Chapter 6 Protein: The Tissue Builder

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Dietary Protein
Protein is one of our most important essential nutrients
Structure of body tissues Formation of enzymes May provide energy

Implications for sports

Protein needs of strength and endurance athletes

Implications for health

The good proteins in the OmniHeart diet

What is protein?
Protein is a complex structure containing carbon, hydrogen, oxygen, and nitrogen, and in some cases sulfur.

Amino acids
Building blocks of protein Each has
an amino group (NH2) an acid group (COOH) a unique side chain

Formation of peptides and protein

Is there a difference between animal and plant protein?

Two main classes of amino acids Essential (indispensable) amino acids
Must be obtained from foods in the diet

Nonessential (dispensable) amino acids

May be formed in the body

Animal and plant protein

In natural, unprocessed foods, both animal and plant protein have all 20 amino acids The quality of a protein source is in its ability to provide nitrogen and amino acid requirements for growth, maintenance and repair of tissues

Animal and plant protein

Various analytical techniques are used, most focus on the concept of nitrogen balance
Protein Digestibility-Corrected Amino Acid Score (PDCAAS) PDCAAS scores range from 1.0 to 0.0

Complete Proteins
High-quality proteins Foods that contain an adequate content of all essential amino acids Animal proteins are this type PDCAAS for egg white is 1.0 PDCAAS for meat is 0.92

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Incomplete Protein
Foods that are low in one or more essential amino acids Plant proteins
PDCAAS for legumes is 0.68 PDCAAS for wheat bread is 0.40

An essential amino acid that is in limited supply in a particular food is a limiting amino acid
Legumes (methionine) Grains (Lysine)

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What are some common foods that are good sources of protein?
The Food Exchange System
High
Meat and meat substitutes (legumes) Milk

Lower
Starch Vegetable Fruit Fat
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Food Exchange Groups

Food Exchange
Milk (1 cup) Skim/very low fat 12 0-3 8 90

Carbohydrate

Fat

Protein

Calories

Low fat
Whole Meat/substitutes (1 oz) Very lean

12
12 0

5
8 0-1

8
8 7

120
150 35

Lean
Medium fat High fat Starch (1 oz; cup) Fruit (1 medium; cup) Vegetable (1/2 cup) Fat (1 teaspoon)

0
0 0 15 15 5 0

3
5 8 0-1 0 0 5

7
7 7 3 0 2 0

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75 100 80 60 25 45

Carbohydrate, fat and protein in grams per serving 1 g carbohydrate = 4 Calories; 1 gram fat = 9 Calories; 1 gram protein = 4 Calories
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How much protein do I need?

Humans need enough protein to provide adequate amounts of nitrogen and essential amino acids Recommended Dietary Allowance (RDA) Based on age and body weight Acceptable Macronutrient Distribution Range (AMDR) Based on percentage of daily energy intake

ChooseMyPlate.gov

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Protein RDA

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Protein AMDR
10-35% of daily energy intake Adult Female
132 lbs (60 kg) 2,000 Calorie diet

RDA is 48 grams of protein (60 x 0.8) AMDR of 10% provides 50 grams of protein
2,000 x 0.10 = 200 protein Calories 200/4 Calories per gram of protein = 50 grams of protein

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How much of the essential amino acids do I need?

RDA have been established for the 9 essential AA

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What are some dietary guidelines to ensure adequate protein intake?

For omnivorous individuals
Eat a wide variety of animal and plant foods Select animal foods low in fat Eat animal foods with plant foods 70% from plant foods; 30% from animal foods

For vegans
Ensure consumption of adequate amounts of complementary protein foods

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Metabolism and Function

What happens to protein in the human body?
Digestion into specific amino acids Metabolic fate of amino acids Role of the liver Protein synthesis in body cells

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 Protein catabolism Nitrogen: excreted as urea Alpha-ketoacid: Used as energy Converted to carbohydrate or fat

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Formation of carbohydrate and fat from excess protein

Glucogenic amino acids
Form pyruvate Gluconeogenesis

Ketogenic amino acids

Form acetyl CoA

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Formation of carbohydrate and fat from excess protein

Glucogenic amino acids
14 glucogenic amino acids

Ketogenic amino acids

Only leucine and lysine

Glucogenic and ketogenic amino acids

5 amino acids can be both glucogenic and ketogenic Isoleucine, phenylalanine

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Can protein be formed from carbohydrates and fats?

