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To cite this article: Kevin D Tipton & Robert R Wolfe (2004): Protein and amino acids for athletes, Journal of Sports Sciences,
22:1, 65-79
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Journal of Sports Sciences, 2004, 22, 6579
The main determinants of an athletes protein needs are their training regime and habitual nutrient intake. Most
athletes ingest sufcient protein in their habitual diet. Additional protein will confer only a minimal, albeit
arguably important, additional advantage. Given sufcient energy intake, lean body mass can be maintained
within a wide range of protein intakes. Since there is limited evidence for harmful effects of a high protein intake
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and there is a metabolic rationale for the efcacy of an increase in protein, if muscle hypertrophy is the goal, a
higher protein intake within the context of an athletes overall dietary requirements may be benecial. However,
there are few convincing outcome data to indicate that the ingestion of a high amount of protein (23 g kg71
BW day71, where BW = body weight) is necessary. Current literature suggests that it may be too simplistic to
rely on recommendations of a particular amount of protein per day. Acute studies suggest that for any given
amount of protein, the metabolic response is dependent on other factors, including the timing of ingestion in
relation to exercise and/or other nutrients, the composition of ingested amino acids and the type of protein.
and energy balance, may all contribute to discrepant have no relationship with athletic performance. Athletes
results (Buttereld, 1987; Millward, 1999). Nitrogen and coaches are more interested in the optimum protein
balance is the most common method used to estimate intake for athletic success, rather than the actual
protein requirements. The limitations of nitrogen denition of protein requirement based on nitrogen
balance measures are well known. (Readers are referred balance. In fact, the appropriate denition of protein
to one of the many excellent reviews on this topic for requirement that is, the optimal protein intake will
more detailed information: Hegsted, 1976, 1978; vary depending on the training and competition goals of
Young, 1986; Lemon and Proctor, 1991; Tome and the athlete. It is important to bear in mind the goals of
Bos, 2000.) However, from a practical standpoint, different athletes when discussing the importance of
coaches and athletes are not usually interested in the protein ingestion. For each individual, the impact of
myriad of scientic arguments for the impact of exercise increased protein on whole-body and muscle nitrogen
on protein requirements. They simply wish to know balance must be considered in terms of the different
whether a particular athletes performance will be nitrogen metabolic pathways (Tome and Bos, 2000).
enhanced by consuming more, or less, protein. None For example, an endurance athlete would probably
of the methods that have been utilized in studies seeking consider the protein necessary to maintain lean body
to determine protein intakes for athletes has a direct mass and not impair performance as the protein
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relationship with athletic performance. The impact of requirement. Aside from obligatory uses, protein would
diet on performance is what we are interested in, but it be necessary for increased energy demands, protein
is difcult to quantify. At this time, there is no clear synthesis of enzymes that are stimulated by endurance
consensus on the importance of elevated protein for the training and, perhaps, repair of muscle proteins
athletic population. damaged by intense training. On the other hand, a
Meanwhile, there is, perhaps, a more fundamental strength athlete and many team sport athletes, such as
problem for determination of the protein requirements rugby or hockey players, would not consider the intake
of athletes. Much of the controversy surrounding necessary for maintenance of lean body mass sufcient,
protein requirement in athletes may be due to the exact but rather the protein requirement would be the
meaning of this term for this population. In our amount necessary to increase muscle mass and strength
opinion, it is difcult to dene protein requirement as or power. Additionally, not only would the denition be
it applies to competitive athletes. The most commonly different for athletes in different sports, but also in
used denition for the nutritional requirement for individual circumstances (e.g. weight loss) in any given
protein is the minimum amount ingested that will sport. For athletes, muscle protein is possibly the most
balance all nitrogen losses and thus maintain nitrogen important body protein to consider. Those athletes
equilibrium (Millward, 2001). Losses are considered to desiring muscle hypertrophy expect their training and
be the obligatory nitrogen losses (i.e. all nitrogen losses diet to stimulate protein accretion. Clearly, chronic
on a protein-free diet), thus representing the minimum exercise training has a dramatic impact on muscle
metabolic demands for amino acid nitrogen. This protein metabolism. Exercise training results in funda-
denition is based on nitrogen balance studies and it, mental adaptations in the muscle. The metabolic basis
or something very similar, has typically been used in for protein accretion is net muscle protein synthesis
studies that examined the impact of exercise on protein that is, protein synthesis exceeds protein breakdown
requirements (Tarnopolsky et al., 1988, 1992; Meredith over the given period in question. The primary
et al., 1989; Lemon et al., 1997; Forslund et al., 1998). adaptation to resistance exercise training is muscle
Millward (2001) also suggested a more complex hypertrophy, whereas endurance training results in
denition of protein requirement based on the Adaptive increased muscle oxidative capacity. The response of
Demands Model, in which the metabolic demands muscle protein metabolism to the training stimulus has
include both obligatory and adaptive components. a major impact on these adaptations. Very little research
Thus, protein requirement is dened as the minimum has examined the chronic response of muscle protein
protein intake that satises the metabolic demands and metabolism to exercise training. Phillips et al. (1999)
which maintains body composition. For the sedentary demonstrated that the responses of mixed-muscle (i.e.
