Top

Published in:

01-03-2019 | Original Contribution

Even effect of milk protein and carbohydrate intake but no further effect of heavy resistance exercise on myofibrillar protein synthesis in older men

Authors: Søren Reitelseder, Kasper Dideriksen, Jakob Agergaard, Nikolaj M. Malmgaard-Clausen, Rasmus L. Bechshoeft, Rasmus K. Petersen, Anja Serena, Ulla R. Mikkelsen, Lars Holm

Published in: European Journal of Nutrition | Issue 2/2019

Abstract

Purpose

The responsiveness of older individuals’ skeletal muscle to anabolic strategies may be impaired. However, direct comparisons within the same experimental setting are sparse. The aim of this study was to assess the resting and post-resistance exercise muscle protein synthesis rates in response to two types of milk protein and carbohydrate using a unilateral exercise leg model.

Methods

Twenty-seven older (69 ± 1 year, mean ± SE) men were randomly assigned one of three groups: Whey hydrolysate (WH), caseinate (CAS), or carbohydrate (CHO). By applying stable isotope tracer techniques (L-[¹⁵N]phenylalanine), the fasted-rested (basal) myofibrillar fractional synthesis rate (FSR) was measured. Hereafter, FSR was measured in the postprandial phase (0.45 g nutrient/kg LBM) in both legs, one rested (fed-rest) and one exercised (10 × 8 reps at 70% 1RM; fed-exercise). In addition, the activity of p70S6K and venous plasma insulin, phenylalanine, and leucine concentrations were measured.

Results

Insulin, phenylalanine, and leucine concentrations differed markedly after intake of the different study drinks. The basal FSR in WH, CAS, and CHO were 0.027 ± 0.003, 0.030 ± 0.003, and 0.030 ± 0.004%/h, the fed-rested FSR were 0.043 ± 0.004, 0.045 ± 0.003, and 0.035 ± 0.004%/h, and the fed-exercised FSR were 0.041 ± 0.004, 0.043 ± 0.004, and 0.034 ± 0.004%/h, respectively. No significant differences were observed at any state between the groups. Fed-rested- and fed-exercised FSR were higher than basal (P < 0.001). 3 h after exercise and feeding, no significant group differences were detected in the activity of p70S6K.

Conclusions

Milk protein and carbohydrate supplementation stimulate myofibrillar protein synthesis in older men, with no further effect of heavy resistance exercise within 0–3 h post exercise.

Available only for authorised users

Cuthbertson D, Smith K, Babraj J, Leese G, Waddell T, Atherton P, Wackerhage H, Taylor PM, Rennie MJ (2005) Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle. FASEB J 19:422–424CrossRefPubMed

Guillet C, Prod’homme M, Balage M, Gachon P, Giraudet C, Morin L, Grizard J, Boirie Y (2004) Impaired anabolic response of muscle protein synthesis is associated with S6K1 dysregulation in elderly humans. FASEB J 18:1586–1587CrossRefPubMed

Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR (2005) Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr 82:1065–1073CrossRefPubMed

Durham WJ, Casperson SL, Dillon EL, Keske MA, Paddon-Jones D, Sanford AP, Hickner RC, Grady JJ, Sheffield-Moore M (2010) Age-related anabolic resistance after endurance-type exercise in healthy humans. FASEB J 24:4117–4127CrossRefPubMedPubMedCentral

Fry CS, Drummond MJ, Glynn EL, Dickinson JM, Gundermann DM, Timmerman KL, Walker DK, Dhanani S, Volpi E, Rasmussen BB (2011) Aging impairs contraction-induced human skeletal muscle mTORC1 signaling and protein synthesis. Skelet Muscle 1:11CrossRefPubMedPubMedCentral

Kumar V, Selby A, Rankin D, Patel R, Atherton P, Hildebrandt W, Williams J, Smith K, Seynnes O, Hiscock N, Rennie MJ (2009) Age-related differences in the dose-response relationship of muscle protein synthesis to resistance exercise in young and old men. J Physiol 587:211–217CrossRefPubMed

Phillips BE, Hill DS, Atherton PJ (2012) Regulation of muscle protein synthesis in humans. Curr Opin Clin Nutr Metab Care 15:58–63CrossRefPubMed

Rennie MJ (2009) Anabolic resistance: the effects of aging, sexual dimorphism, and immobilization on human muscle protein turnover. Appl Physiol Nutr Metab 34:377–381CrossRefPubMed

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel J-P, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M (2010) Sarcopenia: European consensus on definition and diagnosis. Age Ageing 39:412–423CrossRefPubMedPubMedCentral

10.

