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Lehmann L, Giacomoni M, Del Sordo G, Raymond JJ, Duché P, Margaritis I. Energy and Macronutrient Intakes in Young Athletes: A Systematic Review and Meta-analysis. Int J Sports Med 2024; 45:3-16. [PMID: 37956875 DOI: 10.1055/a-2108-5691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of differences in energy and macronutrient intakes between young athletes and non-athletes, considering age, gender and sport characteristics. The study included original research articles that compared energy and macronutrient intakes of 8 to 18-year-old athletes to non-athletes. Mean difference (MD) meta-analyses were performed to quantify energy and macronutrient intake differences between athletes and non-athletes. Eighteen observational studies were included. Results revealed that the energy and carbohydrate consumption of athletes was higher than that of non-athletes (MD=4.65kcal/kg/d, p<0.01 and MD=1.65% of total energy intake, p<0.01, respectively). Subgroup analyses revealed a significant effect of total training time on the observed mean differences between athletes and non-athletes. As practice time increased, the differences between athletes and non-athletes increased for carbohydrate and decreased for protein. Sport type analysis revealed a higher protein intake by mixed sport athletes compared to endurance and power sports. Analyses also indicated an age effect: the older the athletes, the smaller the differences between athletes and non-athletes for energy intake. However, the methods used to match groups and estimate dietary intakes forced us to moderate the results. More rigorous research methods are needed to define the dietary intakes of athletes and non-athletes.
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Affiliation(s)
- Lisa Lehmann
- Laboratoire IAPS, Université de Toulon - Campus de La Garde, Toulon, France
| | - Magali Giacomoni
- Laboratoire IAPS, Université de Toulon - Campus de La Garde, Toulon, France
| | - Giovanna Del Sordo
- Laboratoire IAPS, Université de Toulon - Campus de La Garde, Toulon, France
| | - Jean-Jacques Raymond
- Laboratoire IAPS, Centre Hospitalier Intercommunal Toulon - La Seyne-sur-Mer, Toulon, France
| | - Pascale Duché
- Laboratoire IAPS, Université de Toulon - Campus de La Garde, Toulon, France
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Garcia-Iborra M, Castanys-Munoz E, Oliveros E, Ramirez M. Optimal Protein Intake in Healthy Children and Adolescents: Evaluating Current Evidence. Nutrients 2023; 15:nu15071683. [PMID: 37049523 PMCID: PMC10097334 DOI: 10.3390/nu15071683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
High protein intake might elicit beneficial or detrimental effects, depending on life stages and populations. While high protein intake in elder individuals can promote beneficial health effects, elevated protein intakes in infancy are discouraged, since they have been associated with obesity risks later in life. However, in children and adolescents (4–18 years), there is a scarcity of data assessing the effects of high protein intake later in life, despite protein intake being usually two- to three-fold higher than the recommendations in developed countries. This narrative review aimed to revise the available evidence on the long-term effects of protein intake in children and adolescents aged 4–18 years. Additionally, it discusses emerging techniques to assess protein metabolism in children, which suggest a need to reevaluate current recommendations. While the optimal range is yet to be firmly established, available evidence suggests a link between high protein intake and increased Body Mass Index (BMI), which might be driven by an increase in Fat-Free Mass Index (FFMI), as opposed to Fat Mass Index (FMI).
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Affiliation(s)
- Maria Garcia-Iborra
- Abbott Nutrition R & D, Granada University Science Park, 18016 Granada, Spain; (M.G.-I.); (E.C.-M.)
| | - Esther Castanys-Munoz
- Abbott Nutrition R & D, Granada University Science Park, 18016 Granada, Spain; (M.G.-I.); (E.C.-M.)
