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Training civilians to be soldiers is a challenging task often resulting in musculoskeletal injuries, especially bone stress injuries. This study evaluated bone health biomarkers (P1NP/CTX) and whey protein or carbohydrate supplementations before and after Army initial entry training (IET). Ninety male IET soldiers participated in this placebo-contr...
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Methods:
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Background: Both aerobic exercise and whey protein can improve glucose regulation. The purpose of this study was to investigate how a single bout of vigorous-intensity aerobic exercise and whey protein, independently, as well as when combined, influence glycemia during an oral glucose tolerance test in sedentary, young men.
Methods: Healthy males (...
Citations
... The majority of studies investigating the impact of protein supplementation during military training have been conducted in the United States (15,(17)(18)(19)(20). These results may not be entirely applicable to British Army recruits due to potential differences in habitual dietary intake, energy expenditure during BT, training entry standards and weekly training loads. ...
... A 20 − 40 g protein dose optimises the stimulation of muscle protein synthesis (MPS) (10) but it is not known if higher doses are beneficial to British Army recruits' performance outcomes and recovery. Most studies to date have employed a placebo or control group to compare the effects of protein supplementation, meaning the impact of an increased protein intake, independent of energy intake is not known (15,(17)(18)(19)(20). This study will provide evidence as to the potential benefit of additional protein intake on the performance outcomes, body composition changes and recovery of British Army recruits which could have important implications on the health and performance of new recruits during BT. ...
... British Army BT has been shown to improve BMD (52). A lack of effect of protein intake on bone adaptations in this study is supported by data from the United States, with protein having no impact on markers of bone turnover during 12 weeks on U.S. Army BT (20). Notably, in this study, only the PLA group experienced no reductions in BMD and BMC in the ribs and was the only group to gain BMD and BMC at the trunk. ...
Dietary protein is crucial for optimising physical training adaptations such as muscular strength and mass, which are key aims for athletic populations, including British Army recruits. New recruits fail to meet the recommended protein intake during basic training (BT), with negligible amounts consumed in the evening. This study assessed the influence of a daily bolus of protein prior to sleep on performance adaptations, body composition and recovery in British Army recruits. 99 men and 23 women [mean ± standard deviation (SD): age: 21.3 ± 3.5 years, height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg] were randomised into a dietary control (CON), carbohydrate placebo (PLA), moderate (20 g) protein (MOD) or high (60 g) protein (HIGH) supplementation group. Supplements were isocaloric and were consumed on weekday evenings between 2000 and 2100 for 12 weeks during BT. Performance tests (mid-thigh pull, medicine ball throw, 2 km run time, maximal push-up, and maximal vertical jump) and body composition were assessed at the start and end of BT. Dietary intake, energy expenditure, salivary hormones, urinary nitrogen balance, perceived muscle soreness, rating of perceived exertion, mood, and fatigue were assessed at the start, middle and end of BT. Protein supplementation increased protein intake in HIGH (2.16 ± 0.50 g⸱kg⁻¹⸱day⁻¹) and MOD (1.71 ± 0.48 g⸱kg⁻¹⸱day⁻¹) compared to CON (1.17 ± 0.24 g⸱kg⁻¹⸱day⁻¹) and PLA (1.31 ± 0.29 g⸱kg⁻¹⸱day⁻¹; p < 0.001). Despite this, there was no impact of supplementation on mid-thigh pull performance (CON = 7 ± 19%, PLA = 7 ± 19%, MOD = 0 ± 16%, and HIGH = 4 ± 14%; p = 0.554) or any other performance measures (p > 0.05). Fat-free mass changes were also similar between groups (CON = 4 ± 3%, PLA = 4 ± 4%, MOD = 3 ± 3%, HIGH = 5 ± 4%, p = 0.959). There was no impact of protein supplementation on any other body composition or recovery measure. We conclude no benefits of pre-bed protein supplementation to improve performance, body composition and recovery during BT. It is possible the training stimulus was great enough, limiting the impact of protein supplementation. However, the high degree of inter-participant variability suggests an individualised use of protein supplementation should be explored, particularly in those who consume sub-optimal (<1.6 g⸱kg⁻¹⸱day⁻¹) habitual amounts of protein.
