, 81 ± 35 mm vs. TC 72 ± 36 mm) (time effect; p = 0.0001; ηp² = 0.821) but there were no differences between TC and CON at either time point post-exercise (p = 0.807; ηp² = 0.035). Wellness scores were ~15% lower at M+1 (p = 0.023; ηp² = 0.638) but there were no differences between the two conditions at any time point (p = 0.647; ηp² = 0.160). In conclusion, tart cherry juice did not attenuate soreness or alter wellbeing in a team of professional rugby union players following a competitive match.

Muscle and intestinal damage in triathletes

The aim of the paper was to assess indicators of muscle and intestinal damage in triathletes. The study involved 15 triathletes whose objective for the season was to start in the XTERRA POLAND 2017 event (1,500-m swimming, 36-km cycling, and 10-km mountain running). Before the 14-week preparatory period, the competitors’ body composition was measured, aerobic capacity was tested (graded treadmill test) and blood samples were collected to determine markers showing the level of muscle and intestinal damage. Subsequent tests for body composition were carried out before and after the competition. Blood samples for biochemical indicators were collected the day before the competition, after the completed race, and 24 and 48 hours later. A significant decrease in body mass was observed after completing the race (–3.1±1.5%). The mean maximal oxygen uptake level among the studied athletes equalled 4.9±0.4 L·min^–1, 58.8±4.5 mL·kg^–1·min^–1. The significant increase in concentrations of cortisol, c-reactive protein and myoglobin after the competition, significantly correlated with the significant increase in zonulin concentration (post 1h: r = 0.88, p = 0.007, r = 0,79, p = 0.001, r = 0.78, p = 0.001, and post 12h: r = 0.75, p = 0.01, r = 0.71, p = 0.011, r = 0.83, p = 0.02). No significant changes in the concentration of tumour necrosis factor alpha among the examined competitors were noted at following stages of the study. The results of our research showed that in order to monitor overload in the training of triathletes, useful markers reflecting the degree of muscle and intestinal damage include cortisol, testosterone, testosterone to cortisol ratio, c-reactive protein, myoglobin and zonulin. Changes in muscle cell damage markers strongly correlated with changes in zonulin concentration at particular stages of the study. Thus, one can expect that the concentrations of markers depicting the level of muscle cell damage after an intense and long-lasting effort will significantly influence the level of the intestinal barrier.

Whole-body net protein balance plateaus in response to increasing protein intakes during post-exercise recovery in adults and adolescents

Background

Muscle protein synthesis and muscle net balance plateau after moderate protein ingestion in adults. However, it has been suggested that there is no practical limit to the anabolic response of whole-body net balance to dietary protein. Moreover, limited research has addressed the anabolic response to dietary protein in adolescents. The present study determined whether whole-body net balance plateaued in response to increasing protein intakes during post-exercise recovery and whether there were age- and/or sex-related dimorphisms in the anabolic response.

Methods

Thirteen adults [7 males (M), 6 females (F)] and 14 adolescents [7 males (AM), 7 females (AF) within ~ 0.4 y from peak height velocity] performed ~ 1 h variable intensity exercise (i.e., Loughborough Intermittent Shuttle Test) prior to ingesting hourly mixed meals that provided a variable amount of protein (0.02-0.25 g·kg^- 1·h^- 1) as crystalline amino acids modeled after egg protein. Steady-state protein kinetics were modeled noninvasively with oral L-[1-¹³C]phenylalanine. Breath and urine samples were taken at plateau to determine phenylalanine oxidation and flux (estimate of protein breakdown), respectively. Whole-body net balance was determined by the difference between protein synthesis (flux - oxidation) and protein breakdown. Total amino acid oxidation was estimated from the ratio of urinary urea/creatinine.

Results

Mixed model biphasic linear regression explained a greater proportion of net balance variance than linear regression (all, r ² ≥ 0.56; P < 0.01), indicating an anabolic plateau. Net balance was maximized at ~ 0.15, 0.12, 0.12, and 0.11 g protein·kg^- 1·h^- 1 in M, F, AM, and AF, respectively. When collapsed across age, the y-intercept (net balance at very low protein intake) was greater (overlapping CI did not contain zero) in adolescents vs. adults. Urea/creatinine excretion increased linearly (all, r ≥ 0.76; P < 0.01) across the range of protein intakes. At plateau, net balance was greater (P < 0.05) in AM vs. M.