Nitrogen from excess amino acids can combine with an alpha-ketoacid to form some non-essential amino acids in the liver. The ketoacids are derived from carbohydrate or fat metabolites or intermediates in the Krebs cycle

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What are the major functions of protein in human nutrition?

Dietary protein serves all three major functions of nutrients
Forms the structural basis for the vast majority of body tissues Forms numerous enzymes and hormones to help regulate body metabolism Used as an energy source if needed Importance of carbohydrate for protein-sparing effect

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Proteins and Endurance Performance

Protein Use as Energy Source
During rest <5% of total daily expenditure Endurance training may reduce protein oxidation at rest, increasing the amount of energy derived from fat

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Proteins and Exercise

Protein use for energy during exercise Exercise and protein losses Protein metabolism during recovery from exercise Effect of training on protein metabolism Protein needs of athletes Prudent protein recommendations for athletes

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Are proteins used for energy during exercise?

Measures of protein use during exercise
Urea concentration Measures of 3-methylhistidine in urine Nitrogen balance Labeled isotopes

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Protein use during exercise

Resistance exercise training
Does not appear to increase protein oxidation May provoke muscle tissue catabolism Both catabolism and anabolism may occur during recovery, with anabolism prevailing over time

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Protein use during exercise

Aerobic endurance exercise training
Protein use is minimal compared to carbohydrate and fat Dynamic exercise activates BCAA dehydrogenase, an enzyme that oxidizes BCAA Some amino acids are used to promote gluconeogenesis Protein use may increase when body carbohydrates stores decrease

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Protein use during exercise

Aerobic endurance exercise training
Exact mechanism not determined, but proposed mechanisms include activation of proteolytic enzymes that degrade myofibrillar protein Six amino acids may be metabolized in the muscle, including the three BCAA

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Protein use during exercise

Exercise by-products include ammonia, alanine, and glutamine which can transport nitrogen and ketoacids to the liver Glutamine is an important fuel for the immune system

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Protein use during exercise

Leucine and the Glucose-Alanine Cycle
Leucine is the major BCAA to be oxidized during exercise The alpha-ketoacid may enter the Krebs cycle The amino group combines with pyruvate to form alanine, which may be transported to the liver to form glucose Estimated glucose generation from alanine is very limited

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Protein use and importance of carbohydrate

Carbohydrate availability is an important factor affecting the use of protein as an energy source during aerobic endurance exercise Research indicates that elevate endogenous stores of carbohydrate or provision or exogenous carbohydrate during exercise may exert a proteinsparing effect

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Does exercise increase protein losses in other ways?

Urinary losses
Proteinuria Greater losses following intense or prolonged exercise Losses are small, about 3 grams per day

Sweat losses
Losses are minor, about 1 gram of AA/liter of sweat

Gastrointestinal losses
Minor losses

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What effect does exercise training have upon protein metabolism?

Training induces specific adaptations in body cells depending on the type of training
Resistance or strength training Aerobic endurance training

In general, exercise training produces a positive protein balance that may contribute to performance enhancement

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What effect does exercise training have upon protein metabolism?

Chronic exercise training appears to decrease protein catabolism during standardized exercise tasks Aerobic endurance training appears to increase the ability of the muscle to use protein as an energy source, if needed.
May help preserve glucose for the brain when carbohydrate levels are low

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Exercise training and protein

Training may decrease the formation of ammonia during standardized exercise
Ammonia is thought to contribute to fatigue, possibly by impairing muscle cell metabolism

Eccentric muscle training may help prevent muscle protein damage and delayed onset of muscle soreness (DOMS)

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Do individuals in strenuous physical training, including the developing adolescent athletes, need more protein in the diet?
Varying viewpoints
Need more protein ACSM, ADA, DC Position Statement on Nutrition for the athlete ISSN Position Stand

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Do individuals in strenuous physical training, including the developing adolescent athletes, need more protein in the diet?
Do not need more protein National Academy of Sciences in DRI report May need less protein Opinion of a protein/exercise scientist

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Dietary protein needs: Strength-type activities

Additional protein is often recommended to help support or promote increases in muscle tissue

