Tag: fat loss

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Successful Weight Loss Maintenance

Yo Yo Dieting
Successful Weight Loss Maintenance

What are the most prevalent strategies and habits utilized by individuals who have lost weight, and kept it off? A recent systematic review reveals factors common to groups of people who have achieved successful weight loss maintenance.*

Behaviors and Habits

  • Continued Intake Monitoring. Individuals who successfully maintained their weight loss were more likely to continually monitor, notably with food diaries or tracking apps. Mindfulness of portion sizes and use of food scales were noted as ways to mitigate overindulgence.
  • Meal Planning. Planning and preparing meals in advance was noted as an important habit to stay on track and remain in control during challenging situations. Preparing for events by checking out menu options and foods before, and selecting what to eat in advance was also a frequently mentioned strategy.
  • Dining in. Home cooking was frequently employed as a strategy to lean about ingredients and how the contribute to total intake as well as understanding appropriate portions.
  • Stable Eating Routines. Individuals who maintained their weight loss generally kept same pattern of everyday eating in terms of limiting their food choices and eating at certain times of day.
  • Weight loss maintainers more often used progress photos, clothes fit, and/or weight measurements to provide a sense of staying on track and for accountability.
  • External Support. Successful individuals were more likely to utilize family, friends, and professionals as part of a system of ongoing support and accountability. This support system also provided a beneficial sense of belonging.
  • Continued Goal Pursuit. Maintainers kept (and refreshed) a well-defined set of nutrition, fitness, and other health goals which drove their routines. Examples include keeping a weekly schedule for the gym or playing a sport or establishing calorie/macronutrient/food category goals.

Challenges and Feelings

Successful weight loss maintainers more strongly identified with their new lifestyle and had an improved self-image, but reported a mix of encouraging and discouraging feelings. They expressed feelings of freedom and self-identified as people who live healthy lives and pursue new and challenging life opportunities. On the other hand, many expressed a high degree of fear of weight regain and some degree of loneliness (criticism by others of their new healthy life choices).

Finally, successful weight loss maintainers highlighted that one (if not the most) difficult aspect is managing through intrinsic and extrinsic challenges. This includes unsupportive peers, feeling of social isolation, divorce, pregnancy, illness, injury, house moves, and social events.

Life events present ample opportunity to revert to old habits. Remember your “why” and focus on the benefits in how you feel and your capability. Center around the people who are positive forces in your life and support your continued success.

Weight Loss Management Framework

Spreckley, M., Seidell, J.; Halberstadt, J., Perspectives into the experience of successful, substantial long-term weight loss maintenance: a systematic review, Int J Qual Stud Health Well-being, 16(1), 2021.

*Because this review was the analysis of 15 different studies, the definition of “successful weight loss maintenance” was variable. Most studies were within the boundary weight loss between 5-10% of bodyweight maintained for 1-7 years.

Ready to start working on (or need help maintaining) your nutrition to achieve your performance and physique goals? Contact me for a consultation.

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Breaking a Fat Loss Plateau

It’s frustrating to be consistent with nutrition, make amazing weight loss progress, but then for no reason hit a wall. Many give up when the scale stops moving. A fat loss plateau is disheartening.

You may be a bit relieved to hear that you’re not alone. A fat loss plateau – two or more weeks where the scale doesn’t move – is almost EXPECTED during a dieting phase. The good news is there are fundamental reasons why it happens, and there are methods to break through.

Need a plan and support to improve your physique, strength and energy? Contact me to explore options.

Why We Plateau

Human metabolism is dynamic and adaptive to changes in energy intake. Total daily energy expenditure (TDEE) aka “calories out” decreases in response to a sustained reduction in calorie intake. Two adaptations are primarily responsible:

  • Reduction in basal metabolic rate (BMR). BMR is the energy we expend to breathe, move blood through our bodies, maintain organ function…basically to keep us alive. In a sustained calorie deficit, BMR slows down as we lose weight – the body is adapting to the calorie deficit. You don’t have much control over BMR.
  • Reduction in non-exercise activity thermogenesis (NEAT).  Whether you are aware of it or not, in a sustained calorie deficit you will expend less energy throughout the day – sitting for a bit longer than normal, less fidgeting, etc.

