Abstract
Purpose
Age-related decrease in muscle mass is, among several other factors, caused by suboptimal dietary protein intake. The protein intake of the general population has a skewed distribution towards the evening meal. However, it is hypothesised that an intake of protein with an even meal distribution leads to a more frequently maximised protein synthesis. This review investigates whether an even protein distribution is associated with preservation or gain in muscle mass, muscle strength, and protein turnover.
Methods
Seven databases: PubMed, Web of Science, Google Scholar, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Embase were searched. Studies included had a healthy population between 20 and 85 years of age, with a BMI between 18.5 and 30.0, investigated even vs. skewed protein distribution, and measured skeletal muscle relevant outcomes. Case studies and systematic reviews were excluded. Studies were appraised using the AXIS scale for observational studies and the PEDro scale for the remaining studies.
Results
Fifteen studies met the eligibility criteria and were included. Three out of seven studies showed an association between even protein distribution and higher muscle mass. Two out of seven studies showed an association between greater muscle strength and an even protein distribution. Only one out of six studies found a positive association between protein synthesis and an even protein distribution.
Conclusion
Evidence indicated an association between muscle mass and an even protein intake. However, the evidence is currently insufficient to conclude whether an even protein intake is positively associated with muscle strength or protein turnover.
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Abbreviations
- AA:
-
Amino acids
- AXIS:
-
Appraisal of cross-sectional studies
- BW:
-
Body weight
- CA:
-
Comparative study
- CD:
-
Cohort study design
- CI:
-
Confidence interval
- CS:
-
Cross-sectional study
- CT:
-
Clinical trial
- CV:
-
Coefficient of variance
- DXA:
-
Dual-energy X-ray absorptiometry
- EAA:
-
Essential amino acids
- FFM:
-
Fat free mass
- FSR:
-
Fractional synthesis rate
- IQR:
-
Interquartile range
- MPB:
-
Muscle protein breakdown
- MPS:
-
Muscle protein synthesis
- PEDro:
-
Physiotherapy evidence database
- RCT:
-
Randomised-controlled trial
- RDA:
-
Recommended daily allowance
- RM:
-
Repetition maximum
- SEM:
-
Standard error of the mean
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The author contributions were as follows: SEJ and JA designed research; SEJ conducted research; SEJ and JA analysed data; SEJ wrote the paper. JA had primary responsibility for the final content. Both authors read and approved the final manuscript.
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Jespersen, S.E., Agergaard, J. Evenness of dietary protein distribution is associated with higher muscle mass but not muscle strength or protein turnover in healthy adults: a systematic review. Eur J Nutr 60, 3185–3202 (2021). https://doi.org/10.1007/s00394-021-02487-2
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DOI: https://doi.org/10.1007/s00394-021-02487-2