Zhenping Ding

Functional electrical stimulation cycling improves body composition, metabolic and neural factors in persons with spinal cord injury

Persons with spinal cord injury (SCI) are at a heightened risk of developing type II diabetes and cardiovascular disease. The purpose of this investigation was to conduct an analysis of metabolic, body composition, and neurological factors before and after 10 weeks of functional electrical stimulation (FES) cycling in persons with SCI. Eighteen individuals with SCI received FES cycling 2-3 times per week for 10 weeks. Body composition was analyzed by dual X-ray absorptiometry. The American Spinal Injury Association (ASIA) neurological classification of SCI test battery was used to assess motor and sensory function. An oral glucose tolerance (OGTT) and insulin-response test was performed to assess blood glucose control. Additional metabolic variables including plasma cholesterol (total-C, HDL-C, LDL-C), triglyceride, and inflammatory markers (IL-6, TNF-alpha, and CRP) were also measured. Total FES cycling power and work done increased with training. Lean muscle mass also increased, whereas, bone and adipose mass did not change. The ASIA motor and sensory scores for the lower extremity significantly increased with training. Blood glucose and insulin levels were lower following the OGTT after 10 weeks of training. Triglyceride levels did not change following training. However, levels of IL-6, TNF-alpha, and CRP were all significantly reduced.

The effect of a carbohydrate and protein supplement on resistance exercise performance, hormonal response, and muscle damage.

The purpose of this study was to determine whether resistance exercise performance and postexercise muscle damage were altered when consuming a carbohydrate and protein beverage (CHO-PRO; 6.2% and 1.5% concentrations). Thirty-four male subjects (age: 21.5 ± 1.7 years; height: 177.3 ± 1.1 cm; weight: 77.2 ± 2.2 kg) completed 3 sets of 8 repetitions at their 8 repetition maximum to volitional fatigue. The exercise order consisted of the high pull, leg curl, standing overhead press, leg extension, lat pull-down, leg press, and bench press. In a double-blind, posttest-only control group design, subjects consumed 355 ml of either CHO-PRO or placebo (electrolyte and artificial sweetener beverage) 30 minutes prior to exercise, 177 ml immediately prior to exercise, 177 ml halfway through the exercise bout, and 355 ml immediately following the exercise bout. There were no significant differences between groups relative to exercise performance. Cortisol was significantly elevated in the placebo group compared to the CHO-PRO group at 24 hours postexercise. Insulin was significantly elevated immediately pre-exercise, after the fourth lift, immediately postexercise, 1 hour, and 6 hours postexercise in CHO-PRO compared to the placebo group. Myoglobin levels in the placebo group approached significance halfway through the exercise bout and at 1 hour postexercise (p = 0.06 and 0.07, respectively) and were significantly elevated at 6 hours postexercise compared to the CHO-PRO group. Creatine kinase levels were significantly elevated in the placebo group at 24 hours postexercise compared to the CHO-PRO group. The CHO-PRO supplement did not improve performance during a resistance exercise bout, but appeared to reduce muscle damage, as evidenced by the responses of both myoglobin and creatine kinase. These results suggest the use of a CHO-PRO supplement during resistance training to reduce muscle damage and soreness.

Postexercise carbohydrate-protein supplementation improves subsequent exercise performance and intracellular signaling for protein synthesis.

Ferguson-Stegall, L, McCleave, EL, Ding, Z, Doerner III, PG, Wang, B, Liao, Y-H, Kammer, L, Liu, Y, Hwang, J, Dessard, BM, and Ivy, JL. Postexercise carbohydrate-protein supplementation improves subsequent exercise performance and intracellular signaling for protein synthesis. J Strength Cond Res 25(5): 1210-1224, 2011-Postexercise carbohydrate-protein (CHO + PRO) supplementation has been proposed to improve recovery and subsequent endurance performance compared to CHO supplementation. This study compared the effects of a CHO + PRO supplement in the form of chocolate milk (CM), isocaloric CHO, and placebo (PLA) on recovery and subsequent exercise performance. Ten cyclists performed 3 trials, cycling 1.5 hours at 70% &OV0312;o2max plus 10 minutes of intervals. They ingested supplements immediately postexercise and 2 hours into a 4-hour recovery. Biopsies were performed at recovery minutes 0, 45, and 240 (R0, R45, REnd). Postrecovery, subjects performed a 40-km time trial (TT). The TT time was faster in CM than in CHO and in PLA (79.43 ± 2.11 vs. 85.74 ± 3.44 and 86.92 ± 3.28 minutes, p ≤ 0.05). Muscle glycogen resynthesis was higher in CM and in CHO than in PLA (23.58 and 30.58 vs. 7.05 μmol·g−1 wet weight, p ≤ 0.05). The mammalian target of rapamycin phosphorylation was greater at R45 in CM than in CHO or in PLA (174.4 ± 36.3 vs. 131.3 ± 28.1 and 73.7 ± 7.8% standard, p ≤ 0.05) and at REnd in CM than in PLA (94.5 ± 9.9 vs. 69.1 ± 3.8%, p ≤ 0.05). rpS6 phosphorylation was greater in CM than in PLA at R45 (41.0 ± 8.3 vs. 15.3 ± 2.9%, p ≤ 0.05) and REnd (16.8 ± 2.8 vs. 8.4 ± 1.9%, p ≤ 0.05). FOXO3A phosphorylation was greater at R45 in CM and in CHO than in PLA (84.7 ± 6.7 and 85.4 ± 4.7 vs. 69.2 ± 5.5%, p ≤ 0.05). These results indicate that postexercise CM supplementation can improve subsequent exercise performance and provide a greater intracellular signaling stimulus for PRO synthesis compared to CHO and placebo.

