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Wang Y, Sun D, Zhu Z. Sex differences in the associations of dietary protein intake with lean mass and grip strength in children and adolescents. J Int Soc Sports Nutr 2025; 22:2471471. [PMID: 39994891 PMCID: PMC11864004 DOI: 10.1080/15502783.2025.2471471] [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: 12/11/2024] [Accepted: 02/18/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND Childhood and adolescence are critical developmental periods during which dietary protein plays a crucial role in musculoskeletal health. While the significance of protein in muscle development is well acknowledged, the complex associations between dietary protein intake and musculoskeletal parameters during these stages remain incompletely elucidated. METHODS This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 cycles, including 3,455 children and adolescents aged 8-19 years. Dietary protein intake was assessed through two 24-hour dietary recalls. Appendicular lean mass index (ALMI) and combined grip strength were measured as indicators of musculoskeletal health. Multivariate linear regression models and smooth curve fitting techniques were employed to analyze associations. RESULTS Higher protein intake was positively associated with both ALMI (β = 0.003, 95% CI: 0.002, 0.004, p < 0.001) and combined grip strength (β = 0.043, 95% CI: 0.027, 0.058, p < 0.001) in fully adjusted models. Notably, sex-specific effects were observed, with stronger associations in boys, particularly in the 8-11 years age group. CONCLUSIONS This study reveals significant positive associations between dietary protein intake and musculoskeletal health indicators in children and adolescents, with pronounced sex-specific effects. These findings underscore the importance of adequate protein intake during critical developmental periods and may inform targeted nutritional strategies for optimizing long-term musculoskeletal health.
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Affiliation(s)
- Yanfei Wang
- Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hospital Tendering Management Center, The First People’s Hospital of Xiaoshan District, Hangzhou, China
| | - Dan Sun
- Community Health Service Center of Guali, Department of Pediatrics, Hangzhou, Zhejiang, China
| | - Zhongxin Zhu
- Xiaoshan Affiliated Hospital of Wenzhou Medical University, Department of Osteoporosis Care and Control, The First People’s Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
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2
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Wu Y, Du Y, Zhang Y, Ye M, Wang D, Zhou L. Transcriptome-derived evidence reveals the regulatory network in the skeletal muscle of the fast-growth mstnb -/- male tilapia. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. PART D, GENOMICS & PROTEOMICS 2025; 54:101405. [PMID: 39729946 DOI: 10.1016/j.cbd.2024.101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 12/18/2024] [Accepted: 12/19/2024] [Indexed: 12/29/2024]
Abstract
Myostatin (Mstn) negatively regulates muscle growth and Mstn deficiency induced "double-skeletal muscle" development in vertebrates, including tilapias. In this study, we performed a transcriptomic analysis of skeletal muscle from both wild-type and mstnb-/- males to investigate the molecular mechanisms underlying skeletal muscle hypertrophy in mstnb-/- mutants. We identified 4697 differentially expressed genes (DEGs), 113 differentially expressed long non-coding RNAs (DE lncRNAs), 211 differentially expressed circular RNAs (DE circRNAs), and 98 differentially expressed microRNAs (DE miRNAs). The DEGs were significantly enriched in proteasome and ubiquitin-mediated proteolysis pathways. Cis- and trans-targeting genes of DE lncRNAs were also notably enriched in the above two pathways. The putative host genes of DE circRNAs linked to myofibrils, contractile fibers, and so on. Additionally, DE miRNAs were associated with ubiquitin-mediated proteolysis and key signaling pathways, including AMPK, FoxO, and mTOR. Furthermore, the core competing endogenous RNA (ceRNA) network was constructed comprising 31 DEGs, 37 DE miRNAs, 14 DE circRNAs, and 45 DE lncRNAs. The key roles of ubiquitin-proteasome system were highlighted in the ceRNA network. Taken together, this study provides a novel perspective on muscle mass increase in Mstn mutants through the repression of protein degradation and facilitates our understanding of the molecular mechanisms of skeletal muscle hypertrophy in fish.
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Affiliation(s)
- You Wu
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China
| | - Yiyun Du
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China
| | - Yanbin Zhang
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China
| | - Maolin Ye
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China
| | - Deshou Wang
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China.
| | - Linyan Zhou
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City, Key Laboratory of Freshwater Fish Reproduction and Development (Ministry of Education), School of Life Science, Southwest University, Fisheries Engineering Institute, Chinese Academy of Fishery Sciences, Chongqing 400715, PR China.
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3
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Brum ISC, Cardozo LFMF, Alvarenga L, Kemp JA, Baptista BG, Britto IK, Borges NA, Renouf D, Wong MMY, Fouque D, Mafra D. Fad diets for non-dialysis chronic kidney disease patients: Can "the miracle diet" be a threat? Nutrition 2025; 132:112668. [PMID: 39827647 DOI: 10.1016/j.nut.2024.112668] [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: 09/17/2024] [Revised: 10/29/2024] [Accepted: 12/01/2024] [Indexed: 01/22/2025]
Abstract
In the pursuit of an effortless "miracle cure", there has been a significant increase in the proliferation of fad diets. These diets generally exclude a food group or macronutrients and may also restrict energy intake; they become popular quickly but often lack substantial scientific evidence to support their efficacy and safety. They only show short-term results rather than promoting a lifestyle change. Fad diets are nutritionally unbalanced and can be dangerous for some individuals. Most fad diets are generally restrictive in carbohydrates, high in protein, or unbalanced and have low energy intake, which can harm patients with early stages of chronic kidney damage (CKD) who need a low-protein diet with adequate energy intake. This narrative review discusses the risk of fad diet prescriptions for non-dialysis CKD patients.
