Skip to main content Accessibility help

Efficacy and consequences of very-high-protein diets for athletes and exercisers

  • Kevin D. Tipton (a1)


Athletes and exercisers have utilised high-protein diets for centuries. The objective of this review is to examine the evidence for the efficacy and potential dangers of high-protein diets. One important factor to consider is the definition of a ‘high-protein diet’. There are several ways to consider protein content of a diet. The composition of the diet can be determined as the absolute amount of the protein (or other nutrient of interest), the % of total energy (calories) as protein and the amount of protein ingested per kg of body weight. Many athletes consume very high amounts of protein. High-protein diets most often are associated with muscle hypertrophy and strength, but now also are advocated for weight loss and recovery from intense exercise or injuries. Prolonged intake of a large amount of protein has been associated with potential dangers, such as bone mineral loss and kidney damage. In otherwise healthy individuals, there is little evidence that high protein intake is dangerous. However, kidney damage may be an issue for individuals with already existing kidney dysfunction. Increased protein intake necessarily means that overall energy intake must increase or consumption of either carbohydrate or fat must decrease. In conclusion, high protein intake may be appropriate for some athletes, but there are potential negative consequences that must be carefully considered before adopting such a diet. In particular, care must be taken to ensure that there is sufficient intake of other nutrients to support the training load.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Efficacy and consequences of very-high-protein diets for athletes and exercisers
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Efficacy and consequences of very-high-protein diets for athletes and exercisers
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Efficacy and consequences of very-high-protein diets for athletes and exercisers
      Available formats


Corresponding author

Corresponding author: Professor Kevin D. Tipton, fax +44 178 6467816, email


Hide All
1.Westerterp-Plantenga, MS (2007) How are normal, high- or low-protein diets defined? Br J Nutr 97, 217218.
2.Phillips, S (2004) Protein requirements and supplementation in strength sports1. Nutrition 20, 689695.
3.US Department of Agriculture, Agricultural Research Service, Beltsirlle Human Nutrition Centre, Food Surveys Research Group (Beltsirlle, MD). (accessed 4 February 2011).
4.Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press.
5.Phillips, SM (2006) Dietary protein for athletes: from requirements to metabolic advantage. Appl Physiol Nutr Metab 31, 647654.
6.Burd, NA, Tang, JE, Moore, DR et al. (2008) Exercise training and protein metabolism: influences of contraction, protein intake, and sex-based differences. J Appl Physiol 106, 16921701.
7.Tipton, KD & Ferrando, AA (2008) Improving muscle mass: response of muscle metabolism to exercise, nutrition and anabolic agents. Essays Biochem 44, 8598.
8.Tipton, KD & Witard, OC (2007) Protein requirements and recommendations for athletes: relevance of ivory tower arguments for practical recommendations. Clin Sports Med 26, 1736.
9.Phillips, SM (2009) Physiologic and molecular bases of muscle hypertrophy and atrophy: impact of resistance exercise on human skeletal muscle (protein and exercise dose effects). Appl Physiol Nutr Metab 34, 403410.
10.Phillips, SM, Moore, DR & Tang, JE (2007) A critical examination of dietary protein requirements, benefits, and excesses in athletes. Int J Sport Nutr Exe 17, S58S76.
11.Rennie, MJ, Selby, A, Atherton, P et al. (2010) Facts, noise and wishful thinking: muscle protein turnover in aging and human disuse atrophy. Scand J Med Sci Sports 20, 59.
12.Rennie, MJ, Wackerhage, H, Spangenburg, EE et al. (2004) Control of the size of the human muscle mass. Annu Rev Physiol 66, 799828.
13.Phillips, SM (2011) The science of muscle hypertrophy: making dietary protein count. Proc Nutr Soc 70, 100103.
14.Wilkinson, SB, Phillips, SM, Atherton, PJ et al. (2008) Differential effects of resistance and endurance exercise in the fed state on signalling molecule phosphorylation and protein synthesis in human muscle. J Physiol 586(Pt 15), 37013717.
15.Phillips, SM, Tipton, KD, Aarsland, A et al. (1997) Mixed muscle protein synthesis and breakdown after resistance exercise in humans. Am J Physiol 273(1 Pt 1), E99–107.