Post exercise carbohydrate–protein supplementation: phosphorylation of muscle proteins involved in glycogen synthesis and protein translation

Summary.The enzymes Akt, mTOR, p70S6K, rpS6, GSK3, and glycogen synthase interact in the control of protein and/or glycogen synthesis in skeletal muscle, and each has been found to respond to exercise and nutrient supplementation. In the present study, we tested the hypothesis that nutrient supplementation post exercise, in the form of a carbohydrate–protein (CHO–PRO) supplement, would alter the phosphorylation state of these enzymes in a manner that should increase muscle protein and glycogen synthesis above that produced by exercise alone. After a 45 min cycling session followed by sprints and again 15 min later, the subjects (n = 8) ingested 400 ml of a CHO–PRO drink (7.8% dextrose and 1.8% protein-electrolyte) or a placebo drink, as assigned using a randomized, counter-balanced design with repeated measures. Biopsies of the vastus lateralis were taken before exercise and at 45 min of recovery. At 45 min after supplementation, CHO–PRO treatment yielded greater phosphorylation of Akt (65%), mTOR (86%), rpS6 (85-fold), and GSK3α/β (57%) than pre-exercise levels (p < 0.05). Although p70S6k showed an exercise response after 45 min, there were no differences between treatments. Glycogen synthase (GS) phosphorylation was significantly reduced 45 min after exercise for both treatments, but the reduction in phosphorylation was greatest during the CHO–PRO treatment (3-fold decrease; p < 0.05), indicating greater activation of GS following supplementation. No difference between treatments was detected prior to exercise for any of the enzymes. These results suggest that a post exercise CHO–PRO supplement alters the phosporylation levels of the enzymes tested in a manner that should accelerate muscle glycogen synthesis and protein initiation during recovery from cycling exercise.

An amino acid mixture improves glucose tolerance and insulin signaling in Sprague-Dawley rats

The aims of this investigation were to evaluate the effect of an amino acid supplement on the glucose response to an oral glucose challenge (experiment 1) and to evaluate whether differences in blood glucose response were associated with increased skeletal muscle glucose uptake (experimental 2). Experiment 1 rats were gavaged with either glucose (CHO), glucose plus an amino acid mixture (CHO-AA-1), glucose plus an amino acid mixture with increased leucine concentration (CHO-AA-2), or water (PLA). CHO-AA-1 and CHO-AA-2 had reduced blood glucose responses compared with CHO, with no difference in insulin among these treatments. Experiment 2 rats were gavaged with either CHO or CHO-AA-1. Fifteen minutes after gavage, a bolus containing 2-[(3)H]deoxyglucose and [U-(14)C]mannitol was infused via a tail vein. Blood glucose was significantly lower in CHO-AA-1 than in CHO, whereas insulin responses were similar. Muscle glucose uptake was higher in CHO-AA-1 compared with CHO in both fast-twitch red (8.36 ± 1.3 vs. 5.27 ± 0.7 μmol·g(-1)·h(-1)) and white muscle (1.85 ± 0.3 vs. 1.11 ± 0.2 μmol·g(-1)·h(-1)). There was no difference in Akt/PKB phosphorylation between treatment groups; however, the amino acid treatment resulted in increased AS160 phosphorylation in both muscle fiber types. Glycogen synthase phosphorylation was reduced in fast-twitch red muscle of CHO-AA-1 compared with CHO, whereas mTOR phosphorylation was increased. These differences were not noted in fast-twitch white muscle. These findings suggest that amino acid supplementation can improve glucose tolerance by increasing skeletal muscle glucose uptake and intracellular disposal through enhanced intracellular signaling.