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Dietary protein needs: Strength-type activities

Some exercise scientists recommend an optimal intake of about 1.5 to 1.8 grams/kg body weight The NAS indicates that the RDA is sufficient

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Dietary protein needs: Endurance-type activities

Carbohydrate is the main fuel for endurancetype athletes More dietary protein is recommended to
Restore protein used for energy Promote synthesis of oxidative enzymes and mitochondria Help prevent sports anemia

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Dietary protein needs: Endurance-type activities

Some exercise scientists recommend an optimal intake of about 1.1 to 1.4 grams/kg body weight for aerobic endurance athletes, and 1.4 to 1.7 grams/kg body weight for intermittent high-intensity sports
The NAS indicates that the RDA is sufficient

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Recommendations for protein intake in athletes

1. Obtain about 15 percent or more of daily energy

intake from protein Some athletes may need more protein than others
Athletes in weight-control sports Female endurance athletes with low energy intake

Protein intake is within the AMDR

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Recommendations for protein intake in athletes

2. Consume protein, preferably with carbohydrate, before and after workouts: The concept of Nutrient Timing. There appears to be little difference in anabolic responses if protein is consumed either before or after exercise The protein source should contain all essential amino acids
About 0.1 gram per kg body weight is recommended 7 grams for a 70-kg individual
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Recommendations for protein intake in athletes

Consuming carbohydrate with the protein may also enhance the anabolic effects after exercise, possibly attributed to increase insulin secretion Whole foods, such as a turkey breast sandwich, appear to be as effective as amino acid solutions Carbohydrate: protein ratio 3:1 or 4:1
Commercial products Chocolate milk

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Recommendations for protein intake in athletes

3. Be prudent regarding protein intake.
There is insufficient evidence that increased protein intake will enhance exercise performance Experts contend that given sufficient energy intake, lean muscle mass may be maintained within a wide range of protein intakes There is a metabolic rationale for increasing protein intake if muscle hypertrophy is the goal, but the intake need not be excessive and may be within the AMDR of 10-35% of daily energy intake

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Protein: Ergogenic Aspects

Three of the top 5 most popular sport supplements Protein Amino acids Creatine

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What types of protein supplements are marketed to physically active individuals?

Variety of products, but the protein source is usually natural protein from milk, eggs, or soy
Special high protein foods or diets Commercial liquid meals such as Nutrament Sports drinks and shakes; sports bars

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What types of protein supplements are marketed to physically active individuals?

Whey and colostrum
Whey protein isolates from cheese-making process Colostrum is first milk form cows (Theory: IGF-1)

Other protein sources Protein/carbohydrate solutions

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Do high-protein diets or protein supplements increase muscle mass and strength in resistancetrained individuals?
High-protein diets
Research data are equivocal, but suggest additional protein may increase lean body mass but has no effect on measures of strength Consuming protein after strenuous resistance exercise may enhance muscle repair

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Do high-protein diets or protein supplements increase muscle mass and strength in resistancetrained individuals?
Whey
Research findings are mixed, but in general show positive effects of whey protein supplementation, about 1.2-1.5 grams per kg body weight daily, on lean body mass and muscular strength. In one study, soy protein was also effective.

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Do high-protein diets or protein supplements increase muscle mass and strength in resistancetrained individuals?
Colostrum
Several studies suggest colostrum supplementation may increase lean body mass, but effects on strength are mixed

Additional research is recommended to evaluate the ergogenic potential of whey and colostrum

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Do high-protein diets or protein supplements improve aerobic endurance performance in endurance-trained individuals?
High-protein diets or meals
The Zone Diet (40:30:30), a high-protein diet, has been advocated for endurance athletes Studies do not support an ergogenic effect of high-protein diets on aerobic endurance Several studies suggest that a Zone Diet eating plan over the course of a week may actually impair aerobic endurance performance, particularly if protein replaces carbohydrate in the diet

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High-protein diets and aerobic endurance: Protein/Carbohydrate Preparations

Effects on aerobic endurance performance
Early studies have shown increased endurance with protein/carbohydrate versus carbohydrate alone; however, the protein/carbohydrate solutions contained more energy More recent studies balanced the energy content of both solutions and report no difference between the two

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High-protein diets and aerobic endurance: Protein/Carbohydrate Preparations

