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On a global scale, the number of people over 60 yr is expected to more than double from 841 million in 2012 to more than 2 billion by 2050. This change in demographics will have profound implications for many aspects of life (Thomson et al. 2016). Furthermore, Government bodies worldwide will be faced with considerable challenges related to ageing policy and how best to deal with this new reality.
Of the many things that occur during the ageing process one of the most obvious signs is the loss of skeletal muscle mass and strength, with decrements in physical function and potential predisposition to disability. In academic speak, this is known as sarcopenia. The research and interest in this area has been gradually increasing as evidenced by the below graph that shows – since the term sacropenia was first coined in 1989 – a massive increase has occurred. To enhance functional physical capacity and reduce disability into older age, it is therefore critical to develop strategies that facilitate the attenuation of skeletal muscle mass and strength. With more than 30 years of scientific evidence to show that exercise – and, more specifically, resistance training – as both very effective and safe methods to maintain skeletal lean muscle tissue mass and strength (see hereand here), current recommendations strongly advocate this form of exercise for older adults.
Interestingly, gains in skeletal lean muscle tissue and muscular strength may be potentiated through the application of appropriate nutritional strategies and in particular increased protein intake. A recent meta-analysis by Cermak and colleagues (2012) reported ~35% greater enhancement in muscle mass and strength can be achieved in older adults undertaking resistance training who consumed at least 1.2 g/kg of body weight/d of protein through supplementation or diet compared with other control groups that were either non-protein, lower protein diet or exercise training with no nutrition co-intervention. Thus, protein quality or source may further augment the effect of the resistance training stimulus by eliciting a greater stimulatory effect on muscle protein synthesis. Dairy protein compared to soy protein has been shown to be more effacacious post-exercise in stimulating increases in lean mass in young healthy males. In older adults though this response to resistance training and increased protein intake may be blunted which necessitates that higher doses of protein are required to bring about an increase.
The aim of the study under review for this article was to determine whether increased dairy or soy protein intake combined with resistance training improved strength gains in older adults.
Does Soy Protein Suppress Strength Gains?
Researchers recruited one hundred and ninety two older adults (age, 50-79 yr; BMI, 20-35 kg/m²) by public advertisement. Participation was allowed if they were physically active but not engaged in formal exercise. Those that meet the inclusion criteria undertook a resistance training program for 12 weeks. Randomisation to one of three experimental diets was performed:
High dairy protein diet (HP-D)
High non-dairy (soy) protein diet (HPeS)
Usual protein diet (UP).
DIET: Each diet was isocaloric and low-fat (30% fat, <8% saturated fat) and aimed to maintain energy balance. The diets provided ~1 g/kg of body weight/d of dietary protein, mainly from lean meat sources. HP-D including additional dairy protein of ~27 g per day in the form of a shake (475 g Devondale Smart reduced fat milk, 200 g Nestle Soleil diet no fat yoghurt & 20 ml Bickfords vanilla milk mix syrup). The HP-S providing in the form of a shake – 300 g So Good reduced fat soy milk, 100 g Kingland soy yoghurt, 20 g Nature’s Way instant natural protein powder & 15 g poly-joule – which added an extra ~27 g of soy protein. Protein intake was distribtuted evenly across the day with the three main meals providing >20 g per feed; this is consistent with best practice for optimising muscle protein synthesis in older adults. Following resistance training sessions participants consumed the appropriate additional foods immediately after training and that represented the main meal of that day. Participants were supplied with key foods specific to their allocated diet for the duration of the study to facilitate adherence. Energy and macronutrient intakes from daily food checklists were analysed to monitor food intake and dietary compliance.
Resistance training: a key component of healthy ageing?
