Schoenfeld et al.

Journal of the International Society of Sports Nutrition 2013, 10:53

http://www.jissn.com/content/10/1/53

REVIEW

Open Access

The effect of protein timing on muscle strength

and hypertrophy: a meta-analysis
Brad Jon Schoenfeld1*, Alan Albert Aragon2 and James W Krieger3

Abstract
Protein timing is a popular dietary strategy designed to optimize the adaptive response to exercise. The strategy
involves consuming protein in and around a training session in an effort to facilitate muscular repair and
remodeling, and thereby enhance post-exercise strength- and hypertrophy-related adaptations. Despite the apparent biological plausibility of the strategy, however, the effectiveness of protein timing in chronic training studies has
been decidedly mixed. The purpose of this paper therefore was to conduct a multi-level meta-regression of randomized controlled trials to determine whether protein timing is a viable strategy for enhancing post-exercise muscular adaptations. The strength analysis comprised 478 subjects and 96 ESs, nested within 41 treatment or control
groups and 20 studies. The hypertrophy analysis comprised 525 subjects and 132 ESs, nested with 47 treatment or
control groups and 23 studies. A simple pooled analysis of protein timing without controlling for covariates showed
a small to moderate effect on muscle hypertrophy with no significant effect found on muscle strength. In the full
meta-regression model controlling for all covariates, however, no significant differences were found between treatment and control for strength or hypertrophy. The reduced model was not significantly different from the full
model for either strength or hypertrophy. With respect to hypertrophy, total protein intake was the strongest predictor of ES magnitude. These results refute the commonly held belief that the timing of protein intake in and
around a training session is critical to muscular adaptations and indicate that consuming adequate protein in combination with resistance exercise is the key factor for maximizing muscle protein accretion.

Background
Protein timing is a popular dietary strategy designed to
optimize the adaptive response to exercise [1]. The strategy involves consuming protein in and around a training
session in an effort to facilitate muscular repair and remodeling, and thereby enhance post-exercise strengthand hypertrophy-related adaptations [2]. It is generally
accepted that protein should be consumed just before
and/or immediately following a training session to take
maximum advantage of a limited anabolic window [3].
Proponents of the strategy claim that, when properly executed, precise intake of protein in the peri-workout
period can augment increases in fat-free mass [4]. Some
researchers have even put forth the notion that the
timing of food intake may have a greater positive
effect on body composition than absolute daily nutrient consumption [5].
* Correspondence: [email protected]
1
Department of Health Science, Lehman College, Bronx, NY, USA
Full list of author information is available at the end of the article

A number of studies support the superiority of protein

timing for stimulating increases in acute protein synthesis pursuant to resistance training when compared to
placebo [6-9]. Protein is deemed to be the critical nutrient required for optimizing post-exercise protein synthesis. The essential amino acids, in particular, are believed
primarily responsible for enhancing this response, with
little to no contribution seen from provision of nonessential amino acids [10,11]. Borsheim et al. [10] found
that a 6 g dose of essential amino acids (EAAs) consumed immediately post-exercise produced an approximate twofold increase in net protein balance compared
to a comparable dose containing an approximately equal
mixture of essential and non-essential amino acids, indicating a doseresponse relationship up to 6 g EAAs.
However, increasing EAA intake beyond this amount
has not been shown to significantly heighten postexercise protein synthesis [2]. There is limited evidence
that carbohydrate has an additive effect on enhancing
post-exercise muscle protein synthesis when combined

2013 Schoenfeld et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
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Schoenfeld et al. Journal of the International Society of Sports Nutrition 2013, 10:53
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with amino acid ingestion [12], with a majority of studies

failing to demonstrate any such benefit [13-15].
Despite the apparent biological plausibility of the strategy, the effectiveness of protein timing in chronic training studies has been decidedly mixed. While some
studies have shown that consumption of protein in the
peri-workout period promotes increases in muscle
strength and/or hypertrophy [16-19], others have not
[20-22]. In a review of literature, Aragon and Schoenfeld
[23] concluded that there is a lack of evidence to support
a narrow anabolic window of opportunity whereby
protein need to be consumed in immediate proximity to
the exercise bout to maximize muscular adaptations.
However, these conclusions were at least in part a reflection of methodological issues in the current research.
One issue in particular is that studies to date have
employed small sample sizes. Thus, it is possible that
null findings may be attributable to these studies being
underpowered, resulting in a type II error. In addition,
various confounders including the amount of EAA supplementation, matching of protein intake, training status,
and variations in age and gender between studies make
it difficult to draw definitive conclusions on the topic.
Thus, by increasing statistical power and controlling for
confounding variables, a meta-analysis may help to provide clarity as to whether protein timing confers potential benefits in post-exercise skeletal muscle adaptations.
A recent meta-analysis by Cermak et al. [24] found
that protein supplementation, when combined with regimented resistance training, enhances gains in strength
and muscle mass in both young and elderly adults. However, this analysis did not specifically investigate protein
timing per se. Rather, inclusion criteria encompassed all
resistance training studies in which at least one group
consumed a protein supplement or modified higher protein diet. The purpose of this paper therefore is to conduct a meta-analysis to determine whether timing
protein near the resistance training bout is a viable strategy for enhancing muscular adaptations.

