How Much Protein Do Athletes Need?

Written by Dr. Steve Chaney on . Posted in How Much Protein Do You Need

Position of the International Society of Sports Nutrition On Protein & Exercise

Author: Dr. Stephen Chaney

how much protein do athletes needThere is so much conflicting information about how much protein we should be getting. Some experts say we are eating too much. Others say we are eating too little. Some experts say we should just eat fruits and vegetables. Others say we should load up on meat. Some experts say athletes need more protein. Others say they get plenty of protein in the standard American diet. No wonder you are confused!

So, how much protein do athletes need?

Because of all the conflicting advice, I thought it would be worthwhile to share with you the International Society of Sports Nutrition Position Statement on protein and exercise (R. Jagr et al, Journal of the International Society of Sports Nutrition 14:20, 2017. DOI: 10.1186/s12970-017-0177-8).

How Much Protein Do Athletes Need?

 

Before summarizing the International Society of Sports Nutrition (ISSN) recommendations, I should start by pointing out that these recommendations are focused on the effect of protein on exercise performance. They are also focused more on high performance athletes than on those of us who are just trying to stay fit.

I have covered protein needs of people of all ages and exercise intensities in my article “How Much Protein Do You Need?” and will refer to that article from time to time.

Here are the ISSN recommendations:

exercise and protein#1: “An acute exercise stimulus, particularly resistance exercise, and protein ingestion both stimulate muscle protein synthesis and are synergistic”. In simple English, exercise and protein work synergistically to help you increase muscle mass.

#2: “For building and maintaining muscle mass…, an overall daily protein intake in the range of 0.6 – 0.9 gm/pound body weight/day is sufficient for most exercising individuals”. This is 1.7-2.5 times the RDA for sedentary individuals, and is more appropriate for elite athletes than for your average weekend warrior or fitness enthusiast.

Protein Requirements Calculator

They make the point that protein alone is sufficient for increasing muscle mass following resistance training. However, they also say that addition of carbohydrate to a protein supplement improves muscle glycogen recovery and reduces post-workout muscle soreness.

I also prefer some carbohydrate with a protein supplement because of a phenomenon called “protein sparing.”  In brief, in the absence of carbohydrate, some of the ingested protein is converted to glucose to restore blood glucose levels and muscle glycogen stores. If you include carbohydrate with the protein, the carbohydrate will be used to restore blood glucose & glycogen, and all the protein can be used to increase muscle mass.

#3: “There is novel evidence that suggests higher protein intake (>1.36 gm/pound body weight/day) may promote loss of fat mass in resistance-trained individuals”. This recommendation is primarily for body builders.

#4: “Optimal protein intake per serving…depends on age and [the intensity of] recent resistance exercise. General recommendations are…a dose of 20-40g”. In general, young people require less protein following exercise than older people. I have covered age-specific protein recommendations in my article “How Much Protein Do You Need?”. As for intensity of exercise, most of us engage in moderate intensity exercise and should aim for the lower dose recommended by the ISSN. The higher dose is more appropriate for elite athletes engaged in high intensity training.

leucine protein and exercise#5: “Acute protein doses should strive to contain 700-3,000 mg of leucine…in addition to a balanced array of the essential amino acids”. Older people also need more leucine than younger people. I have discussed age-related leucine needs in my article “Does Leucine Trigger Muscle Growth?”.

It is worth noting that in their position statement, the ISSN did not recommend any of the other ingredients that you often find in protein supplements.

#6: “These protein doses should be evenly distributed, every 3-4 h, across the day”. If you consume too much protein at one time, the excess will not be used for building muscle.

#7: “The optimal time period during which to ingest protein is likely a matter of individual tolerance…However, the anabolic effect of exercise is long-lasting (at least 24 h), but likely diminishes with increasing time post-exercise”. While the anabolic effect of exercise lasts for 24 hours or more, the maximum anabolic effect occurs during the first 2-4 hours after exercise. This is why a post-workout supplement is generally recommended immediately following a workout. Because there is a limit to how much protein can be consumed at any one time, additional protein should be consumed at regular intervals over the next 24 hours (recommendation #6).

#8: “While it is possible for physically active individuals to obtain their daily protein requirements through the consumption of whole foods, supplementation is a practical way of ensuring intake of adequate protein quality and quantity, while minimizing caloric intake.”

protein shakes#9: “Rapidly digested proteins that contain high proportions of essential amino acids and adequate leucine are most effective in stimulating muscle protein synthesis.”  This recommendation is most appropriate for protein(s) ingested during the acute 2-4 hour anabolic phase immediately after exercise. During the remaining 24 hours of the anabolic phase, it is more important to maintain a constant amino acid concentration in the bloodstream. For this reason, I generally recommend more slowly digested proteins, such as meat or soy, between 4 and 24 hours after exercise.