16.Burd, NA, West, DWD, Staples, AW et al. . (2010) Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PLoS One 5, e12033.
17.Gibala, MJ, Interisano, SA, Tarnopolsky, MA et al. (2000) Myofibrillar disruption following acute concentric and eccentric resistance exercise in strength-trained men. Can J Physiol Pharmacol 78, 656661.
18.Stupka, N, Tarnopolsky, MA, Yardley, NJ et al. (2001) Cellular adaptation to repeated eccentric exercise-induced muscle damage. J Appl Physiol 91, 16691678.
19.Biolo, G, Maggi, SP, Williams, BD et al. (1995) Increased rates of muscle protein turnover and amino acid transport after resistance exercise in humans. Am J Physiol 268(3 Pt 1), E514E520.
20.Biolo, G, Tipton, KD, Klein, S et al. (1997) An abundant supply of amino acids enhances the metabolic effect of exercise on muscle protein. Am J Physiol 273(1 Pt 1), E122E129.
21.Hather, BM, Tesch, PA, Buchanan, P et al. (1991) Influence of eccentric actions on skeletal muscle adaptations to resistance training. Acta Physiol Scand 143, 177185.
22.Roig, M, O'Brien, K, Kirk, G et al. (2009) The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. Br J Sports Med 43, 556568.
23.Rennie, MJ & Tipton, KD (2000) Protein and amino acid metabolism during and after exercise and the effects of nutrition. Annu Rev Nutr 20, 457483.
24.Campbell, B, Kreider, RB, Ziegenfuss, T et al. . (2007) International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr 4, 8.
25.Lemon, PW (2000) Beyond the zone: protein needs of active individuals. J Am Coll Nutr 19, Suppl. 5, 513S521S.
26.Rodriguez, NR, Di Marco, NM & Langley, S (2009) American College of Sports Medicine position stand. Nutrition and athletic performance. Med Sci Sports Exerc 41, 709731.
27.Lemon, PW, Tarnopolsky, MA, MacDougall, JD et al. (1992) Protein requirements and muscle mass/strength changes during intensive training in novice bodybuilders. J Appl Physiol 73, 767775.
28.Tarnopolsky, MA, Atkinson, SA, MacDougall, JD et al. (1992) Evaluation of protein requirements for trained strength athletes. J Appl Physiol 73, 19861995.
29.Tarnopolsky, MA, MacDougall, JD & Atkinson, SA (1988) Influence of protein intake and training status on nitrogen balance and lean body mass. J Appl Physiol 64, 187193.
30.Young, VR (1986) Nutritional balance studies: indicators of human requirements or of adaptive mechanisms? J Nutr 116, 700703.
31.Burke, DG, Chilibeck, PD, Davidson, KS et al. (2001) The effect of whey protein supplementation with and without creatine monohydrate combined with resistance training on lean tissue mass and muscle strength. Int J Sport Nutr Exerc Metab 11, 349364.
32.Nissen, SL & Sharp, RL (2003) Effect of dietary supplements on lean mass and strength gains with resistance exercise: a meta-analysis. J Appl Physiol 94, 651659.
33.Harber, MP, Schenk, S, Barkan, AL et al. (2005) Effects of dietary carbohydrate restriction with high protein intake on protein metabolism and the somatotropic axis. J Clin Endocrinol Metab 90, 51755181.
34.Chittenden, RH (1907) The Nutrition of Man. London: Heinamann.
35.Moore, DR, Del Bel, NC, Nizi, KI et al. (2007) Resistance training reduces fasted- and fed-state leucine turnover and increases dietary nitrogen retention in previously untrained young men. J Nutr 137, 985991.
36.Hartman, JW, Moore, DR & Phillips, SM (2006) Resistance training reduces whole-body protein turnover and improves net protein retention in untrained young males. Appl Physiol Nutr Metab 31, 557564.
37.Butterfield, GE & Calloway, DH (1984) Physical activity improves protein utilization in young men. Br J Nutr 51, 171184.
