How Much Protein? By: Brad Pilon 2 Copyright © 2008-2011 by Strength Works, Inc. All rights Reserved No portion of this book may be used, reproduced, or transmitted in any form or by any means, electronic or mechanical, including fax, photocopy, recording, or any information storage and retrieval system by anyone but the purchaser for their own personal use. This manual may not be reproduced in any form without the express written permission of Brad Pilon, except in the case of a reviewer who wishes to quote brief passages for the sake of a review written for inclusion in a magazine, newspaper, or journal, and all of these situations require the written approval of Brad Pilon prior to publication. The information in this book is for educational purposes only. The information in this book is based on my own personal experiences and my own interpretation of available research. It is not medical advice and I am not a medical doctor. The information within this book is meant for healthy adult individuals. You should consult with your physician to make sure it is appropriate for your individual circumstances. Keep in mind that nutritional needs vary from person to person, depending on age, sex, health status and total diet. If you have any health issues or concerns please consult with your physician. Always consult your physician before beginning or making any changes in your diet or exercise program, for diagnosis and treatment of illness and injuries, and for advice regarding medications. 3 Contents Introduction 5 Protein Basics 17 The Effect of Resistance Training on Muscle Mass 37 How Muscles Grow 41 The Muscle Building Effects of Protein 48 Testosterone and muscle growth 54 Muscle growth and vegetarian diets 63 Muscle growth and low protein diets 66 Muscle growth and Very High protein diets 71 Muscle growth, high protein and high calorie diets 73 Protein and meal timing 80 Post workout protein 82 The infamous research 85 Ultra High Protein fails again 90 Building Muscle, Nitrogen Balance and Protein Synthesis 92 Protein and Muscle – An Alternative Hypothesis 109 Protein and Muscle – Maybe it’s all a Race 120 What Does Build Muscle Mass? 126 Conclusions 136 Eat Stop Eat, Protein Intake and Muscle Mass 147 Frequently Asked Questions 152 References 159 4 Introduction 5 Introduction As you begin reading this book, you may be thinking to yourself “does the world really need another book on protein?” The truth is this book is not really about protein per se, but rather it is about building muscle. However, you really can’t separate the two. Over the last 5 decades ‘protein’ has become synonymous with ‘muscle’. When people think of bodybuilders, they think of protein shakes – lots of them. So the purpose of this book is to examine the relationship between the protein you eat and your ability to build muscle. In other words, I am trying to answer the question – “Can nutrition – specifically the amount of protein you eat – help you build muscle?” Protein is one of the most popular and controversial topics in all of nutrition. It has become the ‘nutritional golden child’ of muscle building and fat loss. Some people may try to avoid eating carbohydrates, and others may avoid fat, but nobody avoids protein these days. It may be hard to believe, but protein hasn’t always been considered the nutrient that can do no wrong. Throughout recent history each of the major macronutrients (protein, fat and carbohydrates) has taken its turn as the evil stepchild in the trio. 6 In the early 1900’s diet gurus such as John Harvey Kellogg (the creator of the modern cereal food giant Kellogg’s) and Horace Fletcher rallied against the intake of dietary protein due to its “negative effects on digestion and health”. [Polland M, 2008] In the 1950’s Ancel Keys led the charge against fat, saturated fat and cholesterol as he proclaimed they were the major cause of heart disease. His campaigning was so successful that even to this day we all live in fear of dietary fat even though there are hundreds of research papers that have since proven that different kinds of fat have different properties in the body (including some that are beneficial) and that dietary cholesterol may not have a cause-and-effect relationship with the cholesterol our bodies. In the late 90’s and early 2000’s Dr. Robert Atkins lead the low carb revolution claiming carbohydrates were the cause of all of our ills. We are now living in the wake of the ‘low carb is good for you’ AND ‘fat is bad for you’ eras. Both ideas are firmly rooted in the nutrition and fitness industries as well as in the mind of the most people whom are interested in health and fitness. 7 Protein has had enough time to get off the ‘bad guy’ list and is perfectly positioned to take top spot on the podium of healthy nutrients. It has been almost 100 years since Kellogg and Fletcher were trying to convince the population that protein was the bad guy. By default protein is the only macronutrient left that could possibly be good for us. So the stage is set once again for protein to be the cure for all of our ills. Fitness magazines constantly repeat the pro-protein message: “If you want to build big muscles you have to eat your protein”, “If you want to lose fat and look like a fitness model, then you have to eat your protein”. Browse the pages of any popular fitness magazine and you will find the following two golden rules of dietary protein: 1. Eat a minimum of 30 grams of protein every two to three hours. 2. Always drink your post-workout protein shake! When I first started working in the sports supplement industry I was a sales person at a local supplement shop. I believed in these protein recommendations and followed them with almost fanatical dedication. I drank my protein shakes and ate my protein bars. In fact, it wasn’t unusual for me to drink 4 to 5 shakes per day. I would constantly keep my protein intake up around 250 grams per day. Why? Because I thought it was scientifically PROVEN that more protein meant more muscle, and more muscle was what I wanted. 8 When a customer came into the store, it didn’t matter what they were shopping for, I knew that I could convince them to buy protein. It wasn’t because I was an amazing sales person, or that I was sinister or deceitful, rather it was because I believed in protein so much that my enthusiasm became contagious. I would get people so worked up about how great protein was for them that they would end up buying two, sometimes three tubs of the stuff! Nowadays, I realize that much of what I was led to believe as fact was really just very clever (and powerful) marketing, combined with my inability to truly understand the available research. However, I’m not embarrassed by my mistakes. After all, if you’ve ever seen a protein supplement advertisement you know how convincing they can be. The protein supplement industry is massive, with projected sales of over 6 billion dollars by 2011 [Packaged Facts, 2008]. With this much money on the line, I’m sure you can imagine why so much time and effort is spent on the marketing of protein supplements. But the sports supplement industry isn’t the only one that stands to profit from the new golden era of protein. Beef, poultry, pork, dairy and eggs are the major sources of protein in the North American diet and you can bet these industries are capitalizing big time on the new found love affair we have with protein. 9 These food industries dwarf the supplement industry so they have even more money to spend on advertising to make sure you are reminded that protein is the critical piece of your diet and fitness puzzle. As an example of the food industry’s interest in promoting protein as healthy we can look to the fact that the funding for the scientific meeting “Protein Summit 2007: Exploring the Impact of High-Quality Protein on Optimal Health” was supplied by the following industries: Egg Nutrition Center, National Dairy Council, National Pork Board, and The Beef Checkoff through the National Cattlemen's Beef Association [Fulgoni VL, 2008]. The pro-protein message doesn’t just come from the industry side. According to the mass media, there are many different reasons why we should eat more protein, from improved overall health, to fat burning, to muscle building. On any given day you could find an article that says eating more protein will fix any and all of your diet and fitness shortcomings. The theory is simple: by eating more protein you can force your body to an improved level of function, including larger muscles, less fat, and a host of other health benefits. The question is whether or not the scientific research actually supports these theories. 10 Protein has been given so many benefits by the media that it is hard to find a health benefit that protein does NOT have. From preventing diabetes to building muscle, protein seems to be able to do it all. These are some pretty big claims, and it would be amazing if even half of these claims were true. The prospect of curing many of the world’s health issues by simply increasing the amount of protein we eat is definitely a very exciting concept, but again, we need to know if it is indeed backed by scientific research. In order to get to the bottom of this story and figure out just how much protein we really need, it makes sense for us to start at the beginning. Of all the claims about protein, the one that almost everyone simply accepts as fact is that eating protein builds more muscle. It is this one simple assumption that leads to so many of the additional benefits of protein. Surprisingly, this assumption has never been fully proven. Or more accurately, it has never been properly defined. I can still remember the time when I first realized that protein might not be the iron-clad muscle builder it was made out to be. It was during a very exclusive dinner in Glasgow Scotland, where I had just put the finishing touches on a 11 new research contract examining the muscle building and ergogenic (performance enhancing) effects of a new supplement. It was a night of firsts for me. It was my first time to Scotland, my first time trying scotch and blood pudding (and later in my trip, Haggis), and it was the first time I had ever had a world renowned scientist openly question my belief in protein, in front of a table full of academics no less. Charged As a True Believer It was during the closing comments of the dinner, when the pointed comments about protein came up. I had made a suggestion that adding protein to the new formula may in fact increase the muscle building effects. The lead scientist looked at me and said “Brad, if you BELIEVE in protein, then we will add it into the formula”. As soon as I heard this statement I realized they understood and knew something about protein and muscle building that I did not. At this moment I realized I was missing some vital information about the connection between protein and building muscle and that everyone else at the table had this information. I felt as though my understanding was wholly inadequate, as the concept of ‘belief’ has no place in a conversation about known scientific facts. And if a scientist needed to caudle my feelings of belief about consuming protein then they also recognized that I simply had not done 12 enough research to bring a sound scientific argument to this dinner table. At that moment I felt like I was in my first year of university all over again. In the world of science you do not ‘believe’ in anything, you either understand the facts or you do not. In science, to believe in something means to have a certain amount of blind optimism that you use to fill in the gaps where you are missing the facts, which is really a kind way of saying you are already biased towards an outcome (not a good allegation if you are in science). Afterwards, when I had arrived back in my hotel room, I started to think about that statement “If you BELIEVE in protein”. Was I the only person at the table who believed in protein? And what did they mean by ‘believe’ – I thought it was a scientifically proven fact? I thought they knew this to be true as well. An uncomfortable feeling starting gnawing at me as I contemplated the very real possibility that I was dead wrong about how much protein I or anyone else really needed to eat to build muscle. Then my cognitive dissonance started to set in. “Whatever” I thought to myself “I’m bigger than all those scientists, so what do they know?” Of course, I knew that being ‘bigger’ did not justify my assumptions as to WHY I was bigger. I 13 started to feel silly for trying to give the credit of my hard earned muscle to my protein intake instead of my years of hard work in the gym. After this trip I decided to get to the bottom of the story about dietary protein and find the true scientific answer to the question “how much protein do I need to build muscle”. The purpose then of this book is to review the current body of scientific research and find out if there is any truth to the alleged muscle building benefits of protein. Specifically, it will examine the benefits of eating high protein diets (In excess of the 90 grams per day that is the average intake in North America [Fulgoni VL, 2008]), and it will also examine the muscle building benefits of post-workout protein intake. I would like to take this time to point out that I do agree that it may be completely possible that some of us need to eat a little more protein than we typically do, (some people still consume less than the recommended amounts). I also recognize that protein malnutrition is a serious and documented health condition (albeit mostly occurring in very young children), and that protein supplementation may possibly improve the health of hospitalized adult patients [Potter J, 1998]. 14 I also absolutely do not want you do think that this is some sort of anti-protein supplement manifesto. While I do not think that protein supplements are any better than simple food, I also do not think that they are any worse. They’re just another protein source in our diets. They are neither the Hero, nor the Villain of this story. The actual recommended amounts for daily protein intake vary from country to country, but generally fall into the range of 40-60 grams of protein per day for a healthy adult – Roughly the range of protein you might find in one large chicken breast or 9 ounces of steak. Therefore, I will review the evidence that supports the theory that we need “super-mega” amounts of protein that are well in excess (triple or even quadruple amounts) of the recommended 40-60 grams per day in order to pack on muscle. I will also review the research that supports the necessity of post-workout protein meals (whether from foods or protein supplements) for the purpose of muscle growth. As you are reading this book, please keep in mind that I am exploring the specific question of “how much protein is needed to build muscle mass’. I am not attempting to answer questions such as “how much protein to increase longevity?” or “how much protein for optimal life-long health”. In order to keep this book on topic (and less that 5,000 pages) we have to maintain this specific focus. 15 Along the way to discovering how much protein we need to build muscle I will show you the difference between a exact scientific end point like ‘increased muscle mass’ and a surrogate end point like ‘increased protein synthesis’ and how these two very different measurements end up being confused and lumped together as the same thing for marketing purposes. I also will share with you the exact amount of protein, or range of protein intakes that an adult human needs to eat to allow for measureable increases in skeletal muscle mass. Finally I will explain where the fitness industry gets its information about the effects of protein and how this information can be and usually is misinterpreted. 16 Protein Basics 17 Protein Basics In order to keep this book to a reasonable length I am going to quickly review the basics of protein and protein digestion. Keep in mind that there are massive textbooks on this topic. Protein metabolism is much more complicated than this simplified explanation. Along with fat and carbohydrates, protein is a "macronutrient," meaning that the body needs relatively large amounts of it. Vitamins and minerals, which are needed in only small quantities, are called "micronutrients." For example: think of macronutrients like the wood, drywall and concrete needed to build your house, and think of your micronutrients as the screws and nails. They are both essential, one is just much bigger than the other. Fat Protein Carbohydrates Protein is typically found in the highest concentration in meat and animal products such as milk and eggs. However protein is also found in most of the 18 other foods you eat, including fruits and vegetables (albeit in much smaller amounts). Protein is made up of amino acids. Amino acids are the building blocks of all the protein in your body and are found in the all of the protein that you eat. It could be argued that the very reason we eat protein is for the amino acids that become available once protein is digested. Think of amino acids like Lego blocks that fit together to build a bigger block of protein. Amino Acid Amino Acid Amino Acid Amino Acid Amino Acid When you eat protein it is broken down into smaller fragments of di, tri, and oligopeptides (short chains of amino acids) as part of the digestion process. These small fragments along with individual amino acids are then absorbed through the gastro-intestinal tract and enter the blood stream. From there they are transported throughout the body ultimately being re-incorporated into new proteins (including muscle, organs, blood proteins etc) or used in various metabolic pathways. It is important to note that the function of amino acids in the body involves much more than just muscle tissue repair and growth. It also includes repair and development of red blood cells, hair and fingernail growth, regulation of 19 hormone secretion, movement (muscle contraction), digestion, maintenance of the body's water balance, protection against disease, transport of nutrients to and from cells, the carrying of oxygen and regulation of blood clotting. Simply put, amino acids play a much bigger role than solely being building blocks for muscle. In other words, if you were to eat 100 grams of amino acids it is not as if those 100 grams would all be used for muscle building! There are twenty-two different amino acids that combine in various arrangements to make up all the proteins in your body, including hormones, enzymes, your internal organs and muscle tissue. Your body can produce the majority of the amino acids by itself, however there are nine amino acids that the body cannot manufacture, and thus it is essential to consume these amino acids from your diet – hence why they are called the ‘Essential Amino Acids’. The Nine Essential Amino Acids: • Phenylalanine • Isoleucine • Leucine • Lysine • Threonine • Methionine • Tryptophan • Valine • Histidine 20 In order for muscle and organ tissue to be built by the body, these nine amino acids must be present in sufficient amounts, and therefore they must be provided by your diet on a ‘somewhat’ regular basis. It is the definition of ‘sufficient amounts’ and ‘somewhat regular basis’ that is the center of the ‘protein builds muscle’ controversy. To date, we have never had a scientific consensus on the amount of protein we should eat that everyone would agree is sufficient, nor do we have consensus on how often and when we should be eating protein. In the late 1800’s researchers by the name of Carl Voit and Wilbur Atwater recommended a dietary protein intake of 118 grams per day for adult humans doing moderate muscular work. In 1905 a scientist named Chittenden concluded “one-half of the 118 grams of protein food called for daily by the ordinary standards is quite sufficient to meet all the real physiologic needs of the body” [Chittenden RH, 1905]. Obviously this was a very controversial recommendation – suggesting that the accepted 118 grams was DOUBLE what was actually required by the human body, and that 60 grams of protein daily was more than sufficient for most people. 