The body is driven to maintain balance. Therefore, when we place our bodies in an energy deficit through consumption of fewer calories (energy in < energy out), there are regulatory drivers that act to restore neutrality. For example, reductions in energy intake influences the rate of release of certain hormones. Ghrelin hormone is upregulated in an energy deficit, promoting increased feelings of hunger. Satiety hormone leptin is downregulated (due to shrinking size of fat cells and fatty acid mobilization). Further, “stress” hormone cortisol increases which can lead to reduced energy expenditure, and insulin sensitivity of fat cells increases (easier to assimilate glucose and store fat).

Calories in and calories out are not independent variables – they are influenced by one another. Energy intake level impacts energy expenditure level. Fat loss is not just a matter of calorie counting, NOR can we simply blame our hormones.

As you diet and lose weight, what was once calorie deficit becomes maintenance calorie level through metabolic adaptation. Therefore, it’s expected at some point there would be a fat loss plateau. To again achieve an energy deficit, energy intake and expenditure require adjustment.

We also need to consider that downward scale movement may not be the best indicator of fat loss. If you have recently initiated resistance training, are noticing your measurements change and/or you look different in photos, you may be building muscle while losing fat. In this case, the scale is not directly providing fat loss feedback.

Overcoming the Fat Loss Plateau

Before considering adjustments, perform an audit of current dietary compliance. There’s no need to reduce nutrients if energy intake is actually higher than the calories you are accounting for.

Dietary Compliance Audit

  • “Extras”.  Assess use of condiments and sauces – these can add 100’s of calories per day.
  • Nibbles. Are you doing fly-bys of the fridge, and “just” having bites? It’s easy to lose sight of these unaccounted-for bites, but this accumulation of small amounts of additional calories throughout the day may take you out of a calorie deficit. Utilize mindfulness – all food consumed on a plate sitting down, with minimal distraction. Personally, I’m still working on this habit!
  • Variability in dining out portions. Restaurant portion size and nutrition information is not tightly controlled. It may vary significantly depending on who is preparing your food. If you are eating out frequently and the cook is regularly overserving on portions, this could also be adding 100’s of additional calories per day or week
  • Tracker inputs. Food entries in programs such as MyFitnessPal are user-generated, and potentially have errors. To be safe, double check your inputs against the nutrition information on the products you use. The USDA database is also an excellent source of nutrition information.
  • Food Measurement – there’s a tradeoff between accuracy and practicality in “eyeballing” portions, using measuring cups (volume), and weighing food. If you feel that your portions may be off, consider weighing food for a period to make sure portions are accurate.

If the scale hasn’t budged for about 2 weeks and you’ve passed your audit, it’s time to consider adjusting your plan. We don’t want to do anything extreme or non-sustainable. Rather, make small changes to energy intake and expenditure.

Adjusting Energy Intake and Expenditure

  • Small reduction in energy intake: reduce your calories in small steps versus large jumps  – 50 to 100 calories/day is a good place to start. Wait a week or so between each step before deciding on further adjustment. You may find that in order to reduce calories it will require swapping out some higher calorie density foods for lower calorie dense foods to feel full.
  • Increase daily movement (increase NEAT): it’s not sustainable to continually increase exercise to offset metabolic adaptation. You can’t out-exercise your diet. Rather, consider a few easy NEAT habits! Assuming you are sleeping 8h per day and training 1 hour per day, that leaves more than 60% of your waking hours to get in a bit more movement! Some examples of NEAT are walking when you’re talking on the phone, parking further away while out shopping, going for a dog walk, cleaning the house, and of course doing a quick happy dance for no reason. You may find that this extra movement helps your mood and overall energy stability throughout the day as well.

Final Thoughts on the Fat Loss Plateau

If you are experiencing significant fatigue and stress, gym performance has crashed, have negative changes in sleeping, or are noticing unhealthy feelings about food, a plateau may be a sign to take a break. By shifting into maintenance, you’ll provide yourself with breathing room to enjoy more flexible eating. This has physical and psychological benefit. It’s perfectly acceptable to hit the pause button on fat loss and focus on stability. Likewise, if you’ve been dieting strictly for an extended period of time, consider taking a couple of months in energy maintenance before proceeding with further fat loss.

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Holiday Weight Gain – Review and Tips

Holiday Weight Gain

The winter season is golden opportunity to utilize healthy balance habits for weight management. This review provides context and recommendations regarding holiday weight gain.

