TIMING AND OPTIMIZATION OF DIETARY SUPPLEMENTS FOR RECOVERY AND PERFORMANCE

1
TIMING AND OPTIMIZATION OF DIETARY SUPPLEMENTS
FOR RECOVERY AND PERFORMANCE

• John L. Ivy
• The University of Texas at Austin
• Austin, Texas

2
TWO MAJOR CONSIDERATIONS FOR RECOVERY FROM
EXHAUSTIVE EXERCISE

• A. Replenishment of muscle glycogen stores
• B. Initiation of protein synthesis and muscle
  tissue repair

3
NUTRIENT TIMING INTERVENTION
INSULIN SENSITIVE
NORMAL INSULIN SENSITIVITY
INSULIN RESISTANT
Exercise (ENERGY)
Post-Exercise (ANABOLIC)
Remainder of the Day (GROWTH)
4
Metabolic Window
100
80
Potential Anabolic Activity (percent)
60
40
20
0
0
15
30
45
60
75
90
120
Minutes
Without nutrient intervention, the metabolic
window begins to close within forty-five minutes
following exercise.
5
RECOVERY OF MUSCLE GLYCOGEN STORES
6
Timing of Carbohydrate Supplementation
7
HYPOTHESIS

• The time of consumption of a carbohydrate
  supplement post exercise will have a significant
  impact on the rate of muscle glycogen storage

8
PROTOCOL

• Exercised subjects at 70 VO2max for 2 h to
  deplete glycogen stores
• Provided 2g CHO/kg body wt either immediately
  after exercise or 2 h after exercise
• Muscle biopsies performed immediately and 1.5 h
  post supplement

Ivy et al. J. Appl. Physiol. (1988).
9

Glycogen Storage (µmol g-1 wet wt 2h-1)
10
Amount and Sequence of Carbohydrate
Supplementation
11
HYPOTHESIS

• A rapid rate of muscle glycogen storage can be
  maintained if CHO supplements are provided
  periodically.
• There is an amount of carbohydrate consumption
  that is optimal for muscle glycogen storage

12
40
1.40g/kg
Increase in Muscle Glycogen Concentration (mmol
kg-1 wet weight)
.35 g/kg
20
0
0
2
4
6
TIME (h)
13
6
5
4
GLYCOGEN SYNTHESIS (µmol/g/h)
3
2
1
0
0.0
0.5
1.0
1.5
2.0
2.5
3.0
CHO SUPPLEMENT g/kg body wt Provided immediately
after and 2h after exercise
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Carbohydrate Protein Supplementation
15
HYPOTHESIS

• The addition of protein to a carbohydrate
  supplement will enhance the blood insulin
  response and accelerate muscle glycogen synthesis.

16
PROTOCOL
Treatments 1) 112g CHO and 40.7g protein
immediately post and 2h post exercise 2) 112g
CHO immediately post and 2h post
exercise 3) 40.7g protein immediately post and
2h post exercise Exercise Cycling 90 min with
the exercise intensity alternating between 65
and 75 VO2max, last 15 min. alternating between
50 and 85 VO2max Muscle biopsies Immediately
and 4h post exercise
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8
CHO-PRO CHO PRO


7




6


GLUCOSE (mM)




5

4
3
120
PRE
POST
30
60
90
150
180
210
240
TIME (min)
19
38 storage
40
30
Muscle Glycogen Storage (µmol/g)
20
10
0
CHO-PRO
CHO
PRO
TREATMENTS
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COMPARE ISOCALORIC CHO AND CHO-PROTEIN SUPPLEMENTS

• Treatments
• 1) 112g CHO and 40.7g protein immediately post
  and 2h post exercise
• 2) 112g CHO immediately post and 2h post
  exercise
• 3) 160g CHO immediately post and 2h post
  exercise
• Exercise
• Cycling 120 min 70 VO2max, sprints until blood
  glucose is below 68 mg.
• Glycogen measurement
• NMRS

21
50
40 greater storage
55 greater storage
40
30
Glycogen Storage (mmol/l/4h)
20
10
0
CHO-PRO
HCHO
LCHO
22
Recovery of Depleted Glycogen
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7
6
5
GLYCOGEN SYNTHESIS (µmol/g/h)
4
3
2
1
0
CHO SUPPLEMENT g/kg body wt
Ivy. Int. J. Sports. Med. 1998.
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RECOMMENDATION

• A. Consume a CHO supplement immediately after
  exercise and continue at regular intervals for
  several hours.
• B. Supplement should contain 1.2-1.4 g CHO/kg
  body wt.
• C. The addition of protein (.3-.5 g/kg body wt)
  will increase the effectiveness of the supplement
  to replenish muscle glycogen.