Methodology
Inclusion criteria

Only randomized controlled trials or randomized crossover trials involving protein timing were considered for
inclusion. Protein timing was defined here as a study
where at least one treatment group consumed a minimum of 6 g essential amino acids (EAAs) 1 hour preand/or post-resistance exercise and at least one control
group did not consume protein < 2 hours pre- and/or
post-resistance exercise. Resistance training protocols
had to span at least 6 weeks and directly measure dynamic muscle strength and/or hypertrophy as a primary
outcome variable. There were no restrictions for age,
gender, training status, or matching of protein intake,

Page 2 of 13

but these variables were controlled via subgroup analysis

using meta-regression.
Search strategy

To carry out this review, English-language literature

searches of the PubMed and Google Scholar databases
were conducted for all time periods up to March 2013.
Combinations of the following keywords were used as
search terms: nutrient timing; protein supplementation; nutritional supplementation; protein supplement; nutritional supplement; resistance exercise;
resistance training; strength training. Consistent with
methods outlined by Greenhalgh and Peacock [25], the
reference lists of articles retrieved in the search were
then screened for any additional articles that had relevance to the topic. Abstracts from conferences, reviews,
and unpublished dissertations/theses were excluded
from analysis. A total of 34 studies were identified as potentially relevant to this review. To reduce the potential
for selection bias, each of these studies were independently perused by two of the investigators (BJS and AAA),
and a mutual decision was made as to whether or not
they met basic inclusion criteria. Study quality was then
assessed with the PEDro scale, which has been shown to
be a valid measure of the methodologic quality of RCTs
[26] and possesses acceptable inter-rater reliability [27].
Only those studies scoring 5 on the PEDro scalea
value considered to be of moderate to high quality [27]were accepted for analysis. Any inter-reviewer disagreements were settled by consensus and/or consultation
with the third investigator. Initial pre-screening revealed
29 potential studies that investigated nutrient timing
with respect to muscular adaptations. Of these studies, 3
did not meet criteria for sufficient supplemental protein
intake [28-30] and in another the timing of consumption
was outside the defined post-workout range [31]. Thus,
a total of 25 studies ultimately were deemed suitable for
inclusion. Two of the studies were subsequently excluded because they did not contain sufficient data for
calculating an effect size and attempts to obtain this information from the authors were unsuccessful [19,32],
leaving a total 23 studies suitable for analysis. The average PEDro score of these studies was 8.7, indicating an
overall high level of methodological quality. Table 1
summarizes the studies meeting inclusion criteria.
Coding of studies

Studies were read and individually coded by two of the

investigators (BJS and AAA) for the following variables:
Descriptive information of subjects by group including
gender, body mass, training status (trained subjects were
defined as those with at least one year resistance training
experience), age, and stratified subject age (classified as
either young [1849 years] or elderly [50+ years];

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Table 1 Summary of studies meeting inclusion criteria

Protein
matched
with
control?

Anthropometric
and/or body
composition
assessment
method

Training protocol

Strength results

Body composition
results

19 untrained 18.3 g EAA or an

young
equal dose of
women
cellullose placebo
taken (collectively)
20 minutes pre and
post-exercise

No

DXA

Periodized
progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
3 days/wk for 6 wks

Total weight lifted

at the 12 RM
intensity did not
significantly change
in either group

No significant body
composition
changes occurred in
either group

Goddard
et al., [34]

17 untrained 12 g of essential
older men
amino acids and
(6080 y)
72 g (total) of
fructose and
dextrose consumed
immediately after
exercise

No

Computed
tomography (CT).

Progressive
resistance training
consisting of knee
extensions
preformed 3 days/
wk for 12 wks

Training produced a
significant increase
in 1RM strength and
measures of
maximal torque, no
differences between
groups

No significant
differences in
muscle CSA increase
between groups

Rankin
et al., [35]

13 untrained Chocolate milk

No
young men (providing a protein
dose of 0.21 g/kg)
or a CHO-electrolyte
beverage (Gatorade)
immediately after
exercise

Dual X-ray absorptiometry (DXA) and

multiple upper &
lower body circumference
measurements

Periodized
progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
3 days/wk for 10
wks

1 RM strength
increased in all
exercises, with no
significant difference
between groups

No significant
differences in fat
reduction, mean
mass gain, or
circumference
changes between
groups

Andersen
et al., [36]

22 untrained 25 g protein
young men (combination of
whey, casein, egg
white, and
glutamine) or 25 g
maltodextrin
immediately before
and after exercise

No

Muscle biopsy

Periodized
progressive
resistance training
consisting of lower
body exercises
performed 3 days/
wk for 14 wks

Squat jump height

increased only in
the protein group,
whereas
countermovement
jump height and
peak torque during
slow isokinetic
muscle contraction
increased similarly in
both groups.