Adults tend to gain weight throughout middle age at a rate of 1.1 – 2.2 lbs/year, [1] with the most significant acceleration occurring in the 20s and 30s.  As we age, our energy needs tend to decrease. If our calorie intake remains the same (or increases) and calorie expenditure decreases, weight gain is inevitable. A small to modest accumulation of weight every year may have health implications. It’s a contributing factor to the growing US obesity rate. [2]

Individualized circumstances may contribute to weight gain at certain points in life. Major events can create stress, change in habits, and decrease time available for self-care. Major life events aside, is every day, week, and month throughout the year equivalent in terms of weight gain?

The winter holiday (Thanksgiving through 1st week of January) appears to be a key time for higher risk of weight gain. These winter weeks may contribute more towards long-term weight gain throughout adulthood. Let’s delineate between an acute weight spike related to a specific event, versus seasonal weight gain.

Acute Weight Gain (Temporary)

A weight spike following individual eating event – e.g. a party serving decadent food and drink is unlikely to be true gain of fat mass. If you see a 3+ lb. jump on the scale the following morning, there is good news. Unless you literally ate more than 10,000 Calories at the party, you did not gain 3+ lbs of fat or tissue. It’s mostly water!

  • Increased carbohydrate consumption results in higher glycogen (sugar) stores in the muscles and liver. This leads to retention of additional water. Each gram of glycogen stored holds ~ 3g additional water.
  • Increased consumption of sodium from salty foods increases water retention. This retention may come from free body water, independent of increased water intake.[3]
  • Alcohol is a diuretic (makes you pee more) and it suppresses a hormone that tells your body to retain water. Your body is going to try to counterbalance by holding on to as much water as possible.[4,5]
  • The human body is ~60% water, sometimes a bit more and sometimes a bit less depending on what we do. I spent my early years overanalyzing individual scale readings assuming they were tied exclusively to gain and loss of actual body tissue.

I recommend not weighing yourself the day after a big night out. After a few days back into your regular eating routine, your weight will return somewhere close to your pre-party weight. A single indulgent meal has little to no impact on the big picture.

Seasonal Weight Gain (Sustained)

In contrast to an acute weight spike, seasonal weight gain is attributed to sustained calorie surplus from continual over-eating during the holiday period. Higher availability of energy-dense snacks, and more frequent snacking on higher carbohydrate and higher fat foods contribute to gain of true body mass, specifically increased fat mass.

According to a prospective study on seasonal weight gain, Americans gain an average of 0.8 lbs through the period of November through early January.[6] Most weight gained during the holiday period is not subsequently lost, leading to a net gain of approximately 1 lb/year through the full study period.

Weight gain during the winter holiday period is not subsequently lost in a year, and represents more than 50% of the weight gained throughout the year.

Although the AVERAGE weight gain in the study population was 1 lb, segmentation of the data reveals that some participants had major holiday weight gain ( ≥ 5 lb). These individuals were more likely to already be overweight or obese.

Weight management through the holiday period may be even more important for those who are already at risk for obesity-related comorbid conditions.

Recommendations

Here are some recommendations to keep in mind through the winter to support healthy weight management:

  1. Set practical boundaries to create a healthy balance. It’s unrealistic to avoid ALL temptation and over-restrict during the holidays. Prioritize your special meals and treats and skip the less important foods. Be mindful of portions and eat slowly to maximize enjoyment.
  2. Self-monitor. Individuals who were provided weight management information, other support, and encouraged to self-monitor weight achieved better control of body weight versus those that did not self- monitor [7,8].
  3. Keep up with your training. An increase in food intake is the primary cause for seasonal weight gain (versus a decrease in activity), but keeping up with your regular routine will support your health. Don’t skip because it’s cold out. 🙂
  4. Reflect/journal on how you did with your nutrition through the holidays: assess how you physically and mentally feel, what habits you maintained and which you broke (if any), and seek support as needed to address gaps. The start of the year is a natural period to set new goals and focus areas.

Ready to improve your nutrition? Contact me for nutrition coaching.

[1] https://www.cdc.gov/nchs/data/series/sr_03/sr03_039.pdf

[2] https://www.cdc.gov/nchs/data/databriefs/db360-h.pdf

[3] Rakova N.; Kitada, K.; et al., Increased salt consumption induces body water conservation and decreases fluid intake, J Clin Invest., 127(5), 1932-1943 (2017).

[4] Eggleton M.G., The diuretic action of alcohol in man, J Physiol., 101(2), 172-91, (1942).

[5] Cederbaum A.I., Alcohol metabolism, Clin Liver Dis., 16(4), 667-85, (2012).

[6] Yanovski J.A.; Yanovski, S.Z., et al., A prospective study of holiday weight gain, N Engl J Med., 342(12), 861-7, (2000).