38.Todd, KS, Butterfield, GE & Calloway, DH (1984) Nitrogen balance in men with adequate and deficient energy intake at three levels of work. J Nutr 114, 21072118.
39.Tarnopolsky, M (2004) Protein requirements for endurance athletes. Nutrition 20, 662668.
40.Hawley, JA, Tipton, KD & Millard-Stafford, ML (2006) Promoting training adaptations through nutritional interventions. J Sports Sci 24, 709721.
41.Moore, DR, Robinson, MJ, Fry, JL et al. (2008) Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Am J Clin Nutr 89, 161168.
42.Cuthbertson, D, Smith, K, Babraj, J et al. (2005) Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle. FASEB J 19, 422424.
43.Bohe, J, Low, JF, Wolfe, RR et al. (2001) Latency and duration of stimulation of human muscle protein synthesis during continuous infusion of amino acids. J Physiol 532(Pt 2), 575579.
44.Borsheim, E, Tipton, KD, Wolf, SE et al. (2002) Essential amino acids and muscle protein recovery from resistance exercise. Am J Physiol Endocrinol Metab 283, E648E657.
45.Miller, SL, Tipton, KD, Chinkes, DL et al. (2003) Independent and combined effects of amino acids and glucose after resistance exercise. Med Sci Sports Exerc 35, 449455.
46.Tang, JE, Moore, DR, Kujbida, GW et al. (2009) Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. J Appl Physiol 107, 987992.
47.Tipton, KD, Ferrando, AA, Phillips, SM et al. (1999) Postexercise net protein synthesis in human muscle from orally administered amino acids. Am J Physiol 276(4 Pt 1), E628E634.
48.Wilkinson, SB, Tarnopolsky, MA, Macdonald, MJ et al. (2007) Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy-protein beverage. Am J Clin Nutr 85, 10311040.
49.Tipton, KD, Elliott, TA, Cree, MG et al. (2004) Ingestion of casein and whey proteins result in muscle anabolism after resistance exercise. Med Sci Sports Exerc 36, 20732081.
50.Tipton, KD, Rasmussen, BB, Miller, SL et al. (2001) Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab 281, E197E206.
51.Layman, DK, Boileau, RA, Erickson, DJ et al. (2003) A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr 133, 411417.
52.Layman, DK (2004) Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr 23, Suppl. 6, 631S636S.
53.Meckling, KA & Sherfey, R (2007) A randomized trial of a hypocaloric high-protein diet, with and without exercise, on weight loss, fitness, and markers of the metabolic syndrome in overweight and obese women. Appl Physiol Nutr Metabol 32, 743752.
54.Westerterpplantenga, M (2008) Protein intake and energy balance. Regul Pept 149, 6769.
55.Westerterp-Plantenga, MS, Luscombe-Marsh, N, Lejeune, MPGM et al. (2006) Dietary protein, metabolism, and body-weight regulation: dose–response effects. Int J Obes 30, S16S23.
56.Wycherley, TP, Noakes, M, Clifton, PM et al. (2010) A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care 33, 969976.
57.Buchholz, AC & Schoeller, DA (2004) Is a calorie a calorie? Am J Clin Nutr 79, 899S906S.
58.Layman, DK (2003) The role of leucine in weight loss diets and glucose homeostasis. J Nutr 133, 261S267S.
59.Feinman, RD & Fine, EJ (2004) “A calorie is a calorie” violates the second law of thermodynamics. Nutr J 3, 9.
60.Feinman, RD & Fine, EJ (2007) Nonequilibrium thermodynamics and energy efficiency in weight loss diets. Theor Biol Med Model 4, 27.
61.Anthony, JC, Anthony, TG & Layman, DK (1999) Leucine supplementation enhances skeletal muscle recovery in rats following exercise. J Nutr 129, 11021106.
62.Browne, GJ & Proud, CG (2002) Regulation of peptide-chain elongation in mammalian cells. Eur J Biochem 269, 53605368.
63.Labayen, I, Diez, N, Parra, D et al. (2004) Basal and postprandial substrate oxidation rates in obese women receiving two test meals with different protein content. Clin Nutr 23, 571578.
64.Labayen, I, Diez, N, Gonzalez, A et al. (2003) Effects of protein vs. carbohydrate-rich diets on fuel utilisation in obese women during weight loss. Forum Nutr 56, 168170.
