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The use of BCAA to decrease delayed-onset muscle soreness after a single bout of exercise: a systematic review and meta-analysis.
Weber, MG, Dias, SS, de Angelis, TR, Fernandes, EV, Bernardes, AG, Milanez, VF, Jussiani, EI, de Paula Ramos, S
Amino acids. 2021;(11):1663-1678
Abstract
Branched-chain amino acids (BCAA) are used as a recovery method after exercise-induced muscle damage (EIMD). Although data suggest that BCAA may alleviate the delayed-onset muscle soreness (DOMS) evoked by EIMD, there is no consensus about the most effective supplementation protocol. To investigate the effects of BCAA on DOMS after a single exercise session that caused EIMD, a systematic review and meta-analysis were conducted on the effectiveness of BCAA supplementation to reduce DOMS symptoms in healthy subjects after a single session of EIMD. Randomized clinical trials (RCT) were searched in Medline, Cochrane Library, Science Direct, SciELO, LILACS, SciVerse Scopus, Springer Link journals, Wiley Online Library, and Scholar Google, until May 2021. Ten RCTs were included in the systematic review and nine in the meta-analysis. Seven studies demonstrated that BCAA reduced DOMS after 24 to 72 h. BCAA doses of up to 255 mg/kg/day, or in trained subjects, for mild to moderate EIMD, could blunt DOMS symptoms. However, high variability between studies due to training status, different doses, time of treatment, and severity of EIMD do not allow us to conclude whether BCAA supplementation is efficient in untrained subjects, applied acutely or during a period of pre to post days of EIMD, and at higher doses (> 255 mg/kg/day). The overall effects of BCAA on DOMS after a single session of exercise were considered useful for improving muscle recovery by reducing DOMS in trained subjects, at low doses, in mild to moderate EIMD, and should not be administered only after the EIMD protocol.
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Bariatric surgery reduces branched-chain amino acids' levels: a systematic review and meta-analysis.
Barati-Boldaji, R, Esmaeilinezhad, Z, Babajafari, S, Kazemi, A, Clark, CCT, Mazidi, M, Ofori-Asenso, R, Haghighat, N, Shafiee, M, Mazloomi, SM
Nutrition research (New York, N.Y.). 2021;:80-90
Abstract
Bariatric surgery is a metabolic surgery known to be an efficient treatment for weight loss, with adequate long-term maintenance. Interestingly, some studies have reported a reduction in branched chained amino acids (BCAAs) after bariatric surgery, which putatively contributes to post-surgical metabolic improvement. The current systematic review and meta-analysis investigated the effect of bariatric surgery on the level of BCAAs. PubMed, SCOPUS, EMBASE, and Web of Science databases were searched from their inception to July 2019. All clinical trials which investigated the effect of bariatric surgery on the levels of valine, leucine, and isoleucine, for more than one week, were included. Nine studies (11 effect sizes) were analyzed via meta-analytical techniques using random-effects models. The pooled data suggested that bariatric surgery significantly reduced the valine (standardized mean difference [SMD]: -1.89, 95% confidence interval [CI]: -2.79, -0.99, I2 = 90.9%), leucine (SMD: -0.96, 95% CI: -1.48, -0.44, I2 = 72.4%), and isoleucine (SMD: -0.58, 95% CI: -0.84, -0.31, I2 = 66.3%) levels after surgery compared with before the surgery. Overall, bariatric surgery significantly reduced the levels of valine, leucine, and isoleucine compared with before the surgery. Further large-scale and homogenous trials are needed to better discern the generalizability of our findings.
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The effect of branched-chain amino acid on muscle damage markers and performance following strenuous exercise: a systematic review and meta-analysis.
Doma, K, Singh, U, Boullosa, D, Connor, JD
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2021;(11):1303-1313
Abstract
This systematic review and meta-analysis determined whether the ergogenic effects of branched-chain amino acids (BCAA) ameliorated markers of muscle damage and performance following strenuous exercise. In total, 25 studies were included, consisting of 479 participants (age 24.3 ± 8.3 years, height 1.73 ± 0.06 m, body mass 70.8 ± 9.5 kg, females 26.3%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the BCAA and placebo conditions at 24 and 48 hours following muscle-damaging exercises, using standardised mean differences and associated p-values via forest plots. Our meta-analysis demonstrated significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) at 48 hours post-exercise (standardised mean difference [SMD] = -0.41; p < 0.05) for the BCAA than placebo conditions, whilst muscle soreness was significant at 24 hours post-exercise (SMD = -0.28 ≤ d ≤ -0.61; p < 0.05) and 48 hours post-exercise (SMD = -0.41 ≤ d≤ -0.92; p < 0.01). However, no significant differences were identified between the BCAA and placebo conditions for muscle performance at 24 or 48 hours post-exercise (SMD = 0.08 ≤ d ≤ 0.21; p > 0.05). Overall, BCAA reduced the level of muscle damage biomarkers and muscle soreness following muscle-damaging exercises. However, the potential benefits of BCAA for muscle performance recovery is questionable and warrants further investigation to determine the practicality of BCAA for ameliorating muscle damage symptoms in diverse populations. PROSPERO registration number: CRD42020191248. Novelty: BCAA reduces the level of creatine kinase and muscle soreness following strenuous exercise with a dose-response relationship. BCAA does not accelerate recovery for muscle performance.
