Presented By: Presented By: Jessica CalhounJessica CalhounHeather Mason Heather Mason Thusita KannangaraThusita KannangaraOctober 11, 2010October 11, 2010

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Americans have become obsessed with protein!

In gyms, restaurants, medical offices and stores we are bombarded with ads and displays of protein supplements.

Many of these beliefs about protein are incredibly exaggerated or just plain wrong.

Derived from Greek “of first rank” or “primary”

Found in 40% of skeletal muscle, 25% in organs and the remainder in the skin and blood

Play vital roles in almost every biological process

Macromolecules composed of C, H, O and N which are formed when large amounts of subunits or amino acids link together creating long chains

Composed of amino acids (AA’s)

Contain a central carbon atom, amino group (NH2), carboxylic group (-COOH), and a side chain.

Twenty AA’s, 9 essential Complete proteins

contain all 9 essential AA’s

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ALL ANIMAL SOURCES

Meat Poultry Fish Milk Cheese Yogurt

VEGETABLE SOURCES

Soy Tempeh Grains Nuts Beans Soy/ Almond milk Starchy

vegetables

Requirements reflect the need to offset protein losses to maintain nitrogen homeostasis

Proteins constantly being synthesized and degraded “protein turnover”

Most AA’s are recycled, but a small portion are oxidized and must be replaced

Protease enzymes in the stomach and small intestine (SI), break down the amino acid chains in proteins into polypeptides then further separate into individual amino acids.

Absorption occurs along the SI Absorption of AA’s into the intestinal cells

requires carriers; but paracellular absorption can also occur

In general, BCAA absorbed faster than smaller amino acids

DRI for healthy individuals: 0.8 g/kg/day Strength and endurance athletes may have

increased needs Endurance athletes: 1.2 to1.4g/kg/day

9-10% daily energy Resistance athletes: 1.6 to 1.7g/kg/day

14-15% daily energy Extra protein is needed to repair damaged

muscle fibers, decrease the rate of muscle protein breakdown, replenishment of depleted energy stores, and synthesis of new protein molecules

18th century: muscles primarily composed of protein

18th century: Belief that protein was the major fuel source during exercise

Observations of affluent laborers diets lead to the “Voit Standard” or 118 grams of pro/day

1904: 35–50 g of protein a day was believed adequate for adults

2010: It is understood that the major energy fuel source is carbohydrates and not protein

Coronary artery disease Dehydration Increased Calcium excretionSupplements – possible risk for

toxicity and metabolic imbalancesStrain on liver and kidneys

Edema Anemia Muscle atrophy Hormone imbalanceSevere cases: Marasamus &

Kwashikor

http://www.bio.ilstu.edu/armstrong/syllabi/cassava/cassava8.htm

Branched-Chain Amino Acid Supplementation and Indicators of Muscle Damage After Endurance Exercise

Greer, B. , Woodard, J. , White, J. , Arguello, E. , & Haymes, E. (2007). Branched-chain amino acid supplementation and indicators of muscle damage after endurance exercise. International Journal of Sport Nutrition & Exercise Metabolism, 17(6), 595-607.

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Determine if branched-chain amino acid (BCAA) supplementation decreases indicators of muscle damage compared with a carbohydrate (CHO) beverage or a noncaloric placebo (PLAC) beverage.

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Goal is to reduce muscle damage during training

BCAA may reduce the extent of muscle damage via the release of anabolic hormones or by inhibiting proteolysis

Ingesting BCAA’s pre and post workout has been shown to decrease post exercise creatine kinase (CK) and lactate dehydrogenase (LDH) activities

Nine untrained, healthy college men Kept detailed diet record and were

encouraged to maintain the same dietary pattern

Avoid eating for 3 hours before each trial Subjects assigned to 1 of 3 treatment

orders Exercise at 50% V02 max for 90 min. Beverages were administered at 5 minute

pre exercise and at 60 min. mark.

