Dairy vs Carbs vs Water for Bone Health and Inflammation

(BIONEX Trial)

Overseen By Emily C Fraschetti, MSc

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: York University

Must not be taking: Chronic condition medications

Disqualifiers: Smoking, Chronic, Inflammatory, Auto-immune, others

Compensation: Varies

Number of Visits: Unknown

Duration: 16 weeks

25 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how different drinks—such as Greek yogurt, milk, a carbohydrate drink (Maltodextrin powder mixed with water), and water—affect bone health and inflammation after intense exercise. Researchers seek to determine if dairy products aid bone recovery more effectively than carbohydrates or water. The trial includes high-intensity interval cycling, resistance exercise, and plyometrics. It seeks healthy young adults who exercise lightly (0-2 times a week) and have no dairy allergies. As an unphased trial, participants have the opportunity to contribute to new insights on nutrition and exercise recovery.

Will I have to stop taking my current medications?

The trial requires that participants are not on any medication related to a chronic condition, so you may need to stop such medications to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that Greek yogurt is generally safe and beneficial when combined with exercise. Some studies found it helps build stronger bones in young adults over time, with no reports of negative effects on bones when paired with intense exercise.

Studies have also shown that milk is well-tolerated after exercise, potentially reducing inflammation and supporting recovery. No serious side effects have been reported from drinking milk post-workout.

Regarding maltodextrin, a type of carbohydrate, research suggests it is safe to consume during exercise and may improve performance without significant side effects.

Overall, the treatments in this study—Greek yogurt, milk, and maltodextrin—are considered safe when used with exercise. Each has been studied in different contexts, confirming their good safety records. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about this trial because it explores how different post-exercise nutrition options—Greek yogurt, skim milk, maltodextrin, and water—affect bone health and inflammation. Unlike traditional treatments that may rely heavily on supplements or medications, this approach focuses on everyday foods and drinks. This could make maintenance of bone health and reduction of inflammation more accessible and appealing. Additionally, the study investigates the combination of high-intensity exercise with these nutritional strategies, offering insights into how exercise and diet can work together to support health.

What evidence suggests that this trial's treatments could be effective for bone health and inflammation?

This trial will compare the effects of different post-exercise consumables on bone health and inflammation. Research has shown that eating Greek yogurt after exercise can help build bones and slow bone loss, especially when combined with physical activity. One study found that young adults who ate Greek yogurt during a 12-week exercise program experienced better bone growth. Participants in this trial may receive Greek yogurt as part of their regimen. Drinking milk is also linked to stronger bones because it can increase bone mineral density. Studies indicate that regularly drinking milk benefits bone health, and some participants will receive milk in this trial. Additionally, a carbohydrate drink with maltodextrin might reduce inflammation after exercise. Some research suggests that consuming carbohydrates can improve bone density in the hip and spine, and this trial includes a carbohydrate arm to evaluate these effects. ^{6 7 8 9 10}

Who Is on the Research Team?

Andrea R Josse, PhD

Principal Investigator

York University

Are You a Good Fit for This Trial?

This trial is for healthy young adults aged 18-30 with a normal BMI who are low to moderately active. Participants must either be on birth control or have regular menstrual cycles, and not be taking medication for chronic conditions. They should not have allergies to dairy protein, lactose intolerance, or smoke regularly.

Inclusion Criteria

You are physically active either rarely or a few times per week.

You do not have any allergy to dairy protein or lactose intolerance.

Normal BMI (18.5-24.9) kg/m^2

Exclusion Criteria

I have a long-term illness, inflammation, or an auto-immune disease.

You smoke cigarettes, use e-cigarettes (like vapes), or use cannabis regularly.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete 4 different acute exercise and nutritional supplement trials, each separated by 2-4 weeks

16 weeks

Multiple visits for each exercise and supplement trial

Follow-up

Participants are monitored for bone turnover, inflammatory markers, muscle soreness, and performance post-exercise

24 hours post-exercise for each trial

What Are the Treatments Tested in This Trial?

Interventions

• Carbohydrate (Maltodextrin powder mixed with water)
• Greek yogurt
• High-Intensity Exercise
• Skim Milk
• Water

Trial Overview The study is examining if consuming dairy products like Greek yogurt and skim milk can influence bone health and reduce inflammation after high-intensity exercise compared to just having a carbohydrate drink (maltodextrin powder in water) or plain water.

How Is the Trial Designed?

Group I: Exercise and Milk (Milk) Experimental Treatment 2 Interventions

Participants will have a fasted baseline blood sample taken upon arrival to the lab. Then they will take part in a high-intensity exercise protocol, consisting of high-intensity interval cycling, resistance exercise, and plyometrics. Following exercise, participants will return to the lab for a 5min post-exercise blood sample, and then consume \~500ml plain skim milk (0% milk fat). An additional blood sample will be taken at 1h post-exercise, followed by an additional \~500ml of skim milk. Blood samples will also be taken at 4h and 24h post-exercise. Participants will also rate their muscle soreness and perform a jump height test at pre-exercise, 5min post-exercise, 4h and 24h post-exercise.