[7]Boutelle, K.N.; Baker, R.C.; et al., How can obese weight controllers minimize weight gain during the high risk holiday season? By self-monitoring very consistently, Health Psychology, 18(4), 364–368 (1999).

[8] Mason F.; Farley A.; et al., Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial, BMJ, 363, (2018).

[9] Bhutani, S.; Wells, N., Change in eating pattern as a contributor to energy intake and weight gain during the winter holiday period in obese adults, Int J Obes, 44(7), 1586-1595, (2020).

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Low-fat vs. Low-carb

Low Carb Low Fat
Low-fat vs low-carb diets

Low-fat vs. low-carb diets….is one better than the other? You’ve likely come across stories about going low-carb or keto for more effective weight loss. These stories create confusion more than they help, so let’s clear the air by reviewing a few concepts.

1. Eating carbohydrates does not make you inherently gain fat.

Carbohydrates raise blood glucose (and therefore insulin) which suppresses burning fat for energy, but this is not the same thing as fat gain. Burning fat (the breakdown of fat for energy) is NOT the same thing as body fat loss. The fuel that your body burns day to day for energy is a matter of what fuel you are giving it:

  • If you eat a higher fat diet, you burn more fat AND store excess fat if you are in calorie surplus
  • If you eat a diet higher in carbohydrates, you burn more carbohydrates AND store more carbohydrates as glycogen, and then surplus converted and stored as fat

2. “Calories in < calories out” is an oversimplification of how weight loss works. Equally incorrect is “calories don’t matter, hormones control weight loss”.

Both matter to varying degrees. Food quantity and composition influences our hunger and satiety hormones (among others), and vice versa. These hormones are released from different locations in our bodies and send signals to our brains which in turn drive feeding cues, energy expenditure, and release of other hormones.

While a net calorie deficit is required, calorie intake and expenditure influence your particular hormone levels to a different degree than someone else, and likewise your hormone levels have a varying degree of influence over your calorie intake and expenditure. This recognizes that it can be more challenging for some than others to create a calorie deficit.

Type of calories have implications on your energy balance, body weight, and body composition. The way intake calories are partitioned between protein, carbohydrates, and fats AND specific foods selected within those categories have different capabilities to impact hunger and fullness. They also have different energy costs to digest, absorb, and metabolize. For example, appropriate protein intake supports lean mass retention and a small degree of additional spontaneous energy expenditure (energy cost of protein digestion).

3. Effective weight loss can be achieved with a higher carb, lower fat diet or a lower carb, higher fat diet.

Some people find that they are less hungry and it’s easier to stick to a lower carb diet, while others feel more satisfied eating more carbohydrates. If you are training hard and trying to lose fat at the same time, you may want to consider keeping your carbs relatively high at the expense of dietary fats to to fuel your performance.

The Carbohydrate Insulin Model posits that diets heavier in high glycemic load carbohydrates shift body homeostatic mechanisms towards fat gain and therefore a lower carbohydrate diet is more effective for weight loss. Specifically, a higher carbohydrate diet increases insulin levels to promote energy storage in fat cells. Increased adiposity creates hormone dysregulation leading to increased hunger and reduction in metabolic rate.[1] This model is not supported by well-conducted studies. In reality, effective weight loss can be achieved with a higher carbohydrate, lower fat diet OR lower carbohydrate, higher fat diet. A meta-analysis of controlled feeding trials (calories and protein held constant) indicates that differences in weight loss between a low-carb and low-fat diets are not statistically significant [2] or in one example may lean slightly in favor of low-fat diets as it specifically relates to fat loss.[3] In a population with abdominal obesity and metabolic syndrome risk, a one-year study indicated that a low-fat isocaloric diet is equally as effective as a very low-carb diet for weight loss.[4] Further, a 12-week crossover study[5] with overweight, postmenopausal women also concluded the same, in addition to no significant lipid, insulin, or glucose differences between the two diets.

4. Tracking food intake and calories is not a requirement for weight loss, but it can be a helpful tool for some.

For weight loss you must consume less calories than you expend, but you do not need to quantify it by measuring food and logging calories. Tracking is helpful for some, but a possible detriment to others. Consider your dieting history and potential for disordered eating behavior. Consistent and frequent self-monitoring has some association with weight loss and improved weight maintenance after weight loss.[6] Tracking food intake may improve awareness about what you’re eating.