Clinical trial registration: The study was registered with ClinicalTrials.gov, U.S. national institutes (identifier: NCT05998590).
... Stress fractures are a common problem in subjects who participate intensively in sports, such as soldiers and athletes. In such groups, a diet rich in protein and minerals can be beneficial [60]. Prospective case-control studies are needed to confirm which dietary behaviors require immediate modifications to prevent future bone fractures. ...
Osteoporosis is a frequent yet unsolved health problem among older people. The influence of dietary protein still raises many questions regarding its quality and quantity in the context of bone health. The aim of this manuscript is to review the latest evidence on plant and animal protein influences on bone health in various groups of patients. The review is based on original studies, meta-analyses, randomized controlled trials, and prospective cohort studies published in PubMed and Cochrane databases during the last five years. Combining plant and animal protein with physical activity has the best effect on bones (muscle strengthening and reducing the risk of falls), while high protein intake can have adverse effects during bed rest. Despite the content of isoflavones, plant protein is not more beneficial than animal protein (dairy products) and can increase bone resorption markers. Hypoestrogenism due to menopause or eating disorders leads to low bone density and an increased risk of osteoporosis. A well-balanced diet with sufficient energy supply and protein intake (both of plant and animal origins) and adequate physical activity are crucial to ensure bone health. Dietary interventions should consider the quantity and quality of protein in patients with other comorbidities, particularly in an aging society.
... The multistressor training environment and reduced energy availability (combined high energy expenditures and nutritional restrictions) have the potential to underpin numerous physiological changes. As such, biochemical markers have also been used to assess changes in immune function [36]; inflammation, oxidative stress, and redox balance [28]; nutrient deficiency [59]; responses to nutritional supplementation [58]; and changes in bone metabolism [60]. Collectively, this work has shown that both acute and chronic exposure to military activities can elicit marked changes in biochemical measures of various physiological processes, which may have various impacts on (mal)adaptation and performance that would require dedicated experimental studies to elucidate. ...
Military personnel are required to complete physically demanding tasks when performing work and training, which may be quantified through the physical stress imposed (external load) or the resultant physiological strain (internal load). The aim of this narrative review is to provide an overview of the techniques used to monitor work and training load in military settings, summarise key findings, and discuss important practical, analytical, and conceptual considerations. Most investigations have focused upon measuring external and internal load in military training environments; however, limited data exists in operational settings. Accelerometry has been the primary tool used to estimate external load, with heart rate commonly used to quantify internal load. Supplemental to heart rate, psychophysiological and biochemical measures have also been investigated to elucidate aspects of internal load. Broadly, investigations have revealed that military training requires personnel to perform relatively large volumes of physical activity (e.g., averaging ∼15,000 steps·day⁻¹) of typically low-moderate intensity activity (<6 MET), although considerable temporal and inter individual variability is observed from these gross mean estimates. There are limitations associated with these measures and, at best, estimates of external and internal load can only be inferred. These limitations are particularly pertinent for military tasks such as load carriage and manual material handling, which often involve complex activities performed individually or in teams, in a range of operational environments, with multiple layers of protection, over a protracted duration. Comprehensively quantifying external and internal loads during these functional activities poses substantial practical and analytical challenges.
Background and Aims
A major public health concern worldwide, osteoporosis causes an increased risk of bone fractures and a decrease in bone mineral density (BMD). The present systematic review and meta-analysis aimed to determine the effect of whey protein and MBP (milk basic protein) on bone health parameters.
Methods
We performed a systematic review and meta-analysis of randomized clinical trial (RCT) studies. The online databases of PubMed, Scopus, Web of Science, and Google Scholar was searched up to 30 July 2022, using controlled terms (e.g. MESH) and text words for milk protein or whey and bone-health outcomes, including lumbar-BMD, hip-BMD, Urinary N-terminal telopeptides of type I collagen (NTx) serum C-terminal telopeptides of type I collagen (CTx), Osteocalcin, and IGF levels.