Morley JE, Abbatecola AM, Argiles JM et al (2011) Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc 12:403–409CrossRefPubMedPubMedCentral

11.

Shad BJ, Thompson JL, Breen L (2016) Does the muscle protein synthetic response to exercise and amino acid-based nutrition diminish with advancing age? A systematic review. Am J Physiol Endocrinol Metab 311:E803–E817CrossRefPubMed

12.

Dangin M, Boirie Y, Garcia-Rodenas C, Gachon P, Fauquant J, Callier P, Ballèvre O, Beaufrère B (2001) The digestion rate of protein is an independent regulating factor of postprandial protein retention. Am J Physiol Endocrinol Metab 280:E340–E348CrossRefPubMed

13.

Boirie Y, Dangin M, Gachon P, Vasson M-P, Maubois J-L, Beaufrère B (1997) Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci USA 94:14930–14935CrossRefPubMedPubMedCentral

14.

Volpi E, Kobayashi H, Sheffield-Moore M, Mittendorfer B, Wolfe RR (2003) Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr 78:250–258CrossRefPubMed

15.

Burd NA, Yang Y, Moore DR, Tang JE, Tarnopolsky MA, Phillips SM (2012) Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. micellar casein at rest and after resistance exercise in elderly men. Br J Nutr 108:958–962CrossRefPubMed

16.

Pennings B, Boirie Y, Senden JMG, Gijsen AP, Kuipers H, van Loon LJC (2011) Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men. Am J Clin Nutr 93:997–1005CrossRefPubMed

17.

Gorissen SHM, Horstman AMH, Franssen R, Crombag JJR, Langer H, Bierau J, Respondek F, van Loon LJC (2016) Ingestion of wheat protein increases in vivo muscle protein synthesis rates in healthy older men in a randomized trial. J Nutr 146:1651–1659CrossRefPubMed

18.

Dideriksen KJ, Reitelseder S, Petersen SG, Hjort M, Helmark IC, Kjaer M, Holm L (2011) Stimulation of muscle protein synthesis by whey and caseinate ingestion after resistance exercise in elderly individuals. Scand J Med Sci Sports 21:e372–e383CrossRefPubMed

19.

Soop M, Nehra V, Henderson GC, Boirie Y, Ford GC, Nair KS (2012) Coingestion of whey protein and casein in a mixed meal: demonstration of a more sustained anabolic effect of casein. Am J Physiol Endocrinol Metab 303:E152–E162CrossRefPubMedPubMedCentral

20.

Mitchell WK, Phillips BE, Williams JP, Rankin D, Lund JN, Wilkinson DJ, Smith K, Atherton PJ (2015) The impact of delivery profile of essential amino acids upon skeletal muscle protein synthesis in older men: clinical efficacy of pulse vs. bolus supply. Am J Physiol Endocrinol Metab 309:E450–E457CrossRefPubMed

21.

Timmerman KL, Dhanani S, Glynn EL, Fry CS, Drummond MJ, Jennings K, Rasmussen BB, Volpi E (2012) A moderate acute increase in physical activity enhances nutritive flow and the muscle protein anabolic response to mixed nutrient intake in older adults. Am J Clin Nutr 95:1403–1412CrossRefPubMedPubMedCentral

22.

Dideriksen K, Reitelseder S, Malmgaard-Clausen NM, Bechshoeft R, Petersen RK, Mikkelsen UR, Holm L (2016) No effect of anti-inflammatory medication on postprandial and postexercise muscle protein synthesis in elderly men with slightly elevated systemic inflammation. Exp Gerontol 83:120–129CrossRefPubMed

23.

Agergaard J, Bülow J, Jensen JK, Reitelseder S, Drummond MJ, Schjerling P, Scheike T, Serena A, Holm L (2017) Light-load resistance exercise increases muscle protein synthesis and hypertrophy signaling in elderly men. Am J Physiol Endocrinol Metab 312:E326–E338CrossRefPubMed

24.

Bülow J, Agergaard J, Kjaer M, Holm L, Reitelseder S (2016) No additional effect of different types of physical activity on 10-hour muscle protein synthesis in elderly men on a controlled energy- and protein-sufficient diet. Exp Gerontol 79:16–25CrossRefPubMed

25.

Holm L, Reitelseder S, Dideriksen K, Nielsen RH, Bülow J, Kjaer M (2014) The single-biopsy approach in determining protein synthesis in human slow-turning-over tissue: use of flood-primed, continuous infusion of amino acid tracers. Am J Physiol Endocrinol Metab 306:E1330–E1339CrossRefPubMed

26.