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Affiliation(s)
- Isabela S C Brum
- Graduate Program in Medical Sciences, Federal Fluminense University (UFF), Niteroi, Rio de Janeiro, Brazil
| | - Ludmila F M F Cardozo
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil; Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Livia Alvarenga
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil; Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julie A Kemp
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Beatriz G Baptista
- Graduate Program in Medical Sciences, Federal Fluminense University (UFF), Niteroi, Rio de Janeiro, Brazil
| | - Isadora K Britto
- Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália A Borges
- Institute of Nutrition, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dani Renouf
- St. Paul's Hospital, Providence Health Care, Vancouver, Rio de Janeiro, Canada
| | - Michelle M Y Wong
- Division of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, Canada
| | - Denis Fouque
- Department of Nephrology, Centre Hopitalier Lyon Sud, Lyon, France
| | - Denise Mafra
- Graduate Program in Medical Sciences, Federal Fluminense University (UFF), Niteroi, Rio de Janeiro, Brazil; Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil; Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil.
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4
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Witard OC, Hearris M, Morgan PT. Protein Nutrition for Endurance Athletes: A Metabolic Focus on Promoting Recovery and Training Adaptation. Sports Med 2025:10.1007/s40279-025-02203-8. [PMID: 40117058 DOI: 10.1007/s40279-025-02203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2025] [Indexed: 03/23/2025]
Abstract
The purpose of this narrative review is to provide an evidence-based update on the protein needs of endurance athletes with a focus on high-quality metabolic studies conducted on the topics of recovery and training adaptation over the past decade. We use the term 'protein needs' to delineate between the concepts of a daily protein requirement and per meal protein recommendations when devising scientific evidence-based protein guidelines for the endurance athlete to promote post-exercise recovery, enhance the adaptive response to endurance training and improve endurance performance. A habitual protein intake of 1.5 g/kg of body mass (BM)-1·day-1 is typical in male and female endurance athletes. Based on findings from a series of contemporary protein requirement studies, the evidence suggests a daily protein intake of ~ 1.8 g·kgBM-1·day-1 should be advocated for endurance athletes, with the caveat that the protein requirement may be further elevated in excess of 2.0 g·kgBM-1·day-1 during periods of carbohydrate-restricted training and on rest days. Regarding protein recommendations, the current lack of metabolic studies that determine the dose response of muscle protein synthesis to protein ingestion in relation to endurance exercise makes it difficult to present definitive guidelines on optimal per meal protein intakes for endurance athletes. Moreover, there remains no compelling evidence that co-ingesting protein with carbohydrate before or during endurance exercise confers any performance advantage, nor facilitates the resynthesis of liver or muscle glycogen stores during recovery, at least when carbohydrate recommendations are met. However, recent evidence suggests a role for protein nutrition in optimising the adaptive metabolic response to endurance training under conditions of low carbohydrate and/or energy availability that represent increasingly popular periodised strategies for endurance athletes.
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Affiliation(s)
- Oliver C Witard
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, Strand Campus, Strand, London, WC2R 2LS, UK.
| | - Mark Hearris
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Paul T Morgan
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
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5
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López-Moreno M, Kraselnik A. The Impact of Plant-Based Proteins on Muscle Mass and Strength Performance: A Comprehensive Review. Curr Nutr Rep 2025; 14:37. [PMID: 39982647 DOI: 10.1007/s13668-025-00628-1] [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] [Accepted: 02/10/2025] [Indexed: 02/22/2025]
Abstract
PURPOSE OF REVIEW Plant-based diets, which prioritize plant foods and limit or exclude animal-based products, have gained popularity due to their potential health and environmental benefits. While these diets are recognized as nutritionally adequate for all life stages, plant-based proteins have traditionally been considered less effective for muscle growth and athletic performance compared to animal-based proteins. This study aims to assess the quality of plant-based protein sources and their effects on muscle mass gain and strength performance. RECENT FINDINGS Although plant-based proteins may have lower digestibility and amino acid quality, combining protein sources and employing different processing techniques, such as cooking or fermentation, can improve their bioavailability. Animal protein supplementation has been associated with greater gains in lean mass and muscle strength. However, focusing exclusively on isolated protein supplementation fails to reflect the habitual dietary patterns, which typically involve consuming diverse protein sources throughout the day. Consequently, there is a growing interest in examining the broader impact of comprehensive dietary patterns on muscle mass and strength. Recent research suggests that when consumed in adequate amounts and with appropriate combinations, plant-based proteins can effectively support muscle protein synthesis and strength performance when consumed in adequate amounts and with appropriate combinations. When derived from diverse sources and consumed in sufficient quantities, plant-based proteins can effectively support muscle protein synthesis and promote strength development. Further research is needed to assess the impact of plant-based diets on muscle mass and strength in elite athletes and older adults, particularly those at risk of sarcopenia. Long-term studies are essential for a more comprehensive understanding of the sustained effects of plant-based nutrition on these outcomes.
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Affiliation(s)
- Miguel López-Moreno
- Diet, Planetary Health and Performance, Faculty of Health Sciences, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda Km 1,800, 28223, Madrid, Spain.
- School of Physiotherapy, Faculty of Health Sciences, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda Km 1,800, 28223, Madrid, Spain.
| | - Ariel Kraselnik
- Faculty of Chemistry, Universidad del Centro Educativo Latinoamericano, Rosario, Argentina
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6
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Reljic D, Herrmann HJ, Neurath MF, Zopf Y. Impact of Different Low-Volume Concurrent Training Regimens on Cardiometabolic Health, Inflammation, and Fitness in Obese Metabolic Syndrome Patients. Nutrients 2025; 17:561. [PMID: 39940419 PMCID: PMC11820124 DOI: 10.3390/nu17030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 01/29/2025] [Accepted: 01/30/2025] [Indexed: 02/16/2025] Open
Abstract
BACKGROUND/OBJECTIVES Evidence supports the benefits of concurrent training (CT), which combines endurance and resistance exercises, for enhancing health and physical fitness. Recently, low-volume, time-efficient exercise approaches such as low-volume high-intensity interval training (LOW-HIIT), whole-body electromyostimulation (WB-EMS), and single-set resistance training (1-RT) have gained popularity for their feasibility and efficacy in improving various health outcomes. This study investigated the effects of low-volume CT, focusing on (1) whether exercise order affects cardiometabolic health, inflammation, and fitness adaptations and (2) which combination, LOW-HIIT plus WB-EMS or LOW-HIIT plus 1-RT, yields better results. METHODS Ninety-three obese metabolic syndrome (MetS) patients undergoing caloric restriction were randomly assigned to four groups performing the different low-volume CT protocols over 12 weeks. Outcomes included cardiometabolic, inflammatory, and fitness parameters. RESULTS In both combinations, no significant differences were found regarding exercise order. However, the pooled LOW-HIIT and 1-RT group achieved superior improvements in blood pressure, blood lipids, inflammation markers (CRP, hsCRP), the MetS severity score, and overall fitness compared to the LOW-HIIT and WB-EMS combination. Compared to previous studies using these modalities individually, LOW-HIIT plus 1-RT appeared to further reduce inflammation, whereas LOW-HIIT combined with WB-EMS was less effective for cardiometabolic health, potentially due to interference effects between modalities. CONCLUSIONS While LOW-HIIT plus WB-EMS appears to be a viable option for individuals unable to perform traditional resistance training, the findings suggest prioritizing LOW-HIIT plus 1-RT to maximize health outcomes. These findings highlight the importance of tailored exercise prescriptions and the need for further research into optimizing CT protocols for diverse populations.