Group II: Exercise and Greek Yogurt (GY) Experimental Treatment 2 Interventions

Participants will have a fasted baseline blood sample taken upon arrival to the lab. Then they will take part in a high-intensity exercise protocol, consisting of high-intensity interval cycling, resistance exercise, and plyometrics. Following exercise, participants will return to the lab for a 5min post-exercise blood sample, and then consume \~200g Greek yogurt (0% milk fat). An additional blood sample will be taken at 1h post-exercise, followed by an additional \~200g of Greek yogurt. Blood samples will also be taken at 4h and 24h post-exercise. Participants will also rate their muscle soreness and perform a jump height test at pre-exercise, 5min post-exercise, 4h and 24h post-exercise.

Group III: Exercise and Carbohydrate (CHO) Active Control 2 Interventions

Participants will have a fasted baseline blood sample taken upon arrival to the lab. Then they will take part in a high-intensity exercise protocol, consisting of high-intensity interval cycling, resistance exercise, and plyometrics. Following exercise, participants will return to the lab for a 5min post-exercise blood sample, and then consume \~50g of maltodextrin mixed with water (\~500ml). An additional blood sample will be taken at 1h post-exercise, followed by an additional \~500ml of the maltodextrin drink. Blood samples will also be taken at 4h and 24h post-exercise. Participants will also rate their muscle soreness and perform a jump height test at pre-exercise, 5min post-exercise, 4h and 24h post-exercise.

Group IV: Exercise and Water (W) Placebo Group 2 Interventions

Participants will have a fasted baseline blood sample taken upon arrival to the lab. Then they will take part in a high-intensity exercise protocol, consisting of high-intensity interval cycling, resistance exercise, and plyometrics. Following exercise, participants will return to the lab for a 5min post-exercise blood sample, and then consume \~500ml water. An additional blood sample will be taken at 1h post-exercise, followed by an additional \~500ml water. Blood samples will also be taken at 4h and 24h post-exercise. Participants will also rate their muscle soreness and perform a jump height test at pre-exercise, 5min post-exercise, 4h and 24h post-exercise.

Who Is Running the Clinical Trial?

York University

Lead Sponsor

Trials

64

Recruited

521,000+

Published Research Related to This Trial

In a study involving 13 untrained females, consuming skim milk after high-intensity exercise was found to reduce the relative inflammatory response of certain cytokines (IL-1β and IL-10) at 48 hours compared to a carbohydrate drink.

While milk did not significantly affect pro-inflammatory cytokines, it showed potential in modulating anti-inflammatory responses, suggesting that nutrient-dense whole foods like milk may aid recovery from exercise-induced inflammation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Acute Effects of Milk Consumption on Systemic Inflammation after Combined Resistance and Plyometric Exercise in Young Adult Females. Fraschetti, EC., Skelly, LE., Prowting, JL., et al.[2022]

High-intensity interval exercise (HIIE) significantly improves cardiovascular health and cardiorespiratory fitness, as indicated by greater increases in maximal oxygen uptake (V˙O2max) and flow-mediated dilation (FMD) compared to moderate-intensity continuous training (MICT).

Conversely, MICT is more effective for long-term glucose metabolism improvements, as shown by better reductions in glycated hemoglobin (HbA1c), suggesting that both exercise types have unique benefits that can be tailored to individual health needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis. Mattioni Maturana, F., Martus, P., Zipfel, S., et al.[2023]

Current interventional studies show that while exercise has some modest effects on improving bone mass in osteoporosis patients, these effects are not strong enough to justify exercise as a standalone treatment compared to drug therapies.

Exercise can effectively reduce or partially reverse bone loss in cases of musculoskeletal disuse, suggesting that optimizing exercise programs by considering factors like intensity and participant motivation could enhance their efficacy in treating osteoporosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise for osteoporosis: how to navigate between overeagerness and defeatism. Ireland, A., J Rittweger, J.[2018]

A scoping review of 69 studies on high-intensity interval training (HIIT) in older adults found that HIIT protocols are generally well-tolerated and can provide significant health benefits, particularly in improving cardiorespiratory fitness.

Most research has focused on healthy older adults, highlighting a need for larger studies and more investigation into HIIT's effects on older adults with various health conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Older Adults: a Scoping Review. Marriott, CFS., Petrella, AFM., Marriott, ECS., et al.[2021]

In a 12-week study involving 35 overweight/obese adolescent girls, those consuming higher dairy (4 servings/day) showed a significant decrease in bone resorption markers compared to those with low dairy intake (0-2 servings/day), suggesting that increased dairy can enhance bone health.

The study found that changes in bone markers, specifically β-CTX and osteocalcin, were positively correlated with the number of dairy servings consumed, indicating that adequate dairy intake can improve the osteogenic response during diet and exercise interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dairy product intake decreases bone resorption following a 12-week diet and exercise intervention in overweight and obese adolescent girls. Josse, AR., Ludwa, IA., Kouvelioti, R., et al.[2021]

In a study involving trained female runners, acute intake of high dairy calcium (500 mg) did not significantly affect exercise energy metabolism or endurance performance compared to low dairy calcium intake (80 mg).

