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Asiriwardhana MU, Dinesh OC, Brunton JA, Bertolo RF. Dietary Methionine Enhances Portal Appearance of Guanidinoacetate and Synthesis of Creatine in Yucatan Miniature Piglets. J Nutr 2024; 154:1571-1581. [PMID: 38527737 PMCID: PMC11130667 DOI: 10.1016/j.tjnut.2024.03.017] [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: 07/03/2023] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Creatine plays a significant role in energy metabolism and positively impacts anaerobic energy capacity, muscle mass, and physical performance. Endogenous creatine synthesis requires guanidinoacetic acid (GAA) and methionine. GAA can be an alternative to creatine supplements and has been tested as a beneficial feed additive in the animal industry. When pigs are fed GAA with excess methionine, creatine is synthesized without feedback regulation. In contrast, when dietary methionine is limited, creatine synthesis is limited, yet, GAA does not accumulate in plasma, urine, or liver. OBJECTIVE We hypothesized that portal GAA appearance requires adequate dietary methionine. METHODS Yucatan miniature piglets (17-21 d old; n = 20) were given a 4 h duodenal infusion of complete elemental diets with supplemental GAA plus 1 of 4 methionine concentrations representing either 20%, 80%, 140%, or 200% of the dietary methionine requirement. Arterial and portal blood metabolites were measured along with blood flow to determine mass balance across the gut. [3H-methyl] methionine was infused to measure the methionine incorporation rate into creatine. RESULTS GAA balance across the gut was highest in the 200% methionine group, indicating excess dietary methionine enhanced GAA absorption. Creatine synthesis in the liver and jejunum was higher with higher concentrations of methionine, emphasizing that the transmethylation of GAA to creatine depends on sufficient dietary methionine. Hepatic GAA concentration was higher in the 20% methionine group, suggesting low dietary methionine limited GAA conversion to creatine, which led to GAA accumulation in the liver. CONCLUSIONS GAA absorption and conversion to creatine require a sufficient amount of methionine, and the supplementation strategies should accommodate this interaction.
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Affiliation(s)
| | - Olupathage C Dinesh
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Janet A Brunton
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Robert F Bertolo
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, NL, Canada.
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2
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Barretto JR, Gouveia MADC, Alves C. Use of dietary supplements by children and adolescents. J Pediatr (Rio J) 2024; 100 Suppl 1:S31-S39. [PMID: 38529679 PMCID: PMC10960193 DOI: 10.1016/j.jped.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVES Narrative review evaluating the use of dietary supplements by children and adolescents. DATA SOURCE The terms "dietary supplements", "children" and "adolescents" were used in combination in the PubMed, MEDLINE, and SciELO databases, between 2000 and 2023, evaluating studies in humans, published in Portuguese, English, French and Spanish. DATA SYNTHESIS The use of dietary supplements by children and adolescents has increased in recent decades. The most commonly used supplements are vitamins, minerals, trace elements, proteins, amino acids, melatonin, fatty acids, probiotics and energy drinks. CONCLUSION Despite having specific indications, most of the time they are not prescribed by a healthcare professional. The reasons for use are varied. In children, the main reasons are protection against infections, stimulating growth, and poor food intake, with multivitamins and minerals being the most commonly used supplements. In adolescents, they are used to improve athletic performance and attain the "ideal body", with proteins and amino acids being the most often used nutrients. As they are not regulated by health agencies and are sold without a prescription, their unsupervised use can lead to inadequate doses, with inefficiency or overdose risk. As for compounding formulations, or when available in preparations with multiple nutrients, the chance of errors increases. It is essential that pediatricians advise parents and patients about the indications, risks and benefits, prescribing them when necessary.
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Affiliation(s)
| | | | - Crésio Alves
- Universidade Federal da Bahia, Faculdade de Medicina, Serviço de Endocrinologia Pediátrica do Hospital Universitário Prof. Edgard Santos, Salvador, BA, Brazil.
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3
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Fitzgerald H, Fitzgerald DA, Selvadurai H. Exercise testing for young athletes. Paediatr Respir Rev 2023:S1526-0542(23)00082-9. [PMID: 38176989 DOI: 10.1016/j.prrv.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Abstract
With increasing competitiveness across the sporting landscape, there is a need for more research into monitoring and managing the young athlete, as the needs of a young athlete are vastly different to those of an older athlete who is already established in their respective sport. As the age of sports specialisation seems to decrease, exercise testing in the younger cohort of athletes is crucial for safety and long-term success. This article provides a comprehensive summary of available testing and monitoring methods that can be used to assist young athletes as they mature and attempt to excel in their chosen sport.
