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NCT Number: NCT06256744

Resistance Exercise-induced Anabolism in Youths and Adults

Resistance exercise training (RET) in children and adolescents has become a popular area of research, with a growing body of evidence supporting its use. Position and consensus statements about RET for children indicate that it is safe and effective at increasing muscular strength, improving sport performance, and mitigating injury risk. Neural and muscular mechanisms can improve muscle strength following RET. Neural factors include improved recruitment and firing of an individual's motor units, and muscular factors primarily include an increase in the size of the muscle (hypertrophy).

In children, little is known about how these mechanisms relate to muscle strength. There is very little evidence of morphological changes following RET in children. Therefore, conventional wisdom is that children rely only on neural factors to improve strength following RET. Nevertheless, some studies have suggested RET-induced muscle hypertrophy in children and adolescents, indicating that with certain training protocols, children may achieve muscle growth.

Hypertrophy of muscle fibres occurs when the rate of muscle protein synthesis (MPS) is greater than the rate of protein breakdown, and is enhanced with the ingestion of dietary amino acids. Due to ethical concerns with obtaining muscle samples (i.e., from muscle biopsies) in pediatric populations, MPS rates have not been previously assessed following RET in children. Recent advancements in stable-isotope methodology (specifically, leucine) allow for the estimation of MPS in a non-invasive breath test.

The objective of the proposed research is to examine the effects of an acute bout of RET on leucine retention (a proxy for MPS) in children, adolescents, and adults using a non-invasive breath test.

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Key information

Age range

7 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Brock University

St. Catharines, Ontario, L2S3A1, Canada

Location status: Recruiting

Location contact

Bareket Falk, PhD

CONTACT

About this study

Resistance exercise training (RET) in children and adolescents has become a popular area of research, with a growing body of evidence supporting its use. Position and consensus statements about RET for children indicate that it is safe and effective at increasing muscular strength, improving sport performance, and mitigating injury risk. Neural and muscular mechanisms can improve muscle strength following RET. Neural factors include improved recruitment and firing of an individual's motor units, and muscular factors primarily include an increase in the size of the muscle (hypertrophy).

In children, little is known about how these mechanisms relate to muscle strength. There is very little evidence of morphological changes following RET in children. Therefore, conventional wisdom is that children rely only on neural factors to improve strength following RET, possibly due to their lower levels of circulating androgens. Nevertheless, some studies have suggested RET-induced muscle hypertrophy in children and adolescents, indicating that with certain training protocols, children may achieve muscle growth.

Hypertrophy of muscle fibres occurs when the rate of muscle protein synthesis (MPS) is greater than the rate of protein breakdown, and is enhanced with the ingestion of dietary amino acids. Due to ethical concerns with obtaining muscle samples (i.e., from muscle biopsies) in pediatric populations, MPS rates have not been previously assessed following RET in children. Recent advancements in stable-isotope methodology allow for the estimation of MPS in a non-invasive breath test, which is based on the retention of an essential amino acid (i.e., leucine) that is preferentially metabolized within skeletal muscle. Given that amino acids can only be 'stored' in functional body proteins with any excess being converted to energy (i.e., oxidized), this non-invasive technique is ideal to safely estimate the anabolic (i.e., growth) potential of RET in children. Indeed, similar techniques using ingested stable isotopes have been safely and successfully used in children and adolescents.

The objective of the proposed research is to examine the effects of an acute bout of RET on leucine retention (a proxy for MPS) in children, adolescents, and adults using a non-invasive breath test. It is hypothesized that following a bout of RET, protein retention will be augmented in all groups compared to a non-exercised condition. However, due to a greater basal rate of leucine retention (i.e., for growth processes), the RET-induced increase will be relatively lower in the children and adolescents.

Design: The proposed study will use a cross-sectional design that will compare leucine retention at rest, as well as following a bout of resistance exercise in children, adolescents, and adults.

Procedures: Participants will be required to make three visits to the Applied Physiology Laboratory at Brock University for the completion of all procedures.

During visit 1, the participants and their guardian(s) (if under the age of 18) will be informed of all tests and procedures that will take place over the duration of the study. Written and verbal consent will be obtained from the participants and their guardians (in the case of children and adolescents) before proceeding with further questionnaires. Questionnaires screening for medical concerns, pubertal stage, athletic training practices, menarche and oral contraceptive use (for adolescent and adult females), habitual eating habits, and habitual physical activity will then be completed. Anthropometric measurements will also be performed (i.e., height, seated height, body fat composition, skinfold thickness, limb lengths, limb circumferences, muscle cross sectional area). Following questionnaires and anthropometric measurements, participants will be familiarized with the exercises to be performed in their RET session. Each participant's strength will also be tested for these exercises.

Visits 2 and 3 will serve as the experimental sessions and will consist of a RET and a rest session, done in a counterbalanced order. For these sessions, participants will arrive fasted in the morning, and will be provided with a standardized breakfast and beverage. At the beginning of the experimental sessions, participants will have their breath collected. This will be followed by RET in one of the sessions, or continued rest. A dose of L-[1-13C]leucine isotope will then be consumed based on each participant's body mass (within a protein and carbohydrate beverage) and the breath of each participant will continue to be collected for the next 5 hours (total of 11 breath samples). A small snack will be given to each participant during this breath collection period.