Effects on recovery from exercise
Recent studies find that when energy content is balanced, protein/carbohydrate solutions provide no advantage over carbohydrate alone on subsequent exercise performance Some data suggest protein/carbohydrate solutions may prevent muscle soreness, while other research does not

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High-protein diets and aerobic endurance: Colostrum

Preliminary research suggests that colostrum supplementation during training (10-20 grams of colostrum daily for 9-10 weeks) could improve performance in some tasks
Cycle time trial after 2-hours of cycling Performance in a 40-kilometer time trial

However, the data should be considered preliminary and additional research is recommended

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Are amino acid, amine, and related nitrogencontaining supplements effective ergogenic aids?
Arginine and Citrulline Arginine, Lysine, and Ornithine Tryptophan BCAA Glutamine Aspartates Glycine Glucosamine and Chondroitin Creatine HMB Beta-alanine and Carnosine Tyrosine Inosine

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Branched Chain Amino Acids (BCAA)

Leucine, isoleucine, and valine are three major amino acids in muscle tissue Theoretical ergogenic mechanisms:
Use as a fuel during exercise and spare muscle glycogen Decrease the rate of muscle tissue degradation Prevent adverse changes in brain neurotransmitter function

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BCAA supplementation and the Central Fatigue Hypothesis

1. Prolonged aerobic endurance exercise decreases muscle glycogen and increase serum FFA 2. BCAA uptake by exercising muscles is enhanced in prolonged exercise 3. Serum free tryptophan:BCAA ratio (fTRP:BCAA) increases 4. High levels of serum free tryptophan may induce formation of serotonin

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BCAA supplementation and the Central Fatigue Hypothesis

5. Elevated brain serotonin may induce fatigue through depressant activity 6. High levels of BCAA compete with free tryptophan for entry into brain cells, thereby decreasing serotonin formation and preventing fatigue

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BCAA and the Central Fatigue Hypothesis Main research findings:

Some human research suggests increases in serotonin may be associated with fatigue, but other neurotransmitters, like dopamine, are also involved BCAA supplementation may be used for energy and may help maintain serum BCAA levels

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BCAA and the Central Fatigue Hypothesis Main research findings:

Mental performance: Results of field studies are equivocal, but several have found enhanced mental alertness in prolonged sport events, such as tennis and soccer Perceived exertion: Results of laboratory studies involving intense endurance exercise are equivocal.

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BCAA and the Central Fatigue Hypothesis Main research findings:

Physical performance with acute supplementation
Study with 193 marathon runners suggested improved performance in slower runners (3:05-3:30) but not faster runners (<3:05) when consuming 7-12 grams during running Slower runners may have depleted muscle glycogen earlier and thus benefited more from supplementation Criticism of the study -Unorthodox statistical procedure
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BCAA and the Central Fatigue Hypothesis Main research findings:

Physical performance with acute supplementation: Most well-controlled laboratory and field studies have reported no significant effects on exercise performance. Studies usually involved 3 separate treatments:
Carbohydrate alone BCAA alone Carbohydrate with BCAA

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BCAA supplementation - Additional research findings:

Acute B CAA supplementation does not enhance exercise performance in the heat Results of chronic BCAA supplementation (2 weeks) are equivocal, but generally indicate no ergogenic effect
A recent study with leucine (45 g/kg for 6 weeks) found improved endurance in a rowing test

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BCAA supplementation -Additional research findings:

BCAA supplementation not necessary if carbohydrate is available
Carbohydrate is the best fuel for endurance athletes Carbohydrate helps attenuate decreases in fTRP:BCAA

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BCAA supplementation -Additional research findings:

BCAA supplementation may be an effective protocol for athletes in weight-control sports who are on a diet Research is needed to help clarify the role of BCAA supplements, or protein in general, on muscle tissue recovery following strenuous exercise

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Creatine
Creatine is found naturally in animal foods, especially meat Creatine may also be synthesized by the liver and kidney
Food Milk Tuna Salmon Beef Pork Creatine (g/kg) 0.1 4.0 4.5 4.5 5.0

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Creatine
Discovered 1927 Synthesized in 1990s as a dietary supplement Research as an ergogenic aid progressed rapidly

