Flavanol-Rich Cacao Mucilage Juice Enhances Recovery of Power but Not Strength from Intensive Exercise in Healthy, Young Men

Evaluation of a preemptive intervention regimen with hesperidin methyl chalcone in delayed-onset muscle soreness in young adults: a randomized, double-blinded, and placebo-controlled trial study

PURPOSE

Delayed-onset muscle soreness (DOMS) describes an entity characterized by ultrastructural muscle damage. Hesperidin methyl chalcone (HMC) is a synthetic flavonoid presenting analgesic, anti-inflammatory, and antioxidant properties. We evaluated the effects of HMC upon DOMS.

METHOD

In a preventive paradigm, 31 sedentary young men were submitted to a randomized, double-blinded parallel trial and received HMC 500 mg or one placebo capsule × 3 days before an intense dynamic exercise protocol (concentric/eccentric actions) applied for lower limbs for inducing muscle damage. Assessments were conducted at baseline, and 24 and 48 h after, comprising physical performance, and post-muscle soreness and damage, inflammation, recovery of muscle strength, and postural balance associated with DOMS. HMC safety was also evaluated. Thirty participants completed the study.

RESULTS

HMC improved the performance of participants during exercise (40.3 vs 51.3 repetitions to failure, p = 0.0187) and inhibited CPK levels (90.5 vs 57.9 U/L, p = 0.0391) and muscle soreness during passive quadriceps palpation (2.6 vs 1.4 VAS cm, p = 0.0439), but not during active actions, nor did it inhibit IL-1β or IL-10 levels. HMC improved muscle strength recovery, and satisfactorily refined postural balance, without inducing injury to kidneys or liver.

CONCLUSIONS

Preemptive HMC supplementation may be beneficial for boosting physical performance and for the amelioration of clinical parameters related to DOMS, including pain on muscle palpation, increased blood CPK levels, and muscle strength and proprioceptive deficits, without causing adverse effects. These data advance the understanding of the benefits provided by HMC for DOMS treatment, which supports its usefulness for such purpose.

The Use of Some Polyphenols in the Modulation of Muscle Damage and Inflammation Induced by Physical Exercise: A Review

Food bioactive compounds (FBC) comprise a vast class of substances, including polyphenols, with different chemical structures, and they exert physiological effects on individuals who consume them, such as antioxidant and anti-inflammatory action. The primary food sources of the compounds are fruits, vegetables, wines, teas, seasonings, and spices, and there are still no daily recommendations for their intake. Depending on the intensity and volume, physical exercise can stimulate oxidative stress and muscle inflammation to generate muscle recovery. However, little is known about the role that polyphenols may have in the process of injury, inflammation, and muscle regeneration. This review aimed to relate the effects of supplementation with mentation with some polyphenols in oxidative stress and post-exercise inflammatory markers. The consulted papers suggest that supplementation with 74 to 900 mg of cocoa, 250 to 1000 mg of green tea extract for around 4 weeks, and 90 mg for up to 5 days of curcumin can attenuate cell damage and inflammation of stress markers of oxidative stress during and after exercise. However, regarding anthocyanins, quercetins, and resveratrol, the results are conflicting. Based on these findings, the new reflection that was made is the possible impact of supplementation associating several FBCs simultaneously. Finally, the benefits discussed here do not consider the existing divergences in the literature. Some contradictions are inherent in the few studies carried out so far. Methodological limitations, such as supplementation time, doses used, forms of supplementation, different exercise protocols, and collection times, create barriers to knowledge consolidation and must be overcome.

