The Role of Protein and Amino Acids in Sustaining and Enhancing Performance -- Copyright -- Preface -- HISTORY OF THE COMMITTEE -- FOCUS OF THE REPORT -- ORGANIZATION OF THE REPORT -- ACKNOWLEDGMENTS -- Contents -- Executive Summary -- COMMITTEE'S TASK -- METHODS -- FINDINGS -- Effect of Stressors on Protein Requirements of Military Personnel -- Baseline Protein and Amino Acid Requirements -- Physical Activity -- Infection, Injury, and Illness -- Other Stressors -- THE MRDA FOR PROTEIN -- Pregnancy and Lactation -- Benefits and Risks of Protein and Amino Acid Supplements and Alternative Sources of Dietary Protein -- Protein and Amino Acid Supplements and Cognitive Performance -- Protein, Amino Acids, Muscle Mass, and Physical Performance -- Protein, Amino Acids, and Immune Function -- Issues of Protein Quality and Timing of Consumption -- Dietary Protein and Renal Function -- Dietary Protein and Calcium Status -- Amino Acid Toxicity -- Protein and Amino Acid Supplements and Pregnancy -- CONCLUSIONS AND RECOMMENDATIONS -- Effects of Stressors on Protein Requirements -- Military Recommended Dietary Allowances for Protein -- Benefits and Risks of Supplemental Protein, Amine Acids, and Alternative Sources of Dietary Protein -- REFERENCES -- I Committee Summary and Recommendations -- 1 Committee Overview -- INTRODUCTION -- THE ARMY'S INTEREST IN DIETARY PROTEIN AND PROTEIN BALANCE -- ESTIMATION OF PROTEIN REQUIREMENTS -- Protein Metabolism -- Methods for Assessment of Protein Requirements -- FAO/WHO/UNU Requirements and RDAs: Current Estimates of Average Protein Intake -- Importance of the Debate over Indispensable Amino Acid Requirements -- Argument for Higher Indispensable Amine Acid Requirements -- Argument Against Higher Indispensable Amino Acid Requirements -- The Rebuttal -- Resolution of the Debate.

STRESSORS THAT INFLUENCE PROTEIN REQUIREMENTS -- Physical Activity and Energy Restriction -- Exercise and Amino Acid Catabolism -- Contractile Activity and Muscle Protein Turnover -- Energy Balance and Protein Requirements -- Infection, Injury, and Illness -- Other Stressors -- Heat -- Cold and High Altitude -- Combined Stressors -- THE MRDA FOR PROTEIN -- Protein Intake Studies of Military Personnel -- Pregnancy, Lactation, and the MRDA for Protein -- Summary -- PERFORMANCE BENEFITS AND HEALTH RISKS OF SUPPLEMENTAL PROTEIN, AMINOACIDS, AND PLANT PROTEINS -- Supplement Use Among Army Personnel -- Protein and Amine Acid Supplements and Cognitive Performance -- Tryptophan -- Tyrosine -- Protein, Amino Acids, Muscle Mass, and Physical Performance -- Measurement of Muscle Mass -- Control of Muscle Mass and Function -- Hormonal Interactions -- Catabolic Hormones -- Effects of Protein, Energy, and Amine Acid Supplementation on Physical Performance -- Protein and Energy Intake in Long-Distance Cyclists -- The Fatigue Theory -- Amine Acids and Immune Function -- Issues of Protein Quality and Timing of Consumption -- Potential Benefits of Plant and Legume Proteins -- Effects of Timing of Protein Intake -- Risks Associated with High-Protein Diets and Supplements -- Protein and Renal Function -- Protein and Calcium Status -- Toxicity of Amino Acid Supplements -- REFERENCES -- 2 Responses to Questions, Conclusions, and Recommendations -- REFERENCES -- II AUTHORED PAPERS AND WORKSHOP DISCUSSIONS -- 3 Protein and Amino Acids: Physiological Optimization for Current and Future Military Operational Scenarios -- INTRODUCTION -- REFERENCES -- 4 Overview of Garrison, Field, and Supplemental Protein Intake by U.S. Military Personnel -- INTRODUCTION -- PROTEIN AVAILABILITY FROM OPERATIONAL RATIONS -- HISTORIC RATION INTAKE -- CURRENT RATION INTAKE.

Energy and Protein Intakes of Military Men -- Energy and Protein Intakes of Military Women -- DETERMINATION OF PROTEIN REQUIREMENTS FOR OPERATIONAL RATIONS -- SUPPLEMENT INTAKE -- AUTHORS' CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- 5 The Energy Costs of Protein Metabolism: Lean and Mean on Uncle Sam's Team -- ORIGIN OF THE WORD "PROTEIN" -- FUNCTIONS OF BODY PROTEINS AND AMINO ACIDS -- PROTEIN METABOLISM AS AN ENERGY-REQUIRING PROCESS -- ENERGY COSTS OF PROTEIN SYNTHESIS AND REGULATION -- ENERGY COSTS OF PROTEIN BREAKDOWN -- CONCLUSION -- REFERENCES -- DISCUSSION -- 6 Regulation of Muscle Mass and Function: Effects of Aging and Hormones -- INTRODUCTION -- SARCOPENIA OF AGING -- HORMONAL EFFECTS ON MUSCLE PROTEIN -- Insulin -- Growth Hormone and IGF-I -- Sex Steroids -- CATABOLIC HORMONES (GLUCAGON, CORTISOL, EPINEPHRINE, AND THYROID HORMONES) -- SUBSTRATES AND NUTRITION -- AUTHORS' CONCLUSIONS -- REFERENCES -- DISCUSSION -- 7 Effects of Protein Intake on Renal Function and on the Development of Renal Disease -- INTRODUCTION -- NEPHROLITHIASIS -- Calcium Excretion and Calcium-Containing Stones -- Calcium Intake -- Determinants of Calcium Clearance -- Patterns of Urinary Excretion in Stone Formers -- Uric Acid Stones -- Prophylactic Treatment of Nephrolithiasis -- ACUTE RENAL FAILURE -- PROTEIN INTAKE AND THE DEVELOPMENT OF GLOMERULOSCLEROSIS -- AUTHOR'S CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- DISCUSSION -- 8 Infection and Injury: Effects on Whole Body Protein Metabolism -- BACKGROUND AND GENERAL RESPONSE CHARACTERISTICS -- THE TRANSLOCATION OF NITROGEN FROM CARCASS TO VISCERA -- REGULATORS OF THE TRANSLOCATION OF PROTEIN -- CONCLUSIONS -- REFERENCES -- DISCUSSION -- 9 Inherent Difficulties in Defining Amino Acid Requirements -- INTRODUCTION -- BACKGROUND TO THE CURRENT CONTROVERSY -- METABOLIC BACKGROUND -- Obligatory Metabolic Demand.