RESISTANCE TRAINING: All subjects participated in a whole body resistance training program three days per week on non-consecutive days for 12 weeks and the principles of progressive overload were applied. Five exercises on weight stack pin loaded machines were performed: leg press, chest press, knee extension, lat pull down and leg curl, and seated bent knee hip flexions. Trainees started with one set x 8 repetition maximum (RM; maximum weight lifted for eight repetitions), this was maintained until individuals could perform three sets of 12 repetitions and then the load was increased. This cycle was repeated again for the duration of the trial. Assessment of muscle strength, body composition, physical function and quality of life was conducted at baseline and 12 weeks. All exercise training was completed in the research gymnasium at the University of South Australia under the supervision of gymnasium staff.
Assessment of muscle strength using handgrip, isokinetic dynamometry and 8RM was completed. The leg press, chest press, knee extension, lat pull down and leg curl were tested with 8RM and a summed total 8RM for all exercises was recorded Dominant handgrip strength was measured using hydraulic handgrip dynamometer and isometric strength of the knee extensor muscles of the right leg was assessed using an isokinetic dynamometer.
You don’t have to lift weights to do resistance training
RESULTS: 83 participants completed the intervention being adherent to both diet and resistance training protocols. HP-D and HP-S had higher protein intakes compared with UP (HP-D 1.41 ± 0.14 g/kg/d, HP-S 1.42 ± 0.61 g/kg/d, UP 1.10 ± 0.10 g/kg/d; P < 0.001 treatment effect). Baseline characteristics, compliance with the intakes of the additional protein foods and adherence to the resistance training program in those that meet all relevant study protocols was not different between groups.
Increase in muscular strength as ascertained by total 8RM was significantly less in HP-S compared with HP-D and UP (HP-D 92.1 ± 40.8%, HP-S 63.0 ± 23.8%,UP 92.3 ± 35.4%; P=0.002 treatment effect). 8RM percent improvement in leg press was much greater in HP-D and UP compared with HP-S (HP-D, 136.8 ± 88.2%; HP-S, 64.8 ± 35.2%; UP, 135.0 ± 62.0%; P < 0.001). For most other exercises, 8RM was not signficantly different for each diet group. Total training volume over the 12 weeks was not different between groups.
Weight, waist circumference and total body fat decreased and lean mass and the distance covered during the 6 min walk test increased significantly increased with no difference between diets. As expected absolute protein intake (g) and relative protein intake (per kg body weight) were different with HP-D and HP-S greater than UP. Dairy protein in HP-D was significantly greater compared with both HP-S and UP with the amount of non-dairy protein in HP-S significantly greater compared with both HP-D and UP.
DISCUSSION: This study has demonstrated that 12 weeks of progressive resistance training exercise in healthy older adults did not provide any additional benefit for improvements in strength, body composition, physical function, or quality of life when additional protein from either dairy or soy is compared to usual (lower) protein intake. Perhaps of more significant interest is that results suggested that increased soy protein intake attenuated improvements in muscular strength. I am going to publish this article before it is entirely finished as I believe this is important research for those interested in this area and facilitating discussion on this topic should start now.
Stay strong and prosper
Over the next week or so I will be posting a part 2 in relation to this study as there is a lot more to explore. For example, why did the authors fail to acknowledge or discuss the fact that the attentuated strength improvement in the HP-S was confined exclusively to the leg press exercise? For all other exercises, no difference for dietary influence on strength improvement was found. Whilst not a criticism, it seems rather odd that whey protein was not included as one of the intervention dietary arms of the study. The evidence for whey protein augmenting the development of strength and facilitating the accretion of lean muscle mass from resistance training is well documented. Comparing this with the other diets would have provided some interesting insights into whether there are any further benefits of whey protein to older adults. Finally, one thing that does disappoint me about many of the studies that investigate the efficacy and safety of resistance training in older adults is the reliance on exercises that are machine-based.
CONCLUSION: Increased soy protein intake attenuated gains in muscle strength during resistance training in older adults compared with increased intake of dairy protein or usual protein intake.
Look out for part 2 (see here) titled “Does Soy Protein Really Inhibit Resistance Training Induced Strength Gains In Older Adults?” where I will discuss some of the things I mentioned above in more depth and some possible mechanisms of action as to why soy protein may or may not suppress strength gains from resistance training.