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Affiliation(s)
- H Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia.
| | - D A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - H Selvadurai
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
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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: 13] [Impact Index Per Article: 13.0] [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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5
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Millán-Jiménez A, Fernández-Fontán IM, Sobrino-Toro M, Fernández-Torres B. Protein supplement consumption prevalence, habits and complications in adolescents. An Pediatr (Barc) 2023; 99:240-251. [PMID: 37770287 DOI: 10.1016/j.anpede.2023.08.014] [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: 06/03/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION The consumption of nutritional and protein supplements by adolescents may have important consequences for their health. METHODS Prospective observational study based on a survey of adolescents enrolled in 6 schools selected at random in the city of Seville. Our primary objective was to determine the actual consumption of dietary supplements in the adolescent population and quantifying their protein content. RESULTS We obtained a total of 263 valid responses that showed a prevalence of consumption of nutritional supplements of any kind of 19.01%, of which 56.0% (10.64% of the total) corresponded to adolescents that consumed protein supplements for a mean protein intake of 0.26 g/kg/day (SD, 0.18). The profile of consumers of any type of supplements differed from that of nonconsumers in age, use of long-term medication and weight loss or high-protein diets. The comparison of adolescents who consumed protein supplements versus nonprotein supplements only evinced a significant difference in the control of supplement consumption. Although most of these adolescents were not subject to external control, 25.92% of those who consumed protein supplements were monitored by a professional, compared to 7.38% of consumers of nonprotein supplements. In the group that consumed protein supplements, 85.18% of adolescents achieved the desired effect and 18.51% reported some form of negative effect. CONCLUSIONS The prevalence of protein supplement consumption among adolescents in our area is 10.64%, with consumption of amounts corresponding to 25% of the recommended daily allowance of protein. The profile of protein supplement consumers is very similar to that of nonprotein supplement consumers.
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Affiliation(s)
- Antonio Millán-Jiménez
- Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo de Investigación Transhumancias HUM-965, Universidad de Sevilla, Spain
| | | | | | - Bartolomé Fernández-Torres
- Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo de Investigación Transhumancias HUM-965, Universidad de Sevilla, Spain.
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Vargas-Molina S, García-Sillero M, Kreider RB, Salinas E, Petro JL, Benítez-Porres J, Bonilla DA. A randomized open-labeled study to examine the effects of creatine monohydrate and combined training on jump and scoring performance in young basketball players. J Int Soc Sports Nutr 2022; 19:529-542. [PMID: 35966022 PMCID: PMC9364731 DOI: 10.1080/15502783.2022.2108683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Creatine monohydrate (CrM) supplementation has been shown to be an effective and safe nutritional supplement to improve performance; however, the impact of CrM supplementation in young basketball players is less clear. This study evaluated the effects of CrM supplementation during a strength and conditioning training (SCT) program on lower-limb strength parameters and performance in under-16 (U16) basketball players. Methods Twenty-three male U16 basketball players participated in this study (14.3 ± 0.4 years; BMI: 20.7 ± 2.2 kg∙m−2). The players were randomly assigned to either a CrM group (n = 12) that ingested 0.1 g·kg−1·day−1 of CrM or to a non-supplemented control group (n = 11, CON). The athletes participated in an 8-week SCT program consisting of two lower-limb resistance-training sessions and two plyometric sessions per week. Squat jump (SJ), drop jump (DP), countermovement jump (CMJ), and Abalakov (ABK) jump power tests as well as basketball performance (points and minutes per game) were measured before, during and/or after the intervention. Data were analyzed using a general linear model with repeated measures with independent Student’s t-test pairwise comparisons. Results The results (95% confidence interval for mean change from baseline) show that there were significant differences for all variables for CrM and CON, respectively: SJ (cm): 2.6 – 6.4, P < 0.01 and 2.2–5.1 P < 0.01; DJ (cm): 2.5–5.6, P < 0.01, and 1.8–4.4, P < 0.01; CMJ (cm): 0.3–0.8, P < 0.01, and 0.2–0.5, P < 0.01; ABK (cm): 2.8–5.5, P < 0.01 and 0.7–2.6, P = 0.003. A significant group x time interaction (p = 0.003, ηp2 = 0.342) was observed in ABK performance. No significant group x time effects were seen in squat jump (p = 0.449, ηp2 = 0.028), drop jump (p = 0.143, ηp2 = 0.099), or counter movement jump (p = 0.304, ηp2 = 0.05). A significant interaction effect was also observed in points per game (p = 0.049, ηp2 = 0.149), while a non-significant but medium effect was seen in minutes per game (p = 0.166, ηp2 = 0.094). Conclusions CrM supplementation in conjunction with resistance and plyometric training increased the lower-limb ABK power and scoring performance in U16 basketball players.
