(통번역) ISSN: 단백질 섭취에 대한 오해

 

Journal of the International Society of Sports Nutrition

국제 스포츠 영양 학회 저널

Common protein supplementation evidence .pdf

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Common questions and misconceptions about protein supplementation: what does the scientific evidence really show?

 

단백질 보충제에 대한 일반적인 질문과 오해: 과학적 증거는 실제로 무엇을 보여주나요?

 

 

KEYWORDS

Erogenic aid; performance; exercise; supplement

 

키워드
에로제닉 보조, 수행, 운동, 보충제

 

 

 

 

ABSTRACT
Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their pro- tein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of “protein and exercise performance” reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming “excess” protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough pro- tein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal mus- cle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily require- ments of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scien- tific assessment of the literature concerning protein supplementation.

 

 

 

추상적인
단백질 보충제는 종종 분말, 바로 마실 수 있는 쉐이크, 바 형태의 식이 보충제를 통해 특정 다량 영양소의 섭취를 늘리는 것을 의미합니다. 단백질 보충제의 주요 목적은 식이 단백질 섭취를 증가시켜 개인이 프로틴 요구량을 충족하는 데 도움을 주는 것입니다. 특히 일반 음식(예: 닭고기, 소고기, 생선, 돼지고기 등)만으로는 단백질 섭취가 어려울 수 있습니다. 많은 증거가 단백질이 운동과 좌식하는 개인에게 중요한 역할을 한다는 것을 보여줍니다. "단백질 및 운동 성과"에 대한 PubMed 검색 결과 수천 개의 출판물이 밝혀졌습니다. 상당한 양의 증거에도 불구하고 단백질에 대한 몇 가지 지속적인 질문과 오해가 존재한다는 사실은 다소 놀랍습니다. 다음과 같이 설명합니다: 1) 단백질이 신장에 해롭습니까? 2) "과다" 단백질을 섭취하면 지방량이 증가할 수 있습니까? 3) 식이 단백질이 뼈 건강에 해로울 수 있습니까? 4) 채식주의자와 채식주의자가 훈련 적응을 지원하기 위해 충분한 프로틴을 섭취할 수 있습니까? 6) 치즈나 땅콩버터를 섭취하면 건강에 좋지 않은 결과를 초래합니까? 6) 육류(즉, 동물성 단백질)를 섭취하면 건강에 해로울까요? 7) 신체 활동이 없는 경우 단백질이 필요합니까? 8) 골격근-클릭에서 동화 환경을 조성하기 위해 저항 훈련 세션 후 1시간 이내에 단백질을 섭취해야합니까? 9) 지구력 운동선수가 추가 단백질이 필요합니까? 10) 운동 훈련을 받은 개인의 일일 요구량을 충족하기 위해 단백질 보충제가 필요합니까? 11) 한 끼 식사에 얼마나 많은 단백질을 섭취할 수 있는지에 제한이 있습니까? 이러한 질문을 해결하기 위해 단백질 보충에 관한 문헌을 철저히 과학적으로 평가했습니다.

 

 

1. Introduction

The International Society of Sports Nutrition (ISSN) initially published a Position Stand on Protein in 2007 [1]; subsequently, a revision of that paper came out in 2017 [2]. As of 2023, the 2017 Position Stand on Protein has been cited 890 times. Despite the extensive outreach of the 2017 ISSN position stand paper [2] and numerous reviews and meta-analyzes on protein [3–8], questions and misconceptions regarding protein intake persist. Indeed, some of the most persistent misconceptions include but are not necessarily limited to protein being harmful to one’s kidneys and bones. Other ques- tions surround the limits of protein intake [9,10]. Debate surrounds the optimal amount of protein that can be effectively utilized to promote gains in skeletal muscle mass in a single meal, particularly for individuals engaged in structured resistance training programs. It has been previously suggested (and often accepted) that the rates of muscle protein synthesis (MPS) peak in young adults with approximately 20– 25g of high-quality protein [11]. However, a recent study shows that the limit of protein intake per meal is likely much higher [9]. Furthermore, investigators have posited potential harm associated with high protein consumption (i.e. surpassing the Recommended Dietary Allowance), particularly under specific conditions [12–15]. Consequently, in the management of chronic kidney disease, restricting protein intake may play a significant role [14]. However, Levey et al. found that a 2- to 3-year dietary protein restriction intervention did not yield conclusive effects on renal health in individuals with kidney disease [12]. Moreover, Zhu et al. stated that a “low-protein diet was not significantly associated with improvements in renal function in patients with either type 1 or 2 diabetic nephropathy [15].” It’s important to note that concerns related to dietary protein intake are generally linked to conditions not applicable to exercise-trained individuals. In fact, there is a lack of evidence-based research indicat- ing that high-protein diets pose harm to otherwise healthy, exercise-trained indivi- duals. The development of common questions and misconceptions surrounding protein supplementation stems from the widespread interest and adoption of this dietary practice. As protein supplementation gained popularity, individuals naturally began to seek information to guide their usage. Additionally, as with any emerging trend in nutrition and fitness, misconceptions inevitably arise due to misinformation, conflicting advice, and anecdotal experiences. Therefore, addressing these questions and misconceptions becomes essential to provide accurate information and ensure individuals make informed decisions about incorporating protein supplementation into their diets.

 

 

1. 소개
국제 스포츠 영양 학회(ISSN)는 2007년에 처음으로 단백질에 대한 입장을 발표했으며 [1], 그 후 2017년에 그 논문의 개정판이 발표되었습니다 [2]. 2023년 기준으로 2017년 단백질에 대한 입장을 890번 인용했습니다. 2017년 ISSN 입장을 발표한 논문 [2]와 단백질에 대한 수많은 검토 및 메타분석에도 불구하고, 단백질 섭취에 대한 질문과 오해는 여전히 남아 있습니다 [3-8]. 실제로 가장 지속적인 오해 중 일부는 단백질이 신장과 뼈에 해로운 것을 포함하지만 반드시 이에 국한되지는 않습니다. 다른 질문들은 단백질 섭취의 한계를 둘러싸고 있습니다 [9,10]. 특히 구조화된 저항 훈련 프로그램에 참여하는 개인들에게 단일 식사에서 골격근량 증가를 효과적으로 촉진할 수 있는 최적의 단백질 양에 대한 논쟁이 있습니다. 근육 단백질 합성(MPS) 비율이 약 20-25g의 고품질 단백질을 섭취한 젊은 성인에서 최고조에 달한다는 이전에 제안된 바 있으며, 종종 받아들여지고 있습니다 [11]. 그러나 최근 연구에 따르면 식사당 단백질 섭취 한도는 훨씬 더 높을 가능성이 높습니다 [9]. 또한, 연구자들은 특히 특정 조건 하에서 높은 단백질 섭취(즉, 권장 식이 허용량 초과)와 관련된 잠재적인 해악을 지적했습니다 [12-15]. 따라서 만성 신장 질환 관리에서 단백질 섭취를 제한하는 것이 중요한 역할을 할 수 있습니다 [14]. 그러나 Levey 등은 2년에서 3년의 식이 단백질 제한 개입이 신장 질환을 가진 개인의 신장 건강에 결정적인 영향을 미치지 않는다는 것을 발견했습니다 [12]. 게다가, Zhu 등은 "저단백 식단은 제1형 또는 제2형 당뇨병성 신병증 환자의 신장 기능 개선과 유의미한 관련이 없다"고 말했습니다 [15]. 식이 단백질 섭취와 관련된 우려는 일반적으로 운동 훈련을 받은 개인에게 적용되지 않는 조건과 관련이 있다는 점에 유의하는 것이 중요합니다. 사실, 고단백 식단이 건강하고 운동에 능숙한 개인에게 해를 끼친다는 증거 기반 연구는 부족합니다. 단백질 보충제를 둘러싼 일반적인 질문과 오해의 발전은 이러한 식이 요법에 대한 광범위한 관심과 채택에서 비롯됩니다. 단백질 보충제가 인기를 얻으면서 개인들은 자연스럽게 자신의 사용법을 안내할 정보를 찾기 시작했습니다. 또한, 영양 및 피트니스의 새로운 트렌드와 마찬가지로 잘못된 정보, 상충되는 조언, 일화적 경험으로 인해 오해가 발생할 수밖에 없습니다. 따라서 이러한 질문과 오해를 해결하는 것은 정확한 정보를 제공하고 개인이 단백질 보충제를 식단에 포함시키는 것에 대한 정보에 입각한 결정을 내릴 수 있도록 하는 데 필수적입니다.

 

 

 

2. Is protein harmful to your kidneys?

Perhaps one of the most common misconceptions regarding dietary protein is the purported harm caused to kidney function [16]. It is known that dietary protein intake can modulate renal function [17]. The origin of this misconception stems back to reports which indicated that consuming protein in increased amounts would promote the development of renal disease due to increased glomerular pressure and hyperfiltration [18,19]. It should be noted that issues regarding the potential harm of protein are typically associated with a clinical population. Nonetheless, this does not apply to healthy, exer- cised-trained individuals. In relation to chronic kidney disease (CKD), Kamper et al. stated that “Daily red meat consumption over years may increase CKD risk, whereas white meat and dairy proteins appear to have no such effect, and fruit and vegetable proteins may be renal protective [20].” Thus, in this clinical population, a specific type of protein (i.e. red meat) may be detrimental. Conversely, dairy and white meat protein may be renal protective [20].

 

 

2. 단백질이 신장에 해롭습니까?
식이 단백질에 관한 가장 일반적인 오해 중 하나는 신장 기능에 대한 해악으로 알려져 있습니다 [16]. 식이 단백질 섭취가 신장 기능을 조절할 수 있는 것으로 알려져 있습니다 [17]. 이러한 오해의 원인은 단백질을 다량 섭취하면 사구체 압력 증가와 과여과로 인해 신장 질환의 발병을 촉진할 수 있다는 보고에서 비롯됩니다 [18,19]. 단백질의 잠재적 해악과 관련된 문제는 일반적으로 임상 인구와 관련이 있다는 점에 유의해야 합니다. 그럼에도 불구하고, 이는 건강하고 이전에 병에 걸린 사람들에게는 해당되지 않습니다. 만성 신장 질환(CKD)과 관련하여 Kamper 등은 "수년에 걸쳐 매일 붉은 고기를 섭취하면 만성 신장 질환(CKD) 위험이 증가할 수 있는 반면, 흰 고기와 유제품 단백질은 그러한 영향이 없는 것으로 보이며 과일 및 채소 단백질은 신장 보호 단백질일 수 있습니다 [20]."라고 말했습니다. 따라서 이 임상 인구에서는 특정 유형의 단백질(즉, 붉은 고기)이 해로울 수 있습니다. 반대로 유제품 및 흰 고기 단백질은 신장 보호 단백질일 수 있습니다 [20].

 

 

Athletes or exercising populations commonly consume increased amounts of dietary protein, and there is no evidence that this population is at increased risk of renal disease [21,22]. For example, Poortsman and Dellalieux [23] reported that protein intakes in the range of 1.4–1.9 g/kg/day did not impair renal function in a group of athletes consuming increased amounts of dietary protein, while similar outcomes could be concluded from the results of longitudinal studies that have examined the impact of protein supplemen- tation on strength and body composition changes [24–26].

 

 

운동선수나 운동 인구는 일반적으로 식이 단백질 섭취량이 증가하며, 이 인구가 신장 질환의 위험이 높아진다는 증거는 없습니다[21,22]. 예를 들어, Portsman과 Dellalieux[23]는 하루에 1.4–1.9 g/kg 범위의 단백질 섭취가 식이 단백질 섭취량이 증가한 운동선수 그룹에서 신장 기능을 손상시키지 않는다고 보고했으며, 단백질 보충제가 근력과 체성분 변화에 미치는 영향을 조사한 종단 연구 결과에서도 유사한 결과를 도출할 수 있었습니다[24–26].

 

 

 

 

Original research studies have been completed that administered daily intakes of dietary protein greater than the current recommended dietary allowance (RDA) while examining changes in health, glycemic control, body composition, and fat loss [27–34]. Antonio and colleagues [27–30] conducted a series of studies to examine the effect of increased protein intake on health and body composition changes in exercise-trained men and women. Data from these investigations suggest that protein intakes ranging from 3.2–4.4 g/kg/day (4–5.5× greater than the current RDA of 0.8 g/kg/day) are well tolerated with no significant changes in clinical safety markers. For example, one year of a high protein diet (~2.5–3.3 g/kg daily) in resistance-trained males had no effect on blood lipids (i.e. total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides) [29].

 

 

건강, 혈당 조절, 체성분 및 지방 손실의 변화를 조사하면서 현재 권장 식이 허용량(RDA)을 초과하는 식이 단백질을 매일 투여한 기존 연구가 완료되었습니다 [27–34]. 안토니오와 동료들 [27–30]은 운동 훈련을 받은 남성과 여성의 단백질 섭취 증가가 건강 및 체성분 변화에 미치는 영향을 조사하기 위해 일련의 연구를 수행했습니다. 이러한 조사 데이터에 따르면 단백질 섭취량은 3.2–4.4 g/kg/일 (현재 RDA인 0.8 g/kg/일보다 4–5.5배 많은) 범위에서 임상 안전성 지표에 큰 변화 없이 잘 견딜 수 있는 것으로 나타났습니다. 예를 들어, 저항 훈련을 받은 남성의 고단백 식단 1년(하루 약 2.5–3.3 g/kg)은 혈중 지질(즉, 총 콜레스테롤, 고밀도 지단백 콜레스테롤, 저밀도 지단백 콜레스테롤, 중성지방)에 영향을 미치지 않았습니다 [29].

 

 

 

Furthermore, there was no effect on markers of kidney function (i.e. blood urea nitrogen [BUN], creatinine, estimated glomerular filtration rate [eGFR], and the BUN/ creatinine ratio) [29]. In a series of case reports in male bodybuilders, protein intakes ranging from 2.6 to 5.8 g/kg daily over a period of two years had no effect on clinical markers of kidney (BUN, creatinine, and eGFR) and liver function (i.e. aspartate transami- nase and alanine transaminase) [35].

 

 

또한 신장 기능 마커(예: 혈중 요소 질소[BUN], 크레아티닌, 추정 사구체 여과율[eGFR] 및 BUN/크레아티닌 비율)에는 영향을 미치지 않았습니다[29]. 남성 보디빌더를 대상으로 한 일련의 사례 보고에서 2년 동안 매일 2.6~5.8g/kg의 단백질 섭취량은 신장(BUN, 크레아티닌, eGFR) 및 간 기능(예: 아스파르트 트랜스아미나제 및 알라닌 트랜스아미나제)의 임상 마커에는 영향을 미치지 않았습니다[35].