Conclusions

Our data suggest there is a practical limit to the anabolic response to protein ingestion within a mixed meal and that higher intakes lead to deamination and oxidation of excess amino acids. Consistent with a need to support lean mass growth, adolescents appear to have greater anabolic sensitivity and a greater capacity to assimilate dietary amino acids than adults.

Fluid, energy, and nutrient recovery via ad libitum intake of different commercial beverages and food in female athletes

This study investigated the effect of consuming different commercial beverages with food ad libitum after exercise on fluid, energy, and nutrient recovery in trained females. On 4 separate occasions, 8 females (body mass (BM): 61.8 ± 10.7 kg; maximal oxygen uptake: 46.3 ± 7.5 mL·kg^-1·min^-1) lost 2.0% ± 0.3% BM cycling at ∼75% maximal oxygen uptake before completing a 4-h recovery period with ad libitum access to 1 of 4 beverages: Water, Powerade (Sports Drink), Up & Go Reduced Sugar (Lower Sugar (LS)-MILK) or Up & Go Energize (Higher Protein (HP)-MILK). Participants also had two 15-min opportunities to access food within the first 2 h of the recovery period. Beverage intake, total water/nutrient intake, and indicators of fluid recovery (BM, urine output, plasma osmolality), gastrointestinal tolerance and palatability were assessed periodically. While total water intake (from food and beverage) (Water: 1918 ± 580 g; Sports Drink: 1809 ± 338 g; LS-MILK: 1458 ± 431 g; HP-MILK: 1523 ± 472 g; p = 0.010) and total urine output (Water: 566 ± 314 g; Sports Drink: 459 ± 290 g; LS-MILK: 220 ± 53 g; HP-MILK: 230 ± 117 g; p = 0.009) differed significantly by beverage, the quantity of ingested water retained was similar across treatments (Water: 1352 ± 462 g; Sports Drink: 1349 ± 407 g; LS-MILK: 1238 ± 400 g; HP-MILK: 1293 ± 453 g; p = 0.691). Total energy intake (from food and beverage) increased in proportion to the energy density of the beverage (Water: 4129 ± 1080 kJ; Sports Drink: 5167 ± 643 kJ; LS-MILK: 6019 ± 1925 kJ; HP-MILK: 7096 ± 2058 kJ; p = 0.014). When consumed voluntarily and with food, different beverages promote similar levels of fluid recovery, but alter energy/nutrient intakes. Providing access to food and understanding the longer-term dietary goals of female athletes are important considerations when recommending a recovery beverage.

Effects of Coffee Components on Muscle Glycogen Recovery: A Systematic Review

Coffee is one of the most consumed beverages in the world, and it can improve insulin sensitivity, stimulating glucose uptake in skeletal muscle when adequate carbohydrate intake is observed. The aim of this review is to analyze the effects of coffee and coffee components on muscle glycogen metabolism. A literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and seven studies were included, that explored the effects of coffee components on various substances and signaling proteins. In one of the studies with humans, caffeine was shown to increase glucose levels, Ca²⁺/calmodulin-dependent protein kinase phosphorylation, glycogen resynthesis rates, and glycogen accumulation after exercise. After intravenous injection of caffeine in rats, caffeine increased adenosine monophosphate-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylation, and glucose transport. In in vitro studies, caffeine raised AMPK and ACC phosphorylation, increasing glucose transport activity and reducing energy status in rat muscle cells. Cafestol and caffeic acid increased insulin secretion in rat beta cells and glucose uptake into human muscle cells. Caffeic acid also increased AMPK and ACC phosphorylation, reducing the energy status and increasing glucose uptake in rat muscle cells. Chlorogenic acid did not show any positive or negative effect. The findings from this review must be taken with caution due to the limited number of studies on the subject. In conclusion, various coffee components had a neutral or positive role in the metabolism of glucose and muscle glycogen, whereas no detrimental effect was described. Coffee beverages should be tested as an option for athletes' glycogen recovery.