Aerobic Exercise Training Adaptations Are Increased by Postexercise Carbohydrate-Protein Supplementation

Carbohydrate-protein supplementation has been found to increase the rate of training adaptation when provided postresistance exercise. The present study compared the effects of a carbohydrate and protein supplement in the form of chocolate milk (CM), isocaloric carbohydrate (CHO), and placebo on training adaptations occurring over 4.5 weeks of aerobic exercise training. Thirty-two untrained subjects cycled 60 min/d, 5 d/wk for 4.5 wks at 75–80% of maximal oxygen consumption (VO2 max). Supplements were ingested immediately and 1 h after each exercise session. VO2 max and body composition were assessed before the start and end of training. VO2 max improvements were significantly greater in CM than CHO and placebo. Greater improvements in body composition, represented by a calculated lean and fat mass differential for whole body and trunk, were found in the CM group compared to CHO. We conclude supplementing with CM postexercise improves aerobic power and body composition more effectively than CHO alone.

Adding protein to a carbohydrate supplement provided after endurance exercise enhances 4E-BP1 and RPS6 signaling in skeletal muscle

To examine the role of both endurance exercise and nutrient supplementation on the activation of mRNA translation signaling pathways postexercise, rats were subjected to a 3-h swimming protocol. Immediately following exercise, the rats were provided with a solution containing either 23.7% wt/vol carbohydrates (CHO), 7.9% wt/vol protein (Pro), 31.6% wt/vol (23.7% wt/vol CHO + 7.9% wt/vol Pro) carbohydrates and Pro (CP), or a placebo (EX). The rats were then killed at 0, 30, and 90 min postexercise, and phosphorylation states of mammalian target of rapamycin (mTOR), ribosomal S6 kinase (p70(S6K)), ribosomal protein S6 (rpS6), and 4E-binding protein 1 (4E-BP1), were analyzed by immunoblot analysis in the red and white quadriceps muscle. Results demonstrated that rat groups provided with any of the three nutritional supplements (CHO, Pro, CP) transiently increased the phosphorylation states of mTOR, 4E-BP1, rpS6, and p70(S6K) compared with EX rats. Although CHO, Pro, and CP supplements phosphorylated mTOR and p70(S6K) after exercise, only CP elevated the phosphorylation of rpS6 above all other supplements 30 min postexercise and 4E-BP1 30 and 90 min postexercise. Furthermore, the phosphorylation states of 4E-BP1 (r(2) = 0.7942) and rpS6 (r(2) = 0.760) were highly correlated to insulin concentrations in each group. These results suggest that CP supplementation may be most effective in activating the mTOR-dependent signaling pathway in the postprandial state postexercise, and that there is a strong relationship between the insulin concentration and the activation of enzymes critical for mRNA translation.

Added protein maintains efficacy of a low-carbohydrate sports drink.

Martínez-Lagunas, V, Ding, Z, Bernard, JR, Wang, B, and Ivy, JL. Added protein maintains efficacy of a low-carbohydrate sports drink. J Strength Cond Res 24(1): 48-59, 2010-The purpose of the present study was to investigate the aerobic capacity characteristics of an isocaloric carbohydrate (CHO) plus protein (PRO) drink and a low-calorie CHO plus PRO drink against a traditional 6% CHO sports beverage. Twelve male and female trained cyclists exercised on 4 separate occasions at intensities that varied between 55 and 75% &OV0312;o2max for 2.5 hours and then at 80% &OV0312;o2max until fatigued. Supplements (255.4 ± 9.1 mL) were provided every 20 minutes and consisted of a 4.5% carbohydrate plus 1.15% protein complex (CHO/PRO H), a 3% carbohydrate plus 0.75% protein complex (CHO/PRO L), a 6% carbohydrate supplement (CHO), or a placebo (PLA). Time to fatigue at 80% &OV0312;o2max was significantly longer (p < 0.05) during the CHO (26.9 ± 6.1 minutes, mean ± SE), the CHO/PRO H (30.5 ± 5.9 minutes), and the CHO/PRO L (28.9 ± 6.5 minutes) trials compared with the PLA trial (14.7 ± 3.4 minutes), with no significant differences among the CHO, CHO/PRO H, and CHO/PRO L treatments. In general, blood glucose, plasma insulin, and carbohydrate oxidation were elevated above PLA during the CHO, CHO/PRO H, and CHO/PRO L trials, whereas plasma free fatty acids, rating of perceived exertion, and fat oxidation values were lower during the CHO, CHO/PRO H, and CHO/PRO L trials compared with the PLA trial. Only minor differences in blood parameters occurred among the CHO, CHO/PRO H, and CHO/PRO L treatments. In summary, partially substituting PRO for CHO in a sports drink did not enhance aerobic capacity, but substitution was able to occur without loss of efficacy. Thus, adding PRO to a low-calorie CHO sports drink may be an effective strategy to enhance aerobic capacity while limiting carbohydrate and caloric consumption.