The protein group

showed hypertrophy
of type I & II muscle
fibers, whereas no
significant change
occurred in the CHO
group

Bird et al.,
[37]

32 untrained 6 g EAA or 6% CHO

young men solution + 6 g EAA
or placebo during
exercise

No

DXA and muscle

biopsy

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
2 days/wk for 12
wks

Training caused a
significant increase
in 1RM in the leg
press similarly in
both treatment
groups compared to
placebo, isokinetic
strength increased
in all groups, with
no differences
between groups

CHO + EAA showed

greater gains in fatfree mass compared
to placebo, fat mass
decreased in all
groups without any
significant difference
between groups

Coburn
et al., [38]

33 untrained 20 g whey + 6.2 g

young men leucine or 26.2 g
maltodextrin
30 minutes prior to
and immediately
after exercise

No

Progressive
Magnetic
resonance imaging resistance training
consisting of knee
(MRI)
extensions
performed 3 days/
wk for 8 wks

Significantly greater
1 RM strength
increase in the
trained limb in the
protein group
compared to
placebo

No significant body
composition
changes occurred in
any of the groups,
CSA increases did
not differ between
the protein and
placebo groups

DXA

1 RM strength
increases in the
squat and bench
press were
significantly greater
in the protein

Lean mass increase

was significantly
greater in the
protein groups than
placebo

Study

Subjects

Antonio
et al., [33]

Supplementation

27 untrained Whey (1.2 g/kg) +

Candow,
No
Burke, et al., young men sucrose (0.3 g/kg) or
placebo (1.2 g/kg
& women
[39]
maltodextrin +
0.3 g/kg sucrose)

Progressive,
periodized
resistance training
consisting of
exercises for all
major muscle

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Table 1 Summary of studies meeting inclusion criteria (Continued)

groups performed
groups than
4 days/wk for 6 wks placebo

Note that only the

soy treatment was
excluded from
analysis.
Candow,
Chilibeck,
et al., [40]

29 untrained Multi-ingredient
No
older men
supplement
containing a protein
dose of 0.3 g/kg
immediately before
exercise and a CHObased placebo immediately after, or
the reverse order of
the latter, or placebo before & after
exercise

Cribb and
Hayes, [16]

23 young
recreational
male
bodybuilders

Hartman
et al., [41]

Air-displacement
plethysmography,
ultrasound

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
3 days/wk for 12
wks

1 RM strength
increases in the leg
press & bench press
occurred in all
groups, no
significant
differences between
groups

Lean mass and

muscle thickness
increased in all
groups, no
significant difference
between groups

1 g/kg of a
Yes
supplement
containing 40 g
whey isolate, 43 g
glucose, and 7 g
creatine
monohydrate
consumed either
immediately before
and after exercise or
in the early morning
and late evening

DXA and muscle

biopsy

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
3 days/wk for 10
wks

Immediate pre-post
supplementation
caused greater increases in 1-RM in 2
out of 3 exercises

Significant increases
in lean body mass
and muscle CSA of
type II fibers in
immediate vs.
delayed
supplementation

56 untrained 17.5 g protein

No
young men within milk or a soy
beverage, or CHO
control immediately
after exercise and
again 1 hr after
exercise

DXA and muscle

biopsy

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
5 days/wk for 12
wks

All groups
experienced 1RM
strength gains, but
no between-group
differences were
seen

Type II muscle fiber

area increased in all
groups, but with
greater increases in
the milk group than
in the soy and
control groups, fatfree mass increased
to a greater extent
in the milk group
compared to the
soy & control
groups

DXA

Progressive,
periodized
resistance training
consisting of
exercises for all
major muscle
groups performed
4 days/wk for 12
wks

1 RM bench press
strength (but not
squat strength)
significantly
increased in the
protein group, while
no measures of
strength increased
in the placebo
group

No significant
between-group or
absolute changes in
body composition
occurred

Note that only the

soy treatment was
excluded from
analysis.
42 g protein within
a multi-ingredient
supplement or a
CHO placebo taken
once in the morning and again after
training

Hoffman
et al., [42]

21 welltrained
young men

Willoughby
et al., [17]

19 untrained 20 g wheyNo
young men dominant protein or
20 g dextrose consumed 1 hour before and after
exercise

Hydrostatic
weighing, muscle
biopsy, surface
measurements

Progressive
resistance training
consisting of
exercise for all
major muscle
groups performed
4 days/wk for 10
wks