 

 

 

Another perspective to consider is the popularity of prescribing diets with increased amounts of dietary protein as an effective way to stimulate fat loss and improve one’s body composition in populations generally recognized as being at an increased risk for kidney disease (e.g. dyslipidemia, obesity, hypertension). Consistently, these studies provide evidence supporting the utility of higher protein diets to promote fat loss, improve body composition, and improve health markers without demonstrating any evidence of damage to the renal system. For example, original investigations by Josse

[36], Kerksick [31,32], Kreider [33,34], Layman [37–39], Longland [40], Noakes [41], Skov [42] and others have consistently highlighted the favorable impact of increased dietary protein on improving the quality of weight loss and improving various biomarkers reflective of improved glycemic control, cholesterol, and risk for cardiovascular disease. Taken further, Parker et al. [43] and Boden et al. 

 

고려해야 할 또 다른 관점은 일반적으로 신장 질환(예: 이상지질혈증, 비만, 고혈압)의 위험이 증가하는 것으로 인식되는 인구 집단에서 지방 손실을 촉진하고 체성분을 개선하는 효과적인 방법으로 식이 단백질을 증가시킨 식단을 처방하는 것이 인기가 있다는 점입니다. 일관되게, 이러한 연구들은 신장 시스템 손상의 증거를 입증하지 않고도 고단백 식단이 지방 손실을 촉진하고 체성분을 개선하며 건강 지표를 개선하는 데 유용하다는 증거를 제공합니다. 예를 들어, Josse의 원래 연구들은
[36], Kerksick [31,32], Kreider [33,34], Layman [37–39], Longland [40], Noakes [41], Skov [42] 등은 식이 단백질 증가가 체중 감량의 질을 개선하고 혈당 조절, 콜레스테롤 및 심혈관 질환 위험을 개선하는 다양한 바이오마커를 개선하는 데 긍정적인 영향을 미친다는 점을 지속적으로 강조해 왔습니다. 또한 Parker et al. [43]과 Boden et al.

 

examined the impact of a higher protein diet on health and weight loss outcomes in patients diagnosed with type 2 diabetes, a population known to have varying degrees of compromised renal function. Results from the Parker study [43] reported that increased dietary protein caused greater fat loss in women and greater reductions in low-density lipoprotein cholesterol while failing to instigate any negative health outcomes in this population. In contrast, Boden et al. [44] reported positive improvements in lipid parameters, insulin sensitivity, and hemoglobin A1c. Finally, Moller and colleagues [45] analyzed data from 310 pre-diabetic older (~55 yrs.) adults. They concluded that a higher protein intake was not associated with any changes in creatinine clearance, glomerular filtration rate, or serum creatine. There was no evidence of impaired kidney function after one year of following a diet with a higher protein intake.

 

 

제2형 당뇨병 진단을 받은 환자들에서 고단백 식단이 건강과 체중 감량 결과에 미치는 영향을 조사했습니다. 이는 신장 기능 저하 정도가 다양한 것으로 알려져 있습니다. Parker 연구 결과 [43]는 식이 단백질 증가가 여성의 지방 손실을 더 크게 일으키고 저밀도 지단백 콜레스테롤을 더 많이 감소시키는 반면, 이 집단에서는 부정적인 건강 결과를 유발하지 못했다고 보고했습니다. 반면, Boden 등 [44]은 지질 매개변수, 인슐린 민감도 및 헤모글로빈 A1c에서 긍정적인 개선을 보고했습니다. 마지막으로 Moller와 동료들 [45]은 310명의 당뇨병 전 연령대(~55세) 성인의 데이터를 분석했습니다. 그들은 단백질 섭취가 많을수록 크레아티닌 제거율, 사구체 여과율 또는 혈청 크레아틴의 변화와 관련이 없다는 결론을 내렸습니다. 단백질 섭취가 많은 식단을 1년간 복용한 후에도 신장 기능이 저하되었다는 증거는 없었습니다.

 

 

The final perspective to consider is the Institute of Medicine [46] and the World Health Organization [47] reports on protein intake, stating there is no evidence linking a higher protein diet to renal disease. Furthermore, a panel charged with establishing reference intakes for Australia and New Zealand [48] stated that no published evidence was available to suggest a diet containing up to 2.8 g/kg/day produces adverse outcomes regarding renal health in athletes and that no known association is available to link elevated protein intake with progressive deterioration of renal function [17].

 

마지막으로 고려해야 할 관점은 의학연구소(46)와 세계보건기구(47)가 단백질 섭취에 대해 보고하는 것으로, 단백질 섭취가 높은 식단과 신장 질환을 연관짓는 증거는 없다고 말합니다. 또한, 호주와 뉴질랜드의 기준 섭취량을 설정한 패널(48)은 하루에 최대 2.8g/kg을 함유한 식단이 운동선수의 신장 건강에 부정적인 결과를 초래한다는 발표된 증거가 없으며, 단백질 섭취 증가와 신장 기능의 점진적인 악화를 연관짓는 알려진 연관성도 없다고 밝혔습니다(17).

 

 

In summary, individuals engaged in exercise training and who are otherwise healthy can consume protein up to 4 or 5 times the RDA without experiencing adverse effects

 

 

요약하자면, 운동 훈련에 참여하고 건강한 사람들은 부작용 없이 RDA의 최대 4배 또는 5배까지 단백질을 섭취할 수 있습니다

 

 

 

3. Does consuming “excess” protein increase body fat mass?

Several studies have examined the relationship between high-protein intake and gains in fat mass [49–52]. It is important to note the various definitions for a “high-protein” intake. Operational definitions include protein intakes ranging from 1.0–1.8 g/kg/day, which is greater than the RDA of 0.8 g/kg/day but on the low end of recommendations for active individuals [21,22]. Bray et al. [52] reported the effects of overconsumption of low (5% energy intake), normal (15% energy intake), or high (25% energy intake) protein intakes in healthy but otherwise untrained individuals (16 males and 9 females, 18–35 yrs.). Body mass increased in all groups, and the medium and high-protein intake groups gained more mass compared to the low group; however, all groups experienced similar increases in body fat. However, the normal and high-protein groups gained lean body mass, whereas the low-protein group experienced decreased lean mass. The authors concluded that “calories alone contributed to increased body fat. In contrast, protein contributed to the changes in energy expenditure and lean body mass, but not to the increase in body fat [52].”

 

 

3. "과도한" 단백질 섭취가 체지방량을 증가시키나요?
여러 연구에서 고단백 섭취와 지방량 증가 사이의 관계를 조사했습니다 [49–52]. "고단백" 섭취에 대한 다양한 정의를 주목하는 것이 중요합니다. 운영 정의에는 1.0–1.8 g/kg/일의 단백질 섭취량이 포함되며, 이는 RDA인 하루 0.8 g/kg/일보다 크지만 활동적인 개인에 대한 권장량이 낮은 경우 [21,22]에 해당합니다. Bray 등 [52]은 건강하지만 훈련되지 않은 개인(남성 16명, 여성 9명, 18–35세)에서 저에너지 섭취(에너지 섭취량 5%), 정상에너지 섭취(에너지 섭취량 15%), 고에너지 섭취(에너지 섭취량 25%)의 과소비 효과를 보고했습니다. 모든 그룹에서 체질량이 증가했으며, 중단백질 섭취 그룹과 고단백질 섭취 그룹은 저지방 그룹에 비해 더 많은 체질량이 증가했지만 모든 그룹에서 비슷한 체지방 증가를 경험했습니다. 그러나 정상 단백질 그룹과 고단백질 그룹은 제지방량이 증가한 반면 저단백질 그룹은 제지방량이 감소했습니다. 저자들은 "칼로리만으로도 체지방 증가에 기여했다"고 결론지었습니다. 반면 단백질은 에너지 소비와 제지방량 증가에는 기여했지만 체지방 증가에는 기여하지 않았다 [52]

 

 

 

Recent studies have found higher protein intakes promote favorable changes in body composition [29,39,40,52–59]. Under hypocaloric conditions, higher protein intakes attenuate the loss of lean body mass and increase the loss of fat mass

[39,40,53,54,56,58–60]. This is well documented in healthy weight, active individuals, and overweight/obese individuals. Higher protein intakes (>1 g/kg) correlated with a decreased consumption of refined grains and sugary foods [53]. 

 

최근 연구에 따르면 단백질 섭취량이 많을수록 체성분의 유리한 변화가 촉진되는 것으로 나타났습니다 [29,39,40,52-59]. 저칼로리 조건에서는 단백질 섭취량이 많을수록 제지방량 감소가 완화되고 지방량 감소가 증가합니다
[39,40,53,54,56,58–60]. 이는 건강한 체중, 활동적인 개인, 과체중/비만 개인에서 잘 문서화되어 있습니다. 단백질 섭취량(>1g/kg)이 높을수록 정제된 곡물과 설탕 식품의 섭취가 감소하는 것과 상관관계가 있었습니다[53].

 

Similar body composition changes are reported during hypercaloric conditions despite an increase in body mass. Antonio et al. conducted several studies that assessed the effects of a high-protein diet on body composition in exercised-trained individuals [30,61–65]. In one of the studies [30], subjects in the high-protein group consumed 4.4g/kg/protein, resulting in a significant increase in total energy intake. Body composition and body mass did not change in either the high-protein or control group [30]. A follow-up study compared two different dietary protein intakes (i.e. 2.3 vs. 3.4 g/kg/d) in resistance-trained males and females who underwent a traditional bodybuilding training program [64]. Both groups experienced a similar increase in lean body mass; 

 

고칼로리 조건에서도 체질량 증가에도 불구하고 유사한 체성분 변화가 보고되었습니다. 안토니오 등은 운동 훈련을 받은 사람들을 대상으로 고단백 식단이 체성분에 미치는 영향을 평가한 여러 연구를 수행했습니다[30,61–65]. 한 연구 [30]에서 고단백 그룹의 피험자들은 4.4g/kg/단백질을 섭취하여 총 에너지 섭취량이 크게 증가했습니다. 고단백 그룹이나 대조군 모두 체성분과 체질량은 변하지 않았습니다[30]. 후속 연구에서는 저항성 훈련을 받은 남성과 여성의 두 가지 다른 식이 단백질 섭취량(즉, 2.3g/kg/d 대 3.4g/d)을 비교했습니다[64]. 두 그룹 모두 제지방량이 비슷한 수준으로 증가했습니다;

 

 

however, the higher-protein group (3.4g/kg/d) experienced a greater reduction in fat mass. Furthermore, in an 8-week crossover study in resistance-trained males [28], a high-protein group consumed significantly more protein (3.3 ± 0.8 g/kg/day) and calories than the control group (2.6 ± 1.0 g/kg/day), yet there was no change in fat mass. These studies dispute the notion that excess energy from protein alone promotes gains in fat mass; however, diets high in fats and/or carbohydrates and low in protein tend to promote greater increases in fat mass as well as body mass [66–70].

 

 

 

그러나 고단백 그룹(3.4g/kg/d)은 지방량이 더 크게 감소했습니다. 또한 내성이 훈련된 남성을 대상으로 한 8주 교차 연구(28명)에서 고단백 그룹은 대조군(2.6 ± 1.0g/kg/day)보다 단백질과 칼로리를 훨씬 더 많이 섭취했지만 지방량에는 변화가 없었습니다. 이러한 연구는 단백질의 과도한 에너지만으로도 지방량 증가를 촉진한다는 개념에 이의를 제기하지만, 지방 및/또는 탄수화물이 많고 단백질이 적은 식단은 지방량뿐만 아니라 체질량 증가를 촉진하는 경향이 있습니다(66-70).

 

 

In summary, a high-protein intake does not necessarily increase body fat mass in exercise- trained individuals. In fact, very high-protein diets in exercise-trained males and females will likely have a neutral effect on body composition unless training is altered. Increases in fat mass are more likely the result of excess energy intake from carbohydrates and fats.

 

요약하자면, 고단백 섭취가 운동 훈련을 받은 사람의 체지방량을 반드시 증가시키는 것은 아닙니다. 실제로 운동 훈련을 받은 남성과 여성의 고단백 식단은 훈련을 변경하지 않는 한 체성분에 중립적인 영향을 미칠 가능성이 높습니다. 체지방량 증가는 탄수화물과 지방에서 과도한 에너지 섭취로 인한 결과일 가능성이 높습니다.

 

 

 

4. Can dietary protein have a deleterious effect on bone health?

Protein is involved in numerous metabolic and physiological processes critical to main- taining overall health and performance [2]. As such, athletes are often recommended to ingest a higher protein intake much greater than the general population (e.g. 1.6 g/kg/day vs. 0.8 g/kg/day [2,71]. In contrast to these recommendations, there is a common mis- conception that higher protein intakes adversely affect bone health [72,73]. This miscon- ception is associated with the acid-ash hypothesis [74]. According to this hypothesis, a dietary pattern abundant in protein and grain foods, combined with low potassium intake, generates an acidic dietary load. Consequently, this triggers heightened net acid excretion (NAE), increased calcium levels in urine, and the release of calcium from the skeleton, potentially playing a role in the onset of osteoporosis [74,75]. Subsequently, an individual ingesting a high-protein diet (especially animal-based) would theoretically have an elevated risk of bone loss over a lifetime. However, there are several limitations to this purported hypothesis. First, the assumption that urinary excretion of calcium comes exclusively from bone is questionable; furthermore, there is evidence that a high- protein [76] diet increases calcium absorbed from foods (which may counter the loss) [77]. Secondly, it is important to consider the diet as a whole; as such, the acidity of the diet may be due to a reduction in other foods, such as fruits and vegetables, which are important for bone health [78].

 

 

 

4. 식이 단백질이 뼈 건강에 해로운 영향을 미칠 수 있습니까?
단백질은 전반적인 건강과 경기력을 유지하는 데 중요한 수많은 대사 및 생리적 과정에 관여합니다 [2]. 따라서 운동선수들은 일반 인구보다 훨씬 더 많은 단백질 섭취량을 섭취하는 것이 권장됩니다 (예: 1.6 g/kg/일 대 0.8 g/kg/일 [2,71]). 이러한 권장 사항과는 대조적으로, 높은 단백질 섭취량이 뼈 건강에 부정적인 영향을 미친다는 일반적인 오해가 있습니다 [72,73]. 이러한 오해는 산회 가설 [74]과 관련이 있습니다. 이 가설에 따르면 단백질과 곡물 식품에 풍부한 식단 패턴과 낮은 칼륨 섭취량이 결합되어 산성 식이 부하를 발생시킵니다. 따라서 이는 순산 배설(NAE) 증가, 소변의 칼슘 수치 증가, 골격에서 칼슘 방출을 유발하여 골다공증 발병에 영향을 미칠 수 있습니다 [74,75]. 따라서 고단백 식단(특히 동물성 식단)을 섭취하는 개인은 이론적으로 평생 동안 뼈 손실의 위험이 높아질 수 있습니다. 그러나 이 가설에는 몇 가지 한계가 있습니다. 첫째, 칼슘의 소변 배설이 뼈에서만 발생한다는 가정은 의문이며; 더 나아가 고단백 식단이 음식에서 흡수된 칼슘을 증가시킨다는 증거가 있습니다 (손실을 상쇄할 수 있습니다) [77]. 둘째, 식단 전체를 고려하는 것이 중요하며, 따라서 식단의 산도는 뼈 건강에 중요한 과일과 채소와 같은 다른 음식의 감소로 인한 것일 수 있습니다 [78].