population, the US RDA for protein is 0.8 g pro- the weighted average of all proteins in muscle) protein
tein kg71 BW day71, but it is not clear whether synthesis and breakdown to acute resistance exercise
athletes in training need more than this amount. were ameliorated in resistance-trained individuals
These denitions may be appropriate for normal, compared with untrained individuals (Fig. 1). These
healthy or even clinical populations, but we feel that and more recent results (Phillips et al., 2002) are
neither is necessarily appropriate for athletes in training. consistent with the principle of general adaptation to
Accepted denitions of protein requirement are based training. That is, as a system in this case, muscle
on nitrogen balance measures in the laboratory and may adapts to a stress, greater stress must be added to
Protein and amino acids for athletes 67
generate the desired adaptations. Muscle mass clearly Interestingly, both endurance and resistance exercise
adapts to the type and severity of training, as well as the increase mixed-muscle protein synthesis. Clearly, mus-
nutritional intake of the athlete. To maintain muscle cular adaptation to endurance exercise is profoundly
mass at greater than normal (i.e. that which is different from that to resistance exercise. Thus, it is
genetically determined), muscle protein synthesis must difcult to accept that the response of muscle protein
be increased regularly. Over 24 h, the response of metabolism to an acute bout is the same for both types
muscle to resistance exercise plus hyperaminoacidae- of training. There are several possible explanations for
mia is additive to the normal 24-h muscle protein why the response of mixed-muscle protein synthesis to
balance (Tipton et al., 2003) (Fig. 2). To date, there endurance and to resistance exercise is qualitatively
have been no studies on the impact of chronic similar. Mixed-muscle protein synthesis represents the
endurance training on muscle protein metabolism. weighted average of all the proteins in the muscle, each
However, endurance training increases the activity of which may have a unique response to a particular
and amount of mitochondrial enzymes and the size type of exercise. Certainly, since the major result of
and amount of muscle mitochondria (Neufer, 1989), chronic resistance training is muscle hypertrophy, it is
suggesting that muscle protein metabolism, at least for intuitive to expect resistance exercise to inuence
some proteins, must be inuenced by endurance myobrillar more than mitochondrial proteins; the
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0 Endurance Resistance
24h 3h
exercise exercise
Fig. 2. Difference in phenylalanine exchange (area under the
curve for net muscle protein balance in mg) between rest and Mixed-muscle protein : : or ::
exercise + essential amino acid supplement (ES) over the synthesis
entire 24 h and over 3 h, in both trials, corresponding to the Myofibrillar protein $ or ; ? : or ::
time of amino acid ingestion and exercise in the ES trial. synthesis
Thus, the response to exercise and amino acid ingestion for Mitochondrial protein : $ or : ?
3 h represents the response over the entire 24-h period (from synthesis
Tipton et al., 2003).
68 Tipton and Wolfe
greater than the RDA for sedentary individuals) as well exercise was compensated for by small and undetect-
as for protein intakes that are similar to those of able changes throughout the day. Support for this
sedentary individuals. So, we will attempt to illustrate notion comes from Devlin et al. (1990), who showed
the data supporting arguments both for and against that during 3 h of cycling at 75% VO2max, leucine
higher intakes for top sport athletes. Moreover, we hope oxidation was less than at rest. These data do not
to convey the notion that a general value for protein support the contention that dynamic exercise increases
requirements for athletes is difcult to ascertain and protein requirements. The impact of resistance exercise
determination of appropriate protein intake must take on amino acid oxidation has received far less attention,
into account the demands of the individual goals and but there is no indication that resistance exercise
training regimen of each athlete. increases leucine oxidation either during or after
exercise (Tarnopolsky et al., 1991). Thus, it seems that
the whole-body amino acid data are somewhat equivo-
Protein requirements cal and it cannot be concluded with certainty that
habitual exercise increases protein requirements. Leu-
Since the original consensus report in 1991, protein cine oxidation appears to be increased by endurance
requirements have been examined in additional studies, exercise, but this increase may not reect an increased
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but controversy continues regarding the impact of requirement for dietary protein.