| | - Elena Oliveros
- Abbott Nutrition R & D, Abbott Laboratories, 18004 Granada, Spain;
| | - Maria Ramirez
- Abbott Nutrition R & D, Abbott Laboratories, 18004 Granada, Spain;
- Correspondence: ; Tel.: +34-669127998
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Alberty R, Čillík I. Effect of after-school physical activity on body composition in primary school children: The Slovak "PAD" project. Physiol Rep 2023; 11:e15540. [PMID: 36597192 PMCID: PMC9810785 DOI: 10.14814/phy2.15540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/24/2022] [Accepted: 11/25/2022] [Indexed: 01/05/2023] Open
Abstract
Physical activity is associated with many physical and mental health benefits. This study aimed to investigate the effect of a 24-month after-school physical activity intervention on body composition in normal-weight children. Participating students (6-7 years of age at baseline) were divided by reason of their parental preference to intervention and control groups. Children in the intervention group (n = 20; 10 boys and 10 girls) followed an aerobic training program (two 60-min sessions per week), whereas children in the control group (n = 20; 10 boys and 10 girls) participated in the usual practice. Body composition characteristics were repeatedly measured by means of bioelectrical impedance method. At 2 years, finally, intervention boys had a smaller rise in BMI (mean difference, MD: -0.97 kg/m2 , p < 0.05), BMI z-score (-0.44, p < 0.09), body fat % (BF%) (-6.47%, p < 0.01), and fat mass index (FMI) (-1.32 kg/m2 , p < 0.001) than controls. In girls, however, the intervention program induced no significant differences (p > 0.9) in the measured variables compared to controls at the final follow-up (MD: -0.04 kg/m2 for BMI and -0.01 for BMI z-score). Changes in BF% and FMI in a positive direction occurred at 18 months (MD: -3.38%, p < 0.05 and -0.99 kg/m2 , p < 0.01, respectively), but did not persist over time (p > 0.07). In addition, no significant changes (p > 0.07) in the fat-free mass index were associated with the physical activity intervention in either boys or girls. In conclusion, compared to the controls, a long-term physical activity intervention in boys was associated with a significantly smaller rise in BMI and improvement of body composition by reducing both BF % and FMI. In girls, however, this intervention did not result in any statistically significant changes in body composition variables.
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Affiliation(s)
- Roman Alberty
- Department of Biology and Ecology, Faculty of Natural Sciences of Matej Bel University, Banská Bystrica, Slovakia
| | - Ivan Čillík
- Department of Physical Education and Sports, Faculty of Arts of Matej Bel University, Banská Bystrica, Slovakia
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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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Hudson JL, Baum JI, Diaz EC, Børsheim E. Dietary Protein Requirements in Children: Methods for Consideration. Nutrients 2021; 13:nu13051554. [PMID: 34063030 PMCID: PMC8147948 DOI: 10.3390/nu13051554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
The current protein requirement estimates in children were largely determined from studies using the nitrogen balance technique, which has been criticized for potentially underestimating protein needs. Indeed, recent advances in stable isotope techniques suggests protein requirement as much as 60% higher than current recommendations. Furthermore, there is not a separate recommendation for children who engage in higher levels of physical activity. The current evidence suggests that physical activity increases protein requirements to support accretion of lean body masses from adaptations to exercise. The indicator amino acid oxidation and the 15N-end product methods represent alternatives to the nitrogen balance technique for estimating protein requirements. Several newer methods, such as the virtual biopsy approach and 2H3-creatine dilution method could also be deployed to inform about pediatric protein requirements, although their validity and reproducibility is still under investigation. Based on the current evidence, the Dietary Reference Intakes for protein indicate that children 4–13 years and 14–18 years require 0.95 and 0.85 g·kg−1·day−1, respectively, based on the classic nitrogen balance technique. There are not enough published data to overturn these estimates; however, this is a much-needed area of research.
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Affiliation(s)
- Joshua L. Hudson
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (E.C.D.); (E.B.)
- Arkansas Children’s Nutrition Center, Little Rock, AR 72202, USA
- Arkansas Children’s Research Institute, Little Rock, AR 72202, USA
- Correspondence:
| | - Jamie I. Baum
- Center for Human Nutrition, Department of Food Science, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, USA;
| | - Eva C. Diaz
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (E.C.D.); (E.B.)
- Arkansas Children’s Nutrition Center, Little Rock, AR 72202, USA
- Arkansas Children’s Research Institute, Little Rock, AR 72202, USA
| | - Elisabet Børsheim
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (E.C.D.); (E.B.)
- Arkansas Children’s Nutrition Center, Little Rock, AR 72202, USA
- Arkansas Children’s Research Institute, Little Rock, AR 72202, USA
- Reynolds Institute on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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Abstract
Understanding how exercise and dietary protein alter the turnover and synthesis of body proteins in youth can provide guidelines for the optimal development of lean mass. This review hypothesizes that active youth obtain similar anabolic benefits from exercise and dietary protein as adults, but the requirement for amino acids to support growth renders them more sensitive to these nutrients.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Volterman KA, Moore DR, Breithaupt P, Grathwohl D, Offord EA, Karagounis LG, Timmons BW. Timing and pattern of postexercise protein ingestion affects whole-body protein balance in healthy children: a randomized trial. Appl Physiol Nutr Metab 2017; 42:1142-1148. [PMID: 28683243 DOI: 10.1139/apnm-2017-0185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The dose and timing of postexercise protein ingestion can influence whole-body protein balance (WBPB) in adults, although comparable data from children are scarce. This study investigated how protein intake (both amount and distribution) postexercise can affect WBPB in physically active children. Thirty-five children (26 males; 9-13 years old) underwent a 5-day adaptation diet, maintaining a protein intake of 0.95 g·kg-1·day-1. Participants consumed [15N]glycine (2 mg·kg-1) before performing 3 × 20 min of variable-intensity cycling, and whole-body protein kinetics were assessed over 6 and 24 h of recovery. Fifteen grams of protein was distributed across 2 isoenergetic carbohydrate-containing beverages (15 and 240 min postexercise) containing reciprocal amounts of protein (i.e., 0 + 15 g, 5 + 10 g, 10 + 5 g, and 15 + 0 g for Groups A-D, respectively). Over the 6 h that included the exercise bout and consumption of the first beverage at 15 min postexercise, WBPB (i.e., synthesis - breakdown) demonstrated a linear increase of 0.647 g·kg-1·day-1 per 1 g protein intake (P < 0.001). Over 24 h, robust regression revealed that WBPB was best modeled by a parabola (P < 0.05), suggesting that a maximum in WBPB was achieved between groups B and C. In conclusion, despite a dose response early in recovery, a periodized protein intake with multiple smaller doses after physical activity may be more beneficial than a single bolus dose in promoting daily WBPB in healthy active children.