THE EFFECT OF A LOW CARBOHYDRATE BEVERAGE WITH ADDED PROTEIN ON CYCLING ENDURANCE PERFORMANCE IN TRAINED ATHLETES

Ferguson-Stegall, L, McCleave, EL, Ding, Z, Kammer, LM, Wang, B, Doerner, PG, Liu, Y, and Ivy, JL. The effect of a low carbohydrate beverage with added protein on cycling endurance performance in trained athletes. J Strength Cond Res 24(10): 2577-2586, 2010-Ingesting carbohydrate plus protein during prolonged variable intensity exercise has demonstrated improved aerobic endurance performance beyond that of a carbohydrate supplement alone. The purpose of the present study was to determine if a supplement containing a mixture of different carbohydrates (glucose, maltodextrin, and fructose) and a moderate amount of protein given during endurance exercise would increase time to exhaustion (TTE), despite containing 50% less total carbohydrate than a carbohydrate-only supplement. We also sought post priori to determine if there was a difference in effect based on percentage of ventilatory threshold (VT) at which the subjects cycled to exhaustion. Fifteen trained male and female cyclists exercised on 2 separate occasions at intensities alternating between 45 and 70% &OV0312;o2max for 3 hours, after which the workload increased to ∼74-85% &OV0312;o2max until exhaustion. Supplements (275 mL) were provided every 20 minutes during exercise, and these consisted of a 3% carbohydrate/1.2% protein supplement (MCP) and a 6% carbohydrate supplement (CHO). For the combined group (n = 15), TTE in MCP did not differ from CHO (31.06 ± 5.76 vs. 26.03 ± 4.27 minutes, respectively, p = 0.064). However, for subjects cycling at or below VT (n = 8), TTE in MCP was significantly greater than for CHO (45.64 ± 7.38 vs. 35.47 ± 5.94 minutes, respectively, p = 0.006). There were no significant differences in TTE for the above VT group (n = 7). Our results suggest that, compared to a traditional 6% CHO supplement, a mixture of carbohydrates plus a moderate amount of protein can improve aerobic endurance at exercise intensities near the VT, despite containing lower total carbohydrate and caloric content.

A low carbohydrate-protein supplement improves endurance performance in female athletes.

McCleave, EL, Ferguson-Stegall, L, Ding, Z, Doerner, PG III, Wang, B, Kammer, LM, and Ivy, JL. A low carbohydrate-protein supplement improves endurance performance in female athletes. J Strength Cond Res 25(4): 879-888, 2011-The purpose of this study was to investigate if a low mixed carbohydrate (CHO) plus moderate protein (PRO) supplement, provided during endurance exercise, would improve time to exhaustion (TTE) in comparison to a traditional 6% CHO supplement. Fourteen (n = 14) trained female cyclists and triathletes cycled on 2 separate occasions for 3 hours at intensities varying between 45 and 70% &OV0312;O2max, followed by a ride to exhaustion at an intensity approximating the individuals ventilatory threshold average 75.06% &OV0312;O2max. Supplements (275 mL) were provided every 20 minutes during exercise and were composed of a CHO mixture (1% each of dextrose, fructose, and maltodextrin) + 1.2% PRO (CHO + PRO) or 6% dextrose only (CHO). The TTE was significantly greater with CHO + PRO in comparison to with CHO (49.94 ± 7.01 vs. 42.36 ± 6.21 minutes, respectively, p < 0.05). Blood glucose was significantly lower during the CHO + PRO trial (4.07 ± 0.12 mmol·L−1) compared to during the CHO trial (4.47 ± 0.12 mmol·L−1), with treatment × time interactions occurring from 118 minutes of exercise until exhaustion (p < 0.05). Results from the present study suggest that the addition of a moderate amount of PRO to a low mixed CHO supplement improves endurance performance in women above that of a traditional 6% CHO supplement. Improvement in performance occurred despite CHO + PRO containing a lower CHO and caloric content. It is likely that the greater performance seen with CHO + PRO was a result of the CHO-PRO combination and the use of a mixture of CHO sources.