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Li G, Li Z, Liu J. Amino acids regulating skeletal muscle metabolism: mechanisms of action, physical training dosage recommendations and adverse effects. Nutr Metab (Lond) 2024; 21:41. [PMID: 38956658 PMCID: PMC11220999 DOI: 10.1186/s12986-024-00820-0] [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] [Received: 02/28/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
Maintaining skeletal muscle mass is important for improving muscle strength and function. Hence, maximizing lean body mass (LBM) is the primary goal for both elite athletes and fitness enthusiasts. The use of amino acids as dietary supplements is widespread among athletes and physically active individuals. Extensive literature analysis reveals that branched-chain amino acids (BCAA), creatine, glutamine and β-alanine may be beneficial in regulating skeletal muscle metabolism, enhancing LBM and mitigating exercise-induced muscle damage. This review details the mechanisms of these amino acids, offering insights into their efficacy as supplements. Recommended dosage and potential side effects are then outlined to aid athletes in making informed choices and safeguard their health. Lastly, limitations within the current literature are addressed, highlighting opportunities for future research.
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Affiliation(s)
- Guangqi Li
- School of Physical Education, Northeast Normal university, No. 5268, Renmin Street, Changchun city, Jilin province, 130024, People's Republic of China
| | - Zhaojun Li
- Gaomi Municipal Center for Disease Control and Prevention, Gaomi city, Shandong, People's Republic of China
| | - Junyi Liu
- School of Physical Education, Northeast Normal university, No. 5268, Renmin Street, Changchun city, Jilin province, 130024, People's Republic of China.
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2
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Davies TW, Watson N, Pilkington JJ, McClelland TJ, Azzopardi G, Pearse RM, Prowle J, Puthucheary Z. Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta-analysis. JPEN J Parenter Enteral Nutr 2024; 48:389-405. [PMID: 38417175 DOI: 10.1002/jpen.2607] [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: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear. METHODS We conducted a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, and CINAHL from inception to November 2022. Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit-to-stand test after pooling data using random-effects modeling. We also performed a Bayesian meta-analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk-of-bias tool. RESULTS We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01-1.00; I2 = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper-body muscle strength (SMD: 0.25; 95% CI: 0.06-0.44; I2 = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01-0.45; I2 = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77-1.38; I2 = 26%; P < 0.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias. CONCLUSION Creatine supplementation improves sit-to-stand performance, muscle function, and lean tissue mass. It is crucial to conduct high-quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929).
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Affiliation(s)
- Thomas W Davies
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Naomi Watson
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - James J Pilkington
- Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Manchester, UK
| | - Thomas J McClelland
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Giada Azzopardi
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Rupert M Pearse
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - John Prowle
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Zudin Puthucheary
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
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3
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Forbes SC, Candow DG, Neto JHF, Kennedy MD, Forbes JL, Machado M, Bustillo E, Gomez-Lopez J, Zapata A, Antonio J. Creatine supplementation and endurance performance: surges and sprints to win the race. J Int Soc Sports Nutr 2023; 20:2204071. [PMID: 37096381 PMCID: PMC10132248 DOI: 10.1080/15502783.2023.2204071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Creatine supplementation is an effective ergogenic aid to augment resistance training and improve intense, short duration, intermittent performance. The effects on endurance performance are less known. The purpose of this brief narrative review is to discuss the potential mechanisms of how creatine can affect endurance performance, defined as large muscle mass activities that are cyclical in nature and are >~3 min in duration, and to highlight specific nuances within the literature. Mechanistically, creatine supplementation elevates skeletal muscle phosphocreatine (PCr) stores facilitating a greater capacity to rapidly resynthesize ATP and buffer hydrogen ion accumulation. When co-ingested with carbohydrates, creatine enhances glycogen resynthesis and content, an important fuel to support high-intensity aerobic exercise. In addition, creatine lowers inflammation and oxidative stress and has the potential to increase mitochondrial biogenesis. In contrast, creatine supplementation increases body mass, which may offset the potential positive effects, particularly in weight-bearing activities. Overall, creatine supplementation increases time to exhaustion during high-intensity endurance activities, likely due to increasing anaerobic work capacity. In terms of time trial performances, results are mixed; however, creatine supplementation appears to be more effective at improving performances that require multiple surges in intensity and/or during end spurts, which are often key race-defining moments. Given creatines ability to enhance anaerobic work capacity and performance through repeated surges in intensity, creatine supplementation may be beneficial for sports, such as cross-country skiing, mountain biking, cycling, triathlon, and for short-duration events where end-spurts are critical for performance, such as rowing, kayaking, and track cycling.
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Affiliation(s)
- Scott C Forbes
- Brandon University, Department of Physical Education Studies, Brandon, MB, Canada
| | - Darren G Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | | | - Michael D Kennedy
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, AB, Canada
| | - Jennifer L Forbes
- Brandon University, Department of Physical Education Studies, Brandon, MB, Canada
| | | | - Erik Bustillo
- Train 8Nine/CrossFit Coconut Grove, Erik Bustillo Consulting, Miami, FL, USA
| | - Jose Gomez-Lopez
- Rehab & Nutrition Center, Human Performance Laboratory, Motion Training, Lo Barnechea, Chile
| | | | - Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
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4
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Candow DG, Prokopidis K, Forbes SC, Rusterholz F, Campbell BI, Ostojic SM. Resistance Exercise and Creatine Supplementation on Fat Mass in Adults < 50 Years of Age: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4343. [PMID: 37892421 PMCID: PMC10609732 DOI: 10.3390/nu15204343] [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: 09/19/2023] [Revised: 10/03/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
The combination of resistance exercise and creatine supplementation has been shown to decrease body fat percentage in adults ≥ 50 years of age. However, the effect on adults < 50 years of age is currently unknown. To address this limitation, we systematically reviewed the literature and performed several meta-analyses comparing studies that included resistance exercise and creatine supplementation to resistance exercise and placebo on fat mass and body fat percentage Twelve studies were included, involving 266 participants. Adults (<50 years of age) who supplemented with creatine and performed resistance exercise experienced a very small, yet significant reduction in body fat percentage (-1.19%, p = 0.006); however, no difference was found in absolute fat mass (-0.18 kg, p = 0.76). Collectively, in adults < 50 years of age, the combination of resistance exercise and creatine supplementation produces a very small reduction in body fat percentage without a corresponding decrease in absolute fat mass.