Reitelseder S, Agergaard J, Doessing S, Helmark IC, Lund P, Kristensen NB, Frystyk J, Flyvbjerg A, Schjerling P, van Hall G, Kjaer M, Holm L (2011) Whey and casein labeled with L-[1-¹³C]leucine and muscle protein synthesis: effect of resistance exercise and protein ingestion. Am J Physiol Endocrinol Metab 300:E231–E242CrossRefPubMed

27.

Wolfe RR, Chinkes DL (2005) Isotope tracers in metabolic research: principles and practice of kinetic analysis, 2nd edn. John Wiley, Hoboken

28.

Reidy PT, Rasmussen BB (2016) Role of ingested amino acids and protein in the promotion of resistance exercise-induced muscle protein anabolism. J Nutr 146:155–183CrossRefPubMedPubMedCentral

29.

Koopman R, Crombach N, Gijsen AP, Walrand S, Fauquant J, Kies AK, Lemosquet S, Saris WHM, Boirie Y, van Loon LJC (2009) Ingestion of a protein hydrolysate is accompanied by an accelerated in vivo digestion and absorption rate when compared with its intact protein. Am J Clin Nutr 90:106–115CrossRefPubMed

30.

Areta JL, Burke LM, Ross ML, Camera DM, West DWD, Broad EM, Jeacocke NA, Moore DR, Stellingwerff T, Phillips SM, Hawley JA, Coffey VG (2013) Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. J Physiol 591:2319–2331CrossRefPubMedPubMedCentral

31.

Fujita S, Dreyer HC, Drummond MJ, Glynn EL, Cadenas JG, Yoshizawa F, Volpi E, Rasmussen BB (2007) Nutrient signalling in the regulation of human muscle protein synthesis. J Physiol 582:813–823CrossRefPubMedPubMedCentral

32.

Tipton KD, Elliott TA, Cree MG, Wolf SE, Sanford AP, Wolfe RR (2004) Ingestion of casein and whey prosteins result in muscle anabolism after resistance exercise. Med Sci Sports Exerc 36:2073–2081CrossRefPubMed

33.

Groen BBL, Res PT, Pennings B, Hertle E, Senden JMG, Saris WHM, van Loon LJC (2012) Intragastric protein administration stimulates overnight muscle protein synthesis in elderly men. Am J Physiol Endocrinol Metab 302:E52–E60CrossRefPubMed

34.

Tang JE, Moore DR, Kujbida GW, Tarnopolsky MA, Phillips SM (2009) Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. J Appl Physiol 107:987–992CrossRefPubMed

35.

Wilkinson SB, Tarnopolsky MA, MacDonald MJ, MacDonald JR, Armstron D, Phillips SM (2007) Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy-protein beverage. Am J Clin Nutr 85:1031–1040CrossRefPubMed

36.

Burd NA, Gorissen SH, van Vliet S, Snijders T, van Loon LJC (2015) Differences in postprandial protein handling after beef compared with milk ingestion during postexercise recovery: a randomized controlled trial. Am J Clin Nutr 102:828–836CrossRefPubMed

37.

Baillie AGS, Garlick PJ (1991) Responses of protein synthesis in different skeletal muscles to fasting and insulin in rats. Am J Physiol Endocrinol Metab 260:E891–E896CrossRef

38.

Morrison PJ, Hara D, Ding Z, Ivy JL (2008) Adding protein to a carbohydrate supplement provided after endurance exercise enhances 4E-BP1 and RPS6 signaling in skeletal muscle. J Appl Physiol 104:1029–1036CrossRefPubMed

39.

Biolo G, Fleming RYD, Wolfe RR (1995) Physiologic hyperinsulinemia stimulates protein synthesis and enhances transport of selected amino acids in human skeletal muscle. J Clin Invest 95:811–819CrossRefPubMedPubMedCentral

40.

Drummond MJ, Bell JA, Fujita S, Dreyer HC, Glynn EL, Volpi E, Rasmussen BB (2008) Amino acids are necessary for the insulin-induced activation of mTOR/S6K1 signaling and protein synthesis in healthy and insulin resistant human skeletal muscle. Clin Nutr 27:447–456CrossRefPubMedPubMedCentral

41.

Biolo G, Williams BD, Fleming RYD, Wolfe RR (1999) Insulin action on muscle protein kinetics and amino acid transport during recovery after resistance exercise. Diabetes 48:949–957CrossRefPubMed

42.