21 It should be pointed out that Carl Voit’s original recommendation of 118 grams was questioned mainly because meeting this required protein intake would hardly be feasible without substantial meat consumption, and at the time vegetarianism was beginning to become a popular way of eating. So even back in the early 1900’s it was a mix of politics and scientific interest that led to some of the controversy surrounding protein [Heyll U, 2007] Even today, more than 100 years later this seemingly basic argument of ‘how much protein’ still rages on, with differing recommendations coming from different nutrition authorities. Even government regulations within the same country do not agree on the topic of protein. In fact, two such regulations, the DRI and RDA, are quite possibly the two most confusing and misunderstood guidelines in all of nutrition policy. DRI stands for Dietary Reference Intakes and it is meant to be the supporting research and recommendations for governments and related health associations for setting things like the Recommended Dietary Allowance (RDA). The development of the DRI was a joint initiative by the United States and Canada to expand and replace both the RNI (Recommended Nutrient Intakes) for Canadians and the RDA (Recommended Dietary Allowances) for Americans. 22 The process of establishing the DRI’s was managed by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board, the Institute of Medicine, and The National Academies in the United States, in collaboration with Health Canada. The results appeared as a series of reports from a panel of American and Canadian scientists starting in 1997 with the final report being released in 2004. The DRI’s include recommendations for total daily energy (in calories), carbohydrates, fiber, fat, fatty acids, cholesterol, protein and amino acids. This DRI document is the supportive data for all the following recommendations; Recommended Daily Allowance (RDA) in America, the tolerable upper intake limit (UL), and adequate intake (AI). The Recommended Daily Allowance (RDA) is the most widely recognized term and has the greatest influence in daily nutrition practice. An American committee known as the Food and Nutrition Board developed the RDA in 1941 and it has updated consistently every 5 – 10 years thereafter. The current RDA uses the DRI as its foundation and is defined as follows: The Recommended Daily Allowance is an estimate of the minimum daily average dietary intake level that meets the nutrient requirements of nearly all (97-98%) healthy individuals. 23 The RDA for protein for adults (18 years or older) is 0.8 grams of protein per kilogram of bodyweight per day (about 64 grams for a 175 pound person). The RDA for protein was based on the results of all the available research that estimate the minimum protein intake necessary to avoid a progressive loss of lean body mass as reflected by a measurement called nitrogen balance. You may be wondering ‘what the heck is nitrogen balance and what does it have to do with my muscles?’ In order to determine if you need more or less protein, scientists first have to determine a way of measuring the effect protein is having on your body. In the case of the RDA, scientists chose nitrogen balance as their measurement marker. While Nitrogen Balance is a scientifically valid measurement of the amount of nitrogen moving in and out of your body (all amino acids contain nitrogen and thus all protein contains nitrogen), it does contain one small flaw - There is no scientific evidence to date that nitrogen balance is an accurate measure of any relevant physiological end point other than the amount of nitrogen moving in and out of the body. 24 In other words, some scientists speculate that nitrogen balance might have the ability to predict muscle gain or loss, but to date this theory has not been proven. While this may sound like a very controversial statement, keep in mind that even the Food and Nutrition Board acknowledge that using Nitrogen Balance to set the RDA for protein was a major limitation due to its lack of accuracy and applicability. Or, in there own words – “Because this method does not measure any relevant physiological end point”[Wolfe RR, 2008]. If that isn’t enough to raise your skeptical eyebrow, then you may be interested to know that almost all of the research data used to come up with the RDA for protein was calculated using college aged men. Few if any studies were done on men of middle age or older, and almost no research exists on women. So the current RDA for protein is simply a guess (based on the measurement of nitrogen balance) at how much protein a healthy young man in college might need. That’s it. In reality we do have a general idea how much protein a person needs, but it is also true that this idea is based on a lot of broad assumptions and estimates. These assumptions and estimates are based on what we currently know about 25 human physiology and follow some very logical principles, but this does not change the fact that they are still assumptions and estimates. Or, in nonscientific terms, we have to remember that we’re just sort of guessing. If you’re not confused enough with all of these acronyms and terms I’m going to introduce you to one more – The AMDR. The AMDR stands for The Acceptable Macronutrient Distribution Range (established by the Institute of Medicine in 2005). The AMDR is similar to the other forms of recommendations accept that it is slightly more vague and allows for a much larger range of protein intakes. The major difference is that the RDA is a strict hard and fast number for protein– 0.8g of protein for every kilogram (2.2 pounds) of bodyweight per day, whereas the AMDR is a range with the RDA presumably as its lower end (but not necessarily). The AMDR for protein has been recommended at between 10%-35% of a person’s daily caloric energy intake. This recommendation is dependent upon how many calories you eat in a day, and how much lean body mass you have. 26 Total daily calorie requirements by their definition change based on activity level as well, so there is a huge amount of variation to this recommendation. This still doesn’t help us answer the now not so simple question, “how much protein?” The AMDR is a rather large range (10 -35% of total daily calories) and it doesn’t necessarily account for total activity level (sleeping all day vs a marathon run), type of activity (a 2 hour run vs. a 2 hour power lifting workout), and the specific goals of the activity (weight loss, muscle gain or fitness). Lastly, if you look closely you’ll also notice that the AMDR is based on the amount of calories you are eating, but not the amount of calories you SHOULD be eating. Meaning if you should be eating 2,000 calories, but you are eating 5,000 calories for whatever reason, there is a range of 50 to 437 grams of protein! Logically we can say that overeating by 3,000 calories does not somehow create an essential need for almost 400 extra grams of protein per day. At this point you can see that the RDA is set as a minimum and might end up being too low on high activity days. It therefore doesn’t give us any information about what is optimum, and gives us absolutely no information about what is needed to build muscle beyond what you naturally have with no weight training. 27 On the other hand the AMDR gives us a very wide range that could have us consuming two or three times as much protein from one day to the next. It makes sense physiologically (and economically) to avoid chronically eating excessive protein if we know it isn’t necessary, especially considering protein food sources are typically the most expensive and most forms (meat, fish, eggs and dairy) require energy for storage (ie: fridges) and can spoil easily. However, it is also counter productive to eat so little protein that we hinder our ability to build muscle mass. Therefore my goal for the rest of this book is to determine how much protein is needed to build muscle and achieve your fitness goals without grossly under or overestimating as the RDA and AMDR seem to do. In fact, the one good thing we can take from the current protein recommendations is that the DRI does not define a tolerable upper limit for protein. So at the very least it appears that despite the large discrepancies in suggested protein intakes, there does seem to be agreement that from a health standpoint there is no level of protein intake that appears to be detrimental to the health of an average person. This brings us all the way back to the current scientific view of the amount of protein that constitutes ‘sufficient amounts’. Some researchers argue that 28 ‘sufficient amounts’ means 2 grams of protein per pound of bodyweight. That is about 350 grams per day for a man who weighs 175 pounds. Others will argue that a single dose of as little as 3.5 grams of essential amino acids may be enough to allow your muscles to grow. This is roughly the amount of essential amino acids found in one single glass of milk. That is a huge difference from 350 grams of protein. So which one is the right answer? Well it’s not that simple. A very interesting point about protein digestion is that your body’s ability to digest protein can be up-regulated or down-regulated depending on the amount of protein that you normally eat. In other words, if you constantly eat high amounts of protein at every meal, your body will be able to absorb high amounts of protein at every meal. If you are not used to eating large amounts of protein and you suddenly start eating double or triple the amount of protein you typically would eat, your body will have a difficult time digesting the extra protein. This typically results in some very bad Gastro Intestinal (aka: stomach and gut) upset and some rather pungent flatulence. 29 Protein Consumption Protein Absorption If you were to suddenly double your protein intake, it would only take your body a couple days to get used to all the extra protein. Some people make the mistake of thinking this is proof that their body has started to build more muscle once it has adapted to the new higher protein intake, but this is not the case. From examining the protein intake of many different cultures around the world we are able to see that humans can survive on a wide range of protein intakes. From levels as low as around 0.3 grams of protein per pound of body mass (about 50 grams per day for a 180 pound man) all the way up to ten times this amount in people who survive eating a diet that consists almost exclusively of meat. Obviously, even though our protein intake can vary by a factor of ten times, our muscle mass cannot. 30 There is no culture of people on earth who have ten times more muscle than another culture. Even the current champion bodybuilder, with all the amazing genetic potential and anabolic steroid abuse, still does not have anywhere near ten times the muscle of an extremely skinny Olympic long distance runner. So while people can chronically eat massively different amounts of protein, this drastic difference is not reflected in their muscle mass. 10 X More Protein 10 X More Muscle This is a very important point. One of the major ways we prove cause-and-effect relationships in science is with something called a ‘dose response’. Meaning if eating extra protein truly caused you to build extra muscle, then the more protein you eat, the more muscle you should have. Since we now have evidence that this does not occur, we need to examine the reasons why this relationship doesn’t exist. Our bodies compensate easily to extreme variations in protein intake in a number of different ways. As stated earlier your body can up-regulate and down-regulate the amount of protein that is absorbed from the intestinal tract 31 after a meal. It can also up- and down-regulate the amount of amino acids that get oxidized as fuel (burned for energy). Research from Robinson et al, published in 1990 has shows that when you suddenly start eating high protein your body starts to burn more amino acids as fuel [Robinson et al, 1990]. This adaptation is logical if you consider it from a supply and demand point of view. Your body can only get energy from the protein, fat and carbohydrates (and sometimes alcohol) that you consume. If you choose to eat more protein and less fat and carbohydrates, your body will adjust to what you are doing and burn more of that protein for fuel. The answer to the age-­‐old question of ‘how much protein can you digest in one meal?’ is: Your body can learn to digest very large amounts of protein, if given the proper amount of time to adapt So our bodies can adapt and digest varying amounts of protein, as well as absorbing varying amounts of amino acids. It can also handle large or small intakes of protein by increasing or decreasing the amount of amino acids that it burns for energy. This is an example of how our bodies are constantly adapting to maintain a state of equilibrium or balance (aka: homeostasis). There are many other ‘facts’ about protein that simply do not make sense. For instance, I have always found it interesting that bodybuilders and athletes have accepted the goal of using ultra-high amounts of protein to try and force muscle 32 growth, rather than try to teach the body to be more efficient by attempting to force muscle growth using normal or even slightly less than normal protein intakes. After all, it has been suggested that this is one of the ways in which anabolic steroids act to increase muscle size – allowing for a more efficient use of available proteins and amino acids [Sheffield-Moore et al, 2000]. When I worked in the supplement industry, product development was all about more protein. If a competitor had 40 grams of protein in their protein shake, we HAD to have 42 grams. If they had 23 grams of protein in their protein bar, we HAD to have 25 grams. It is funny how we strive for creating a very inefficient process rather than trying to optimize an already very efficient one. This is just one of the nonsensical points about ultra-high protein diets. Here is some more little known information about protein. If you were to eat 50 grams of protein on any given day, you would actually be digesting between 100 and 150 grams of protein! This is because your body also digests an additional 50 to 100 grams of endogenous protein every single day. Endogenous protein is the protein that is secreted into your gastrointestinal tract by your body (endogenous means that your body produced it without getting it from your diet). 33 These proteins come from saliva, gastric juice, pancreatic enzymes and other secretions as well as intestinal cells and proteins that have leaked into the intestine from the blood. We basically have a built-in protein recycling operation, utilizing ‘scrap’ proteins that are no longer needed by the body to build new proteins that are ‘in demand’. Here is another piece of astonishing protein information. We may also absorb amino acids from our colon that are created by our microflora (the bacteria in our Gastro Intestinal system). In other words, there may be yet another, previously unknown way that our bodies are supplied with the amino acids that we require. Endogenous Food Bacteria Daily Protein Supply These facts make it clear that your body is in a constant state of cycling and reusing its own proteins. Some of the amino acids in your right biceps may have at one time been part of your heart, or part of an enzyme system in your saliva. 34 The proteins and amino acids in your body are almost like interchangeable Lego blocks. They can be built up and stored in one part of your body, then taken apart and built up and reused in another part of your body. As long as you have enough Lego blocks available, your body will decide the best place to use them. The same 20 different Lego block types (the amino acids) can be used everywhere throughout your body to make millions of different proteins, cells and structures. Heart Enzymes Biceps Blood Vessel To be clear: All throughout the day you are continually breaking down and building up proteins in your body. It’s an ongoing cycle of anabolism and catabolism – they don’t just happen one at a time! 35 So as you can see, not only is your body incredibly efficient at adapting to different levels of protein intake, it is also very efficient at making use of its own amino acids, by recycling them in and out of different body systems and tissues when it has to. Now that we know the basics of protein digestion and absorption we will answer the more pointed questions of “how much protein (or more specifically, how much EXTRA protein) is needed to fuel the muscle building process?” and “Do I need to eat protein immediately after my workouts in order to gain muscle?” However, before we answer these questions, we must first examine the effects that resistance training (weight lifting) has on muscle mass. 36 The Effect of Resistance Training on Muscle Mass 37 The Effect of Resistance Training on Muscle Mass I think just about everyone will agree that working out with weights (or any other form of resistance) will result in increased muscle mass given that the effort used is high enough and the rest and recovery is adequate. It was more than 30 years ago that a group of experts scientifically proved that the amount you use your muscles is the main factor in influencing how big they are (other than genetics and height). In other words, how much and how often you stress your muscles dictates how big your muscles will become [Goldeberg AL, 1975]. For example, a muscle that is consistently trained with heavy weights gets bigger and stronger, conversely a muscle that is in a cast and cannot move gets smaller and weaker (just think of any time you or anyone you know has had a cast on an arm or leg for any length of time – Once the cast came off I’m sure you noticed that limb had become significantly smaller and weaker while it was immobilized in the cast). Muscle growth is also specific to the type of resistance it is forced to endure. Each muscle fiber in our body is extremely small. Even in bodybuilders the fibers are still really, really small – And with good reason. In order to remain functional Muscle fibers require nutrients supplied by the blood, so fibers must 38 be small enough to allow diffusion of these nutrients from the capillaries to supply their energy and waste-disposal needs. Depending on the type of exercise, the fibers have different needs. A muscle that is chronically involved in long endurance-style training has a requirement to stay within a certain size, since its needs for nutrients and waste-disposal is high (muscle metabolism makes a lot of bi-products that need to be removed by the blood). Weight training on the other hand, does not have as high a nutrient requirement as endurance training, nor does it create as much waste. It does however need to produce a lot more force. Therefore weight training increases the size of a muscle fiber, since it is not limited by its nutrient needs, but does need to get bigger in order to create the required force. If you read through all the research on resistance training and muscle growth, you would find the average amount of muscle mass that is typically gained by a healthy adult man or woman through resistance training is about 2 to 5 pounds over the course of 8-16 weeks [Cureton KJ, 1988; Abe T, 2000; Abe T 2003; Hartman 2006; Bhasin S, 1996; Treuth MS, 1994; Kraemer WJ, 2003; Hartman JW, 2006; Hartman JW, 2007]. Therefore, from this research we see that (in healthy people) a really good resistance training program alone can cause gains in muscle mass between 2-5 pounds in 2 to 4 months, regardless of any extra nutrition or supplements. 