#10: “Different types and quality of protein can affect amino acid bioavailability following protein supplementation.”  Simply put, there are a lot of “junk” protein supplements out there. Look for a manufacturer with a reputation for integrity and for product quality.

#11: “Athletes should consider focusing on whole food sources of protein that contain all the essential amino acids.”  Simply put, you should avoid supplements that contain only a few selected amino acids. Instead, choose supplements that provide whole protein from natural sources. Leucine, for example, is very beneficial when added to a whole protein supplement containing all the essential amino acids, but leucine by itself would be of little value.

protein endurance#12: “Endurance athletes should focus on achieving adequate carbohydrate intake to promote optimal performance; the addition of protein may help offset muscle damage and promote recovery.”  In short, endurance athletes benefit from a combination of carbohydrate and protein, but carbohydrate is of primary importance.

#13: “Pre-sleep casein intake (30-40 g) provides increases in overnight muscle protein synthesis and metabolic rate without decreasing the overnight fat breakdown.”  The definitive studies on this have been fairly recent. This recommendation is most appropriate for elite athletes who are primarily interested in increasing muscle mass. For the rest of us, calorie considerations would outweigh the small increment in muscle mass we could gain overnight.

The above gives a summary the ISSN statement on protein and exercise and offers an answer to the question how much protein do athletes need?

 

The Bottom Line

 

This article is different from my previous articles in that it is a summary. It would be pointless to make a summary of a summary, so I have done away with “The Bottom Line.”  Read the article above for a quick summary of the International Society for Sports Nutrition position statement on protein and exercise.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Do Omega-3s Lower Blood Pressure in Young, Healthy Adults?

Posted August 14, 2018 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

 

Do omega-3s lower blood pressure in healthy adults?

omega-3s lower blood pressure young adultsThe literature on the potential health benefits of omega-3s is very confusing. That’s because a lot of bad studies have been published. Many of them never determined the omega-3 status of their subjects prior to omega-3 supplementation. Others relied on dietary recalls of fish consumption, which can be inaccurate.

Fortunately, a much more accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes. Using modern technology, it can be determined from a single finger prick blood sample. It is a very accurate reflection of omega-3 intake relative to other fats in the diet over the past few months. More importantly, it is a measure of the omega-3 content of your cell membranes, which is a direct measure of your omega-3 nutritional status.

A recent extension of the Framingham Heart Study reported that participants with an Omega-3 Index >6.8% had a 39% lower risk of cardiovascular disease than those with an Omega-3 Index <4.2% (WS Harris et al, Journal of Clinical Lipidology, 12: 718-724, 2018 ). Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk, while 8% or better is considered indicative of low cardiovascular risk. For reference, the average American has an Omega-3 Index in the 4-5% range. In Japan, where fish consumption is much higher and cardiovascular risk much lower, the Omega-3 Index is in the 9-11% range.

Previous studies have suggested that omega-3 fatty acids lower blood pressure to a modest extent. Thus, it is not surprising that more recent studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, those studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Unfortunately, there were no studies looking at that population. The current study was designed to fill that gap.

 

How Was The Study Done?

omega-3s lower blood pressure young healthy adultsThe current study (M.G. Filipovic et al, Journal of Hypertension, 36: 1548-1554, 2018 ) was based on data collected from 2036 healthy adults, aged 25-41, from Liechtenstein. They were participants in the GAPP (Genetic and Phenotypic Determinants of Blood Pressure) study. Participants were excluded from the study if they had been diagnosed with high blood pressure and were taking medication to lower their blood pressure. They were also excluded if they had heart disease, chronic kidney disease, other severe illnesses, obesity, sleep apnea, or daily use of non-steroidal anti-inflammatory medications.

Blood samples were collected at the time of their enrollment in the study and frozen for subsequent determination of Omega-3 Index. Blood pressure was also measured at their time of enrollment in two different ways. The first was a standard blood pressure measurement in a doctor’s office.

For the second measurement they were given a wearable blood pressure monitor that recorded their blood pressure over 24 hours every 15 minutes during the day and every 30 minutes while they were sleeping. This is considered more accurate than a resting blood pressure measurement in a doctor’s office because it records the variation in blood pressure, while you are sleeping, while you are exercising, and while you go about your everyday activities.