Branched-Chain Amino Acids Are the Primary Limiting Amino Acids in the Diets of Endurance-Trained Men after a Bout of Prolonged Exercise

Background

The indicator amino acid oxidation (IAAO) method estimates the protein intake required to maximize whole-body protein synthesis and identify the daily protein requirement in a variety of populations. However, it is unclear whether the greater requirements for endurance athletes previously determined by the IAAO reflect an increased demand for all or only some amino acids.

Objective

The aim of this study was to determine the primary rate-limiting amino acids in endurance-trained athletes after prolonged exercise, by measuring the oxidation of ingested [1-13C]phenylalanine in response to variable amino acid intake.

Methods

Five endurance-trained men (means ± SDs: age, 26 ± 7 y; body weight, 66.9 ± 9.5 kg; maximal oxygen consumption, 63.3 ± 4.3 mL · kg-1 · min-1) performed 5 trials that involved 2 d of controlled diet (1.4 g protein · kg-1 · d-1) and running (10 km on day 1 and 5 km on day 2) prior to performing an acute bout of endurance exercise (20-km treadmill run) on day 3. During recovery on day 3, participants consumed test diets as 8 isocaloric hourly meals providing sufficient energy and carbohydrate but a variable amino acid intake. The test diets, consumed in random order, were deficient (BASE: 0.8 g · kg-1 · d-1) and sufficient (SUF; 1.75 g · kg-1 · d-1) amino acid diets modeled after egg protein, and BASE supplemented with branched-chain amino acids (BCAA diet; 1.03 g · kg-1 · d-1), essential amino acids (EAA diet; 1.23 g · kg-1 · d-1), or nonessential amino acids (NEAA diet; 1.75 g · kg-1 · d-1). Whole-body phenylalanine flux (Q), 13CO2 excretion (F13CO2), and phenylalanine oxidation (OX) were determined according to standard IAAO methodology.

Results

There was no effect of amino acid intake on Q (P = 0.43). F13CO2 was significantly (all P < 0.01) lower than BASE for the BCAA (∼32%), EAA (∼31%), and SUF (∼36%) diet treatments. F13CO2 for the NEAA diet was ∼18% lower than for BASE (P < 0.05) but ∼28% greater than for SUF (P < 0.05). OX was similarly decreased (∼24-41%) in all conditions compared with BASE (all P < 0.05).

Conclusion

Our results suggest that the BCAAs may be the primary rate-liming amino acids in the greater daily protein requirement of endurance trained men. This trial was registered at clinicaltrials.gov as NCT02628249.

Endurance Exercise Attenuates Postprandial Whole-Body Leucine Balance in Trained Men

PURPOSE

Endurance exercise increases indices of small intestinal damage and leucine oxidation, which may attenuate dietary amino acid appearance and postprandial leucine balance during postexercise recovery. Therefore, the purpose of this study was to examine the effect of an acute bout of endurance exercise on postprandial leucine kinetics and net leucine balance.

METHODS

In a crossover design, seven trained young men (age = 25.6 ± 2.3 yr; V˙O2peak = 61.4 ± 2.9 mL·kg·min; mean ± SEM) received a primed constant infusion of L-[1-C]leucine before and after ingesting a mixed macronutrient meal containing 18 g whole egg protein intrinsically labeled with L-[5,5,5-H3]leucine, 17 g fat, and 60 g carbohydrate at rest and after 60 min of treadmill running at 70% V˙O2peak.

RESULTS

Plasma intestinal fatty acid binding protein concentrations and leucine oxidation both increased (P < 0.01) to peaks that were ~2.5-fold above baseline values during exercise with a concomitant decrease (P < 0.01) in nonoxidative leucine disposal. Meal ingestion attenuated (P < 0.01) endogenous leucine rates of appearance at rest and after exercise. There were no differences (both, P > 0.05) in dietary leucine appearance rates or in the amount of dietary protein-derived leucine that appeared into circulation over the 5-h postprandial period at rest and after exercise (62% ± 2% and 63% ± 2%, respectively). Leucine balance over the 5-h postprandial period was positive (P < 0.01) in both conditions but was negative (P < 0.01) during the exercise trial after accounting for exercise-induced leucine oxidation.

