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The Role of Protein and Amino Acids in Sustaining and Enhancing Performance (1999)
Institute of Medicine (IOM)

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. "7 Effects of Protein Intake on Renal Function and on the Development of Renal Disease." The Role of Protein and Amino Acids in Sustaining and Enhancing Performance. Washington, DC: The National Academies Press, 1999.

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The Role of Protein and Amino Acids in Sustaining and Enhancing Performance

FIGURE 7-4 Glomerular filtration rate, measured as inulin clearance, in four groups of subjects. Young NT: healthy subjects 26 ± 3 years of age with normal blood pressure. Elderly NT: healthy subjects 68 ± 7 years of age with normal blood pressure. Elderly HT: subjects 70 ± 6 years of age with hypertension but not receiving diuretics. Elderly with heart failure: subjects 69 ± 6 years of age with heart failure. Symbols: open circles, men; solid circles, women.

Source: Used with permission from Kidney International, 1997, 51:1196-1204.

the decline of renal function with age and that restriction of dietary protein might prevent this decline.

This recommendation cannot be supported for a number of reasons as pointed out in a recent review (Walser, 1992). First, caloric restriction is more effective in rats than is protein restriction in retarding the age-associated decline in renal function (Tapp et al., 1989). Furthermore, caloric restriction without protein restriction markedly retarded the progression of glomerulosclerosis. Rats prefer rations containing higher proportions of protein, and the earlier studies indicating that protein restriction retarded renal damage failed to monitor food intake.

Second, protein restriction tends to lower GFR rather than increase it. Lew and Bosch (1991) recorded the dependence of creatinine clearance on spontaneous protein intake in subjects aged 22 to 50 years and in subjects aged

Page
145
Front Matter (R1-R18)
Executive Summary (1-16)
I Committee Summary and Recommendations (17-18)
1 Committee Review (19-76)
2 Responses to Questions, Conclusions, and Recommendations (77-82)
II Authored Papers and Workshop Discussions (83-84)
3 Protein and Amino Acids: Physiological Optimization for Current and Future Military Operational Scenarios (85-92)
4 Overview of Garrison, Field, and Supplemental Protein Intake by U.S. Military Personnel (93-108)
5 The Energy Costs of Protein Metabolism: Lean and Mean on Uncle Sam's Team (109-120)
6 Regulation of Muscle Mass and Function: Effects of Aging and Hormones (121-136)
7 Effects of Protein Intake on Renal Function and on the Development of Renal Disease (137-154)
8 Infection and Injury: Effects on Whole Body Protein Metabolism (155-168)
9 Inherent Difficulties in Defining Amino Acid Requirements (169-216)
10 Amino Acid Flux and Requirements: Counterpoint Tentative Estimates are Feasible and Necessary (217-242)
11 Physical Exertion, Amino Acid and Protein Metabolism, and Protein Requirements (243-254)
12 Skeletal Muscle Markers (255-278)
13 Alterations in Protein Metabolism Due to the Stress of Injury and Infection (279-284)
Discussion I (285-288)
14 Amino Acid and Protein Requirements: Cognitive Performance, Stress, and Brain Function (289-308)
15 Supplementation with Branched-Chain Amino Acids, Glutamine, and Protein Hydrolysates: Rationale for Effects on Metabolism and Performance (309-330)
16 Dietary Supplements Aimed at Enhancing Performance: Efficacy and Safety Considerations (331-340)
Discussion II (341-346)
Appendixes (347-348)
A Workshop Agenda (349-352)
B Biographical Sketches (353-368)
C Acronyms and Abbreviations (369-372)
D Proteins and Amino Acids - A Selected Bibliography (373-410)
E Protein and Energy Content of Selected Operational Rations (411-412)
Index (413-429)