{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T03:00:52Z","timestamp":1783047652075,"version":"3.54.6"},"reference-count":68,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,15]],"date-time":"2024-12-15T00:00:00Z","timestamp":1734220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CASS"},{"name":"Royal Australasian College of Physicians foundations (RACP)"},{"name":"Monash Graduate Scholarship (MGS)"},{"name":"Monash International Tuition Scholarship (MITS)"},{"name":"Australian National Health and Medical Research Council (NHMRC)"},{"name":"Flamma Group"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Type 2 diabetes (T2D) is associated with an increased risk of adverse musculoskeletal outcomes likely due to heightened chronic inflammation, oxidative stress, and advanced glycation end-products (AGE). Carnosine has been shown to have anti-inflammatory, anti-oxidative, and anti-AGE properties. However, no clinical trials have examined the impact of carnosine on musculoskeletal health in adults with prediabetes or T2D. Methods: In a randomized, double-blind clinical trial, 49 participants with prediabetes or T2D and without existing musculoskeletal conditions were assigned to receive either 2 g\/day carnosine or matching placebo for 14 weeks. Whole-body dual-energy X-ray absorptiometry (DXA) was used to assess body composition, and peripheral quantitative computed tomography (pQCT) was used to assess bone health at the distal and proximal tibia. Results: Forty-three participants completed this study. Carnosine supplementation had no effect on change in hand grip strength (HGS) or upper-limb relative strength (HGS\/lean mass) versus placebo. Change in appendicular lean mass, percentage of body fat, visceral fat area, proximal tibial cortical volumetric bone mineral density (vBMD), distal tibial trabecular vBMD, and stress-strain index did not differ with carnosine compared to placebo. Fourteen weeks of carnosine supplementation did not improve muscle strength, body composition, or bone health in adults with prediabetes or T2D. Conclusions: Carnosine supplementation may not be an effective approach for improving musculoskeletal health in adults with prediabetes and T2D without musculoskeletal conditions. However, appropriately powered trials with longer duration are warranted to confirm our findings. The trial was registered at clinicaltrials.gov (NCT02917928).<\/jats:p>","DOI":"10.3390\/nu16244328","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T10:08:53Z","timestamp":1734343733000},"page":"4328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Effect of Carnosine Supplementation on Musculoskeletal Health in Adults with Prediabetes and Type 2 Diabetes: A Secondary Analysis of a Randomized Controlled Trial"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5352-0670","authenticated-orcid":false,"given":"Saeede","family":"Saadati","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Jansons","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"},{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-1972","authenticated-orcid":false,"given":"David","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"},{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9997-9359","authenticated-orcid":false,"given":"Maximilian","family":"de Courten","sequence":"additional","affiliation":[{"name":"Australian Health Policy Collaboration, Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC 8001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-4523","authenticated-orcid":false,"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Feehan","sequence":"additional","affiliation":[{"name":"School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Mesinovic","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"},{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8760-2511","authenticated-orcid":false,"given":"Barbora","family":"de Courten","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia"},{"name":"School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021","volume":"402","author":"Ong","year":"2023","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.maturitas.2017.12.011","article-title":"The risks of sarcopenia, falls and fractures in patients with type 2 diabetes mellitus","volume":"109","author":"Sarodnik","year":"2018","journal-title":"Maturitas"},{"key":"ref_3","first-page":"137","article-title":"Muscle strength as a predictor of bone fragility in patients with type 2 diabetes mellitus","volume":"13","year":"2021","journal-title":"Rev. Osteoporos. Metab. Miner."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1093\/gerona\/glab062","article-title":"Risk factors for incident falls and fractures in older men with and without type 2 diabetes mellitus: The Concord Health and Ageing in Men Project","volume":"76","author":"Mesinovic","year":"2021","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e466","DOI":"10.1210\/clinem\/dgad415","article-title":"Obesity and Skeletal Fragility","volume":"109","author":"Chen","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2337\/db07-0887","article-title":"Insulin resistance of protein metabolism in type 2 diabetes","volume":"57","author":"Pereira","year":"2008","journal-title":"Diabetes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jcjd.2013.01.007","article-title":"Insulin resistance of protein metabolism in type 2 diabetes and impact on dietary needs: A