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Affiliation(s)
- Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2, Canada;
| | - Konstantinos Prokopidis
- Department of Musculoskeletal and Ageing Science, University of Liverpool, Liverpool L69 3BX, UK;
| | - Scott C. Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB R7A 6A9, Canada;
| | - Flavia Rusterholz
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2, Canada;
| | - Bill I. Campbell
- College of Education, University of South Florida, Tampa, FL 33620, USA
| | - Sergej M. Ostojic
- Department of Nutrition and Public Health, University of Agder, 4630 Kristiansand, Norway;
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5
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Shi Y, Tang Y, Stanmore E, McGarrigle L, Todd C. Non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia: a scoping review. Arch Gerontol Geriatr 2023; 112:105022. [PMID: 37084601 DOI: 10.1016/j.archger.2023.105022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/17/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Sarcopenia is a progressive, age-related muscle disease that, if left untreated, imposes significant personal, social, and economic burdens. OBJECTIVE To compile and document the nature and extent of existing studies exploring non-pharmacological interventions as a strategy to prevent or treat possible sarcopenia or sarcopenia in community-dwelling older adults. METHOD Thirteen databases were searched up from January 2010 to March 2023 and filters were limited to English and Chinese language. Studies with older adults (≥60 y) in the community were included. The review was conducted and reported according to the PRISMA-ScR guidance and seven stages of methodology framework. A descriptive synthesis of trial characteristics and effectiveness was conducted. RESULTS A total of 59 studies were included in the analysis. Most studies were RCTs. Few studies enrolled older adults with possible sarcopenia. The 70-79 age group has been studied more than any other age group. Six intervention types were identified, including exercise-only, nutrition-only, health education-only, traditional Chinese medicine-only, multicomponent intervention and control type. Majority of exercise-only interventions received resistance-based exercise. In nutrition-only category, overall food intervention or nutrients intervention was more than dietary pattern. Moreover, exercise plus nutrition was the main sub-type in multicomponent interventions. Health education-only and traditional Chinese medicine-only interventions were less frequently identified. Most studies had high and moderate compliance. CONCLUSION There is evidence for the effectiveness of exercise and exercise plus nutrition interventions in improving muscle strength and physical performance, whereas the effectiveness of other intervention types or their combinations requires additional research. SCOPING REVIEW REGISTRATION Open Science Framework (OSF) Registration DOI 10.17605/OSF.IO/RK3TE.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; School of Nursing & School of Public Health, Yangzhou University, Yangzhou, Jiangsu province, China.
| | - Yimin Tang
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK.
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK.
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6
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Jaramillo AP, Jaramillo L, Castells J, Beltran A, Garzon Mora N, Torres S, Barberan Parraga GC, Vallejo MP, Santos Y. Effectiveness of Creatine in Metabolic Performance: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e45282. [PMID: 37720119 PMCID: PMC10503229 DOI: 10.7759/cureus.45282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
Using the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this meta-analysis (MA) tried to figure out how well creatine (Cr) improves metabolic performance. We searched Google Scholar, PubMed, and the Cochrane Library to identify relevant randomized clinical trials (RCTs) exploring the various effects of Cr across different age groups compared to a placebo (PLA). We also investigated the synergistic effects of combining other supplements with Cr. In order to emphasize the different ways and sports where Cr has been used in the past years, we found from the selected articles that Cr demonstrated a more pronounced effect during aerobic or anaerobic exercise compared to PLA groups in the studies. Furthermore, in sports that demand significant cumulative energy, such as long-distance races, biking, or triathlons, athletes have observed performance enhancements with Cr supplementation. We also stipulate that Cr enhances resistance training in people over 50 years old and that adding other training supplements, such as β-hydroxy β-methylbutyrate (HMB), synergistically improves training outcomes when combined with Cr. The current MA was based on a thorough analysis of 10 separate studies. When these results were added together, we found that taking Cr supplements demonstrated statistically significant benefits over PLA. In conclusion, the present MA has found evidence that Cr has positive effects on metabolic outcomes for people who consume it.
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Affiliation(s)
| | - Luisa Jaramillo
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Javier Castells
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Andres Beltran
- General Practice, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Neyla Garzon Mora
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | - Sol Torres
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
| | | | - Maria P Vallejo
- Medicine, Universidad Catolica Santiago De Guayaquil, Guayaquil, ECU
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7
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Mazzotti A, Langone L, Arceri A, Artioli E, Zielli SO, Bonelli S, Abdi P, Faldini C. Probiotics in Orthopedics: From Preclinical Studies to Current Applications and Future Perspective. Microorganisms 2023; 11:2021. [PMID: 37630580 PMCID: PMC10458220 DOI: 10.3390/microorganisms11082021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
In recent years, probiotics have been emerging as an attractive therapeutic strategy for several diseases. In orthopedics, probiotics seem to be a promising supplementation for treatment of osteoporosis, osteoarthritis, muscle loss-related disease, wound and ulcer issues, and prevention of surgical antibiotic prophylaxis side effects. Although probiotics are still not included in guidelines for these conditions, several studies have reported theoretical benefits of their administration. Further high-level clinical trials are necessary to convert research into solid clinical practice. However, probiotics represent a cost-effective future perspective and may play a role in association with traditional orthopedic therapies.
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Affiliation(s)
- Antonio Mazzotti
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy
| | - Laura Langone
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Alberto Arceri
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Elena Artioli
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Simone Ottavio Zielli
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Simone Bonelli
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Pejman Abdi
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
| | - Cesare Faldini
- 1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.M.); (L.L.); (E.A.); (S.O.Z.); (S.B.); (P.A.); (C.F.)
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy
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8
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Liu S, Zhang L, Li S. Advances in nutritional supplementation for sarcopenia management. Front Nutr 2023; 10:1189522. [PMID: 37492597 PMCID: PMC10365293 DOI: 10.3389/fnut.2023.1189522] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/20/2023] [Indexed: 07/27/2023] Open
Abstract
Sarcopenia is a syndrome characterized by a decline in muscular mass, strength, and function with advancing age. The risk of falls, fragility, hospitalization, and death is considerably increased in the senior population due to sarcopenia. Although there is no conclusive evidence for drug treatment, resistance training has been unanimously recognized as a first-line treatment for managing sarcopenia, and numerous studies have also pointed to the combination of nutritional supplementation and resistance training as a more effective intervention to improve quality of life for people with sarcopenia. People with both malnutrition and sarcopenia have a higher mortality rate, so identifying people at risk of malnutrition and intervening early is extremely important to avoid sarcopenia and its associated problems. This article provides important information for dietary interventions in sarcopenia by summarizing the discoveries and developments of nutritional supplements such as protein, leucine, β-hydroxy-β-methylbutyric acid, vitamin D, vitamin C, vitamin E, omega-3 fatty acids, creatine, inorganic nitrate, probiotics, minerals, collagen peptides, and polyphenols in the management of sarcopenia.