Protein
supplementation
caused greater
increases in relative
strength (maximal
strength corrected
for bodyweight) in
bench press & leg
press

Significant increase
in total body mass,
fat-free mass, and
thigh mass with protein vs. carb
supplementation

Eliot et al.,
[43]

42 untrained 35 g whey protein

older men
+ CHO-electrolyte
solution, or whey/
CHO + 5 g creatine,
or creatine-only, or
CHO placebo

DXA and
bioelectrical
impedance

Progressive
resistance training
consisting of
exercise for all
major muscle
groups performed

Not measured

No significant
effects of any of the
whey and/or
creatine treatments
were seen beyond
body composition

No

No

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Table 1 Summary of studies meeting inclusion criteria (Continued)

3 days/wk for 14
wks

Note that creatine

treatments were
excluded from
analysis

changes caused by
training alone

Mielke
et al., [44]

39 untrained 20 g whey protein

No
young men + 6.2 g of leucine or
20 g maltodextrin
30 minutes before
and immediately
after exercise

Hydrodensitometry, Dynamic constant

external resistance
(DCER) bilateral leg
extension and
bench press
exercises were
performed 3 days/
wk for 8 wks.

1 RM strength
increased
significantly in both
groups without any
between-group
differences

No significant
training-induced
changes in body
composition in either group,

Verdijk
et al., [21]

28 untrained 10 g casein
elderly men hydrolysate or
placebo consumed
immediately before
and after exercise

DXA, CT, and

muscle biopsy

Progressive
resistance training
consisting leg press
and knee extension
performed 3 days/
wk for 12 wks

1 RM leg press & leg

extension strength
increased, with no
significant difference
between groups

No significant
differences in
muscle CSA increase
between groups

Hoffman
et al., [20]

33 welltrained
young men

DXA

Progressive
resistance training
consisting exercises
for the major
muscle groups
peformed 4 days/
wk for 10 wks.

1 RM & 5 RM bench
press & squat
strength increased,
with no significant
difference between
groups

No significant
differences in total
body mass or lean
body mass between
groups.

MRI, muscle biopsy Progressive,

periodized total
body resistance
training consisting
of exercises for all
major muscle
groups trained
performed 2 days/
wk for 21 wks

Strength increased
similarly in the
protein & placebo
group, but only the
protein group
increased isometric
leg extension
strength vs the
control group

Significant increase
in CSA of the vastus
lateralis but not of
the other
quadriceps muscles
in the protein group
vs placebo

No

Supplement
Yes
containing 42 g
protein (milk/
collagen blend) and
2 g carbohydrate
consumed either
immediately before
and after exercise or
in the early morning
and late evening

Hulmi et al., 31 untrained 15 g whey isolate or No

[18]
young men placebo consumed
immediately before
and after exercise

Josse et al.,
[45]

20 untrained 18 g protein within

young
milk or an isocaloric
women
maltodextrin
placebo
immediately after
exercise and again
1 hr later

No

DXA

Progressive,
periodized
resistance training
consisting of
exercises for all
major muscle
groups performed
5 days/wk for 12
wks

1 RM strength
increased similarly in
both groups, but
milk significantly
outperformed
placebo in the
bench press

Lean mass increased

in both groups but
to a significantly
greater degree in
the milk group, fat
mass decreased in
the milk group only

Walker
et al., [46]

30
moderately
trained men
and women

19.7 g of whey
protein and 6.2 g
leucine or isocaloric
CHO placebo 30
45 minutes before
exercising and the
second packet 30
45 minutes after
exercising.

No

DXA

Bodyweight-based
exercises and
running at least
3 days/wk,
externally loaded
training not
specified

1 RM bench press
strength increased
significantly in the
protein group only

Total mass, fat-free

mass, and lean body
mass increased significantly in the protein group only

Vieillevoye
et al., [47]

29 untrained 15 g EAA + 15 g
young men saccharose. or 30 g
saccharose
consumed with
breakfast and
immediately after
exercise

No

Ultrasonography, 3site skinfold assessment with calipers,

3-site circumference
measurements

Progressive,
periodized
resistance training
consisting of
exercises for all
major muscle
groups performed
2 days/wk for 12
wks

Maximal strength
significantly
increased in both
groups, with no
between-group
diffrerence

Muscle mass
significantly
increased in both
groups with no
differences between
groups, muscle
thickness of the
gastrocnemius
medialis significantly
increased in the EAA
group only

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Table 1 Summary of studies meeting inclusion criteria (Continued)

Wycherly
et al., [22]

34
untrained,
older men &
women w/
type 2
diabetes

Erskine
et al., [48]

33 untrained 20 g whey protein

young men or placebo
consumed
immediately before
and after exercise

Weisgarber
et al., [49]

