1. Timing and optimization of nutrient intake for exercise recovery and performance Cho. Joon-Yong Korea National Sport University CHO. Joon-Yong chojy86@knsu.ac.kr

2. POST EXERCISE ENVIRONMENT l Dehydrated l Blood insulin is low l Cortisol and other catabolic hormones are elevated l Immune system suppressed l Muscle and liver glycogen reduced or depleted l Muscle is in a catabolic state with increased proteolysis

3. CONVERTING POST EXERCISE ENVIROMMENT FROM A CATABOLIC STATE TO AN ANABOLIC STATE l Rehydrate l Increase blood insulin levels l Lower blood cortisol levels and other catabolic hormones l Strengthen the immune system l Restore muscle and liver glycogen l Stimulate muscle protein synthesis and tissue repair

4. WHAT IS NECESSARY TO CONVERT THE POST EXERCISE ENVIROMMENT FROM A CATABOLIC STATE TO AN ANABOLIC STATE? 1. The timing of nutrient supplementation 2. The types of nutrients to supplement (carbohydrate/protein)

5. TIMING EFFECT The sooner after exercise the appropriate nutrients can be consumed the greater the anabolic effect

6. 100 80 60 20 0 PotentialAnabolicEffect(percent) Minutes 40 0153045607590120 Metabolic Window Without nutrient intervention, the metabolic window begins to close within forty-five minutes following exercise.

7. TYPES OF NUTRIENTS TO SUPPLEMENT Should supplement with a combination of carbohydrate and protein. ~ 3 parts carbohydrate to 1 part protein

8. EFFECT OF A CARBOHYDRATE/PROTEIN SUPPLEMENT ON REHYDRATION

9. EXPERIMENTAL PROTOCOL Subjects exercised to dehydrate by 2.5% of body weight. Immediately after exercise subjects consumed one of three liquid supplements equivalent to weight loss: 1. Carbohydrate/protein 6g CHO, 1.75g PRO, 45.8 mg Na 2. Carbohydrate 6g CHO, 45.8 mg Na 3. Water Monitored recover for 3 hours

10. C/PCHOWater 0 150 300 450 600 Urine Osmolality (mOsm/kg) †* * URINE OSMOLALITY

11. C/PCHOWater 0 250 500 750 1000 Total Urine Output (ml) †* * TOTAL URINE OUTPUT

12. †* * C/PCHOWater 0 270 280 290 Serum Osmolality (mOsm/kg) SERUM OSMOLALITY

13. C/PCHOWater 0 20 40 60 80 100 % Fluid Retention *† * FLUID RETENTION

14. Change in KG 0-0.5-1.5-2 Time (min) 0560120180 Body Weight Change WatAccGat 9030 * * @

15. Conclusion The addition of protein to a sports drink helps with retention of fluid and increases rate of rehydration

16. RECOVERY OF MUSCLE GLYCOGEN STORES

17. Timing of Carbohydrate Supplementation 4

18. HYPOTHESIS The time of consumption of a carbohydrate supplement post exercise will have a significant impact on the rate of muscle glycogen storage 5

19. PROTOCOL l Exercised subjects at 70% VO 2 max for 2 h to deplete glycogen stores l Provided 1.5g CHO/kg body wt either immediately after exercise or 2 h after exercise l Muscle biopsies performed immediately and 2 h post supplement Ivy et al. J. Appl. Physiol. (1988). 6

20. 0 5 10 15 20 1.5g CHO kg Immediately Post Exercise 1.5g CHO kg 2 Hours Post Exercise Glycogen Storage (µmol g -1 wet wt 2h -1 ) * 7

21. Carbohydrate & Protein Supplementation

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

23. 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% VO 2 max, last 15 min. alternating between 50 and 85% VO 2 max Muscle biopsies Immediately and 4h post exercise 14

24. 15

25. GLUCOSE (mM) * TIME (min) 4 120 5 6 7 8 PREPOST306090150180210240 CHO-PRO CHO PRO *† * * 3 *† *† *† * * * * * * 16

26. 40 Muscle Glycogen Storage (µmol/g) 30 20 10 0*†CHO-PROCHOPRO TREATMENTS* 38% storage 17

27. Conclusion 1. For rapid glycogen storage, a post recovery CHO supplement should be consumed as soon after exercise as possible. 2. The addition of protein to a CHO supplement will accelerate the rate of muscle glycogen synthesis and speed recovery

28. STIMULATION OF MUSCLE PROTEIN SYNTHESIS

29. Interaction of Protein and Carbohydrate on Muscle Protein Synthesis

30. 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. 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.