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Dietary branched-chain amino acids intake exhibited a different relationship with type 2 diabetes and obesity risk: a meta-analysis.
Okekunle, AP, Zhang, M, Wang, Z, Onwuka, JU, Wu, X, Feng, R, Li, C
Acta diabetologica. 2019;(2):187-195
Abstract
AIM: To assess whether oral branched-chain amino acids (BCAA) supplementation exerts influence on circulating BCAA and the significance of dietary BCAA in type 2 diabetes and obesity risk. METHOD We searched PUBMED, EMBASE and Cochrane library through June 2018 to retrieve and screen published reports for inclusion in the meta-analysis after methodological assessment. Heterogeneity of studies was evaluated using I2 statistics, while sensitivity analysis and funnel plot were used to evaluate the potential effect of individual studies on the overall estimates and publication bias, respectively, using RevMan 5.3. RESULT Eight articles on randomized clinical trial of oral BCAA supplementation, and seven articles on dietary BCAA intake and type 2 diabetes/obesity risks were eligible for inclusion in our meta-analyses. Mean difference and 95% confidence interval (CI) of circulating leucine was 39.65 (3.54, 75.76) µmol/L, P = 0.03 post-BCAA supplementation. Also, OR and 95% CI for higher total BCAA intake and metabolic disorder risks were, 1.32 (1.14, 1.53), P = 0.0003-type 2 diabetes and 0.62 (0.47, 0.82), P = 0.0008-obesity. CONCLUSION Oral BCAA supplementation exerts modest influence on circulating leucine profile and higher total BCAA intake is positively and contra-positively associated with type 2 diabetes and obesity risk, respectively.
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Branched-chain amino acid supplementation and exercise-induced muscle damage in exercise recovery: A meta-analysis of randomized clinical trials.
Rahimi, MH, Shab-Bidar, S, Mollahosseini, M, Djafarian, K
Nutrition (Burbank, Los Angeles County, Calif.). 2017;:30-36
Abstract
OBJECTIVE Accumulating evidence suggests positive effects of branched-chain amino acids (BCAAs) on moderate muscle damage. However, findings vary substantially across studies. The aim of this review was to examine the effect of BCAAs on recovery following exercise-induced muscle damage. METHODS Controlled trials were identified through a computerized literature search and tracking of citations performed up to November 2015. To pool data, either a fixed-effects or a random-effects model was used; for assessing heterogeneity, Cochran's Q and I2 tests were used. RESULTS Eight trials met the inclusion criteria. Pooled data from the eight studies showed that BCAAs significantly reduced creatine kinase at two follow-up times (<24 and 24 h) in comparison with placebo recovery (<24 h: mean difference, -71.55 U/L, 95% confidence interval, -93.49 to -49.60, P < 0.000, n = 5 trials; 24 h: mean difference, -145.04 U/L, 95% confidence interval, -253.66 to -36.43, P = 0.009, n = 8 trials). In contrast, effects were not significant in any of the follow-up times for muscle soreness or lactate dehydrogenase. CONCLUSION The current evidence-based information indicates that use of BCAAs is better than passive recovery or rest after various forms of exhaustive and damaging exercise. The advantages relate to a reduction in muscle soreness and ameliorated muscle function because of an attenuation of muscle strength and muscle power loss after exercise.
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Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes.