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Affiliation(s)
- Dejan Reljic
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Hans Joachim Herrmann
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Markus Friedrich Neurath
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Deutsches Zentrum Immuntherapie (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Yurdagül Zopf
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
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7
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Yu Q, Zhang Z, Herold F, Ludyga S, Kuang J, Chen Y, Liu Z, Erickson KI, Goodpaster BH, Cheval B, Pindus DM, Kramer AF, Hillman CH, Liu-Ambrose T, Kelley KW, Moon HY, Chen A, Zou L. Physical activity, cathepsin B, and cognitive health. Trends Mol Med 2025:S1471-4914(24)00343-5. [PMID: 39848868 DOI: 10.1016/j.molmed.2024.12.010] [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: 10/25/2024] [Revised: 12/03/2024] [Accepted: 12/17/2024] [Indexed: 01/25/2025]
Abstract
Regular physical activity (PA) is beneficial for cognitive health, and cathepsin B (CTSB) - a protease released by skeletal muscle during PA - acts as a potential molecular mediator of this association. PA-induced metabolic and mechanical stress appears to increase plasma/serum CTSB levels. CTSB facilitates neurogenesis and synaptic plasticity in brain regions (e.g., hippocampus and prefrontal cortex) that support performance in specific cognitive domains including memory, learning, and executive function. However, the evidence regarding the role of PA-induced changes in CTSB as a mediator of PA-induced cognitive health in humans is mixed. To guide future research, this article identifies key factors that may explain the observed heterogeneity in the findings from human studies and proposes a PA-CTSB-cognition model.
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Affiliation(s)
- Qian Yu
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China; Faculty of Education, University of Macau, Macau, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Fabian Herold
- Research Group on Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, 14476, Germany
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Jin Kuang
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yanxia Chen
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China; Department of Physical Education, Shanghai Jiaotong University, Shanghai, China
| | - Zijun Liu
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Kirk I Erickson
- Department of Neuroscience, AdventHealth Research Institute, Orlando, FL, USA
| | - Bret H Goodpaster
- AdventHealth Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France; Univ Rennes, École normale supérieure de Rennes, VIPS(2), F-35000 Rennes, France
| | - Dominika M Pindus
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Center for Cognitive and Brain Health, Northeastern University, Boston, MA, 02115, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Charles H Hillman
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, 02115, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, 02115, USA
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada; Centre for Aging SMART (Solutions for Mobility, Activity, Rehabilitation, and Technology), Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Keith W Kelley
- Department of Pathology, College of Medicine, and Department of Animal Sciences, College of Agricultural, Consumer, and Environmental Sciences (ACES), University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Hyo Youl Moon
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea; Institute of Sport Science, Seoul National University, Seoul, Republic of Korea; Institute on Aging, Seoul National University, Seoul, Republic of Korea; Learning Sciences Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Aiguo Chen
- Nanjing Sport Institute, Nanjing, China.
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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8
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Pandey A, Pearlman M, Bonnes SL, Nour SI. Can We Maintain Muscle Mass on a Plant-Based Diet? Curr Nutr Rep 2025; 14:16. [PMID: 39797993 DOI: 10.1007/s13668-024-00594-0] [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] [Accepted: 12/09/2024] [Indexed: 01/13/2025]
Abstract
PURPOSE OF REVIEW This review aims to determine whether muscle mass and function can be effectively maintained without relying on animal-based protein sources. We evaluate the quality, digestibility, and essential amino acid profiles of plant-based proteins to understand their potential in preventing and managing sarcopenia. RECENT FINDING Recent studies indicate that while animal-based proteins have traditionally been considered the gold standard for supporting muscle protein synthesis, certain plant-based protein blends, fortified with leucine or other essential amino acids, can produce comparable anabolic responses. Advances in processing techniques have improved the bioavailability and overall quality of plant proteins, and emerging research suggests that strategic meal planning and supplementation can overcome prior limitations. Although animal-based proteins remain highly effective in preserving muscle mass, plant-based proteins can serve as a viable alternative in many scenarios. Future research should focus on well-designed, large-scale studies across diverse populations to refine guidelines for optimizing plant-based protein intake in sarcopenia prevention and management.