Koopman R, Wagenmakers AJM, Manders RJF, Zorenc AHG, Senden JMG, Gorselink M, Keizer HA, van Loon LJC (2005) Combined ingestion of protein and free leucine with carbohydrate increases postexercise muscle protein synthesis in vivo in male subjects. Am J Physiol Endocrinol Metab 288:E645–E653CrossRefPubMed

43.

Tang JE, Manolakos JJ, Kujbida GW, Lysecki PJ, Moore DR, Phillips SM (2007) Minimal whey protein with carbohydrate stimulates muscle protein synthesis following resistance exercise in trained young men. Appl Physiol Nutr Metab 32:1132–1138CrossRefPubMed

44.

Beelen M, Koopman R, Gijsen AP, Vandereyt H, Kies AK, Kuipers H, Saris WHM, van Loon LJC (2008) Protein coingestion stimulates muscle protein synthesis during resistance-type exercise. Am J Physiol Endocrinol Metab 295:E70–E77CrossRefPubMed

45.

Rahbek SK, Farup J, Møller AB, Vendelbo MH, Holm L, Jessen N, Vissing K (2014) Effects of divergent resistance exercise contraction mode and dietary supplementation type on anabolic signalling, muscle protein synthesis and muscle hypertrophy. Amino Acids 46:2377–2392CrossRefPubMed

46.

Howarth KR, Moreau NA, Phillips SM, Gibala MJ (2009) Coingestion of protein with carbohydrate during recovery from endurance exercise stimulates skeletal muscle protein synthesis in humans. J Appl Physiol 106:1394–1402CrossRefPubMed

47.

Koopman R, Verdijk L, Manders RJF, Gijsen AP, Gorselink M, Pijpers E, Wagenmakers AJM, van Loon LJC (2006) Co-ingestion of protein and leucine stimulates muscle protein synthesis rates to the same extent in young and elderly lean men. Am J Clin Nutr 84:623–632CrossRefPubMed

48.

Børsheim E, Aarsland A, Wolfe RR (2004) Effect of an amino acid, protein, and carbohydrate mixture on net muscle protein balance after resistance exercise. Int J Sport Nutr Exerc Metab 14:255–271CrossRefPubMed

49.

Miller SL, Tipton KD, Chinkes DL, Wolf SE, Wolfe RR (2003) Independent and combined effects of amino acids and glucose after resistance exercise. Med Sci Sports Exerc 35:449–455CrossRefPubMed

50.

Roy BD, Fowles JR, Hill R, Tarnopolsky MA (2000) Macronutrient intake and whole body protein metabolism following resistance exercise. Med Sci Sports Exerc 32:1412–1418CrossRefPubMed

51.

Chanet A, Verlaan S, Salles J, Giraudet C, Patrac V, Pidou V, Pouyet C, Hafnaoui N, Blot A, Cano N, Farigon N, Bongers A, Jourdan M, Luiking Y, Walrand S, Boirie Y (2017) Supplementing breakfast with a vitamin D and leucine-enriched whey protein medical nutrition drink enhances postprandial muscle protein synthesis and muscle mass in healthy older men. J Nutr 147:2262–2271CrossRefPubMed

52.

Pennings B, Groen B, de Lange A, Gijsen AP, Zorenc AH, Senden JMG, van Loon LJC (2012) Amino acid absorption and subsequent muscle protein accretion following graded intakes of whey protein in elderly men. Am J Physiol Endocrinol Metab 302:E992–E999CrossRefPubMed

53.

Pennings B, Koopman R, Beelen M, Senden JMG, Saris WHM, van Loon LJC (2011) Exercising before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscle protein synthesis in both young and elderly men. Am J Clin Nutr 93:322–331CrossRefPubMed

54.

Symons TB, Sheffield-Moore M, Mamerow MM, Wolfe RR, Paddon-Jones D (2011) The anabolic response to resistance exercise and a protein-rich meal is not diminished by age. J Nutr Health Aging 15:376–381CrossRefPubMedPubMedCentral

55.

Symons TB, Sheffield-Moore M, Wolfe RR, Paddon-Jones D (2009) A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 109:1582–1586CrossRefPubMedPubMedCentral

56.

Symons TB, Schutzler SE, Cocke TL, Chinkes DL, Wolfe RR, Paddon-Jones D (2007) Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr 86:451–456CrossRefPubMed

57.

Moore DR, Churchward-Venne TA, Witard O, Breen L, Burd NA, Tipton KD, Phillips SM (2015) Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci 70:57–62CrossRefPubMed

58.

Drummond MJ, Rasmussen BB (2008) Leucine-enriched nutrients and the regulation of mammalian target of rapamycin signalling and human skeletal muscle protein synthesis. Curr Opin Clin Nutr Metab Care 11:222–226CrossRefPubMedPubMedCentral

59.

