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Adaptations to exercise training are determined by the response of metabolic and molecular mechanisms that determine changes in proteins. The type, intensity, and duration of exercise, as well as nutrition, determine these responses. The importance of protein, in the form of intact proteins, hydrolysates, or free amino acids, for exercise adaptations is widely recognized. Exercise along with protein intake results in accumulation of proteins that influence training adaptations. The total amount of protein necessary to optimize adaptations is less important than the type of protein, timing of protein intake, and the other nutrients ingested concurrently with the protein. Acute metabolic studies offer an important tool to study the responses of protein balance to various exercise and nutritional interventions. Recent studies suggest that ingestion of free amino acids plus carbohydrates before exercise results in a superior anabolic response to exercise than if ingested after exercise. However, the difference between pre- and post exercise ingestion of intact proteins is not apparent. Thus, the anabolic response to exercise plus protein ingestion seems to be determined by the interaction of timing of nutrient intake in relation to exercise and the nutrients ingested. More research is necessary to delineate the optimal combination of nutrients and timing for various types of training adaptations. Protein and amino acid intake have long been deemed important for athletes and exercising individuals. Olympic athletes, from the legendary Milo to many in the 1936 Berlin games, reportedly consumed large amounts of protein. Modern athletes may consume slightly less than these historical figures, yet protein is deemed extremely important by most. Protein is important as a source of amino acids for recovery from exercise and repair of damaged tissues, as well as for adaptations to exercise training, such as muscle hypertrophy and mitochondrial biogenesis.

Many athletes use dietary supplements, with use more prevalent among those competing at the highest level. Supplements are often self-prescribed, and their use is likely to be based on an inadequate understanding of the issues at stake. Supplementation with essential micronutrients may be useful when a diagnosed deficiency cannot be promptly and effectively corrected with food-based dietary solutions. When used in high doses, some supplements may do more harm than good: Iron supplementation, for example, is potentially harmful. There is good evidence from laboratory studies and some evidence from field studies to support health or performance benefits from appropriate use of a few supplements. The available evidence from studies of aquatic sports is small and is often contradictory. Evidence from elite performers is almost entirely absent, but some athletes may benefit from informed use of creatine, caffeine, and buffering agents. Poor quality assurance in some parts of the dietary supplements industry raises concerns about the safety of some products. Some do not contain the active ingredients listed on the label, and some contain toxic substances, including prescription drugs, that can cause health problems. Some supplements contain compounds that will cause an athlete to fail a doping test. Supplement quality assurance programs can reduce, but not entirely eliminate, this risk.

Exercise has a profound effect on muscle growth, which can occur only if muscle protein synthesis exceeds muscle protein breakdown; there must be a positive muscle protein balance. Resistance exercise improves muscle protein balance, but, in the absence of food intake, the balance remains negative (i.e., catabolic). The response of muscle protein metabolism to a resistance exercise bout lasts for 24-48 hours; thus, the interaction between protein metabolism and any meals consumed in this period will determine the impact of the diet on muscle hypertrophy. Amino acid availability is an important regulator of muscle protein metabolism. The interaction of postexercise metabolic processes and increased amino acid availability maximizes the stimulation of muscle protein synthesis and results in even greater muscle anabolism than when dietary amino acids are not present. Hormones, especially insulin and testosterone, have important roles as regulators of muscle protein synthesis and muscle hypertrophy. Following exercise, insulin has only a permissive role on muscle protein synthesis, but it appears to inhibit the increase in muscle protein breakdown. Ingestion of only small amounts of amino acids, combined with carbohydrates, can transiently increase muscle protein anabolism, but it has yet to be determined if these transient responses translate into an appreciable increase in muscle mass over a prolonged training period.

The acute response of muscle protein synthesis (MPS) to resistance exercise and nutrition is often used to inform recommendations for exercise programming and dietary interventions, particularly protein nutrition, to support and enhance muscle growth with training. Those recommendations are worthwhile only if there is a predictive relationship between the acute response of MPS and subsequent muscle hypertrophy during resistance exercise training. The metabolic basis for muscle hypertrophy is the dynamic balance between the synthesis and degradation of myofibrillar proteins in muscle. There is ample evidence that the process of MPS is much more responsive to exercise and nutrition interventions than muscle protein breakdown. Thus, it is intuitively satisfying to translate the acute changes in MPS to muscle hypertrophy with training over a longer time frame. Our aim is to examine and critically evaluate the strength and nature of this relationship. Moreover, we examine the methodological and physiological factors related to measurement of MPS and changes in muscle hypertrophy that contribute to uncertainty regarding this relationship. Finally, we attempt to offer recommendations for practical and contextually relevant application of the information available from studies of the acute response of MPS to optimize muscle hypertrophy with training.