39 As a rule of thumb, a really good resistance-­‐training program should be able to cause a fully grown adult to gain 2-­‐5 pounds of muscle mass in 2 to 4 months, regardless of any extra nutrition or supplements Based on this finding, 2-5 pounds is what we can call the baseline increase in lean mass we can expect from a good weight-training program. This baseline depends on a number of factors including but not limited to age, sex, height, training background, workout intensity and workout design. Supplement ads and magazine headlines may tell you that you can gain 15-20 pounds of muscle in a single month, however actual scientific research suggests that this is simply not possible in healthy adult humans without the aid of anabolic steroids. Obviously our estimate of an increase in muscle mass between 2-5 pounds in 2 to 4 months is conservative, and meant to represent a very large population of people. For some people (such as young men between the ages of 18 and 25) the gains in muscle size may be more than double our estimates (close to 10 pounds), but rarely will they ever approach 15-20 pounds in one month, unless their beginning amount of muscle mass was somehow artificially low – perhaps due to an underlying illness. So how do muscles grow anyway? 40 How Muscles Grow 41 How Muscles Grow We know that weight training on its own can add about 2-5 pounds in 24 months, we need to next ask “how exactly do muscles grow?” Your muscles are made up of a collection of microscopic fibers simply called ‘muscle fibers’. Muscle fibers are long narrow fibers that can run the complete length of your muscle. In fact, a single fiber in your thigh can be almost a foot long in length. 42 Inside each of these fibers is the sacroplasm, which is largely comprised of ‘myofibrils’ – the stuff that makes your muscles contract. A typical muscle fiber can contain anywhere from 100’s to 1,000’s of myofibrils. Now if you look closely at these fibers you will see little purple dots on them, these are the nuclei of the fibers, sometimes referred to as myonuclei. These nuclei are like the governing body of the muscle fiber. They control everything. However, they can only control a small section of any given fiber. This area is called their domain (kind of like a castle and its kingdom). The ‘domain’ is the sarcoplasm – the stuff that is packed with the contractile and metabolic machinery of the fiber, so the nucleus oversees all of the metabolic processes on your muscle fiber [Luff & Atwood 1971]. 43 Because muscle fibers are so long they need multiple nuclei, which is very important in our quest to understand muscle growth. Research has shown us that no matter how big a muscle fiber becomes, the ratio of nucleus-to-domain remains relatively equal. Research has also found that under normal circumstances, adult skeletal muscle is a very stable tissue with very little turnover of nuclei [Charge SBP, 2004]. This means that as a muscle fiber grows, somehow it needs to find more nuclei, and this is where satellite cells come into play. Satellite cells are like ‘dormant muscle seeds’ that sit on the outside of the muscle fiber (hence the name satellite cells). They are present in all skeletal muscles and are associated with all muscle fiber types - albeit with unequal distribution (some muscles have more some have less) [Charge SBP, 2004]. When muscle fibers are damaged through resistance training, satellite cells are activated, and move into the muscle where they provide new nuclei for muscle fiber growth (now that the muscle has a new nucleus it can add more ‘domain’ around the nucleus) [Robertson 1990; Toth KG 2011]. You can think of satellite cells as the body’s reserve of muscle cell nuclei. In fact, because muscle cells are ‘post-mitotic’ meaning they cannot create new nuclei by themselves, they have to rely on satellite cells as the exclusive source of new nuclei for the maintenance and growth. In fact, satellite cells are considered ESSENTIAL for the physiological adaptations that drive muscle growth. Scientists have tested the importance of 44 satellite cells by using low dose radiation in animal studies. In this study one of the animals legs are exposed to radiation while protecting the other leg. The radiation effectively ‘kills’ the satellite cells in the exposed leg leaving the satellite cells useless, while the other leg still has its full compliment of satellite cells. When this happens the muscles exposed to radiation can still adapt to exercise by becoming more efficient, but with the exception of a small amount of beginner growth, they simply cannot increase their size. [Rosenblatt 1992; Adams GR 2002]. In other words, because they couldn’t add more nuclei, they could not increase their size in response to resistance training. With the exception of the small amount of growth that is possible with a muscle fibers already existing amount of nuclei, muscle growth is dependent on satellite cells being activated and moving inside the muscle. And while this seems like some very dry science, it does become very important when we start looking at the role that protein plays in muscle growth. Let’s take a moment to review what we know so far: 1. We know that resistance training stimulates satellite cell activation, which is what drives muscle growth. 2. We know that 4 pounds of mass gain as a result of 3 months of training is a conservative estimate of the muscle growth potential in healthy adults. 45 What we do not know is the role that dietary protein plays in this process. However, before we tackle this problem we do need to address some of the common claims that are made regarding muscle building. It is easy to argue that the suggestion of gaining 20 pounds in one month is an unrealistic expectation set by the supplement and fitness industry. I can remember when a claim of 50 pounds of muscle growth in less than two months was made in a supplement ad, a noted researcher sent me an email which read: “I am sorry, but even in an untrained person on 3,000 mg of testosterone a week and taking growth hormone... they still would not even come close to being able to build that much muscle.” So while we do know that muscles can grow, we also know that there are logical limitations to this growth, and that exaggerated marketing claims of 20 pounds of muscle growth in as little as one month are not going to be supported by the available scientific research. So the point of this book is not to try and dispel these types of grandiose claims, but rather to try and uncover the amount of dietary protein necessary to support the anabolic effects of resistance training. All of the published scientific research to date has outlined some of the more important aspects of muscle growth including the role of testosterone and growth hormone, and the extreme importance of the inflammatory response to muscle growth. All of these components are important however none of them fully explain the role of dietary protein in the muscle growth process. 46 Therefore, based on the scientific findings we have discussed to this point, we can now ask the question, “If working out without the addition of ultra-high daily protein intakes can cause a person to gain 2-5 pounds of muscle, what happens if they increase their daily protein intake above normal amounts?” Or in more simplified terms, we can call 5 pounds our ‘normal and expected level of growth’ and look for evidence that eating high amounts of protein can cause muscle growth beyond this number. 47 The Muscle Building Effects of Protein 48 The Muscle Building Benefits of Protein High protein diet advocates would like you to believe there are literally thousands of research studies proving the effectiveness of high protein diets for building muscle. The truth is that there are relatively few studies done on high protein diets and muscle building. In fact, there is much more research on lowprotein diets then there is on high-protein diets! [Garlick PJ, 1999] I’ll be the first to admit that there is a strong theoretical basis for expecting a beneficial effect from an increased protein intake. I believed this was true for many years and I’ve even helped formulate several different protein powder supplements in the hopes of helping people put on more muscle. I can also tell you that nobody wants protein to work for muscle building more than I do. If all it takes to build extra pounds of muscle is drinking an extra whey protein shake or two I am all for it. We do know that there is a strong relationship between protein intake and muscle growth – It’s not as if you can simply do away with all of the protein in you diet for long periods of time and not expect to lose a significant amount of muscle mass. What we don’t know is whether or not this strong relationship is permissive (you need a certain amount to allow for the muscle building effects 49 to occur) or if it’s causal (the amount of protein you eat dictates how much muscle you will grow – dose response). Increasing the availability of amino acids does increase muscle protein synthesis, at least for a little while. Research has shown that when amino acids are provided at a constant rate, muscle protein synthesis increases after about an hour, stays increased for about 90 minutes, then returns back to normal levels, even when amino acids are still present [Bohe J 2001]. So while protein can increase protein synthesis, these effects are short lived. We also know that adults humans in different cultures survive on a wide range of protein intakes, spanning from a marginal level of 0.3 grams per pound of bodyweight all the way up to as high as 3 grams per pound of bodyweight per day. [Garlick PJ, 1999] Finally there seems to be some sort of relationship between resistance exercise and protein intake. Resistance exercise can change the way your muscles respond to dietary protein, but in the longer term it may actually decrease your dietary protein requirements [Todd 1984; Butterfield 1984] 50 Despite these facts, the science behind protein and muscle growth is not as cut and dried as it may seem. There is still a serious debate as to how much muscle we can add, and how protein influences this number. The difficulty arises when we consider the fact that muscle grows very, very slowly. Your muscle mass will ‘turn over’ at a rate of 2 to 8 times per year [Smith et al, 2010]. Compare this to your internal organs with a turnover rate that can be as quick as once every 24-48 hours and you will see that muscle ‘grows’ very slowly, which makes muscle growth difficult to measure during short or medium length studies (anywhere from 4 weeks to 6 months in duration). Nevertheless, the research that actually measures increases in muscle mass (as opposed to measuring markers of protein synthesis or nitrogen retention) does not support the theory that there is a dose response relationship between protein intake and muscle mass (the more you eat the bigger your muscles get), or that this dose response continues with ultra or mega doses of protein. My life experiences tend to support these findings. When I was working out diligently in my early twenties I did a two month experiment where I drank a protein shake every three hours, including waking up in the middle of the night to make a shake, yet at the end of this experiment I did not put on any measureable amount of muscle (Remember, I had access to an exercise 51 physiology lab, so my measurements were made using a BodPod and were accurate and consistent). I have also experimented with starting every day with a breakfast that consisted of 100 grams of protein (A protein shake, egg white omelet and two cups of whole milk). During this experiment, I didn’t change my workout regimen at all; therefore I could conclude that the extra protein did not result in any measurable increases in muscle mass. However, this is purely an anecdotal experience; to truly determine if there is a muscle building effect of protein I had to ignore my own personal experiences and attempt to use scientific research to answer the question “Can eating extra protein build muscle?” To accomplish this I reviewed research that studied changes in muscle mass using advanced techniques like Dual energy X-ray absorptiometry (DXA), Magnetic resonance imaging (MRI), air displacement (BodPod) or water displacement (underwater weighing). These are some of the most advanced measurement techniques science has to offer that actually measures true changes in muscle mass. If any research was going to show a benefit, this would be it. I also reviewed the research that used markers of muscle growth such as ‘protein synthesis’, ‘mTOR activation’ and ‘nitrogen balance’ as these were the studies most commonly used to support the muscle building effects of protein. 52 My goal was to find research that used healthy individuals (men and women) between the ages of 18-55 and examine how much change they could see in their muscle mass, and how long it took for that change to occur. Using these search criteria I was able to find several examples of significant muscle growth with and without the intake of extra protein. I will review some of the better research studies over the next few pages. 53 Testosterone and Muscle Growth Studies One of the most interesting studies showing the effect of resistance exercise without any extra protein was published back in 1996. 43 men who were experienced weight lifters took part in research that involved exercise and weekly injections of anabolic steroids (testosterone enanthate) for 10 weeks [Bhasin S, 1996]. The men in the study were divided into 4 groups; working out or not working out, and receiving weekly steroid injections or not receiving them. * Group 1: NO EXERCISE + NO STERIODS * Group 2: EXERCISE + NO STERIODS * Group 3: NO EXERCISE + WEEKLY STEROID INJECTION * Group 4: EXERCISE + WEEKLY STEROID INJECTION. It is probably no surprise that after 10 weeks of lifting weights 3 times per week, the group that was receiving the steroid injections and working out gained a very impressive amount of muscle (over 13 pounds!). 54 It is also not surprising that Group 2, (the group who were working out but didn’t get any steroids) also increased their muscle mass, packing on almost 4.5 pounds of muscle in only ten weeks – In line with our ‘based’ level of 2-5 pounds. What was surprising is that the men who were injected with steroids and then sat around doing nothing for 10 weeks amazingly saw an increase in lean mass that exceeded what the guys working out but not without steroids gained. Imagine gaining over 6 pounds of lean mass just by sitting around on your couch all day not lifting a finger! Obviously, the group who did not receive any steroids and didn't workout did not see any change in their lean mass. So what does a study on steroids have to do with protein? Well, all four groups were on the same diet. They were all consuming about 0.7 grams of protein per pound of body weight (roughly 120 grams of protein per day) and about 16 Calories per pound of body weight. 55 15lbs Muscle Gain All four groups consumed approx 120 grams of protein per day. 10lbs 5lbs 0lbs 4 3 2 1 Groups This research clearly shows that approximately 120 grams of protein per day was enough for a group of men taking steroids and lifting weights to gain 13.5 pounds of lean mass! Even in their steroid-heightened anabolic state, 120 grams was enough to supply all of the necessary building blocks for a 13.5pound gain in lean mass. Interestingly, it was also the same amount of protein that Group 2 the exerciseonly group ate to gain 4.5 pounds of lean mass. So even though we know that these men consumed enough protein to provide for a 13.5-pound increase in lean mass, they only saw a third of this increase. The difference was obviously due to the anabolic effects of the steroids and NOT due to the protein intake. 56 Since the 120 grams was also the same amount of protein that the control group ate (who not surprisingly saw no change). It seems apparent the protein ITSELF did not have any growth promoting effect above the effects of the testosterone itself. This study shows us that you can gain an impressive amount of muscle without increasing your protein intake to super high levels (albeit it, through the use of anabolic steroids). It also shows that protein alone does not cause the body to increase muscle mass. In fact, resistance training and the combination of resistance training and steroids can have dramatically different effects on lean body mass without any change in protein intake at all. In 2005, a similar research paper was published examining the connection between testosterone and muscle growth. 52 men in their sixties received varying doses of the anabolic steroid testosterone enanthate in doses ranging from 25 mg, 50 mg, 125 mg, 300 mg and 600 mg weekly for 20 weeks [Bashin S, 2005]. During this time frame the men were instructed to avoid any resistance training or heavy endurance exercise. 57 The men ate about 90 to 110 grams of protein per day and about 2,400 to 2,700 Calories per day. At the end of the 20 weeks, without working out or eating massive amounts of protein, these men put on a very impressive amount of fat-free mass. The group getting the highest dose of testosterone gained 16 pounds of fat free mass in 20 weeks without any exercise. Even the group getting 125 mg of testosterone per day gained 9.5 pounds of fat free mass in 5 months. Therefore, in these studies on steroids, as long as testosterone levels are elevated, men can gain muscle while eating typical amounts of protein. In both of these studies, slightly above average protein intake in the 70-120 gram range (depending on bodyweight) was enough to allow for very large increases in lean mass. These studies confirm what many others have already found – There is a direct and causal link between testosterone levels (in both men and women) and muscle mass. And, that manipulating testosterone levels can cause massive decreases and increases in skeletal muscle mass without any change in protein intake what so ever. 58 What is very interesting about this connection between testosterone and muscle mass is that this testosterone induced muscle growth is associated with a dose dependent increase in the number of myonuclei, and the of number satellite cells available to the muscle for future growth [Sinha-Hikim 2003]. In other words it seems that intake of anabolic steroids in combination with resistance training causes an increased activation of satellite cells, above and beyond what would normally be found with resistance training alone [Kadi F, 1999]. These findings effectively line up the role of testosterone in muscle growth with our understanding of how muscle growth occurs (satellite cell activation and the addition of more nuclei to the muscle fiber). At this point you might be thinking, “True enough, but still - these guys were on steroids!” The take home message is that in each case protein was not the limiting factor to muscle growth, it was testosterone. These studies clearly show these men were consuming more than enough protein to gain impressive amounts of muscle if enough testosterone was given. The next step is to determine how much muscle can be added without steroids or added protein. 