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Affiliation(s)
- Simin Liu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shuangqing Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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9
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Prokopidis K, Giannos P, Kirwan R, Ispoglou T, Galli F, Witard OC, Triantafyllidis KK, Kechagias KS, Morwani-Mangnani J, Ticinesi A, Isanejad M. Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta-analysis of randomized controlled trials. J Cachexia Sarcopenia Muscle 2023; 14:30-44. [PMID: 36414567 PMCID: PMC9891957 DOI: 10.1002/jcsm.13132] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/27/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.42, 95% CI: 0.10-0.74, I2 = 57%, P = 0.009), although no changes were revealed in relation to total lean mass (k = 12; SMD: -0.03, 95% CI: -0.19 - 0.13, I2 = 0%, P = 0.69). Interestingly, a significant increase in global muscle strength was also observed among six RCTs (SMD: 0.69, 95% CI: 0.33-1.06, I2 = 64%, P = 0.0002). Probiotic supplementation enhances both muscle mass and global muscle strength; however, no beneficial effects were observed in total lean mass. Investigating the physiological mechanisms underpinning different ageing groups and elucidating appropriate probiotic strains for optimal gains in muscle mass and strength are warranted.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Society of Meta-research and Biomedical Innovation, London, UK
| | - Panagiotis Giannos
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, UK
| | - Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Francesco Galli
- Department of Pharmaceutical Sciences, Lipidomics and Micronutrient Vitamins Laboratory and Human Anatomy Laboratory, University of Perugia, Perugia, Italy
| | - Oliver C Witard
- Faculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Konstantinos K Triantafyllidis
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Nutrition & Dietetics, Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton, UK
| | - Konstantinos S Kechagias
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Jordi Morwani-Mangnani
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Andrea Ticinesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Masoud Isanejad
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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10
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Mellen RH, Girotto OS, Marques EB, Laurindo LF, Grippa PC, Mendes CG, Garcia LNH, Bechara MD, Barbalho SM, Sinatora RV, Haber JFDS, Flato UAP, Bueno PCDS, Detregiachi CRP, Quesada K. Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review. Biomedicines 2023; 11:biomedicines11010136. [PMID: 36672642 PMCID: PMC9856128 DOI: 10.3390/biomedicines11010136] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Sarcopenia is a multifactorial condition related to the loss of muscle mass and strength due to aging, eating habits, physical inactivity, or even caused by another disease. Affected individuals have a higher risk of falls and may be associated with heart disease, respiratory diseases, cognitive impairment, and consequently an increased risk of hospitalization, in addition to causing an economic impact due to the high cost of care during the stay in hospitals. The standardization of appropriate treatment for patients with sarcopenia that could help reduce pathology-related morbidity is necessary. For these reasons, this study aimed to perform a systematic review of the role of nutrition and drugs that could ameliorate the health and quality of life of sarcopenic patients and PRISMA guidelines were followed. Lifestyle interventions have shown a profound impact on sarcopenia treatment but using supplements and different drugs can also impact skeletal muscle maintenance. Creatine, leucine, branched-chain amino acids, omega 3, and vitamin D can show benefits. Although with controversial results, medications such as Metformin, GLP-1, losartan, statin, growth hormone, and dipeptidyl peptidase 4 inhibitors have also been considered and can alter the sarcopenic's metabolic parameters, protect against cardiovascular diseases and outcomes, while protecting muscles.
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Affiliation(s)
- Rodrigo Haber Mellen
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Otávio Simões Girotto
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Eduarda Boni Marques
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Paulo Cesar Grippa
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation—University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Claudemir Gregório Mendes
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation—University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Lorena Natalino Haber Garcia
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Marcelo Dib Bechara
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation—University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation—University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- School of Food and Technology of Marilia (FATEC), São Paulo 17590-000, Brazil
- Correspondence: ; Tel.: 55-14-99655-3190
| | - Renata Vargas Sinatora
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | | | - Uri Adrian P. Flato
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Patricia Cincotto dos Santos Bueno
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- Department of Animal Sciences, School of Veterinary Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Claudia Rucco Penteado Detregiachi
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation—University of Marília (UNIMAR), São Paulo 17525-902, Brazil
| | - Karina Quesada
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), São Paulo 17525-902, Brazil
- School of Food and Technology of Marilia (FATEC), São Paulo 17590-000, Brazil
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11
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Candow DG, Forbes SC, Roberts MD, Roy BD, Antonio J, Smith-Ryan AE, Rawson ES, Gualano B, Roschel H. Creatine O'Clock: Does Timing of Ingestion Really Influence Muscle Mass and Performance? Front Sports Act Living 2022; 4:893714. [PMID: 35669557 PMCID: PMC9163789 DOI: 10.3389/fspor.2022.893714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
It is well-established that creatine supplementation augments the gains in muscle mass and performance during periods of resistance training. However, whether the timing of creatine ingestion influences these physical and physiological adaptations is unclear. Muscle contractions increase blood flow and possibly creatine transport kinetics which has led some to speculate that creatine in close proximity to resistance training sessions may lead to superior improvements in muscle mass and performance. Furthermore, creatine co-ingested with carbohydrates or a mixture of carbohydrates and protein that alter insulin enhance creatine uptake. The purpose of this narrative review is to (i) discuss the purported mechanisms and variables that possibly justify creatine timing strategies, (ii) to critically evaluate research examining the strategic ingestion of creatine during a resistance training program, and (iii) provide future research directions pertaining to creatine timing.
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Affiliation(s)
- Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Scott C. Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
- *Correspondence: Scott C. Forbes
| | | | - Brian D. Roy
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric S. Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, United States
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Rheumatology Division, Faculty of Medicine FMUSP, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, Rheumatology Division, Faculty of Medicine FMUSP, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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12
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Dhar M, Kapoor N, Suastika K, Khamseh ME, Selim S, Kumar V, Raza SA, Azmat U, Pathania M, Rai Mahadeb YP, Singhal S, Naseri MW, Aryana IGPS, Thapa SD, Jacob J, Somasundaram N, Latheef A, Dhakal GP, Kalra S. South Asian Working Action Group on SARCOpenia (SWAG-SARCO) – A consensus document. Osteoporos Sarcopenia 2022; 8:35-57. [PMID: 35832416 PMCID: PMC9263178 DOI: 10.1016/j.afos.2022.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/20/2021] [Accepted: 04/23/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Minakshi Dhar
- Department of Internal Medicine, AIIMS, Rishikesh, India
| | - Nitin Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
- Non Communicable Disease Unit, The Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ketut Suastika
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University Denpasar, Bali, Indonesia
| | - Mohammad E. Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Vijay Kumar
- Department of Geriatric Medicine AIIMS New Delhi, India
| | - Syed Abbas Raza
- Department of Medicine, Shaukat Khanum Cancer Hospital and Research Center, Lahore, Pakistan
| | - Umal Azmat
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | | | - Sunny Singhal
- Department of Geriatric Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - Mohammad Wali Naseri
- Internal Medicine, Division of Endocrinology Metabolism and Diabetes, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan
| | - IGP Suka Aryana
- Geriatric Division of Internal Medicine Department, Udayana University, Bali, Indonesia
| | - Subarna Dhoj Thapa
- Department of Endocrinology and Metabolism, Grande International Hospital, Kathmandu, Nepal
| | - Jubbin Jacob
- Department of Endocrinology, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Noel Somasundaram
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, 10, Sri Lanka
| | - Ali Latheef
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Maldives
| | - Guru Prasad Dhakal
- Department of Gastroenterology, Jigme Dorji Wangchuk National Referral Hospital, Thimpu, Bhutan
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
- Corresponding author.
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13
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Role of Creatine Supplementation in Conditions Involving Mitochondrial Dysfunction: A Narrative Review. Nutrients 2022; 14:nu14030529. [PMID: 35276888 PMCID: PMC8838971 DOI: 10.3390/nu14030529] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 12/14/2022] Open
Abstract
Creatine monohydrate (CrM) is one of the most widely used nutritional supplements among active individuals and athletes to improve high-intensity exercise performance and training adaptations. However, research suggests that CrM supplementation may also serve as a therapeutic tool in the management of some chronic and traumatic diseases. Creatine supplementation has been reported to improve high-energy phosphate availability as well as have antioxidative, neuroprotective, anti-lactatic, and calcium-homoeostatic effects. These characteristics may have a direct impact on mitochondrion's survival and health particularly during stressful conditions such as ischemia and injury. This narrative review discusses current scientific evidence for use or supplemental CrM as a therapeutic agent during conditions associated with mitochondrial dysfunction. Based on this analysis, it appears that CrM supplementation may have a role in improving cellular bioenergetics in several mitochondrial dysfunction-related diseases, ischemic conditions, and injury pathology and thereby could provide therapeutic benefit in the management of these conditions. However, larger clinical trials are needed to explore these potential therapeutic applications before definitive conclusions can be drawn.