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Affiliation(s)
- Akash Pandey
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition Arnold Palmer Children's Hospital, 60 West Gore St, MP373, Orlando, FL, 32806, USA.
| | | | - Sara L Bonnes
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shirin I Nour
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
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9
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Paquin J, Tremblay R, Islam H, Riesco E, Marcotte-Chénard A, Dionne IJ. Resistance training, skeletal muscle hypertrophy, and glucose homeostasis: how related are they? A Systematic review and Meta-analysis. Appl Physiol Nutr Metab 2024; 49:1622-1635. [PMID: 39484808 DOI: 10.1139/apnm-2024-0128] [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] [Indexed: 11/03/2024]
Abstract
Resistance training (RT) promotes skeletal muscle (Skm) hypertrophy, increases muscular strength, and improves metabolic health. Whether changes in fat-free mass (FFM; a surrogate marker of muscle hypertrophy) moderate RT-induced improvements in glucose homeostasis has not been determined, despite extensive research on the benefits of RT for health and performance. The aim of this meta-analysis is to examine whether RT-induced Skm hypertrophy drives improvements in glucose metabolism and to explore confounders, such as biological sex and training parameters. Random-effects meta-analyses were performed using variance random effects. Meta-regressions were performed for confounding factors depending on the heterogeneity (I2). Analyses from 33 intervention studies revealed significant within-study increases in FFM with a moderate effect size (within-studies: (effect size; ES = 0.24 [0.10; 0.39]; p = 0.002; I2 = 56%) and a tendency for significance when compared with control groups (ES = 0.42 [-0.04-0.88]; p = 0.07). Within-study significant increases in glucose tolerance (2 h glucose: ES = -0.3 [-0.50; -0.11]; p < 0.01; I2 = 43%; glucose area under the curve (AUC): -0.40 [-0.66; -0.13] I2 = 76.1%; p < 0.01) and insulin sensitivity (ES = 0.38 [0.13; 0.62]; I2 = 53.0%; p < 0.01) were also apparent with RT. When compared to control groups, there was no significant difference in 2 h glucose, nor in glucose AUC from baseline in RT intervention groups. Meta-regression analyses failed to consistently reveal increases in FFM as a moderator of glucose homeostasis. Other mixed-effect models were also unsuccessful to unveil biological sex or training parameters as moderators of FFM increases and glucose homeostasis changes. Although Skm hypertrophy and improvements in glycemic control occur concurrently during RT, changes in these variables were not always related. Well-controlled trials including detailed description of training parameters are needed to inform RT guidelines for improving metabolic health. Registration and protocol number (Prospero): CRD42023397362.
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Affiliation(s)
- J Paquin
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- University of Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
| | - R Tremblay
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- University of Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
| | - H Islam
- University of British Columbia, School of Health and Exercise Science, Kelowna, BC, Canada
| | - E Riesco
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- University of Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
| | - A Marcotte-Chénard
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- University of Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
- University of British Columbia, School of Health and Exercise Science, Kelowna, BC, Canada
| | - I J Dionne
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- University of Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
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10
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Houtvast DCJ, Betz MW, Van Hooren B, Vanbelle S, Verdijk LB, van Loon LJC, Trommelen J. Underpowered studies in muscle metabolism research: Determinants and considerations. Clin Nutr ESPEN 2024; 64:334-343. [PMID: 39461591 DOI: 10.1016/j.clnesp.2024.10.152] [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: 06/17/2024] [Revised: 10/01/2024] [Accepted: 10/10/2024] [Indexed: 10/29/2024]
Abstract
Biomedical research frequently employs null hypothesis testing to determine whether an observed difference in a sample is likely to exist in the broader population. Null hypothesis testing generally assumes that differences between groups or interventions are non-existent, unless proven otherwise. Because biomedical studies with human subjects are often limited by financial and logistical resources, they tend to have low statistical power, i.e. a low probability of statistically confirming a true difference. As a result, small but potentially clinically important differences may be overseen or ignored simply due to the absence of a statistically significant difference. This absence is often misinterpreted as 'equivalence' of treatments. In this educational paper, we will use practical examples related to the effects of exercise and nutrition on muscle protein metabolism to illustrate the most important determinants of statistical power, as well as their implications for both investigators and readers of scientific articles. Changes in muscle mass occur at a relatively slow rate, making it practically challenging to detect differences between treatment groups in a long-term setting. One way to make it 'easier' to differentiate between groups and hence increase statistical power is to have a sufficiently long study duration to allow treatment effects to become apparent. This is especially relevant when comparing treatments with relatively small expected differences such as the effect of modest changes in daily protein intake. Secondly, one could try to minimize the variance and response heterogeneity within groups, for example by using strict inclusion criteria and standardization protocols (e.g., meal provision), by using cross-over designs, or even within-subject designs where two interventions are compared simultaneously (e.g., studying an exercised limb vs a contralateral control limb) although this might limit the generalizability of the findings (e.g. such single-limb exercise training is not common in practice). In terms of data interpretation, investigators should obviously refrain from drawing strong conclusions from underpowered studies. Yet, such studies still provide valuable data for meta-analyses. Finally, because muscle protein synthesis rates are highly responsive to anabolic stimuli, acute metabolic studies are more sensitive to detect potentially clinically relevant differences in the anabolic response between treatments. Apart from further elaborating on these topics, this educational article encourages readers to more critically question null findings and scientists to more clearly discuss limitations that may have compromised statistical power.
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Affiliation(s)
- Dion C J Houtvast
- Department of Human Biology, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands
| | - Milan W Betz
- Department of Human Biology, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands
| | - Bas Van Hooren
- Department of Nutrition and Movement Sciences, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands
| | - Sophie Vanbelle
- Department of Methodology and Statistics, Institute for Public Health and Primary Care (CAPHRI), Maastricht University, the Netherlands
| | - Lex B Verdijk
- Department of Human Biology, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands
| | - Luc J C van Loon
- Department of Human Biology, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands
| | - Jorn Trommelen
- Department of Human Biology, Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands.
