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Get the Essentials: Protein in

the Diets of Healthy, Physically


Active Men and Women
by Nancy R. Rodriguez Ph.D., R.D., FACSM, and P. Courtney Gaine, Ph.D., R.D.

Learning Objective The Concept of Protein Turnover


To provide health/fitness professionals with a basic Protein turnover refers to the dynamic exchange between free
understanding of current recommendations regarding amino acid pools and proteins in the body in the ongoing
dietary protein intake and the practical application of this cycle of protein synthesis and breakdown. Figure 1 illustrates
information to the lifestyles of healthy men and women the integration of various aspects of protein utilization
who routinely exercise. by the body and the role of dietary protein in providing
amino acids to the free amino acid pools. In the fasted state,
Key words: Protein Turnover, Exercise, Macronutrients, the breakdown of the body’s own protein stores is the source
Energy Balance, Amino Acids.

P
rotein is reemerging as an important nutrient in
contemporary diet plans for improving weight
management. Whether the directives of current
approaches are as extreme as the Atkins diet or a more
subtle approach such as the Zone or South Beach plans,
protein has regained equal footing with carbohydrates.
For many health/fitness professionals, the reemergence of
this essential nutrient is a welcome change. Indeed, the vital
role of protein in the maintenance, repair, and synthesis
of skeletal muscle and other body tissues in physically active
men and women has long been known.

Protein as a Macronutrient
Proteins serve a number of structural (i.e., skeletal muscle)
and functional (i.e., enzymes) roles in the body. As a
macronutrient, protein is unique, given that it contains
essential amino acids that cannot be produced by the
body and must be consumed as part of the diet (Table 1).
Additionally, protein can be distinguished from
carbohydrate or fat, the other macronutrients, because
proteins are made from amino acids that contain nitrogen.
Whereas all three of the macronutrients can be used for
fuel by the body, this fate is the least preferable for protein.
Rather, amino acids, in general, and the essential amino
acids, in particular, should be used in the synthesis (growth),
repair, or maintenance of body proteins. These processes
are often referred to as protein turnover.

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a number of other essential nutrients relative to their


Table 1. The Essential Amino Acids
calorie content. The nutrient density of foods with
phenylalanine threonine specific regard to their protein or nitrogen content can
tryptophan methionine be referred to as the energy (E) or calorie to nitrogen
leucine* histidine (N) ratio (i.e., E:N). The lower the E:N ratio, the more
protein dense the food source (Table 2). For active
valine* arginine
individuals interested in weight maintenance, gains in
Isoleucine* lysine
lean body mass, or even weight loss, high quality proteins
*Branched chain amino acids. are found in nutrient-dense foods that are easily
incorporated into daily menu plans.
of amino acids to the free amino acid pools. Therefore,
the amount of protein being consumed is important for Importance of Adequate Energy Intake to
maintaining rates of protein turnover, particularly in Optimal Protein Utilization
maximizing muscle synthesis and growth. Because protein turnover (i.e., synthesis and breakdown)
and amino acid metabolism are energy dependent,
energy balance plays a central role in the best use
Recommended Intakes of Protein
of protein by the body (2). Studies using nitrogen
In 2005, the Institute of Medicine published Dietary
balance methodology (NitrogenIn vs. NitrogenOut)
Reference Intakes (DRIs) for specific nutrients, including
provide an overview of protein utilization because
protein (1). The DRIs are a set of reference values
nitrogen is present in every amino acid. When nitrogen
that include the commonly recognized recommended dietary
balance is negative (NitrogenIn < NitrogenOut), the
allowance (RDA; 0.8 g of protein/kg body weight). The
body is considered to be in a catabolic state, where
RDA is defined as the average daily nutrient intake level
amino acids are being used for energy production rather
sufficient to meet the nutrient requirement of nearly all
than for synthetic processes. A positive nitrogen balance
(97% to 98%) healthy individuals (1). The DRIs are based
(NitrogenIn > NitrogenOut) reflects an anabolic situation
on the concept that there is a range of protein intakes for
associated with incorporation of amino acids into
optimal protein utilization when energy (calorie) intake is
body proteins (i.e., growth). Nitrogen balance improves
sufficient to meet energy needs.
with increasing energy intake for any given amount
of protein consumed. However, increasing protein intake
Importance of Protein Source while energy intake is adequate does not improve
Protein source is an important consideration in meeting nitrogen balance or protein utilization (3); rather,
protein needs and obtaining the essential amino acids consumption of protein in excess of what is needed for
from the diet. Foods such as meat, eggs, fish, and dairy maintenance, synthesis, or repair of proteins leads to
products contain all of the essential amino acids and are
considered sources of complete or high-quality proteins.
These foods also are nutrient dense because they provide Table 2. Energy and Protein Content of
Selected Foods
Energy Protein
Food (kcal) (g) E:N*
Egg (1) 75 6.2 78y
Skim milk (8 oz) 86 8.4 66y
Cheese (1 oz) 114 7.1 104y
Hamburger patty (3 oz) 213 22 61y
Fruit yogurt (8 oz) 238 11 135
Soy milk (8 oz) 79 6.6 75y
Bagel (1) 289 11 164
Cream cheese (1 T) 51 1.1 283
*Energy (E) to Nitrogen (N) ratio.
y
Higher quality protein sources.
Figure 1. Protein turnover.

