We have developed a direct method for the measurement of human musculoskeletal collagen synthesis on the basis of the incorporation of stable isotope-labeled proline or leucine into protein and have used it to measure the rate of synthesis of collagen in tendon, ligament, muscle, and skin. In postabsorptive, healthy young men (28 Ϯ 6 yr) synthetic rates for tendon, ligament, muscle, and skin collagen were 0.046 Ϯ 0.005, 0.040 Ϯ 0.006, 0.016 Ϯ 0.002, and 0.037 Ϯ 0.003%/h, respectively (means Ϯ SD). In postabsorptive, healthy elderly men (70 Ϯ 6 yr) the rate of skeletal muscle collagen synthesis is greater than in the young (0.023 Ϯ 0.002%/h, P Ͻ 0.05 vs. young). The rates of synthesis of tendon and ligament collagen are similar to those of mixed skeletal muscle protein in the postabsorptive state, whereas the rate for muscle collagen synthesis is much lower in both young and elderly men. After nutritient provision, collagen synthesis was unaltered in tendon and skeletal muscle, remaining at postabsorptive values (young: tendon, 0.045 Ϯ 0.008%/h; muscle, 0.016 Ϯ 0.003%/h; elderly: muscle, 0.024 Ϯ 0.003%/h). These results demonstrate that the rate of human musculoskeletal tissue collagen synthesis can be directly and robustly measured using stable isotope methodology. stable-isotope tracers; musculoskeletal collagen synthesis; nutrition; aging THE EXTRACELLULAR MATRIX of skeletal muscle, tendon, ligament, and bone is important for maintaining tissue structure and vital for transmission of force during muscular contraction (15). Collagen is the major protein in the extracellular matrix of the musculoskeletal tissue, but despite its importance to tissue function, knowledge of the physiological regulation of the amount and turnover of collagen in human beings is poor, partly due to the absence of direct methods for determination of collagen turnover in vivo under different conditions. The overall contribution of collagen to whole body protein turnover is unknown, despite the fact that collagen probably contributes 3.5 kg to the lean body mass compared with 12 kg for muscle myocellular protein, about which much more is known (22).It has been demonstrated that the concentration of collagen in skeletal muscle increases (16, 29) in aging rats, whereas in tendon and ligament there is a decrease (13). In the collagen found in tendon, ligament, and skeletal muscle, there is an increase in the nonreducible collagen cross-linking with aging, possibly resulting in stiffer, less compliant tissues (17, 23, 13). Direct measurements of collagen synthesis in rats (6 and 15 mo old), using a flooding dose of radioactive [14 C]proline (19), have shown increased turnover, including both a greater collagen fractional synthetic rate and an increased degradation rate of newly synthesized collagen, with maturity. It might be expected that a similar temporal change might exist in human beings. Unfortunately, little is known about human musculoskeletal collagen metabolism and aging in vivo.Feeding of protein or amino acids is a major, dose-de...