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14
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Sánchez Y Sánchez de la Barquera B, Martínez Carrillo BE, Aguirre Garrido JF, Martínez Méndez R, Benítez Arciniega AD, Valdés Ramos R, Soto Piña AE. Emerging Evidence on the Use of Probiotics and Prebiotics to Improve the Gut Microbiota of Older Adults with Frailty Syndrome: A Narrative Review. J Nutr Health Aging 2022; 26:926-935. [PMID: 36259581 PMCID: PMC9483424 DOI: 10.1007/s12603-022-1842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The gut microbiota can impact older adults' health, especially in patients with frailty syndrome. Understanding the association between the gut microbiota and frailty syndrome will help to explain the etiology of age-related diseases. Low-grade systemic inflammation is a factor leading to geriatric disorders, which is known as "inflammaging". Intestinal dysbiosis has a direct relationship with low-grade systemic inflammation because when the natural gut barrier is altered by age or other factors, some microorganisms or their metabolites can cross this barrier and reach the systemic circulation. OBJECTIVES This review had two general goals: first, to describe the characteristics of the gut microbiota associated with age-related diseases, specifically frailty syndrome. The second aim was to identify potential interventions to improve the composition and function of intestinal microbiota, consequently lessening the burden of patients with frailty syndrome. METHODS A search of scientific evidence was performed in PubMed, Science Direct, and Redalyc using keywords such as "frailty", "elderly", "nutrient interventions", "probiotics", and "prebiotics". We included studies reporting the effects of nutrient supplementation on frailty syndrome and older adults. These studies were analyzed to identify novel therapeutic alternatives to improve gut microbiota characteristics as well as subclinical signs related to this condition. RESULTS The gut microbiota participates in many metabolic processes that have an impact on the brain, muscles, and other organs. These processes integrate feedback mechanisms, comprising their respective axis with the intestine and the gut microbiota. Alterations in these associations can lead to frailty. We report a few interventions that demonstrate that prebiotics and probiotics could modulate the gut microbiota in humans. Furthermore, other nutritional interventions could be used in patients with frailty syndrome. CONCLUSION Probiotics and prebiotics may potentially prevent frailty syndrome or improve the quality of life of patients with this disorder. However, there is not enough information about their appropriate doses and periods of administration. Therefore, further investigations are required to determine these factors and improve their efficacy as therapeutic approaches for frailty syndrome.
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Affiliation(s)
- B Sánchez Y Sánchez de la Barquera
- Alexandra Estela Soto Piña, Facultad de Medicina, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Z.C. 50180 Toluca de Lerdo, México; Email address:
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15
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Forbes SC, Krentz JR, Candow DG. Timing of creatine supplementation does not influence gains in unilateral muscle hypertrophy or strength from resistance training in young adults: a within-subject design. J Sports Med Phys Fitness 2021; 61:1219-1225. [PMID: 34610729 DOI: 10.23736/s0022-4707.20.11668-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Creatine supplementation, in close proximity to resistance training sessions, may be an important strategy to augment muscle accretion and strength. The purpose of this study was to examine the effects of creatine supplementation immediately before compared to immediately after unilateral resistance training on hypertrophy and strength. METHODS Using a counter-balanced, double-blind, repeated measures within-subject design, ten recreationally active participants (7 males; 3 females; age: 23±5 years; height: 174±9 cm; body mass: 73.5±9.7 kg) were randomized to supplement with creatine monohydrate (0.1 g/kg of body mass) immediately before and placebo immediately after training one side of the body and placebo immediately before and creatine immediately after training the other side of the body on alternate days. Resistance training consisted of elbow flexion and knee extension (3-6 sets at 80% 1-repetition maximum [1-RM]) for 8 weeks. Prior to and following training, muscle thickness (elbow flexors and leg extensors; ultrasonography) and strength (1-RM for the elbow flexors and knee extensors) was assessed. RESULTS There was a significant increase over time for muscle thickness, strength, and relative strength (P<0.01), with no differences between creatine ingestion strategies. Total training volume performed was similar between conditions (P=0.56). CONCLUSIONS Creatine supplementation, immediately before or immediately after unilateral resistance training, produces similar gains in muscle hypertrophy and strength in young adults.
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Affiliation(s)
- Scott C Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada -
| | - Joel R Krentz
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
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16
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Yan Z, Yan Z, Liu S, Yin Y, Yang T, Chen Q. Regulative Mechanism of Guanidinoacetic Acid on Skeletal Muscle Development and Its Application Prospects in Animal Husbandry: A Review. Front Nutr 2021; 8:714567. [PMID: 34458310 PMCID: PMC8387576 DOI: 10.3389/fnut.2021.714567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/22/2021] [Indexed: 12/12/2022] Open
Abstract
Guanidinoacetic acid is the direct precursor of creatine and its phosphorylated derivative phosphocreatine in the body. It is a safe nutritional supplement that can be used to promote muscle growth and development. Improving the growth performance of livestock and poultry and meat quality is the eternal goal of the animal husbandry, and it is also the common demand of today's society and consumers. A large number of experimental studies have shown that guanidinoacetic acid could improve the growth performance of animals, promote muscle development and improve the health of animals. However, the mechanism of how it affects muscle development needs to be further elucidated. This article discusses the physical and chemical properties of guanidinoacetic acid and its synthesis pathway, explores its mechanism of how it promotes muscle development and growth, and also classifies and summarizes the impact of its application in animal husbandry, providing a scientific basis for this application. In addition, this article also proposes future directions for the development of this substance.
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Affiliation(s)
- Zhaoming Yan
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Zhaoyue Yan
- Chemistry Department, University of Liverpool, Liverpool, United Kingdom
| | - Shuangli Liu
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Yunju Yin
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Tai Yang
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
| | - Qinghua Chen
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
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17
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Timing of Creatine Supplementation around Exercise: A Real Concern? Nutrients 2021; 13:nu13082844. [PMID: 34445003 PMCID: PMC8401986 DOI: 10.3390/nu13082844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 01/21/2023] Open
Abstract
Creatine has been considered an effective ergogenic aid for several decades; it can help athletes engaged in a variety of sports and obtain performance gains. Creatine supplementation increases muscle creatine stores; several factors have been identified that may modify the intramuscular increase and subsequent performance benefits, including baseline muscle Cr content, type II muscle fibre content and size, habitual dietary intake of Cr, aging, and exercise. Timing of creatine supplementation in relation to exercise has recently been proposed as an important consideration to optimise muscle loading and performance gains, although current consensus is lacking regarding the ideal ingestion time. Research has shifted towards comparing creatine supplementation strategies pre-, during-, or post-exercise. Emerging evidence suggests greater benefits when creatine is consumed after exercise compared to pre-exercise, although methodological limitations currently preclude solid conclusions. Furthermore, physiological and mechanistic data are lacking, in regard to claims that the timing of creatine supplementation around exercise moderates gains in muscle creatine and exercise performance. This review discusses novel scientific evidence on the timing of creatine intake, the possible mechanisms that may be involved, and whether the timing of creatine supplementation around exercise is truly a real concern.