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STIMULATION OF PROTEIN SYNTHESIS AND MUSCLE
TISSUE REPAIR
26
Effect of Amino Acids on Protein Synthesis
27
HYPOTHESIS

• An increase in blood amino acids at rest or after
  exercise will stimulate muscle protein synthesis

Biolo et al. Am. J. Physiol. 1997
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AMINO ACIDS SUPPLY AND PROTEIN SYNTHESIS

• Intravenous infusion of a balanced amino acid
  mixture at rest and after a leg resistance
  exercise

Biolo et al. Am. J. Physiol. 1997
29
400

300
200
Change from Basal
100
0
AA (Rest)
AA (Post-exercise)
Protein Synthesis
Biolo et al. Am. J. Physiol. 1997
30
Effect of Carbohydrate on Protein Synthesis
31
Values are means SE for 1st 2.5h postexercise
n8. Plt0.01 between 2 conditions.
From Roy, B.D. et al. J. Appl Physiol. 82(6)
1882-1888, 1997.
32
Urine results (24h). Values are means SE n8
Plt0.01 between 2 conditions.
From Roy, B.D. et al. J. Appl Physiol. 82(6)
1882-1888, 1997.
33
Values are means SE n8, MPS, Muscle Protein
Synthetic rate
From Roy, B.D. et al. J. Appl Physiol. 82(6)
1882-1888, 1997.
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Effect of Insulin on Muscle Protein Synthesis
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CARBOHYDRATE AND AMINO ACID SUPPLEMENT AND
PROTEIN ANABOLISM

• Supplement containing 6 g essential amino acids
  and 35 g sucrose
• Given 1 h after exercise

Rasmussen et al. Am. J. Physiol. 2000
36
60
EAA 1 hr No Supplement
50
40
Insulin (uU/ml)
30
20
10
0
-200
-150
-100
-50
0
50
100
150
200
250
Minutes Post Exercise
Rasmussen et al., Am. J. Physiol. 2000.
37
Supplement 1 h after exercise
Protein Breakdown (nmolmin-1100 ml leg volume-1)
No Supplement
Protein Breakdown (nmolmin-1100 ml leg volume-1)
0-1
1-2
2-3
(Hours Post Exercise)
Rasmussen et al., Am. J. Physiol. 2000.
38

Supplement 1 h after exercise
Protein Synthesis (nmolmin-1100 ml leg volume-1)
No Supplement
Protein Synthesis (nmolmin-1100 ml leg volume-1)
0-1
1-2
2-3
(Hours Post Exercise)
Rasmussen et al., Am. J. Physiol. 2000.
39

125
Supplement 1 h after exercise
100
75
Net Balance (nmolmin-1100 ml leg volume-1)
50
25
75
50
25
0
125
No Supplement
100
75
Net Balance (nmolmin-1100 ml leg volume-1)
50
25
0
-25
-50
0-1
1-2
2-3
Hours Post Exercise
Rasmussen et al., Am. J. Physiol. 2000.
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Interaction of Amino Acids and Insulin on Muscle
Protein Synthesis
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HYPOTHESIS

• The combination of an amino acid and
  carbohydrate supplement post exercise will
  stimulate protein synthesis more effectively than
  either a carbohydrate or amino acid supplement
  alone.