exercise, especially exercise as intense as that top sport Nitrogen balance is the most common method used to
athletes must perform, on protein requirements (Tar- determine protein requirements. Using this method,
nopolsky, 1999; Rennie and Tipton, 2000; Wolfe, many authors have concluded that both endurance and
2000). The basis of the argument for increased protein resistance athletes require more than the 0.8 g pro-
needs by exercising individuals is often an increase in tein kg71 BW day71 dietary recommendation (Lem-
amino acid (usually represented by leucine) oxidation on, 1991). The results of more recent studies support
during dynamic exercise. Leucine oxidation was found this argument (Tarnopolsky et al., 1992; Phillips et al.,
to be increased during dynamic exercise in recent 1993). Feeding athletes different amounts of protein and
studies (Tarnopolsky et al., 1992; Phillips et al., 1993; measuring nitrogen balance, then extrapolating to the
El Khoury et al., 1997; Lemon et al., 1997; Bowtell et zero line, was the basis for the conclusion that athletes
al., 1998, 2000; Forslund et al., 1998; Lamont et al., require more dietary protein. In all these studies, zero
1999; Millward, 1999). Increased amino acid oxidation balance was calculated to be above 0.8 g protein kg71
during exercise is thought to be due to increased BW day71; thus, a widely accepted notion that athletes
utilization of amino acids as fuel; therefore, regular and need more protein has been promulgated. It is important
repeated exercise would then lead to increased protein to note that nitrogen balance is the method that is
requirements. commonly used to determine the protein needs of
On the other hand, previous work from our sedentary populations; thus comparing like to like, these
laboratory showed that the fate of leucine during studies indicate that active individuals, particularly
exercise might not reect that of all amino acids and athletes, require more protein in their diet.
leucine oxidation is not matched by urea production On the other hand, the notion that athletes require
(Wolfe et al., 1984). Also, lysine oxidation was not more protein than sedentary individuals is not uni-
increased, suggesting that short-term increases in versally accepted. There is ample evidence to suggest
leucine oxidation do not reect whole-body protein that protein needs are not increased by habitual
breakdown. Training does not increase branched-chain exercise. In fact, the opposite interpretation that is,
amino acids (BCAA) oxidation (Lamont et al., 1999) exercise training increases the efciency of protein
and, in fact, may attenuate the increase due to exercise utilization, thus making increased intake unnecessary
(McKenzie et al., 2000). Furthermore, increased amino has been argued. In a series of studies from the
acid oxidation during exercise must inuence 24-h laboratory of the late Gail Buttereld, it was demon-
oxidation of amino acids and thus nitrogen balance for strated that protein utilization is increased and protein
protein requirements to be changed. The 24-h leucine requirements are decreased by endurance exercise
oxidation and balance were measured in healthy men (Buttereld and Calloway, 1984; Todd et al., 1984).
performing 180 min of cycling exercise at protein Similarly, in a classic study, Gontzea et al. (1975)
intakes of 1.0 and 2.5 g protein kg71 BW day71 (El demonstrated that nitrogen balance was initially nega-
Khoury et al., 1997; Forslund et al., 1998). Whereas tive upon initiation of an exercise training programme
leucine oxidation was increased during exercise and by while maintaining constant protein intake, but returned
the higher protein intake, 24-h whole-body leucine to equilibrium after a period of accommodation.