review","volume":"37","author":"Gougeon","year":"2013","journal-title":"Can. J. Diabetes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2147\/DMSO.S186600","article-title":"Sarcopenia and type 2 diabetes mellitus: A bidirectional relationship","volume":"12","author":"Mesinovic","year":"2019","journal-title":"Diabetes Metab. Syndr. Obes. Targets Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1093\/gerona\/gly233","article-title":"Advanced glycation end product accumulation is associated with low skeletal muscle mass, weak muscle strength, and reduced bone density: The Nagahama study","volume":"74","author":"Tabara","year":"2019","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.tem.2022.11.003","article-title":"Contributors to impaired bone health in type 2 diabetes","volume":"34","author":"Sheu","year":"2023","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"112227","DOI":"10.1016\/j.exger.2023.112227","article-title":"Associations of body mass index, body fat percentage and sarcopenia components with bone health estimated by second-generation high-resolution peripheral quantitative computed tomography in older adults with obesity","volume":"179","author":"Gandham","year":"2023","journal-title":"Exp. Gerontol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/cen.13947","article-title":"Sex-specific associations between insulin resistance and bone parameters in overweight and obese older adults","volume":"90","author":"Mesinovic","year":"2019","journal-title":"Clin. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cavati, G., Pirrotta, F., Merlotti, D., Ceccarelli, E., Calabrese, M., Gennari, L., and Mingiano, C. (2023). Role of Advanced Glycation End-Products and Oxidative Stress in Type-2-Diabetes-Induced Bone Fragility and Implications on Fracture Risk Stratification. Antioxidants, 12.","DOI":"10.3390\/antiox12040928"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s11914-016-0332-1","article-title":"Advanced glycation end products, diabetes, and bone strength","volume":"14","author":"Yamamoto","year":"2016","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nrneph.2014.112","article-title":"Mechanisms of muscle wasting in chronic kidney disease","volume":"10","author":"Wang","year":"2014","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s11255-022-03392-1","article-title":"Frailty, sarcopenia and diabetic kidney disease: Where do we stand?","volume":"55","author":"Karakousis","year":"2023","journal-title":"Int. Urol. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/jdi.12658","article-title":"Diabetic polyneuropathy is a risk factor for decline of lower extremity strength in patients with type 2 diabetes","volume":"9","author":"Nomura","year":"2018","journal-title":"J. Diabetes Investig."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Denaro, V., De Salvatore, S., Sangiovanni, M.C., and Longo, U.G. (2023). The Musculoskeletal System in Neurological Pathologies. Textbook of Musculoskeletal Disorders, Springer.","DOI":"10.1007\/978-3-031-20987-1_6"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"104827","DOI":"10.1016\/j.archger.2022.104827","article-title":"Association of diabetes mellitus with gait and falls in community-dwelling older adults: Serial mediation of vision and cognition","volume":"104","author":"Han","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1001\/jamaophthalmol.2017.4983","article-title":"Association between the severity of diabetic retinopathy and falls in an Asian population with diabetes: The Singapore epidemiology of eye diseases study","volume":"135","author":"Gupta","year":"2017","journal-title":"JAMA Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.maturitas.2015.06.001","article-title":"Peripheral arterial disease decreases muscle torque and functional walking capacity in elderly","volume":"81","author":"Dziubek","year":"2015","journal-title":"Maturitas"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11914-017-0341-8","article-title":"Is diabetic skeletal fragility associated with microvascular complications in bone?","volume":"15","author":"Fajardo","year":"2017","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"60","DOI":"10.21037\/qims.2018.01.05","article-title":"Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia","volume":"8","author":"Guerri","year":"2018","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_24","first-page":"234","article-title":"Bone fragility and imaging techniques","volume":"6","author":"Caracchini","year":"2009","journal-title":"Clin. Cases Miner. Bone Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3621","DOI":"10.1210\/jc.2017-00042","article-title":"Type 2 diabetes and osteoporosis: A guide to optimal management","volume":"102","author":"Paschou","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"155585","DOI":"10.1016\/j.metabol.2023.155585","article-title":"Diet, exercise, and pharmacotherapy for sarcopenia in people with diabetes","volume":"144","author":"Hashimoto","year":"2023","journal-title":"Metabolism"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1464-5491.2007.02332.x","article-title":"Compliance with physical activity recommendations in US adults with diabetes","volume":"25","author":"Zhao","year":"2008","journal-title":"Diabet. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.pmedr.2017.02.010","article-title":"Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey","volume":"6","author":"Larsen","year":"2017","journal-title":"Prev. Med. