Churchward-Venne TA, Cotie LM, MacDonald MJ, Mitchell CJ, Prior T, Baker SK, Phillips SM. Citrulline does not enhance blood flow, microvascular circulation, or myofibrillar protein synthesis in elderly men at rest or following exercise. Am J Physiol Endocrinol Metab 307: E71-E83, 2014. First published May 13, 2014; doi:10.1152/ajpendo.00096.2014.-Aging is associated with anabolic resistance, a reduced sensitivity of myofibrillar protein synthesis (MPS) to postprandial hyperaminoacidemia, particularly with low protein doses. Impairments in postprandial skeletal muscle blood flow and/or microvascular perfusion with hyperaminoacidemia and hyperinsulinemia may contribute to anabolic resistance. We examined whether providing citrulline, a precursor for arginine and nitric oxide synthesis, would increase arterial blood flow, skeletal muscle microvascular perfusion, MPS, and signaling through mTORC1. Twentyone elderly males (65-80 yr) completed acute unilateral resistance exercise prior to being assigned to ingest a high dose (45 g) of whey protein (WHEY) or a low dose (15 g) of whey protein with 10 g of citrulline (WHEY ϩ CIT) or with 10 g of nonessential amino acids (WHEY ϩ NEAA). A primed, continuous infusion of L-[ring-13 C6] phenylalanine with serial muscle biopsies was used to measure MPS and protein phosphorylation, whereas ultrasound was used to measure microvascular circulation under basal and postprandial conditions in both a rested (FED) and exercised (EX-FED) leg. Argininemia was greater in WHEY ϩ CIT vs. WHEY and WHEY ϩ NEAA from 30 to 300 min postexercise (P Ͻ 0.001), but there were no treatment differences in blood flow or microvascular perfusion (all P Ͼ 0.05). Phosphorylation of p70S6K-Thr 389 was greater in WHEY vs. WHEY ϩ NEAA (P ϭ 0.02). Postprandial MPS was greater in WHEY vs. WHEY ϩ CIT and WHEY ϩ NEAA under both FED (WHEY: ϳ128%; WHEY ϩ CIT: ϳ56%; WHEY ϩ NEAA: ϳ38%) and EX-FED (WHEY: ϳ251%; WHEY ϩ CIT: ϳ124%; WHEY ϩ NEAA: ϳ108%) conditions (P ϭ 0.003). Citrulline coingestion with a low quantity of protein was ineffective in augmenting the anabolic properties of protein compared with nonessential amino acids. citrulline; myofibrillar protein synthesis; elderly DECLINES IN MUSCLE MASS WITH AGING are due to rates of myofibrillar protein synthesis (MPS) being less than the net rate of muscle protein breakdown (37). Aminoacidemia and physical exercise are potent anabolic stimuli that elicit the synthesis of new muscle proteins; however, aging is associated with a reduced MPS response following both hyperaminoacidemia (54) and resistance exercise (28), a phenomenon termed "anabolic resistance" (for review, see Ref. 10). Although the mechanisms underlying anabolic resistance are not fully understood, age-related impairments in blood flow may be involved (31,48,50).Aminoacidemia and insulinemia increase MPS (54), arterial blood flow (54), and muscle microvascular perfusion (52) in the young; however, these responses are blunted in the elderly (48, 54). Age-related impairments in vascular function may be...