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11
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McKendry J, Coletta G, Nunes EA, Lim C, Phillips SM. Mitigating disuse-induced skeletal muscle atrophy in ageing: Resistance exercise as a critical countermeasure. Exp Physiol 2024; 109:1650-1662. [PMID: 39106083 PMCID: PMC11442788 DOI: 10.1113/ep091937] [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: 05/09/2024] [Accepted: 07/17/2024] [Indexed: 08/07/2024]
Abstract
The gradual deterioration of physiological systems with ageing makes it difficult to maintain skeletal muscle mass (sarcopenia), at least partly due to the presence of 'anabolic resistance', resulting in muscle loss. Sarcopenia can be transiently but markedly accelerated through periods of muscle disuse-induced (i.e., unloading) atrophy due to reduced physical activity, sickness, immobilisation or hospitalisation. Periods of disuse are detrimental to older adults' overall quality of life and substantially increase their risk of falls, physical and social dependence, and early mortality. Disuse events induce skeletal muscle atrophy through various mechanisms, including anabolic resistance, inflammation, disturbed proteostasis and mitochondrial dysfunction, all of which tip the scales in favour of a negative net protein balance and subsequent muscle loss. Concerningly, recovery from disuse atrophy is more difficult for older adults than their younger counterparts. Resistance training (RT) is a potent anabolic stimulus that can robustly stimulate muscle protein synthesis and mitigate muscle losses in older adults when implemented before, during and following unloading. RT may take the form of traditional weightlifting-focused RT, bodyweight training and lower- and higher-load RT. When combined with sufficient dietary protein, RT can accelerate older adults' recovery from a disuse event, mitigate frailty and improve mobility; however, few older adults regularly participate in RT. A feasible and practical approach to improving the accessibility and acceptability of RT is through the use of resistance bands. Moving forward, RT must be prescribed to older adults to mitigate the negative consequences of disuse atrophy.
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Affiliation(s)
- James McKendry
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Giulia Coletta
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Everson A. Nunes
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Changhyun Lim
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Stuart M. Phillips
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
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12
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Thomas ACQ, Stead CA, Burniston JG, Phillips SM. Exercise-specific adaptations in human skeletal muscle: Molecular mechanisms of making muscles fit and mighty. Free Radic Biol Med 2024; 223:341-356. [PMID: 39147070 DOI: 10.1016/j.freeradbiomed.2024.08.010] [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: 04/26/2024] [Revised: 07/30/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024]
Abstract
The mechanisms leading to a predominantly hypertrophied phenotype versus a predominantly oxidative phenotype, the hallmarks of resistance training (RT) or aerobic training (AT), respectively, are being unraveled. In humans, exposure of naïve persons to either AT or RT results in their skeletal muscle exhibiting generic 'exercise stress-related' signaling, transcription, and translation responses. However, with increasing engagement in AT or RT, the responses become refined, and the phenotype typically associated with each form of exercise emerges. Here, we review some of the mechanisms underpinning the adaptations of how muscles become, through AT, 'fit' and RT, 'mighty.' Much of our understanding of molecular exercise physiology has arisen from targeted analysis of post-translational modifications and measures of protein synthesis. Phosphorylation of specific residue sites has been a dominant focus, with canonical signaling pathways (AMPK and mTOR) studied extensively in the context of AT and RT, respectively. These alone, along with protein synthesis, have only begun to elucidate key differences in AT and RT signaling. Still, key yet uncharacterized differences exist in signaling and regulation of protein synthesis that drive unique adaptation to AT and RT. Omic studies are required to better understand the divergent relationship between exercise and phenotypic outcomes of training.
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Affiliation(s)
- Aaron C Q Thomas
- Protein Metabolism Research Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada; Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Connor A Stead
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jatin G Burniston
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Stuart M Phillips
- Protein Metabolism Research Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
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13
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Witard OC, Mettler S. The Anabolic Response to Protein Ingestion During Recovery From Exercise Has No Upper Limit in Magnitude and Duration In Vivo in Humans: A Commentary. Int J Sport Nutr Exerc Metab 2024; 34:322-324. [PMID: 38991545 DOI: 10.1123/ijsnem.2024-0041] [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: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/13/2024]
Abstract
A comprehensive recent study by Trommelen et al. demonstrated that muscle tissue exhibits a greater capacity to incorporate exogenous exogenous protein-derived amino acids into bound muscle protein than was previously appreciated, at least when measured in "anabolically sensitive," recreationally active (but not resistance-trained), young men following resistance exercise. Moreover, this study demonstrated that the duration of the postprandial period is modulated by the dose of ingested protein contained within a meal, that is, the postexercise muscle protein synthesis response to protein ingestion was more prolonged in 100PRO than 25PRO. Both observations represent important scientific advances in the field of protein metabolism. However, we respectfully caution that the practical implications of these findings may have been misinterpreted, at least in terms of dismissing the concept of protein meal distribution as an important factor in optimizing muscle tissue anabolism and/or metabolic health. Moreover, based on emerging evidence, this idea that the anabolic response to protein ingestion has no upper limit does not appear to translate to resistance-trained young women.
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Affiliation(s)
- Oliver C Witard
- Centre for Human & Applied Physiological Sciences, King's College London, London, United Kingdom
| | - Samuel Mettler
- Department of Health, Bern University of Applied Sciences, Bern, Switzerland
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14
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Novelli G, Calcaterra G, Casciani F, Pecorelli S, Mehta JL. 'Exerkines': A Comprehensive Term for the Factors Produced in Response to Exercise. Biomedicines 2024; 12:1975. [PMID: 39335489 PMCID: PMC11429193 DOI: 10.3390/biomedicines12091975] [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: 08/05/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/30/2024] Open
Abstract
Regular exercise and physical activity are now considered lifestyle factors with positive effects on human health. Physical activity reduces disease burden, protects against the onset of pathologies, and improves the clinical course of disease. Unlike pharmacological therapies, the effects mediated by exercise are not limited to a specific target organ but act in multiple biological systems simultaneously. Despite the substantial health benefits of physical training, the precise molecular signaling processes that lead to structural and functional tissue adaptation remain largely unknown. Only recently, several bioactive molecules have been discovered that are produced following physical exercise. These molecules are collectively called "exerkines". Exerkines are released from various tissues in response to exercise, and play a crucial role in mediating the beneficial effects of exercise on the body. Major discoveries involving exerkines highlight their diverse functions and health implications, particularly in metabolic regulation, neuroprotection, and muscle adaptation. These molecules, including peptides, nucleic acids, lipids, and microRNAs, act through paracrine, endocrine, and autocrine pathways to exert their effects on various organs and tissues. Exerkines represent a complex network of signaling molecules that mediate the multiple benefits of exercise. Their roles in metabolic regulation, neuroprotection, and muscle adaptation highlight the importance of physical activity in maintaining health and preventing disease.