Zheng, Y, Li, Y, Qi, Q, Hruby, A, Manson, JE, Willett, WC, Wolpin, BM, Hu, FB, Qi, L
International journal of epidemiology. 2016;(5):1482-1492
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Abstract
BACKGROUND Plasma branched-chain amino acids (BCAAs, including leucine, isoleucine and valine) were recently related to risk of type 2 diabetes (T2D). Dietary intake is the only source of BCAAs; however, little is known about whether habitual dietary intake of BCAAs affects risk of T2D. METHODS We assessed associations between cumulative consumption of BCAAs and risk of T2D among participants from three prospective cohorts: the Nurses' Health Study (NHS; followed from 1980 to 2012); NHS II (followed from 1991 to 2011); and the Health Professionals Follow-up Study (HPFS; followed from 1986 to 2010). RESULTS We documented 16 097 incident T2D events during up to 32 years of follow-up. After adjustment for demographics and traditional risk factors, higher total BCAA intake was associated with an increased risk of T2D in men and women. In the meta-analysis of all cohorts, comparing participants in the highest quintile with those in the lowest quintile of intake, hazard ratios (95%confidence intervals) were for leucine 1.13 (1.07-1.19), for isoleucine 1.13 (1.07-1.19) and for valine 1.11 (1.05-1.17) (all P for trend < 0.001). In a healthy subsample, higher dietary BCAAs were significantly associated with higher plasma levels of these amino acids (P for trend = 0.01). CONCLUSIONS Our data suggest that high consumption of BCAAs is associated with an increased risk of T2D.
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Genetic Predisposition to an Impaired Metabolism of the Branched-Chain Amino Acids and Risk of Type 2 Diabetes: A Mendelian Randomisation Analysis.
Lotta, LA, Scott, RA, Sharp, SJ, Burgess, S, Luan, J, Tillin, T, Schmidt, AF, Imamura, F, Stewart, ID, Perry, JR, et al
PLoS medicine. 2016;(11):e1002179
Abstract
BACKGROUND Higher circulating levels of the branched-chain amino acids (BCAAs; i.e., isoleucine, leucine, and valine) are strongly associated with higher type 2 diabetes risk, but it is not known whether this association is causal. We undertook large-scale human genetic analyses to address this question. METHODS AND FINDINGS Genome-wide studies of BCAA levels in 16,596 individuals revealed five genomic regions associated at genome-wide levels of significance (p < 5 × 10-8). The strongest signal was 21 kb upstream of the PPM1K gene (beta in standard deviations [SDs] of leucine per allele = 0.08, p = 3.9 × 10-25), encoding an activator of the mitochondrial branched-chain alpha-ketoacid dehydrogenase (BCKD) responsible for the rate-limiting step in BCAA catabolism. In another analysis, in up to 47,877 cases of type 2 diabetes and 267,694 controls, a genetically predicted difference of 1 SD in amino acid level was associated with an odds ratio for type 2 diabetes of 1.44 (95% CI 1.26-1.65, p = 9.5 × 10-8) for isoleucine, 1.85 (95% CI 1.41-2.42, p = 7.3 × 10-6) for leucine, and 1.54 (95% CI 1.28-1.84, p = 4.2 × 10-6) for valine. Estimates were highly consistent with those from prospective observational studies of the association between BCAA levels and incident type 2 diabetes in a meta-analysis of 1,992 cases and 4,319 non-cases. Metabolome-wide association analyses of BCAA-raising alleles revealed high specificity to the BCAA pathway and an accumulation of metabolites upstream of branched-chain alpha-ketoacid oxidation, consistent with reduced BCKD activity. Limitations of this study are that, while the association of genetic variants appeared highly specific, the possibility of pleiotropic associations cannot be entirely excluded. Similar to other complex phenotypes, genetic scores used in the study captured a limited proportion of the heritability in BCAA levels. Therefore, it is possible that only some of the mechanisms that increase BCAA levels or affect BCAA metabolism are implicated in type 2 diabetes. CONCLUSIONS Evidence from this large-scale human genetic and metabolomic study is consistent with a causal role of BCAA metabolism in the aetiology of type 2 diabetes.
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[Effects of branched amino acids in endurance sports: a review].