Subjects blinded to beverage, same taste and appearance

1. BCAA beverage – isoleucine, leucine, valine (200 kcal)

2. Isocaloric CHO beverage (Gatorade) (200 kcal)

3. PLAC- noncaloric, water, artificial sweetener, lemon flavor, and salts

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Creatine kinase (CK)Lactate dehydrogenase (LDH) Isokinetic leg extension torqueLed flexion torque Muscle soreness of quads (self

rating)Measurements taken before

exercise and at 4, 24, and 48 hours post exercise

CK activities significantly lower after the BCAA trial than in the PLAC trial at all times, only lower than the CHO at 24 h

CK lower in the CHO trial than PLAC at 24 and 48 h

LDH was lower in the BCAA trial at 4 H, no sig. difference between CHO and BCAA

No sig. effects for leg extension torque Leg flexion torque in the BCAA trial was

significantly greater than both the CHO and PLAC trials at 48 h postexercise

Leg Extension torque increased, but not significantly

Leg Flexion Increased significantly at 48 h

Data suggests BCAA supplementation attenuates muscle damage during prolonged endurance exercise in untrained college age men

Smaller changes in markers in this study than previous, isocaloric?

Intensity too low? AA with coingestion of CHO may be more

effective than AA alone Possible mechanism- when ingested before

aerobic exercise BCAA increases concentrations of human growth hormone and helps attenuate a drop in testosterone, resulting in more anabolic environment

Strengths

Subjects blinded Isocaloric beverage Average athlete,

not highly trained All subjects

performed all three trials

Separated by 8 weeks

Limitations

Researchers not blinded

No women Small sample size Intensity too low? Only theorized

mechanism

Timing Protein Intake Increases Energy Expenditure 24 h after Resistance Training

Hackney, K., Bruenger, A., Lemmer, J. (2010). Timing Protein Intake Increases Energy Expenditure 24 h after Resistance Training. Medicine and Science in Sports and Exercise. 42(5), 998-1003.

http://tiptoptone.com/resistance_training.html

To determine the effect of protein (PRO) supplementation before an acute bout of heavy resistance training (HRT) on post exercise resting energy expenditure (REE) and the non protein respiratory exchange ration (RER).

Hypothesis: REE would be increased and RER would be decreased up to 48 hours after HRT in those receiving PRO compared with CHO

Double-blind two trial crossover design 6 resistance trained men, 3 trained

women Measure one rep max (RM) 4 day dietary journal Consumed supplement 20 mins before

single bout of HRT PRO supplement- 18 g whey, 2 g CHO,

1.5 g fat CHO supplement- 19 g CHO, 1 g PRO, 1 g

fat REE measured 4 consecutive days with

Sensor Medics metabolic system

REE elevated significantly in both CHO and PRO groups at 24 and 48 h post HRT

REE in response to PRO was significantly greater compared with CHO at 24 h

RER decreased significantly in both groups at 24 h compared to baseline

No differences observed in total energy intake or HRT volume = sets x reps x kg lifted

Reduced RER indicates there is greater reliance at fat oxidation at rest

Ingesting protein before HRT may be an effective way to increase energy expenditure

Increases in REE may lead to improvements in body composition

Volume was not increased so did not increase strength!

Strengths Men and women Double-blind Controlled diet 40 references,

many within the last 10 years

Limitations No control group Small sample size Could use more

graphs for clearer data presentation

Health, ethical, religious reasonsRange of vegetarianism from semi

veg. to veganObservational studies have not

detected differences in performanceShort term intervention studies have

had similar results

Protein about 85% digestible from plant diet compared to 95% with mixed diet

RDA .9 g protein/ kg BW/ day for regular human

Most people surpass this amount RDA could be increased to 1.3 to 1.8 g/ kg

for athlete No need for strict combination of foods Choose a variety of plant sources from all

food groups and achieve adequate protein balance

Vegan Soy Milk Tofu Tempeh Certain Veggie

burgers Nuts Peanutbutter Beans Corn, potatoes Whole grains

Vegetarian Vegan foods plus Milk Eggs Cheese Fish?

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Rowlands, D. S., Rossler, K., Thorp, R. M., Graham, D.F., Timmons, B. W., Stannard, S.R., Tarnopolsky, M. A. (2008). Effect of dietary protein content during recovery from high-intensity cycling on subsequent performance and markers of stress, inflammation, and muscle damage in well-trained men. Applied physiology, nutrition, and metabolism, 33(1), 39-51.

Effect of dietary protein content during recovery from high-

intensity cycling on subsequent performance and markers of

stress, inflammation, and muscle damage in well-trained men

http://www.treehugger.com/files/2008/09/helmet-debate-is-over.php

It may be most beneficial to consume protein during immediate hours of post exercise.

Exercised muscle has increased blood flow, amino acid uptake and protein synthesis

Amino acid uptake from high protein meal appears to be greatest following exercise

Evaluate the effect of post exercise protein consumption on next day high intensity cycling performance

Investigate presence of recovery and evaluate high intensity performance after 3 days.