Effect of a fruit and vegetable drink on muscle recovery after resistance exercise

Objective: To evaluate the effect of fruit and vegetable drink supplementation on muscle recovery after resistance exercise. Methods: 11 men performed two experimental conditions 12 days apart, in a randomized and double-blind manner: 1) Supplementation with Smoothie - drink based on pineapple, mint, sage, ginger, and pomegranate; and 2) Placebo - drink based on artificial pineapple juice. Participants ingested 400 mL of Smoothie or Placebo drinks daily for 9 days, starting one week before performing the exercise (10 sets of 10 unilateral maximum repetitions in leg press 45º). The perceived subjective recovery (PSR), thickness (MT) and soreness (MS) in the anterior thigh muscles, and maximum isometric strength (MIS) were measured before, 24, 48, 72, and 96 h after exercise. Results: There was a reduction in MIS and PSR and an increase in MS 24 h after exercise (p < 0.05). In both situations, MIS returned to baseline values at 72 h (p > 0.05), while PSR and MS returned to baseline values 96 h after exercise. There was no change in MT (p > 0.05). Conclusion: Supplementation with pineapple, mint, sage, ginger, and pomegranate drinks did not accelerate muscle recovery over 96 h after the 45º leg press exercise.

Effects of Polyphenol Consumption on Recovery in Team Sport Athletes of Both Sexes: A Systematic Review

Previous studies have shown that polyphenol consumption enhances recovery of the muscle after exercise-induced muscle damage (EIMD). However, EIMD markers have not been studied by sport type. The main aim of this research was to perform a systematic review to determine the efficacy of polyphenolic consumption in increasing muscle recovery for performing team sport skills. Eligible studies included, following PICOS structure, presented at least one of the following outcomes: maximal isometric voluntary contraction (MVIC); countermovement jump (CMJ); delayed onset muscle soreness (DOMS); 20 m sprint test; creatine kinase (CK); and C-reactive protein (hsCRP). A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the PEDro scale tool. The review showed a possibly positive impact of polyphenol consumption on recovery after EIMD in team sports athletes. No differences were found between sexes. Considering the limitations, there is moderate to very low certainty of polyphenol supplementation effects on recovery of team sport females and males. A dose of 60 mL/day, divided into two times per day, ingested for >7 days may present positive effects on muscle function and muscle soreness in team sport athletes. However, further investigation is required, specifically in females.

The effects of date seed (Phoenix dactylifera) supplementation on exercise-induced oxidative stress and aerobic and anaerobic performance following high-intensity interval training sessions: a randomised, double-blind, placebo-controlled trial

High-intensity interval training (HIIT) is an efficient method to improve vascular function, maximal oxygen consumption, and muscle mitochondrial capacity. However, acute HIIT overstresses the oxidative system and causes muscle soreness and damage. The aim of the present study was to investigate the effects of date seeds on exercise-induced oxidative stress and aerobic and anaerobic performance following HIIT sessions. Thirty-six physically active men and women aged 18-35 years were assigned to take 26 g/d of date seed powder (DSP, n 18) or wheat bran powder (placebo, n 18) before and after HIIT workouts for 14 d. Total antioxidant capacity (TAC), oxidative stress index (OSI), total oxidant status (TOS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid, malondialdehyde (MDA), and 8-iso-PGF2α were determined at baseline, at the end of the intervention, and 24-h post-intervention. We used the Cooper and running-based anaerobic sprint test to assess aerobic and anaerobic performance at the study's beginning and end. Independent-samples Student's t tests, ANCOVA and repeated-measures ANOVA were used to compare the quantitative variables. Positive changes were observed in TAC, TOS, OSI, GPx, MDA and visual analogue scale after intervention and at 24-h post-exercise (P < 0·05). Likewise, peak power and fatigue index were significantly improved in DSP in comparison with the placebo group. Levels of SOD, uric acid, 8-iso-PGF2α, VO2 max and average power were not changed after training. Our results showed that date seed supplementation in active participants performing HIIT bouts ameliorated oxidative stress and improved performance parameters.