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Affiliation(s)
- Salvador Vargas-Molina
- Department of Sport Sciences, EADE-University of Wales Trinity Saint David, Málaga, Spain
- University of Málaga, Physical Education and Sport, Faculty of Medicine, Spain
| | - Manuel García-Sillero
- Department of Sport Sciences, EADE-University of Wales Trinity Saint David, Málaga, Spain
| | - Richard B. Kreider
- College Station, Human Clinical Research Facility, Texas A&M University, Exercise & Sport Nutrition Lab, Texas, USA
| | - Enrique Salinas
- Department of Sport Sciences, EADE-University of Wales Trinity Saint David, Málaga, Spain
| | - Jorge L. Petro
- Physical Education and Sport Area, Research Group in Physical Activity, Sports and Health Sciences, Universidad de Córdoba, Montería, Colombia
| | | | - Diego A. Bonilla
- Dynamical Business & Science Society – DBSS INTERNATIONAL, Research Division, Bogotá, Colombia
- Universidad Distrital Francisco José de Caldas, Research Group in Biochemistry and Molecular Biology, Bogotá, Colombia
- University of the Basque Country UPV/EHU, Sport Genomics Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, Donostia-San Sebastián, Spain
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7
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [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: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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8
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Kreider RB, Jäger R, Purpura M. Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review. Nutrients 2022; 14:nu14051035. [PMID: 35268011 PMCID: PMC8912867 DOI: 10.3390/nu14051035] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 12/12/2022] Open
Abstract
In 2011, we published a paper providing an overview about the bioavailability, efficacy, and regulatory status of creatine monohydrate (CrM), as well as other “novel forms” of creatine that were being marketed at the time. This paper concluded that no other purported form of creatine had been shown to be a more effective source of creatine than CrM, and that CrM was recognized by international regulatory authorities as safe for use in dietary supplements. Moreover, that most purported “forms” of creatine that were being marketed at the time were either less bioavailable, less effective, more expensive, and/or not sufficiently studied in terms of safety and/or efficacy. We also provided examples of several “forms” of creatine that were being marketed that were not bioavailable sources of creatine or less effective than CrM in comparative effectiveness trials. We had hoped that this paper would encourage supplement manufacturers to use CrM in dietary supplements given the overwhelming efficacy and safety profile. Alternatively, encourage them to conduct research to show their purported “form” of creatine was a bioavailable, effective, and safe source of creatine before making unsubstantiated claims of greater efficacy and/or safety than CrM. Unfortunately, unsupported misrepresentations about the effectiveness and safety of various “forms” of creatine have continued. The purpose of this critical review is to: (1) provide an overview of the physiochemical properties, bioavailability, and safety of CrM; (2) describe the data needed to substantiate claims that a “novel form” of creatine is a bioavailable, effective, and safe source of creatine; (3) examine whether other marketed sources of creatine are more effective sources of creatine than CrM; (4) provide an update about the regulatory status of CrM and other purported sources of creatine sold as dietary supplements; and (5) provide guidance regarding the type of research needed to validate that a purported “new form” of creatine is a bioavailable, effective and safe source of creatine for dietary supplements. Based on this analysis, we categorized forms of creatine that are being sold as dietary supplements as either having strong, some, or no evidence of bioavailability and safety. As will be seen, CrM continues to be the only source of creatine that has substantial evidence to support bioavailability, efficacy, and safety. Additionally, CrM is the source of creatine recommended explicitly by professional societies and organizations and approved for use in global markets as a dietary ingredient or food additive.
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Affiliation(s)
- Richard B. Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
- Correspondence: ; Tel.: +1-972-458-1498
| | - Ralf Jäger
- Increnovo LLC, Milwaukee, WI 53202, USA; (R.J.); (M.P.)