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an increase in the oxidation of protein as a fuel source (4).


As a result, energy balance is more important to protein
metabolism when protein intakes are at the lower
range of the DRIs so that amino acids are spared for
protein synthesis and not oxidized to assist in meeting
energy needs. Because exercise training contributes to
energy expenditure, participation in routine exercise
programs challenges this relationship and suggests that
training-specific nutritional strategies are needed for optimal
protein utilization.

The Impact of Resistance Training


on Protein Metabolism
For muscle to increase in size, two conditions must be
met: the synthesis of new muscle proteins must increase
and muscle protein synthesis must be greater than
breakdown so that protein balance is positive. Numerous
studies have shown that a single session of resistance
training stimulates an increase in both muscle protein
synthesis and breakdown in the period after the exercise.
The increase in synthesis seems to be more pronounced
in untrained subjects, where rates of synthesis remain
elevated for 48 hours after exercise (5), whereas routine
training leads to an attenuated response (6). As Figure 2. Muscle protein balance in response to feeding and
resistance exercise. (Figure adapted from reference 8).

mentioned previously, in the fasted state, net muscle


protein balance is negative (i.e., breakdown > synthesis;
Figure 2). Although resistance exercise increases the
rate of protein synthesis, it cannot match the rate of
protein breakdown caused by fasting, and net protein
balance remains negative. Only when adequate amounts
of amino acids are provided does muscle protein balance
become positive (7). In this way, resistance exercise
and amino acids work together to stimulate muscle
growth. Therefore, for muscles to experience growth,
adequate amounts of amino acids should be available
at the same time the stimulus for increased synthesis is
present.
Because resistance training stimulates an increase
in protein turnover and results in muscle damage, it is
widely recommended that individuals who resistance train
consume protein at intakes above those recommended
for healthy, nonexercising individuals. Although
determining precise requirements for protein is difficult,
analysis of several nitrogen balance studies indicate that
a protein intake of approximately 1.3 g/kg protein/day
is sufficient for strength-trained individuals to achieve
nitrogen balance when energy balance exists (8). For
individuals just beginning a strength training program,

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protein needs may be higher initially, given the heightened individuals who routinely participate in endurance exercise
effect of resistance exercise on increasing skeletal muscle has been debated for several years. It is likely that significant
protein turnover. However, given that typical protein increases in protein needs (up to 1.6 g/[kg  day]) apply
intakes for those who strength train is usually in excess only to ‘‘elite’’ endurance athletes exercising at high
of current recommendations, consuming adequate protein intensities for several hours a day (14). For people who
is likely not a concern unless they are restricting calorie engage in routine endurance exercise and have adequate
intake to lose weight. energy intake, the recommendations for protein intake
Much research has been done on the timing, (1.0 g/[kg  day]) are not much greater than for
composition, and quantity of amino acids needed in nonexercisers (0.8 g/[kg  day]) (14). Although evidence
relation to resistance exercise to optimize muscle protein exists that suggests people beginning an endurance
synthesis. Studies have found no difference in protein exercise program may have increased protein needs during
synthesis when amino acids are consumed before versus the initial few weeks (15), consumption of calories
1 hour after exercise, and no difference when amino sufficient to maintain energy balance during this time
acids are consumed at 1 hour versus 3 hours after exercise, will improve protein utilization in response to aerobic
providing individuals with some flexibility with timing training (12, 16).
of protein intake (9). Interestingly, when amino acids are
consumed at 1 hour and again at 3 hours after exercise (10), Considerations for Protein in Weight Management
there is an increase in synthesis after consumption of
Habitual reduction in energy intake for weight loss
amino acids at both time points, suggesting an added
has been shown to have a negative impact on protein
benefit to two small feedings after exercise. The amount
utilization because of the simultaneous slowing down of
of amino acids needed to elicit this anabolic effect is
metabolic processes (17). Typically, weight loss is associated
surprisingly small, with as little as 6 g of essential amino
with a reduction in both body fat and lean body (i.e.,
acids (in combination with 35 g of sucrose) eliciting an
muscle) mass, although the intent of diet interventions
increase in synthesis and resulting in a positive protein
remains the loss of fat and maintenance of muscle mass.
balance in muscle (9). Quality, and not quantity, of
Recent reports by Donald K. Layman, Ph.D., et al (18, 19)
protein is an important concept, with studies showing
have demonstrated that consumption of reduced calorie
that nonessential amino acids are not necessary to increase
diets for which protein provides a greater percentage of
protein synthesis (11); rather, provision of adequate
calorie intake than conventional weight loss diet plans
amounts of essential amino acids is important to
(i.e., 30% vs. ~15%, respectively) is associated with better
maximize protein utilization in response to routine
maintenance of muscle mass during weight loss. When
resistance exercise.
exercise is added to a weight loss program that uses a
higher-protein diet intervention, reductions in body fat and
The Role of Protein in Endurance Exercise
sparing of muscle mass is even greater (19). These studies
The impact that endurance exercise has on protein
encourage integration of exercise programs with nutrition
turnover is far less studied than resistance exercise. Protein
plans that provide a higher amount of dietary energy
has typically not been considered to play a major role in
in the form of protein for weight management.
the diets of endurance athletes because carbohydrates and fat
are the primary fuel sources during endurance exercise and
because muscle hypertrophy is not typically observed with Summary and Recommendations
endurance training. However, protein metabolism is Protein is essential to the diets of healthy, physically
affected by endurance exercise, especially when either energy active men and women. The essential amino acids
intake or carbohydrate intake is inadequate (12, 13). provided by high-quality proteins are important to
During exercise, it is generally thought that protein synthesis maximize rates of protein synthesis and to optimize protein
is decreased and breakdown is either increased or not utilization in response to habitual participation in resistance
different from rest. After exercise, rates of protein training and endurance exercise. The role of energy balance
synthesis are restored. should not be overlooked. Clearly, anabolic processes
At rest, the use of amino acids for energy is very low. (i.e., tissue building) require energy. Therefore, attention
During aerobic exercise, however, amino acid oxidation should be given to sufficient consumption of calories for
for energy to support muscular work increases, especially either weight maintenance or increases in muscle mass if
with increasing intensity, duration, and low glycogen amino acids are to be directed to synthetic (i.e., anabolic)
stores. Whether this increases the protein requirements for rather than catabolic processes. When negative energy