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18
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Benton MJ, Spicher JM, McCormick S. Community-Based Survey Exploring Use of the Dietary Supplement Creatine by Adult Non-Athletes. Nutrients 2021; 13:nu13082529. [PMID: 34444689 PMCID: PMC8401943 DOI: 10.3390/nu13082529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022] Open
Abstract
Creatine is classified as a “sports supplement”, but it also has health benefits. The purpose of this study was to assess use of creatine as a dietary supplement in adult non-athletes. Three hundred ninety-nine adults (19–89 years) completed an online survey. Among the respondents, 77% (n = 307) were regularly active, including participation in weightlifting (34%), running (34%), and cycling (21%). Twenty-eight percent (n = 111) reported use of creatine with an average dose of 6.4 ± 4.5 g. Daily creatine use was reported by 45%, and 38% reported using creatine 2–6 times weekly. Primary sources of information about creatine were trainers/coaches (29%), friends/family (32%), and internet (28%). Forty percent (n = 44) of creatine users were female. When compared by age, 46% of young, 32% of midlife, and 6% of old respondents reported creatine use with no differences in dose or frequency. Young and midlife respondents reported primarily trainers/coaches, friends/family, and internet as sources of information about creatine, but old respondents limited their sources to friends/family and fitness magazines. Although creatine is widely used by adult non-athletes who regularly exercise, dietitians and other healthcare providers are not the primary source of information. Fitness trainers can appropriately provide guidance and education regarding safe and effective use of creatine.
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19
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Lewgood J, Oliveira B, Korzepa M, Forbes SC, Little JP, Breen L, Bailie R, Candow DG. Efficacy of Dietary and Supplementation Interventions for Individuals with Type 2 Diabetes. Nutrients 2021; 13:2378. [PMID: 34371888 PMCID: PMC8308746 DOI: 10.3390/nu13072378] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of Type 2 diabetes (T2D) is increasing, which creates a large economic burden. Diet is a critical factor in the treatment and management of T2D; however, there are a large number of dietary approaches and a general lack of consensus regarding the efficacy of each. Therefore, the purpose of this narrative review is twofold: (1) to critically evaluate the effects of various dietary strategies on diabetes management and treatment, such as Mediterranean diet, plant-based diet, low-calorie and very low-calorie diets, intermittent fasting, low-carbohydrate and very low-carbohydrate diets, and low glycemic diets and (2) to examine several purported supplements, such as protein, branched-chain amino acids, creatine, and vitamin D to improve glucose control and body composition. This review can serve as a resource for those wanting to evaluate the evidence supporting the various dietary strategies and supplements that may help manage T2D.
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Affiliation(s)
- Jessica Lewgood
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
| | - Barbara Oliveira
- Okanagan Campus, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V1V7, Canada; (B.O.); (J.P.L.)
| | - Marie Korzepa
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (M.K.); (L.B.)
| | - Scott C. Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB R7A6A9, Canada;
| | - Jonathan P. Little
- Okanagan Campus, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V1V7, Canada; (B.O.); (J.P.L.)
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (M.K.); (L.B.)
| | - Robert Bailie
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
| | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
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Abstract
ABSTRACT Creatine is a popular and widely used ergogenic dietary supplement among athletes, for which studies have consistently shown increased lean muscle mass and exercise capacity when used with short-duration, high-intensity exercise. In addition to strength gains, research has shown that creatine supplementation may provide additional benefits including enhanced postexercise recovery, injury prevention, rehabilitation, as well as a number of potential neurologic benefits that may be relevant to sports. Studies show that short- and long-term supplementation is safe and well tolerated in healthy individuals and in a number of patient populations.
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Affiliation(s)
- Matthew Hall
- Sports Medicine, UConn Primary Care Sports Medicine Fellowship, Department of Orthopedics, UConn Health, Farmington, CT
| | - Elizabeth Manetta
- Department of Family Medicine, University of Connecticut, St. Francis Hospital, Hartford, CT
| | - Kristofer Tupper
- Department of Family Medicine, University of Connecticut, St. Francis Hospital, Hartford, CT
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21
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Forbes SC, Candow DG, Ostojic SM, Roberts MD, Chilibeck PD. Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults. Nutrients 2021; 13:nu13061912. [PMID: 34199420 PMCID: PMC8229907 DOI: 10.3390/nu13061912] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/30/2021] [Indexed: 12/25/2022] Open
Abstract
Creatine supplementation in conjunction with resistance training (RT) augments gains in lean tissue mass and strength in aging adults; however, there is a large amount of heterogeneity between individual studies that may be related to creatine ingestion strategies. Therefore, the purpose of this review was to (1) perform updated meta-analyses comparing creatine vs. placebo (independent of dosage and frequency of ingestion) during a resistance training program on measures of lean tissue mass and strength, (2) perform meta-analyses examining the effects of different creatine dosing strategies (lower: ≤5 g/day and higher: >5 g/day), with and without a creatine-loading phase (≥20 g/day for 5-7 days), and (3) perform meta-analyses determining whether creatine supplementation only on resistance training days influences measures of lean tissue mass and strength. Overall, creatine (independent of dosing strategy) augments lean tissue mass and strength increase from RT vs. placebo. Subanalyses showed that creatine-loading followed by lower-dose creatine (≤5 g/day) increased chest press strength vs. placebo. Higher-dose creatine (>5 g/day), with and without a creatine-loading phase, produced significant gains in leg press strength vs. placebo. However, when studies involving a creatine-loading phase were excluded from the analyses, creatine had no greater effect on chest press or leg press strength vs. placebo. Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.
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Affiliation(s)
- Scott C. Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB R7A6A9, Canada
- Correspondence: ; Tel.: +1-204-727-9637
| | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4SOA2, Canada;
| | - Sergej M. Ostojic
- Applied Bioenergetics Lab, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, 21000 Novi Sad, Serbia;
| | | | - Philip D. Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK S7N 5B2, Canada;
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22
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Pakulak A, Candow DG, Totosy de Zepetnek J, Forbes SC, Basta D. Effects of Creatine and Caffeine Supplementation During Resistance Training on Body Composition, Strength, Endurance, Rating of Perceived Exertion and Fatigue in Trained Young Adults. J Diet Suppl 2021; 19:587-602. [PMID: 33759701 DOI: 10.1080/19390211.2021.1904085] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The primary purpose was to determine the separate and combined effects of creatine and caffeine supplementation during resistance training on body composition and muscle performance in trained young adults. Twenty-eight participants were randomized to supplement with creatine and caffeine (CR-CAF; n = 9, 22 ± 4 years; 0.1 g·kg-1·d-1 of creatine monohydrate + 3 mg·kg-1·d-1 of caffeine anhydrous micronized powder); creatine (CR; n = 7, 22 ± 4 years, 0.1 g·kg-1·d-1 of creatine + 3 mg·kg-1·d-1 of micronized cellulose), caffeine (CAF; n = 6, 19 ± 1 years, 3 mg·kg-1·d-1 of caffeine + 0.1 g·kg-1·d-1 of maltodextrin) or placebo (PLA; n = 6, 23 ± 7 years, 0.1 g·kg-1·d-1 of maltodextrin + 3 mg·kg-1·d-1 micronized cellulose) one hour prior to performing resistance training for 6 weeks. Before and after training and supplementation, fat-free and fat mass (air-displacement plethysmography), muscle thickness (elbow and knee flexors and extensors; ultrasound), muscle strength (1-repetition maximum [1-RM] for the leg press and chest press), and endurance (one set of repetitions to volitional fatigue using 50% baseline 1-RM for leg press and chest press) were assessed. There was a group x time interaction (p = 0.049) for knee extensor muscle thickness with CR experiencing an increase over time with no changes in the other groups. There were no other between group differences for any variable. In conclusion, creatine supplementation and resistance training results in a small improvement in knee extensor muscle accretion in trained young adults.