 

 

In contrast, there is evidence that a high-protein diet is beneficial for bone health. [76,79] First, it is important to note that bone tissue comprises protein (50% by weight and 33% by mass) [80]; therefore, an adequate amount of protein is critical for bone health. Furthermore, protein stimulates insulin-like growth factor-1, which is important for bone formation [76,80]. In addition, protein is important in stimulating muscle mass and strength adaptations [2]. Having more muscle and strength will place a greater force or stress on bone tissue and may augment bone adaptations over time [81].

 

 

반면에 고단백 식단이 뼈 건강에 유익하다는 증거가 있습니다. [76,79] 먼저, 뼈 조직은 단백질(중량 50%, 질량 33%)로 구성되어 있으므로 충분한 양의 단백질은 뼈 건강에 매우 중요합니다 [80]. 또한 단백질은 인슐린과 유사한 성장 인자-1을 자극하여 뼈 형성에 중요합니다 [76,80]. 또한 단백질은 근육량과 근력 적응을 자극하는 데 중요합니다 [2]. 근육과 근력이 증가하면 뼈 조직에 더 큰 힘이나 스트레스를 주고 시간이 지남에 따라 뼈 적응을 강화할 수 있습니다 [81].

 

 

Beyond mechanistic data, there is evidence from high-quality studies and meta- analyzes that protein does not have detrimental effects on bone health. [79,82,83] Antonio et al. [83] examined the effects of a large amount of protein (>2.2 g/kg/day) for six to 12 months in exercising females [83,84]. They found no detrimental effects from protein on whole body or lumbar bone mineral density compared to controls (ingesting ~1.5 g/kg/day) [83,84]. A recent meta-analysis examining milk-derived protein derivatives further noted that protein from dairy (or animal) origin does not support the myth that they are detrimental to bone health [82]. A consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation [79] noted that variations in protein intakes within normal ranges account for 2–4% of bone mineral variation in adults. They also concluded that higher protein intakes above the RDA (0.8 g/ kg/day) are associated with higher bone mineral density, a slower rate of bone loss, and reduced hip fractures (provided there was adequate calcium intake) in older adults.

 

 

기계적 데이터 외에도 단백질이 뼈 건강에 해로운 영향을 미치지 않는다는 고품질 연구와 메타 분석의 증거가 있습니다. [79,82,83] Antonio 등 [83]은 운동하는 여성을 대상으로 6~12개월 동안 다량의 단백질(>2.2g/kg/일)의 영향을 조사했습니다 [83,84]. 그들은 대조군(약 1.5g/kg/일 섭취)과 비교했을 때 단백질이 전신 또는 요추 골밀도에 미치는 해로운 영향을 발견하지 못했습니다 [83,84]. 우유 유래 단백질 유도체를 조사한 최근 메타 분석에서는 유제품(또는 동물) 유래 단백질이 뼈 건강에 해롭다는 신화를 뒷받침하지 않는다고 언급했습니다[82]. 유럽 골다공증, 골관절염, 근골격계 질환 임상 및 경제적 측면 협회와 국제 골다공증 재단(79)이 지지한 합의 논문에 따르면 정상 범위 내에서 단백질 섭취의 변화가 성인의 뼈 미네랄 변화의 2~4%를 차지한다고 합니다. 또한 RDA(0.8g/kg/일)를 초과하는 단백질 섭취량이 많을수록 노인의 뼈 미네랄 밀도가 높아지고 뼈 손실 속도가 느리며 고관절 골절(충분한 칼슘 섭취가 있는 경우)이 감소하는 것과 관련이 있다는 결론을 내렸습니다.

 

In summary, there is no evidence that a high-protein diet is deleterious to bone health and may be beneficial.

 

요약하자면, 고단백 식단이 뼈 건강에 해롭고 유익할 수 있다는 증거는 없습니다.

 

 

 

5. Can vegans and vegetarians consume enough protein to support training adaptations?

The misconception that vegetarians (VE) and vegans (VG) cannot consume enough protein to induce favorable training adaptations (i.e. muscle growth, increased strength, reductions in body fat) is rooted in the fact that animal protein sources are recognized as higher quality proteins with a greater concentration of essential amino acids (EAA) [85– 91]. Seminal work by Boirie et al. [92] demonstrated that MPS is affected differently depending on the speed of digestion and absorption, as well as the EAA content of the protein source (i.e. whey or casein). In this regard, animal proteins contain a greater amount of EAA (up to ≈ 42% more than plant-based sources), are quickly absorbed, and increase plasma EAA concentrations to serve as a potent stimulator of MPSs. Comparatively, plant-based proteins (i.e. soy, tofu, legumes) are absorbed at slower rates due to their incomplete amino acid profile and lower EAA content [93,94] and thereby do not stimulate MPS to the same magnitude as whey protein [95,96].

 

5. 비건과 채식주의자가 훈련 적응을 지원하기에 충분한 단백질을 섭취할 수 있습니까?
채식주의자(VE)와 비건(VG)이 충분한 단백질을 섭취하여 유리한 훈련 적응(즉, 근육 성장, 근력 증가, 체지방 감소)을 유도할 수 없다는 오해는 동물성 단백질 공급원이 필수 아미노산(EAA) 농도가 높은 고품질 단백질로 인식된다는 사실에 뿌리를 두고 있습니다[85–91]. Boirie 등 [92]의 중요한 연구는 MPS가 소화 및 흡수 속도와 단백질 공급원의 EAA 함량(즉, 유청 또는 카제인)에 따라 다르게 영향을 받는다는 것을 입증했습니다. 이와 관련하여 동물성 단백질은 식물성 공급원보다 최대 ≈ 42% 더 많은 양의 EAA를 포함하고 있으며, 빠르게 흡수되어 혈장 EAA 농도를 증가시켜 MPS의 강력한 자극제 역할을 합니다. 반면, 식물성 단백질(즉, 콩류)은 불완전한 아미노산 프로필과 낮은 EAA 함량[93,94]으로 인해 느린 속도로 흡수되어 유청 단백질[95,96]과 같은 크기로 MPS를 자극하지 않습니다.

 

 

 

For example, Tang and colleagues [95] demonstrated that whey protein produced an 18% (p < 0.067) and 31% (p < 0.05) greater MPS response than soy protein at rest and post- exercise, respectively. In addition, Yang et al. [97] demonstrated that 20 g and 40 g doses of whey protein effectively stimulated MPS at rest and post-exercise, while the 40 g dose of soy protein post-exercise produced an increase in MPS that was marginally lower (i.e. ≈0.08%/h vs. ≈0.06%/h for whey and soy, respectively). While whey protein triggers the most robust MPS response [92,98–105], emerging evidence suggests that plant-based proteins can elevate MPS above rest levels [94,106–109].

 

예를 들어, Tang과 동료들[95]은 유청 단백질이 휴식 시와 운동 후에 각각 18%(p < 0.067)와 31%(p < 0.05) 더 큰 MPS 반응을 일으킨다는 것을 입증했습니다. 또한, Yang 등[97]은 20g과 40g의 유청 단백질이 운동 후와 운동 후에 MPS를 효과적으로 자극하는 반면, 운동 후 40g의 유청 단백질은 MPS를 약간 낮게 증가시킨다는 것을 입증했습니다 (즉, 유청과 콩의 경우 각각 ≈ 0.08%/h 대 ≈ 0.06%/h). 유청 단백질이 가장 강력한 MPS 반응을 유발하는 반면[92,98–105], 식물성 단백질이 휴식 수준 이상으로 MPS를 높일 수 있다는 새로운 증거가 제시되었습니다[94,106–109].

 

 

Active individuals and athletes need to consume 1.4–2.0 g/kg/d of protein to maintain positive nitrogen balance and consume protein servings containing at least 6.0 g of EAA [110,111] and 2.0 g of leucine [2,112,113] to optimize MPS to promote favorable changes in muscle mass and strength during training [2]. Importantly, VE and VG may need to increase the amount of plant-based protein consumed to ensure they are obtaining adequate amounts of EAA (especially leucine) that are comparable to animal protein products [88,94,97,114]. One may have to consume up to 53% or 75% more plant-based protein than animal protein to obtain 2.0 g of leucine or 6.0 g of EAA, respectively, depending on the amino acid profiles of the protein source. Consequently, it is important for VE and VG to ensure their protein source(s) contain a sufficient amount of EAA and leucine in a highly digestible format. In addition, VE and VG athletes have been reported to consume less energy and protein compared to their omnivore counterparts [115] and are more susceptible to energy deficits, protein malnutrition, and overtraining [116]. Therefore, emphasis should be placed on VE and VG athletes consuming adequate calories and protein, especially during intense training periods, to maintain a positive protein balance and enhance training adaptation [117].

 

활동적인 개인과 운동선수는 양성 질소 균형을 유지하기 위해 1.4–2.0 g/kg/d의 단백질을 섭취해야 하며, 훈련 중 근육량과 근력의 유리한 변화를 촉진하기 위해 최소 6.0 g의 EAA(110,111)와 2.0 g의 류신(2,112,113)을 함유한 단백질을 섭취해야 합니다 [2]. 중요한 것은 VE와 VG가 동물성 단백질 제품 [88,94,97,114]과 비슷한 양의 EAA(특히 류신)를 섭취하기 위해 식물성 단백질의 섭취량을 늘려야 할 수 있다는 점입니다. 단백질 공급원의 아미노산 프로필에 따라 동물성 단백질보다 최대 53% 또는 75% 더 많은 식물성 단백질을 섭취해야 할 수도 있습니다. 따라서 VE와 VG는 단백질 공급원이 소화 가능한 형태로 충분한 양의 EAA와 류신을 함유하고 있는지 확인하는 것이 중요합니다. 또한 VE와 VG 운동선수는 잡식성 운동선수에 비해 에너지와 단백질을 덜 소비하며 에너지 결핍, 단백질 영양실조 및 과도한 훈련에 더 취약한 것으로 보고되었습니다 [116]. 따라서 VE와 VG 운동선수는 특히 강도 높은 훈련 기간 동안 양성 단백질 균형을 유지하고 훈련 적응을 향상시키기 위해 적절한 칼로리와 단백질을 섭취하는 데 중점을 두어야 합니다 [117].

 

Evidence indicates that plant-based diets, with supplemental plant protein sources, can increase MPS and augment exercise training adaptions [98,118–128]. With the excep- tion of Volek et al. [99], it appears that plant protein sources can favorably impact body composition and exercise training adaptions when 1) the total daily intake of protein equates to ≈ 1.4–2.0 g/kg/d, 2) the plant protein source delivers ≥ 8–10 g/d of EAA, and 3) the plant protein source delivers ≈2.0 g of leucine [98,100,118–122,124–129]. For exam- ple, Hevia-Larrain et al. [128] reported that physically active habitual VG consuming 1.6 g/ kg/d from whole foods and supplemental soy (containing sufficient EAA and leucine) for 12 weeks experienced similar body composition and resistance training adaptions com- pared to a habitual, protein-matched omnivore diet. Both the habitual VG and omnivore groups experienced similar increases in whole-body lean mass (4.4% and 6.2%, respec- tively), muscle fiber cross-sectional area (data not reported), and one repetition maximum (1-RM) leg press (98% and 102%, respectively). These findings suggest that consuming an exclusively plant-based diet may adequately aid training outcomes when optimal protein ingestion is achieved. Similarly, Candow et al. [120] assessed 27 untrained males and females ingesting either soy or whey protein (three equal doses to meet 1.2 g/kg/d total daily protein) or a placebo for six weeks while following a whole-body resistance training program (4 days/week, 6–12 repetitions at 60–90% 1RM on 6–9 different exercises).

 

증거에 따르면 식물성 단백질 공급원을 보충하는 식물성 식단은 MPS를 증가시키고 운동 훈련 적응을 증가시킬 수 있습니다 [98,118–128]. Volek 등 [99]의 예외를 제외하면, 식물성 단백질 공급원은 1) 단백질의 일일 총 섭취량이 ≈ 1.4–2.0 g/kg/d, 2) 식물성 단백질 공급원은 ≥ 8–10 g/d의 EAA를, 3) 식물성 단백질 공급원은 ≈ 2.0 g의 류신을 공급합니다 [98,100,118–122,124–129]. 예를 들어, Hevia-Larrain 등 [128]은 12주 동안 전체 음식과 보충 콩(충분한 EAA와 류신을 함유한)을 섭취하는 신체적으로 활동적인 습관적인 VG가 습관적이고 단백질이 일치하는 잡식성 식단과 비교하여 유사한 체성분 및 저항 훈련 적응을 경험했다고 보고했습니다. 습관적인 VG 그룹과 잡식성 그룹 모두 전신 제지방량(각각 4.4% 및 6.2%,), 근육 섬유 단면적(보고되지 않은 데이터), 한 번의 최대 반복(1-RM) 다리 압박(각각 98% 및 102%)에서 유사한 증가를 경험했습니다. 이러한 발견은 식물성 식단만을 섭취하는 것이 최적의 단백질 섭취가 달성될 때 훈련 결과에 충분히 도움이 될 수 있음을 시사합니다. 유사하게, Candow 등 [120]은 6주 동안 훈련되지 않은 27명의 남녀가 콩이나 유청 단백질(하루 총 단백질 1.2 g/kg/d를 충족하기 위해 3회 동일한 용량) 또는 위약을 섭취하는 것을 평가했으며, 전신 저항 훈련 프로그램을 진행했습니다(4일/주, 6-9개의 다른 운동에서 60–90% 1RM으로 6-12회 반복).