In an investigator-blind, randomized cross-over design, male cyclists (mean± SD) age 34.0 (± 10.2) years, body mass 74.6 (±7.9) kg, stature 178.3 (±8.0) cm, peak power output (PPO) 393 (±36) W, and VO_2max 62 (±9) ml·kg⁻¹min⁻¹ training for more than 6 hr/wk for more than 3y (n = 20) completed four experimental trials. Each trial consisted of a 2-hr constant load ride at 95% of lactate threshold (185 ± 25W) then a work-matched time trial task (~30min at 70% of PPO). Three commercially available carbohydrate (CHO) beverages, plus a control (water), were administered during the 2-hr ride providing 0, 20, 39, or 64g·hr⁻¹ of CHO at a fluid intake rate of 1L·hr⁻¹. Performance was assessed by time to complete the time trial task, mean power output sustained, and pacing strategy used. Mean task completion time (min:sec ± SD) for 39g·hr⁻¹ (34:19.5 ± 03:07.1, p = .006) and 64g·hr⁻¹ (34:11.3 ± 03:08.5 p = .004) of CHO were significantly faster than control (37:01.9 ± 05:35.0). The mean percentage improvement from control was −6.1% (95% CI: −11.3 to −1.0) and −6.5% (95% CI: −11.7 to −1.4) in the 39 and 64g·hr⁻¹ trials respectively. The 20g·hr⁻¹ (35:17.6 ± 04:16.3) treatment did not reach statistical significance compared with control (p = .126) despite a mean improvement of −3.7% (95% CI −8.8−1.5%). No further differences between CHO trials were reported. No interaction between CHO dose and pacing strategy occurred. 39 and 64g·hr⁻¹ of CHO were similarly effective at improving endurance cycling performance compared with a 0g·hr⁻¹ control in our trained cyclists.

Soccer players often experience eccentric exercise-induced muscle damage given the physical demands of soccer match-play. Since long chain n-3 polyunsaturated fatty acids (n-3PUFA) enhance muscle sensitivity to protein supplementation, dietary supplementation with a combination of fish oil–derived n-3PUFA, protein, and carbohydrate may promote exercise recovery. This study examined the influence of adding n-3PUFA to a whey protein, leucine, and carbohydrate containing beverage over a six-week supplementation period on physiological markers of recovery measured over three days following eccentric exercise. Competitive soccer players were assigned to one of three conditions (2 × 200 mL): a fish oil supplement beverage (FO; n = 10) that contained n-3PUFA (1100 mg DHA/EPA—approximately 550 mg DHA, 550 mg EPA), whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); a protein supplement beverage (PRO; n = 10) that contained whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); and a carbohydrate supplement beverage (CHO; n = 10) that contained carbohydrate (24 g). Eccentric exercise consisted of unilateral knee extension/flexion contractions on both legs separately. Maximal force production was impaired by 22% during the 72-hour recovery period following eccentric exercise (p < 0.05). Muscle soreness, expressed as area under the curve (AUC) during 72-hour recovery, was less in FO (1948 ± 1091 mm × 72 h) than PRO (4640 ± 2654 mm × 72 h, p < 0.05) and CHO (4495 ± 1853 mm × 72 h, p = 0.10). Blood concentrations of creatine kinase, expressed as AUC, were ~60% lower in FO compared to CHO (p < 0.05) and tended to be lower (~39%, p = 0.07) than PRO. No differences in muscle function, soccer performance, or blood c-reactive protein concentrations were observed between groups. In conclusion, the addition of n-3PUFA to a beverage containing whey protein, leucine, and carbohydrate ameliorates the increase in muscle soreness and blood concentrations of creatine kinase following eccentric exercise in competitive soccer players.

Branched-chain amino acids (BCAA) and carbohydrate (CHO) are commonly recommended postexercise supplements. However, no study has examined the interaction of CHO and BCAA ingestion on myofibrillar protein synthesis (MyoPS) rates following exercise. We aimed to determine the response of MyoPS to the co-ingestion of BCAA and CHO following an acute bout of resistance exercise. Ten resistance-trained young men completed two trials in counterbalanced order, ingesting isocaloric drinks containing either 30.6-g CHO plus 5.6-g BCAA (B + C) or 34.7-g CHO alone following a bout of unilateral, leg resistance exercise. MyoPS was measured postexercise with a primed, constant infusion of L-[ring¹³C₆] phenylalanine and collection of muscle biopsies pre- and 4 hr postdrink ingestion. Blood samples were collected at time points before and after drink ingestion. Serum insulin concentrations increased to a similar extent in both trials (p > .05), peaking at 30 min postdrink ingestion. Plasma leucine (514 ± 34 nmol/L), isoleucine (282 ± 23 nmol/L), and valine (687 ± 33 nmol/L) concentrations peaked at 0.5 hr postdrink in B + C and remained elevated for 3 hr during exercise recovery. MyoPS was ∼15% greater (95% confidence interval [−0.002, 0.028], p = .039, Cohen’s d = 0.63) in B + C (0.128%/hr ± 0.011%/hr) than CHO alone (0.115%/hr ± 0.011%/hr) over the 4 hr postexercise period. Co-ingestion of BCAA and CHO augments the acute response of MyoPS to resistance exercise in trained young males.

Branched-chain amino acids (BCAA) are one of the most popular sports supplements, marketed under the premise that they enhance muscular adaptations. Despite their prevalent consumption among athletes and the general public, the efficacy of BCAA has been an ongoing source of controversy in the sports nutrition field. Early support for BCAA supplementation was derived from extrapolation of mechanistic data on their role in muscle protein metabolism. Of the three BCAA, leucine has received the most attention because of its ability to stimulate the initial acute anabolic response. However, a substantial body of both acute and longitudinal research has now accumulated on the topic, affording the ability to scrutinize the effects of BCAA and leucine from a practical standpoint. This article aims to critically review the current literature and draw evidence-based conclusions about the putative benefits of BCAA or leucine supplementation on muscle strength and hypertrophy as well as illuminate gaps in the literature that warrant future study.