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Affiliation(s)
- Giuseppe Novelli
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00173 Rome, Italy
- Giovanni Lorenzini Medical Foundation, 20129 Milan, Italy
- Giovanni Lorenzini Medical Foundation New York, Woodcliff Lake, NJ 07677, USA
- Italian Federation of Sports Medicine, 00196 Rome, Italy
| | - Giuseppe Calcaterra
- Postgraduate Medical School of Cardiology, University of Palermo, 90127 Palermo, Italy
| | - Federico Casciani
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00173 Rome, Italy
| | - Sergio Pecorelli
- Giovanni Lorenzini Medical Foundation, 20129 Milan, Italy
- Giovanni Lorenzini Medical Foundation New York, Woodcliff Lake, NJ 07677, USA
- Italian Federation of Sports Medicine, 00196 Rome, Italy
- School of Medicine, University of Brescia, 25123 Brescia, Italy
| | - Jawahar L Mehta
- Giovanni Lorenzini Medical Foundation, 20129 Milan, Italy
- Giovanni Lorenzini Medical Foundation New York, Woodcliff Lake, NJ 07677, USA
- Department of Medicine (Cardiology), University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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15
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King A, Kwan K, Jukic I, Zinn C, Helms E. Fueling for and recovering from resistance training: The periworkout nutrition practices of competitive powerlifters. Nutrition 2024; 122:112389. [PMID: 38428220 DOI: 10.1016/j.nut.2024.112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Nutrient timing is a concept that emphasizes the intentional ingestion of whole or fortified foods, and dietary supplements, to adequately fuel for, and recover from, acute and chronic exercise. The nutrition strategies used by powerlifters around training sessions have not, to our knowledge, been previously investigated. This study explored the self-reported periworkout (before, during, and after) nutrition practices of competitive powerlifters, including what, why, and information source that informed practice, with comparison to current sport nutrition guidelines. METHODS Actively competing male (n = 240) and female (n = 65) powerlifters completed a cross-sectional online survey of self-reported periworkout nutrition practices in the pre-, intra-, and postexercise periods, fasted training, and supplementation. Data are presented as the number (n) and percentage (%) of all powerlifters practicing a given strategy followed by a % of responses reporting various practices or beliefs within this strategy. Categorical subgroups (sex, age, and weight class; and competitive caliber) were analyzed with a chi-square test or Fisher's exact test and denoted where significant (P ≤ 0.05). RESULTS Most powerlifters reported paying specific attention to nutrition practices in the pre-exercise period (n = 261; 85.6%) by ingesting more carbohydrate (CHO) rich foods (n = 234; 89.6%) for the purpose of assisting in training performance (n = 222; 85.1%). Most powerlifters reported intraexercise nutrition strategies (n = 211; 69.2%), of which most included ingesting more CHO rich foods (n = 159; 74.5%) for the purpose of feeling less hungry and/or boosting energy levels during training (n = 129; 61.1%). Most powerlifters reported paying attention to postexercise nutrition (n = 244; 80%), by ingesting more protein rich foods (n = 182; 74.6%) for the purpose of recovering better for the whole day (n = 152; 62.3%) and enhancing the benefits of training (n = 149; 61.1%). Most powerlifters did not complete training sessions in the fasted state (n = 262; 85.9%). Most powerlifters reported paying attention to supplementation before training (n = 237; 77.7%), of which preworkout formulas (n = 137; 57.8%), energy drinks (n = 101; 42.6%), creatine (n = 88; 37.1%), and caffeine pills (n = 70; 29.5%) were most reported. Supplementation was used to assist in training performance (n = 197; 83.1%) and increase wakefulness/alertness (n = 183; 77.2%). Males reported more often than females that they informed multiple elements of their nutrition practices with the information they read or watched somewhere (P = 0.002-0.012). CONCLUSION The periworkout nutrition practices used by competitive powerlifters followed current sport nutrition guidelines, by using CHO sources to fuel for training and ensuring the provision of protein postexercise. Competitive powerlifters may wish to exert caution with supplementation, as there is a risk of harm or inadvertent doping.
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Affiliation(s)
- Andrew King
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand.
| | - Kedric Kwan
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Ivan Jukic
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Caryn Zinn
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Eric Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand; Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Florida Atlantic University, Boca Raton, Florida, USA
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16
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Hughes AK, Francis T, Rooney J, Pollock R, Witard OC. The effect of protein or amino acid provision on immobilization-induced muscle atrophy in healthy adults: A systematic review and meta-analysis. Exp Physiol 2024; 109:873-888. [PMID: 38424716 PMCID: PMC11140175 DOI: 10.1113/ep090434] [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: 12/11/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
Bed rest and limb immobilization are models of muscle disuse associated with skeletal muscle atrophy and reduced strength. The purpose of this systematic review was to examine the impact of protein or amino acid provision before and/or during a period of muscle disuse on muscle atrophy (primary outcome), strength and muscle protein synthesis (secondary outcomes) following a disuse period. We performed a systematic review of Embase, MEDLINE, Web of Science, PubMed and Clinical Trials in December 2022. Eligible studies were randomized controlled trials that combined a dietary protein or amino acid intervention versus control during an experimental model of disuse (bed rest or unilateral limb immobilization) in healthy individuals aged ≥18 years. Nine articles from eight independent trials were identified and rated for risk of bias by two authors. A meta-analysis of muscle mass data revealed no effect (standardized mean difference: 0.2; 95% confidence interval: -0.18 to 0.57, P = 0.31) of protein/amino acid intervention in preventing disuse-induced muscle atrophy. Although the meta-analysis was not conducted on strength or muscle protein synthesis data, there was insufficient evidence in the reviewed articles to support the use of protein/amino acid provision in mitigating the disuse-induced decline in either outcome measurement. Additional high-quality studies, including the reporting of randomization procedures and blinding procedures and the provision of statistical analysis plans, might be required to determine whether protein or amino acid provision serves as an effective strategy to attenuate muscle atrophy during periods of disuse.