17 untrained Whey protein dosed No

young men at 0.3 g/kg or
and women isocaloric CHO
immediately before,
during, and after
exercise

21 g protein, 0.7 g
fat, 29.6 g
carbohydrate
consumed either
immediately prior
to, or at least 2 h
following exercise

Yes

DXA, waist
circumference

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
3 days/wk for 16
wks

Not measured

Fat mass, fat-free

mass, and waist circumference decreased with no
significant differences between
groups

No

MRI

4-6 sets of elbow

flexion performed
3 days/wk for
12 weeks

No significant
differences in
maximal isometric
voluntary force or 1
RM strength
between groups

No significant
differences in
muscle CSA
between groups

DXA and
ultrasound

Progressive
resistance training
consisting of
exercises for all
major muscle
groups performed
4 days/wk for 8 wks

1 RM strength in
the chest press
increased in both
groups without any
between-group
difference

Significant increases
in muscle mass
were seen without
any difference
between groups

whether or not total daily protein intake between groups

was matched; whether the study was an RCT or crossover design; the number of subjects in each group;
blinding (classified as single, double, or unblinded); duration of the study; type of hypertrophy measurement
(MRI, CT, ultrasound, biopsy, etc.) and region/muscle of
body measured, if applicable; lean body mass measurement (i.e. DXA, hydrostatic weighing, etc.), if applicable,
and; strength exercise (s) employed for testing, if applicable. Coding was cross-checked between coders, and any
discrepancies were resolved by mutual consensus. To assess potential coder drift, 5 studies were randomly selected
for recoding as described by Cooper et al. [50]. Per case
agreement was determined by dividing the number of variables coded the same by the total number of variables. Acceptance required a mean agreement of 0.90.
Calculation of effect size

For each 1-RM strength or hypertrophy outcome, an effect size (ES) was calculated as the pretest-posttest
change, divided by the pretest standard deviation (SD)
[51]. The sampling variance for each ES was estimated
according to Morris and DeShon [51]. Calculation of the
sampling variance required an estimate of the population
ES, and the pretest-posttest correlation for each individual ES. The population ES was estimated by calculating
the mean ES across all studies and treatment groups
[51]. The pretest-posttest correlation was calculated
using the following formula [51]:



r s1 2 s2 2 sD 2 =2 s1 s2
where s1 and s2 are the SD for the pre- and posttest
means, respectively, and sD is the SD of the difference

scores. Where s2 was not reported, s1 was used in its

place. Where sD was not reported, it was estimated using
the following formula [52]:
sD

p
s1 2 =n s2 2 =n

Statistical analyses

Meta-analyses were performed using hierarchical linear

mixed models, modeling the variation between studies
as a random effect, the variation between treatment and
control groups as a random effect nested within studies,
and group-level predictors as fixed effects [53]. The
within-group variances were assumed known. Observations were weighted by the inverse of the sampling variance [51]. An intercept-only model was created,
estimating the weighted mean ES across all studies and
treatment groups. Second, a basic model was created
which only included the class of the group (treatment or
control) as a predictor. A full model was then created
with the following predictors: the class of the group
(treatment or control), whether or not the groups were
protein matched, training status (experienced or novice),
blinding (double, single, or none), gender (male, female,
or mixed), age (young or old), body mass in kg, and the
duration of the study in weeks. The full model was then
reduced by removing one predictor at a time, starting
with the most insignificant predictor [54]. The final
model represented the reduced model with the lowest
Akaikes Information Corrected Criterion (AICC) [55]
and that was not significantly different (P > 0.05) from
the full model when compared using a likelihood ratio
test (LRT). Model parameters were estimated by the
method of restricted maximum likelihood (REML) [56];

Schoenfeld et al. Journal of the International Society of Sports Nutrition 2013, 10:53
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an exception was during the model reduction process, in

which parameters were estimated by the method of
maximum likelihood (ML), as LRTs cannot be used to
compare nested models with REML estimates. Denominator df for statistical tests and CIs were calculated according to Berkey et al. [57]. The treatment/control
classification variable was not removed during the model
reduction process.
Separate analyses were performed for strength and
hypertrophy. ESs for both changes in cross-sectional
area (CSA) and FFM were pooled in the hypertrophy
analysis. However, because resistance exercise is associated with the accretion of non-muscle tissue, separate
sub-analyses on CSA and FFM were performed. Because
the effect of protein timing might interact with whether
the treatment and control groups were matched for total
protein intake, an additional model was created that included an interaction term between the treatment/control classification variable and the protein match
variable. Also, because the effect of protein timing might
vary by training experience, a model was created that included an interaction term between the treatment/control classification variable and the training status
variable. Adjustment for post hoc multiple comparisons
was performed using a simulation-based procedure [58].
All analyses were performed using SAS Enterprise Guide
Version 4.2 (Cary, NC). Effects were considered significant at P 0.05. Data are reported as means (SEs) and
95% CIs.

