H]glucose kinetics in healthy men were compared between hyperinsulinemic, euglycemic, isoaminoacidemic (Hyper-1, n ϭ 10) and Hyper-3 (n ϭ 9) clamps. In Hyper-3 vs. Hyper-1, nonoxidative leucine R d [rate of disappearance (synthesis)] was stimulated more (45 Ϯ 4 vs. 24 Ϯ 4 mol/min, P Ͻ 0.01) and endogenous R a [rate of appearance (breakdown)] was inhibited similarly; hence net balance increased more (86 Ϯ 6 vs. 49 Ϯ 2 mol/min, P Ͻ 0.001). Glucose R d was similar; thus Hyper-3 metabolic clearance rate (331 Ϯ 23 vs. 557 Ϯ 41 ml/min, P Ͻ 0.0005) and R d/insulin (M, 0.65 Ϯ 0.10 vs. 1.25 Ϯ 0.10 mg ⅐ min Ϫ1 ⅐ pmol Ϫ1 ⅐ l, P Ͻ 0.001) were less, despite higher insulin (798 Ϯ 74 vs. 450 Ϯ 24 pmol/l, P Ͻ 0.005). In vastus lateralis muscle biopsies, phosphorylation of Akt (P ϭ 0.025), mammalian target of rapamycin (mTOR), ribosomal protein S6 kinase (p70 S6K1 ; P ϭ 0.008), S6 (P ϭ 0.049), and 4E-binding protein 1 (4E-BP1; P ϭ 0.001) increased. With decreased eukaryotic initiation factor-4E (eIF4E) ⅐ 4E-BP1 complex (P ϭ 0.01), these are consistent with increased mTOR complex 1 (mTORC1) signaling and translation initiation of protein synthesis. Although mRNA expression of ubiquitin, MAFbx 1, and MuRF-1 was unchanged, total ubiquitinated proteins decreased 20% (P Ͻ 0.01), consistent with proteolysis suppression. The Hyper-3 clamp increases whole body protein synthesis, net anabolism, and muscle protein translation initiation pathways and decreases protein ubiquitination. The main contribution of hyperaminoacidemia is stimulation of synthesis rather than inhibition of proteolysis, and it attenuates the expected increment of glucose disposal. translation initiation; ubiquitin pathway; leucine kinetics; glucose turnover; insulin resistance THE HYPERINSULINEMIC EUGLYCEMIC CLAMP is the "gold standard" for determining in vivo insulin sensitivity of glucose metabolism. Although the conventional clamp achieves hyperinsulinemia within the postprandial range, it does not replicate postmeal circulating metabolite concentrations. Indeed, it generates hypoaminoacidemia by insulin inhibition of protein catabolism, thereby preventing the testing of insulin sensitivity of protein anabolism by decreasing amino acid (AA) availability (6,38,46). Since insulin stimulation of protein synthesis and inhibition of proteolysis are unambiguously established in vitro, and abnormal protein metabolism occurs in both type 1 (45) and type 2 diabetes (17, 19) we have previously used an hyperinsulinemic, euglycemic, isoaminoacidemic clamp (8) to explore whole body protein turnover. This has established the presence of postabsorptive and clamp insulin resistance of protein metabolism in obesity (10), type 2 diabetes (37), and aging (7) and, additionally, sex differences in clamp responses (9). However, this "Hyper-1" clamp does not replicate postprandial physiology, in which plasma insulin, glucose, and AA concentrations increase and free fatty acids (FFA) decrease. Daily repletion of overnight protein depletion must take place at high rates postprandially. We...