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Creatine Supplements: Forms

Powder Pills Candy Chews Gels Serum Micronized

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Creatine Supplementation - Theory

May increase muscle levels of PCr May increase performance in very high intensity exercise May enhance performance in prolonged endurance events which incorporate short sprints May enhance interval training

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Recommended Protocol
Loading phase Fast protocol: 20-30 grams/day for 5-7 days Slow protocol: 3 grams/day for 30 days Maintenance phase 2-5 grams/day
Creatine Supplementation (20g/day for 5 days) with and without Carbohydrate (360g)
Adapted from Green, A., et al. ACTA Physiol Scand, 1996. 82

Creatine supplementation: Ergogenic effect on tasks dependent on PCr

Maximal force in isometric contraction Strength and endurance in isotonic tests Muscular force and endurance in isokinetic tests Maximal cycle ergometer performance from 6-30 seconds Sprint run, swim, and cycle performance from 5-100 meters or up to 30 seconds duration

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Creatine Supplementation
These findings may be applicable to sports such as weightlifting, cycle, swim and run sprints, and soccer In general, research findings also indicate that creatine supplementation may enhance performance in very high-intensity exercise tasks, such as the 100meter sprint in track and sprint cycling

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Creatine Supplementation
In five of seven recent well-controlled studies using a standard creatine-loading protocol and evaluating the effect on single or repetitive sprint-run or sprintcycle performance ranging from 5 to 100 meters, creatine supplementation improved performance A meta-analysis of 57 studies revealed an effect size of 0.24 favoring creatine over the placebo treatment

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Creatine supplementation: Effect on the Lactic Acid energy system

Research findings suggest an enhancement effect in some events where athletes maximize power output from 30 to 150 seconds Some beneficial effects noted in a 300-meter run No beneficial effects in 100-meter swimming Additional research is merited

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Creatine supplementation: Effect on the Oxygen energy system

There is very little theoretical support Possible adverse effects
Weight gain

Some theories include:

Enhanced performance in events with short sprints Enhanced interval training

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Creatine Supplementation: Effect on 6-kilometer cross-country run

18 habitually active males consumed either a placebo or creatine (20 g/day for 6 days) They ran a 6K terrain run on a forest trail before and after supplementation Major findings: Creatine supplementation significantly
Increased body mass 0.9 kg Impaired run performance (pre = 23.36; post = 23.79)

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Creatine Supplementation:
Increase in body water weight

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Creatine Supplementation Effect On Training For Aerobic Endurance

Creatine supplementation has been shown to improve performance in interval run repeats of 300 and 1000 meters. Theoretically, if creatine supplementation could help an athlete train more effectively at shorter distances, conceivably performance in longer distances might eventually be improved.

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Creatine Supplementation: Effects on Training for Aerobic Endurance

Trained competitive rowers undertook standard creatine loading for 5 days with a maintenance dose for 5 weeks, coupled with rowing and resistance training for 6 weeks.

Although the training significantly improved body composition, VO2max, repeated power interval performance, and 2000-meter rowing times in both groups, creatine provided no additional advantage.

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Creatine Supplementation: Effect on body mass

In general, research indicates increases in body mass, mainly as muscle tissue, in both males and females, including both trained and untrained Studies report increases in myosin and myonuclei concentration

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Creatine supplementation: Other points of consideration

Caffeine and creatine
Caffeine may counteract the effect of creatine in highpower events as the caffeine may prolong muscle relaxation time

Formulation
Creatine powder has been used in most studies. Serum creatine may not contain significant amounts of creatine

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Creatine supplementation: Safety

Kidney and liver function
Consuming recommended dose does not appear to increase health risks Those with liver or kidney disease may be at risk

Gastrointestinal distress
Large doses may cause nausea, vomiting and diarrhea

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Creatine supplementation: Safety

Dehydration, muscle cramps and tears
Appears to cause few problems with exercise in the heat Possibility of anterior compartment syndrome

Overdoses and contaminants

Creatine appears to be safe at 5 grams per day Some products may contain contaminants, like ephedrine

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Creatine supplementation: Medical applications

Increased strength in some conditions
Muscular dystrophy Patients with heart disease Injury to the spinal cord

Facilitate rehabilitation from musculoskeletal injury Reduce the loss of muscle mass (sarcopenia) with aging

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