Figure 1 Impact of protein timing on strength by study.

Page 7 of 13

Results
Study characteristics

The strength analysis comprised 478 subjects and 96

ESs, nested within 41 treatment or control groups and
20 studies. The weighted mean strength ES across all
studies and groups was 1.39 0.24 (CI: 0.88, 1.90). The
hypertrophy analysis comprised 525 subjects and 132
ESs, nested with 47 treatment or control groups and 23
studies. The weighted mean hypertrophy ES across all
studies and groups was 0.47 0.08 (CI: 0.31, 0.63).
Basic model

There was no significant difference between the treatment and control for strength (difference = 0.38 0.36;
CI: -0.34, 1.10; P = 0.30). The mean strength ES difference between treatment and control for each individual
study, along with the overall weighted mean difference
across all studies, is shown in Figure 1. For hypertrophy,
the mean ES was significantly greater in the treatment
compared to the control (difference = 0.24 0.10; CI:
0.04, 0.44; P = 0.02). The mean hypertrophy ES difference between treatment and control for each individual
study, along with the overall weighted mean difference
across all studies, is shown in Figure 2.
Full model

In the full meta-regression model controlling for all covariates, there was no significant difference between the
treatment and control for strength (difference = 0.28

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Figure 2 Impact of protein timing on hypertrophy by study.

0.40; CI: -0.52, 1.07; P = 0.49) or hypertrophy (difference

=0.16 0.11; CI: -0.07, 0.38; P = 0.18).
Reduced model: strength

After the model reduction procedure, only training

status and blinding remained as significant covariates.
The reduced model was not significantly different
from the full model (P = 0.73). In the reduced model,
there was no significant difference between the treatment and control (difference = 0.39 0.36; CI: -0.34,
1.11; P = 0.29). The mean ES for control was 0.93
0.31 (CI: 0.32, 1.54). The mean ES for treatment was
1.31 0.30 (CI: 0.71, 1.92).
Reduced model: hypertrophy

After the model reduction procedure, total protein intake, study duration, and blinding remained as significant covariates. The reduced model was not significantly
different from the full model (P = 0.87). In the reduced
model, there was no significant difference between the
treatment and control (difference = 0.14 0.11; CI: -0.07,
0.35; P = 0.20). The mean ES for control was 0.36 0.09
(CI: 0.18, 0.53). The mean ES for treatment was 0.49
0.08 (CI: 0.33, 0.66). Total protein intake (in g/kg) was
the strongest predictor of ES magnitude (estimate = 0.41
0.14; CI: 0.14, 0.69; P = 0.004).
To confirm that total protein intake was mediator
variable in the relationship between protein timing and
hypertrophy, a model with only total protein intake as a

covariate was created. The difference between treatment

and control was not significant (difference = 0.14 0.11;
CI: -0.07, 0.35,; P = 0.19). Total protein intake was a significant predictor of ES magnitude (estimate = 0.39
0.15; CI: 0.08, 0.69; P = 0.01). Figure 3 shows the total
protein intake-adjusted ESs for each study, as well as
the overall effect from the meta-regression with only
total protein intake as a covariate.
Interactions

For strength, the interaction between treatment and

training status was nearly significant (P = 0.051), but post
hoc comparisons between treatment and control within
each training status classification were not significant
(adjusted P = 0.47 for difference within non-experienced
groups, and adjusted P = 0.99 for difference within experienced groups). There was no significant interaction
between treatment and whether groups were protein
matched (P = 0.43). For hypertrophy, there was no
significant interaction between treatment and training
status (P = 0.63) or treatment and protein matching
(P = 0.59).
Hypertrophy sub-analyses

Separating the hypertrophy analysis into CSA or FFM

did not materially alter the outcomes. For FFM, there
was no significant difference between treatment and
control (difference = 0.08 0.07; CI: -0.07, 0.24; P = 0.27).
Total protein intake remained a strong predictor of ES

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Figure 3 Impact of protein timing on hypertrophy by study, adjusted for total protein intake.

magnitude (estimate = 0.39 0.07; CI: 0.25, 0.53; P <

0.001). For CSA, there was no significant difference between treatment and control (difference = 0.14 0.16;
CI: -0.17, 0.46; P = 0.37). Total protein intake was again
a predictor of ES magnitude (estimate = 0.55 0.24; CI:
0.08, 1.20; P = 0.02).