 

Do Omega-3s Lower Blood Pressure In Young, Healthy Adults?

omega-3s lower blood pressure young adults equipmentNone of the participants in the study had significantly elevated blood pressure. The mean systolic and diastolic office blood pressures were 120±13 and 78±9 respectively. The average Omega-3 Index in this population was 4.6%, which is similar to the average Omega-3 Index in the United States.

When they compared the group with the highest Omega-3 Index (average = 5.8%) with the group with the lowest Omega-3 Index (average = 4.6%):

  • The office measurement of systolic and diastolic blood pressure was decreased by 3.3% and 2.6% respectively
  • While those numbers appear small, the differences were highly significant.
  • The 24-hour blood pressure measurements showed a similar decrease.
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index. [In studies of this kind, a linear dose-response is considered an internal validation of the differences observed between the group with the highest Omega-3 Index and the group with the lowest Omega-3 Index.]

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

 

What Does This Mean For You?

omega-3s lower blood pressure young adults questionPerhaps I should first comment on the significance of the relatively small decrease in blood pressure observed in this study.

  • These were young adults, all of whom had normal or near normal blood pressure.
  • The difference in Omega-3 Index was rather small (5.8% to 4.6%). None of the participants in the study were at the 8% or above that is considered optimal.
  • Liechtenstein is a small country located between Switzerland and Spain. Fish consumption is low and omega-3 supplement consumption is rare.

Under these conditions, even a small, but statistically significant, decrease in blood pressure is remarkable.

We should think of this study as the start of the investigation of the relationship between omega-3 status and blood pressure. Its weakness is that it only shows an association between high Omega-3 Index and low blood pressure. It does not prove cause and effect.

Its strength is that it is consistent with many other studies showing omega-3 fatty acids lower blood pressure. Furthermore, it suggests that the effect of omega-3s on blood pressure may also be seen in young, healthy adults who have not yet developed high blood pressure.

Finally, the authors suggested that a diet rich in omega-3s might reduce the incidence of high blood pressure by slowing the age-related increase in blood pressure that most Americans experience. This idea is logical, but speculative at present.

However, the GAPP study is designed to provide the answer to that question. It is a long-term study with follow-up examinations scheduled every 3-5 years. It will be interesting to see whether the author’s prediction holds true, and a higher Omega-3 Index is associated with a slower increase in blood pressure as the participants age.

 

Why Is The Omega-3 Index Important?

 

The authors of this study said: “The Omega-3 Index is very robust to short-term intake of omega-3 fatty acids and reliably reflects an individual’s long-term omega-3 status and tissue omega-3 content. Therefore, the Omega-3 Index has the potential to become a cardiovascular risk factor as much as the HbA1c is for people with diabetes…” That is a bit of an overstatement. HbA1c is a measure of disease progression for diabetes because it is a direct measure of blood sugar control.

In contrast, Omega-3 Index is merely a risk factor for cardiovascular disease. However, if it is further validated by future studies, it is likely to be as important for predicting cardiovascular risk as are cholesterol levels and markers of inflammation.

However, to me the most important role of Omega-3 Index is in the design of future clinical studies. If anyone really wants to determine whether omega-3 supplementation reduces cardiovascular risk, high blood pressure, diabetes or any other health outcome they should:

  • Start with a population group with an Omega-3 Index in the deficient (4-5%) range.
  • Supplement with omega-3 fatty acids in a double blind, placebo-controlled manner.
  • Show that supplementation brought participants up to an optimal Omega-3 Index of 8% or greater.
  • Look at health outcomes such as heart attacks, cardiovascular deaths, hypertension, stroke, or depression.
  • Continue the study long enough for the beneficial effects of omega-3 supplementation to be measurable. For cardiovascular outcomes the American Heart Association has stated that at least two years are required to obtain meaningful results.

These are the kind of experiments that will be required to give definitive, reproducible results and resolve the confusion about the health effects of omega-3 fatty acids.

 

The Bottom Line

 

An accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes.

Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk while 8% or better is considered indicative of low cardiovascular risk.

Previous studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, these studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Until now, there have been no studies looking at that population.

The study described in this article was designed to fill that gap. The participants in this study were ages 25-41, were healthy, and none of them had elevated blood pressure.

When the group with the highest Omega-3 Index (average = 5.8%) was compared with the group with the lowest Omega-3 Index (average = 4.6%):

  • Both systolic and diastolic blood pressure were decreased
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index.

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

Let me translate that last sentence into plain English for you. The authors were saying that optimizing omega-3 intake in young adults may slow the age-related increase in blood pressure and reduce the risk of them developing high blood pressure as they age. This may begin to answer the question “Do omega-3s lower blood pressure in young, healthy adults?”

Or even more simply put: Aging is inevitable. Becoming unhealthy is not.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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