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

32. CHOAA MIX Net Phenylalanine Uptake (mg / 3h / leg) From: Miller, SL, KD Tipson, DL Chinkes, SE Wolf, RR Wolfe. Med. Sci. Sports Exerc. 35(3): 449-455, 2003. 0 40 80 140 160 180 20*100 120 60

33. Timing of CHO/Protein Supplementation

34. 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.

35. From: Levenhagen DK, JD Gresham, MG Carlson, DJ Maron, MJ Borel, PJ Flakoll. Am. J. Physiol. Endocrinol. Metab. 280: E982-E993, 2001. Basal Early Late Protein Breakdown Protein Synthesis Net Balance Leg Protein Dynamics (µg min -1 100cc -1 ) -100 0 100 250 300 -50 150 200 50 * *

36. Conclusion 1. To stimulate muscle protein synthesis post exercise consume a protein and carbohydrate supplementation. 2. For maximal results, the supplement should be consumed within the first hour post exercise.

37. EFFECT OF A CHO/PROTEIN SUPPLEMENT ON IMMUNE SYSTEM

38. Above average Average Below average Sedentary Moderate Very high Amount and intensity of exercise Risk of upper respiratory tract infection

39. Maintain Blood Glucose Increase Blood Insulin Maintain Immune Function NUTRIENT SUPPLEMENTATION Suppress Blood Cortisol

40. Postexercise protein supplementation improves health And muscle soreness during basic military training in Marine recruits by Flakoll, PJ et al. J Appl Physiol. 96: 951-6, 2004. Experimental Protocol Subjects:US Marine recruits Treatments: Placebo, CHO, CHO/PRO Supplement Supplements provided immediately after exercise during 54 days of basis training

41. RESULTS Compared with the placebo and carbohydrate groups the CHO/PRO supplemented group had; 1.33% fewer total medical visits to infirmary 2.25% fewer visits due to bacterial/viral infections 3.37% fewer visits due to muscle/joint problems 4.83% fewer visits due to heat exhaustion

42. Conclusion Providing a CHO/PRO supplement post exercise will: 1. Raise blood insulin levels, reduce blood cortisol levels, provide fuel for the immune system and limit exercise-induced immune system suppression. 2. Reduce the risk of bacterial, and viral infection and muscle and joint problems

43. CHO/PRO SUPPLEMENTATION REDUCES MUSCLE DAMAGE AND IMPROVES PERFORMANCE

44. Ride to fatigue at 75% VO2peak Ride to fatigue at 85% VO2peak Ride to fatigue at 75% VO2peak Ride to fatigue at 85% VO2peak Experimental Protocol 12-15 hours 7-14 days Crossover design 12-15 hours Treatment 2 CHO/PRO Drink Treatment 1 Traditional Sports Drink From: Saunders, M.J. et al., MSSE, In Press. 1.8 ml/kg per 15 min 10 ml/kg

45. From: Saunders, M.J. et al., MSSE, In Press. Ride 1 120 100 80 60 40 20 0 Time to Fatigue (min) CHO+PROCHO Ride 2 * * *Significantly greater (p<0.05) than CHO Ride.

46. From: Saunders, M.J. et al., MSSE, In Press. *Significantly lower (p<0.05) than CHO Ride. Ride 1 1400 1200 1000 800 600 200 0 Plasma CPK (U/L) CHO+PROCHO Ride 2 * 400

47. Conclusion A CHO/PRO drink provided during and immediately post exercise will 1. Reduce muscle tissue damage 2. Improve performance during exercise 3. And improve subsequent performance

48. FINAL REMARKS Providing a CHO/PRO supplement immediately post exercise will: 1. Speed rehydration 2. Increase the rate of muscle glycogen synthesis 3. Increase the rate of muscle protein synthesis 4. Limit the suppression of the immune system 5. Reduce muscle damage and speed its repair 6. Increase performance in a subsequent exercise bout