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-Strategies to enhance weight loss with a high fat-to-lean ratio in overweight/obese older adults are important since lean loss could exacerbate sarcopenia. We examined how dietary protein distribution affected muscle protein synthesis during energy balance (EB), energy restriction (ER), and energy restriction plus resistance training (ER ϩ RT). A 4-wk ER diet was provided to overweight/obese older men (66 Ϯ 4 yr, 31 Ϯ 5 kg/m 2 ) who were randomized to either a balanced (BAL: 25% daily protein/meal ϫ 4) or skewed (SKEW: 7:17:72:4% daily protein/meal; n ϭ 10/group) pattern. Myofibrillar and sarcoplasmic protein fractional synthetic rates (FSR) were measured during a 13-h primed continuous infusion of L-[ring-13 C6]phenylalanine with BAL and SKEW pattern of protein intake in EB, after 2 wk ER, and after 2 wk ER ϩ RT. Fed-state myofibrillar FSR was lower in ER than EB in both groups (P Ͻ 0.001), but was greater in BAL than SKEW (P ϭ 0.014). In ER ϩ RT, fed-state myofibrillar FSR increased above ER in both groups and in BAL was not different from EB (P ϭ 0.903). In SKEW myofibrillar FSR remained lower than EB (P ϭ 0.002) and lower than BAL (P ϭ 0.006). Fed-state sarcoplasmic protein FSR was reduced similarly in ER and ER ϩ RT compared with EB (P Ͻ 0.01) in both groups. During ER in overweight/obese older men a BAL consumption of protein stimulated the synthesis of muscle contractile proteins more effectively than traditional, SKEW distribution. Combining RT with a BAL protein distribution "rescued" the lower rates of myofibrillar protein synthesis during moderate ER. aging; energy restriction; stable isotope

Leu co-ingestion with daily meals enhances integrated MyoPS in free-living older men in rested and REX conditions and is equally effective in older men who consume daily protein intakes greater than or equal to the RDA. This trial was registered at clinicaltrials.gov as NCT02371278.