Post-script: Following further analysis and publication of part 2 of this blog, I wrote a letter to the Editor of Clinical Nutrition Journal outlining some of the, what I believed, flaws regarding the interpretation of the results of this trial. Upon peer review this was accepted for publication and can be found here. If you are unable to access this correspondence and the authors reply to my letter, please contact me and I should be able to assist.
References
Cermak et al. (2012) Protein supplementaiton augments the adaptrive response of skeletal muscle to resistance-type exercise training: a meta-analysis Am J Clin Nutr 96: 1454- 64.
Thomson et al. (2016) Muscle strength gains during resistance exercise training are attenuated with soy compared with dairy or usual protein intake in older adults: A randomized controlled trial. Clinical Nutrition. 35: 27-33
Wilson, SA (2016) Comment on: Muscle strength gains during resistance exercise training are attenuated with soy compared with dairy or usual protein intake in older adults: A randomized controlled trial. Clinical Nutrition. 35(6):1575-1576
Disclaimer: All contents of the FitGreyStrong website/blog are provided for information and education purposes only. Those interested in making changes to their exercise, lifestyle, dietary, supplement or medication regimens should consult a relevantly qualified and competent health care professional. Those who decide to apply or implement any of the information, advice, and/or recommendations on this website do so knowingly and at their own risk. The owner and any contributors to this site accept no responsibility or liability whatsoever for any harm caused, real or imagined, from the use or distribution of information found at FitGreyStrong. Please leave this site immediately if you, the reader, find any of these conditions not acceptable.
Published in the American Journal of Clinical Nutrition, researchers Dr Thomas Longland and co. showed that during marked energy deficit a diet higher in protein was more effective in promoting increases in lean body mass (muscle) and losses of fat mass when combined with a high volume of resistance training (weights) and anaerobic exercise (sprints).
Protein requirements are increased during intense exercise training
When attempting to decrease body fat through intense exercise and an energy deficit diet, ensure you consume high protein foods (i.e eggs, fish, meat, WPC etc) regularly across the day to maintain a steady supply of amino acids to help facilitate muscle recovery and adaptation. This study provides further confirmation of the importance of adequate protein to support muscle protein synthesis.
This is particularly important in older adults with the latest review of the evidence (discussed here) showing that maximising skeletal muscle protein synthesis rates during recovery from resistance training exercise in younger adults being different to older adults. The ingestion of ∼20 g of protein or ∼0.25 g protein/kilogram bodyweight appears to be sufficient. Older adults, on the other hand, demonstrate a blunted post-prandial muscle protein synthetic response. Older adults as opposed to younger adults therefore require higher amounts of protein during recovery from resistance training exercise to optimally stimulate muscle protein synthesis. Intakes even up to ∼40 g appear necessary. Currently, no consensus exists regarding the amount of protein required to maximally stimulate skeletal muscle protein synthesis rates during recovery from resistance training exercise in older adults.
Further comments:
Interestingly, one of the key takeouts of this study is that an energy deficit diet was utilised to elicit fat mass loss. It is very important to acknowledge that the research conducted over the last 8 decades has conclusively demonstrated that weight or fat loss will only occur if this fundamental physiological requirement is met. For an extensive discussion of this research and what the metabolic-unit based weight loss studies reveal see here.
No caloric deficit = no fat loss
Therefore, don’t believe the hype. Food quality is a an absolute must and essential to good health. However, weight or fat loss will not be realised no matter how good your diet is unless an energy deficit exists. Increased total physical activity during all waking hours and an energy-deficit diet that is wholesome, natural, minimally-processed and nutrient-dense will provide a significant opportunity for weight loss to be achieved.