42
EXPERIMENTAL PROTOCOL

• Exercise was performed by weightlifting
• Immediately after exercise and 1 hour after
  exercise 6 g of an essential amino acid mix and
  30 g CHO were provided
• Protein synthesis and degradation were determined
  for the first 3 hours post exercise

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180
160
140
120
100
Net Phenylalanine Uptake (mg / 3h / leg)
80
60
40
20
0
MIX
CHO
AA
From Miller, SL, KD Tipson, DL Chinkes, SE Wolf,
RR Wolfe. Med. Sci. Sports Exerc. 35(3)
449-455, 2003.
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Timing of CHO/Protein Supplementation
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EXPERIMENTAL PROTOCOL

• Exercise - 60 VO2max for 60 min
• Supplement - 10g protein, 8g CHO and 3g fat
• Times of supplement administration - immediately
  after exercise or 3 hours after exercise
• Protein synthesis and proteolysis were measured 3
  hours after supplementation

From Levenhagen DK, JD Gresham, MG Carlson, DJ
Maron, MJ Borel, PJ Flakoll. Am. J. Physiol.
Endocrinol. Metab. 280 E982-E993, 2001.
46
Basal Early Late
300

250
200
150

Leg Protein Dynamics (µg min-1 100cc-1)
100
50
0
-50
-100
Protein Breakdown
Protein Synthesis
Net Balance
From Levenhagen DK, JD Gresham, MG Carlson, DJ
Maron, MJ Borel, PJ Flakoll. Am. J. Physiol.
Endocrinol. Metab. 280 E982-E993, 2001.
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RECOMMENDATIONS

• A. To stimulate muscle protein synthesis post
  exercise consume a protein or amino acid
  supplementation.
• B. The addition of CHO to the protein supplement
  will enhance the effectiveness of the supplement
  to promote protein accretion,tissue repair and
  growth.
• C. The supplement should be consumed within the
  first hour post exercise.

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EFFECT OF A CHO/PROTEIN SUPPLEMENT ON RECOVERY
AND PERFORMANCE
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HYPOTHESIS

• A CHO/protein supplement compared with a
  traditional sports drink will speed recovery and
  enhance subsequent physical performance

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PROTOCOL

• A. Muscle glycogen was depleted with 2h of
  cycling at 70 VO2max plus sprints
• B. Subjects received 12 oz of a CHO/protein
  supplement or a traditional sports drink
  immediately post and 2h post exercise
• C. Muscle biopsies were performed immediately
  post and 4h post exercise
• D. 4h post exercise subjects cycled to
  exhaustion at 80 VO2max

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110
CHO-PRO Sports Drink

100

90
GLUCOSE (mg/dl)
80
70
60
50
120
PRE
POST
30
60
90
150
180
210
240
TIME (min)
53
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55 greater performance
40

Minutes of Exercise Following Recovery
30
20
10
Sports Drink
CHO-PRO
55
CONCLUSION

• A CHO/PRO drink following glycogen depleting
  exercise will facilitate a greater rate of muscle
  glycogen synthesis than a CHO only beverage,
  hasten the recovery process and improve exercise
  endurance during a second bout of exercise
  performed on the same day.

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FINAL REMARKS

• A. CHO/protein supplements maximize muscle
  glycogen storage and protein synthesis post
  exercise
• B. The rapid replacement of muscle glycogen and
  protein synthesis will speed recovery and
  improved subsequent physical performance
• C. For optimal results the CHO/protein
  supplements should provide 1.2-1.4g CHO and
  .3-.5g protein per kg body weight at 2 hour
  intervals

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HOW DOES A THE ADDITION OF PROTEIN TO A CHO
SUPPLEMENT INCREASE GLYCOGEN SYNTHESIS?
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Interactions of Insulin Amino Acids
Insulin
Amino Acids
Activation Inhibition
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Akt
140

120
100
80
Relative Units
60
40
20
0
PRE
POST
PRE
POST
Placebo
CHO/PRO
60
GSK3a/b
120

100
80
Relative Units
60
40
20
0
PRE
POST
PRE
POST
Placebo
CHO/PRO
61
mTOR
80

70
60
50
Relative Units
40
30
20
10
0
PRE
POST
PRE
POST
Placebo
CHO/PRO
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p70s6k
120

100
80
Relative Units
60
40
20
0
PRE
POST
PRE
POST
Placebo
CHO/PRO
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GS
180
160
140
120

100
Relative Units
80

60
40
20
0
PRE
POST
PRE
POST
Placebo
CHO/PRO