59 Muscle growth and protein – Non-Responders versus Ultra-Responders We can examine the roll that dietary protein plays in muscle growth by using a technique called ‘cluster analysis’ to try and determine why some people gained more muscle than others when using the exact same resistance training program [Thalacker-Mercer et al, 2009]. In this study, 60 untrained healthy men and women took part in a 16 week workout program training with weights 3 days per week. At the beginning and again at the end of the study the researchers measured the cross sectional area of the vastus lateralis myofibers (the size of the muscle fibers in one of the thigh muscles). Based on this measurement the subjects were divided into one of the following groups: • Non-responders (Change in muscle size was about -16 +- 99 um2, lean mass increased by a little over half a pound) • Moderate-responders(Change in muscle size was about 1,111 +- 46 um2, lean mass increased by about 2 pounds) • Ultra-responders (Change in muscle size was about 2,475 +- 140 um2, lean mass increased by 3.75 pounds) After the people in the study were placed into the appropriate group the researchers analyzed their diet records to see if they could find any correlation 60 between what the people ate, and how much their muscle size increased in response to exercise. In the results of the study, despite massive differences in the increases in muscle size the researchers found no recorded difference between any of the groups in the amount of protein the subjects were eating on a daily basis (between 70 and 80 grams per day), the amount of Essential Amino Acids (Between 27 and 31 grams per day) or Branched Chain Amino Acids (Between 12 and 14 grams per day). Obviously there are limitations to using diet records in research. We’ve known for a long time that people are notoriously bad at remembering what they ate, and how much they ate. However, the vast majority of diet records are uniformly inaccurate, meaning that it’s highly unlikely that one group was any worse than the other at reporting what they ate (in reality, we’re all really bad at it!) So while there may be some debate to the amount of protein these people ate, it’s unlikely that there was a large discrepancy between the groups. This study showed that slightly higher than average protein intakes (again in the 70-120 gram range) is adequate, and perhaps even optimal for muscle growth in some individuals, but it also shows that such an intake does not guarantee muscle growth in others, even when in combination with a 16 week long weight training program. 61 While it would be easy to suggest that more protein may have helped the ‘non responders’ gain more muscle, a follow up study published in 2008 suggests that satellite cells were the culprit for deciding how much muscle a person did, or did not gain. In line with our previous findings on how muscles grow, this research found that the people who started the study with the most satellite cells, ended up adding the highest increase in muscle mass [Petrella JK, 2008]. In other words the ‘ultra-responders’ started the study with the most satellite cells, and thus by the end of the study had gained the most muscle mass. This cluster analysis research clearly illustrates that the determining factor in how much muscle you can gain is related to the amount of satellite cells you have available for muscle growth. It doesn’t discount the role of protein in muscle growth, but simply illustrates that a wide degree of muscle growth is possible at relatively equal protein intakes, and without the use of post-workout supplementation. 62 Muscle Growth and Weight Training In Vegetarians We can look at the research that explored the effect of resistance training on vegetarians as another way to assess the need for protein. Not only do vegetarians eat somewhat below average intakes of protein, they also obviously do not eat any animal meat, which in the sports nutrition world are largely considered to be the most “anabolic” of all protein sources. In a study published in the scientific journal ‘Medicine Science, Sports and Exercise’, two groups of people were asked to follow weight-training programs for 8 weeks [Burke DG, 2003]. Both groups followed the exact same high volume, heavy load resistance training workout program for the 8 full weeks. The only difference between the groups was that one consisted of people who have all been vegetarians for at least the last 3 years of their lives. They were either lacto-ovo (milk and eggs only) or even stricter forms of vegetarians. The other group consisted of people who ate the traditional North American diet that included all forms of meat. 63 The vegetarian group ate almost 450 less calories per day than the nonvegetarian subjects, while the non-veggie group ate around 1.75 times more protein than the veggie subjects (79 grams per day versus 138.5 grams per day). Neither group took any form of post-workout supplement other than creatine monohydrate (A supplement we discuss later). The two groups were further subdivided into two more groups, his time with people either taking creatine or not taking any form of supplement. So the study design ended up looking like this: * Group 1: VEGETARIAN + NO CREATINE * Group 2: VEGETARIAN + CREATINE * Group 3: NON-VEGETARIAN + NO CREATINE * Group 4: NON-VEGETARIAN + CREATINE By the end of this study all four groups had gained similar amounts of lean mass (between roughly 2-5 pounds, the exact amount we would expect from a resistance training program of this length). The only group that was significantly different was the vegetarian plus creatine group, who gained slightly more muscle weight than the non-vegetarian plus creatine group. 64 This research illustrates that muscle growth is possible without eating ultrahigh amounts of protein, and also suggests that once minimum protein (and calorie) requirements are met, adding more protein and more calories does not seem to increase the total amount of lean mass that is gained from a resistance training program. From this research we can see that 79 grams of protein per day was enough to allow for muscle growth, and 138.5 grams of protein per day did not seem to promote any ADDITIONAL muscle growth. This evidence is in keeping with the previous studies, in which 70-120 grams of protein was enough to allow for an impressive amount of muscle growth in most (but not all) people studied. 65 Muscle Growth and Low Protein Diets Now that we have seen a couple different examples of muscle growth with normal protein intakes, we can also look at the research examining what happens when people follow a resistance training program while eating a low protein diet. It is generally believed that low protein diets instantly cause large losses of muscle mass. From a scientific point of view this belief may be short-sighted. When a person is transferred from a high protein diet to a low protein diet there is a delay before the body comes into balance, and during this time there is a net loss of nitrogen from the body, which people believe indicates a loss of muscle mass. However, this loss is only transient and represents a change in proteins that are easily lost or gained when intake is altered, but doesn’t necessarily represent a permanent change in muscle mass [Munro et al, 1964]. In other words the temporary negative or positive nitrogen balances which occur when the intake of dietary protein is drastically altered reflect a lag in metabolic adaptation [Waterlow et al, 1968]. Research has found that it takes about 7 days to adapt to a low protein diet, with some nitrogen loss, however it is lost preferentially from the liver and gut (not your muscles) [Adds et al, 1936]. 66 So studying short periods of low protein diets may give us a false idea of what happens over the long term. However, there are groups of people we can study for long term results of a lower than normal protein diet. When diets are extremely low in protein (under 0.25 grams of protein per pound of bodyweight) for extended periods of time, skeletal muscle will have to be catabolized (broken down) to obtain essential amino acids. This will result in decreased lean body mass, especially in the elderly [Hansen RD, 2000; Castaneda C, 2000; Campbell WW, 2001; Morse MH, 2001]. You cannot go without any protein at all, but we still need to determine, how low is too low? People with chronic renal insufficiency must eat a very low protein diet as this disease impairs their ability to process protein. For these people eating even a normal amount of protein would be dangerous. So any research showing that these people could gain muscle would prove that muscle growth is possible with a very low protein intake. It can also show us if eating small amounts of protein can actually CAUSE losses in muscle mass. A group of scientists decided to study the effect of resistance training on people with chronic renal insufficiency [Castaneda C, 2001]. The scientists postulated that these people would be at risk for losing muscle mass because of their 67 inability to eat enough protein. These scientists were working under the assumption that weight training would be the best way for these people to maintain their lean body mass and build their muscles. The people in this study were all over 50 years of age and were eating a very low protein diet. On average these subjects were eating slightly under 0.3 grams of protein per pound of body weight. To put that into perspective, a 180-pound man would be eating about 50 grams of protein per day, for 12 weeks. According to the current fitness industry dogma, this amount of protein is probably 3 times lower than the amount of protein needed for building muscle. At the end of the study, the subjects working out 3 times per week maintained their body weight, while the group that was not lifting weights lost about 7 pounds. This type of weight loss is very typical with this disease (to be clear a low protein diet alone will not cause this kind of rapid weight loss). The group lifting weights also saw increases in muscle strength and muscle size. Meanwhile the group that was not weight training lost some muscle and a little bit of strength. 68 This study is a great example of people actually maintaining and possibly even gaining muscle size as a direct result of resistance training while on a low protein diet. I realize the study was done on people who were over 50, and had a medical condition, and who were eating a diet much lower in protein than I would ever recommend. Despite these facts, this research does show that weight training alone can build muscle size even in these people who for medical reasons can barely reach the minimum daily requirement of protein. It is possible to suggest that these people would have seen better gains in muscle mass had they been able to eat more protein, but this would have been extremely difficult in these people given their medical condition. So we do not know if we would have seen better results if more protein was consumed, but at least we know that we can still see some results even when protein is lower than average for an extended period of time. From this collection of research it seems that the range of 70-120 grams of protein per day was enough to allow for substantial muscle growth. Going slightly below this range did not cause muscle loss, but it also did not result in large increases in muscle mass. 69 While we did see evidence that going above this range did not improve the subjects ability to gain muscle mass, it is logical to suggest that the doses of protein in the research I have reviewed so far were all too low to see any result. In fact, it could be that we need ‘super massive’ doses of protein to cause muscle growth. 70 Muscle Growth and Very High Protein Diets One of highest doses of protein I could find was in a study published by Burke et al in 2001. In this study Forty-two men between the ages of 18 and 31 were divided into 3 groups. The first group supplemented their diet wit an additional 0.54 grams of protein per pound of body weight. To put this into perspective, for a 180-pound man that’s approximately 100 EXTRA grams of protein per day from protein powder. This is the equivalent of taking about 5 extra scoops of protein powder every day in addition to your normal protein intake! The second group took the same amount of extra protein plus an additional 0.045 grams of creatine per pound body weight (about 10 grams of creatine per day for a 180 pound man). The third group received 0.54 grams of maltodextrin (a simple carbohydrate) per pound of body weight as their supplement (the placebo group). The whey protein group gained about 5 pounds in six weeks, while the placebo group somehow managed to gain an insignificant 2 pounds. Impressively, the 71 group taking creatine gained 8.8 pounds of lean tissue mass! (We will discuss how creatine works later) [Burke DG, 2001]. High Protein + Creatine 10 lbs High Protein Muscle Gain 5 lbs Placebo 1 lbs What you need to know: The high protein groups drank their shakes in 4 equal servings throughout the day (this was not a post-­‐workout trial). This research was funded by MuscleTech Research and Development Inc.. These findings agree with the findings of the other studies that have shown that resistance training in conjunction with protein intakes above 120 grams of protein per day do not increase muscle mass above the 2-5 pounds we would expect to see from resistance training, unless it is accompanied by the use of creatine monohydrate [Hoffman JR, 2006]. However, if you look closely something interesting did happen with this study. The subjects had an average increase of about 5 pounds of lean body mass and they did it in only 6 weeks. This suggests another possibility; protein may not make you grow more muscle, but it may help you grow the same amount of muscle faster than you would without the extra protein. 72 We’ve seen that massive amounts of protein (well above the 70-120 gram per day range) do not cause muscle building above the 2-5 pounds we can expect from a resistance training workout, but it may possibly allow you to build that 2-5 pounds a little faster. The next question to answer is what happens when we eat a huge amount of calories with our protein? High Protein + High Calorie Diet and Muscle Growth In a research study published in 2002 by Rozenek et al, 73 healthy men were assigned to an 8-week workout program and divided into three diet groups. • Group 1 consumed an extra 2010 Calories per day that included an extra 106 grams of protein. • Group 2 consumed an extra 2010 Calories but only 24 extra grams of protein. • Group 3 did the same 8 week long workout program, but didn’t have to drink the extra 2010 calories. I don’t know if you’ve ever tried this, but drinking an extra 2010 calories per day is actually very difficult to do. Not only is this an incredibly large, incredibly thick shake, but it also makes you feel sickly full for hours. 73 I once designed a Mass Gaining shake that contained roughly 2000 calories per serving, and I can distinctly remember trying to avoid doing any of the flavor testing for this product, because after about 2 servings, I was too full to eat for the rest of the day! To put this into perspective, it was like downing 2 extra large fast food style milkshakes every day and then trying to eat your normal food. Luckily the people in this specific trial managed to drink all of their shakes AND eat their normal meals. After 8 weeks all 3 groups made significant gains in fatfree mass. The high protein group gained a little over 6 pounds, the Carbohydrate group that only received an extra 24 g of protein gained almost 7.5 pounds of lean mass and the group who did not receive any supplements still gained over 3 pounds of fat free mass. Let’s say that again. Between the two groups who took extra protein, the group who took LESS extra protein gained MORE muscle. 74 2010 extra calories + 106 grams extra protein 10lbs Muscle Gain 5lbs 2010 extra calories + 24 grams extra protein Placebo 0lbs To put it into perspective, the group getting no supplements gained a little over 3 pounds of fat-free mass and dropped about 2 pounds of fat while eating roughly 2,400 Calories every day. The other two groups gained between 6 and 7 pounds of fat-free mass, didn’t lose any fat, and were eating roughly 4,500 Calories every day. The difference in the amount of protein the men were eating clearly had little to do with the weight gain as the lower protein group gained more mass than the high protein group. This suggests that the people in the group eating an extra 24 grams of protein had possibly already maximized the muscle building 75 potential of protein, and that the men in taking the extra 100 grams of protein were simply eating in excess of what they needed. An interesting finding in this trial was that even though the 2-5 pounds of the muscle that was gained was within the range we would expect, the time course (8 weeks), that it took to gain this muscle was on the lower end of the amount of time we would expect for these types of gains. What you need to know: The high calorie groups drank their shakes in the morning and at night (this was not a post-­‐workout trial). The group with the best gains (green bar) still consumed roughly 120 grams of protein per day. Hopefully by now you are starting to see a trend. No matter how the story is spun, if you are working out, taking a little protein, a lot of protein, protein with carbs, protein with over 2000 extra total calories per day, or no protein at all you should expect to gain about 2-7 pounds of lean mass after roughly 2-4 months of working out. Considering our ‘baseline’ muscle gain from working out alone was 2-5 pounds of muscle, these results hardly seem to support the need for post-workout protein, or high protein diets. 76 There seems to be evidence to suggest that a higher range of protein intake (in the 70-120 grams per day range) is beneficial, but anything above this amount does not seem to increase the muscle building effects of a weight-training program to any degree that is measurable in research studies of 2-6 months in duration. The range of 70-120 grams of protein per day was also enough to allow women involved in a weight loss experiment to actually increase the cross sectional area of their muscle fibers while on a weight reducing diet – These women actually gained muscle size while losing over 30 pounds of bodyweight. [Donnelly JE, 1993]. It was also the amount that allowed women to gain lean body mass while following a resistance-training program, even though they were also on a severely calorically restricted diet. [Hunter GR, 2008]. In fact, if we look through actual scientific research what we find is that to scientists the words ‘high protein’ generally refer to a range of 1.2 to 1.5 grams of protein per kilogram of body weight – an amount higher than the current government recommendations but certainly much lower that the 1-2 grams per POUND of bodyweight that we see in most of the fitness magazines. 77 In scientific studies ‘High Protein’ = 0.55 to 0.7 grams of protein per pound of body weight. In fitness and supplement advertising ‘High Protein’ = 2 to 3 grams of protein per pound of body weight. When we consider this range to be ‘high’ then it is true that there is an abundance of research which seems to suggest that for muscle building purposes there may be an advantage to consuming protein that is above the generally recommended levels [Haub MD, 2002]. If we look at our current recommendation of 70-120 grams of protein per day (on average) we see that we could meet the needs of a 220 pound man (100 kg*1.2 g protein =120 grams per day) and the needs of a 110 pound woman (50 kg*1.4 grams of protein = 70 grams of protein per day) while still falling within the ranges of what scientist consider to be ‘high’ protein. To answer the question, ‘how much protein do we need to build muscle?’, it seems that the original recommendations from the late 1800’s of around 100 grams per day seem to be enough to meet the muscle building needs of most adult men and women who are not using anabolic steroids. Not only this, but even in people who are using steroids it is enough protein to allow for a considerable amount of muscle growth! 78 If we wanted to build a margin of error into this recommendation of 150% overage (to account for excessively tall individuals with high lean body mass) we still see an upper range of roughly 150 grams of protein per day at its highest levels. Now that we have a strong theoretical basis for the amount of protein that seems to help promote muscle growth, the next question to consider is whether or not there is a particular way in which we are supposed to ‘take’ this protein. 79 Protein and Meal Timing One of the most common beliefs with protein is that it has to be consumed every 2-3 hours, otherwise your body will become catabolic and begin eating away at your muscle mass. While this recommendation is certainly effective at increasing the amount of protein you need to buy, it does not seem to be supported by scientific evidence. In a research paper published in the American Journal of Clinical Nutrition a group of healthy men and women were asked to eat all of their daily calories in either 1 meal or 3 meals for a period of 8 weeks [Stote KS, 2007]. Both experimental diets contained a slightly higher than normal protein content, consisting of roughly 85 grams of protein, (which lands them right in the 70-120 gram range I recommended earlier). These people either consumed all of their protein in one big meal or ate the traditional breakfast, lunch, dinner, with each meal containing between 25-30 grams of protein. 