Salinas-García, ME, Martínez-Sanz, JM, Urdampilleta, A, Mielgo-Ayuso, J, Norte Navarro, A, Ortiz-Moncada, R
Nutricion hospitalaria. 2014;(2):577-89
Abstract
INTRODUCTION The report issued by the European Food Safety Agency (EFSA) in 2010 on nutrition and health claims, shows that there is no scientific evidence to support supplementation with branched chain amino acids (BCAAs). The aim of this study is to analyze the effects of consumption of BCAAs in endurance sports. METHODS A literature review on the current state of the effect of consumption of dietary supplements of BCAAs. We conducted a search in the PubMed database and snowball strategy. INCLUSION CRITERIA Spanish / English randomized clinical trial related to the consumption of BCAAs, leucine, valine and isoleucine in endurance sports and its effects on muscle damage, athletic performance, central fatigue, anabolic signals during recovery and immune system response published in any country until May 2014. RESULTS Out of 330 studies identified, 14 met the inclusion criteria. The mean of subjects participating in the study was (11.36±7.43). Only two studies included a group of women. The sports that we found in the studies were: run, cycling, combining cycling and running, Olympic distance triathlon and one study included 2 groups of athletes (Olympic distance triathletes and runners). The effects of BCAAs and muscle damage, athletic performance, central fatigue, anabolic signals during recovery period and immune response were studied at different times: before, during and after training or a combination of these. DISCUSSION It is observed that there is a lesser degree of pain and muscle damage, less perceived exertion and mental fatigue, greater anabolic response in recovery period and improved immune response when supplemented with BCAAs, notwithstanding its decision before or during physical activity does not improve athletic performance. No consensus was found in the dose and timing of the most effective decision, although it is more effective if there is 2-3/1/1g relationship between leucine / isoleucine and valine amino acids.
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Branched-chain amino acid supplementation in adults with cirrhosis and porto-systemic encephalopathy: systematic review.
Metcalfe, EL, Avenell, A, Fraser, A
Clinical nutrition (Edinburgh, Scotland). 2014;(6):958-65
Abstract
BACKGROUND & AIMS Branched-chain amino acid supplementation in porto-systemic encephalopathy remains controversial. Here, we examined the systematic review evidence for their effect on encephalopathy, hepatic decompensation, survival, infection, hospital stay and quality of life, and review data on adherence, side-effects and cost/economic evaluation. METHODS Four electronic databases were searched from 1980 to June 2011, with an update search in two databases in July 2013. Hand-searching was performed of references lists from included trials and six conference proceedings from 2005 to 2010. We included randomised controlled trials of branched chain amino acids versus other nutritional supplements in adults with cirrhosis and porto-systemic encephalopathy. Data extraction and quality assessment were performed by two independent assessors. Meta-analysis was performed if data were sufficient. RESULTS The search identified nine randomised controlled trials (436 patients in total) of branched-chain amino acid therapy for ≥2 weeks' duration. The overall quality of trials was poor. At meta-analysis, a significant improvement in the grade of encephalopathy was demonstrated in favour of branched-chain amino acids compared to other nutritional supplements (Risk Ratio 2.6, 95% Confidence Interval 1.7-3.9, p < 0.001, 2 trials, n 122) but no significant difference was found for either resolution or worsening of encephalopathy, gastrointestinal bleeding, survival or infection. Limited data suggested no difference in health-related quality of life, ascites or admission to hospital. Studies did not include cost data or economic evaluations. Side-effects appeared mild and gastrointestinal in nature. CONCLUSIONS Branched-chain amino acids might improve porto-systemic encephalopathy but more robust trials are needed to determine their role.
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Oral branched-chain amino acids have a beneficial effect on manifestations of hepatic encephalopathy in a systematic review with meta-analyses of randomized controlled trials.
Gluud, LL, Dam, G, Borre, M, Les, I, Cordoba, J, Marchesini, G, Aagaard, NK, Risum, N, Vilstrup, H
The Journal of nutrition. 2013;(8):1263-8
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Abstract
Supplements with branched-chain amino acid (BCAA) have cerebral, metabolic, and nutritional effects that may benefit patients with hepatic encephalopathy (HE). We therefore conducted a systematic review on the effects of oral BCAAs compared with control supplements or placebo for patients with cirrhosis and recurrent overt or minimal HE. The quantitative analyses included data from 8 trials (n = 382 patients). Individual patient data were retrieved from 4 trials to recalculate outcomes (n = 255 patients). The mean dose of the oral BCAA supplements was 0.25 g/(kg body weight · d). Random effects meta-analysis showed that improvements in HE manifestations were registered for 87 of 172 patients in the BCAA group compared with 56 of 210 controls [risk ratio = 1.71 (95% CI: 1.17, 2.51) number needed to treat = 5 patients]. The effect of BCAAs differed (P = 0.04) for patients with overt [risk ratio = 3.26 (95% CI: 1.47, 7.22)] and minimal HE [risk ratio = 1.32 (95% CI: 0.97, 1.79)]. Subgroup, sensitivity, regression, and sequential analyses found no other sources of heterogeneity or bias. BCAA supplements had no effect on mortality or markers of nutritional status and did not induce adverse events. In conclusion, oral BCAA supplements improve manifestations of HE but have no effect on survival.