Double-blind, randomized, crossover design 12 trained male cyclists Cyclists performed 3, 2.5 hour programmed

cycling endurance exercise tests over a 4 day period in the laboratory. Day 3 was a rest day.

Day 1 & 2, each cyclist consumed treatment.

The protein group received 0.8 g of pro/kg/hr in form of bar or beverage. Control group consumed 0.12 g pro/kg/hr and 2.35g cho/kg/hr

Instructed to consume 8 times throughout a 4 hour period.

Day 1 – Cycling protocol performed. Treatment was given and blood samples taken every 30 min over 3 hour period.

Day 2 – Blood samples -> cycling protocol -> treatment -> blood samples 3x in 90 minutes.

Day 3 – Rest day. Rich CHO diet provided to replenish glycogen stores

Day 4 – Repeat performance of day 2

Sensation perception charts for sprints and intervals on days 2 and 4

Plasma lactate, glucose, creatine kinase (CK) cortisol, interleukin-6, C Reactive Protein (CRP), tumor necrosis factor,

Net nitrogen balance

Overall mean sprint power in protein group was greater on day 4 and less in control group

Minor increases in strength and less nausea reported in protein group on day 4

Relative to control, protein group had reduced CK before exercise on day 4

Day 1 post exercise to day 2, control had positive N balance and negative in control.

Relative to control, plasma lactate was higher in control during sprints

No significant differences in glucose, cortisol & Interleukin 6

High protein post exercise diet followed by a high carbohydrate diet may enhance endurance sprinting performance in subsequent performance days.

http://gymaddicts.com/the-benefits-of-protein-bars/

STRENGTHS

Ample background information

Cycling protocol was programmed into cycle software

Semi- realistic environment

Thorough explanation of measurements

Invites more research on recovery and performance in endurance athletes

LIMITATIONS

Small sample size (n=12) Low external validity 30 y/o

male cyclists Cyclists complained of being

full Unrealistic to consume

frequent and large amounts of pro bars/beverages post exercise

Invasive Possible Day 2 and Day 3 non

dietary compliance Limited similar studies Minimal studies with

endurance athletes and protein recovery

Hoffman, J. R., Ratamess, N. A., Tranchina, C. P., Rashti, S. L., Kang, J., Faigenbaum, A. D. (2009). Effect of a proprietary protein supplement on recovery indices following resistance exercise in strength/power athletes. Amino acids, 38(3), 771-778.http://www.eshop-healthcare.com/muscle-milk-high-protein-shake-mix/

To evaluate the effect of pre and post exercise protein ingestion on recovery in resistance exercise

Double-blind, randomized design. Participants were matched for strength

15 male strength/football athletes Supplement group consumed 42 grams

of proprietary protein blend (“New Whey Liquid Protein”) pre and post exercise.

Placebo group consumed protein free beverage

Reported to a performance laboratory four different sessions (T1-T4)

T1 - Athletes tested for maximum strength T2 - Treatment consumed 10 minutes prior

to exercise and 15 minutes post exercise. Blood samples taken pre and post exercise

Lower body resistance exercise was performed at 80% maximum strength

T3 & T4 - muscle soreness rating, treatment, resistance exercise, treatment, blood samples pre and post exercise

Soreness questionnaireBlood samples to measure serum

testosterone, cortisol, hemoglobin and hematocrit

Dietary recall

Dietary recall - no difference in energy expenditure between the groups

No significant difference in muscle soreness

PL performed significantly fewer repetitions at T3 and T4 than they did at T2

SUP performed better than the placebo group at T3 and T4 when compared T2

PL elevated CK in T3 and T4. SUP CK remained stable

Protein ingestion pre and post resistance exercise may have a greater improvement in exercise recovery in the following days

STRENGTHS

Ample background information

Variety of references Unexpected findings

were explained with other studies

States that more research is needed in regards to protein timing and muscle repair

LIMITATIONS

Limited sample size (n=15) Low external validity – study

only looked at college male resistance/football athletes

Results not attributed to pre or post PRO ingestion individually

One of the first studies to show significant recovery from PRO SUP pre and post exercise

Dietary recall was taken 1 week prior to study

Milou, B., Koopman, R., Gijsen. A., Vandereyt, H., Kies, A. K., Kuipers, H., Saris, W.H.M., VanLoon, L.J.C. (2008). Protein co-ingestion stimulates muscle protein synthesis during resistance type exercise. American Journal Physiological Endocrinal Metabolism, 5:70-77.  