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Affiliation(s)
- Alix K. Hughes
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Thomas Francis
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Jessica Rooney
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Ross Pollock
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Oliver C. Witard
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
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17
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Phillips N, Gray SR, Combet E, Witard OC. Long-chain n -3 polyunsaturated fatty acids for the management of age- and disease-related declines in skeletal muscle mass, strength and physical function. Curr Opin Clin Nutr Metab Care 2024; 27:98-105. [PMID: 37874045 DOI: 10.1097/mco.0000000000000986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
PURPOSE OF REVIEW This review uses the hierarchy of evidence as a framework to critically evaluate the effect of long chain n -3 polyunsaturated fatty acid (LC n -3 PUFA) ingestion alone, or as an adjunctive intervention to resistance training, on muscle health-related outcomes in healthy and clinical older adult populations. RECENT FINDINGS Systematic reviews and meta-analyses of randomized controlled trials consistently report small, but clinically-relevant, effects of LC n -3 PUFA ingestion on strength outcomes, whereas mixed findings have been reported regarding changes in muscle mass and physical function. Cohort studies indicate an association between higher dietary LC n -3 PUFA intake and reduced likelihood of a sarcopenia diagnosis. Acute metabolic studies provide limited evidence for an effect of LC n -3 PUFA ingestion alone, or in combination with resistance training, on free-living integrated rates of MPS, static markers of muscle protein breakdown, or satellite cell activation in healthy older adults. SUMMARY Recent data supports the efficacy of LCn-3 PUFA ingestion to facilitate small, but clinically relevant, improvements in muscle strength in healthy and clinical older adult populations. The mechanism(s) that underpin the action of LC n -3 PUFA in promoting strength outcomes remain unknown, but likely relate to neuromuscular function.
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Affiliation(s)
- Nathan Phillips
- School of Cardiovascular and Metabolic Health, BHF Glasgow Cardiovascular Research Center, College of Medical, Veterinary and Life Sciences
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, BHF Glasgow Cardiovascular Research Center, College of Medical, Veterinary and Life Sciences
| | - Emilie Combet
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Scotland
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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18
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Heileson JL, Machek SB, Harris DR, Tomek S, de Souza LC, Kieffer AJ, Barringer ND, Gallucci A, Forsse JS, Funderburk LK. The effect of fish oil supplementation on resistance training-induced adaptations. J Int Soc Sports Nutr 2023; 20:2174704. [PMID: 36822153 PMCID: PMC9970203 DOI: 10.1080/15502783.2023.2174704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. METHODS A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES). RESULTS Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p< .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: -5.2%, PL: 0.0%, p = .092), and %BF (FOS: -5.9%, PL: -2.5%, p = .136) were observed, although, the between-group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]-1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045). CONCLUSIONS When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.
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Affiliation(s)
- Jeffery L. Heileson
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA,Nutrition Services Division, Walter Reed National Military Medical Center, Bethesda, MD, USA,CONTACT Jeffery L. Heileson Nutrition Services Division, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Steven B. Machek
- Kinesiology Department, College of Health Sciences and Human Services, California State University - Monterey Bay, Seaside, CA, USA
| | - Dillon R. Harris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Sara Tomek
- Department of Educational Psychology, Baylor University, Waco, TX, USA
| | - Leticia C. de Souza
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Adam J. Kieffer
- Department of Nutrition, U.S. Military-Baylor University Graduate Program in Nutrition, Fort Sam Houston, TX, USA
| | - Nicholas D. Barringer
- Department of Nutrition, U.S. Military-Baylor University Graduate Program in Nutrition, Fort Sam Houston, TX, USA
| | - Andrew Gallucci
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Jeffrey S. Forsse
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - LesLee K. Funderburk
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA,Department of Human Sciences and Design, Baylor University, Waco, TX, USA
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19
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Chapman S, Roberts J, Roberts AJ, Ogden H, Izard R, Smith L, Chichger H, Struszczak L, Rawcliffe AJ. Pre-sleep protein supplementation does not improve performance, body composition, and recovery in British Army recruits (part 1). Front Nutr 2023; 10:1262044. [PMID: 38144428 PMCID: PMC10748761 DOI: 10.3389/fnut.2023.1262044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Dietary protein is crucial for optimising physical training adaptations such as muscular strength and mass, which are key aims for athletic populations, including British Army recruits. New recruits fail to meet the recommended protein intake during basic training (BT), with negligible amounts consumed in the evening. This study assessed the influence of a daily bolus of protein prior to sleep on performance adaptations, body composition and recovery in British Army recruits. 99 men and 23 women [mean ± standard deviation (SD): age: 21.3 ± 3.5 years, height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg] were randomised into a dietary control (CON), carbohydrate placebo (PLA), moderate (20 g) protein (MOD) or high (60 g) protein (HIGH) supplementation group. Supplements were isocaloric and were consumed on weekday evenings between 2000 and 2100 for 12 weeks during BT. Performance tests (mid-thigh pull, medicine ball throw, 2 km run time, maximal push-up, and maximal vertical jump) and body composition were assessed at the start and end of BT. Dietary intake, energy expenditure, salivary hormones, urinary nitrogen balance, perceived muscle soreness, rating of perceived exertion, mood, and fatigue were assessed at the start, middle and end of BT. Protein supplementation increased protein intake in HIGH (2.16 ± 0.50 g⸱kg-1⸱day-1) and MOD (1.71 ± 0.48 g⸱kg-1⸱day-1) compared to CON (1.17 ± 0.24 g⸱kg-1⸱day-1) and PLA (1.31 ± 0.29 g⸱kg-1⸱day-1; p < 0.001). Despite this, there was no impact of supplementation on mid-thigh pull performance (CON = 7 ± 19%, PLA = 7 ± 19%, MOD = 0 ± 16%, and HIGH = 4 ± 14%; p = 0.554) or any other performance measures (p > 0.05). Fat-free mass changes were also similar between groups (CON = 4 ± 3%, PLA = 4 ± 4%, MOD = 3 ± 3%, HIGH = 5 ± 4%, p = 0.959). There was no impact of protein supplementation on any other body composition or recovery measure. We conclude no benefits of pre-bed protein supplementation to improve performance, body composition and recovery during BT. It is possible the training stimulus was great enough, limiting the impact of protein supplementation. However, the high degree of inter-participant variability suggests an individualised use of protein supplementation should be explored, particularly in those who consume sub-optimal (<1.6 g⸱kg-1⸱day-1) habitual amounts of protein. Clinical trial registration: The study was registered with ClinicalTrials.gov, U.S. national institutes (identifier: NCT05998590).