65.Labayen, I, Diez, N, Parra, MD et al. (2004) Time-course changes in macronutrient metabolism induced by a nutritionally balanced low-calorie diet in obese women. Int J Food Sci Nutr 55, 2735.
66.Soenen, S, Plasqui, G, Smeets, AJ et al. (2010) Protein intake induced an increase in exercise stimulated fat oxidation during stable body weight. Physiol Behav 101, 770774.
67.Lejeune, MPGM, Kovacs, EMR & Westerterp-Plantenga, MS (2007) Additional protein intake limits weight regain after weight loss in humans. Br J Nutr 93, 281.
68.Westerterp-Plantenga, MS, Lejeune, MPGM, Nijs, I et al. (2004) High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes 28, 5764.
69.Veldhorst, M, Smeets, A, Soenen, S et al. (2008) Protein-induced satiety: effects and mechanisms of different proteins. Physiol Behav 94, 300307.
70.Westerterp-Plantenga, MS, Nieuwenhuizen, A, Tome, D et al. (2009) Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr 29, 2141.
71.Paddon-Jones, D, Westman, E, Mattes, RD et al. (2008) Protein, weight management, and satiety. Am J Clin Nutr 87, 1558S1561S.
72.Veldhorst, MA, Westerterp, KR, van Vught, AJ et al. (2010) Presence or absence of carbohydrates and the proportion of fat in a high-protein diet affect appetite suppression but not energy expenditure in normal-weight human subjects fed in energy balance. Br J Nutr 22, 111.
73.Westerterp-Plantenga, MS, Lejeune, MP, Smeets, AJ et al. (2009) Sex differences in energy homeostatis following a diet relatively high in protein exchanged with carbohydrate, assessed in a respiration chamber in humans. Physiol Behav 97, 414419.
74.Mettler, S, Mitchell, N & Tipton, KD (2010) Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc 42, 326337.
75.Kerksick, C, Thomas, A, Campbell, B et al. . (2009) Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women. Nutr Metab 6, 23.
76.Layman, DK, Evans, E, Baum, JI et al. (2005) Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr 135, 19031910.
77.Walberg, JL, Leidy, MK, Sturgill, DJ et al. (1988) Macronutrient content of a hypoenergy diet affects nitrogen retention and muscle function in weight lifters. Int J Sports Med 9, 261266.
78.Forbes, GB (2000) Body fat content influences the body composition response to nutrition and exercise. Ann NY Acad Sci 904, 359365.
79.Hall, KD (2007) Body fat and fat-free mass inter-relationships: Forbes's theory revisited. Br J Nutr 97, 10591063.
80.Burke, LM, Kiens, B & Ivy, JL (2004) Carbohydrates and fat for training and recovery. J Sports Sci 22, 1530.
81.Burd, NA, Holwerda, AM, Selby, KC et al. . (2010) Resistance exercise volume affects myofibrillar protein synthesis and anabolic signalling molecule phosphorylation in young men. J Physiol 588, 31193130.
82.Kumar, V, Selby, A, Rankin, D et al. (2008) Age-related differences in the dose-response relationship of muscle protein synthesis to resistance exercise in young and old men. J Physiol 587, 211217.
83.Howatson, G & van Someren, KA (2008) The prevention and treatment of exercise-induced muscle damage. Sports Med 38, 483503.
84.Jackman, SR, Witard, OC, Jeukendrup, AE et al. (2010) Branched-chain amino acid ingestion can ameliorate soreness from eccentric exercise. Med Sci Sports Exerc 42, 962970.
85.Jeukendrup, AE, Hesselink, MK, Snyder, AC et al. (1992) Physiological changes in male competitive cyclists after two weeks of intensified training. Int J Sports Med 13, 534541.
86.Halson, SL & Jeukendrup, AE (2004) Does overtraining exist? An analysis of overreaching and overtraining research. Sports Med 34, 967981.
87.Witard, OC, Jackman, SR, Kies, AK et al. (2010) Effect of increased dietary protein on tolerance to intensified training. Med Sci Sports Exerc (Epublication ahead of print).