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9
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Effects of Creatine Supplementation on Brain Function and Health. Nutrients 2022; 14:nu14050921. [PMID: 35267907 PMCID: PMC8912287 DOI: 10.3390/nu14050921] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/06/2023] Open
Abstract
While the vast majority of research involving creatine supplementation has focused on skeletal muscle, there is a small body of accumulating research that has focused on creatine and the brain. Preliminary studies indicate that creatine supplementation (and guanidinoacetic acid; GAA) has the ability to increase brain creatine content in humans. Furthermore, creatine has shown some promise for attenuating symptoms of concussion, mild traumatic brain injury and depression but its effect on neurodegenerative diseases appears to be lacking. The purpose of this narrative review is to summarize the current body of research pertaining to creatine supplementation on total creatine and phophorylcreatine (PCr) content, explore GAA as an alternative or adjunct to creatine supplementation on brain creatine uptake, assess the impact of creatine on cognition with a focus on sleep deprivation, discuss the effects of creatine supplementation on a variety of neurological and mental health conditions, and outline recent advances on creatine supplementation as a neuroprotective supplement following traumatic brain injury or concussion.
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Abstract
Adolescence (ages 13–18 years) is a period of significant growth and physical development that includes changes in body composition, metabolic and hormonal fluctuations, maturation of organ systems, and establishment of nutrient deposits, which all may affect future health. In terms of nutrition, adolescence is also an important time in establishing an individual’s lifelong relationship with food, which is particularly important in terms of the connection between diet, exercise, and body image. The challenges of time management (e.g., school, training, work and social commitments) and periods of fluctuating emotions are also features of this period. In addition, an adolescent’s peers become increasingly powerful moderators of all behaviours, including eating. Adolescence is also a period of natural experimentation and this can extend to food choice. Adolescent experiences are not the same and individuals vary considerably in their behaviours. To ensure an adolescent athlete fulfils his/her potential, it is important that stakeholders involved in managing youth athletes emphasize eating patterns that align with and support sound physical, physiological and psychosocial development and are consistent with proven principles of sport nutrition.
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Affiliation(s)
- Ben Desbrow
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.
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Negro M, Cerullo G, Parimbelli M, Ravazzani A, Feletti F, Berardinelli A, Cena H, D'Antona G. Exercise, Nutrition, and Supplements in the Muscle Carnitine Palmitoyl-Transferase II Deficiency: New Theoretical Bases for Potential Applications. Front Physiol 2021; 12:704290. [PMID: 34408664 PMCID: PMC8365340 DOI: 10.3389/fphys.2021.704290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
Carnitine palmitoyltransferase II (CPTII) deficiency is the most frequent inherited disorder regarding muscle fatty acid metabolism, resulting in a reduced mitochondrial long-chain fatty acid oxidation during endurance exercise. This condition leads to a clinical syndrome characterized by muscle fatigue and/or muscle pain with a variable annual frequency of severe rhabdomyolytic episodes. While since the CPTII deficiency discovery remarkable scientific advancements have been reached in genetic analysis, pathophysiology and diagnoses, the same cannot be said for the methods of treatments. The current recommendations remain those of following a carbohydrates-rich diet with a limited fats intake and reducing, even excluding, physical activity, without, however, taking into account the long-term consequences of this approach. Suggestions to use carnitine and medium chain triglycerides remain controversial; conversely, other potential dietary supplements able to sustain muscle metabolism and recovery from exercise have never been taken into consideration. The aim of this review is to clarify biochemical mechanisms related to nutrition and physiological aspects of muscle metabolism related to exercise in order to propose new theoretical bases of treatment which, if properly tested and validated by future trials, could be applied to improve the quality of life of these patients.