 

 

Both the soy and whey groups experienced similar increases in lean mass (3.1% and 4.7%, respectively) and 1-RM bench press (13.4% and 14%, respectively) and hack squat strength (34% and 38.6%, respectively) compared to placebo (lean mass: 0.5%; 1-RM bench press: 7.1%; 1-RM hack squat: 19.7%). These findings indicate that resistance training adaptations can be conferred independent of the protein source. Moon et al. [124] also reported that 24 healthy, resistance-trained males consuming 24 g of either rice or a whey protein supplement while following a resistance training program (4 days/ week, split body, 3–4 sets of 6–10 repetitions) experienced similar increases in body mass (0.6% vs. 1.4%), lean mass (0.9% vs. 0.7%), and 1-RM bench press strength (3.6% vs. 2.2%) and leg press (6.9% vs. 8.2%) for the rice and whey groups, respectively. Notably, the assessed dose of rice and whey protein delivered ≈10 g of EAA and ≈2.0 g of leucine. 

 

대두 그룹과 유청 그룹 모두 위약(유청 질량: 0.5%, 1-RM 벤치 프레스: 7.1%, 4.7%)과 핵 스쿼트 강도(각각 13.4%, 14%)가 유사하게 증가했습니다(유청 질량: 0.5%, 1-RM 벤치 프레스: 7.1%, 1-RM 핵 스쿼트: 19.7%). 이러한 결과는 단백질 공급원과 무관하게 저항 훈련 적응을 부여할 수 있음을 나타냅니다. Moon 등 [124]은 또한 저항 훈련 프로그램(주 4일, 분할체, 6~10회 반복 3~4세트)을 수행하는 동안 24명의 건강하고 저항 훈련을 받은 남성이 체질량(0.6% vs. 1.4%), 희박 질량(0.9% vs. 0.7%), 1-RM 벤치 프레스 강도(3.6% vs. 2.2%)와 다리 프레스(6.9% vs. 8.2%)에서 비슷한 증가를 경험했다고 보고했습니다. 특히 쌀과 유청 단백질의 평가 용량은 각각 ≈ 10g의 EAA와 ≈ 2.0g의 류신을 제공했습니다.

 

This further supports the notion that with careful nutritional planning, plant-based protein sources can trigger favorable training outcomes. Furthermore, Lynch and Collogues [127] demonstrated that untrained males and females supplementing immediately post- training with either soy (19 g) and whey (24 g) protein isolates that were leucine- matched (i.e. ≈2.0 g) experienced similar increases in lean mass (2.5% vs. 3.4%) and isokinetic dynamometer torque for knee flexion (25.3% vs. 33.7%) and knee extension (21.5% vs. 32.3%), as well as similar reductions in body fat percentage (−3.6% vs. −5.4%) for the soy and whey groups, respectively. Last, Banaszek et al. [100] reported 15 trained males supplementing with two 24 g doses of either pea or whey protein pre- and post- high-intensity functional training sessions (i.e. 4×/week of CrossFit at 60–100% 1-RM plus metabolic conditioning) for eight weeks experienced similar increases in 1-RM strength for the squat (6.2% vs. 3.7%, respectively) and deadlift (3.9% vs. 5.2%, respectively). Conversely, Volek et al. [99] reported that less favorable training adaptations (i.e. 1-RM strength and lean mass) would occur when careful planning is not taken to ensure the necessary amounts of EAA and leucine content are delivered per the plant-based source.

 

이는 신중한 영양 계획을 통해 식물성 단백질 공급원이 유리한 훈련 결과를 유발할 수 있다는 개념을 더욱 뒷받침합니다. 또한, 린치와 콜로그스(127)는 훈련 후 즉시 류신과 일치하는 콩(19g)과 유청(24g) 단백질 분리주(즉, ≈ 2.0g)를 보충하는 훈련받지 않은 남성과 여성이 유사한 제지방량 증가(2.5% 대 3.4%)와 무릎 굴곡(25.3% 대 33.7%) 및 무릎 신전(21.5% 대 32.3%)을 경험했으며, 콩 그룹과 유청 그룹의 체지방률 감소(-3.6% 대 -5.4%)도 비슷하다는 것을 입증했습니다. 마지막으로, 바나젝(Banaszek) 등 [100]은 8주 동안 고강도 기능 훈련 세션(즉, 60-100% 1-RM에서 4×/주 CrossFit)과 대사 조절 세션(각각 6.2% 대 3.7%) 및 데드리프트(각각 3.9% 대 5.2% 대 3.2%)를 경험했다고 보고했습니다. 반대로, 볼렉(Volek) 등 [99]은 식물성 공급원당 필요한 양의 EAA와 류신 함량이 전달되지 않도록 신중한 계획을 세우지 않으면 훈련 적응(즉, 1-RM 강도와 제지방량)이 덜 발생할 것이라고 보고했습니다.

 

 

 

Whey protein does appear to promote a greater mean change from baseline values (that are not always statistically significant) for body mass, lean mass, 1-RM upper- and lower- body strength, and muscle thickness compared to the plant-based protein source. Collectively, these studies indicate that plant-based protein sources can promote similar exercise training and body composition adaptations to that of animal protein sources when adequate amounts of EAA and leucine are consumed in the diet. Readers are directed to several more comprehensive reviews on this topic [2,94,106,130].

 

 

유청 단백질은 식물성 단백질 공급원에 비해 체질량, 제지방량, 1-RM 상체 및 하체 근력, 근육 두께에 대해 기준값(항상 통계적으로 유의미하지는 않음)보다 더 큰 평균 변화를 촉진하는 것으로 보입니다. 종합적으로, 이러한 연구들은 식물성 단백질 공급원이 적절한 양의 EAA와 류신을 섭취할 때 동물성 단백질 공급원과 유사한 운동 훈련 및 체성분 적응을 촉진할 수 있음을 보여줍니다. 독자들은 이 주제에 대한 몇 가지 더 포괄적인 리뷰 [2,94,106,130]를 참고하시기 바랍니다.

 

In summary, vegans and vegetarians can meet their total daily energy and protein needs despite the superiority of animal proteins to plant proteins. Vegan and vegetarian athletes generally need to consume ~ 20–40% more plant protein than animal-based protein to provide similar amounts of EAA and leucine, especially during periods of resistance training.

 

 

요약하자면, 비건과 채식주의자는 동물성 단백질이 식물성 단백질보다 우수함에도 불구하고 일일 총 에너지와 단백질 요구량을 충족할 수 있습니다. 비건과 채식주의 운동선수는 일반적으로 저항성 훈련 기간 동안 유사한 양의 EAA와 류신을 제공하기 위해 동물성 단백질보다 식물성 단백질을 약 20~40% 더 많이 섭취해야 합니다.

 

 

6. Is cheese or peanut butter a good protein source?

Many energy-dense food products such as cheese or peanut butter are proudly labeled as good sources of protein, a marketing tactic that might encourage uninformed individuals to consume large quantities of such foods to meet daily protein intake targets. However, these foods often have much higher fat and calorie content with lower protein content per serving compared to popular protein-rich foods such as lean meat or low-fat dairy products like Greek yogurt [131]. In the United States, labeling laws dictate that for a food to be labeled a “good source” of protein, it must contain 10–19% of the daily reference value per serving, which equates to a range of 5–9.5 g of protein. However, consuming a single 2 tbsp serving of creamy peanut butter would not yield sufficient protein (roughly 7 g [132]) to align with evidence-based sports nutrition guidelines such as those put forth by the ISSN, which recommend consuming an absolute dose of protein between 20 – 40 g per meal to maximize MPS and resultant athletic recovery [2]. Standardized US Department of Agriculture data suggests that approximately three servings (roughly 100 g) of peanut butter would be required to meet the threshold of absolute protein intake specified in these guidelines.

 

 

 

6. 치즈나 땅콩버터가 좋은 단백질 공급원인가요?
치즈나 땅콩버터와 같은 에너지 밀도가 높은 많은 식품들은 좋은 단백질 공급원으로 자랑스럽게 분류되고 있습니다. 이 마케팅 전략은 정보에 입각하지 않은 개인들이 일일 단백질 섭취 목표를 달성하기 위해 이러한 식품을 대량으로 섭취하도록 장려할 수 있습니다. 그러나 이러한 식품들은 종종 살코기나 그릭 요거트와 같은 저지방 유제품과 같은 인기 있는 단백질이 풍부한 식품에 비해 지방과 칼로리 함량이 훨씬 높고 1회 제공량당 단백질 함량이 낮습니다[131]. 미국에서는 라벨링 법에 따라 식품이 "좋은 단백질 공급원"으로 분류되기 위해서는 1회 제공량당 일일 기준 값의 10-19%가 포함되어야 하며, 이는 5-9.5g의 단백질 범위에 해당합니다. 그러나 크리미한 땅콩버터를 2큰술로 섭취하는 것만으로는 ISSN이 제시한 증거 기반 스포츠 영양 지침에 부합하는 충분한 단백질(약 7g[132g])을 얻을 수 없으며, 이 지침은 MPS와 운동 회복을 극대화하기 위해 식사당 20-40g의 절대 단백질 섭취를 권장합니다[2]. 표준화된 미국 농무부 데이터에 따르면 이 지침에 명시된 절대 단백질 섭취 기준을 충족하기 위해 약 3인분(약 100g)의 땅콩버터가 필요할 것으로 예상됩니다.

 

 

 

Though 100 g of creamy peanut butter contains 24 g of protein [132], it also has 49.4 g of fat, resulting in 632 kcal per 100 g. Similarly, 100 g of cheddar cheese contains 23.3 g of protein, 34 g of fat, and 409 kcal [133]. In contrast, 100 g of cooked, skinless chicken breast contains 32.1 g protein, 3.24 g fat, and 158 kcal [134], making it and similar foods a more compelling choice for athletes attempting to consume adequate dietary protein without also ingesting additional unnecessary calories from fat which could increase the risk of unintentional weight gain.

 

 

크리미한 땅콩버터 100g에는 단백질이 24g 포함되어 있지만(132g), 지방도 49.4g 포함되어 있어 100g당 632kcal가 됩니다. 마찬가지로 체다 치즈 100g에는 단백질 23.3g, 지방 34g, 칼로리 409kcal가 포함되어 있습니다(133g). 반면, 조리된 껍질 없는 닭가슴살 100g에는 단백질 32.1g, 지방 3.24g, 칼로리 158kcal가 포함되어 있어 지방에서 불필요한 칼로리를 추가로 섭취하지 않고 적절한 식이 단백질을 섭취하려는 운동선수에게는 이와 유사한 음식이 더 매력적인 선택이 될 수 있으며, 이는 의도치 않은 체중 증가 위험을 높일 수 있습니다.

 

 

 

A recent overfeeding study conducted by Antonio and colleagues illustrated the propensity for overconsumption of energy-dense foods like peanut butter to cause weight gain [135]. The researchers recruited 17 exercise-trained males and females to complete a 4-week overfeeding protocol. The participants were instructed to continue their usual dietary and exercise regimens but were also required to consume five addi- tional 16 oz jars of peanut butter across the intervention. Analysis of nutritional intake data from the 14 compliant participants revealed that their dietary fat and total caloric intake significantly increased across the intervention by approximately 46 g and 526 kcal, respectively. The group also experienced a significant increase in fat mass with no concomitant increases in lean body mass or total body water, suggesting that the extra peanut butter intake had a deleterious effect on physique parameters. From a practical perspective, individuals should be wary of consuming large amounts of energy-dense protein sources during periods of caloric restriction when protein needs may need to be higher than usual to minimize the loss of muscle mass [136]. The high caloric content of these foods could make it much more difficult to meet energy intake targets, resulting in stagnation or reversal of diet progress.

 

 

안토니오와 동료들이 최근 실시한 과식 연구에 따르면 땅콩버터와 같은 에너지 밀도가 높은 음식의 과식이 체중 증가를 유발하는 경향이 있는 것으로 나타났습니다[135]. 연구진은 운동 훈련을 받은 17명의 남녀를 모집하여 4주간의 과식 프로토콜을 완료했습니다. 참가자들은 평소의 식이 요법과 운동 요법을 계속하도록 지시받았지만, 중재 기간 동안 땅콩버터 16온스 병 5개를 추가로 섭취해야 했습니다. 14명의 순응적인 참가자의 영양 섭취 데이터를 분석한 결과, 중재 기간 동안 식이 지방과 총 칼로리 섭취량이 각각 약 46g과 526kcal 증가한 것으로 나타났습니다. 또한, 이 그룹은 제지방량이나 총 수분의 증가 없이 지방량이 크게 증가했으며, 이는 추가적인 땅콩버터 섭취가 체격 매개변수에 해로운 영향을 미쳤음을 시사합니다. 실용적인 관점에서 볼 때, 근육량 손실을 최소화하기 위해 단백질 섭취가 평소보다 높아야 할 수 있는 칼로리 제한 기간 동안 개인은 많은 양의 에너지 밀도가 높은 단백질 공급원을 섭취하는 것을 경계해야 합니다[136]. 이러한 음식의 높은 칼로리 함량은 에너지 섭취 목표를 달성하는 것을 훨씬 더 어렵게 만들어 식단 진행이 정체되거나 역전될 수 있습니다.

 

In addition to concerns surrounding the energy density and dietary fat content of protein foods, attention should also be given to the quality of the protein source itself. Measures of protein quality and digestibility such as the Protein Digestibility Corrected Amino Acid Score (PDCAAS) and Digestible Indispensable Amino Acid Score (DIAAS) rank plant-based protein sources like peanut butter, nuts, and legumes far below animal sources like dairy and meat [137], meaning that less of the dietary protein contained in the plant-based products is digested, absorbed, and makes its way into the bloodstream. Indeed, recent evidence shows that whole-body net protein balance is appreciably lower after a standardized serving of peanut butter or mixed nuts compared to higher-quality protein sources like beef, eggs, or pork [138]. Therefore, energy-dense plant-based protein foods like peanut butter and nuts should not be used as a primary protein source due to their inferior quality and higher energy density compared to animal protein sources or less energy-dense plant-based products.

 

 

 

단백질 식품의 에너지 밀도와 식이 지방 함량에 대한 우려 외에도 단백질 공급원 자체의 품질에도 주의를 기울여야 합니다. 단백질 소화율 보정 아미노산 점수(PDCAAS) 및 소화 불가능한 필수 아미노산 점수(DIAAS)와 같은 단백질 품질 및 소화율 측정은 땅콩버터, 견과류, 콩류와 같은 식물성 단백질 공급원을 유제품 및 육류와 같은 동물성 공급원보다 훨씬 낮게 평가하여[137], 식물성 제품에 포함된 식이 단백질이 소화, 흡수 및 혈류로 유입되는 비율이 적다는 것을 의미합니다. 실제로 최근 증거에 따르면 표준화된 땅콩버터 또는 혼합 견과류를 제공한 후 전신 순 단백질 균형이 소고기, 달걀, 돼지고기와 같은 고품질 단백질 공급원에 비해 현저히 낮다는 사실이 밝혀졌습니다[138]. 따라서 땅콩버터 및 견과류와 같은 에너지 밀도가 높은 식물성 단백질 식품은 동물성 단백질 공급원이나 에너지 밀도가 낮거나 에너지 밀도가 낮은 식물성 제품에 비해 품질이 낮고 에너지 밀도가 높기 때문에 1차 단백질 공급원으로 사용해서는 안 됩니다.