Few studies have examined the effect of co-ingestion protein and carbohydrate on muscle protein synthesis during exercise.

The results of these studies show that the stimulation effects of CHO + Protein on body protein synthesis during endurance and resistance type exercise

Assess the effect of protein and carbohydrate supplementation on synthesis of muscle protein and whole body protein balance during resistance exercise at fed state.

• Ten healthy male volunteers• All subjects participated in two

screening sessions• Body composition –using hydrostatic

weighing• Leg volume • Maximal oxygen uptake capacity• One repetition maximum – for two legs• Work load capacity

• All subjects received a standardized diet of 54.3 ±1.8 kJ/kg body weight, consisting of 62% Carbohydrate, 22% Fat, and 16% Protein evening before each experimental day.

• During experimental day 0.16±0.01MJ.kg body wt -1.day-1, consisting of 62% carbohydrate, 13% Protein, and 26% Fat.

• Subjects ingested 78±g protein via standardized diet and additional 21±1 g from CHO+ Protein treatment

• Each subject participated in two treatments separated by two weeks

• During 2hr resistance type exercise either carbohydrate or Carbohydrate +protein treatment received

• Subjects received a dose of 0.15g.kg-1.h-1 carbohydrate (50% glucose and50%maltodextrin), with or without 0.15g.kg-1.h-1 protein hydrolysate beverage (1.5ml/kg)every 15 mins during exercise

• Arterialized blood samples and muscle biopsies were taken every 15 min( t=0 and t=120)

Whole body net protein balance positive in CHO +Protein treatment

CHO treatment achieved negative net protein balance

Whole body protein breakdown rates lower in CHO+ Protein experiment

Mixed muscle protein synthesis rates higher in the CHO+ PRO treatment

Protein co-ingestion with carbohydrate improves whole body protein balance and increases mixed muscle protein synthesis rate during resistance type exercise

STRENGTHS

Same group of participants used in both experiments (act as own control)

Athletes performed in a fed state

Recent reference articles (after 2000)

LIMITATIONS

Small sample size (n=10)

They were not elite or trained athletes

Do not participate in any regular sports activities.

When counseling athletes in regards to protein needs and exercise, it is important to understand the athletes needs and goals to help them perform optimally.

A tool that dietitians can be use when counseling athletes in regards to protein needs and exercise.

Connected through 4 Levels Macrosystem: wider society, culture, media

and Ex. Athletes are susceptible to media and advertisements of high protein diets, supplement use and are often intrigued by such items that claim to performance.

Mesosystem: school policies, trainers and coaches

Ecosystem: family values, norms and expectations

Macrosystem: personal beliefs, values and skills

http://gozips.uakron.edu/~susan8/devparch/urie.jpg

In regards to protein and exercise, dietitians are often called on to design athletic diets

Understand the sport, physical requirements, time dedication, living situation, cultural needs, age, goals and education level

Recommendations can be made based of the athlete’s everyday influences

Increased communication and understanding between the athlete and dietitian

Lead to improved athletic performance

"Mix one part fact with several parts ignorance; season with advertising, sprinkle on a need for that all-important competitive edge, and you have a recipe for protein supplements" (Caffery, 2010)

http://rawfoodsos.com/2010/02/16/the-great-protein-debate-part-2/

Protein ingestion before exercise has been shown effective in decreasing muscle soreness and improving repetition performance in resistance trained athletes

Protein has shown to improve mean sprint performance in well trained endurance cyclists

Supplementation is overused in college athletes and has not proved to be more effective than dietary protein

Further research is needed to determine the optimal amount and timing of protein needed for sports

Berardi, N.J., Price, T. B., Noreen, E. E., Lemon, P. W. R. (2006) Post exercise muscle glycogen recovery enhanced with a carbohydrate- protein supplement. Medicine and science in sports and exercise, 38:6, 1106-1113.

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Butterfield, G.E. (1987). Whole body protein utilization in humans. Medicine and science in sports and exercise, 19:157-165.

Chelsy, A., MacDougall J. D., Tarnapolsky, M. A., Atkinson, S. A., Smith, K. (1992). Changes in human muscle protein synthesis after resistance exercise. Journal of Applied Physiology, 73:1383-1388. 

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Protein co-ingestion stimulates muscle protein synthesis during resistance type exercise. American Journal Physiological Endocrinal Metabolism, 5:70-77.  

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