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100153","DOI":"10.1016\/j.crphar.2023.100153","article-title":"The therapeutic potential of carnosine: Focus on cellular and molecular mechanisms","volume":"4","author":"Caruso","year":"2023","journal-title":"Curr. Res. Pharmacol. Drug Discov."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1196\/annals.1354.052","article-title":"Would carnosine or a carnivorous diet help suppress aging and associated pathologies?","volume":"1067","author":"Hipkiss","year":"2006","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"28163","DOI":"10.1074\/jbc.M113.504753","article-title":"Role of aldose reductase in the metabolism and detoxification of carnosine-acrolein conjugates","volume":"288","author":"Baba","year":"2013","journal-title":"J. Biol. Chem."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3892\/mmr.2022.12899","article-title":"Carnosine and bone","volume":"27","author":"Yang","year":"2023","journal-title":"Mol. Med. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Cesak, O., Vostalova, J., Vidlar, A., Bastlova, P., and Student Jr, V. (2023). Carnosine and Beta-Alanine Supplementation in Human Medicine: Narrative Review and Critical Assessment. Nutrients, 15.","DOI":"10.3390\/nu15071770"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.numecd.2023.10.012","article-title":"Carnosine supplementation improves glucose control in adults with pre-diabetes and type 2 diabetes: A randomised controlled trial","volume":"34","author":"Hariharan","year":"2023","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1093\/nutrit\/nuad150","article-title":"Effects of carnosine and histidine-containing dipeptides on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis","volume":"82","author":"Saadati","year":"2023","journal-title":"Nutr. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.nutres.2017.11.003","article-title":"L-Carnosine supplementation attenuated fasting glucose, triglycerides, advanced glycation end products, and tumor necrosis factor\u2013\u03b1 levels in patients with type 2 diabetes: A double-blind placebo-controlled randomized clinical trial","volume":"49","author":"Houjeghani","year":"2018","journal-title":"Nutr. Res."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Saadati, S., Cameron, J., Menon, K., Hodge, A., Lu, Z.X., de Courten, M., Feehan, J., and de Courten, B. (2023). Carnosine Did Not Affect Vascular and Metabolic Outcomes in Patients with Prediabetes and Type 2 Diabetes: A 14-Week Randomized Controlled Trial. Nutrients, 15.","DOI":"10.3390\/nu15224835"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Saadati, S., de Courten, M., Deceneux, C., Plebanski, M., Scott, D., Mesinovic, J., Jansons, P., Aldini, G., Cameron, J., and Feehan, J. (2024). Carnosine Supplementation Has No Effect on Inflammatory Markers in Adults with Prediabetes and Type 2 Diabetes: A Randomised Controlled Trial. Nutrients, 16.","DOI":"10.3390\/nu16223900"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects","volume":"310","author":"Association","year":"2013","journal-title":"JAMA"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e7586","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: Guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"726","DOI":"10.7326\/0003-4819-152-11-201006010-00232","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials","volume":"152","author":"Schulz","year":"2010","journal-title":"Ann. Intern. Med."},{"key":"ref_42","unstructured":"World Health Organization (1999). Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation, World health organization. Part 1, Diagnosis and classification of diabetes mellitus."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1002\/oby.21434","article-title":"Effects of carnosine supplementation on glucose metabolism: Pilot clinical trial","volume":"24","author":"Jakubova","year":"2016","journal-title":"Obesity"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s12603-012-0004-5","article-title":"How to assess functional status: A new muscle quality index","volume":"16","author":"Rolland","year":"2012","journal-title":"J. Nutr. Health Aging"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1002\/jbmr.1972","article-title":"Muscle size, strength, and physical performance and their associations with bone structure in the Hertfordshire Cohort Study","volume":"28","author":"Edwards","year":"2013","journal-title":"J. Bone Miner. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.carj.2010.04.011","article-title":"Reproducibility of peripheral quantitative computed tomography measurements at the radius and tibia in healthy pre-and postmenopausal women","volume":"62","author":"Szabo","year":"2011","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_47","first-page":"401","article-title":"Strength indices from pQCT imaging predict up to 85% of variance in bone failure properties at tibial epiphysis and diaphysis","volume":"8","author":"Kontulainen","year":"2008","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1053\/apmr.2002.32743","article-title":"Test-retest strength reliability: Hand-held dynamometry in community-dwelling elderly fallers","volume":"83","author":"Wang","year":"2002","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Varanoske, A.N., Hoffman, J.R., Church, D.D., Wang, R., Baker, K.M., Dodd, S.J., Coker, N.A., Oliveira, L.P., Dawson, V.L., and Fukuda, D.H. (2017). Influence of