 

In summary, energy-dense foods such as peanut butter and cheese are not ideal sources of protein as they often contain high amounts of fat. Such foods should be viewed as fat rather than protein sources and consumed in moderation to ensure appropriate energy needs are met.

 

 

요약하자면, 땅콩버터나 치즈와 같은 에너지 밀도가 높은 식품은 종종 많은 양의 지방을 함유하고 있기 때문에 이상적인 단백질 공급원이 아닙니다. 이러한 식품은 단백질 공급원이 아닌 지방으로 간주하고 적절한 에너지 요구를 충족하기 위해 적당히 섭취해야 합니다.

 

 

 

 

 

7. Does consuming meat (i.e. animal protein) cause unfavorable health outcomes?

Meat is a common part of the human diet in many cultures [139]. It is most commonly harvested from animal skeletal muscle and primarily consists of varying quantities of protein (deemed animal protein), saturated fatty acids, and monounsaturated fatty acids, namely oleic acid [140]. According to the Food and Agriculture Organization, poultry, pork, and beef comprise about 85% of meat consumption worldwide [141].

 

 

7. 육류(즉, 동물성 단백질) 섭취가 건강에 좋지 않은 결과를 초래합니까?
육류는 많은 문화에서 인간 식단의 일반적인 부분입니다 [139]. 육류는 동물 골격근에서 가장 흔히 수확되며 주로 다양한 양의 단백질(동물성 단백질로 간주됨), 포화 지방산, 단일 불포화 지방산, 즉 올레산으로 구성됩니다 [140]. 식량농업기구에 따르면 가금류, 돼지고기, 소고기는 전 세계 육류 소비의 약 85%를 차지합니다 [141].

 

 

Epidemiological studies often categorize meats into white meat (including poultry), red meat (including beef and pork), and processed meat (including sausage, cold cuts, etc.) [142]. A 2010 systematic review and meta-analysis of prospective cohort and case- control studies including 56,311 participants found red meat consumption was not significantly related to coronary artery disease. However, processed meat consumption was associated with increased risk [143]. These findings are often attributed to the high content of saturated fatty acids and/or cholesterol; however, there is evidence that saturated fatty acids and/or cholesterol intake are not associated with increased serum lipid concentrations or cardiovascular disease risk [144,145].

 

역학 연구는 종종 육류를 흰 고기(가금류 포함), 붉은 고기(소시지 및 돼지고기 포함), 가공육(소시지, 콜드컷 등 포함)으로 분류합니다 [142]. 2010년에 56,311명의 참가자를 포함한 전향적 코호트 및 사례 대조 연구를 체계적으로 검토하고 메타 분석한 결과, 붉은 고기 섭취는 관상동맥질환과 유의미한 관련이 없는 것으로 나타났습니다. 그러나 가공육 섭취는 위험 증가와 관련이 있는 것으로 나타났습니다 [143]. 이러한 발견은 종종 포화 지방산 및/또는 콜레스테롤 함량이 높기 때문에 발생하지만, 포화 지방산 및/또는 콜레스테롤 섭취가 혈청 지질 농도 증가나 심혈관 질환 위험 증가와 관련이 없다는 증거가 있습니다 [144,145].

 

 

Another factor to consider is the potential impact of meat intake on cancer risk. During the cooking process, heterocyclic aromatic amines and polycyclic aromatic hydrocarbons are synthesized from amino acids, creatine, and fatty acids present in meat [146]. It is speculated that exposure to these compounds is associated with cancers, especially of the lung, esophagus, stomach, and colon [147,148]. Several meta-analyzes of prospective cohort studies show an increased risk of cancer in those who consume high amounts of red meat and processed meat [149–154]. Further, a dose-response analysis shows that for each additional 100 grams of red meat and processed meat consumed per day, there is an increase (12 to 35%) in cancer risk [154]. 

 

 

또 다른 고려해야 할 요소는 육류 섭취가 암 위험에 미치는 잠재적 영향입니다. 조리 과정에서 헤테로사이클릭 방향족 아민과 다환 방향족 탄화수소는 육류에 존재하는 아미노산, 크레아틴, 지방산으로부터 합성됩니다 [146]. 이러한 화합물에 대한 노출은 특히 폐, 식도, 위, 대장의 암과 관련이 있는 것으로 추정됩니다 [147,148]. 전향적 코호트 연구에 대한 여러 메타 분석에 따르면 붉은 고기와 가공육을 다량 섭취하는 사람들의 암 위험이 증가하는 것으로 나타났습니다 [149-154]. 또한, 용량 반응 분석 결과, 매일 100그램의 붉은 고기와 가공육을 추가로 섭취할 때마다 암 위험이 증가하는 것으로 나타났습니다 [154].

 

 

However, these conclusions should be inter- preted with caution as much of the data comes from observational studies. Han et al. suggested that the possible absolute effects of red meat and processed meat consump- tion on cancer mortality and incidence are very small, and the certainty of the evidence is low to very low [155]. Further, Hur et al. concluded that it is difficult to conclude that dietary red meat is the main cause of colorectal cancer [156]. Indeed, multiple factors can impact the etiology of colorectal cancer, such as fruit and vegetable intake, alcohol consumption, smoking, overweight, obesity, and stress [156]. In addition, Yun et al. reported that processed meat intake increases the risk of colorectal cancer rather than other digestive tract cancers; however, no causal relationship was observed between red and white meat intake and digestive tract cancers [157]. Wu et al. found that processed meat may increase lung cancer risk with no evidence of red meat affecting other cancers [158].

 

 

 

그러나 이러한 결론은 많은 데이터가 관찰 연구에서 나온 것이므로 신중하게 해석해야 합니다. Han 등은 붉은 고기와 가공육 섭취가 암 사망률과 발생률에 미치는 절대적인 영향이 매우 작으며, 증거의 확실성이 낮거나 매우 낮다고 제안했습니다[155]. 또한 Hur 등은 식이 붉은 고기가 대장암의 주요 원인이라고 단정하기 어렵다고 결론지었습니다[156]. 실제로 과일과 채소 섭취, 알코올 섭취, 흡연, 과체중, 비만, 스트레스[156]와 같은 여러 요인이 대장암의 원인에 영향을 미칠 수 있습니다. 또한 윤 등은 가공육 섭취가 다른 소화관암보다 대장암 위험을 증가시킨다고 보고했지만, 붉은 고기와 흰 고기 섭취와 소화관암 사이에는 인과 관계가 관찰되지 않았습니다[157]. Wu 등은 가공육이 다른 암에 영향을 미친다는 증거가 없어 폐암 위험을 증가시킬 수 있음을 발견했습니다[158].

 

 

It is imperative that we are aware of other dietary or lifestyle factors that can modify the relationship between meat intake and cancer [152,159]. It is also important to note that white meat and fish consumption is not linked to the same negative effects. A recent review of 13 prospective cohort studies showed that white meat is not associated with the incidence of diabetes mellitus but is minimally associated with hypertension, as one included study showed a positive association and was negatively associated with meta- bolic syndrome [160]. Two meta-analyzes have shown that white meat consumption was negatively associated with colorectal, lung, esophageal, and gastric cancers and not associated with other cancers, including pancreatic and renal [151,161].In addition, fish consumption has been negatively linked to the risk of various cancers, including esopha- geal [162], colorectal [163], and bladder [164].

 

 

 

육류 섭취와 암 사이의 관계를 수정할 수 있는 다른 식이 또는 생활 방식 요인을 인지하는 것이 중요합니다 [152,159]. 또한 흰 고기와 생선 섭취가 동일한 부정적인 영향과 관련이 없다는 점도 주목할 필요가 있습니다. 최근 13개의 전향적 코호트 연구를 검토한 결과, 흰 고기는 당뇨병 발생률과 관련이 없지만 고혈압과 최소한의 관련이 있는 것으로 나타났습니다. 이 연구 중 하나는 긍정적인 연관성을 보였고 메타볼릭 증후군과도 부정적인 연관이 있는 것으로 나타났습니다 [160]. 두 가지 메타 분석에 따르면 흰 고기 섭취는 대장암, 폐암, 식도암, 위암과 부정적인 연관이 있으며 췌장암 및 신장암을 포함한 다른 암과는 관련이 없는 것으로 나타났습니다 [151,161]. 또한 생선 섭취는 식도암[162], 대장암[163], 방광암[164]을 포함한 다양한 암의 위험과 부정적인 연관이 있습니다.

 

 

In a large multinational investigation published in the American Journal of Clinical Nutrition, the authors suggested that moderate consumption of unprocessed meat is fine, whereas processed meat consumption should be limited. The PURE study (i.e. Prospective Urban Rural Epidemiology (PURE Study) was a cohort of 134,297 individuals enrolled from 21 low-, middle-, and high-income countries. Food intake was recorded using country- specific validated food frequency questionnaires [165]. The primary endpoints were total mortality and major cardiovascular disease (CVD). Processed meat intake was associated with higher CVD risk and total mortality. Conversely, they did not find such an association with poultry and unprocessed meat intake.

 

 

반면 가공육 소비는 제한되어야 합니다. PURE 연구(즉, 전향적 도시 농촌 역학(PURE Study))는 저소득, 중산층, 고소득 국가 21개국에서 134,297명이 등록된 코호트 연구였습니다. 음식 섭취량은 국가별 검증된 음식 빈도 설문지를 사용하여 기록되었습니다 [165]. 주요 평가지표는 총 사망률과 주요 심혈관 질환(CVD)이었습니다. 가공육 섭취는 높은 심혈관 질환 위험과 총 사망률과 관련이 있었습니다. 반대로, 그들은 가금류 및 가공되지 않은 육류 섭취와 이러한 연관성을 발견하지 못했습니다.

 

 

As with all studies on meat intake per se, it would be virtually impossible to conduct a randomized controlled trial to establish causality vis-a-vis mortality as it relates to CVD, cancer, etc. Thus, we are left with seemingly contradictory information on this topic.

In summary, processed meats may have many negative effects on health outcome measures. Nonetheless, one must be cognizant of the effects of other dietary and lifestyle factors. Consuming white meat and fish ostensibly does not pose an increased risk for cardiovascular disease or various cancers and may even reduce the risk of gastrointestinal cancers.

 

 

육류 섭취 자체에 대한 모든 연구와 마찬가지로, 심혈관 질환, 암 등과 관련된 인과관계를 규명하기 위해 무작위 대조 시험을 실시하는 것은 사실상 불가능할 것입니다. 따라서 이 주제에 대해 모순된 정보가 남게 됩니다.
요약하자면, 가공육은 건강 결과 측정에 많은 부정적인 영향을 미칠 수 있습니다. 그럼에도 불구하고 다른 식이 및 생활 습관 요인의 영향을 인식해야 합니다. 표면적으로 흰살과 생선을 섭취하는 것은 심혈관 질환이나 다양한 암의 위험을 증가시키지 않으며 위장암의 위험을 줄일 수도 있습니다.

 

 

 

8. Do you need protein if you are not physically active?

Generally, it is believed that only athletes or physically active individuals need protein. However, protein plays a critical role in various physiological processes in the human body, such as protein synthesis, cell signaling, satiety, thermogenesis, and glycemic regulation [166]. The human body comprises approximately 50,000 distinct proteins, of which 65% are found in skeletal muscle [167]. Therefore, adequate dietary protein is essential to maintain muscle, bone, and overall health [166].

 

 

8. 신체 활동이 없으면 단백질이 필요합니까?
일반적으로 운동선수나 신체적으로 활동적인 개인만이 단백질을 필요로 한다고 여겨집니다. 그러나 단백질은 단백질 합성, 세포 신호 전달, 포만감, 열 발생 및 혈당 조절과 같은 인체의 다양한 생리적 과정에서 중요한 역할을 합니다[166]. 인체는 약 50,000개의 서로 다른 단백질로 구성되어 있으며, 그 중 65%는 골격근에서 발견됩니다[167]. 따라서 근육, 뼈 및 전반적인 건강을 유지하기 위해서는 충분한 식이 단백질이 필수적입니다[166].

 

 

The Institute of Medicine [168] advised that all healthy adults require a minimum of 0.8 g/kg/day and an estimated average requirement (EAR) of 0.66 g/kg/day to maintain bodily functions and general health. However, evidence suggests that these recommen- dations may need to be revised for sedentary individuals [166]. The basis for these protein intake recommendations is drawn from 19 studies that examined nitrogen balance, which measures nitrogen loss (via waste products and sweat) against nitrogen intake (via food consumption) [169]. However, the nitrogen balance method is complex and has over- estimated nitrogen retention with an underestimated excretion, thus underestimating protein needs [169,170]. In a follow-up analysis using 28 nitrogen balance studies (includ- ing the 19 studies used in the Rand et al. 2003 study), Humayun et al. [171] used a two- phase linear regression instead of the linear regression that was used in the analysis and recommendation of Rand et al. [169] for the 0.8 g/kg/day recommendation for today’s 0.8 g/kg/day recommendation. Humayun et al. [171] suggest that a range of 0.91–0.99 g/kg/ day is recommended for sedentary adults, which is 12–20% higher than current recommendations.

 

의학연구소[168]는 모든 건강한 성인이 신체 기능과 일반적인 건강을 유지하기 위해 최소 0.8g/kg/day, 추정 평균 요구량(EAR)이 0.66g/kg/day가 필요하다고 조언했습니다. 그러나 이러한 권장 사항은 앉아서 생활하는 사람들을 위해 수정이 필요할 수 있음을 시사합니다[166]. 이러한 단백질 섭취 권장 사항의 근거는 질소 균형을 조사한 19개의 연구에서 도출되었으며, 질소 섭취(음식 섭취를 통한 노폐물 및 땀을 통한)에 대한 질소 손실을 측정한 것입니다[169]. 그러나 질소 균형 방법은 복잡하고 질소 보유량이 과대평가되어 배설량이 과소평가되어 단백질 수요를 과소평가하고 있습니다[169,170]. 28개의 질소 균형 연구(Rand et al. 2003 연구에 사용된 19개의 연구 포함)를 사용한 후속 분석에서 Humayun et al. [171]은 오늘의 0.8g/kg/day 권장 사항에 대해 Rand et al. [169]의 분석 및 권장에 사용된 선형 회귀 대신 2상 선형 회귀를 사용했습니다. Humayun et al. [171]은 앉아서 생활하는 성인에게 현재 권장 사항보다 12~20% 높은 0.91~0.99g/kg/day 범위가 권장된다고 제안합니다.