80 At the end of the study, the researchers noted no difference in the lean body mass of the subjects, illustrating that eating protein only once in a 24 hour period for 8 weeks straight does not cause you to lose muscle mass (as long as the protein content is high enough to meet your daily needs). Eating protein only once in a 24 hour period does not cause you to lose muscle mass (as long as the protein content is high enough to meet your daily needs). So either eating all your protein in one meal does not increase your risk of losing muscle, or the muscle loss was so slow it was undetectable after 8 weeks. Either way, from the available data it seems as though whether you eat slightly more protein less frequently, or less protein more frequently, it looks like you are good no matter how you decide to eat your protein. Research examining protein synthesis (as opposed to measuring changes in muscle mass) agrees with this finding. Research examining what happens when amino acids are provided constantly for 6 hours (supplied intravenously – like an I.V. drip) has shown that muscle protein synthesis increases after about an hour of amino acid availability, stays increased for about 90 minutes, then returns back to normal levels for the remaining 4 hours, even when amino acids are still present at measureable levels in the blood [Bohe J 2001]. 81 Post-Workout Protein When it comes to protein and muscle mass, one of the most commonly held beliefs in the sport nutrition industry is that you need to eat protein after your workouts to fuel the muscle building process. Even people who do not believe in the merits of a high protein diet will still be sure to eat protein immediately after their workouts. On the surface this theory seems to make sense. Since weight-training workouts can stimulate muscle growth, and muscles are built of protein, and you want more muscle, I can see why some people think that adding more protein to the mix might enhance the muscle building effect. The idea that there is a magical window of time immediately after the workout where protein MUST be taken is what doesn’t make sense to me. Somehow, people have been lead to believe that they will lose the muscle building benefits of the workout if they don’t take a protein supplement immediately after their workout. It is this belief that leads me to my next question “Do I need to eat (or drink) protein immediately after my workout to make my muscles grow?”, but to answer this, I must first answer the question “Can my muscles grow without 82 taking protein immediately after my workout?”, and the answer to this second question seems to be “yes”. In a study published in 2007, people performed weight-training exercises for 12 weeks while taking one of the following four supplements immediately after their workout a) Protein b) Protein plus colostrum c) Protein plus creatine d) Creatine plus colostrum The two groups of people who were taking post-workout protein only gained 2 pounds of muscle in 12 weeks, while the creatine groups gained about five pounds in 12 weeks. So in this trial, creatine had a much more potent muscle building effect than a post-workout protein supplement, but none of the results were outside of our 2 to 5 pound baseline we came up with at the beginning of this book [Kerksick CM, 2007]. What you need to know about this study: The average protein intake for all groups combined was 165 grams of protein per day, well above our range of 70-­‐120 grams. This study was funded by General Nutrition Centers Inc. (GNC) 83 In another trial published in 2000, scientists studied men who took part in a resistance-training program for 10 weeks. During the study these men also took a post-workout supplement containing either 40 grams of whey protein or 40 grams of whey protein with an added 5grams of L-glutamine and an extra 3 grams of Branched Chain Amino Acids (BCAAs). Note: L-glutamine and BCAA’s are popular muscle building supplements that have been theorized to be beneficial for gaining muscle. They have been found to have beneficial effects on short-term protein synthesis measures but have failed to show any measurable results changes in actual lean body mass measurements. At the end of the trial the whey protein group gained an insignificant halfpound of muscle, and the protein plus extras (BCAA’s and Glutamine) gained an uninspiring pound and a half. Considering that the people in this study were weight training for 10 weeks, these were not very impressive results [Colker CM, 2000]. 84 The Infamous “Research” That Started All the Confusion When it comes to the importance of ‘nutrient timing’ it seems that this popular notion started with a research paper that was published in 2001 that showed that when it comes to protein – ‘timing is everything’. If you read any popular fitness/nutrition publications or websites, you’ll see this research quoted everywhere! Most of the articles you read in magazines or online usually quote the same study published in the Journal of Physiology. The Journal of Physiology is a very reputable journal, so I figured this study must be a pretty solid piece of evidence supporting all the chatter about the specific timing of post workout protein supplementation. Obviously I had to see this research paper myself and see what it said. When I finally tracked this study down I was surprised to learn that the subjects in this trial were older men in their 70’s, and the post-workout protein supplement only contained 10 grams of protein! This is a far cry from the protein mega doses that are currently being promoted by all the latest nutrition and fitness gurus. But the inconsistencies between the study and the current fitness industry dogma don’t stop there. 85 In this study, the older men participated in a weight-training program 3 days a week, for 12 weeks. After their weight training they drank a supplement containing 10 grams of protein and 7 grams of carbs either immediately or 2 hours after their workout. After 12 weeks the group consuming their protein immediately after their exercise gained two pounds of lean mass, while the group who took their protein 2 hours after their workout somehow managed to lose two pounds of lean mass [Esmarck B, 2001]. In my personal opinion, 70-year-old men gaining two pounds of lean mass after 12 weeks of working out is hardly reason enough for me to start recommending post-workout protein (Except maybe to 70 year old men). Not to mention that this is only a significant finding because the non-protein group somehow managed to lose 2 pounds of lean mass, which is very surprising given their weight-training program (I’d even go so far as to say this specific result is fishy, and may be a phenomenon related only to this age group). What you need to know about this study: The supplement in this study was ‘JogMate Protein’ and is produced by a company called Otsuka Pharmaceuticals. The study was funded by Otsuka Pharmaceuticals. Most likely, these findings are due to either poor study designs (all of their data was rounded to the nearest whole pound) or data collection errors. In fact, I am 86 willing to bet that if this study were to be redone using our target population of people aged 18 to 55 we wouldn’t find any significant results at all. Post-Workout Protein – What’s really happening? As it turns out, scientists were correct when they said that post workout nutrition is vitally important to the muscle building process – the issue was the definition of ‘post-workout’. In recent research performed at McMaster University in Hamilton, Ontario Canada in conjunction with the University of Nottingham in England, it was found that the first meal after a workout is extremely important to many markers of muscle growth. They also found that this meal could be as much as 24 hours AFTER a workout [Burd NA, 2011]. In this study 15 recreationally active young men with previous resistance training experience took part in a study where they either: A) Consumed a drink containing 15 grams of protein. B) Completed a weight training workout, then consumed a drink containing 15 grams of protein 24 hours after the completion of their workout. The researchers found that despite the fact that their protein feeding was 24 hours AFTER their workout, the subjects still found elevated changes in markers of muscle growth after protocol B when compared to protocol A. 87 Absolute changes in the fractional synthetic rate of myofibriliar proteins (a marker of muscle growth) were elevated higher after protocol B compared to protocol A. In other words, if the results of protocol A were representative of what happens normally when you just eat some protein, then protocol B illustrated that resistance training heightens this anabolic response, even if the workout occurred 24 hours before the protein feeding. The researchers also found significant increases in many of the molecular markers of muscle growth such as mTOR and 4E-BP1. So while this was not a training study (it wasn’t long term) and it didn’t measure actual changes in muscle mass, it did measure the main surrogate endpoints that most people use to support the need for post workout nutrition/protein. Therefore, as the results of this study show, it is conceivable to say that EVERY meal you eat is a post-workout meal considering an anabolic effect can be measured from consuming protein up to 24 hours after the workout! It is also reasonable to suggest that the most important muscle building meal is the meal you eat after your workout – but that this meal could be as far as 24 hours after your actual workout! 88 The bottom line is that the right weight training with the right intensity and effort does sensitize the muscles to the anabolic effect of dietary protein, but this result remains for as long as 24 hours. It should also be noted that the protein dose in this study was 15 grams, considerably less than the 50 grams some people tend to advocate. Another interesting finding about the relationship between exercise and protein is that exercise may increase the amount of time that dietary protein can increase protein synthesis. Studies have found that simply feeding protein can increase markers of protein synthesis for about 90 minutes, after which muscles seem to become unresponsive to additional stimulation by amino acids. However, when amino acids are fed after a resistance training work out amino acids are able to increase muscle protein synthesis for up to 5 hours [Moore DR 2009]. The main effect of post-workout protein may be that the muscle is some how more sensitized to the anabolic effects of amino acids, and while there isn’t a greater increase in protein synthesis, the elevation in protein synthesis does seem to last longer (5 hours) then it does when feeding protein with no exercise (90 minutes). 89 High Dose Protein Fails to Impress Again In yet another research study examining the effects of protein post-workout, young healthy men were placed in one of two groups. One group received 10 grams of creatine with 75 grams of dextrose (dextrose is a form of sugar) immediately post-workout, while the other group received 10 grams of milk protein plus 75 grams of sugar. After 8 weeks of a very impressive weight training program the protein group gained just under 6 pound of lean mass (again, just a bit above our base line of 2-5 pounds). Interestingly, in this research the creatine group gained almost 9 pounds, which was much more than the protein group. It is also important to note that because of the way the statistics were run in this trial the difference between 5 pounds and 9 pounds was not significant. What this research shows is that even without post-workout protein, the group taking creatine after their workouts gained more lean mass than the group taking protein after their workouts. [Tarnopolsky MA, 2001] (Another example of creatine performing much better than protein as a post-workout supplement). 90 As you can see, when we investigate research on post-workout protein that measures changes in muscle size and weight (as opposed to surrogate endpoints like Amino acids movement) we see very little evidence to support the idea that immediately post-workout protein is essential to increases in muscle weight…it may help, but it is not essential. What you need to know about this study: Both groups consumed an average amount of protein daily that was slightly more than 120 grams (125 and 131 grams). This study was funded by MuscleTech Research and Development, Inc. Based on this review, I see no reason to AVOID post-workout protein, and if possible it seems like a logical time to eat protein, but also does not seem like you need to overly stress if you miss, or have to delay, the meal to a later time. Bottom line – There may be some benefit, but it is also not an essential component of your muscle building process. 91 Building Muscle, Nitrogen Balance and Protein Synthesis 92 Building Muscle, Nitrogen Balance & Protein Synthesis, is there a difference? To understand where the story of protein and muscle began, we need to move away from all the research that actually measured changes in muscle mass and take a look at all of the tracer studies that show a post workout increase in something called “protein synthesis”. You’re probably asking yourself “what is a tracer and why would anybody use it to study changes in muscle mass? Why not just measure actual changes in muscle mass?” Well skeletal muscle turns over very slowly – at a rate of 1.5-2% per day. This means that even at its absolute fastest muscle growth is an incredibly slow process. And, this rate is not constant, as they fluctuate throughout the day [Garlick PJ, 1973]. In fact, it is so slow that it is simply impossible to detect any changes in muscle mass during a short period like hours or days no matter how advanced and sensitive the measuring devices are that the scientists are using. 93 This fact posed a significant problem as scientists became interested in how, when and why muscles grew. Specifically, they wanted to know what caused muscle growth during or after only one workout. Another issue was that different measuring techniques found different results. Scientists can study something called ‘fractional synthetic rate’ (FSR) as a way to characterize the protein turnover that is occurring in human muscles. Without getting too technical this is a measure of the amount of amino acids entering and exiting your muscles, and we can use this measure to figure out if more amino acids are entering your muscle then are leaving your muscles, or vice versa. Depending on how you conduct your measurements, young and middle aged healthy men and women can have a fractional synthetic rate that range from 0.020-0.040% per hour in the low range and 0.080-0.095% per hour in the high range. That’s a big difference and a testament to the need for highly accurate and standardized measuring devices [Smith et al, 2010]. Since scientists do not yet have the tools to measure what they actually want to measure (very small changes in muscle mass) they have to look for something else that might be an indication or “marker” for what they want to measure. 94 In research we call this a surrogate endpoint. We use something we can measure and assume it tells us something about what we cannot measure. In this case, we measure markers of protein synthesis assuming they are an indicator of muscle growth. In other words, muscle mass growth is the true end point we want to measure but cannot. If we assume that muscles need amino acids to grow, and we can measure the amount of amino acids going into and out of muscles, we could guess that if more amino acids are going into and less coming out of a muscle, it must result in growth. Instead of measuring actual changes in muscle mass scientists use the incorporation of amino acids into a muscle as the surrogate end point that we can measure. Definition: Surrogate endpoints are often physiological or biochemical markers that can be quickly and easily measured, and that are thought to be predictive of a true clinical end point. Tracers, (or labeled amino acids) are amino acids that have been labeled with stable, non-radioactive heavy isotopes. Most often this is with carbon-13 atoms. 95 This just means the scientists can see where this exact amino acid travels in your body because it will show up on their computer scans. They can also take muscle samples and see how much of this special amino acid ends up in whatever muscle they choose to test. Through careful measurements and a number of scientific assumptions scientists use tracer amino acids to measure the net balance of amino acids as they move in and out of an area of muscle [Smith K, 1998]. If, during a given period of time more amino acids move into a muscle than moved out of a muscle, that muscle is said to be undergoing protein synthesis. If more amino acids are moving out than are moving in, the muscle is said to be undergoing protein breakdown, or protein catabolism. These however are both assumptions. The net flux of amino acids in or out of a muscle does not, and has not been shown to equal true long-term muscle growth; it is still a scientific assumption, based on extrapolating information over a very small period of time, and assuming it remains constant over a much longer period of time. It seems reasonable to assume that having a net influx of amino acids suggests the muscle is in a state that would allow it to grow. After a maximal load of 96 amino acids your fractional synthetic rate can increase by as much as 90% over normal, and after a workout it can increase by as much as 250%. However this increase only lasts for 1-3 hours, even when amino acid levels in the blood remain elevated [Bohe J et al, 2003; Atherton PJ, et al. 2010]. These are the studies that are typically referenced by the people who advocate high protein diets and post-workout protein, while stating things like “high protein after your workout is PROVEN to increase protein synthesis” Unfortunately, we do not know whether acute measurements of protein synthesis are PROVEN to indicate long-term increases in muscle mass. And as we have just discussed, we don’t even know if tracer studies are actually showing muscle growth at all, or just a lot of amino acid movement in and out of muscles. Remember your body uses amino acids like Lego blocks and reuses them constantly all over your body, a temporarily elevated flux doesn’t necessarily mean more muscle growth. The important thing to remember with these research trials is that they are acute. In other words, they examine what happens during a very short period of time. 97 If you were a subject in one of these studies, your day would have gone something like this... You would be asked not to workout for 3 days, after which you would show up at a research lab around 10 PM, and you would go to sleep (no eating). The researchers would wake you up around 6 AM and start poking and probing you (again no eating). After a bunch of weighing and measurements, you would start working out around 9 AM...you still haven't eaten yet. This would be one of the toughest workouts of your life. Most likely you would do 10 sets of 8 reps on the leg press machine, followed by 8 sets of 8 reps on the leg extension machine. All of your reps would be done at close to 80% of your one rep max. Like I said, a brutal workout. By the time you finished you would be exhausted and it would be about 10 am. It would then finally be time to eat. After your workout you would be given a drink that contains 3 to 6 grams of essential amino acids (the same amount of amino acids found in a glass of milk). 