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Affiliation(s)
- Avery Pakulak
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | | | - Scott C Forbes
- Faculty of Education, Department of Physical Education, Brandon University, Brandon, Canada
| | - Daniele Basta
- University Sport Center, University of Calabria, Cosenza, Italy
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23
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Current Evidence and Possible Future Applications of Creatine Supplementation for Older Adults. Nutrients 2021; 13:nu13030745. [PMID: 33652673 PMCID: PMC7996960 DOI: 10.3390/nu13030745] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/02/2021] [Accepted: 02/20/2021] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia, defined as age-related reduction in muscle mass, strength, and physical performance, is associated with other age-related health conditions such as osteoporosis, osteosarcopenia, sarcopenic obesity, physical frailty, and cachexia. From a healthy aging perspective, lifestyle interventions that may help overcome characteristics and associated comorbidities of sarcopenia are clinically important. One possible intervention is creatine supplementation (CR). Accumulating research over the past few decades shows that CR, primarily when combined with resistance training (RT), has favourable effects on aging muscle, bone and fat mass, muscle and bone strength, and tasks of physical performance in healthy older adults. However, research is very limited regarding the efficacy of CR in older adults with sarcopenia or osteoporosis and no research exists in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia. Therefore, the purpose of this narrative review is (1) to evaluate and summarize current research involving CR, with and without RT, on properties of muscle and bone in older adults and (2) to provide a rationale and justification for future research involving CR in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia.
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Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2021; 18:13. [PMID: 33557850 PMCID: PMC7871530 DOI: 10.1186/s12970-021-00412-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.
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Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, Florida, USA.
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrew R Jagim
- Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
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Kreider RB, Stout JR. Creatine in Health and Disease. Nutrients 2021; 13:nu13020447. [PMID: 33572884 PMCID: PMC7910963 DOI: 10.3390/nu13020447] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/14/2022] Open
Abstract
Although creatine has been mostly studied as an ergogenic aid for exercise, training, and sport, several health and potential therapeutic benefits have been reported. This is because creatine plays a critical role in cellular metabolism, particularly during metabolically stressed states, and limitations in the ability to transport and/or store creatine can impair metabolism. Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised. This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine's role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease. Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence. Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
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Affiliation(s)
- Richard B. Kreider
- Human Clinical Research Facility, Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
| | - Jeffery R. Stout
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA;
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Forbes SC, Candow DG, Ferreira LHB, Souza-Junior TP. Effects of Creatine Supplementation on Properties of Muscle, Bone, and Brain Function in Older Adults: A Narrative Review. J Diet Suppl 2021; 19:318-335. [PMID: 33502271 DOI: 10.1080/19390211.2021.1877232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aging is associated with reductions in muscle and bone mass and brain function, which may be counteracted by several lifestyle factors, of which exercise appears to be most beneficial. However, less than 20% of older adults (> 55 years of age) adhere to performing the recommended amount of resistance training (≥ 2 days/week) and less than 12% regularly meet the aerobic exercise guidelines (≥ 150 min/week of moderate to vigorous intensity aerobic exercise) required to achieve significant health benefits. Therefore, from a healthy aging and clinical perspective, it is important to determine whether other lifestyle interventions (independent of exercise) can have beneficial effects on aging muscle quality and quantity, bone strength, and brain function. Creatine, a nitrogen containing organic compound found in all cells of the body, has the potential to have favorable effects on muscle, bone, and brain health (independent of exercise) in older adults. The purpose of this narrative review is to examine and summarize the small body of research investigating the effects of creatine supplementation alone on measures of muscle mass and performance, bone mineral and strength, and indices of brain health in older adults.
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Affiliation(s)
- Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Luis H B Ferreira
- Research Group on Metabolism, Nutrition and Strength Training, Federal University of Paraná, Curitiba, PR, Brazil
| | - Tacito P Souza-Junior
- Research Group on Metabolism, Nutrition and Strength Training, Federal University of Paraná, Curitiba, PR, Brazil
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Candow DG, Chilibeck PD, Gordon J, Vogt E, Landeryou T, Kaviani M, Paus-Jensen L. Effect of 12 months of creatine supplementation and whole-body resistance training on measures of bone, muscle and strength in older males. Nutr Health 2020; 27:151-159. [PMID: 33234019 DOI: 10.1177/0260106020975247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The combination of creatine supplementation and resistance training (10-12 weeks) has been shown to increase bone mineral content and reduce a urinary indicator of bone resorption in older males compared with placebo. However, the longer-term effects (12 months) of creatine and resistance training on bone mineral density and bone geometric properties in older males is unknown. AIM To assess the effects of 12 months of creatine supplementation and supervised, whole-body resistance training on bone mineral density, bone geometric properties, muscle accretion, and strength in older males. METHODS Participants were randomized to supplement with creatine (n = 18, 49-69 years, 0.1 g·kg-1·d-1) or placebo (n = 20, 49-67 years, 0.1 g·kg-1·d-1) during 12 months of supervised, whole-body resistance training. RESULTS After 12 months of training, both groups experienced similar changes in bone mineral density and geometry, bone speed of sound, lean tissue and fat mass, muscle thickness, and muscle strength. There was a trend (p = 0.061) for creatine to increase the section modulus of the narrow part of the femoral neck, an indicator of bone bending strength, compared with placebo. Adverse events did not differ between creatine and placebo. CONCLUSIONS Twelve months of creatine supplementation and supervised, whole-body resistance training had no greater effect on measures of bone, muscle, or strength in older males compared with placebo.
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Nutrient-dense protein as a primary dietary strategy in healthy ageing: please sir, may we have more? Proc Nutr Soc 2020; 80:264-277. [PMID: 33050965 DOI: 10.1017/s0029665120007892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A progressive decrement in muscle mass and muscle function, sarcopoenia, accompanies ageing. The loss of skeletal muscle mass and function is the main feature of sarcopoenia. Preventing the loss of muscle mass is relevant since sarcopoenia can have a significant impact on mobility and the quality of life of older people. Dietary protein and physical activity have an essential role in slowing muscle mass loss and helping to maintain muscle function. However, the current recommendations for daily protein ingestion for older persons appear to be too low and are in need of adjustment. In this review, we discuss the skeletal muscle response to protein ingestion, and review the data examining current dietary protein recommendations in the older subjects. Furthermore, we review the concept of protein quality and the important role that nutrient-dense protein (NDP) sources play in meeting overall nutrient requirements and improving dietary quality. Overall, the current evidence endorses an increase in the daily ingestion of protein with emphasis on the ingestion of NDP choices by older adults.