 

 

Humayun et al. [171] also employed a newer measure, the indicator amino acid oxidation (IAAO) method, to reassess protein requirements. The IAAO method estimates daily protein needs by gauging the efficiency of our body using a specific indicator of essential amino acids in our diet. Their reanalysis of nitrogen balance data, coupled with the IAAO method, indicated that the ideal protein intake for healthy adults ranged between 0.92–1.2 g/kg/day. These values are 15% to 50% higher than the existing RDA recommendations of 0.8 g/kg/day [166,170].

 

 

Humayun 등[171]은 또한 단백질 요구량을 재평가하기 위해 지표 아미노산 산화(IAAO) 방법이라는 새로운 측정 방법을 사용했습니다. IAAO 방법은 식단의 필수 아미노산을 특정 지표로 사용하여 우리 몸의 효율성을 측정하여 일일 단백질 요구량을 추정합니다. 질소 균형 데이터를 재분석한 결과, IAAO 방법과 함께 건강한 성인의 이상적인 단백질 섭취량은 하루 0.92~1.2g/kg/kg 범위인 것으로 나타났습니다. 이 값은 기존 RDA 권장량인 하루 0.8g/kg/day [166,170]보다 15~50% 높습니다.

 

 

 

Weiler et al. [172] also highlighted the need for more convincing evidence that current protein intake guidelines (0.8 g/kg/day) are adequate or beneficial for all healthy adults. In addition to the IAAO method, which estimates that the optimal range for protein intake is 15–50% higher than the RDA, studies using the IAAO method used high-quality, easily digestible protein sources [172]. However, Weiler et al. [172] highlights that most adults, even in developed countries, still need to consume high-quality proteins. Therefore, because the results of the IAAO method indicated that daily protein intake should be higher than the current recommendation, and this was done with high-quality protein sources, it can be inferred that those who do not eat high-quality protein sources may need even more than the current recommendation range of 0.92–1.2 g/kg/day by Elango et al. [172]. Furthermore, Vieux et al. [173] suggested that 45–60% of the protein con- tribution must come from high-quality animal protein sources, as vegan sources may lead to a deficiency of other nutrients such as vitamin B12, iron, calcium, zinc, and omega-3 fatty acids.

 

 

Weiler 등[172]은 또한 현재의 단백질 섭취 지침(0.8g/kg/일)이 모든 건강한 성인에게 적절하거나 유익하다는 보다 설득력 있는 증거의 필요성을 강조했습니다. 단백질 섭취의 최적 범위가 RDA보다 15~50% 더 높다고 추정하는 IAAO 방법 외에도 IAAO 방법을 사용한 연구에서는 고품질의 소화가 용이한 단백질 공급원을 사용했습니다[172]. 그러나 Weiler 등[172]은 대부분의 성인, 심지어 선진국에서도 여전히 고품질 단백질을 섭취해야 한다고 강조합니다. 따라서 IAAO 방법의 결과에 따르면 일일 단백질 섭취량은 현재 권장량보다 높아야 하며, 이는 고품질 단백질 공급원을 대상으로 수행되었기 때문에 고품질 단백질 공급원을 섭취하지 않는 사람들은 Elango 등[172]의 현재 권장 범위인 0.92~1.2g/kg/일보다 더 많은 양이 필요할 수 있다고 추론할 수 있습니다. 또한 Vieux 등[173]은 비건 공급원이 비타민 B12, 철분, 칼슘, 아연, 오메가-3 지방산과 같은 다른 영양소의 결핍으로 이어질 수 있으므로 단백질 섭취량의 45~60%가 고품질 동물성 단백질 공급원에서 나와야 한다고 제안했습니다.

 

 

Long-term studies have shown that failure to meet protein requirements can negatively impact nitrogen balance, muscle mass, immunity, and functional capacity [174]. A systematic review and meta-analysis by Tagawa et al. concluded that “slightly increasing current protein intake for several months by 0.1 g/kg/d in a dose- dependent manner over a range of doses from 0.5 to 3.5 g/kg/d may increase or maintain lean body mass” [175]. Furthermore, evidence suggests that older adults may need a higher protein intake, as inadequate intake can compromise their health [176]. For example, the Healthy Aging and Body Composition Study showed that older adults who consumed more protein could maintain their lean body mass [177].

 

장기적인 연구에 따르면 단백질 요구 사항을 충족하지 못하면 질소 균형, 근육량, 면역력 및 기능 능력에 부정적인 영향을 미칠 수 있습니다[174]. Tagawa 등의 체계적인 검토와 메타 분석에 따르면 "현재 단백질 섭취량을 0.5g/kg/d에서 3.5g/d 범위의 용량에 걸쳐 몇 달 동안 용량 의존적으로 0.1g/kg/d씩 약간 증가시키면 제지방량이 증가하거나 유지될 수 있다"고 결론지었습니다[175]. 또한, 불충분한 섭취는 건강을 해칠 수 있으므로 노인들은 더 많은 단백질 섭취가 필요할 수 있음을 시사합니다[176]. 예를 들어, 건강한 노화와 신체 구성 연구에 따르면 단백질을 더 많이 섭취한 노인들은 제지방량을 유지할 수 있는 것으로 나타났습니다[177].

 

 

 

 

 

Similarly, a survey of 142 older adults also revealed a positive correlation between beef intake and the muscle area of the mid-arm [178]. Older adults exhibit anabolic resistance (i.e. blunted response to dietary proteins), meaning they need more protein than younger adults to maximally stimulate MPS [179]. Anabolic resistance further highlights the need for older people to consume more protein than current recommendations. In light of previously published studies [170–173], the recom- mended protein consumption should be 1.0–1.2g/kg per day for optimal health, with 45–60% being from animal protein sources, regardless of the level of physical activity.

 

 

 

 

마찬가지로, 142명의 노인을 대상으로 한 설문조사에서도 소고기 섭취량과 중완 근육 면적 사이에 양의 상관관계가 있는 것으로 나타났습니다[178]. 노인들은 동화 저항성(즉, 식이 단백질에 대한 둔감한 반응)을 보이며, 이는 MPS를 최대한 자극하기 위해 젊은 성인들보다 더 많은 단백질이 필요하다는 것을 의미합니다[179]. 동화 저항성은 노인들이 현재 권장량보다 더 많은 단백질을 섭취해야 한다는 필요성을 더욱 강조합니다. 이전에 발표된 연구 [170–173]를 고려할 때, 최적의 건강을 위해 권장되는 단백질 섭취량은 하루 1.0–1.2g/kg이며, 신체 활동 수준에 관계없이 45–60%는 동물성 단백질 공급원에서 섭취해야 합니다.

 

 

 

 

In summary, everyone (including sedentary individuals) must consume sufficient dietary protein. Protein serves a variety of important roles that are not exclusive to exercising individuals. In addition, the current evidence suggests that protein intake is the primary modifier of body composition (i.e., higher intakes may produce better body composition).

 

요약하자면, 모든 사람(앉아 있는 개인 포함)은 충분한 식이 단백질을 섭취해야 합니다. 단백질은 운동하는 개인에게만 국한되지 않는 다양한 중요한 역할을 합니다. 또한 현재 증거에 따르면 단백질 섭취가 체성분의 주요 조절 인자이며(즉, 섭취량이 많을수록 체성분이 더 좋아질 수 있습니다).

 

 

9. Do you need to consume protein ≤1 hour following resistance training sessions to create a muscle anabolic environment?

The notion that protein ingestion has to occur shortly following (≤1 hour) bouts of resistance training likely gained momentum when Esmarck et al. [180] showed that low- dose protein ingestion (10 grams from fat-free milk and soybean) immediately following resistance training sessions (3 days/week) for 12 weeks led to significant increases in muscle cross-sectional and muscle fiber area in healthy older males (n = 7; 74 yrs.). Further, immediate post-exercise protein ingestion increased myosin heavy chain (MHC) IIa dis- tribution. However, delaying protein intake for 2 hours post-exercise resulted in no muscle accretion and caused a decrease in MHC IIx distribution (n = 6; 74 yrs.). 

 

9. 근육 동화 환경을 조성하기 위해 저항성 훈련 세션 후 1시간 이내에 단백질을 섭취해야합니까?
저항성 훈련 직후(1시간 미만) 단백질 섭취가 이루어져야 한다는 개념은 Esmark 등 [180]이 12주 동안 저항성 훈련 세션(3일/주) 직후 저용량 단백질 섭취(지방이 없는 우유와 대두에서 10그램 섭취)가 건강한 고령 남성의 근육 단면적과 근섬유 면적을 크게 증가시켰다는 것을 보여주면서 탄력을 받을 가능성이 높습니다(n = 7; 74세). 또한, exercise 직후 단백질 섭취는 미오신 중쇄(MHC) IIa 분포를 증가시켰습니다. 그러나 exercise 후 2시간 동안 단백질 섭취를 지연시켰을 때 근육이 축적되지 않았고 MHC IIx 분포가 감소했습니다(n = 6; 74세). 

 

 

Regarding muscle performance, both protein groups increased strength over time, but the response was more consistent and robust when protein was consumed immediately post-exercise. While this study has been cited > 800 times in the literature, results and generalizability are questionable due to the very small sample size assessed (resulting in inadequate statistical power and possible error), the low dosage of protein supplementation pre- scribed, and that resistance training failed to produce muscle accretion in the group who delayed protein ingestion 2 hours post-exercise.

 

 

Regarding muscle performance, both protein groups increased strength over time, but the response was more consistent and robust when protein was consumed immediately post-exercise. While this study has been cited > 800 times in the literature, results and generalizability are questionable due to the very small sample size assessed (resulting in inadequate statistical power and possible error), the low dosage of protein supplementation pre- scribed, and that resistance training failed to produce muscle accretion in the group who delayed protein ingestion 2 hours post-exercise.

 

 

근육 동화 환경을 조성하기 위한 저항성 훈련 세션 직후(1시간 미만) 단백질 섭취의 중요성을 반박하는 여러 증거가 이제 제시되고 있습니다. Rasmussen 등 [181]은 기계론적 관점에서 젊은 건강한 성인(n = 6; 34세)을 대상으로 급성 저항성 훈련을 실시한 후 1시간 3시간 동안 필수 아미노산(6g)을 섭취했을 때 페닐라-라닌 소실률(근육 단백질 합성의 지표)에 차이가 없음을 발견했습니다. Burd 등 [182]은 젊고 건강한 성인(n = 15; 21세)을 대상으로 exercise 후 24-27시간 동안 섭취한 단백질 15g에 근섬유 단백질 합성률이 여전히 민감(반응성)하다는 것을 보여주었습니다. 따라서 소량의 단백질을 섭취하기 위해 하루 종일 기다리는 것(exercise 후)도 근육 동화 효과가 있습니다.

 

 

Furthermore, Wall et al. [183] showed that post-exercise pre-sleep protein (60 g of whey) did not blunt the muscle protein synthetic response to 20 grams of whey protein the following morning (~8 hours separated protein ingestions) in young, healthy adults (n = 8; 21 yrs.). Collectively, results across studies indicate that the muscle protein synthetic response to dietary protein remains receptive much longer than 1-hour post-exercise in young, healthy adults.

 

또한, Wall 등 [183]은 젊고 건강한 성인(n = 8; 21세)에서 exercise 후 수면 전 단백질(60g의 유청)이 다음 날 아침(~8시간 분리된 단백질 섭취) 20g의 유청 단백질에 대한 근육 단백질 합성 반응을 무디지 않는다는 것을 보여주었습니다. 종합적으로, 연구 결과에 따르면 식이 단백질에 대한 근육 단백질 합성 반응은 젊고 건강한 성인에서 exercise 후 1시간보다 훨씬 더 오래 수용성을 유지하는 것으로 나타났습니다.

 

The necessity to consume protein shortly following resistance training sessions becomes even more arbitrary because pre-exercise protein ingestion produces similar effects. For example, Tipton et al. [184] showed that whey protein (20g) consumed immediately before or 1 hour following an acute bout of resistance training increased amino acid uptake into skeletal muscle similarly in young, healthy adults (n=17; 27yrs.). Further, Candow et al. [185] showed that protein ingestion (0.3 g/kg) immediately before or immediately following resistance train- ing sessions for 12weeks produced similar changes in whole-body fat-free mass, regional muscle thickness, strength, and a surrogate measure of whole-body pro- tein catabolism (urinary 3-methylhistidine excretion) in healthy older males (59– 76 yrs.).

 

 

저항 훈련 세션 직후 단백질 섭취의 필요성은 exercise 전 단백질 섭취가 유사한 효과를 일으키기 때문에 더욱 자의적으로 변합니다. 예를 들어, Tipton 등 [184]은 저항 훈련 직전 또는 1시간 후에 섭취한 유청 단백질(20g)이 젊고 건강한 성인(n=17세; 27세)에서도 유사하게 골격근으로의 아미노산 흡수를 증가시킨다는 것을 보여주었습니다. 또한, Candow 등 [185]은 12명의 weeks에 대한 저항 훈련 세션 직전 또는 직후 단백질 섭취(0.3g/kg)가 건강한 고령 남성(59-76세)에서 전신 무지방 질량, 국소 근육 두께, 근력 및 전신 단백질 대사(urinary 3-메틸히스티딘 배설)의 대리 측정치에 유사한 변화를 일으킨다는 것을 보여주었습니다.

 

In summary, evidence-based research shows that protein ingestion following (≤1 hour) resistance training sessions is not an absolute requirement to produce an anabolic environ- ment in skeletal muscle. What appears more important is the total daily amount of dietary protein consumed. Conversely, it appears reasonable to incorporate protein into one’s post- workout nutrition as a practical approach to fulfill the overall daily protein goal.

 

 

요약하자면, 증거 기반 연구에 따르면 골격근에서 동화 환경을 조성하기 위해 (1시간 미만의) 저항성 훈련 세션 후 단백질 섭취가 절대적인 요구 사항은 아닙니다. 더 중요한 것은 일일 섭취하는 식이 단백질의 총량입니다. 반대로, 전체 일일 단백질 목표를 달성하기 위한 실용적인 접근 방식으로 운동 후 영양 섭취에 단백질을 통합하는 것이 합리적인 것으로 보입니다.