As you consider the right diet plan, decision factors should include practical ability to adhere and satisfaction, activity level, and health considerations.

Elimination of specific foods or food groups can be challenging to stick with, and at worse could lead to all out binges on foods self-deemed as “bad”. Labeling foods as “allowed” and “not allowed” creates unnecessary rigidity and more likely a negative outcome in long-term weight management. While it may be easier to think of food in good/bad terms, it’s better to instead regard all foods on a spectrum from being “less aligned with my goals and health” to “more aligned with my goals and health”. Seek professional advice if you have concerns and specific circumstances that need attention.

Diet planning is not one size fits all. But please, do not be scared of eating fruit! Contact me if you’re looking for a balanced strategy and plan.

For more tips, please follow me on Instagram and Facebook.

[1 Ludwig, D.S., Ebbeling, C.B., “The Carbohydrate-Insulin Model of Obesity: Beyond Calories In, Calories Out., JAMA Intern Med. (2018), 178(8), 1098.

[2] Hall, K.D., Guo, J., Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition” Gastroenterology (2017), 152(7), 1718.

[3] Schick, A.; Boring, J., et al., “Effects of Ad Libitum Low Carbohydrate Versus Low Fat Diets on Body Weight and Fat Mass”. Current Developments in Nutrition (2020), 4(2),658.

[4] Brinkworth, G.D.; Noakes, M., et al., “Long-term Effects of a Very-low-Carbohydrate Weight Loss Diet Compared with an isocaloric low-fat diet after 12 months”. Am J Clin Nutr. (2009), 90, 23.

[5] Segal-Isaacson, C.J.; Johnson, S., “A Randomized Trial Comparing Low-Fat and Low-Carbohydrate Diets Matched for Energy and Protein”, Obesity Research, (2004), 12 130S.

[6] Peterson, N.D.; Middleton, K.R.; et al., “Dietary self‐monitoring and long‐term success with weight management”, Obesity, (2014), 22, 1962.

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Protein For Fat Loss

Protein is the most valuable macronutrient for retention of lean muscle mass while on a fat loss diet. But how much do we need and how does it help us? Here’s the latest from the research.

The Role of Protein – Three Major Points

1) Protein fuels our muscles with the amino acid building blocks needed to repair damage (catabolism) and grow additional muscle (anabolism). Appropriate protein intake and resistance training facilitates these processes to promote fat loss versus muscle loss.

2) As energy intake decreases, we become increasingly hungry. Beyond it’s critical function in muscle recovery and growth, protein increases levels of our hormones that provide feelings of satiety after a meal, and decrease our appetite stimulating hormone. Extended feelings of fullness enabled by appropriate protein intake is a welcome benefit!

3) Compared to carbohydrates and fats, protein has a greater energy cost to digest and metabolize – around 30%. You are burning more calories by eating protein versus other macronutrients, all in support of maintaining an energy deficit in a fat loss diet.

How Much Protein? Don’t use the US RDA……

The US Recommended Daily Allowance is 0.36 grams per pound of bodyweight per day (g/lb BW) for sedentary individuals – far too low for an exercising individual, particularly someone who engages in some form of resistance training.

A review of the current research on the impact of protein intake on body composition and muscle protein synthesis indicates that a good target for an average adult who is resistance training is 0.73 g/lb BW per day for muscle retention (and accretion).

Practical Example: a 160 lb resistance training individual currently consuming 64 g of protein per day (0.4 g/lb BW) in a calorie deficit would significantly improve their likelihood of lean mass retention by nearly doubling protein intake to 120 g/day. To compensate for the increased protein, this individual would also need to decrease the amount of carbohydrates and fats; simply adding more protein would create a calorie surplus.

So if 0.73g/lb BW is enough, would higher be even better? It’s tempting to make this extrapolation. In a fat loss diet, we want to dial in the right amount of protein to induce beneficial body composition changes, yet not take our dietary protein so high that we excessively reduce carbohydrates and fats to the detriment of performance, mood, hormones, and other markers. There are some studies indicating that higher (upwards of 0.9 g/lb BW) has no detriment and may further support lean mass retention, the overall number of studies are limited and do not yet justify higher levels across the board. That being said, based on some of the other benefits I do recommend higher protein levels to some clients in consideration of lifestyle, food preferences, satiety, training modality and intensity, and existing lean body mass (body fat does not require protein to support it).

What Type of Protein?