Lastly, there are a number of studies and anecdotal evidence that show a significant proportion of exercisers eating an ad libitum diet – possibly as high as 50% – do not achieve the weight loss expected with as much as 15% actually gaining weight. These individuals are often referred to as ‘non–responders‘. Those on the other hand that do achieve weight loss from exercise are referred to as ‘responders‘. The question is, how is this possible and are there any practical solutions? Please see herefor more on the compensatory mechanisms that some suffer from that can thwart the success of an exercise program and some of things that can be done to combat this resistance to fat loss.
Reference: Longland, T.M. et al (2016) Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. The American Journal of Clinical Nutrition (link to reference see here)
For local Townsville residents interested in FitGreyStrong’s Exercise Physiology services or exercise programs designed to improve muscular strength, physical function (how you move around during the day), bring about successful weight loss and change quality of life or programs to enhance athletic performance, contact FitGreyStrong@outlook.com or phone 0499 846 955 for a confidential discussion.
For other Australian residents or oversees readers interested in our services, please see here.
Disclaimer: All contents of the FitGreyStrong website/blog are provided for information and education purposes only. Those interested in making changes to their exercise, lifestyle, dietary, supplement or medication regimens should consult a relevantly qualified and competent health care professional. Those who decide to apply or implement any of the information, advice, and/or recommendations on this website do so knowingly and at their own risk. The owner and any contributors to this site accept no responsibility or liability whatsoever for any harm caused, real or imagined, from the use or distribution of information found at FitGreyStrong. Please leave this site immediately if you, the reader, find any of these conditions not acceptable.
It is often assumed that the best type of exercise – for treating obesity and therefore reducing current widespread levels of societal adiposity – is to preferentially increase aerobic or cardiorespiratory physical activity rather than resistance exercise or training. This assumption is based on the premise that aerobic-based exercise substantially increases total daily energy expenditure (TDEE) compared to the energy cost of resistance training. The argument goes that for the same amount of time invested (aerobic vs resistance exercise), significantly greater energy expenditure will occur in the former.
In fact, a good solid hour of ‘cardio’ can yield a net caloric expenditure of over 500 kcal. This of course varies depending on things like body mass, fitness level, the type of cardio exercise performed, exercise intensity and exercise efficiency. Nonetheless, it makes sense that an increase in TDEE would make it essentially easier to create an energy deficit which would thereby translate into improved body composition and decreased fat mass.
Is Aerobic Exercise The Best For Fat Loss?
However, there are several caveats that must be mentioned which could affect just how successful weight loss and weight loss maintenance is if doing aerobic-only exercise. They include:
Overestimating the energy expenditure of an activity therefore stifling weight loss with erroneous values assigned to a cardio session.
Compensatory adaptation whereby weight loss is curtailed in some individuals with changes to Resting Metabolic Rate (RMR), non-exercise activity thermogenesis (NEAT), fasting appetite, satiety and increased fat consumption (see herefor further information). Professor Neil King, currently based at Brisbane’s QUT Faculty of Health in Australia, has been instrumental in bringing these issues to light (see here).
Recent evidence (see here) also suggests that TDEE may be constrained as aerobic activity levels increase. In other words, it has been shown that a plateauing effect on total energy expenditure occurs in those performing high amounts of aerobic-based physical activity. This lends support to the notion that metabolic adaptation constrains energy expenditure with increased physical activity. Theoretically, it is proposed that this would have probably helped facilitate survival during our evolution.
Research demonstrates that nutritional manipulation combined with aerobic exercise so that an energy deficit exists (a prerequisite for fat loss), causes a loss of lean body mass (LBM) with such loss causing decreases to RMR (see Villareal et al). It is very common to see exercisers lose significant amounts of LBM when only aerobic exercise is undertaken while in an energy deficit state.
The loss of LBM is not desirable for 2 key reasons. Firstly, functional physical capacity could be affected in both the short and long term (see Villreal et al). Secondly, resting metabolic rate will be reduced thereby making weight loss more difficult and weight regain more likely (see herefor further discussion). Such alterations would make continued fat loss increasingly more difficult as energy intake would have to adjust to allow for the decrease in TDEE that would occur concomitantly with decreased LBM.