 

10. Do endurance athletes need additional protein?

While carbohydrate and lipid oxidation account for the large majority of fuel metabolism during endurance exercise, more prolonged bouts (i.e. >2 h) also begin to enhance the oxidation of amino acids, particularly leucine. Additionally, small intestine injury can result from more prolonged or intense endurance training related to hypoxia [186].In both scenarios, negative whole-body protein balance is a common result [187,188]. Though much of the protein research involving resistance training is often focused on MPS and/or skeletal muscle hypertrophy, protein considerations for endurance athletes must consider more than just these outcomes. Performance and recovery effects are often secondary considerations or overlooked altogether [189], even though protein supplementation may support or enhance the physiological training effects of endurance exercise.

 

 

10. 지구력 운동선수들은 추가적인 단백질이 필요합니까?
탄수화물과 지질 산화가 지구력 운동 중 연료 대사의 대부분을 차지하는 반면, 더 긴 시간(즉, >2시간) 동안의 시합은 아미노산, 특히 류신의 산화를 촉진하기 시작합니다. 또한 소장 손상은 저산소증과 관련된 더 긴 지구력 훈련이나 강도 높은 지구력 훈련으로 인해 발생할 수 있습니다[186]. 두 시나리오 모두에서 전신 단백질 균형이 부정적인 결과가 일반적입니다[187,188]. 내성 훈련과 관련된 단백질 연구의 대부분은 종종 MPS 및/또는 골격근 비대에 초점을 맞추고 있지만, 지구력 운동선수를 위한 단백질 고려 사항은 이러한 결과 이상을 고려해야 합니다. 비록 단백질 보충이 지구력 운동의 생리적 훈련 효과를 지지하거나 향상시킬 수 있지만[189], 성과와 회복 효과는 종종 부차적인 고려 사항이거나 완전히 간과되는 경우가 많습니다.

 

Ingestion of branched-chain amino acids alone has been shown to positively affect time-trial performance and peak power [190] and potentially delay central fatigue through modification of serotonin [191]. However, a combination of protein and other nutrients, especially carbohydrates, appears to have the most pronounced influence on endurance training responses and adaptations with dietary intervention. Meta-analytic evidence revealed average performance improvements, particularly for time to exhaus- tion, of 9% when ingesting protein plus carbohydrates compared to just carbohydrates [192]. Furthermore, these effects were not simply due to increased energy intake; even isocaloric conditions demonstrated differences. Post-training protein intake also appears to have a favorable effect on glycogen replenishment, which may further influence performance outcomes [189]. This appears to be most impactful when an athlete’s post- training carbohydrate ingestion is suboptimal [193], which is not uncommon in a real- world setting, particularly when there are multiple training sessions per day. There is also evidence that this co-ingestion decreases symptoms of muscle damage [193]. Even including protein in rehydration beverages has been demonstrated to positively impact fluid uptake by the intestines [194].

 

 

분지 사슬 아미노산의 섭취만으로도 시간 시험 성능과 피크 파워에 긍정적인 영향을 미치고 세로토닌의 수정을 통해 중추 피로를 지연시킬 수 있는 것으로 나타났습니다 [190]. 그러나 단백질과 다른 영양소, 특히 탄수화물의 조합이 지구력 훈련 반응과 식이 개입에 대한 적응에 가장 뚜렷한 영향을 미치는 것으로 나타났습니다. 메타 분석 증거에 따르면, 단백질과 탄수화물을 섭취할 때 평균 9%의 성능 향상이 나타났습니다 [192]. 또한 이러한 효과는 단순히 에너지 섭취 증가로 인한 것이 아니라 등온 조건에서도 차이가 나타났습니다. 훈련 후 단백질 섭취는 글리코겐 보충에도 긍정적인 영향을 미쳐 성과 결과에 추가적인 영향을 미칠 수 있습니다 [189]. 이는 운동선수의 훈련 후 탄수화물 섭취가 최적이 아닐 때 가장 큰 영향을 미치는 것으로 보이며, 이는 특히 하루에 여러 번의 훈련 세션이 있을 때 특히 그렇습니다. 이러한 공동 섭취가 근육 손상 증상을 감소시킨다는 증거도 있습니다 [193]. 수분 보충 음료에 단백질을 포함시키는 것도 장에서 체액 섭취에 긍정적인 영향을 미치는 것으로 입증되었습니다 [194].

 

Training for and competing in marathons presents a unique and real physiological challenge. In one 5-week study, experienced and/or elite marathon runners were supple- mented with either 33.5 g/d of maltodextrin or whey protein following each training session leading up to their race [195]. Protein supplementation was found to favorably affect aspartate aminotransferase and alanine aminotransferase as well as markers of muscle damage (i.e. creatine kinase and lactate dehydrogenase) following the marathon compared to carbohydrate supplementation. Both markers of muscle damage were still elevated at one week following the race in the carbohydrate group compared to the protein group. There were also decreases in total cholesterol in the protein group, potentially suggesting that those individuals more effectively converted cholesterol to steroid hormones, which could help explain the differences in recovery [195]. These differences were not just limited to biochemical markers of stress and damage, as the recovery of function within the week following the marathon was also greater in the protein-supplemented group.

 

 

마라톤에서 훈련하고 경쟁하는 것은 독특하고 실제적인 생리적 도전 과제를 제시합니다. 한 5주간의 연구에서 숙련된 마라톤 참가자들은 각 훈련 세션 후 33.5g/d의 말토덱스트린 또는 유청 단백질을 보충하여 경주를 시작했습니다[195]. 단백질 보충은 탄수화물 보충에 비해 마라톤 후 아스파르트산 아미노전이효소와 알라닌 아미노전이효소뿐만 아니라 근육 손상의 지표(예: 크레아틴 키나제 및 젖산 탈수소효소)에도 긍정적인 영향을 미치는 것으로 나타났습니다. 두 근육 손상 지표 모두 경주 후 일주일 동안 단백질 그룹에 비해 여전히 상승했습니다. 또한 단백질 그룹에서 총 콜레스테롤이 감소하여 이러한 개인들이 콜레스테롤을 스테로이드 호르몬으로 더 효과적으로 전환했음을 시사할 수 있으며, 이는 회복의 차이를 설명하는 데 도움이 될 수 있습니다[195]. 이러한 차이는 스트레스와 손상의 생화학적 지표에만 국한되지 않았으며, 마라톤 다음 주 내 기능 회복이 단백질 보충 그룹에서 더 컸기 때문입니다.

 

 

Power-endurance athletes, such as soccer players, also appear to benefit from increased protein intake. A milk protein concentrate supplement (80% casein and 20% whey) positively impacted high-intensity running performance in the last 15 minutes of a match compared to an isocaloric carbohydrate supplement when ingested over a 1-week period during the season. [196] The protein supplement also enhanced the recovery of knee extensor concentric strength and endogenous antioxidant responses [196].

 

축구 선수와 같은 지구력 운동선수들도 단백질 섭취 증가의 혜택을 받는 것으로 보입니다. 우유 단백질 농축액 보충제(카제인 80%, 유청 20%)는 시즌 중 1주일 동안 섭취했을 때 이소칼로리 탄수화물 보충제에 비해 경기 마지막 15분 동안 고강도 달리기 성능에 긍정적인 영향을 미쳤습니다. [196] 단백질 보충제는 무릎 신전근 동심 강도 회복과 내인성 항산화 반응도 향상시켰습니다 [196].

 

Given the more common conversations surrounding higher protein intakes and impacts on the musculoskeletal system, the role of this macronutrient in other systems and physiological adaptations to training often receives a minimized focus. For the endurance athlete, these other functions may be vital to both health and performance. For example, the risk of upper respiratory tract infection is increased in those engaging in high volumes and intensities of endurance training [197]. Daily dietary protein intake of 3 g/kg has been shown to mitigate circulating immune cell disruption during heavy training periods, with values similar to those seen with lighter training, though protein intakes of 1.5 g/kg/d did not. [198,199] These positive effects on immune function have also been seen with BCAA supplementation of 12 g/d. [190]. Along these same lines, high protein intake (~64 g over a 3-hour period after intense endurance exercise) has favorably impacted gene expression related to improved substrate utilization and mitochondrial protein upregulation [200].

 

더 높은 단백질 섭취량과 근골격계에 미치는 영향을 둘러싼 더 일반적인 대화를 고려할 때, 이 다량 영양소의 역할과 훈련에 대한 생리적 적응은 종종 최소화되는 초점을 받습니다. 지구력 운동선수의 경우, 이러한 다른 기능들은 건강과 경기력 모두에 필수적일 수 있습니다. 예를 들어, 지구력 훈련의 양이 많고 강도가 높은 사람들에게서 상기도 감염의 위험이 증가합니다 [197]. 매일 3g/kg의 식이 단백질 섭취는 무거운 훈련 기간 동안 순환하는 면역 세포의 파괴를 완화하는 것으로 나타났으며, 이는 가벼운 훈련에서 관찰된 것과 유사한 값이지만, 단백질 섭취량은 1.5g/kg/d는 그렇지 않았습니다. [198,199] 이러한 면역 기능에 대한 긍정적인 효과는 BCAA가 12g/d를 보충했을 때도 관찰되었습니다 [190]. 이와 같은 맥락에서, 높은 단백질 섭취량(강도 높은 지구력 운동 후 3시간 동안 약 64g)은 기질 이용 개선 및 미토콘드리아 단백질 상향 조절과 관련된 유전자 발현에 긍정적인 영향을 미쳤습니다 [200].

 

In summary, endurance athletes may benefit from higher protein intakes due to their positive effects on glycogen replenishment, enhanced training adaptations and performance, immune system support, and improved recovery markers. Some of these effects are even more pronounced when combined with carbohydrates.

 

 

요약하자면, 지구력 운동선수는 글리코겐 보충, 훈련 적응력 및 경기력 향상, 면역 체계 지원, 회복 마커 개선에 긍정적인 효과가 있기 때문에 단백질 섭취량 증가의 이점을 누릴 수 있습니다. 이러한 효과 중 일부는 탄수화물과 함께 복용할 때 더욱 두드러집니다.

 

 

11. Does one need protein supplements to meet the daily requirements of exercise-trained individuals?

Exercising populations are recommended to consume protein in amounts ranging from 1.4–2.0 g/kg/day [21,22], and when an individual wishes to maximize their physique through strict dietary restriction, the daily intake and proportion of protein in the diet for these people is recommended to be higher (2.3–3.1 g/kg lean mass/day) [201]. Protein ingestion (3.4 g/kg day) for eight weeks has been shown to improve body composition via an increase in lean body mass coupled with a decrease in fat mass [64]. While this high daily protein intake was achieved through the consumption of whey protein powder [64], Pasiakos and colleagues [202] demonstrated that a daily protein intake 2× and 3× greater than the RDA best maximizes fat loss in the face of a 40% energy deficit over a three-week period in a group of civilian male and female participants. In these situations, total energy intake is a critical consideration, and protein powders offer a pragmatic way to meet increased protein needs while consuming minimal additional calories.

 

 

11. 운동 훈련을 받은 사람들의 일일 요구량을 충족시키기 위해 단백질 보충제가 필요합니까?
운동 인구는 1.4–2.0 g/kg/일 [21,22]의 양으로 단백질을 섭취하는 것이 권장되며, 엄격한 식단 제한을 통해 자신의 체격을 최대화하고자 할 때는 이러한 사람들의 일일 섭취량과 식단 내 단백질 비율을 더 높이는 것이 권장됩니다 (2.3–3.1 g/kg/일). 8주 동안 단백질을 섭취(3.4 g/kg/일)하면 제지방량이 증가하고 지방량이 감소하여 체성분이 개선되는 것으로 나타났습니다 [64]. 이러한 높은 일일 단백질 섭취량은 유청 단백질 분말을 섭취함으로써 달성되었지만 [64], 파시아코스와 동료들 [202]은 민간 남성 및 여성 참가자 그룹에서 3주 동안 40%의 에너지 부족에 직면했을 때 일일 단백질 섭취량이 RDA보다 2배 및 3배 더 많으면 지방 손실을 가장 잘 극대화할 수 있음을 보여주었습니다. 이러한 상황에서는 총 에너지 섭취가 중요한 고려 사항이며, 단백질 분말은 추가 칼로리를 최소화하면서 단백질 요구량을 증가시키는 실용적인 방법을 제공합니다.

 

 

A meta-analysis by Cermak et al. [203] summarized data from 22 separate studies (n = 680), concluding that protein supplementation led to significantly greater gains in fat-free mass and lower-body strength. In 2015, Pasiakos et al. [204] published a narrative review and concluded that added protein supplementation favorably impacted changes in muscle strength and hypertrophy in trained individuals but had a lesser impact on untrained people. Finally, a 2018 meta-analysis and meta-regression by Morton and colleagues [8] summarized data from 49 studies representing 1863 participants and concluded that protein supplementation significantly increased maximal strength and muscle fiber cross-sectional area.

 

 

Cermak et al. [203]의 메타 분석은 22개의 개별 연구(n = 680)의 데이터를 요약하여 단백질 보충이 무지방 질량과 하체 근력의 유의미한 증가로 이어진다는 결론을 내렸습니다. 2015년, Pasiakos et al. [204]는 내러티브 리뷰를 발표하여 단백질 보충제를 추가하면 훈련받은 사람들의 근력과 비대의 변화에 긍정적인 영향을 미치지만 훈련받지 않은 사람들에게는 덜 영향을 미친다는 결론을 내렸습니다. 마지막으로, 2018년 Morton과 동료들[8]의 메타 분석 및 메타 회귀 분석은 1863명의 참가자를 대표하는 49개의 연구 데이터를 요약하고 단백질 보충제가 최대 근력과 근섬유 단면적을 크게 증가시킨다는 결론을 내렸습니다.

 

 

 

In summary, protein supplementation is not required; however, it may provide a convenient adjunct to whole foods to achieve total daily protein requirements.

 

 

요약하자면, 단백질 보충제는 필요하지 않지만, 일일 총 단백질 섭취량을 달성하기 위해 전체 음식에 편리한 보조제를 제공할 수 있습니다.

 

12. Is there a limit to how much protein one can consume in a single meal?

The fundamental requirement for protein intake is the provision of amino acid pre- cursors, particularly the EAA’s, required for protein turnover [205]. Protein turnover is required in all tissues to constantly renew vital body proteins. In muscle, the stimula- tion of protein turnover is a response to mechano-metabolic stimuli and ensures that damaged, less functional tissue is replaced with more efficient components. While body proteins require a wide range of amino acids, it has long been understood that the stimulation of muscle protein turnover is contingent upon the provision of EAAs [206,207]. It has recently been demonstrated that the delivery matrix and pharmaco- kinetics of EAAs directly affect the stimulation of muscle protein turnover and MPS [208], with simpler administration formats such as free-form EAA and/or free-form protein combinations, resulting in greater EAA delivery and stimulation of muscle protein turnover. It has been established that both resistance [208] and aerobic [209] exercise stimulates protein turnover in skeletal muscle. Further, exercise sensi- tizes skeletal muscle to the stimulatory effects of exogenous amino acids [210,211]. Thus, the intuitive conclusion is that muscle activity/exercise requires protein intake for remodeling, performance, and function. However, the question as to a recommended amount of protein is dependent upon several physiological and metabolic factors.