skeletal muscle carnosine content on fatigue during repeated resistance exercise in recreationally active women. Nutrients, 9.","DOI":"10.3390\/nu9090988"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00726-011-1190-x","article-title":"Beta-alanine (Carnosyn\u2122) supplementation in elderly subjects (60\u201380 years): Effects on muscle carnosine content and physical capacity","volume":"43","author":"Roschel","year":"2012","journal-title":"Amino Acids"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.exger.2013.06.003","article-title":"Oral nutritional supplement fortified with beta-alanine improves physical working capacity in older adults: A randomized, placebo-controlled study","volume":"48","author":"McCormack","year":"2013","journal-title":"Exp. Gerontol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.bbrc.2022.04.075","article-title":"Carnosine synthase deficiency in mice affects protein metabolism in skeletal muscle","volume":"612","author":"Wu","year":"2022","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"5080","DOI":"10.1080\/10408398.2021.2012642","article-title":"Effect of \u03b2-alanine and sodium bicarbonate co-supplementation on the body\u2019s buffering capacity and sports performance: A systematic review","volume":"63","author":"Gilsanz","year":"2023","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1249\/00003677-198000080-00005","article-title":"Acid-base balance during exercise","volume":"8","author":"Sahlin","year":"1980","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"585","DOI":"10.3390\/nu4070585","article-title":"Ergogenic effects of \u03b2-alanine and carnosine: Proposed future research to quantify their efficacy","volume":"4","author":"Caruso","year":"2012","journal-title":"Nutrients"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3390\/nu2010075","article-title":"Effects of beta-alanine on muscle carnosine and exercise performance: A review of the current literature","volume":"2","author":"Culbertson","year":"2010","journal-title":"Nutrients"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1152\/japplphysiol.01331.2011","article-title":"Effects of carnosine on contractile apparatus Ca2+ sensitivity and sarcoplasmic reticulum Ca2+ release in human skeletal muscle fibers","volume":"112","author":"Dutka","year":"2012","journal-title":"J. Appl. Physiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4252","DOI":"10.1073\/pnas.1603023113","article-title":"Individual variability in human blood metabolites identifies age-related differences","volume":"113","author":"Chaleckis","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1007\/s00726-021-03086-5","article-title":"Carnosine and skeletal muscle dysfunction in a rodent multiple sclerosis model","volume":"53","author":"Spaas","year":"2021","journal-title":"Amino Acids"},{"key":"ref_61","first-page":"999","article-title":"Does Beta-Alanine Supplementation Potentiate Muscle Performance Following 6 Weeks of Blood Flow Restriction or Traditional Resistance Training?","volume":"16","author":"Pessoa","year":"2023","journal-title":"Int. J. Exerc. Sci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/15502783.2022.2079384","article-title":"Effects of beta-alanine supplementation on body composition: A GRADE-assessed systematic review and meta-analysis","volume":"19","author":"Bagheri","year":"2022","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/jcsm.13258","article-title":"Skeletal muscle analysis of cancer patients reveals a potential role for carnosine in muscle wasting","volume":"14","author":"Posa","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.nut.2004.08.006","article-title":"Histidine supplementation suppresses food intake and fat accumulation in rats","volume":"20","author":"Kasaoka","year":"2004","journal-title":"Nutrition"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1007\/s00125-013-2839-7","article-title":"Histidine supplementation improves insulin resistance through suppressed inflammation in obese women with the metabolic syndrome: A randomised controlled trial","volume":"56","author":"Feng","year":"2013","journal-title":"Diabetologia"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Panickar, K.S., DeBey, M.C., and Jewell, D.E. (2021). Dietary Carnitine and Carnosine Increase Body Lean in Healthy Cats in a Preliminary Study. Biology, 10.","DOI":"10.3390\/biology10040299"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5044","DOI":"10.1002\/jcp.26370","article-title":"Synergistic effect of carnosine on browning of adipose tissue in exercised obese rats; a focus on circulating irisin levels","volume":"233","author":"Schaalan","year":"2018","journal-title":"J. Cell. Physiol."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Yang, Y., Wang, Y., Kong, Y., Zhang, X., Zhang, H., Gang, Y., and Bai, L. (2018). Carnosine prevents type 2 diabetes-induced osteoarthritis through the ROS\/NF-\u03baB pathway. Front. Pharmacol., 9.","DOI":"10.3389\/fphar.2018.00598"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/24\/4328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:52:40Z","timestamp":1760115160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/24\/4328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,15]]},"references-count":68,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["nu16244328"],"URL":"https:\/\/doi.org\/10.3390\/nu16244328","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,15]]}}}