remained in equilibrium at both protein intakes. It is Following the period of accommodation, no increase
thought that the increased leucine oxidation during in protein intake was necessary to maintain nitrogen
Protein and amino acids for athletes 69
equilibrium. These studies suggest that it is not argued that athletes who desire muscle hypertrophy
necessary for physically active individuals to increase should eat very high protein diets to maximize their
protein intake to maintain nitrogen equilibrium; in fact, muscle gain. These data illustrate that high, positive
exercise may decrease protein needs due to increased nitrogen balance can be maintained for an extended
efciency of protein utilization. Critics of this line of period (Oddoye and Margen, 1979), thus providing the
thought suggest that the intensity and volume of capacity for muscle hypertrophy. Whole-body (For-
training in the aforementioned studies was not equiva- slund et al., 1998) and muscle (Borsheim et al., 2002;
lent to that of top sport athletes and thus may not Miller et al., 2003) protein synthesis rates are increased
represent the circumstances the elite athlete faces with increasing protein or amino acid intake, supporting
(Lemon, 1991; Lemon and Proctor, 1991). the notion that the specic requirement for protein
A similar argument can be made for strength athletes. intake may be determined by the desired lean body
Acute resistance exercise in the fasted state has been mass. Furthermore, there is evidence from one study
shown to improve net muscle protein balance (Biolo et that the increase in lean body mass during resistance
al., 1995b; Phillips et al., 1997). Furthermore, training exercise training is greater with increased protein intake
ameliorates the response of muscle to a bout of (Burke et al., 2001). Weightlifters were fed either 1.2 or
resistance exercise in both the fasted (Phillips et al., 2.1 g protein kg71 BW day71. The group that in-
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1999) and fed (Phillips et al., 2002) states. These data gested the higher amount of protein had increased lean
suggest that there is an accommodation of muscle body mass compared with the group receiving less
protein metabolism such that protein needs for main- protein (Fig. 3). Results from a recent bed rest study
tenance of body mass in trained individuals would not from our laboratory further support the notion that
be increased. On the other hand, maintenance of lean increased nitrogen intake may increase muscle mass.
body mass is not the goal of many athletes, especially Two groups of individuals rested in bed for 28 days
those who participate in strength and power sports, and (Paddon-Jones et al., 2003). Both groups were fed
so the protein needed to increase body mass might be weight maintenance diets, but one was given additional
greater. nitrogen in the form of an essential amino acid
Alternative interpretations of the nitrogen balance supplement. Whereas the placebo group lost muscle
data can be used to argue that strength athletes may mass, the supplemented group maintained muscle mass
want to consume large amounts of protein. If an athlete during the bed rest period. Furthermore, although both
is trying to increase muscle mass, then the goal would groups lost strength, the loss was signicantly amelio-
not be nitrogen equilibrium, but positive nitrogen rated by the increase in nitrogen.
balance. Examination of the nitrogen balance data Not all available evidence supports the notion that
presented by Tarnopolsky et al. (1992) for strength- ingesting greater amounts of protein leads to greater
trained athletes could be used to support the contention lean body or muscle mass. The important result of
that increased protein intake will increase nitrogen dietary protein intake is maintenance or increase, in
balance in athletes during intense resistance training. the case of strength and power athletes of lean body
There are data to support the notion that all other mass. Interestingly, if calculations of body composition
things being equal, the more protein ingested, the more
lean body mass may be increased. Indeed, Hegsted
(1978) summarized a variety of nitrogen balance studies
of adults, children and pregnant women. Taken 70
Lean Tissue Mass
are made from the apparent nitrogen retention at high is evidence to suggest that energy intake is, in fact, more
protein intakes, unrealistic estimates of body composi- important for maintenance of nitrogen equilibrium than
tion can result (Hegsted, 1976, 1978). Furthermore, protein intake. Buttereld and co-workers clearly
studies in which lean body mass was measured during demonstrated the importance of energy for mainte-
resistance exercise training while consuming different nance of nitrogen balance and lean body mass (Todd et
amounts of protein do not offer a clear-cut conclusion al., 1984; Buttereld, 1987; Buttereld et al., 1997).
that protein needs are greater in the athletic population. Almost 100 years ago, it was demonstrated that athletes
That is, nitrogen balance may indicate high nitrogen can gain strength and maintain mass on relatively small
retention with increased protein intake without any protein intakes, as long as sufcient energy is available
increase in muscle mass (Tarnopolsky et al., 1988, (Chittenden, 1907). Furthermore, energy intake may be
1992). However, these studies were short (on the order crucial for nitrogen retention and increased lean body
of a few weeks), so it is possible that protein accretion mass. In the study of Gater et al. (1992), individuals
was occurring, but was not sufcient to be measured were resistance trained for 10 weeks on one of three
with existing body composition methods. In a 12-week dietary regimens. One group performed the training
study, elderly individuals were fed the RDA (0.8 g with no additions to their diet, a second was given an
protein kg71 BW day71) or double the RDA for amino acid supplement and a third consumed a diet
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protein during a resistance-training programme with positive energy balance. Positive energy balance
(Campbell et al., 1995). Both nitrogen retention and without additional protein engendered the greatest
body composition were similar in the two dietary gains in lean body mass during the 10-week training
protein groups. Of course, it is possible that young programme. Other investigators also have demon-
athletes would have an entirely different response, so strated that increases in lean body mass result from
the relevance of this study to the athletic population increased energy intake in sedentary individuals (For-
may be questioned. Three groups of rats were fed bes et al., 1986, 1989; Welle et al., 1989; Jebb et al.,
different amounts of protein during functional overload 1993). So, it would appear that increased energy intake
to stimulate muscle hypertrophy in the overloaded may be crucial to increasing lean body mass during
muscle (OHagan et al., 1995). Protein intake was 7, training, possibly more so than protein intake.
