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      A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults

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          Abstract

          Objective

          We performed a systematic review, meta-analysis and meta-regression to determine if dietary protein supplementation augments resistance exercise training (RET)-induced gains in muscle mass and strength.

          Data sources

          A systematic search of Medline, Embase, CINAHL and SportDiscus.

          Eligibility criteria

          Only randomised controlled trials with RET ≥6 weeks in duration and dietary protein supplementation.

          Design

          Random-effects meta-analyses and meta-regressions with four a priori determined covariates. Two-phase break point analysis was used to determine the relationship between total protein intake and changes in fat-free mass (FFM).

          Results

          Data from 49 studies with 1863 participants showed that dietary protein supplementation significantly (all p<0.05) increased changes (means (95% CI)) in: strength—one-repetition-maximum (2.49 kg (0.64, 4.33)), FFM (0.30 kg (0.09, 0.52)) and muscle size—muscle fibre cross-sectional area (CSA; 310 µm 2 (51, 570)) and mid-femur CSA (7.2 mm 2 (0.20, 14.30)) during periods of prolonged RET. The impact of protein supplementation on gains in FFM was reduced with increasing age (−0.01 kg (−0.02,–0.00), p=0.002) and was more effective in resistance-trained individuals (0.75 kg (0.09, 1.40), p=0.03). Protein supplementation beyond total protein intakes of 1.62 g/kg/day resulted in no further RET-induced gains in FFM.

          Summary/conclusion

          Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults. Increasing age reduces and training experience increases the efficacy of protein supplementation during RET. With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute RET-induced gains in FFM.

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          Most cited references56

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          Resistance training-induced changes in integrated myofibrillar protein synthesis are related to hypertrophy only after attenuation of muscle damage.

          Skeletal muscle hypertrophy is one of the main outcomes from resistance training (RT), but how it is modulated throughout training is still unknown. We show that changes in myofibrillar protein synthesis (MyoPS) after an initial resistance exercise (RE) bout in the first week of RT (T1) were greater than those seen post-RE at the third (T2) and tenth week (T3) of RT, with values being similar at T2 and T3. Muscle damage (Z-band streaming) was the highest during post-RE recovery at T1, lower at T2 and minimal at T3. When muscle damage was the highest, so was the integrated MyoPS (at T1), but neither were related to hypertrophy; however, integrated MyoPS at T2 and T3 were correlated with hypertrophy. We conclude that muscle hypertrophy is the result of accumulated intermittent increases in MyoPS mainly after a progressive attenuation of muscle damage.
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            Nutritional interventions to augment resistance training-induced skeletal muscle hypertrophy

            Skeletal muscle mass is regulated by a balance between muscle protein synthesis (MPS) and muscle protein breakdown (MPB). In healthy humans, MPS is more sensitive (varying 4–5 times more than MPB) to changes in protein feeding and loading rendering it the primary locus determining gains in muscle mass. Performing resistance exercise (RE) followed by the consumption of protein results in an augmentation of MPS and, over time, can lead to muscle hypertrophy. The magnitude of the RE-induced increase in MPS is dictated by a variety of factors including: the dose of protein, source of protein, and possibly the distribution and timing of post-exercise protein ingestion. In addition, RE variables such as frequency of sessions, time under tension, volume, and training status play roles in regulating MPS. This review provides a brief overview of our current understanding of how RE and protein ingestion can influence gains in skeletal muscle mass in young, healthy individuals. It is the goal of this review to provide nutritional recommendations for optimal skeletal muscle adaptation. Specifically, we will focus on how the manipulation of protein intake during the recovery period following RE augments the adaptive response.
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              Control of the size of the human muscle mass.

              This review is divided into two parts, the first dealing with the cell and molecular biology of muscle in terms of growth and wasting and the second being an account of current knowledge of physiological mechanisms involved in the alteration of size of the human muscle mass. Wherever possible, attempts have been made to interrelate the information in each part and to provide the most likely explanation for phenomena that are currently only partially understood. The review should be of interest to cell and molecular biologists who know little of human muscle physiology and to physicians, physiotherapists, and kinesiologists who may be familiar with the gross behavior of human muscle but wish to understand more about the underlying mechanisms of change.
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                March 2018
                11 July 2017
                : 52
                : 6
                : 376-384
                Affiliations
                [1 ] departmentDepartment of Kinesiology , McMaster University , Hamilton, Canada
                [2 ] departmentDepartment of Health Sciences , Lehman College of CUNY , Bronx, New York, USA
                [3 ] Bayesian Bodybuilding , Gorinchem, Netherlands
                [4 ] Sport Performance Research Institute New Zealand, AUT University , Auckland, New Zealand
                [5 ] California State University , Northridge, California, USA
                [6 ] departmentDepartment of Kinesiology , University of Waterloo , Waterloo, Canada
                [7 ] departmentHealth Sciences Library , McMaster University , Hamilton, Canada
                [8 ] Weightology, LLC , Issaquah, Washington, USA
                Author notes
                [Correspondence to ] Dr Stuart M Phillips, Department of Kinesiology, McMaster University, 1280 Main Street, West Hamilton, Ontario, Canada; phillis@ 123456mcmaster.ca
                Author information
                http://orcid.org/0000-0002-1956-4098
                Article
                bjsports-2017-097608
                10.1136/bjsports-2017-097608
                5867436
                28698222
                a4ac02b2-c38a-4d09-8a55-c9a5c2232c5f
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 31 May 2017
                Categories
                Review
                1506
                2314
                Custom metadata
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                Sports medicine
                hypertrophy,growth,supplement,whey,performance. leucine
                Sports medicine
                hypertrophy, growth, supplement, whey, performance. leucine

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