98 After that, the researchers would take measurements for the next 4 hours and measure your rate of 'protein synthesis'. This is pretty much the standard protocol for these types of studies, and in these studies researchers almost always find an increase in protein synthesis over the two to four hours that they measure after your workout. (And remember when I say ‘protein synthesis’ we are actually talking about the movement of amino acids in and out of muscles that is ASSUMED, but not proven, to mean protein synthesis) So what does this prove? It proves that if you haven't worked out in 3 days, and you have eaten since 10 PM the night before, and you do a brutal workout at 9 AM the next morning, and drink the equivalent of a glass of milk, you will increase your assumed protein synthesis for four hours. In other words, more amino acids would be going into your muscle then would be coming out of your muscle during the 4 hour testing period! That’s it. So if this is, in fact, a true measure of muscle growth then it definitely disagrees with the idea of needing at least 30 grams of protein every 2-3 hours. As we have just seen the people in these studies haven’t eaten in approximately 15 hours when they are supposedly ‘building muscle’. 99 Furthermore, the only reason I say protein synthesis increases for 4 hours is because the researchers stopped taking measurements after 4 hours. Who knows how long you would have stayed in a muscle building state. Some researchers have estimated that a single workout can put you into 'muscle building mode' for as long as 48 hours after your workout [Phillips SM, 1997]. Even more interesting is that researchers have found similar results when they made people drink the amino acids before their workout, and even when they made them wait and drink the amino acids a couple hours after their workout [Tipton KD, 2001; Rasmussen BB, 2000]. While this research does point to a connection between amino acid intake after either fasting or a single workout and amino acid incorporation into a muscle, it does not show muscle growth. It does show that amino acids from protein can stimulate protein synthesis [Bennet WM, 1989] and that they are able to do so in a ‘dose dependent manner’ – meaning the more amino acids you consume, the higher this measurement becomes [Bohe J, 2003], but again, it doesn’t prove actual long-term, measureable muscle growth. However we also know that massive changes in the amount of protein you eat does NOT create proportionately massive changes in muscle mass, leading to 100 further speculation that the measure of changes in protein synthesis to suggest changes in muscle mass may be flawed, or that things are happening later in time to ‘balance out’ the amount of muscle growth that occurs as a response to feeding. Even when amino acids are infused into a muscle at very high doses, muscle protein synthesis increases and peaks at about 120 minutes, but then it returns to baseline levels, even when amino acid concentrations remain elevated and anabolic signaling molecules like mTOR remain activated [Atherton PJ, 2010]. This suggests that muscles have a limit to how quickly they can build new proteins, and for how long as well. In fact, because these are acute trials that only measure a couple of hour’s worth of markers, they actually can not show muscle growth. They can only show the results of a marker that if interpreted incorrectly could make you assume that the muscle was growing. Even then, the doses of protein used are very small (typically the amount of amino acids found in a glass of milk) and the timing doesn’t seem to be overly important (before workouts, after workouts or 2 hours after a workout all significantly increased these markers). But again, it is essential to remember that none of these research studies actually found a measurable increase in muscle mass. And isn’t that what we’re interested in anyway? 101 This leads me to a very interesting study published in 1992 that provided some startling evidence that illustrated the problems with these acute measurements. Since proteins contain about 16% nitrogen (just a rough average), scientists can make estimates of the amount of nitrogen consumed in food and the amount of nitrogen we lose on a daily basis and use this estimate to calculate our “nitrogen balance”. The scientific assumption is as follows: if our nitrogen balance is positive we are using protein to synthesize new tissues, such as enzymes, cell structures, and structural proteins like organs and muscle. If our balance is negative we are losing protein in the form of energy or nitrogen containing waste products like urea. Using these basic principles, researchers measured both the nitrogen balance (one of those markers I was telling you about) and gains in muscle mass in young men who were eating either a high-protein or low-protein diet while following a resistance training workout program. These subjects were performing an intensive hour and a half of resistance training 6 days a week for 4 weeks. This research is very important because it measured both acute markers measurements (nitrogen balance) AND actual long-term gains in muscle mass. 102 After 4 weeks the people on the high protein diet (1.2 grams per pound of bodyweight) had a significantly higher nitrogen balance than the people on the lower protein diet (0.61 grams of protein per pound of bodyweight). Based on our scientific interpretation of nitrogen balance measurements, these people should have gained muscle mass. The low-protein diet resulted in a nitrogen balance that was actually NEGATIVE, suggesting losses in muscle mass. Incredibly, despite these nitrogen balance findings neither the high or low protein diet made a significant difference on the amount of muscle mass increase. Even the researchers called these findings surprising, stating that if the nitrogen balance measurements were an accurate indicator of increases in muscle mass, then over the one month period the high protein diet should have caused a 17 pound increase in muscle mass! [Tarnopolsky MA, 1992]. Obviously the massive effects noted in these acute measurements of nitrogen balance simply do not add up long term, as a 17 pound increase in muscle mass would have been an absolutely tremendous increase. Similar findings 103 have been found in other studies where the results of the Nitrogen balance measurements indicate increases in Lean Body mass that simply did not occur in the actual study [Lemon 1992; Tarnopolsky MA, 1988]. Research using nitrogen balance does show us that increases in protein intake will cause a measureable but transient retention of nitrogen in the body. But unfortunately that is all they seem to show us. What we do not know for sure is whether this nitrogen retention is a true marker of muscle growth (or it is just another surrogate endpoint). Many scientists agree that the use of nitrogen balance as a surrogate endpoint to show increases in skeletal muscle mass is flawed [Jackson AA, 1999]. And truthfully, we’ve known about these flaws since as early as 1976 [Hegsted 1976]. There are many other explanations for positive nitrogen balance, which include use by other nitrogen sources in the body that turn over much more quickly than muscle, or even an unrecognized error in the scientific methods of studying nitrogen balance. 104 In fact, the weight of the current evidence suggests that the positive Nitrogen balances associated with a high protein diet do not correspond to increased lean tissue, and particularly not skeletal muscle [Garlick PJ, 1999]. The bottom line is that to date we have little proof that any of these surrogate endpoints such as nitrogen balance or tracer studies actually indicate longterm muscle growth. This makes sense for a number of reasons. Firstly these trials are done almost exclusively in acute situations. Only the metabolic effects of the few hours following one single workout are measured and then these results are used to guess at what happens after a series of workouts. Secondly, most researchers are very quick to point out that their findings indicate transient increases in protein synthesis. Transient is another way of saying that something is only happening for a very short period of time, and is most likely going to change or return to existing levels very quickly. Even newer, more sophisticated surrogate endpoints like the phosphorylation of anabolic signaling proteins are still causing scientists to be even more 105 confused. We now know that many amino acids (specifically leucine) can act like signaling molecules within the body. In other words, leucine almost acts like a hormone, turning on various anabolic signaling pathways within the body [Hutson SM, 2001]. So protein (or more accurately the amino acids that make up the protein you eat) serves many purposes in the muscle building process. The most obvious being to act as the actual ‘bricks and mortar’ that create the architecture of a muscle, and they also serve a purpose of being a nutrient signal that turns on some of the muscle building processes [Jefferson LS, 2001]. And while the link between leucine and the mTOR protein had scientists excited that we had ‘unlocked’ the mechanisms of muscle growth, It has recently been shown that an increase in the phosphorylation of the anabolic signaling proteins ‘PKB’ and ‘p70S6K’ can occur without any changes in protein synthesis [Greenhaff PL, 2008]. Supporting this finding is the research we discussed earlier with Satellite cells and radiation. In the legs that were exposed to radiation, weight training resulted in very limited muscle growth. Despite this fact the mTOR protein signaling pathway was still activated. So the signal was still there, but without the satellite cells, it didn’t/couldn’t cause muscle growth [Kadi 2004]. 106 Now we have evidence that ‘key’ anabolic pathways can be activated without causing any changes in protein synthesis, and that protein synthesis can change without causing any measurable changes in actual muscle mass! While this is bad news for people who market things like mTOR activators, it does not mean that studying these pathways is a waste of time – It simply means the relationship is more complicated than we thought With all of the available research it seems evident that the findings in acute trials simply do not translate long term. There are large differences between the acute metabolic effects of dietary protein that happen as an acute response to single high protein meal versus the subsequent adaptations that occur to the longer term intake of a high protein diet. In fact, most adaptations happen within the first 3 days after an increase in protein intake. So while it is true that in a wide variety of studies high protein intake has been shown to result in continued positive nitrogen balance and even an increased protein synthesis. It is not known whether this apparent retention of protein is real, how long it persists, and what form the Nitrogen is taking within the body. 107 Not only this, but is also seems apparent that neither high protein diets, nor post-workout protein can dramatically increase the muscle building effects of resistance training (however, it may speed up the muscle building process in young novice trainers – more on that later). 108 The Need for Protein – An Alternative Hypothesis 109 When discussing muscle growth it is important to note that there are actually two different types of muscle growth. 1) Juvenile Muscle Growth 2) Work Induced Muscle Growth This little known fact could be responsible for many of the high protein success stories you read about on-line and in magazines. When you take a close look at these claims, whether they are before and after testimonials for various diets or workout programs, of if they are articles about athletes and actors, you will typically find a common theme. Upon close inspection you will find that most of the people in question are typically men who are in their late teens and early twenties. This is note worthy because, for a brief period of your life, you are able to harness both types of muscle growth. 110 Juvenile Muscle Growth When you are young your body is undergoing a type of growth called ‘juvenile growth’. Your muscles are growing at an unparalleled rate while your body grows both in height and maturity. Consider that after birth, the human body mass doubles in the first 5 months, then again in the next 30 months, then again in the next 6 years! However, as we become adults our body mass growth rate eventually reaches zero, with the exception of the continuing gain in fat mass (for people who live in environments with enough food to support fat gains) [Lui et al 2011] During and after puberty, human bodies take on their more adult form, and this includes a pronounced increase in skeletal muscle mass. As an example, in the growth chart below provided by the National Institute of Health Statistics, you will see that the average expected weight gain for an adult male from the ages 16 to 20 is roughly 20 pounds. 111 Now, this growth isn’t ALL muscle, however a good chunk of it certain will be. After all, we don’t call it ‘filling out’ without reason. It is this type of muscle growth that is very sensitive to nutrient status, specifically calorie and protein intake. Research suggests that when we are young we have a high degree of Anabolic Sensitivity – Meaning our bodies react to eating protein by increasing the anabolic activity in our muscles – This is in line with the belief that more protein means more muscle (at least in the young). It also helps to explain why poorly fed children tend to be smaller than normally fed children. And it is also why re-­‐feeding a group of poorly fed children will quickly return them to normal ranges of muscle mass. However, 112 while overfeeding children can accelerate growth until they have caught up with roughly where they should be, overfeeding cannot prevent the eventual stoppage of juvenile growth. Forced overfeeding does accelerate weight gain however as we age more and more of the weight gain is attributed to fat rather than muscle [Victoria CG, 2008]. Juvenile growth continues until after you’ve reached full skeletal maturity (when your bones fuse and stop growing), this typically happens when you’re a young adult in your early twenties. Once you have reached your full mature size, this high-­‐speed nutrient dependent growth comes screeching to a halt. In other words, from a biological point of view you are simply done growing. The stop of Juvenile growth happens in a coordinated fashion leading to speculation that there is a complex growth-limiting program in our genetics that turns on in multiple organs (including skeletal muscle) once we hit our ‘adult size’. [Lui and Baron 2011]. To be clear, it’s not just a change in testosterone or growth hormone that causes juvenile growth to slow [Finkelstein JW 1972; Guistina A 1998]. It is more than likely a concentrated complex of multiple genetically inherited factors that decide both the amount of muscle you naturally carry as an adult, and the amount you can increase this muscle’s size by resistance training – so we can’t just fix it by taking a supplement or changing how we eat. 113 This genetic limit is also thought to be inheritable. In a study of arm strength and size in 36 male twins it was found that both strength and size showed a high degree of inheritability [Thomis MA, 1998]. Simply put, if your parents, brothers and sisters are all well muscled, chances are you have the potential to be well muscled too. So while under eating during Juvenile growth will stunt growth to some extent, overeating will not prevent the decline of juvenile muscle growth. When we move into our advanced years we become more and more resistant to the anabolic effects of protein. So even though our ‘basal’ levels of protein synthesis are no different, our response to amino acid feedings is greatly diminished [Cuthbertson D, 2005]. 114 Work Induced Muscle Growth Work induced growth is the second type of muscle growth. This type of muscle growth is caused by placing ‘mechanical stress’ (such as lifting weights) on your muscles, and is driving the incorporation of satellite cells into existing muscle fibers. The explanation behind Work Induced Muscle Growth is as follows: As you stress your muscles and challenge them by making them contract against some form of resistance, they respond by adapting to become stronger and larger. Work induced muscle growth is much slower than juvenile muscle growth and nutrient status (what, or how much you eat) has far less influence over this type of growth. In other words, once you are a full grown adult, it is the work you do in the gym that determines how much more your muscles will grow! (not some magical diet). 115 Why You Grew So Quickly When You Were Younger After puberty, sex steroids like Testosterone are at their highest, and other hormones such as Growth Hormone are also elevated and your satellite cells are fully capable of incorporating into muscle fibers. And while we have not been able to identify any one hormone as the ‘key’ to muscle building, the important thing about the period after puberty is that almost ALL anabolic hormones are elevated. In other words, the human body is in a unique state when work induced AND juvenile growth can happen at the same time. This typically happens in the early to mid twenties. This phenomenon explains why young (18-­‐25 year old) men with little or no training experience are always the ones who see the most impressive weight gain results in clinical research trials (and I suspect this is also the reason why this is the type of person who is always asked to take part in muscle building research studies). This is also the reason why most contact-sport athletes hit their prime between 25 and 30 years of age. The human body simply responds better to resistance exercise at this age. In fact, when comparing the Fractional Synthetic Rate response to resistance training, you will notice that there is a blunted response in men over 65 at almost all exercise intensities. 116 (Older muscle seems to have difficulty responding to exercise in the same manner as young muscle) I think this overlapping effect of juvenile and work induced muscle growth is the reason today’s workout advice confuses so many of us. In research comparing the effects of exercise between a group of men aged 2035 with those aged 60-75 a number of startling findings were uncovered. The most expected finding was that while following the exact same 3 day per week workout program (training legs 3x per week) lasting 16 weeks, the young men gained more lean mass, and more muscle size than the older men. The surprising part was what happened next. After the 16 week training period the subjects in this study were then divided into one of three groups: 1. A detraining group – this group did no exercise at all 2. A low volume group – This group only trained once per week. Doing 3 sets per exercise. 