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Affiliation(s)
- Massimo Negro
- Centro di Ricerca Interdipartimentale nelle Attivitá Motorie e Sportive (CRIAMS) - Sport Medicine Centre, University of Pavia, Voghera, Italy
| | - Giuseppe Cerullo
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - Mauro Parimbelli
- Centro di Ricerca Interdipartimentale nelle Attivitá Motorie e Sportive (CRIAMS) - Sport Medicine Centre, University of Pavia, Voghera, Italy
| | - Alberto Ravazzani
- Centro di Ricerca Interdipartimentale nelle Attivitá Motorie e Sportive (CRIAMS) - Sport Medicine Centre, University of Pavia, Voghera, Italy
| | - Fausto Feletti
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | | | - Hellas Cena
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
| | - Giuseppe D'Antona
- Centro di Ricerca Interdipartimentale nelle Attivitá Motorie e Sportive (CRIAMS) - Sport Medicine Centre, University of Pavia, Voghera, Italy.,Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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12
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Bonilla DA, Moreno Y, Rawson ES, Forero DA, Stout JR, Kerksick CM, Roberts MD, Kreider RB. A Convergent Functional Genomics Analysis to Identify Biological Regulators Mediating Effects of Creatine Supplementation. Nutrients 2021; 13:2521. [PMID: 34444681 PMCID: PMC8397972 DOI: 10.3390/nu13082521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Creatine (Cr) and phosphocreatine (PCr) are physiologically essential molecules for life, given they serve as rapid and localized support of energy- and mechanical-dependent processes. This evolutionary advantage is based on the action of creatine kinase (CK) isozymes that connect places of ATP synthesis with sites of ATP consumption (the CK/PCr system). Supplementation with creatine monohydrate (CrM) can enhance this system, resulting in well-known ergogenic effects and potential health or therapeutic benefits. In spite of our vast knowledge about these molecules, no integrative analysis of molecular mechanisms under a systems biology approach has been performed to date; thus, we aimed to perform for the first time a convergent functional genomics analysis to identify biological regulators mediating the effects of Cr supplementation in health and disease. A total of 35 differentially expressed genes were analyzed. We identified top-ranked pathways and biological processes mediating the effects of Cr supplementation. The impact of CrM on miRNAs merits more research. We also cautiously suggest two dose-response functional pathways (kinase- and ubiquitin-driven) for the regulation of the Cr uptake. Our functional enrichment analysis, the knowledge-based pathway reconstruction, and the identification of hub nodes provide meaningful information for future studies. This work contributes to a better understanding of the well-reported benefits of Cr in sports and its potential in health and disease conditions, although further clinical research is needed to validate the proposed mechanisms.
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Affiliation(s)
- Diego A. Bonilla
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110861, Colombia;
- Research Group in Biochemistry and Molecular Biology, Universidad Distrital Francisco José de Caldas, Bogotá 110311, Colombia
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería 230002, Colombia
- kDNA Genomics, Joxe Mari Korta Research Center, University of the Basque Country UPV/EHU, 20018 Donostia-San Sebastián, Spain
| | - Yurany Moreno
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110861, Colombia;
- Research Group in Biochemistry and Molecular Biology, Universidad Distrital Francisco José de Caldas, Bogotá 110311, Colombia
| | - Eric S. Rawson
- Department of Health, Nutrition and Exercise Science, Messiah University, Mechanicsburg, PA 17055, USA;
| | - Diego A. Forero
- Professional Program in Sport Training, School of Health and Sport Sciences, Fundación Universitaria del Área Andina, Bogotá 111221, Colombia;
| | - Jeffrey R. Stout
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA;
| | - Chad M. Kerksick
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, Saint Charles, MO 63301, USA;
| | - Michael D. Roberts
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA;
- Edward via College of Osteopathic Medicine, Auburn, AL 36849, USA
| | - Richard B. Kreider
- Exercise & Sport Nutrition Laboratory, Human Clinical Research Facility, Texas A&M University, College Station, TX 77843, USA;
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Creatine Levels in Patients with Phenylketonuria and Mild Hyperphenylalaninemia: A Pilot Study. Life (Basel) 2021; 11:life11050425. [PMID: 34066566 PMCID: PMC8148514 DOI: 10.3390/life11050425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Creatine (Cr) levels are strongly dependent on diets, including animal-derived proteins. Cr is an important metabolite as it represents a source of stored energy to support physical performance and potentially sustain positive effects such as improving memory or intelligence. This study was planned to assess Cr levels in PKU children adhering to a diet low in phenylalanine (Phe) content and compared with those of children with mild hyperphenylalaninemia (MHP) on a free diet. Methods: This retrospective pilot study analyzed Cr levels from Guthrie cards in 25 PKU and 35 MHP subjects. Anthropomorphic and nutritional data of the study populations were assessed, compared and correlated. Results: Cr levels of PKU subjects were significantly lower than those of MHP subjects and correlated to the low intake of animal proteins. Although no deficiencies in PKU subjects were identified, PKU subjects were found to have a 26-fold higher risk of displaying Cr levels <25° percentile than MHP counterparts. Conclusions: This pilot study suggests that Cr levels might be concerningly low in PKU children adhering to a low-Phe diet. Confirmatory studies are needed in PKU patients of different age groups to assess Cr levels and the potential benefits on physical and intellectual performance of Cr supplementation.
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