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Nilsson MI, Mikhail A, Lan L, Di Carlo A, Hamilton B, Barnard K, Hettinga BP, Hatcher E, Tarnopolsky MG, Nederveen JP, Bujak AL, May L, Tarnopolsky MA. A Five-Ingredient Nutritional Supplement and Home-Based Resistance Exercise Improve Lean Mass and Strength in Free-Living Elderly. Nutrients 2020; 12:nu12082391. [PMID: 32785021 PMCID: PMC7468764 DOI: 10.3390/nu12082391] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 12/22/2022] Open
Abstract
Old age is associated with lower physical activity levels, suboptimal protein intake, and desensitization to anabolic stimuli, predisposing for age-related muscle loss (sarcopenia). Although resistance exercise (RE) and protein supplementation partially protect against sarcopenia under controlled conditions, the efficacy of home-based, unsupervised RE (HBRE) and multi-ingredient supplementation (MIS) is largely unknown. In this randomized, placebo-controlled and double-blind trial, we examined the effects of HBRE/MIS on muscle mass, strength, and function in free-living, older men. Thirty-two sedentary men underwent twelve weeks of home-based resistance band training (3 d/week), in combination with daily intake of a novel five-nutrient supplement (‘Muscle5’; M5, n = 16, 77.4 ± 2.8 y) containing whey, micellar casein, creatine, vitamin D, and omega-3 fatty acids, or an isocaloric/isonitrogenous placebo (PLA; n = 16, 74.4 ± 1.3 y), containing collagen and sunflower oil. Appendicular and total lean mass (ASM; +3%, TLM; +2%), lean mass to fat ratios (ASM/% body fat; +6%, TLM/% body fat; +5%), maximal strength (grip; +8%, leg press; +17%), and function (5-Times Sit-to-Stand time; −9%) were significantly improved in the M5 group following HBRE/MIS therapy (pre vs. post tests; p < 0.05). Fast-twitch muscle fiber cross-sectional areas of the quadriceps muscle were also significantly increased in the M5 group post intervention (Type IIa; +30.9%, Type IIx, +28.5%, p < 0.05). Sub-group analysis indicated even greater gains in total lean mass in sarcopenic individuals following HBRE/MIS therapy (TLM; +1.65 kg/+3.4%, p < 0.05). We conclude that the Muscle5 supplement is a safe, well-tolerated, and effective complement to low-intensity, home-based resistance exercise and improves lean mass, strength, and overall muscle quality in old age.
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Affiliation(s)
- Mats I. Nilsson
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
- Exerkine Corporation, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (B.P.H.); (A.L.B.)
| | - Andrew Mikhail
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
- Department of Kinesiology, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Lucy Lan
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Alessia Di Carlo
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Bethanie Hamilton
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Kristin Barnard
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Bart P. Hettinga
- Exerkine Corporation, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (B.P.H.); (A.L.B.)
| | - Erin Hatcher
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Milla G. Tarnopolsky
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Joshua P. Nederveen
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Adam L. Bujak
- Exerkine Corporation, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (B.P.H.); (A.L.B.)
| | - Linda May
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
| | - Mark A. Tarnopolsky
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (M.I.N.); (A.M.); (L.L.); (A.D.C.); (B.H.); (K.B.); (E.H.); (M.G.T.); (J.P.N.); (L.M.)
- Exerkine Corporation, McMaster University Medical Center, Hamilton, ON L8N 3Z5, Canada; (B.P.H.); (A.L.B.)
- Correspondence: ; Tel.: +905-521-2100 (ext. 76593); Fax: +905-577-8380
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Boccanegra B, Verhaart IEC, Cappellari O, Vroom E, De Luca A. Safety issues and harmful pharmacological interactions of nutritional supplements in Duchenne muscular dystrophy: considerations for Standard of Care and emerging virus outbreaks. Pharmacol Res 2020; 158:104917. [PMID: 32485610 PMCID: PMC7261230 DOI: 10.1016/j.phrs.2020.104917] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022]
Abstract
At the moment, little treatment options are available for Duchenne muscular dystrophy (DMD). The absence of the dystrophin protein leads to a complex cascade of pathogenic events in myofibres, including chronic inflammation and oxidative stress as well as altered metabolism. The attention towards dietary supplements in DMD is rapidly increasing, with the aim to counteract pathology-related alteration in nutrient intake, the consequences of catabolic distress or to enhance the immunological response of patients as nowadays for the COVID-19 pandemic emergency. By definition, supplements do not exert therapeutic actions, although a great confusion may arise in daily life by the improper distinction between supplements and therapeutic compounds. For most supplements, little research has been done and little evidence is available concerning their effects in DMD as well as their preventing actions against infections. Often these are not prescribed by clinicians and patients/caregivers do not discuss the use with their clinical team. Then, little is known about the real extent of supplement use in DMD patients. It is mistakenly assumed that, since compounds are of natural origin, if a supplement is not effective, it will also do no harm. However, supplements can have serious side effects and also have harmful interactions, in terms of reducing efficacy or leading to toxicity, with other therapies. It is therefore pivotal to shed light on this unclear scenario for the sake of patients. This review discusses the supplements mostly used by DMD patients, focusing on their potential toxicity, due to a variety of mechanisms including pharmacodynamic or pharmacokinetic interactions and contaminations, as well as on reports of adverse events. This overview underlines the need for caution in uncontrolled use of dietary supplements in fragile populations such as DMD patients. A culture of appropriate use has to be implemented between clinicians and patients' groups.
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Affiliation(s)
- Brigida Boccanegra
- Unit of Pharmacology, Department of Pharmacy and Drug Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Ingrid E C Verhaart
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands; Duchenne Parent Project, the Netherlands
| | - Ornella Cappellari
- Unit of Pharmacology, Department of Pharmacy and Drug Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Elizabeth Vroom
- Duchenne Parent Project, the Netherlands; World Duchenne Organisation (UPPMD), the Netherlands
| | - Annamaria De Luca
- Unit of Pharmacology, Department of Pharmacy and Drug Sciences, University of Bari Aldo Moro, Bari, Italy.
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McKendry J, Currier BS, Lim C, Mcleod JC, Thomas AC, Phillips SM. Nutritional Supplements to Support Resistance Exercise in Countering the Sarcopenia of Aging. Nutrients 2020; 12:nu12072057. [PMID: 32664408 PMCID: PMC7399875 DOI: 10.3390/nu12072057] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
Skeletal muscle plays an indispensable role in metabolic health and physical function. A decrease in muscle mass and function with advancing age exacerbates the likelihood of mobility impairments, disease development, and early mortality. Therefore, the development of non-pharmacological interventions to counteract sarcopenia warrant significant attention. Currently, resistance training provides the most effective, low cost means by which to prevent sarcopenia progression and improve multiple aspects of overall health. Importantly, the impact of resistance training on skeletal muscle mass may be augmented by specific dietary components (i.e., protein), feeding strategies (i.e., timing, per-meal doses of specific macronutrients) and nutritional supplements (e.g., creatine, vitamin-D, omega-3 polyunsaturated fatty acids etc.). The purpose of this review is to provide an up-to-date, evidence-based account of nutritional strategies to enhance resistance training-induced adaptations in an attempt to combat age-related muscle mass loss. In addition, we provide insight on how to incorporate the aforementioned nutritional strategies that may support the growth or maintenance of skeletal muscle and subsequently extend the healthspan of older individuals.