117 3. A super-low volume group – this group trained once per week, and only did one set per exercise. This new protocol was continued for an additional 32 weeks while scientists tracked the changes in the subjects muscle mass over time. In the young men there was a clear dose-response to exercise that continued after their initial muscle gain. They were able to continue adding muscle mass with 1/3 of the volume, they could maintain their muscle mass training once per week with a greatly reduced volume per workout, and only lost muscle when they were completely detrained. On the other hand, the older men weren’t so lucky. There was no dose response in the older group. All three groups lost significant muscle mass in the older men. So not only did the older men put on much less muscle then their younger counterparts, but they were also not able to maintain that new muscle mass when asked to do a reduced volume of training [Bickel CS, 2011]. In fact, previous research has shown that it would take up to 4 months of training for the muscle of older adults to reach the same size as UNTRAINED men 40 years younger in age [Kosek DJ 2006]. If you combine the findings of ‘delayed anabolic response’ that occur with aging with the fact that experienced weight lifters have reduced muscle protein 118 turnover due to the fact that weight lifting actually ‘conditions’ muscle to be protein-conserving as part of the adaptation response [Phillips 1999] and you begin to see why it becomes difficult for older, more experienced lifters to continue to build muscle in the same manner they did when they were younger and less experienced. The cold hard truth is that if you are older than 30 or you’ve been training for more than 10 years your days of gaining fifteen pounds of muscle over a summer are long gone. Protein and calories have a minimal, almost undetectable effect on our muscle growth at this stage. For advanced trainers, we are left with nothing but hard work and proper recovery to stimulate our muscles to grow, and even when they do grow, they are going to grow very slowly. Interestingly these facts all lead to the suggestion that since muscle growth is slower in older men and women, and that weight training in and of itself is actually a protein-conserving stimulus it is logical to suggest that weight training actually decreases the dietary protein needs of an individual, especially a person who is no longer experiencing juvenile muscle growth [Phillips, SM 2006; Hartman JW 2006] 119 Maybe it’s all a Race… 120 The most confusing thing about Muscle Growth is that in almost every research study examining the effect of 2-4 months of resistance training and muscle growth we see a positive result. However, whenever those results are extrapolated into the long-term the results flatten. In other words, the amount of muscle gained in the first 4-6 months cannot be expected to continue over years. If this were true all men and women who have been training for more than 10-15 years should be carrying hundreds of pounds of extra muscle, and this is clearly not the case. Consider the following – Some studies have found that resistance training can cause a muscle to increase in size at a rate of about 0.15% (that’s 15% of 1%) per day. Now assuming (and it is only an assumption) that you could cause ALL of the skeletal muscle in your body to increase at this rate we can quickly see an example go from appearing very possible to obviously impossible. Using the basic equation for compound interest we see how the concept of constant muscle growth quickly falls apart. Using an example of an average 5’10” man who has roughly 140 pounds of lean body mass we know that he would have about 70 pounds of skeletal muscle mass (skeletal muscle is typically about 50% of lean body mass). Under these assumptions our man could gain about 7 pounds of muscle in 8 weeks if he were to gain at a rate of 0.15% per day. Seven pounds of muscle in 121 two months time would be very impressive, however to the average person it would also seem like a ‘realistic’ amount of muscle growth. Using the exact same equation we find that he should also be able to gain about 50 pounds in a year and almost 300 pounds of muscle in three years if this rate remains unchanged. Now obviously this is a gross over simplification of how the body works, but the fact remains – there is an obvious and powerfully controlled genetic upper limit to how much muscle we can realistically build on a given frame. This concept is supported by the research on satellite cells, which illustrates that the ability of satellite cells to incorporate into muscles diminished with time and it agrees with other research showing that muscle has limitations to the amount of size it can build [Young VR, 1974]. It is also supported by the research on compensatory hypertrophy and the research on catch up growth. In all of these studies, when people are undergoing ‘catch up’ growth (undernourished children who are being re-fed) they go through a period of highly accelerated muscle growth, but only until the time where they have caught up to roughly the size that they should be, given their age and their height. Similar results occur in studies looking at people in casts. When a broken limb (arm or leg) has been immobilized for several weeks it will undergo a significant amount of muscle loss, but with rehab exercises you can quickly gain back muscle to the point where the you can’t even tell the arm or leg was once 122 broken, or that any muscle loss ever occurred. It is even supported in research studying the muscle growth potential in highlevel bodybuilders eating over 6,000 calories per day, consuming over 300 grams of protein per day and taking anabolic steroids. In this study, highly competitive bodybuilders took part in a 24 week study where researchers examined the growth of their upper arms before and after 24 weeks of a highlevel weight training program. After finding minimal results in these high level bodybuilders compared to non-body builder controls it was concluded that once a high degree of muscularity has been achieved, further improvements are minimal [Always SE, 1992]. This leads to the following hypothesis: If there is an upper limit to how much muscle you can build then it is possible that all of the muscle building research is actually illustrating different speeds or rates of muscle growth. In other words, you may only be able to gain around 8 pounds of muscle, but you may be able to gain it slightly faster by taking protein before or after your workouts, or by increasing your protein intake into the 90-120 grams range. It could simply be that protein may be able to slightly improve the rate at which you build muscle (as can sleep, recovery and the quality of your workouts) but it is highly unlikely that increased dietary protein, even to ultra-high levels is able to alter the upper-limit to how much muscle you can actually build and 123 carry on your given frame with your specific genetic predetermined limits. This theory would help explain why most research finds similar muscle growth in similar time frames, despite varying workout regimens and nutritional interventions. The bottom line is that this theory suggests that while there is a genetically defined upper limit to the amount of muscle growth you can carry given your frame, body type and physiology, the rate at which you obtain this muscle may be influenced by dietary factors such as protein, as well as your ability to rest, recover and by the quality of your workout program. Once this limit has been reached, a high-protein diet would probably become unnecessary. This suggests that our range of 70-120 grams is ideal for muscle growth, after which a more conservative number closer to the RDI could be use for the maintenance of muscle size [Millward DJ 1990]. 124 This basic graph illustrates the basic 4 phases of muscle size. Protein intake, physical activity and overall health and nutritional status can move a person from dangerously low muscle mass all the way into compensatory hypertrophy, but muscles do not enter ‘pathological growth’ without an underlying disease state or the use of anabolic steroids or other growth enhancing drugs (with the exception of the rarest of genetic anomalies). So extra protein isn’t going to move you into ‘pathological growth’ but it may help you reach your top levels of compensatory hypertrophy faster than you would have without the extra protein. 125 What can we do to build MORE muscle? 126 Building MORE muscle I won’t bore you with any more protein studies as I’m sure your head is spinning by now, and we already know that testosterone and other anabolic hormones build muscle, but are generally not an option for the average person. Therefore, what I would like to show you is some very interesting research on good old creatine monohydrate – a dietary supplement that is legal for use in most countries. Many people think that it was the passing of the Dietary Supplement Health and Education Act (DSHEA) back in 1994 that allowed the nutritional supplement industry to become the juggernaut that it is today, but in my opinion, the discovery of the muscle building effect of creatine monohydrate played just as large a role. In fact, my opinion is that there would be no supplement industry without creatine. From the pioneering research conducted by Dr. Eric Hultman and Dr. Roger Harris, to the ongoing work being conducted by Dr. Paul Greenhaff and many others, the scientific research behind the muscle building effects of creatine is very impressive. So impressive that I believe the effectiveness of creatine created a belief that all supplements could work this well with no side effects and be safe and inexpensive. 127 Creatine is truly the poster child for the supplement industry and how amazingly effective a product could be. Unfortunately 16 years later it is still one of the only supplements that can make this claim. There are hundreds of scientific papers on creatine, and easily over a dozen published books, and for good reason - In almost every creatine trial I have ever reviewed, the men (and women) taking creatine always gain impressive amounts of lean mass. Interestingly, these people do this without any other post-workout supplements or changes to their normal diets. So people in creatine research trials gained muscle WITHOUT high protein diets or post-workout protein meals. Now, it may seem odd that creatine has found it’s way into a book on protein and muscle building, but when you consider that creatine is actually a ‘tripepitde’ made of 3 amino acids, and that it is naturally found in our diets in most red meats, it’s not too difficult too see why a muscle building compound made of amino acids and naturally found in meat made its way into this book. If you measure the surrogate endpoints like amino acid flux or nitrogen balance, creatine has no effect [Louis M, 2003]. But, when you measure the true endpoint of muscle weight, creatine does very well. So while creatine may 128 not actually ‘build new muscle’ in the classical sense, it does increase the size and weight of muscles, and that by itself is an excellent achievement. In fact, creatine performs so well that people in creatine research trials typically gain much more muscle than people in research trials who take protein after their workouts. In general it seems that the use of creatine can add 2 to 5 pounds of weight in 4 to 28 days, and that this weight is mostly in the form of fat free mass. This seems to be in addition to the 2 to 5 pounds we would expect from weight training alone. For instance, in a trial published in 2000, 23 men taking creatine gained over 3.5 pounds of lean mass over 6 weeks. The impressive part is that they only worked out on their arms! That’s right, 6 weeks of only blasting their biceps and the men in this study still gained 3.5 pounds of lean mass! In a measure of upper arm muscle area they gained over 2 square inches of muscle size! [Becque DM, 200] In a trial published in 2001, researchers gave creatine to a group of football players for 9 weeks. During this time these red-shirt freshmen were weight training 4 times per week. At the end of the 9 weeks, the creatine group gained over 8 pounds of lean mass [Bemben MG 2001]. In another trial using creatine combined with resistance training (this time in older men in their 70’s), after 12 weeks of resistance training and taking 129 creatine (no post-workout protein) the creatine group gained over 7 pounds of lean tissue mass! [Chrusch MJ 2001]. What you need to know about this study: It’s important to note that in this study the subjects were of advanced age (70’s). This study was funded by MuscleTech Research and Development, Inc. So to put it all into perspective, from what I can tell from reviewing clinical research, working out alone should cause you to gain between 2-5 pounds of lean mass (remember our baseline with no supplemental protein). Adding a protein shake after your workout won’t provide any extra benefit and you should still expect to gain around 2-5 pounds (you just might gain it quicker). If you take creatine in conjunction with your workout program you can expect to gain as much as 10 pounds of muscle mass. The variation in these numbers (whether you gain 2 or 10 pounds) is most likely dependant on your training status and the design of your workout program. Simply put, the better the workout program design, the better the weight gain. This has even been shown in research where better-designed workout programs have caused larger increases in lean mass [Kraemer WJ, 2003]. 130 The interesting thing with creatine research is that it doesn’t matter whether you take your creatine alone, in combination with carbs or protein, or a combination of the two. The research suggests you will still end up gaining around 7-9 pounds. The protein and carbs simply don’t make a difference. In the conclusion section of a research paper published in 2004, the authors stated, “It is likely that a significant portion of any increases in fat free mass that occurs with a supplement containing creatine, protein, amino acids and carbohydrates is due to the creatine.” [Chromiak, J. 2004] What you need to know about this study: The quote from Chromiak comes from a 2004 study that was funded by Numico USA. During the Early 2000’s Numico owned Met-­‐Rx and GNC. Based on my findings, I couldn’t agree more. In fact, Here’s a quick ‘insider tip’ for you – if a protein powder has a claim on its label that it ‘builds muscle’ look in its ingredient list – chances are, you will find creatine monohydrate as an ingredient. As far as I am aware, creatine is one of the only ingredients that has enough evidence behind it to make this strong claim. 131 Based on this evidence it seems logical to say that if you are interested in gaining muscle mass simply taking creatine monohydrate would be your best option. After all, why eat all those extra calories if they don’t make a difference (and instead only increase your chance of gaining body fat)? In fact, recent research has shed some light on why creatine may be so effective, and it will probably come to no surprise to you that it involves the effect that creatine has on muscle satellite cells. In this study, 41 men ranging from 19 to 28 years old (our proverbial sweet spot of muscle growth) were divided into 4 groups. Group 1 took 6 grams of creatine + 14 grams of carbohydrate every day. They also took 80 grams of carbohydrate after their workouts. Group 2 took 14 grams of carbohydate everyday and took 20 grams of protein and 60 grams of carbohydrate after each workout. Group 3 took 14 grams of cabohydrates every day and took 80 grams of carbohydrate after their workout. Group 4 had no supplements and also did no training. The creatine group (group 1) did a traditional loading phase where they took 5 grams of creatine 4 times per day for the first 7 days of the study. After the 132 loading phase they took 6 grams of creatine plus 14 grams of carbohydate (flavor) once per day. The protein group (group 2) did not receive any creatine and instead took 20 grams of protein with 60 grams of carbohydrates as their post-workout supplement. The carbohydrate group (group 3) did not receive any creatine or extra protein and instead took 80 grams of carbohydrate as their post workout supplement. The final group, was the control group and received no supplements, nor did they workout. The men in the first three groups trained 3 times per week for a total of 16 weeks. ALL of these workouts were leg workouts to get the optimal growth. Measurements through muscle biopsy were taken at weeks 0, 4, 8 and 16. What was found shouldn’t be too surprising – The creatine group saw the best increase in the size of their muscles, at weeks 4, 8 and 16. What’s very interesting is that the creatine group also saw the largest increase in satellite cells and number of myonuclei per muscle fiber (remember – muscles need new 133 nuclei in order to grow). The group not receiving creatine or protein saw no increase in myonuclei, but still did see a transient increase in muscle size (in line with our theory that the existing nuclei you already have do have some capacity to increase their domain and thus muscle size) [Kadi 2004] Interestingly the satellite cell content was no longer elevated at week 16 in the creatine group, suggesting that the creatine supplementation accelerated the incorporation of Satellite Cell derived myonuclei to the growing muscles. So it happened quicker than in the other groups, but still had a defined limit. It is believed that you begin to see the benefits of taking creatine once your internal stores are maximized, and once your internal levels of creatine reach their peak, they simply cannot go any higher. Most research on creatine has found that a dose of 3 grams of creatine monohydrate per day for 30 days is enough creatine to maximize internal stores. Another common way to take creatine is with ‘loading’. Loading consists of taking 5 grams of creatine 4 times per day for a period of 5 days. The benefit of loading is that it gets you to the maximal internal levels of creatine in the quickest possible way. 134 Realistically, over the course of a 12-16 week weight training period, you will probably see no difference between the two methods of creatine supplementation. Finally, with regards to the use of creatine for muscle building – It is important to remember that we have not seen any evidence that these dramatic musclebuilding effects are repeatable. In other words, in almost every research paper studying the benefits of creatine, the subjects were using creatine for the very first time. If the people in a creatine trial were to enroll in a second research study examining the effects of creatine on muscle building I would be very surprised if they were able to gain the same amount of muscle. So while creatine has been shown to be effective in many different research studies, it is always important to remember that it has not been shown to be continually effective for gaining measureable amounts of muscle mass – the results may lessen over time. 135 Conclusions 136 Conclusions When you look at all the available research, instead of one single study you begin to see the big picture: Human muscles are equipped with mechanisms that can regulate both short- and long-term changes in protein metabolism. Based on this there is an obvious limit to how much a person can increase the size of their muscles without the use of pharmaceuticals, and possibly another limit that cannot be breached even with high doses of anabolic steroids. From the available research it is easy to say that a full grown adult can expect to gain a conservative estimate of between 2 to 5 pounds of lean mass in 2 to 4 months by resistance training. There is evidence to suggest that you might be able to gain about 7 - 8 pounds of muscle by upping your calorie intake by 2000 calories. Of course, you could get the exact same result by taking creatine, without any potential for gaining body fat. Interestingly, research suggests that protein intake of between 70 and 120 grams per day can allow you to gain the same 2-5 pounds of muscle mass, however you may be able to gain them faster than you would with a protein intake closer to the recommended 60 grams of protein per day. 137 These results lead me to say that protein still has an important role in everyone's nutrition plan, and is an essential nutrient that is obviously important for building and repairing muscles. In fact, from my understanding of the research it makes sense to try and consume above the current recommended amounts, aiming for around 70-120 grams of protein per day, and possibly going as high as 150 grams depending on your body weight and current calorie intake. I would also suggest bigger men or people on a hypocaloric diet aim for the upper end of this scale, and women and people on a hypercaloric weight gaining diet aim for the lower end of this scale. Based on this data I will also say that while 70-120 grams seems ideal for periods when muscle size is increasing. However, it seems that due to the body’s protein needs and the protein-conserving nature of resistance training an intake of