Eating high quality, complete proteins containing all nine essential amino acids (our bodies can’t make these and they must be obtained through diet) is the priority. Complete whole food protein sources include red meat, chicken, turkey, fish, eggs, milk, yogurt, and soy. Beyond recommendation of these foods, a personalized assessment based on your current body composition and goals can be established.

When transitioning to a diet higher in protein, many people find it challenging to meet their daily protein target eating only whole foods. This is where protein powder supplementation can be useful tool. Examples of complete protein powders include, whey, egg, casein, and soy. These are digested at different rates in the body and can be utilized to their advantage at different times of day.

The specific type of complete protein powder used is of secondary importance compared to the importance of meeting daily protein intake. Bottom line – if you are going to start to incorporate protein powder into your regimen, firstly pick one that has all the EAAs, tastes good to you, and is agreeable to your stomach. The specific type and timing can be dialed in after you have formed the habit.

A lot of folks take BCAAs (branched chain amino acids aka leucine, isoleucine, and valine) as a supplement to their diet. Despite their popularity, research is fairly clear that BCAAs are ineffective for muscle protein synthesis and in this regard they are just expensive flavored water. Instead, eat or drink whey protein around workouts. You are getting plenty of BCAAs by consuming the whole foods and the protein powders mentioned above. I’m not against BCAA supplements if they make you feel good – some studies indicate they do help with recovery – but understand you are spending money on something that, from an efficacy perspective isn’t moving the needle much compared to complete protein.

When Should I Eat Protein?

After you’ve locked down the amount high quality protein you need, distribute it relatively even across the snacks and meals that you eat throughout the day, ideally every 2-4 h. There is a diverse body of research regarding how much protein the body can digest and utilize for muscle protein synthesis from each serving/meal and depends on age, gender, body composition, training status, and other considerations. Given the large number of variables, a good range to stay in is 20-40 g of high-quality protein per meal. An example of 20 g of protein would be 57 g (2 oz.) of cooked chicken breast.

Protein Timing and Training?

Specific protein timing is of secondary importance relative to overall protein intake and general distribution. However, if you are engaging in intense resistance training the post-exercise period should incorporate a solid dose of protein and carbohydrate since muscles are depleted of fuel (glycogen and amino acids) and muscle fibers require repair.

There is a misconception that the post-exercise anabolic window for muscle protein synthesis is narrow, whereby if protein is not consumed immediately post-workout, the opportunity for “gainz” will be forfeit. Far from the truth – the aggregation of research suggests that the anabolic period extends many hours post-training. From a practical eating perspective, try to get a dose of protein within 2 hours after training.

Closing Notes

It’s important to remember that fat loss and muscle growth occur by separate, distinct processes. Although it is impossible to convert fat to muscle, it is possible to preserve lean body mass while decreasing fat mass during a calorie deficit, and it is also possible to increase lean body mass while decreasing fat mass. Protein intake has a strong influence over this; I work with clients on customized protein quantity, type, and timing based on meal frequency preferences, training modality and duration, and schedule. This ensures we are maximizing the benefits of protein from a body composition, performance, and sustainability perspective. I’ve seen incredible body composition changes firsthand in my clients.

I love keeping up with latest in protein research. I’ll keep you updated on the latest credible findings. As always, please feel free to reach out with questions.

Ready to get started on your nutrition strategy?

Recommended Further Reading:

Morton, R.W., et al,A systematic review, meta-analysis and metaregression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults, Br J Sports Med, 2018;52:376–38

Schoenfeld, B.J., Aragon, A.A.,How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution, Journal of the International Society of Sports Nutrition (2018) 15:10

Rahmi, M.H., et. al, Branched-chain amino acid supplementation and exercise-induced muscle damage in exercise recovery: A meta-analysis of randomized clinical trials, Nutrition (2017) 42:30

Jaeger et. al., International Society of Sports Nutrition Position Stand: protein and exercise, Journal of the International Society of Sports Nutrition, v14, Article number: 20 (2017)

Longland, T.M. et al, Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial, Am J Clin Nutr 2016;103:738–46

Trommelen, J. , Loon, L.J.C., Pre-Sleep Protein Ingestion to Improve the Skeletal Muscle Adaptive Response to Exercise Training, Nutrients 2016, 8(12), 763

Aragon, A.A., Schoenfeld, B.J., Nutrient timing revisited: is there a post-exercise anabolic window? Journal of the International Society of Sports Nutrition 2013, 10:5

Wycherley, T.P., et al, Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trial, Am J Clin Nutr 2012;96:1281–98