CONCLUSIONS

We demonstrate that endurance exercise does not modulate dietary leucine availability from a mixed meal but attenuates postprandial whole-body leucine balance in trained young men.

Select Skeletal Muscle mRNAs Related to Exercise Adaptation Are Minimally Affected by Different Pre-exercise Meals that Differ in Macronutrient Profile

Background: Substantial research has been done on the impact of carbohydrate and fat availability on endurance exercise adaptation, though its role in the acute adaptive response to resistance exercise has yet to be fully characterized. Purpose: We aimed to assess the effects of a pre-resistance exercise isocaloric mixed meal containing different amounts of carbohydrates and fat, on post-resistance exercise gene expression associated with muscle adaptation. Methods: Thirteen young (age 21.2 ± 1.6 year), recreationally trained (VO_2max 51.3 ± 4.8 ml/kg/min) men undertook an aerobic exercise session of 90-min continuous cycling (70% VO_2max) in the morning with pre- and post-exercise protein ingestion (10 and 15 g casein in a 500 ml beverage pre- and post-exercise, respectively). Subjects then rested for 2 h and were provided with a meal consisting of either 3207 kJ; 52 g protein; 51 g fat; and 23 g carbohydrate (FAT) or 3124 kJ; 53 g protein; 9 g fat; and 109 g carbohydrate (CHO). Two hours after the meal, subjects completed 5 × 8 repetitions (80% 1-RM) for both bilateral leg press and leg extension directly followed by 25 g of whey protein (500 ml beverage). Muscle biopsies were obtained from the vastus lateralis at baseline (morning) and 1 and 3 h post-resistance exercise (afternoon) to determine intramuscular mRNA response. Results: Muscle glycogen levels were significantly decreased post-resistance exercise, without any differences between conditions. Plasma free fatty acids increased significantly after the mixed meal in the FAT condition, while glucose and insulin were higher in the CHO condition. However, PDK4 mRNA quantity was significantly higher in the FAT condition at 3 h post-resistance exercise compared to CHO. HBEGF, INSIG1, MAFbx, MURF1, SIRT1, and myostatin responded solely as a result of exercise without any differences between the CHO and FAT group. FOXO3A, IGF-1, PGC-1α, and VCP expression levels remained unchanged over the course of the day. Conclusion: We conclude that mRNA quantity associated with muscle adaptation after resistance exercise is not affected by a difference in pre-exercise nutrient availability. PDK4 was differentially expressed between CHO and FAT groups, suggesting a potential shift toward fat oxidation and reduced glucose oxidation in the FAT group.

Lower Integrated Muscle Protein Synthesis in Masters Compared with Younger Athletes

PURPOSE

The objective of this study is to compare the integrated muscle protein synthesis (MPS) rates of masters and younger triathletes over three consecutive days of intense endurance training. Recovery of cycling performance, after muscle-damaging running, was also compared between groups.

METHODS

Five masters (age, 53 ± 2 yr; V˙O2max, 55.7 ± 6.9 mL·kg·min) and six younger (age, 27 ± 2 yr; V˙O2max, 62.3 ± 1.5 mL·kg·min) trained triathletes volunteered for the study. Baseline skeletal muscle and saliva were initially sampled, after which a 150-mL bolus of deuterium oxide (70%) was consumed. Participants then completed a 30-min downhill run; three 20-km cycling time trials (TT) were completed 10, 24, and 48 h after the run. Saliva was collected each morning, and skeletal muscle was again sampled 72 h after the run; both were used for MPS analysis. Diet was controlled throughout the study.

RESULTS

Over 3 d, masters triathletes showed a significantly lower myofibrillar fractional synthetic rate (1.49% ± 0.12%·d) compared with the younger (1.70% ± 0.09%·d) triathletes (P = 0.009, d = 1.98). There was also a trend for masters triathletes to produce a slower cycle TT (-3.0%, d = 0.46) than younger triathletes (-1.4%, d = 0.29) at 10 h postrun in comparison with the baseline performance. The between-group comparison of change was moderate (d = 0.51), suggesting slower acute recovery among masters triathletes.

CONCLUSIONS

The present data show lower MPS rates in well-trained masters triathletes over 3 d of training, and this likely contributes to poorer muscle protein repair and remodeling. Furthermore, acute recovery of cycle TT performance tended to be poorer in the masters triathletes.