17.5 or 30% of the diet in the three groups. The amount Even if we accept that the protein needs of athletes are
of dietary protein did not affect the experimentally greater than the RDA, it should not necessarily be a
induced muscle growth in either the plantaris or soleus reason for the broad recommendation that athletes
muscles. Thus, it is not clear whether the increased increase their protein intake. Most athletes, especially
nitrogen retention associated with increased protein those with training volumes such that energy intake is
intake leads to greater lean body mass or muscle necessarily high, probably consume sufcient protein in
hypertrophy. their normal diet (Deuster et al., 1986; Grandjean,
If nitrogen retention increases, but does not result in 1989), even those from underdeveloped countries
increased lean body mass and muscle mass, then what is (Christensen et al., 2002), to cover even the higher
the fate of the excess nitrogen? Certainly, whole-body recommendations that have been published (Lemon,
amino acid oxidation increases with increased protein 1991; Lemon and Proctor, 1991). Viewed another way,
intake (Tarnopolsky et al., 1992; Bowtell et al., 1998; even athletes whose muscle hypertrophy is maximized
Forslund et al., 1998), but the nitrogen must end up are probably eating sufcient protein to cover the need
somewhere. It is possible that the amount of protein for muscle protein accretion (Millward et al., 1994).
deposition is too small to be detected by body Millward et al. (1994) point out that even the rates of
composition methodology. Alternatively, excretion of steroid-induced muscle growth are trivial (*3%)
nitrogen could be underestimated; thus the apparent relative to normal dietary intake. Furthermore, the
nitrogen retention may be due to inherent errors in the increased energy demands of intense resistance training
calculation of nitrogen balance. Exercise increases urea would increase dietary protein intake such that the diet
nitrogen recycling into body proteins (Carraro et al., would supply at least 50% more protein than the
1993). Furthermore, increased protein breakdown maximum rate of accretion that has been reported.
appears to provide amino acids for plasma proteins Thus, for most athletes, recommendations for increased
(Carraro et al., 1990). However, how this relates to protein do not seem necessary. Some athletes who need
long-term changes in nitrogen balance is unclear. Thus, to control their weight may need to increase protein as a
it is uncertain how these factors would be accounted for proportion of their energy intake. Nitrogen balance is
in calculations of the fat-free mass from nitrogen better maintained on a hypoenergetic diet if protein
retention. intake is high. Furthermore, as discussed in more detail
In any discussion of protein requirements, the below, examination of the available data has led to the
importance of energy intake must be considered. There conclusion that athletes wishing to increase muscle mass
Protein and amino acids for athletes 71
may want to consume large amounts of protein. For Composition of ingested protein and amino
example, the argument that strength athletes consuming acids
sufcient energy will consume more than enough
protein to supply amino acids for protein accretion Amino acid composition appears to inuence the
(Millward et al., 1994) presumes that there is a direct response of muscle protein balance following resistance
relationship between protein intake and protein accre- exercise. Net muscle protein synthesis results from
tion. There is ample evidence that amino acids not only ingestion of essential amino acids only (Tipton et al.,
function as precursors for protein synthesis, but also act 2001, 2003; Borsheim et al., 2002). Thus, it is clear that
as regulatory molecules to stimulate net muscle protein non-essential amino acids are not necessary for the
synthesis (Wolfe and Miller, 1999; Kimball, 2002; stimulation of muscle protein synthesis resulting in net
Kimball and Jefferson, 2002); thus that there is a direct muscle protein synthesis. There is evidence that even
relationship between protein intake and protein accre- single amino acids may stimulate protein synthesis and
tion is not necessarily correct. possibly net muscle protein synthesis. Studies in rats
In addition to limitations of nitrogen balance studies, demonstrate that leucine ingested after running results
the discrepancies may be rooted in the inherent in increased muscle protein synthesis by stimulating the
limitations of long-term endpoint studies. Whereas protein translation initiation pathways (Gautsch et al.,
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longitudinal endpoint studies might best be utilized to 1998; Anthony et al., 1999). In resting humans, muscle
answer the question of whether or not increased dietary protein synthesis was stimulated by bolus doses of
protein increases muscle mass, these studies are single essential, but not non-essential, amino acids
difcult to perform with sufcient control to render (Smith et al., 1994). Thus, individual amino acids may
readily interpretable results. Strict control of all aspects act as stimuli for muscle protein synthesis and positive
of an athletes life (e.g. training, rest, sleep, diet, travel) net muscle protein balance. These results suggest that
for a lengthy period is necessary to obtain measurable essential amino acids may act to stimulate muscle
results. The problem is that these studies may not protein synthesis in two ways: (1) by supplying substrate
demonstrate efcacy of increased protein intake even if for muscle protein synthesis and (2) acting as a
effective. Assuming that increasing protein intake is regulatory factor.