 

 

 

12. 한 끼 식사에 섭취할 수 있는 단백질의 양에 제한이 있습니까?
단백질 섭취의 기본 요구 사항은 단백질 전환에 필요한 아미노산 프리커서, 특히 EAAs의 제공입니다 [205]. 단백질 전환은 중요한 신체 단백질을 지속적으로 갱신하기 위해 모든 조직에서 필요합니다. 근육에서 단백질 전환의 자극은 기계 대사 자극에 대한 반응으로, 손상되고 덜 기능적인 조직이 더 효율적인 구성 요소로 대체되도록 합니다. 신체 단백질은 다양한 아미노산을 필요로 하지만, 근육 단백질 전환의 자극은 EAAs의 제공에 따라 달라진다는 것은 오랫동안 이해되어 왔습니다 [206,207]. 최근 EAAs의 전달 매트릭스와 약동학이 근육 단백질 전환 및 MPS의 자극에 직접적으로 영향을 미친다는 것이 입증되었으며, 자유형 EAA 및/또는 자유형 단백질 조합과 같은 더 간단한 투여 형식을 통해 근육 단백질 전환율과 MPS[208]의 전달 및 자극을 증가시킵니다. 저항성 [208]과 유산소성 [209] 운동이 골격근의 단백질 전환을 자극한다는 것이 입증되었습니다. 또한, 운동은 골격근을 외인성 아미노산의 자극 효과에 민감하게 반응시킵니다 [210,211]. 따라서 직관적인 결론은 근육 활동/운동은 리모델링, 성능 및 기능을 위해 단백질 섭취가 필요하다는 것입니다. 그러나 권장 단백질 양에 대한 질문은 여러 생리적 및 대사적 요인에 따라 달라집니다.

 

It has been posited that ingesting 20–30 g of high-quality protein, such as whey, will provide adequate stimulation of muscle protein turnover in conjunction with exercise. This recommendation is largely based on two seminal studies by Moore [212] and Witard [213], who demonstrated a maximal MPS response to 20 g of whey protein ingestion in conjunction with exercise. A subsequent study utilizing a greater exercise stimulus (whole-body resistance exercise) by MacNaughton [214] demonstrated a significant increase in MPS with 40 g of protein. Taken together, these data indirectly suggest that greater exercise stress (likely involving more muscle groups) requires greater protein ingestion. This is consistent with recent findings in analogous military-related studies suggesting that caloric deficit, with [215,216] or without [56] concomitant exercise, requires increased protein intake. For example, a 30% caloric deficit requires 35 g of protein intake to ensure whole-body proteostasis and preserve muscle protein turnover [215]. Finally, when considering optimal protein intake, it is important to recognize the importance of the EAA composition of dietary protein. For example, plant-based dietary proteins generally have a lower content of EAA than animal-based dietary proteins. Most studies of dietary protein and exercise have used whey protein, and a greater amount of plant-based dietary protein is likely required to achieve the same results. However, recent work by Trommelen et al. found that ingesting 100 grams of milk protein resulted in a greater anabolic response than 25 grams [9]. This anabolic response was found to be quite prolonged (>12 hours) [9]. This disputes the notion that muscle protein synthesis peaks at ~ 40 grams post-ingestion.

 

 

20~30g의 고품질 단백질, 예를 들어 유청을 섭취하면 운동과 함께 근육 단백질 회전율을 적절히 자극할 수 있다는 주장이 제기되었습니다. 이 권고는 주로 Moore [212]와 Witard [213]의 두 가지 중요한 연구에 기반하고 있으며, 그는 운동과 함께 20g의 유청 단백질 섭취에 대해 최대 MPS 반응을 보였습니다. 이후 MacNaughton [214]의 더 큰 운동 자극(전신 저항 운동)을 활용한 연구에서는 40g의 단백질로 MPS가 크게 증가한 것으로 나타났습니다. 종합적으로 볼 때, 이러한 데이터는 더 많은 근육 그룹을 포함하는 운동 스트레스가 더 큰 단백질 섭취를 필요로 한다는 것을 간접적으로 시사합니다. 이는 [215,216] 또는 [56] 운동을 병행하지 않는 칼로리 결핍이 단백질 섭취 증가를 필요로 한다는 최근 군사 관련 연구 결과와 일치합니다. 예를 들어, 30%의 칼로리 결핍은 전신 단백질 유지와 근육 단백질 회전율 유지를 위해 35g의 단백질 섭취를 필요로 합니다 [215]. 마지막으로, 최적의 단백질 섭취를 고려할 때 식이 단백질의 EAA 구성의 중요성을 인식하는 것이 중요합니다. 예를 들어, 식물성 식이 단백질은 일반적으로 동물성 식이 단백질보다 EAA 함량이 낮습니다. 식이 단백질과 운동에 대한 대부분의 연구에서는 유청 단백질을 사용했으며, 동일한 결과를 얻기 위해서는 더 많은 양의 식물성 식이 단백질이 필요할 가능성이 높습니다. 그러나 Trommelen 등의 최근 연구에 따르면 우유 단백질 100g을 섭취하면 25g[9]보다 더 큰 동화 반응이 나타났습니다. 이 동화 반응은 상당히 장기적인 것으로 밝혀졌습니다(>12시간) [9]. 이는 근육 단백질 합성이 섭취 후 약 40g에서 최고조에 달한다는 개념에 이의를 제기합니다.

 

 

 

During energy deficit, whole-body proteostasis is maintained at the expense of stimu- lation of muscle protein turnover [215,216]. These data indicate that the physiologic state dictates adequacy and amount of protein intake. Thus, during a homeostatic, non- stressed state, the mantra of It has been suggested that 20–30 g of high-quality protein is adequate. In contrast, increasing metabolic stress requires greater protein intakes to satisfy both whole-body and muscle requirements. Nonetheless, preliminary data sug- gests that acute intakes as high as 100 grams result in a greater and more prolonged anabolic response than lower intakes.

 

에너지 결핍 동안 전신 단백질의 정체성은 근육 단백질 회전율을 자극하는 대가로 유지됩니다 [215,216]. 이러한 데이터는 생리적 상태가 단백질 섭취의 적절성과 양을 결정한다는 것을 나타냅니다. 따라서 항상성, 스트레스가 없는 상태에서는 20-30g의 고품질 단백질이 충분하다는 주장이 제기되었습니다. 반면, 대사 스트레스가 증가하면 전신 및 근육 요구 사항을 모두 충족하기 위해 더 많은 단백질 섭취가 필요합니다. 그럼에도 불구하고 예비 데이터에 따르면 급성 섭취량은 100g으로 낮은 섭취량보다 더 크고 장기적인 동화 반응을 초래합니다.

 

 

In summary, the ideal protein intake is contingent upon the physiologic state. The prepon- derance of the data suggests that ≥20 g can stimulate MPS in young adults. However, with increasing metabolic stress (e.g. weight loss, greater training volume, etc.), benefits are derived with greater intakes. Moreover, it is not known what the upper limit is for protein intake in a single meal although there is evidence that the acute consumption of 100 grams is indeed utilized by the body.

 

 

 

 

요약하자면, 이상적인 단백질 섭취는 생리적 상태에 따라 달라집니다. 데이터의 프리폰-디어런스는 ≥ 20g이 젊은 성인의 MPS를 자극할 수 있음을 시사합니다. 그러나 대사 스트레스(예: 체중 감량, 더 많은 운동량 등)가 증가하면 더 많은 섭취량으로 이점을 얻을 수 있습니다. 또한, 100g의 급성 섭취가 실제로 신체에서 활용된다는 증거는 있지만 단일 식사의 단백질 섭취 상한선이 무엇인지는 알려져 있지 않습니다.

 

 

13. Conclusions

1. (1)  There is no evidence that consuming dietary protein harms the kidneys of other- wise healthy individuals.
2. (2)  In exercise-trained men and women, consuming a high-protein diet either has a neutral effect or may promote the loss of fat mass.
3. (3)  There is no evidence that dietary protein has a harmful effect on the bones.
4. (4)  Vegans and vegetarians can consume enough protein to support training
5. adaptations.
6. (5)  Cheese and peanut butter are inadequate sources of protein.
7. (6)  Red meat does not likely cause unfavorable health outcomes; however, processed
8. meat may cause potential harm (e.g.. increased cardiovascular disease risk).
9. (7)  Individuals who are not physically active still need dietary protein.
10. (8)  Protein ingestion following (≤1 hour) resistance training sessions is not an abso-important is the total daily amount of dietary protein consumed.
11. lute requirement to produce an anabolic environment. What appears more
12. (9)  Endurance athletes need additional protein (i.e., at least twice the RDA) to assist in
13. a variety of issues related to the adaptive response to exercise.
14. (10)  One does not need protein powder to meet the daily requirements of exercise- trained individuals. However, treating protein powder differently than typical
15. protein foods (e.g., beef, chicken, milk, etc.) does not make scientific sense.
16. (11)  For most individuals, consuming 20–30 grams of high-quality protein is sufficient to induce a significant anabolic response; nonetheless, there is data to suggest
17. that 100 grams can elicit a higher and more prolonged anabolic response.

 

 

13. 결론
(1) 식이 단백질을 섭취하는 것이 그렇지 않은 건강한 사람들의 신장에 해를 끼친다는 증거는 없습니다.
(2) 운동 훈련을 받은 남성과 여성의 경우, 고단백 식단을 섭취하면 중성적인 영향을 미치거나 지방량 감소를 촉진할 수 있습니다.
(3) 식이 단백질이 뼈에 해로운 영향을 미친다는 증거는 없습니다.
(4) 비건과 채식주의자는 훈련을 지원하기에 충분한 단백질을 섭취할 수 있습니다
각색.
(5) 치즈와 땅콩버터는 단백질 공급원이 부족합니다.
(6) 붉은 고기는 건강에 좋지 않은 결과를 초래하지 않을 가능성이 높습니다. 그러나 가공된
육류는 잠재적인 해를 끼칠 수 있습니다(예: 심혈관 질환 위험 증가).
(7) 신체 활동이 없는 사람들은 여전히 식이 단백질이 필요합니다.
(8) 저항성 훈련 세션(1시간 미만) 후 단백질 섭취는 절대적인 부작용이 아닙니다.-
동화 환경을 조성하기 위한 황체 요구 사항. 더 많이 나타나는 것
중요한 것은 하루에 섭취하는 식이 단백질의 총량입니다.
(9) 지구력 운동선수는 다음을 돕기 위해 추가 단백질(즉, RDA의 최소 두 배)이 필요합니다
운동에 대한 적응 반응과 관련된 다양한 문제들.
(10) 운동 훈련을 받은 개인의 일일 요구 사항을 충족하기 위해 단백질 분말이 필요하지 않습니다. 그러나 단백질 분말을 일반적인 것과 다르게 취급하는 것은
단백질 식품(예: 소고기, 닭고기, 우유 등)은 과학적으로 이해되지 않습니다.
(11) 대부분의 개인에게 고품질 단백질 20~30그램을 섭취하면 상당한 동화 반응을 유도하기에 충분합니다. 그럼에도 불구하고 다음과 같은 데이터가 있습니다
100그램은 더 높고 장기적인 동화 반응을 이끌어낼 수 있습니다.

 

 

Disclosure statement

JA is the CEO of the International Society of Sports Nutrition (ISSN), a 501c3 academic nonprofit. The ISSN receives grants from companies that sell, market, and manufacture protein-containing sports nutrition products. AF is an inventor of EAA-based compositions (US11,273,138 B2, US20140343112, US20200253908). CMK has no conflict of interest related to this manuscript regarding financial or business interests. Over the past 18 years, he has received grants and contracts to research dietary supplements, served as a paid consultant for industry, and received honoraria for speaking at conferences and writing lay articles about sports nutrition ingredients and topics. DGC has received grants, travel support and product donations for research from various companies that sell, market, or manufacture protein supplements. RBK has conducted sponsored research on nutritional supplements through grants and contracts awarded to the universities with which he has been affiliated, received honorarium for presenting research related to dietary supplements, served as an expert on cases related to dietary supplements, and consulted with industry on product development including dietary supplements containing essential amino acids/protein. JRS has no conflict of interest related to this manuscript regarding financial or business interests. Over the past 25 years, he has received grants and contracts to research dietary supplements, served as a paid consultant for industry, and received honoraria for speaking at conferences and writing lay articles about sports nutrition ingredients and topics. SMA has no current conflicts of interest specifically related to EAAs/protein. He has received other funding from dietary supplement companies for research, honoraria for speaking at conferences or as an advisory board member, and consulting. CE, BA, HC, PH, SCF, FP, and DG have no conflicts to declare.

 

 

재정적 또는 비즈니스적 관심사와 관련하여. 지난 18년 동안 그는 식이보충제 연구를 위한 보조금과 계약을 받았으며, 산업계의 유료 컨설턴트로 활동했으며, 컨퍼런스에서 연설하고 스포츠 영양 성분과 주제에 관한 일반 기사를 작성한 공로로 명예의 전당에 올랐습니다. DGC는 단백질 보충제를 판매, 마케팅 또는 제조하는 다양한 회사로부터 연구를 위한 보조금, 여행 지원 및 제품 기부를 받았습니다. RBK는 소속 대학에 수여하는 보조금과 계약을 통해 영양 보충제에 대한 후원 연구를 수행하고, 식이보충제 관련 연구를 발표하여 명예의 전당에 올랐으며, 식이보충제 관련 사례에 대한 전문가로 활동했으며, 필수 아미노산/단백질을 포함한 제품 개발에 대해 산업계와 상담했습니다. JRS는 재정적 또는 비즈니스적 관심사와 관련하여 이 원고와 관련된 이해 상충이 없습니다. 지난 25년 동안 그는 식이보충제 연구를 위한 보조금과 계약을 받았으며, 산업계의 유료 컨설턴트로 활동했으며, 컨퍼런스에서 연설하고 스포츠 영양 성분과 주제에 관한 일반 기사를 작성한 공로로 명예의 전당에 헌액되었습니다. SMA는 현재 EAA/단백질과 관련된 이해 상충이 없습니다. 그는 식이보충제 회사로부터 연구를 위한 기타 자금, 컨퍼런스에서 연설하거나 자문위원으로 활동한 공로의 명예의 전당, 컨설팅을 받았습니다. CE, BA, HC, PH, SCF, FP, DG는 선언할 충돌이 없습니다.