protein closer to the RDI (around 60 grams) would likely be enough to maintain muscle size, especially in a person who is well conditioned through resistance training. Possible exceptions to this could be the elderly, or people on long-term calorie restricted diets. If a protein containing meal is available post-workout it makes sense to take advantage of this timing, however if protein is not available I would not be too concerned seeing as the evidence is fairly clear that muscles hold on to the 138 anabolic sensitizing effect of a workout for at least 24 hours after a workout. So I would aim to have a ‘post-workout’ dose of protein within a 24-hour period after the completion of any workout. If needed, protein powders can be used to supplement the diet for people who have difficulty reaching their desired protein intake with food, however the same can be accomplished with foods. The benefit of protein powder comes from both the taste (they’ve come a long way since the 1980’s) and convenience. And, as I have said before, while I do not see protein supplements to be superior to food in anyway, I also do not see them to be drastically worse. In fact, I would go so far as to say that protein powder has become exactly what it was always meant to be - an optional supplement to a food based diet. So supplementing with protein is fine, as long as you acknowledge that you will not get a ‘dose response’. In other words it is not as easy as ‘the more protein you eat, the more muscle you have’. Take a look around the gyms of the nation, they are full of young men who regularly consume thousands of dollars worth of protein supplements per year. Now, take a look at the ones who aren’t secretly on steroids (you probably know who they are) are they really any bigger than they were two months ago? For that matter even 2 years ago? 139 Professional bodybuilders regularly consume massive amounts of protein and are on doses of steroids so high they would stop a horse’s heart (not literally of course, but the dosages are surprisingly high), yet they are extremely happy if they are able to put on 5 or 10 pounds of muscle over an entire year. This is a great reminder that muscle growth is a slow process - even when using anabolic steroids. It is also a reminder that even when using anabolic steroids there is a finite limit to how much muscle you can have on your body (As of this writing, there are no 500 pound shredded bodybuilders that I am aware of). Finally, look at your own progress. Have your muscle gains exploded since you started counting the grams of protein you eat? My guess is probably not. In fact, your greatest gains in muscle mass probably occurred when you first started lifting weights. When you didn’t even care about how much or type of protein went into your body. You probably ate when you were hungry, lifted when you needed to, and your muscles grew like a weed. And if you’re still in this enhanced growth state, count yourself lucky and train you butt off because when you get older and the longer you train the growth will slow down. The bottom line is as long as you consistently consume an adequate amount of protein on a regular basis, whether its 1 large serving or 5 to 6 small servings per day, you will have all the protein you need for your muscles to grow. 140 Right now, I feel confident in saying ‘if you want to build muscle, try to eat between 70-120 grams of protein per day, workout consistently with a high amount of effort, and possibly take your creatine’, but that’s about it. If post workout protein is available I don’t think it will hurt your gains, but I do think that the effectiveness is overhyped, and most likely diminishes with training status. The good news is that this means that if you are interested in gaining muscle, you can concentrate on the real hero behind your muscle gaining, and that is you and your workouts. The amount of protein you eat should not concern you any longer. Outside of your height and genetics it is the quality of your workouts that will determine how much muscle you are able to add and keep on your body. My Best Recommendation Probably the very best recommendations I can give you are to eat a variety of protein containing foods. As long as you are eating meals with a wide variety of foods you should be able to reach the 70-120 gram target very easily (the average intake in North America is already around 90 grams). For times when you are not actively trying to gain muscle, 60 grams may suffice, however for 141 the elderly or people on a long-term calorie restricted diet, intakes higher than 60 grams may be warranted. 142 What I DO NOT Recommend Please note that I have not given recommendations as a percentage of your daily calories or as a percentage of your body weight. This is because neither of these equations have ever made any sense to me. Take for instance, the idea of eating 1 gram of protein per pound of body weight. If a man weighs 180 pounds at 15% body fat when you exclude the weight of his fat he actually has 153 pounds of lean mass. If he eats 180 grams of protein, then he is actually eating 1.17 grams per pound lean body mass assuming your fat cells do not need any measurable amounts of protein. Now if over the next year or two this particular man happens to gain weight at a rate of 20 pounds per year (difficult, but not impossible to do) then after two years he would weigh 220 pounds. So now he should be eating 220 grams of protein per day by this logic. But what if the weight he gained was entirely body fat? He would be 220 pounds with approx 30% body fat and would still have 153 pounds of LEAN mass. So now he is eating 1.43 grams of protein per pound of lean body mass. 143 It doesn’t make sense that his protein requirement increased by 40 grams per day if the only thing that changed was the amount of fat on his body. Another example of a confusing protein recommendation is eating a certain percentage of your calories as protein. If a person who eats 2000 calories follows the recommendation of eating 15% of their calories as protein this would mean they would eat 300 calories from protein, or about 75 grams of protein (each gram of protein contains approximately 4 calories). Now if this same person starts to eat 4000 calories per day, and still follows the recommendation of eating 15% of calories form protein they are now eating 150 grams of protein per day. Again, I see no logical reason why doubling your calorie intake would cause a need for a doubling of protein intake. 144 Final thoughts on Protein For the purpose of building muscle mass I think the goal should be a general recommendation of 70-120 grams of protein per day, and this should be an average intake. As long as you average around 70-120 grams per day you could be lower on some days and slightly higher on others, but muscle growth will still occur. There is no magic to the strict time period of 24 hours. We live our lives in 24 hour chunks out of convenience with the sun’s schedule, but we tend to assume our nutritional and metabolic needs work this way as well, but this isn’t the case. There is no reason to stress over the amount of protein you have eaten over a 24 hour period, some days you’ll be a bit higher, some days you’ll be a bit lower, it’s the average over weeks and months that matters not hours and days. Finally, since the average protein intake in North America is roughly 90 grams per day the vast majority of us are already eating enough protein to support muscle growth. Therefore, we don’t need to obsess over our protein intake the way fitness magazines and nutrition experts suggest we should. 145 However, there has been research published that suggests that the current RDA for protein (0.36 grams per pound bodyweight) may be inadequate for the maintenance of skeletal muscle in older adults [Campbell, WW 1994], and this book does agree with the idea that intakes higher than the RDA seem to be involved in a better (or at least faster) response to muscle building. The range of 70-120 grams of protein is typically above 0.5 grams protein per pound of bodyweight for most individuals, and would be classified as ‘high protein’ in the scientific world. Based on all of this research it seems clear to me that there is a very good chance that you don’t need to change anything in your diet and can enjoy the foods you like knowing that you are not hindering your muscle growth. You don’t need to worry about eating a certain proportion of your diet as protein, or use special protein sources every couple of hours. In fact, I would even argue that you do not have to think of foods as protein containing and non-protein containing foods. Eggs contain an average of 6 grams of protein and are largely considered to be a protein food. A piece of bread contains roughly 5 grams of protein and is NOT considered a protein food. This type of obsessive compulsive eating and extreme focus on the individual nutrients contained within foods is simply not required in order to increase your muscle mass. 146 Eat Stop Eat, Protein Intake and Building Muscle 147 Eat Stop Eat, Protein Intake and Building Muscle The reason why I wrote this book is twofold. First, I really wanted to know if I could increase my muscle mass by taking protein after my workouts and secondly, the necessity of post-workout nutrition was the most asked question by people who have read my book “Eat Stop Eat”. It may strike you as odd that the number one question I get about a fat loss program is about muscle building, but it does make sense. After all, the goal of losing weight is not to lose just any weight rather it is to lose weight as body fat exclusively. Therefore following a nutrition strategy like Eat Stop Eat along with a weight training program for muscle mass naturally leads to the question of protein and building or maintaining muscle mass. Eat Stop Eat is a nutrition program that promotes the use of flexible periods of intermittent fasting combined with resistance training. My philosophy is that your nutrition habits will be the driving force behind your ability to lose body fat, and your exercise habits will be the driving force behind your ability to gain and maintain muscle mass. Since the current belief is that post-workout protein is vital to the muscle building process, many people are concerned about lifting weights while in the fasted state for fear of losing muscle. The fear of muscle loss is especially 148 important because losing large amounts of muscle has been associated with a decreased metabolic rate, especially in older populations. So ironically the concern about the ability of dietary protein to build muscle is equally fueled by the desire to build muscle, as it is a desire to burn body fat without losing muscle. From the findings in this book I feel confident saying that you can follow Eat Stop Eat, fast once or twice a week, lift weights and effectively build muscle mass while still losing body fat. With the Eat Stop Eat program you never go a day without eating, so you will be able to eat enough protein to support muscle growth. It’s also important to note that Eat Stop Eat is the combination of fasting and weight training, but you do not have to weight train while fasting if you don’t want to, so you can still have post-workout protein while following Eat Stop Eat if you so choose. On some days you may eat slightly less protein than other days, but when you average it all out you’ll easily be able to maintain an adequate protein intake over the course of a week. You can also work out during your fast if you choose and still stimulate your muscles to grow, especially since the anabolic effect of a single workout lasts for at least 24 hours. 149 If on the days when you are eating normally you feel you need to consume extra protein after your workouts, by all means go ahead. I definitely don’t think it is going to hurt you in anyway (besides maybe hurting your wallet a bit). If you are not gaining the amount of muscle mass that you would like to and you are eating between 70-120 grams of protein per day, then more than likely there is no need to increase the amount of protein you are eating. In fact, I’d guess that the problem lies within your workout program, not your protein intake. The bottom line is your workouts are what cause you to build muscle. Daily protein intake does play a part, as does adequate rest and recovery. There does not seem to be much of a benefit from added post-workout protein, but there is good evidence to warrant the use of creatine after your workout (If you are following Eat Stop Eat you can take creatine on your fasting days). Most importantly, missing a post-workout meal once in a while because you are fasting will not prevent you from gaining muscle. And we can add that there is even research to suggest that the more experienced you are at lifting weights the less likely you are to need extra protein, as you are teaching your body to become more and more efficient at building muscle. 150 So the final answer to “how much protein do I need to eat to build muscle” is the very answer that was first recommended in the late 1800s: Eat between 70-120 grams of protein per day in one or multiple meals. I hope that this book has helped you understand protein and the muscle building process. I also hope that you’ve learned not to stress about your protein intake and that you probably already eat enough protein to build all the muscle you’ll ever want. Now get to the gym enjoy your workout and enjoy your food. 151 Frequently Asked Questions 152 Frequently asked Protein Questions Q: I saw in a bodybuilding magazine that my body can’t absorb more than 30 grams of protein at time, is this true? A: No. You’re body does not have a defined upper limit to the amount of protein it can absorb at a given meal. Your body absorbs and uses all of the protein you ingest at each meal. The protein you eat is first used to replenish amino acid pools that are used for a number of cellular processes and are quite literally the building blocks of all your body’s cells. Any excess protein above this gets converted into glycogen and stored in your liver or muscle cells. Q: Do incomplete proteins count in my total protein amount for the day? A: Yes incomplete protein sources also count in your daily protein amount because they are still adding to the total amount of protein and amino acid youre body is absorbing. Also most people will be ingesting an incomplete protein with some other protein source therefore each meal is still delivering all the essential amino acids. For example corn is missing the amino acid Leucine, whereas rice is missing the amino acid Isoleucine. If you eat both of these foods together (it doesn’t necessarily have to be in the same meal) the meal would provide a source of complete protein even though each individual food source was incomplete. 153 Q: Does it matter where I get my protein from? A: Not really. As long as you are eating mixed meals you will almost always be getting all the amino acids in every meal. In fact, it’s probably best to get your protein from a wide variety of sources. Q: Are some food sources of protein better than others? A: There are two things to consider when looking at the protein in any food source. 1) Is the protein complete? A complete protein supplies all of the amino acids that your body needs for growth and survival. An incomplete protein is missing at least one of the amino acids your body requires and therefore you would need to mix an incomplete protein with another source that provides the rest of the amino acids for proper growth and survival. 2) How much protein does the food have per gram of total foodstuff? For example 100 grams of chicken breast has much more protein compared to 100 grams of pasta. Both food sources have complete protein however one has much more protein per gram. 154 Q: I’m a vegetarian, does this mean I need to eat tofu or take protein powders? No. You might not realize it but there is lots of protein in foods like multigrain bread, pasta, grains, nuts, legumes and beans. Be sure to make mixed meals that include a variety of vegetarian foods, this will ensure that each meal provides the full spectrum of amino acids. Q: Most bodybuilding magazines say that glutamine is ‘conditionally essential’ is this true? A: Glutamine is not one of the essential amino acids. No matter what the supplement companies tell you, glutamine is not essential, or ‘conditionally essential’ to bodybuilders. It’s only essential to supplement companies because it is cheap, tasteless, and mixes easily with water. It makes great ‘filler’ in a product, and because it is so cheap, you can make a huge profit with it. Q: Do you destroy the protein in eggs or meat by cooking them? A: No. Cooking meat, eggs or any protein source does not destroy the protein, it simply changes the way it is shaped at a molecular level. This change in the molecular shape of the protein is what causes it to have a different appearance such as cooked eggs becoming white instead of semi translucent when they are 155 raw. The actual amino acid content of the protein remains the same after cooking. We typically cook protein sources because it makes them tastes better and it kills bacteria that grows on raw foods. Q: Do protein powders really contain as much protein as they say they do? A: I would say most quality brands have the real amount of protein that is stated on the label. However it is possible to make a product appear as though it has a higher protein content than is actually does. The standard protein test measures nitrogen content because protein is the only macronutrient that contains nitrogen, fat and carbohydrates do not. There are a few inexpensive ingredients that can be added to a protein powder that also contain nitrogen which will make it appear as though there is more protein in the product. This is not a very common practice, however it is possible. For the most part I would say you get what you pay for with protein. Stick with a reputable brand and don’t always go for the cheapest protein on the shelf. If the product gives you gas or bloating or other stomach upset it is probably a low quality product and you should try a different brand. 156 Q: What about fast and slow digesting proteins? A: Each protein source will have a characteristic rate of absorption. Protein powders based with whey will absorb somewhat quicker than casein based proteins. The rate each protein absorbs doesn’t have any measureable effect on muscle building or fat burning. Protein manufacturers use the fast and slow absorbing protein story as a marketing angle, but I don’t think you will never notice a difference between the two. Q: I heard that your body can’t turn protein into fat is this true? It doesn’t really matter whether or not your body can turn protein INTO fat. What matters is that no matter what you eat (protein, carbs or fat) if you over eat, you body will GAIN body fat. Q: What about all those popular diets that advocate a super high protein diet? Believe it or not, even some of the most popular high protein diets DO NOT advocate super high protein intakes. In fact, two of the most popular diets “Protein Power” by Dr. Michael Eades and “The Paleo Diet” by Loren Cordain both recommend protein amounts that are in-line with my suggested intake. 157 In “The Paleo Diet for Athletes” It is recommended that a 200 pound person who trains with intense exercise for 5 or less hours per week should eat roughly120 pounds of protein. In “Protein Power” Dr. Eades recommends that we should consume 0.6 grams of protein per pounds of lean body mass. Even someone who is VERY ACTIVE (an hour or more of VIGOROUS activity five or more times per week) is recommended to consume 0.7 grams of protein per pound lean body mass. To put this into perspective, a 175 pound man with less than 15% bodyfat who trains with vigorous exercise for more than an hour 6 days per week, still falls into the range of 70-120 grams of protein. It is only the bodybuilding subculture that recommends super high protein diets. 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