Some research has shown that appetite is suppressed more so with resistance versus aerobic exercise. Appetite attenuation would help facilitate the likelihood of achieving sustainable weight loss.
Resistance Exercise Is Effective At Reducing Body Fat
Recently Clemens Drenowatz from the Department of Exercise Science, University of South Carolina, headed up a study to examine the effect of different exercise types on measures of adiposity across different fat categories i.e. healthy, overfat and obese.
The term overfat was probably used instead of overweight so that a distinction could be made between high adiposity, low LBM versus low adiposity, high LBM. By that I mean, measuring body weight alone does not discern the proportionate breakdown of fat mass and lean body mass. As an example, you could have 2 men, same height, same weight, but with totally different body compositions in terms of percentage body fat. Increased chances of premature death and health morbidism are correlated not to LBM but to increasingly high levels of adipose tissue, in particular, visceral adiposity (internal fat rather than subcutaneous fat).
The key difference noted for this study was that the researchers did not prescribe an exercise program but rather allowed those involved in the study to self-select what activities to partake in and then assessed what effect those choices had on subsequent measures of body composition.
Three-hundred and forty-eight young adults (n=348) provided valid data over a 12 month period. Body composition, fat mass (FM) and lean mass (LM) were measured via a procedure known as dual x-ray absorptiometry every 3 months. Following this, percent body fat was calculated and then used to distinguish normal-fat, overfat and obese. Specifically, percent body fat ranges were less than 20% and 33% for normal fat, 20%-25% and 33%-39% for overfat, and equal to greater than 33% and 39% for obese in men and women, respectively.
Every 3 months participants reported engagement in aerobic exercise, resistance exercise and other forms of exercise such as tennis or football. Time per week spent engaged in endurance exercise, resistance exercise and other exercise was calculated. TDEE, RMR, physical activity level, and energy intake were also ascertained.
The majority of participants (93%) reported some exercise in the observation period. Surprisingly, differences existed as to what type of exercise showed the greatest benefit – for those either classified as normal-fat, overfat and obese – on reducing fat mass, increasing lean body mass and improving overall body composition.
For normal-fat participants, any type of exercise positively affected lean body mass; however fat mass was unaffected by any type of exercise. BMI and percentage body fat in normal-fat participants held steady. It was not an explicit aim of the study to bring about weight or fat reduction so this demonstrates that in those that are relatively lean, homeostasis for fat mass is robust.
Contrastingly, in overfat and obese participants, fat mass was reduced with increasing resistance exercise but not with aerobic exercise. Even adjusting for objectively assessed physical activity did not alter these results thereby suggesting that the real-world effectiveness of resistance exercise is particularly more potent than aerobic exercise to induce a decrease of fat mass in obesity.
Resistive Exercise Is Beneficial for Men and Women
The findings of this study have some important implications for exercise program design aimed at achieving body fat loss and reducing adiposity. With reliance on aerobic exercise continuing to dominant most weight/loss programs, we now have a growing body of evidence that is questioning this approach despite the fact that there is a greater ‘per-minute’ energy expenditure associated with aerobic compared to resistive exercise.
As mentioned above there are several factors that may constrain just how effective aerobic exercise is for altering body composition. Resistive but not aerobic exercise has also recently been shown to increase non-exercise physical activity (Hunter et al. 2015). Furthermore, resistive exercise was shown recently in a 12-year cohort study to have the strongest association with less waist circumference increase compared to aerobic exercise (Mekary et al. 2015). Taken together, these novel findings suggest that resistive exercise should always be included with aerobic exercise in those considered overfat or obese if the primary objective is to reduce fat mass.