effective for increasing muscle mass, the response is The amount of essential amino acids necessary to
likely to be small compared with the normal response to acutely stimulate muscle protein synthesis and net
exercise and meal intake, especially for elite athletes. muscle protein synthesis appears to be relatively small.
The major stimulus for muscle growth will be the Ingestion of as little as 6 g of essential amino acids, both
training regimen and normal nutrient intake. Any with (Tipton et al., 2001) and without carbohydrates
additional stimulus due to elevated protein intake (Borsheim et al., 2002), results in dramatic elevations in
would be relatively minor. On the other hand, a small muscle protein synthesis leading to net muscle protein
response that is difcult to measure may, in fact, be synthesis. Moreover, some data suggest that there is a
physiologically relevant and, if so, increased protein dose dependency of the response of muscle protein
intake would be important to a nutritional programme. synthesis to essential amino acid ingestion after
Difculties with control of variables in longitudinal exercise. The response of net muscle protein balance
studies contribute to the uncertainty and it may be to two doses of 6 g each of essential amino acids
virtually impossible to conduct a study with appropriate (Borsheim et al., 2002) was about double that of two
control that will demonstrate clearly that increased doses of 6 g each of mixed amino acids (Miller et al.,
protein results in increased lean body mass. 2003). The mixed amino acids contained approxi-
Thus far, the discussion of protein requirements has mately 3 g of essential amino acids in each dose or
strictly been in the context of the amount of protein about half the amount in the two 6-g doses. Thus, there
necessary in the diet. There is abundant evidence to may be a point of essential amino acid availability above
suggest that determination of protein needs is not as which no further stimulation occurs. Support for this
simple as merely expressing a quantity to be ingested concept comes from the fact that net muscle protein
per day. Evidence from acute metabolic studies, as well synthesis was similar when *20 g and 40 g of essential
as longitudinal studies, indicates that other factors, such amino acids were ingested after resistance exercise
as composition of the protein and amino acids, timing (Tipton et al., 1999). Any further stimulation must
of ingestion and other nutrients ingested concurrently, occur following the next meal. A summary of the
inuence the utilization of ingested protein and amino response of net muscle protein balance to amino acids,
acids. Thus, for any given protein intake, factors as well as carbohydrates (discussed below), is illustrated
important to an athletes performance may vary in Fig. 4. At this time, the minimum dose of essential
depending on exactly what is ingested and when it is amino acids necessary to stimulate net muscle protein
ingested. synthesis and the amount necessary to stimulate the
72 Tipton and Wolfe
Ingestion of whey proteins resulted in amino acid muscle protein synthesis at rest (Biolo et al., 1995a).