Discussion
This is the first meta-analysis to directly investigate the
effects of protein timing on strength and hypertrophic
adaptations following long-term resistance training protocols. The study produced several novel findings. A
simple pooled analysis of protein timing without controlling for covariates showed a significant effect on
muscle hypertrophy (ES = 0.24 0.10) with no significant
effect found on muscle strength. It is generally accepted
that an effect size of 0.2 is small, 0.5 is moderate, and
0.8 and above is a large, indicating that the effect of protein timing on gains in lean body mass were small to
moderate. However, an expanded regression analysis
found that any positive effects associated with protein
timing on muscle protein accretion disappeared after
controlling for covariates. Moreover, sub-analysis
showed that discrepancies in total protein intake explained the majority of hypertrophic differences noted in
timing studies. When taken together, these results would
seem to refute the commonly held belief that the timing
of protein intake in the immediate pre- and postworkout period is critical to muscular adaptations [3-5].

Perceived hypertrophic benefits seen in timing studies

appear to be the result of an increased consumption of
protein as opposed to temporal factors. In our reduced
model, the amount of protein consumed was highly and
significantly associated with hypertrophic gains. In fact,
the reduced model revealed that total protein intake was
by far the most important predictor of hypertrophy ES,
with a ~0.2 increase in ES noted for every 0.5 g/kg increase in protein ingestion. While there is undoubtedly
an upper threshold to this correlation, these findings
underscore the importance of consuming higher
amounts of protein when the goal is to maximize
exercise-induced increases in muscle mass. Conversely,
total protein intake did not have an impact on strength
outcomes and ultimately was factored out during the
model reduction process.
The Recommended Dietary Allowance (RDA) for protein is 0.8 g/kg/day. However, these values are based on
the needs of sedentary individuals and are intended to
represent a level of intake necessary to replace losses
and hence avert deficiency; they do not reflect the requirements of hard training individuals seeking to increase lean mass. Studies do in fact show that those
participating in intensive resistance training programs
need significantly more protein to remain in a nonnegative nitrogen balance. Position stands from multiple
scientific bodies estimate these requirements to be approximately double that of the RDA [59,60]. Higher
levels of protein consumption appear to be particularly

Schoenfeld et al. Journal of the International Society of Sports Nutrition 2013, 10:53
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important during the early stages of intense resistance

training. Lemon et al. [61] displayed that novice bodybuilders required a protein intake of 1.6-1.7 g/kg/day to
remain in a non-negative nitrogen balance. The increased protein requirements in novice subjects have
been attributed to changes in muscle protein synthetic
rate and the need to sustain greater lean mass rather
than increased fuel utilization [62]. There is some evidence that protein requirements actually decrease
slightly to approximately 1.4 g/kg/day in well-trained individuals because of a greater efficiency in dietary nitrogen utilization [63], although this hypothesis needs
further study.
The average protein intake for controls in the unmatched studies was 1.33 g/kg/day while average intake
for treatment was 1.66 g/kg/day. Since a preponderance
of these studies involved untrained subjects, it seems
probable that a majority of any gains in muscle mass
would have been due to higher protein consumption by
the treatment group. These findings are consistent with
those of Cermak et al. [24], who found that protein supplementation alone produced beneficial adaptations
when combined with resistance training. The study by
Cermak et al. [24] did not evaluate any effects regarding
timing of intake, however, so our results directly lend
support to the theory that meeting target protein requirements is paramount with respect to exerciseinduced muscle protein accretion; immediate intake of
dietary protein pre and/or post-workout would at best
appear to be a minor consideration. The findings also
support previous recommendations that a protein consumption of at least 1.6 g/kg/day is necessary to
maximize muscle protein accretion in individuals involved in resistance training programs [61].
For the matched studies, protein intake averaged
1.91 g/kg/day versus 1.81 g/kg/day for treatment and
controls, respectively. This level of intake for both
groups meets or exceeds suggested guidelines, allowing for a fair evaluation of temporal effects. Only 3
studies that employed matched protein intake met inclusion criteria for this analysis, however. Interestingly, 2 of the 3 showed no benefits from timing.
Moreover, another matched study actually found significantly greater increases in strength and lean body
mass from a time-divided protein dose (i.e. morning
and evening) compared with the same dose provided
around the resistance training session [19]. However,
this study had to be excluded from our analysis because it lacked adequate data to calculate an ES. The
sum results of the matched-protein studies suggest
that timing is superfluous provided adequate protein
is ingested, although the small number of studies
limits the ability to draw firm conclusions on the
matter.