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Affiliation(s)
- Shaun Chapman
- Army Recruit Health and Performance Research, HQ Army Recruiting and Initial Training Command, Medical Branch, UK Ministry of Defence, Upavon, United Kingdom
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Justin Roberts
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Andrew J. Roberts
- Army Recruit Health and Performance Research, HQ Army Recruiting and Initial Training Command, Medical Branch, UK Ministry of Defence, Upavon, United Kingdom
| | - Henry Ogden
- Army Recruit Health and Performance Research, HQ Army Recruiting and Initial Training Command, Medical Branch, UK Ministry of Defence, Upavon, United Kingdom
| | - Rachel Izard
- Defence Science and Technology, UK Ministry of Defence, Salisbury, United Kingdom
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Havovi Chichger
- Biomedical Science Research Group, School of Life Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lauren Struszczak
- Public Health and Sports Sciences, University of Exeter, Exeter, United Kingdom
| | - Alex J. Rawcliffe
- Army Recruit Health and Performance Research, HQ Army Recruiting and Initial Training Command, Medical Branch, UK Ministry of Defence, Upavon, United Kingdom
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, United Kingdom
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20
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Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, Boppart MD, Kavazis AN, Reidy PT, Ogasawara R, Libardi CA, Ugrinowitsch C, Booth FW, Esser KA. Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions. Physiol Rev 2023; 103:2679-2757. [PMID: 37382939 PMCID: PMC10625844 DOI: 10.1152/physrev.00039.2022] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.
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Affiliation(s)
- Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Troy A Hornberger
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo A Nader
- Department of Kinesiology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Marni D Boppart
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Andreas N Kavazis
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Paul T Reidy
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, Ohio, United States
| | - Riki Ogasawara
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Cleiton A Libardi
- MUSCULAB-Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Karyn A Esser
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
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21
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Myers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs. Nutrients 2023; 15:2657. [PMID: 37375561 DOI: 10.3390/nu15122657] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.
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22
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Hermans WJ, Fuchs CJ, Nyakayiru J, Hendriks FK, Houben LH, Senden JM, van Loon LJ, Verdijk LB. Acute Quark Ingestion Increases Muscle Protein Synthesis Rates at Rest with a Further Increase after Exercise in Young and Older Adult Males in a Parallel-Group Intervention Trial. J Nutr 2023; 153:66-75. [PMID: 36913480 DOI: 10.1016/j.tjnut.2022.10.003] [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: 05/23/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Ingestion of protein concentrates or isolates increases muscle protein synthesis rates in young and older adults. There is far less information available on the anabolic response following the ingestion of dairy wholefoods, which are commonly consumed in a normal diet. OBJECTIVES This study investigates whether ingestion of 30 g protein provided as quark increases muscle protein synthesis rates at rest and whether muscle protein synthesis rates are further increased after resistance exercise in young and older adult males. METHODS In this parallel-group intervention trial, 14 young (18-35 y) and 15 older (65-85 y) adult males ingested 30 g protein provided as quark after a single-legged bout of resistance exercise on leg press and leg extension machines. Primed, continuous intravenous L-[ring-13C6]-phenylalanine infusions were combined with the collection of blood and muscle tissue samples to assess postabsorptive and 4-h postprandial muscle protein synthesis rates at rest and during recovery from exercise. Data represent means ± SDs; η2 was used to measure the effect size. RESULTS Plasma total amino acid and leucine concentrations increased after quark ingestion in both groups (both time: P < 0.001; η2 > 0.8), with no differences between groups (time × group: P = 0.127 and P = 0.172, respectively; η2<0.1). Muscle protein synthesis rates increased following quark ingestion at rest in both young (from 0.030 ± 0.011 to 0.051 ± 0.011 %·h-1) and older adult males (from 0.036 ± 0.011 to 0.062 ± 0.013 %·h-1), with a further increase in the exercised leg (to 0.071 ± 0.023 %·h-1 and to 0.078 ± 0.019 %·h-1, respectively; condition: P < 0.001; η2 = 0.716), with no differences between groups (condition × group: P = 0.747; η2 = 0.011). CONCLUSIONS Quark ingestion increases muscle protein synthesis rates at rest with a further increase following exercise in both young and older adult males. The postprandial muscle protein synthetic response following quark ingestion does not differ between healthy young and older adult males when an ample amount of protein is ingested. This trial was registered at the Dutch Trial register, which is accessible via trialsearch.who.int www.trialregister.nl as NL8403.
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Affiliation(s)
- Wesley Jh Hermans
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Cas J Fuchs
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | | | - Floris K Hendriks
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Lisanne Hp Houben
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Joan M Senden
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Luc Jc van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Lex B Verdijk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
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23
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Vigotsky AD, Halperin I, Trajano GS, Vieira TM. Longing for a Longitudinal Proxy: Acutely Measured Surface EMG Amplitude is not a Validated Predictor of Muscle Hypertrophy. Sports Med 2022; 52:193-199. [PMID: 35006527 DOI: 10.1007/s40279-021-01619-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/29/2022]
Abstract
Surface electromyography amplitudes are commonly measured in acute sports and exercise science studies to make inferences about muscular strength, performance, and hypertrophic adaptations that may result from different exercises or exercise-related variables. Here, we discuss the presumptive logic and assumptions underlying these inferences, focusing on hypertrophic adaptations for simplicity's sake. We present counter-evidence for each of its premises and discuss evidence both for and against the logical conclusion. Given the limited evidence validating the amplitude of surface electromyograms as a predictor of longitudinal hypertrophic adaptations, coupled with its weak mechanistic foundation, we suggest that acute comparative studies that wish to assess stimulus potency be met with scrutiny.
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Affiliation(s)
- Andrew D Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, IL, USA.
| | - Israel Halperin
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Taian M Vieira
- Laboratory for Engineering of the Neuromuscular System, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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