concentrations in the blood that were higher and less However, after resistance exercise, additional stimula-
prolonged than those resulting from casein (Boirie et tion of muscle protein synthesis over and above that due
al., 1997). Both resulted in positive whole-body protein to the exercise was limited (Biolo et al., 1999). Whereas
balance, but the anabolic response to casein was ingestion of carbohydrates alone after resistance ex-
superior to that of whey proteins. The digestive ercise improves muscle protein balance, without amino
properties for these proteins are different such that acids present the balance does not reach positive levels
amino acids from casein appear more slowly than those (Miller et al., 2003). Thus, it would appear that while
from whey proteins (Dangin et al., 2001). The digestive the response of muscle protein synthesis to exercise and
properties of the proteins appear to play a role in the amino acids is additive, the response to exercise and
anabolic response to ingestion on a whole-body level, insulin is not additive. The normal post-exercise
but it is unclear if the anabolic response of muscle is stimulation of muscle protein breakdown, on the other
similar or if exercise inuences this response. Thus, hand, was ameliorated by local insulin infusion after
whereas it is clear that supply of amino acids is the resistance exercise (Biolo et al., 1999). The ameliora-
critical factor for stimulating net muscle protein tion of muscle protein breakdown by insulin infusion
synthesis following resistance exercise, other factors resulted in improved net muscle protein balance over
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may also play a role. the basal, post-exercise value; however, this improve-
Net positive muscle protein synthesis clearly results ment did not result in positive balance in the absence of
when amino acids are ingested after resistance exercise, amino acid intake. Taken together, the decrease in
but the response after endurance exercise is not as clear. muscle protein breakdown due to the insulin and the
Blomstrand and Saltin (2001) fed participants a BCAA increase in muscle protein synthesis due to increased
solution during and after cycling exercise. Ingestion of amino acids suggest that addition of an insulin
the solution resulted in slight improvements in net secretagogue, such as carbohydrate, to an amino acid
muscle protein balance, but the balance remained source may result in an optimal response of muscle
negative that is, net muscle protein synthesis did not protein balance.
result. These results could be interpreted to suggest that No study has compared the anabolic response to the
the response to endurance exercise combined with addition of lipids to amino acids to that of amino acids
amino acid intake is different from that to resistance alone but, given the potential importance of digestive
exercise. Alternatively, they could be interpreted to properties to the response, it should not be surprising if
suggest that feeding BCAA only is not sufcient to there was some effect. A recent study provided clear
stimulate net muscle protein synthesis after exercise. evidence, at least on a whole-body level, that ingesting
This notion is supported by the fact that net uptake of proteins as part of a meal engendered a different
amino acids resulted when participants were fed a response than when the proteins were ingested alone
proteincarbohydratelipid solution after 60 min of (Dangin et al., 2003). The rate of appearance of amino
cycling (Levenhagen et al., 2002). Thus, it is more acids in the blood suggests that the digestion rate of
likely that BCAA alone are insufcient to stimulate net whey proteins was slower in the presence of carbohy-
muscle protein synthesis and that, given the appropriate drates and fats than without and the anabolic response
nutritional stimulation, net muscle protein synthesis was improved. Clearly, this factor could have implica-
will occur after endurance exercise. However, since the tions for optimal protein intake for athletes.
usual response to chronic endurance training is not Alternatively, the energy provided by these nutrients
hypertrophy of muscle, the proteins that respond are acutely might act to stimulate net muscle protein
probably different from those that respond to nutrient balance. It has been suggested that stimulation of
ingestion after resistance exercise. Studies must be muscle protein synthesis and the resultant net muscle
conducted to determine the differences between the protein synthesis due to nutrient ingestion is due to
responses of muscle protein to endurance exercise and increased energy availability. However, in resting hu-
those to resistance exercise. mans, lipid infusion was found not to result in elevated
Few studies have examined the impact of carbohy- muscle protein synthesis or net balance (Svanberg et al.,
drates and fats on the response of net muscle protein 1999), suggesting that, at rest, increased energy per se is
balance after exercise. Any effect of consuming not an effective stimulator of muscle protein synthesis.
carbohydrates or fats upon net muscle protein balance Energy may be especially important after exercise. Since
will probably primarily be due to the resulting elevation energy demand is increased after exercise, muscle
of hormones, such as insulin. Carbohydrate ingestion protein synthesis may be more likely to be limited by
results in stimulation of insulin release. Local insulin energy availability, such that any elevation of muscle
infusion, such that arterial amino acid concentrations protein synthesis resulting in net muscle protein
are maintained, has been demonstrated to stimulate synthesis as a consequence of feeding is due to
74 Tipton and Wolfe
replenishment of energy rather than hyperaminoacidae- summarized in Fig. 5. It has also been demonstrated
mia or hyperinsulinaemia per se. Support for this that the anabolic response to resistance exercise is
concept comes from in situ studies on rat muscle inuenced by the timing of ingestion of a mixture of
showing that diminished rates of protein synthesis after carbohydrate, fat and protein and carbohydrates alone
exercise are linked to reduced concentrations of (Roy et al., 1997, 2000). There is also support for this
adenosine triphosphate and phosphocreatine (i.e. a notion from a longitudinal study design. Elderly
reduced energy state) (Bylund-Fellenius et al., 1984). volunteers were given protein-containing supplements
However, in vivo studies do not support this hypothesis. either immediately after resistance exercise or 2 h after
Rats fed a carbohydrate-containing meal post-exercise exercise (Esmarck et al., 2001) during 12 weeks of
did not demonstrate elevated rates of muscle protein resistance training. Those receiving the supplement
synthesis; however, muscle protein synthesis was immediately after exercise experienced greater increases
increased in rats fed an isoenergetic meal of protein in muscle mass and strength than those receiving the
plus carbohydrates (Gautsch et al., 1998). Recent supplement 2 h after exercise.