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Affiliation(s)
- Kimberly A Volterman
- a Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Daniel R Moore
- b Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Peter Breithaupt
- a Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Dominik Grathwohl
- c Department of Nutrition and Health Research, Nestle Research Centre, 1000 Lausanne, Switzerland
| | - Elizabeth A Offord
- c Department of Nutrition and Health Research, Nestle Research Centre, 1000 Lausanne, Switzerland
| | - Leonidas G Karagounis
- c Department of Nutrition and Health Research, Nestle Research Centre, 1000 Lausanne, Switzerland
| | - Brian W Timmons
- a Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
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8
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Poortmans JR, Carpentier A. Protein metabolism and physical training: any need for amino acid supplementation? ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s41110-016-0022-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Moore DR, Volterman KA, Obeid J, Offord EA, Timmons BW. Postexercise protein ingestion increases whole body net protein balance in healthy children. J Appl Physiol (1985) 2014; 117:1493-501. [PMID: 25342704 DOI: 10.1152/japplphysiol.00224.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Postexercise protein ingestion increases whole body and muscle protein anabolism in adults. No study has specifically investigated the combined effects of exercise and protein ingestion on protein metabolism in healthy, physically active children. Under 24-h dietary control, 13 (seven males, six females) active children (∼ 11 yr old; 39.3 ± 5.9 kg) consumed an oral dose of [(15)N]glycine prior to performing a bout of exercise. Immediately after exercise, participants consumed isoenergetic mixed macronutrient beverages containing a variable amount of protein [0, 0.75, and 1.5 g/100 ml for control (CON), low protein (LP), and high protein (HP), respectively] according to fluid losses. Whole body nitrogen turnover (Q), protein synthesis (S), protein breakdown (B), and protein balance (WBPB) were measured throughout exercise and the early acute recovery period (9 h combined) as well as over 24 h. Postexercise protein intake from the beverage was ∼ 0.18 and ∼ 0.32 g/kg body mass for LP and HP, respectively. Q, S, and B were significantly greater (main effect time, all P < 0.001) over 9 h compared with 24 h with no differences between conditions. WBPB was also greater over 9 h compared with 24 h in all conditions (main effect time, P < 0.001). Over 9 h, WBPB was greater in HP (P < 0.05) than LP and CON with a trend (P = 0.075) toward LP being greater than CON. WBPB was positive over 9 h for all conditions but only over 24 h for HP. Postexercise protein ingestion acutely increases net protein balance in healthy children early in recovery in a dose-dependent manner with larger protein intakes (∼ 0.32 g/kg) required to sustain a net anabolic environment over an entire 24 h period.