Combined Carbohydrate and Protein Ingestion During Australian Rules Football Matches and Training Sessions Does Not Reduce Fatigue or Accelerate Recovery Throughout a Weeklong Junior Tournament

Lee, NA, Fell, JW, Pitchford, NW, Hall, AH, Leveritt, MD, and Kitic, CM. Combined carbohydrate and protein ingestion during Australian rules football matches and training sessions does not reduce fatigue or accelerate recovery throughout a weeklong junior tournament. J Strength Cond Res 32(2): 344-355, 2018-Australian rules football (ARF) is a physically demanding sport that can induce high levels of fatigue. Fatigue may be intensified during periods where multiple matches are played with limited recovery time. Combined carbohydrate and protein (CHO + PRO) intake during physical activity may provide performance and recovery benefits. The aim of this study was to investigate whether CHO + PRO ingestion during ARF matches and training sessions throughout a tournament would enhance performance or recovery in comparison with CHO-only ingestion. Australian rules football players (n = 21) competing in a 7-day national tournament participated in this randomized and double-blinded study. Beverages containing either CHO (n = 10) or CHO + PRO (n = 11) were provided during matches (day 1, day 4, and day 7) and training sessions (day 2 and day 3). Countermovement jumps (CMJs), ratings of muscle soreness, and autonomic function were assessed throughout the tournament. Gastrointestinal tract (GI) discomfort was measured after matches. Countermovement jump peak velocity increased in the CHO + PRO group (p = 0.01) but not in the CHO group. There were no differences in the other CMJ variables. In both groups, muscle soreness increased from days 0 and 1 to day 2 (p ≤ 0.05) but did not remain elevated. R-R intervals (time elapsed between successive peaks in QRS complexes) increased in both groups from day 1 to day 7 (mean difference = 59.85 ms, p < 0.01). Postmatch GI discomfort was not different (p > 0.05) between groups. When daily dietary protein is adequate (>1.8 g·kg·d), the ingestion of CHO + PRO during matches and training sessions throughout a tournament does not reduce muscle soreness nor have clear benefits for neuromuscular recovery or modulate autonomic function in junior ARF athletes, compared with that of CHO alone.

What is the Optimal Amount of Protein to Support Post-Exercise Skeletal Muscle Reconditioning in the Older Adult?

Hyperaminoacidemia following protein ingestion enhances the anabolic effect of resistance-type exercise by increasing the stimulation of muscle protein synthesis and attenuating the exercise-mediated increase in muscle protein breakdown rates. Although factors such as the source of protein ingested and the timing of intake relative to exercise can impact post-exercise muscle protein synthesis rates, the amount of protein ingested after exercise appears to be the key nutritional factor dictating the magnitude of the muscle protein synthetic response during post-exercise recovery. In younger adults, muscle protein synthesis rates after resistance-type exercise respond in a dose-dependent manner to ingested protein and are maximally stimulated following ingestion of ~20 g of protein. In contrast to younger adults, older adults are less sensitive to smaller doses of ingested protein (less than ~20 g) after exercise, as evidenced by an attenuated increase in muscle protein synthesis rates during post-exercise recovery. However, older muscle appears to retain the capacity to display a robust stimulation of muscle protein synthesis in response to the ingestion of greater doses of protein (~40 g), and such an amount may be required for older adults to achieve a robust stimulation of muscle protein synthesis during post-exercise recovery. The aim of this article is to discuss the current state of evidence regarding the dose-dependent relationship between dietary protein ingestion and changes in skeletal muscle protein synthesis during recovery from resistance-type exercise in older adults. We provide recommendations on the amount of protein that may be required to maximize skeletal muscle reconditioning in response to resistance-type exercise in older adults.

Recurrent nightly ketosis after prolonged exercise in type 1 diabetes - the need for glycogen replacement strategies. Case report and review of literature

Exercise in diabetes patients has many benefits but also several risks, of which hypoglycemia is most often discussed. We present a case with recurrent keto-acidosis post-exercise, in which we hypothesize that glycogen replacement strategies were insufficient. Our experience in this case and review of the literature emphasize the importance of discussing glycogen replacement strategies with your diabetic athletes.