Page 10 of 13

This meta-analysis had a number of strengths. For

one, the quality of studies evaluated was high, with an
average PEDro score of 8.7. Also, the sample was relatively large (23 trials encompassing 478 subjects for
strength outcomes and 525 subjects for hypertrophy
outcomes), affording good statistical power. In addition,
strict inclusion/exclusion criteria were employed to reduce the potential for bias. Combined, these factors provide good confidence in the ability draw relevant
inferences from findings. Another strength was the rigid
adherence to proper coding practices. Coding was carried out by two of the investigators (BJS and AAA) and
then cross-checked between coders. Coder drift was
then assessed by random selection of studies to further
ensure consistency of data. Finally and importantly, the
study benefited from the use of meta-regression. This
afforded the ability to examine the impact of moderator
variables on effect size and explain heterogenecity between studies [64]. Although initial findings indicated an
advantage conferred by protein timing, meta-regression
revealed that results were confounded by discrepancies
in consumption. This ultimately led to the determination
that total protein intake rather than temporal factors explained any perceived benefits.
There are several limitations to this analysis that
should be taken into consideration when drawing
evidence-based conclusions. First, timing of the meals in
the control groups varied significantly from study to
study. Some provided protein as soon as 2 hours post
workout while others delayed consumption for many
hours. A recent review by Aragon and Schoenfeld [23]
postulated that the anabolic window of opportunity may
be as long as 46 hours around a training session, depending on the size and composition of the meal. Because the timing of intake in controls were all treated
similarly in this meta-analysis, it is difficult to determine
whether a clear anabolic window exists for protein consumption beyond which muscular adaptations suffer.
Second, the majority of studies evaluated subjects who
were inexperienced with resistance exercise. It is wellestablished that highly trained individuals respond differently to the demands of resistance training compared
with those who lack training experience [65]. In part,
this is attributed to a ceiling effect whereby gains in
muscle mass become progressively more difficult as a
trainee gets closer to his genetic hypertrophic potential.
There also is emerging evidence showing that regimented resistance exercise attenuates anabolic intracellular
signaling in rodents [66] and humans [67], conceivably
diminishing the hypertrophic response. Our sub-analysis
failed to show an interaction effect between resistance
training status and protein timing for either strength or
hypertrophy. However, statistical power was low because
only 4 studies using trained subjects met inclusion

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criteria. Future research should therefore focus on determining the effects of protein timing on muscular adaptations in those with at least 1 year or more of regular,
consistent resistance training experience.
Third, in an effort to keep our sample size sufficiently
large, we pooled CSA and FFM data to determine hypertrophy ES. FFM is frequently used as a proxy for hypertrophy, as it is generally assumed that the vast majority
of the gains in fat free mass from resistance training are
myocellular in nature. Nevertheless, resistance exercise
also is associated with the accretion of non-muscle tissue
as well (i.e. bone, connective tissue, etc.). To account for
any potential discrepancies in this regard, we performed
sub-analyses on CSA and FFM alone and the results
essentially did not change. For FFM, the difference
between treatment and control was not significant
(P = 0.27), with a ES difference of 0.08. Protein intake
again was highly significant, with an ES impact of ~0.2
per every 1 g/kg/day. For CSA, the difference between
treatment and control was not significant (P = 0.37), with
a ES difference of 0.14. Protein intake was again significant (P = 0.02) with an ES impact of ~0.33 per every
0.5 g/kg.
Finally and importantly, there was a paucity of timing
studies that attempted to match protein intake. As previously discussed, our results show that total protein intake is strongly and positively associated with postexercise gains in muscle hypertrophy. Future studies
should seek to control for this variable so that the true
effects of timing, if any, can be accurately assessed.
Practical applications

In conclusion, current evidence does not appear to support the claim that immediate ( 1 hour) consumption
of protein pre- and/or post-workout significantly enhances strength- or hypertrophic-related adaptations to
resistance exercise. The results of this meta-analysis indicate that if a peri-workout anabolic window of opportunity does in fact exist, the window for protein
consumption would appear to be greater than one-hour
before and after a resistance training session. Any positive effects noted in timing studies were found to be due
to an increased protein intake rather than the temporal
aspects of consumption, but a lack of matched studies
makes it difficult to draw firm conclusions in this regard.
The fact that protein consumption in non-supplemented
subjects was below generally recommended intake for
those involved in resistance training lends credence to
this finding. Since causality cannot be directly drawn
from our analysis, however, we must acknowledge the
possibility that protein timing was in fact responsible for
producing a positive effect and that the associated increase in protein intake is merely coincidental. Future
research should seek to control for protein intake so that

Page 11 of 13

the true value regarding nutrient timing can be properly

evaluated. Particular focus should be placed on carrying
out these studies with well-trained subjects to better determine whether resistance training experience plays a
role in the response.
Competing interests
The authors declare that they have no competing interests.
Authors contributions
BJS and AAA performed the literature search, performed quality assessment,
and coded the studies. JWK devised and carried out the statistical analysis.
All authors took part in writing the manuscript. All authors read and
approved the final manuscript.
Acknowledgement
This study was supported by a grant from Dymatize Nutrition, Dallas, TX.
Author details
1
Department of Health Science, Lehman College, Bronx, NY, USA. 2California
State University, Northridge, CA, USA. 3Weightology, LLC, Issaquah, WA, USA.
Received: 22 September 2013 Accepted: 20 November 2013
Published: 3 December 2013
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