88.Batterham, AM & Hopkins, WG (2006) Making meaningful inferences about magnitudes. Int J Sports Physiol Perform 1, 5057.
89.Hopkins, WG, Marshall, SW, Batterham, AM et al. (2009) Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 41, 3–13.
90.Burke, LM, Millet, G & Tarnopolsky, MA (2007) Nutrition for distance events. J Sports Sci 25, Suppl. 1, S29S38.
91.Burke, LM, Loucks, AB & Broad, N (2006) Energy and carbohydrate for training and recovery. J Sports Sci 24, 675685.
92.Metges, CC & Barth, CA (2000) Metabolic consequences of a high dietary-protein intake in adulthood: assessment of the available evidence. J Nutr 130, 886889.
93.Bradley-Popovich, GE & Mohr, CR (2003) Augmented protein intake for athletes: Are safety concerns well founded? J Chiropr Med 2, 1315.
94.Lowery, LM & Devia, L (2009) Dietary protein safety and resistance exercise: what do we really know? J Int Soc Sports Nutr 6, 3.
95.Martin, WF, Armstrong, LE & Rodriguez, NR (2005) Dietary protein intake and renal function. Nutr Metab (Lond) 2, 25.
96.Bilsborough, S & Mann, N (2006) A review of issues of dietary protein intake in humans. Int J Sport Nutr Exerc 16, 129152.
97.Tipton, KD & Wolfe, RR (2004) Protein and amino acids for athletes. J Sports Sci 22, 6579.
98.Brenner, BM, Meyer, TW & Hostetter, TH (1982) Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med 307, 652659.
99.Brandle, E, Sieberth, HG & Hautmann, RE (1996) Effect of chronic dietary protein intake on the renal function in healthy subjects. Eur J Clin Nutr 50, 734740.
100.Poortmans, JR, Rawson, ES, Burke, LM et al. (2010) A-Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance Part 11. Br J Sports Med 44, 765766.
101.Martin, W, Cerundolo, L, Pikosky, M et al. (2006) Effects of dietary protein intake on indexes of hydration. J Am Diet Assoc 106, 587589.
102.Heaney, RP & Layman, DK (2008) Amount and type of protein influences bone health. Am J Clin Nutr 87, 1567S1570S.
103.Babraj, JA, Smith, K, Cuthbertson, DJ et al. (2005) Human bone collagen synthesis is a rapid, nutritionally modulated process. J Bone Miner Res 20, 930937.
104.Bolster, DR, Pikosky, MA, Gaine, PC et al. (2005) Dietary protein intake impacts human skeletal muscle protein fractional synthetic rates after endurance exercise. Am J Physiol Endocrinol Metab 289, E678E683.
105.Koopman, R, Manders, RJ, Jonkers, RA et al. (2006) Intramyocellular lipid and glycogen content are reduced following resistance exercise in untrained healthy males. Eur J Appl Physiol 96, 525534.
106.Churchley, EG, Coffey, VG, Pedersen, DJ et al. (2007) Influence of preexercise muscle glycogen content on transcriptional activity of metabolic and myogenic genes in well-trained humans. J Appl Physiol 102, 16041611.
107.Creer, A, Gallagher, P, Slivka, D et al. (2005) Influence of muscle glycogen availability on ERK1/2 and Akt signaling after resistance exercise in human skeletal muscle. J Appl Physiol 99, 950956.
108.Howarth, KR, Phillips, SM, Macdonald, MJ et al. (2010) Effect of glycogen availability on human skeletal muscle protein turnover during exercise and recovery. J Appl Physiol 109, 431438.
109.Jackson, AA (1999) Limits of adaptation to high dietary protein intakes. Eur J Clin Nutr 53, Suppl. 1, S44S52.
110.Eaton, SB (2006) The ancestral human diet: what was it and should it be a paradigm for contemporary nutrition? Proc Nutr Soc 65, 16.
111.Cordain, L, Eaton, SB, Sebastian, A et al. (2005) Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 81, 341354.
112.Eaton, SB (2003) An evolutionary perspective on human physical activity: implications for health. Comp Biochem Physiol A Mol Integr Physiol 136, 153159.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed