20) J Int Soc Sports Nutr. 2023; 20(1): 2263409.

International society of sports nutrition position stand: essential amino acid supplementation on skeletal muscle and Performance

Arny A. Ferrando, ^a Robert R. Wolfe, ^a Katie R. Hirsch, ^b David D. Church, ^a Shiloah A. Kviatkovsky, ^a Michael D. Roberts, ^c Jeffrey R. Stout, ^d Drew E. Gonzalez, ^e Ryan J. Sowinski, ^e Richard B. Kreider, ^e Chad M. Kerksick, ^f Nicholas A. Burd, ^g Stefan M. Pasiakos, ^h Michael J. Ormsbee, ⁱ Shawn M. Arent, ^b Paul J. Arciero, ^{j , k} Bill I. Campbell, ^l Trisha A. VanDusseldorp, ^{m , n} Ralf Jager, ^o Darryn S. Willoughby, ^p Douglas S. Kalman, ^q and Jose Antonio ^r

ABSTRACT

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of literature surrounding the effects of essential amino acid (EAA) supplementation on skeletal muscle maintenance and performance. This position stand is intended to provide a scientific foundation to athletes, dietitians, trainers, and other practitioners as to the benefits of supplemental EAA in both healthy and resistant (aging/clinical) populations. EAAs are crucial components of protein intake in humans, as the body cannot synthesize them. The daily recommended intake (DRI) for protein was established to prevent deficiencies due to inadequate EAA consumption. The following conclusions represent the official position of the Society: 1. Initial studies on EAAs’ effects on skeletal muscle highlight their primary role in stimulating muscle protein synthesis (MPS) and turnover. Protein turnover is critical for replacing degraded or damaged muscle proteins, laying the metabolic foundation for enhanced functional performance. Consequently, research has shifted to examine the effects of EAA supplementation – with and without the benefits of exercise – on skeletal muscle maintenance and performance. 2. Supplementation with free-form EAAs leads to a quick rise in peripheral EAA concentrations, which in turn stimulates MPS. 3. The safe upper limit of EAA intake (amount), without inborn metabolic disease, can easily accommodate additional supplementation. 4. At rest, stimulation of MPS occurs at relatively small dosages (1.5–3.0 g) and seems to plateau at around 15–18 g. 5. The MPS stimulation by EAAs does not require non-essential amino acids. 6. Free-form EAA ingestion stimulates MPS more than an equivalent amount of intact protein. 7. Repeated EAA-induced MPS stimulation throughout the day does not diminish the anabolic effect of meal intake. 8. Although direct comparisons of various formulas have yet to be investigated, aging requires a greater proportion of leucine to overcome the reduced muscle sensitivity known as “anabolic resistance.” 9. Without exercise, EAA supplementation can enhance functional outcomes in anabolic-resistant populations. 10. EAA requirements rise in the face of caloric deficits. During caloric deficit, it’s essential to meet whole-body EAA requirements to preserve anabolic sensitivity in skeletal muscle.