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balance is intended for the purpose of weight loss, a 8. Phillips, S.M. Protein requirements and supplementation in strength
sports. Nutrition 20:689–695, 2004.
small amount of additional protein in the diet is likely
beneficial to maintenance of lean body mass. 9. Rasmussen, B.B., K.D. Tipton, S.L. Miller, et al. An oral essential
amino acid-carbohydrate supplement enhances muscle protein
anabolism after resistance exercise. Journal of Applied Physiology
88:386–392, 2000.
Nancy Rodriguez, Ph.D., R.D., FACSM, 10. Tipton, K.D., E. Borsheim, S.E. Wolf, et al. Acute response of net
is an associate professor of Nutritional muscle protein balance reflects 24-h balance after exercise and amino
Sciences with joint appointments in acid ingestion. American Journal of Physiology, Endocrinology and
Metabolism 284:E76–E89, 2003.
Kinesiology and Allied Health Sciences at
the University of Connecticut. She also 11. Tipton, K.D., B.E. Gurkin, S. Matin, et al. Nonessential amino acids
are not necessary to stimulate net muscle protein synthesis in healthy
is director of the Sports Nutrition Program volunteers. The Journal of Nutritional Biochemistry 10:89–95, 1999.
at the University. Her research focuses on
12. Todd, K.S., G.E. Butterfield, and D.H. Calloway. Nitrogen balance
the relationships between protein intake, exercise, and protein in men with adequate and deficient energy intake at three levels of work.
utilization in children, athletes, and healthy adults. The Journal of Nutrition 114:2107–2118, 1984.
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acid supplements in the athlete’s diet: does type or timing of ingestion
P. Courtney Gaine, Ph.D., R.D., matter? Current Sports Medicine Reports 4:214–221, 2002.
is a postdoctoral research fellow in the 14. Tarnopolsky, M. Protein requirements for endurance athletes.
Department of Nutritional Sciences at Nutrition 20:662–668, 2004.
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is directed at characterization of cellular adaptation to physical effort on nitrogen balance in man. Nutrition
Report International 11:231–236, 1975.
proteins involved in the regulation of skeletal
muscle protein utilization and gender-specific 16. Pikosky, M.A., P.C. Gaine, W.F. Martin, et al. Aerobic exercise training
increases skeletal muscle protein turnover in healthy adults at rest.
responses to diet and exercise interventions with particular The Journal of Nutrition 136:379–383, 2006.
regard for protein metabolism.
17. Stein, T.P., W.V. Rumpler, M.J. Leskiw, et al. Effect of reduced
dietary intake on energy expenditure, protein turnover, and glucose
cycling in man. Metabolism 40:478–483, 1991.

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