The results showed no differences in key metabolic markers such as fat oxidation, lactate levels, or performance times in a 10K time trial, indicating that acute dairy calcium consumption does not enhance endurance in trained athletes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The acute effects of dairy calcium intake on fat metabolism during exercise and endurance exercise performance. White, KM., Lyle, RM., Flynn, MG., et al.[2019]

High-intensity interval training (HIIT) combined with a more active lifestyle in larger cages negatively affected bone strength in trained mice, indicating potential risks of excessive physical training on bone health.

Mice in larger cages that were not subjected to HIIT showed increased spontaneous physical activity and higher calcium levels in their femur bones, suggesting that a more active lifestyle without intense training may benefit bone health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of high-intensity interval training in more or less active mice on biomechanical, biophysical and biochemical bone parameters. Polisel, EEC., Beck, WR., Scariot, PPM., et al.[2023]

A 12-week lifestyle intervention combining exercise training and nutritional counseling significantly reduced the increase in sclerostin levels after acute exercise in adolescent females with obesity, indicating a positive effect on bone metabolism.

The intervention also improved the OPG:RANKL ratio response to exercise, suggesting enhanced bone health, but higher dairy intake did not provide additional benefits in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Twelve weeks of a diet and exercise intervention alters the acute bone response to exercise in adolescent females with overweight/obesity. Kurgan, N., Skelly, LE., Ludwa, IA., et al.[2023]

In a study involving 13 healthy young women, consuming milk after exercise was found to significantly reduce the relative post-exercise bone resorption biomarker (CTX) compared to a carbohydrate control, suggesting that milk may help blunt the usual bone breakdown that occurs after intense physical activity.

While milk did not change the absolute levels of other bone biomarkers compared to the carbohydrate drink, it showed potential benefits in maintaining bone health by moderating the catabolic response to exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Effects of Milk vs. Carbohydrate on Bone Turnover Biomarkers Following Loading Exercise in Young Adult Females. Prowting, JL., Skelly, LE., Kurgan, N., et al.[2023]

High-intensity interval exercise (HIE) significantly increases bone turnover markers, such as bone alkaline phosphatase (BAP) and osteoprotegerin (OPG), shortly after exercise, indicating a positive effect on bone formation.

The study found that HIE also influences inflammatory cytokines, with anti-inflammatory markers like IL-10 correlating positively with bone formation, suggesting that HIE could be a beneficial exercise option for individuals who cannot engage in high-impact activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Response of Bone Turnover Markers and Cytokines to High-Intensity Low-Impact Exercise. Mezil, YA., Allison, D., Kish, K., et al.[2022]

In a study of 1,486 Mexican adults aged 45 and older, changes in the dietary inflammatory index (DII) were linked to significant changes in bone mineral density (BMD) at the total hip and femoral neck, indicating that diet may influence bone health in older adults.

Specifically, higher DII scores (indicating a more pro-inflammatory diet) were associated with a reduction in BMD, while lower DII scores were linked to gains in BMD, highlighting the importance of dietary choices in maintaining bone density as people age.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary inflammatory index and bone mineral density in Mexican population. Rivera-Paredez, B., Quezada-Sánchez, AD., Robles-Rivera, K., et al.[2022]

Sprint-interval training (SIT) was found to be an effective time-efficient alternative to endurance training (ET) for improving cardiorespiratory fitness in sedentary middle-aged men, with significant increases in power output and test duration after training.

However, neither SIT nor ET resulted in changes to body composition, specifically whole-body or visceral fat mass, or plasma inflammation levels, indicating that while these training methods improve fitness, they may not impact fat loss or inflammation in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Limited Effects of Endurance or Interval Training on Visceral Adipose Tissue and Systemic Inflammation in Sedentary Middle-Aged Men. Cooper, JH., Collins, BE., Adams, DR., et al.[2018]

Increasing dairy calcium intake does not enhance fat loss in overweight women when combined with resistance training and energy restriction, as both low and high calcium groups experienced similar reductions in fat mass.

However, higher dairy calcium intake significantly improved lumbar spine bone mineral density compared to a low-calcium diet, suggesting benefits for bone health in premenopausal overweight women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of calcium and resistance exercise on body composition in overweight premenopausal women. Thomas, DT., Wideman, L., Lovelady, CA.[2019]

A systematic review of 13 studies involving 211,938 individuals found that a higher Dietary Inflammatory Index (DII) score is associated with an increased risk of fractures, particularly in non-cohort studies, where the odds ratio was 1.42.

The analysis also revealed that individuals with the highest DII scores had significantly lower bone mineral density (BMD) compared to those with the lowest scores, indicating that an inflammatory diet may negatively impact bone health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A meta-analysis of dietary inflammatory index and bone health status. Taheri, E., Mahdavi-Gorabi, A., Moludi, J., et al.[2023]

Citations

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