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Affiliation(s)
- Daniel R Moore
- Physical Performance and Mobility Group, Nestle Research Centre, Lausanne, Switzerland; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada; and
| | - Kimberly A Volterman
- Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Joyce Obeid
- Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Elizabeth A Offord
- Physical Performance and Mobility Group, Nestle Research Centre, Lausanne, Switzerland
| | - Brian W Timmons
- Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
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Poortmans JR, Carpentier A, Pereira-Lancha LO, Lancha A. Protein turnover, amino acid requirements and recommendations for athletes and active populations. Braz J Med Biol Res 2012; 45:875-90. [PMID: 22666780 PMCID: PMC3854183 DOI: 10.1590/s0100-879x2012007500096] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/25/2012] [Indexed: 12/13/2022] Open
Abstract
Skeletal muscle is the major deposit of protein molecules. As for any cell or tissue, total muscle protein reflects a dynamic turnover between net protein synthesis and degradation. Noninvasive and invasive techniques have been applied to determine amino acid catabolism and muscle protein building at rest, during exercise and during the recovery period after a single experiment or training sessions. Stable isotopic tracers (13C-lysine, 15N-glycine, 2H5-phenylalanine) and arteriovenous differences have been used in studies of skeletal muscle and collagen tissues under resting and exercise conditions. There are different fractional synthesis rates in skeletal muscle and tendon tissues, but there is no major difference between collagen and myofibrillar protein synthesis. Strenuous exercise provokes increased proteolysis and decreased protein synthesis, the opposite occurring during the recovery period. Individuals who exercise respond differently when resistance and endurance types of contractions are compared. Endurance exercise induces a greater oxidative capacity (enzymes) compared to resistance exercise, which induces fiber hypertrophy (myofibrils). Nitrogen balance (difference between protein intake and protein degradation) for athletes is usually balanced when the intake of protein reaches 1.2 g·kg−1·day−1 compared to 0.8 g·kg−1·day−1 in resting individuals. Muscular activities promote a cascade of signals leading to the stimulation of eukaryotic initiation of myofibrillar protein synthesis. As suggested in several publications, a bolus of 15-20 g protein (from skimmed milk or whey proteins) and carbohydrate (± 30 g maltodextrine) drinks is needed immediately after stopping exercise to stimulate muscle protein and tendon collagen turnover within 1 h.
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Affiliation(s)
- J R Poortmans
- Laboratory for Biometry and Sport Nutrition, Faculty of Motor Sciences, Free University of Brussels, Brussels, Belgium
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11
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A critical review of recommendations to increase dietary protein requirements in the habitually active. Nutr Res Rev 2012; 25:142-9. [PMID: 22340626 DOI: 10.1017/s0954422412000030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Some scientists and professional organisations have called for an increase in dietary protein for those who reach a threshold level of exercise, i.e. endurance athletes. But there are individual scientists who question this recommendation. Limitations in the procedures used to justify changing the recommended daily allowance (RDA) are at issue. N balance has been used to justify this increase; but it is limiting even when measured in a well-controlled clinical research centre. Experimental shortcomings are only exacerbated when performed in a sports or exercise field setting. Another laboratory method used to justify this increase, the isotope infusion procedure, has methodological problems as well. Stable isotope infusion data collected during and after exercise cannot account for fed-state gains that counterbalance those exercise losses over a 24 h dietary period. The present review concludes that an adaptive metabolic demand model may be needed to accurately study the protein health of the active individual.
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Boisseau N, Vermorel M, Rance M, Duché P, Patureau-Mirand P. Protein requirements in male adolescent soccer players. Eur J Appl Physiol 2007; 100:27-33. [PMID: 17273884 DOI: 10.1007/s00421-007-0400-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2007] [Indexed: 11/28/2022]
Abstract
Few investigations have studied protein metabolism in children and adolescent athletes which makes difficult the assessment of daily recommended dietary protein allowances in this population. The problematic in paediatric competitors is the determination of additional protein needs resulting from intensive physical training. The aim of this investigation was to determine protein requirement in 14-year-old male adolescent soccer players. Healthy male adolescent soccer players (N = 11, 13.8 +/- 0.1 year) participated in a short term repeated nitrogen balance study. Diets were designed to provide proteins at three levels: 1.4, 1.2 and 1.0 g protein per kg body weight (BW). Nutrient and energy intakes were assessed from 4 day food records corresponding to 4 day training periods during 3 weeks. Urine was collected during four consecutive days and analysed for nitrogen. The nitrogen balances were calculated from mean daily protein intake, mean urinary nitrogen excretion and estimated faecal and integumental nitrogen losses. Nitrogen balance increased with both protein intake and energy balance. At energy equilibrium, the daily protein intake needed to balance nitrogen losses was 1.04 g kg(-1) day(-1). This corresponds to an estimated average requirement (EAR) for protein of 1.20 g kg(-1) day(-1) and a recommended daily allowance (RDA) of 1.40 g kg(-1) day(-1) assuming a daily nitrogen deposition of 11 mg kg(-1). The results of the present study suggest that the protein requirements of 14-year-old male athletes are above the RDA for non-active male adolescents.
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Affiliation(s)
- N Boisseau
- Laboratoire des Adaptations Physiologiques aux Activités Physiques, EA 3813, Faculté des Sciences du Sport, 4 allée Jean Monnet, 86000, Poitiers, France.
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Tipton KD, Witard OC. Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations. Clin Sports Med 2007; 26:17-36. [DOI: 10.1016/j.csm.2006.11.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Boisseau N. Conséquences des restrictions pondérales imposées par le sport chez l’enfant et l’adolescent. ACTA ACUST UNITED AC 2006. [DOI: 10.1159/000095890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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