You Don’t Have To Go To A Gym To Find Resistance
FitGreyStrong’s recommendation: To optimise the effectiveness of exercise interventions in bringing about positive body compositional changes in those carrying excessive body fat, resistive exercise should be a pivotal component of any exercise program undertaken. Aerobic exercise remains a critically important component of any intervention for improving health and should still be incorporated on a daily basis if possible or for a minimum total period of 150 minutes/week at a moderate intensity. However, it is important to be mindful that a ‘Goldilocks’ or sweet spot may exist for some people whereby over-doing aerobic exercise may be counterproductive in terms of maximising fat loss due to factors that have been outlined above.
Basic weekly recommendations for a older beginners-to-intermediate resistance exercise intervention designed to reduce obesity would look something like this:
Two sessions per week
30-40 minutes in duration not including warm-up
Focus on working all major muscle groups primarily based on compound, multi-jointed non-machine orientated movements.
1-2 work sets
6-30 repetitions. The load is not important, the effort is. All loads in older adults have shown to be effective and produce comparable changes in muscle strength and hypertrophy, muscle endurance, bone density and physical function.
Controlled tempo (3-4 seconds on the eccentric, 0-2 seconds on transition, 1-2 seconds concentric, 1 seconds pause then repeat; if you are not sure what this mean please contact me)
60-180 seconds rest between sets. If stronger or more experienced, try longer rests on high effort sets.
At least 48 hours between sessions for recovery
Consume 40 g whey protein post-exercise to maximise muscle protein synthesis rates (see here for an outline on the research supporting post-exercise protein).
References
Blundell J. et al. (2010) “Appetite control: methodological aspects of the evaluation of foods.” Obe Rev 11(3): 251-270
Broom, D.R. (2008) “Influence of resistance and aerobic exercise on hunger, circulating levels of acylated ghrelin, and peptide YY in healthy males” American Journal of Physiology. 296(1): R29-R35.
Drenowatz, C. et al. (2015) “The prospective association between different types of exercise and body composition” Medicine & Science in Sports & Exercise 47(12): 2535-2541.
Hunter, GR. Et al. (2015) “Exercise training and energy expenditure following weight loss” Medicine & Science in Sports & Exercise 47(9): 1950-1957
King, N.A. et al (2012) “Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss.”British Journal of Sports Medicine 46(5):315-22.
King N.A. et al. (2008) “Individual variability following 12 weeks of supervised exercise: identification and characterization of compensation for exercise-induced weight loss.” International Journal of Obesity. 32: 177-184
King N.A. et al. (2009) “Dual-process action of exercise on appetite control: increase in orexigenic drive but improvement in meal-induced satiety.” Am J Clin Nutr. 90: 921-927
Mekary RA et al. (2015) “Weight training, aerobic physical activities, and long-term waist circumference change in men” Obesity 23(2): 461-476
Melanson, E.L. et al. (2013) “Resistance to exercise-induced weight loss: compensatory behavioural adaptations” Med Sci Sports Exerc.August; 45(8): 1600-1609.
Peterson N.D. et al. (2014) “Dietary Self-Monitoring and Long-Term Success with Weight Management”. Obesity 22, 1962–1967
Villareal D.T. et al. (2011) “Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults.” N Engl J Med 364(13): 1218-1229
For local Townsville residents interested in FitGreyStrong’s Exercise Physiology services or exercise programs designed to improve body composition, reduce body fat, increase fitness and strength or to enhance athletic performance, contact FitGreyStrong@outlook.com or phone 0499 846 955 for a confidential discussion.
For other Australian residents or oversees readers interested in our services, please see here.
Disclaimer: All contents of the FitGreyStrong website/blog are provided for information and education purposes only. Those interested in making changes to their exercise, lifestyle, dietary, supplement or medication regimens should consult a relevantly qualified and competent health care professional. Those who decide to apply or implement any of the information, advice, and/or recommendations on this website do so knowingly and at their own risk. The owner and any contributors to this site accept no responsibility or liability whatsoever for any harm caused, real or imagined, from the use or distribution of information found at FitGreyStrong. Please leave this site immediately if you, the reader, find any of these conditions not acceptable.