Resistance Exercise: Strength testing and the training protocol will involve the following exercises which will all be performed using strength training machines. The use of such equipment is considered safer than the use of free weights as there are less degrees of freedom during limb movements, preventing technical failure prior to muscular fatigue. The following exercises will be performed: seated leg press, seated overhead press, seated chest press, seated horizontal row. Exercises will be performed with techniques described by the Canadian Society for Exercise Physiology (CSEP - PATH, 2021).

The RET protocol will comprise of 3-5 sets of each exercise at 70-80% of 1RM. Each exercise will be performed until failure (i.e., until the participant can no longer complete the movement with safe technique), as this has been shown to be optimal for stimulating MPS and eliciting muscle hypertrophy. Approximately 8-15 repetitions are expected to be completed per set and ~90s of rest will be given between sets. A similar acute RET protocol has previously been shown to be a sufficient stimulus to elicit differences in leucine retention compared to rest (tested using the non-invasive breath test that will be used in the proposed study) in adults.

The participants in the proposed study will be male and female prepubertal children (~7-12 years), adolescents (~13-16 years), and adults (18-35 years).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • healthy
  • free of injury that would prevent resistance exercise

Exclusion criteria

  • consumed any medications in the past year which may affect muscle function
  • had an injury in the past 6 months that would limit the movements required for the protocols
  • been told that has diabetes
  • been told that had a heart problem
  • been told that have a breathing problem (e.g., asthma)
  • been told that sometimes experience seizures
  • had joint instability or ongoing join chronic pain
  • been told that had kidney problems
  • had stomach problems such as ulcers
  • experience prolonged bleeding after a cut

Treatment and study plan

Exercise

Other

Resistance exercise

Primary outcomes

  1. Leucine retention

    Time frame: During the experimental session, expired air is collected pre-ingestion and every 30minutes. i.e., at -60, 0, 30, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes.

    retention is calculated as intake minus leucine in expired air (mg). This test involves blowing into a breath collection bag before, and every ~30 minutes after (for ~300 minutes) ingesting a powdered-amino acid supplement (modeled after egg protein - the WHO/FAO gold standard protein source) mixed with water. The supplement will contain 0.25 g/kg body mass of protein as crystalline amino acids, 0.75 g/kg body mass of carbohydrate (~4kcal/kg of body mass), and will be enriched with 1 mg/kg of L-[1-13C]leucine (Cambridge Isotope Laboratories Inc., Tewksbury, MA, USA), which is a stable isotope that can be detected in the breath of the participants when not used for protein synthesis. The amount of the isotope that is expelled (oxidized) in the breath of the participant can be detected using continuous-flow isotope ratio mass spectrometry (ID-Microbreath; Compact Science Systems, Newcastle, UK), which allows for the estimation of leucine retention (intake - oxidation)

Secondary outcomes

  1. body mass

    Time frame: baseline in each experimental session

    mass in kg

  2. body height

    Time frame: baseline, pre-intervention

    height in cm

  3. arm circumference

    Time frame: baseline in each experimental session

    arm circumference in cm

  4. thigh circumference

    Time frame: baseline in each experimental session

    circumference in cm

  5. Skinfold thickness - triceps

    Time frame: baseline, pre-intervention

    skinfold thickness in mm (using Harpenden calipers)

  6. skinfold thickness - subscapula

    Time frame: baseline, pre-intervention

    skinfold thickness in mm (using Harpenden calipers)

  7. Body composition (BIA)

    Time frame: baseline, pre-intervention

    Bioelectrical impedance analysis (BIA) - percentage of body fat

  8. Muscle thickness - thigh, upper arm

    Time frame: baseline, pre-intervention

    muscle thickness in mm - using ultrasound system

  9. [13C]leucine in urine

    Time frame: baseline and post-each experimental session. i.e., at -60 and 300 minutes

    concentration in microgram, using mass spectrometry

  10. maximal strength (1RM)

    Time frame: baseline, pre-intervention

    maximal weight lifted/pushed in kg - seated leg press, seated overhead press, seated chest press, seated horizontal row

  11. oxygen consumption

    Time frame: During the experimental session, every 30 minutes: i.e., at -60, 0, 30, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes.

    Oxygen consumption (l/min) - using open circuit metabolic system

  12. carbon dioxide production

    Time frame: During the experimental session, every 30 minutes: i.e., at -60, 0, 30, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes. (every 30min)

    carbon dioxide production (l/min) - using open circuit metabolic system

  13. nutritional intake

    Time frame: baseline, pre-intervention

    Nutritional intake (carbohydrates, fats, proteins) - in g/day and as % or daily recommendation. Using Food Frequency questionnaire and 24-h recall.

  14. leisure time physical activity level

    Time frame: baseline, pre-intervention

    physical activity level, using the Godin-Shephard leisure time questionnaire. Minimum score is 0, with no maximum limit. Higher score reflects more physical activity

  15. Pubertal stage (children and adolescents only)

    Time frame: baseline, pre-intervention

    Based on secondary sex characteristics of pubertal hair (Tanner scale). Stages are 1-5, where 1 is pre-pubertal and 5 is post-pubertal

Study contacts

Contact information is provided by the study sponsor or research team.

Andrew McKiel, MSc

CONTACT

[email protected]

905-688-5550 ext. 5826

Bareket Falk, PhD

CONTACT

[email protected]

905-688-5550 ext. 4979

Sponsors and collaborators

Lead sponsor

Brock University

Other

Collaborators

  • University of Toronto

Registry information

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Feb 13, 2024
Registry last updated
Aug 16, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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