Wednesday, May 22, 2013

Peri-Workout Hydro-Whey Supplementation: Tried & Proven Muscle Builder Will Also Increase Tendon Size & Strength

Squats are by no means the only exercise that requires strong muscles and tendons.
In a way you could argue that today's SuppVersity article serves two purposes. Firstly, it provides direct evidence for my outrageous claim that the VPX Shotgun + Synthesize study from Saturday's installment of On Short Notice has little to no practical value, because the use of 2x17g of maltodextrin as a control has little to do with the real-world supplementation regimen the potential consumers of respective products are ingesting. I mean, you can safely assume that people who are willing to spend the money on expensive peri-workout kitchen sink supplements will - just like most of you - be ingesting a whey (or other fast acting) protein source after their workouts, anyways.

It goes without saying that it would not have needed a new study to prove this point, so that informing you about another observation Farup et al. made in their most recent study is not just the second, but actually the main purpose of today's SuppVersity article.

A new whey to build tendons of steel

The training protocol: The subjects completed 33 training sessions during the 12 weeks of training. The training program was primarily designed to induce hypertrophy and to a lesser extent maximal muscle strength highlighted by a large number of sets and repetitions and by moderate high intensity. Training frequency was three times per week with a progressive increase in volume and intensity throughout the 12 weeks.
The resistance training exercise consisted of isolated knee extensions in a Technogym knee extensor machine. All repetitions were performed by lifting the load with the concentric leg (while extending the
eccentric leg unloaded). Then, with aid from a training supervisor, an additional load was released onto the weight stack and then lowered with the eccentric leg.
Both the eccentric and concentric leg training program consisted of isotonic knee extensions (TUT 2-0-2s; rest between sets 2min) and applied the following progression in volume and intensity: 6 x 10-15RM (sessions 1–4), 8 x 10-15RM (S 5–10), 10 x 10-15RM (S 11–20), 12¥6–10 RM (S 21–28), and 8 x 6-10RM (S 29–33).
The actual paper is going to be published in one of the future issues of The Scandinavian Journal of Medicine & Science in Sports and deals with the outcomes of a 12-week double-blinded resistance training intervention in the course of which the 22 male subjects (healthy, young, recreationally active height 181.5+/- 1.5 cm, weight 78.1 1.8 kg, age 23.9 +/-0.8 years, fat% 16.0+/- 0.9%) consumed either
  • a high leucine whey protein hydrolysate + carbohydrate group (WHD; 19.5 g whey protein hydrolysate +19.5 g) or 
  • an isoenergetic carbohydrate only supplement for the placebo group (PLA, 36g of carbohydrates)
Regardless of supplementary intake, all subjects performed eccentric training with one leg and concentric training with the other.
"This within-subject design was used to minimize the potential differences in the hypertrophy response that are inherent with group designs (e.g. initial training status, habitual nutritional intake,and/or hormonal status). Eccentric leg was randomly chosen to be either the dominant (preferred kicking leg) or the nondominant leg to exclude any potential pre-training difference between the two." (Farup. 2013)
Overall, we are thus comparing not two, but rather four different training modalities, namely eccentric+WHD, eccentric+PLA, concentric+WHD and concentric+PLA.

Maximal standardization, reliable measuring methods

In the two weeks before commencing the training program, magnetic resonance image (MRI) scans of both thighs and patellar tendons and isometric strength test were taken. In conjunction with the before and after tests that were standardized up to the time of the day, pre- and post-training, "to control for potential effects of diurnal rhythm" (Farup. 2013)

The training sessions were closely supervised and monitored by qualified training instructors to ensure proper execution and loading. The same goes for the ingestion of the supplements, 19.5 g whey protein hydrolysate +19.5 g of carbohydrate (both equal to 4% solution) and the placebo drink consisting of 39 g of carbohydrate, which were handed to the trainees at the beginning of the training sessions and were to be consumed before and after the training (50/50).

Even the intake of additional plain water was standardized, so that the subjects would not ingest and fluids 1 1/2 h prior to and 1 h after completion of an exercise session, "to ensure and standardize the conditions for digestion/absorption and within the range typically applied" (Farup. 2013)

The only methodologically lapse was the absence of dietary control. While the subjects of previous studies in which the participants were advised to "maintain their normal habitual dietary intake throughout the study" (Farup. 2013), did not register any differences in habitual total energy or protein intake (Andersen. 2005; Hartman. 2007; Hulmi. 2009; Erskine. 2012) and the accuracy of food logs is generally questionable, this is kind of awkward in view of the lengths to which the scientists went to exclude any other confounding factors.

Enough of the prelude, what about the results?

So, while we cannot exclude that the subjects in any of the two groups may have skewed the overall results by consuming an additional steak on top of their regular diets, it is quite unlikely that these counfounding factors would have been group specific, so that the overall effects on quadriceps cross-sectional area I plotted in figure 1 are unquestionably reliable.
Figure 1: Relative changes in quadriceps and patella tendon CSA in concentrically and eccentrically trained leg of the subjects in the whey protein hydrolysate and placebo groups (Farup. 2013)
The same obviously goes for the strength increases and the initially mentioned increase in patella tendon CSA. All good and reliable evidence supporting the current "standard" in periworkout supplementation.

Apropos, in conjunction with the recent revelations about the unique glucose-sensitizing effects of the short-chain peptides in whey hydrolysate, it may even be worth to consider adding a "hyrolysate" to the current recommendation to ingest 30g of whey protein in the vicinity of your workouts. Convincing evidence from studies that were specifically designed to elicit the marginal benefits of replacing a regular whey protein with the less tasty (you won't notice that with the tons of flavoring agents, though) and still more expensive "pre-digested" form of whey is yet - at least as far as I know - still missing.

Bottom line: Actually, I already mentioned the most important findings of the study at hand in the introduction:

Figure 2: Whether the effects observed in the study are "hydrolysate specific" and related to the amino acid or peptide composition of the supplement that was used in the study at hand cannot be said without a "regular" whey control. The same goes for the general superiority or inferiority of hydrolysates vs. whey isolates or concentrates.
(a) Whey proteins alone will amplify the effects of regular strength training to a degree that is hard to surpass by the more expensive "advanced muscle builders" - no wonder the producers are reluctant to use anything but an isocaloric carbohydrate supplement as their yardstick. (b) Increases in tendon CSA are a novel benefit to be added to the comprehensive list of benefits of a supplement I suspect most of you are using anyway.

Whether the hydrolyzed whey proteins are actually worth the extra bucks is yet still not 100% certain. As previously mentioned, the number of practically relevant direct comparisons is still scarce. We know that they create a more rapid increase of the amino acid levels in the blood, that they are more insulinogenic and we that some of the short peptides have favorable physiological effects (learn more). A long-term study comparing the muscle and (that's new) tendon building effects of the three commonly available varieties of whey, i.e. concentrate, isolate and hydrolysate, has not yet been conducted. But don't worry, as soon as the pertinent data is going to be available, you'll find all the information you need, as well as the practical implications of the results right here, at the SuppVersity - your #1 source for the latest on exercise, nutrition and supplementation research on the Internet.

  • Farup J, Rahbek SK, Vendelbo MH, Matzon A, Hindhede J, Bejder A, Ringgard S, Vissing K. Whey protein hydrolysate augments tendon and muscle hypertrophy independent of resistance exercise contraction mode. Scand J Med Sci Sports. 2013 May 7.