studies from our laboratory demonstrate that ingestion There is preliminary evidence that the timing of
of additional energy by human volunteers after resis- carbohydrate ingestion relative to amino acid ingestion
tance exercise does not increase in vivo net muscle may be important. After resistance exercise, amino acid
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protein synthesis without additional amino acids (Miller uptake was greatest in the rst hour following amino
et al., 2003). After endurance exercise, ingestion of a acid ingestion and declined during the next 2 h (Miller
carbohydratelipid supplement did not result in positive et al., 2003). On the other hand, amino acid uptake was
net muscle protein balance, but ingestion of carbohy- lowest in the rst hour after ingestion of carbohydrates,
drates, lipids and proteins did result in net muscle but increased in the next 2 h after ingestion (Fig. 6).
protein synthesis in human volunteers (Levenhagen et These results suggest that the greatest response of
al., 2002). These results suggest that acute provision of muscle protein balance to amino acid and carbohydrate
energy per se does not have an inuence on muscle intake may result from staggering the ingestion of
protein metabolism after exercise. These results also carbohydrates and amino acids, such that the responses
demonstrate that addition of lipids does not increase are superimposed and thus maximized. Studies need to
muscle protein balance over and above that seen with be conducted to test this hypothesis.
protein and carbohydrates alone. However, as discussed After endurance exercise, it would appear that timing
previously, chronic energy intake has clearly been of nutrient ingestion also may be important for the
demonstrated to inuence nitrogen balance (Todd et response of net muscle protein balance. It has been
al., 1984; Buttereld, 1987), suggesting that as long as shown that a protein, carbohydrate and lipid supple-
energy balance is sufcient on a chronic basis, other ment resulted in greater amino acid uptake when
factors are responsible for the response of muscle ingested immediately after cycling exercise than 3 h
protein synthesis and muscle protein balance. after cycling (Levenhagen et al., 2001). In another
study, post-exercise macronutrient ingestion resulted in
an attenuation of body weight loss and improved
Importance of timing of ingestion of nutrients
in relation to exercise and other nutrients
300
The timing of nutrient ingestion also inuences the
mg phe/ 3 h
of muscle mass and strength. Thus, for athletes desiring Finally, this review is not meant to advocate very high
muscle hypertrophy, there is little reason to limit protein intakes for athletes, but merely to point out that
protein intake and relatively high intakes might be the it is possible, if not likely, that many athletes, especially
best recommendation. Of course, muscle anabolism those involved in strength and power sports, may
may be enhanced by varying the type and timing of benet from higher intakes. However, as was concluded
protein and amino acid ingestion. Even if 2.53.0 g in the rst consensus paper by Lemon (1991), most
protein kg71 BW day71 is consumed and this amount athletes habitually ingest sufcient protein, so recom-
of protein is more than the synthetic machinery can mending greater protein intakes does not appear
process, the excess will simply be oxidized. As long as warranted. Perhaps other factors, such as the timing
the intake of other nutrients important to the success of of protein or amino acid intake in relation to exercise
an athlete is not compromised, there appears to be little and the intake of other nutrients, are more important
harm in ingesting these high amounts. Furthermore, considerations for those athletes wanting to increase
this amount of protein may be considered to be their body mass. Clearly, there is much to be learned
reasonable given the high energy intakes in these about the optimal protein intake for elite athletes. There
athletes. For example, intakes of *6400 kcal have been is a paucity of research examining the impact of various
reported in strength athletes (Alway et al., 1992). amounts of dietary protein on performance and body
Protein of only 14% of total kcal would be *2.5 g
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