Obligatory Metabolic Demands and Obligatory Oxidative Losses -- Use of the Obligative Oxidative Loss Pattern to Predict a Requirement Pattern -- Animal Data for the Pattern of the Obligatory Metabolic Demand -- The Adaptive Component of the Metabolic Demand -- Diurnal Cycling: A Qualitative Influence on Metabolic Demand? -- Summary of the Metabolic Demand for Indispensable Amine Acids -- FAO REQUIREMENT VALUES AND N BALANCE STUDIES -- Are There Robust N Balance Data that Support the FAO Requirement Values? -- Biological Value of Plant Proteins in Human N Balance Trials -- Adjustment of the Food and Agriculture Organization Requirement Values -- Stable Isotope Estimates of Requirement Values -- Toronto "Break Point" Studies -- Functional Indicators of Adequacy of Intakes Allowing Zero Balance -- Protein Turnover -- Other Metabolic Influences of Amino Acids -- AUTHOR'S CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- DISCUSSION -- 10 Amino Acid Flux and Requirements: Counterpoint -- Tentative Estimates Are Feasible and Necessary -- INTRODUCTION -- Proposed Massachusetts Institute of Technology Amine Acid Requirement Pattern -- Adaptive Aspects of Amino Acid Metabolism -- Diurnal Cycling and Amine Acid Requirements -- Nitrogen Balance and Estimations of IAA Requirements -- Stable Isotope Estimates of Requirement Values -- The MIT Amino Acid Requirement Pattern and Physical Activity -- Author's Conclusions and Recommendations -- REFERENCES -- 11 Physical Exertion, Amino Acid and Protein Metabolism, and Protein Requirements -- INTRODUCTION -- EXERCISE AND AMINO ACID CATABOLISM -- EFFECTS OF CONTRACTILE ACTIVITY ON MUSCLE PROTEIN TURNOVER -- INTERACTIONS BETWEEN ENERGY SUPPLY AND PROTEIN AND AMINE ACID METABOLISMIN THE CONTEXT OF INCREASED ... -- POSSIBLE BENEFICIAL EFFECTS OF BRANCHED CHAIN AMINO ACID SUPPLEMENTATION.

GLUTAMINE, THE OVERTRAINING SYNDROME AND IMMUNE FUNCTION -- THE CRUCIAL QUESTIONS -- AUTHOR'S CONCLUSIONS AND RECOMMENDATIONS -- ACKNOWLEDGMENTS -- REFERENCES -- 12 Skeletal Muscle Markers -- INTRODUCTION -- Method Organization -- AVAILABLE METHODS -- Anthropometry -- Ultrasound -- Bioelectric Impedance Analysis -- Urinary Metabolites -- Imaging Methods -- Dual-Energy X-Ray Absorptiometry -- In Vive Neutron Activation/Whole Body Counting -- Monitoring Changes in Skeletal Muscle Mass Over Time -- CONCLUSIONS -- REFERENCES -- 13 Alterations in Protein Metabolism Due to the Stress of Injury and Infection -- ANABOLIC HORMONES -- AUTHOR'S CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- I DISCUSSION -- 14 Amino Acid and Protein Requirements: Cognitive Performance, Stress, and Brain Function -- INTRODUCTION -- The Blood-Brain Barrier: A Key Determinant of Brain Nutritional Status -- TRYPTOPHAN -- TYROSINE -- CHANGES IN AMINO ACIDS DURING FIELD STUDIES: UNDERNUTRITION AND MENTAL PERFORMANCE -- AUTHOR'S CONCLUSION AND RECOMMENDATIONS -- REFERENCES -- DISCUSSION -- 15 Supplementation with Branched-Chain Amino Acids, Glutamine, and Protein Hydrolysates: Rationale for Effects on ... -- INTRODUCTION -- PROTEIN AND AMINE ACID METABOLISM IN ENDURANCE EXERCISE -- BRANCHED-CHAIN AMINE ACIDS -- Central Fatigue Hypothesis -- Effects of Ingestion of Branched-Chain Amino Acids and Tryptophan on Endurance Performance -- Summary of Performance Studies with BCAA and Tryptophan -- Interaction of the BCAA-Aminotransferase Reaction with the Tricarboxylic Acid (TCA) Cycle in Muscle -- Effect of BCAA Ingestion on Plasma Ammonia Concentrations and Muscle Ammonia Production During Exercise -- GLUTAMINE -- Plasma Glutamine Concentrations Following Prolonged Exercise -- Plasma Glutamine Concentrations in Overtrained Athletes and in Tour de France Cyclists -- Link to Immune System.

GLYCOGEN RESYNTHESIS FOLLOWING EXERCISE.