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Effects of Creatine Supplementation during Resistance Training Sessions in Physically Active Young Adults. Nutrients 2020; 12:nu12061880. [PMID: 32599716 PMCID: PMC7353308 DOI: 10.3390/nu12061880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 01/03/2023] Open
Abstract
The purpose was to examine the effects of creatine supplementation during resistance training sessions on skeletal muscle mass and exercise performance in physically active young adults. Twenty-two participants were randomized to supplement with creatine (CR: n = 13, 26 ± 4 yrs; 0.0055 g·kg-1 post training set) or placebo (PLA: n = 9, 26 ± 5 yrs; 0.0055 g·kg-1 post training set) during six weeks of resistance training (18 sets per training session; five days per week). Prior to and following training and supplementation, measurements were made for muscle thickness (elbow and knee flexors/extensors, ankle plantarflexors), power (vertical jump and medicine ball throw), strength (leg press and chest press one-repetition maximum (1-RM)) and muscular endurance (one set of repetitions to volitional fatigue using 50% baseline 1-RM for leg press and chest press). The creatine group experienced a significant increase (p < 0.05) in leg press, chest press and total body strength and leg press endurance with no significant changes in the PLA group. Both groups improved total body endurance over time (p < 0.05), with greater gains observed in the creatine group. In conclusion, creatine ingestion during resistance training sessions is a viable strategy for improving muscle strength and some indices of muscle endurance in physically active young adults.
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A focused review of myokines as a potential contributor to muscle hypertrophy from resistance-based exercise. Eur J Appl Physiol 2020; 120:941-959. [PMID: 32144492 DOI: 10.1007/s00421-020-04337-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Resistance exercise induces muscle growth and is an important treatment for age-related losses in muscle mass and strength. Myokines are hypothesized as a signal conveying physiological information to skeletal muscle, possibly to "fine-tune" other regulatory pathways. While myokines are released from skeletal muscle following contraction, their role in increasing muscle mass and strength in response to resistance exercise or training is not established. Recent research identified both local and systemic release of myokines after an acute bout of resistance exercise. However, it is not known whether myokines with putative anabolic function are mechanistically involved in producing muscle hypertrophy after resistance exercise. Further, nitric oxide (NO), an important mediator of muscle stem cell activation, upregulates the expression of certain myokine genes in skeletal muscle. METHOD In the systemic context of complex hypertrophic signaling, this review: (1) summarizes literature on several well-recognized, representative myokines with anabolic potential; (2) explores the potential mechanistic role of myokines in skeletal muscle hypertrophy; and (3) identifies future research required to advance our understanding of myokine anabolism specifically in skeletal muscle. RESULT This review establishes a link between myokines and NO production, and emphasizes the importance of considering systemic release of potential anabolic myokines during resistance exercise as complementary to other signals that promote hypertrophy. CONCLUSION Investigating adaptations to resistance exercise in aging opens a novel avenue of interdisciplinary research into myokines and NO metabolites during resistance exercise, with the longer-term goal to improve muscle health in daily living, aging, and rehabilitation.
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Wu G. Important roles of dietary taurine, creatine, carnosine, anserine and 4-hydroxyproline in human nutrition and health. Amino Acids 2020; 52:329-360. [PMID: 32072297 PMCID: PMC7088015 DOI: 10.1007/s00726-020-02823-6] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/29/2020] [Indexed: 12/24/2022]
Abstract
Taurine (a sulfur-containing β-amino acid), creatine (a metabolite of arginine, glycine and methionine), carnosine (a dipeptide; β-alanyl-L-histidine), and 4-hydroxyproline (an imino acid; also often referred to as an amino acid) were discovered in cattle, and the discovery of anserine (a methylated product of carnosine; β-alanyl-1-methyl-L-histidine) also originated with cattle. These five nutrients are highly abundant in beef, and have important physiological roles in anti-oxidative and anti-inflammatory reactions, as well as neurological, muscular, retinal, immunological and cardiovascular function. Of particular note, taurine, carnosine, anserine, and creatine are absent from plants, and hydroxyproline is negligible in many plant-source foods. Consumption of 30 g dry beef can fully meet daily physiological needs of the healthy 70-kg adult human for taurine and carnosine, and can also provide large amounts of creatine, anserine and 4-hydroxyproline to improve human nutrition and health, including metabolic, retinal, immunological, muscular, cartilage, neurological, and cardiovascular health. The present review provides the public with the much-needed knowledge of nutritionally and physiologically significant amino acids, dipeptides and creatine in animal-source foods (including beef). Dietary taurine, creatine, carnosine, anserine and 4-hydroxyproline are beneficial for preventing and treating obesity, cardiovascular dysfunction, and ageing-related disorders, as well as inhibiting tumorigenesis, improving skin and bone health, ameliorating neurological abnormalities, and promoting well being in infants, children and adults. Furthermore, these nutrients may promote the immunological defense of humans against infections by bacteria, fungi, parasites, and viruses (including coronavirus) through enhancing the metabolism and functions of monocytes, macrophages, and other cells of the immune system. Red meat (including beef) is a functional food for optimizing human growth, development and health.
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Affiliation(s)
- Guoyao Wu
- Department of Animal Science and Faculty of Nutrition, Texas A&M University, College Station, TX, 77843-2471, USA.
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Supplements and Nutritional Interventions to Augment High-Intensity Interval Training Physiological and Performance Adaptations-A Narrative Review. Nutrients 2020; 12:nu12020390. [PMID: 32024038 PMCID: PMC7071320 DOI: 10.3390/nu12020390] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/22/2020] [Accepted: 01/29/2020] [Indexed: 12/13/2022] Open
Abstract
High-intensity interval training (HIIT) involves short bursts of intense activity interspersed by periods of low-intensity exercise or rest. HIIT is a viable alternative to traditional continuous moderate-intensity endurance training to enhance maximal oxygen uptake and endurance performance. Combining nutritional strategies with HIIT may result in more favorable outcomes. The purpose of this narrative review is to highlight key dietary interventions that may augment adaptations to HIIT, including creatine monohydrate, caffeine, nitrate, sodium bicarbonate, beta-alanine, protein, and essential amino acids, as well as manipulating carbohydrate availability. Nutrient timing and potential sex differences are also discussed. Overall, sodium bicarbonate and nitrates show promise for enhancing HIIT adaptations and performance. Beta-alanine has the potential to increase training volume and intensity and improve HIIT adaptations. Caffeine and creatine have potential benefits, however, longer-term studies are lacking. Presently, there is a lack of evidence supporting high protein diets to augment HIIT. Low carbohydrate training enhances the upregulation of mitochondrial enzymes, however, there does not seem to be a performance advantage, and a periodized approach may be warranted. Lastly, potential sex differences suggest the need for future research to examine sex-specific nutritional strategies in response to HIIT.
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