Churchward-Venne TA, Burd NA, Mitchell CJ, West DWD, Philp A, Marcotte GR, Baker SK, Baar K, Phillips SM (2012) Supplementation of a suboptimal protein dose with leucine or essential amino acids: effects on myofibrillar protein synthesis at rest and following resistance exercise in men. J Physiol 590:2751–2765CrossRefPubMedPubMedCentral

60.

Churchward-Venne TA, Breen L, Di Donato DM, Hector AJ, Mitchell CJ, Moore DR, Stellingwerff T, Breuille D, Offord EA, Baker SK, Phillips SM (2014) Leucine supplementation of a low-protein mixed macronutrient beverage enhances myofibrillar protein synthesis in young men: a double-blind, randomized trial. Am J Clin Nutr 99:276–286CrossRefPubMed

61.

Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR (2006) A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 291:E381–E387CrossRefPubMed

62.

Koopman R, Verdijk LB, Beelen M, Gorselink M, Kruseman AN, Wagenmakers AJM, Kuipers H, van Loon LJC (2008) Co-ingestion of leucine with protein does not further augment post-exercise muscle protein synthesis rates in elderly men. Br J Nutr 99:571–580CrossRefPubMed

63.

Phillips SM (2014) A brief review of critical processes in exercise-induced muscular hypertrophy. Sports Med 44:S71–S77CrossRefPubMed

64.

Drummond MJ, Dreyer HC, Pennings B, Fry CS, Dhanani S, Dillon EL, Sheffield-Moore M, Volpi E, Rasmussen BB (2008) Skeletal muscle protein anabolic response to resistance exercise and essential amino acids is delayed with aging. J Appl Physiol 104:1452–1461CrossRefPubMed

65.

Sheffield-Moore M, Yeckel CW, Volpi E, Wolf SE, Morio B, Chinkes DL, Paddon-Jones D, Wolfe RR (2004) Postexercise protein metabolism in older and younger men following moderate-intensity aerobic exercise. Am J Physiol Endocrinol Metab 287:E513–E522CrossRefPubMed

66.

Bechshoeft R, Dideriksen KJ, Reitelseder S, Scheike T, Kjaer M, Holm L (2013) The anabolic potential of dietary protein intake on skeletal muscle is prolonged by prior light-load exercise. Clin Nutr 32:236–244CrossRefPubMed

67.

Burd NA, West DWD, Moore DR, Atherton PJ, Staples AW, Prior T, Tang JE, Rennie MJ, Baker SK, Phillips SM (2011) Enhanced amino acid sensitivity of myofibrillar protein synthesis persists for up to 24 h after resistance exercise in young men. J Nutr 141:568–573CrossRefPubMed

68.

Holm L, van Hall G, Rose AJ, Miller BF, Doessing S, Richter EA, Kjaer M (2010) Contraction intensity and feeding affect collagen and myofibrillar protein synthesis rates differently in human skeletal muscle. Am J Physiol Endocrinol Metab 298:E257–E269CrossRefPubMed

69.

Moore DR, Tang JE, Burd NA, Rerecich T, Tarnopolsky MA, Phillips SM (2009) Differential stimulation of myofibrillar and sarcoplasmic protein synthesis with protein ingestion at rest and after resistance exercise. J Physiol 587:897–904CrossRefPubMedPubMedCentral

Title: Even effect of milk protein and carbohydrate intake but no further effect of heavy resistance exercise on myofibrillar protein synthesis in older men
Authors: Søren Reitelseder
Kasper Dideriksen
Jakob Agergaard
Nikolaj M. Malmgaard-Clausen
Rasmus L. Bechshoeft
Rasmus K. Petersen
Anja Serena
Ulla R. Mikkelsen
Lars Holm
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 2/2019
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-018-1641-1

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Even effect of milk protein and carbohydrate intake but no further effect of heavy resistance exercise on myofibrillar protein synthesis in older men

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2019

Dairy products intake and the risk of incident cataracts surgery in an elderly Mediterranean population: results from the PREDIMED study

Gluten-free-rendered products contribute to imbalanced diets in children and adolescents with celiac disease

Adipose tissue fatty acids present in dairy fat and risk of stroke: the Danish Diet, Cancer and Health cohort

Vitamin D supplementation does not prevent the testosterone decline in males with advanced heart failure: the EVITA trial

Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults

Fluid balance and hydration status in combat sport Olympic athletes: a systematic review with meta-analysis of controlled and uncontrolled studies

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page