Results
Outcomes were pooled as standard mean difference (SMD) and 95% confidence interval (CI) in a Random-effect meta-analysis model. Nine RCTs met the eligibility criteria and were selected for the final analyses. The analysis indicated a significant decrease in NTx [SMD: -0.89 nmol/mmol, CI: -1.69 to -0.10%, P = 0.028] following supplementation with MBP compared to the placebo group. Also, whey supplementation resulted in a significant increase in IGF [SMD: 3.55 nmol/l, 95% CI: 3.12 to 3.98%, P = 0.001, \({I}^{2}\) = 58.1%, p = 0.092]. However, there were no significant mean differences in lumbar-BMD, hip-BMD, serum CTx and Osteocalcin between the two groups.
Conclusions
Whey or MBP supplementation may reduce NTx and increase IGF, particularly when adults are supplemented for 12 weeks or longer, however findings on lumbar-BMD, hip-BMD, serum CTx and Osteocalcin are inconclusive.
Purpose:
There has been a persistent claim that dairy products contain calcium-leaching proteins, although the soundness of such a claim has been challenged. A meta-analysis of randomized controlled trials (RCTs) on the effects of milk-derived protein supplementation on bone health indices in adults was performed to reconcile the controversy surrounding the potential skeletal safety concerns of proteins of dairy origin.
Methods:
The PubMed and Web of Science databases were searched for relevant RCTs. A random-effects model was used to generate pooled effect sizes and 95% confidence intervals.
Results:
Milk-derived protein supplementation did not significantly affect whole-body BMD (n = 7 RCTs) and BMD at the lumbar spine (n = 10), hip (n = 8), femoral neck (n = 9), trochanter (n = 5), intertrochanter (n = 2), and ultradistal radius (n = 2). The concentrations of bone formation markers (bone-specific alkaline phosphatase [n = 11], osteocalcin [n = 6], procollagen type 1 amino-terminal propeptide [n = 5]), bone resorption markers (N-terminal telopeptide of type 1 collagen [n = 7], C-terminal telopeptide of type 1 collagen [n = 7], deoxypyridinoline [n = 4]), and parathyroid hormone (n = 7) were not significantly affected. However, increased insulin-like growth factor-1 (IGF-1) concentrations (n = 13) were observed. Reduced IGF-1 concentrations were observed when soy protein was used as a comparator, and increased IGF-1 concentrations were observed when carbohydrate was used.
Conclusion:
Our findings do not support the claim that proteins of dairy origin are detrimental to bone health.
This study investigated sex differences in, and the effect of protein supplementation on, bone metabolism during a 36-hour military field exercise. Forty-four British Army Officer cadets (14 women) completed a 36-hour field exercise. Participants consumed their habitual diet (n = 14 women [Women] and n = 15 men [Men Controls]) or the habitual diet and an additional 46.6 g·d-1 protein in men (n = 15 men [Men Protein]). Women and Men Protein were compared with Men Controls to examine the effect of sex and protein supplementation. Circulating markers of bone metabolism were measured before, 24 hours after (post-exercise), and 96 hours after (recovery) the field exercise. βCTX and cortisol were not different between timepoints or Women and Men Controls (p ≥ 0.094). PINP decreased from baseline to post-exercise (p < 0.001) and recovery (p < 0.001) in Women and Men Controls. PTH increased from baseline to post-exercise (p = 0.006) and decreased from post-exercise to recovery (p = 0.047) in Women and Men Controls. Total 25(OH)D increased from baseline to post-exercise (p = 0.038) and recovery (p < 0.001) in Women and Men Controls. Testosterone decreased from baseline to post-exercise (p < 0.001) and recovery (p = 0.007) in Men Controls, but did not change for Women (all p = 1.000). Protein supplementation in men had no effect on any marker. Men and women experience similar changes to bone metabolism-decreased bone formation and increased PTH-following a short field exercise. Protein had no protective effect likely because of the energy deficit.