Effects of Functional Phenolics Dietary Supplementation on Athletes' Performance and Recovery: A Review

In recent years, many efforts have been made to identify micronutrients or nutritional strategies capable of preventing, or at least, attenuating, exercise-induced muscle damage and oxidative stress, and improving athlete performance. The reason is that most exercises induce various changes in mitochondria and cellular cytosol that lead to the generation of reactive species and free radicals whose accumulation can be harmful to human health. Among them, supplementation with phenolic compounds seems to be a promising approach since their chemical structure, composed of catechol, pyrogallol, and methoxy groups, gives them remarkable health-promoting properties, such as the ability to suppress inflammatory processes, counteract oxidative damage, boost the immune system, and thus, reduce muscle soreness and accelerate recovery. Phenolic compounds have also already been shown to be effective in improving temporal performance and reducing psychological stress and fatigue. Therefore, the aim of this review is to summarize and discuss the current knowledge on the effects of dietary phenolics on physical performance and recovery in athletes and sports practitioners. Overall, the reports show that phenolics exert important benefits on exercise-induced muscle damage as well as play a biological/physiological role in improving physical performance.

Protective and Recovery Effects of Resveratrol Supplementation on Exercise Performance and Muscle Damage following Acute Plyometric Exercise

Plyometric exercise (PE) is an effective training method to increase muscle mass and strength. However, excessive or inappropriate conditions might cause exercise-induced muscle damage (EIMD). Resveratrol (RES) is a natural polyphenol plant antitoxin, which improves exercise performance, and exhibits anti-oxidation, anti-inflammatory, and anti-cancer effects. Therefore, this study investigated the effect of RES supplementation on the recovery of muscle damage, inflammation, soreness, muscle power, and anaerobic performance following plyometric-exercise-induced muscle damage (PEIMD). The present study was a double-blind, placebo-controlled research trial. Thirty-six young, untrained males were enrolled into the placebo (n = 12), RES-500 (500 mg RES/day, n = 12), or RES-1000 (1000 mg RES/day, n = 12) group by a jumping height-counterbalanced grouping design. At baseline, to pre-PEIMD, supplements were pre-loaded 7 days before they conducted PEIMD, and the exercise performance, delayed-onset muscle soreness (DOMS) and muscle damage biomarkers were measured over the experimental period at baseline, pre-PEIMD, and post-PEIMD at 2, 24, 48, and 72 h. As a result, we found that, at 72 h post-EIMD, the force peak (FP) and rate of force development (RFD) of the counter movement jump (CMJ) in RES groups showed no significant difference compared to that at baseline but was significantly greater than the placebo group. In the Wingate anaerobic test (WAnT), supplementation in the RES group had a better recovery effect on the relative peak power (RPP), relative mean power (RMP) and fatigue index (FI) (p < 0.05), especially in the high-dose group. For the detection of muscle pain after PEIMD, the RES supplement group was significantly better than the placebo group (p < 0.05). In addition, for muscle damage indexes, such as creatine kinase (CK) and lactate dehydrogenase (LDH), after PEIMD, supplementation with RES could significantly reduce and accelerate recovery (p < 0.05). In addition, the blood biochemical indicators of blood count, liver function, and kidney function showed that RES will not cause adverse risks to the human body. Our results suggest that replenishing RES in advance could effectively reduce muscle pain, increase exercise performance, and decrease muscle damage indicators caused by PEIMD, and the recovery was faster. Therefore, plyometric exercises combined with suitable RES supplementation could be an effective candidate for controlling muscle damage, improving physical adaption, and recovering anaerobic capacity.

Effect of Polyphenol-Rich Foods, Juices, and Concentrates on Recovery from Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis

Objectives. To determine the effects of consuming polyphenol-rich foods, juices and concentrates on recovery from exercise-induced muscle damage (EIMD). Method. Eligibility criteria. Randomised and quasi-randomised placebo-controlled trials with a parallel or cross-over design evaluating the effects of consuming polyphenol-rich foods, juices and concentrates on recovery from EIMD in humans. Eligible studies included at least one of the primary outcome measures: maximal isometric voluntary contraction; MIVC, delayed onset muscle soreness; DOMS, or countermovement jump; CMJ. Information sources. AMED, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, PUBMED, SCOPUS (Elsevier), SPORTDiscus (EBSCO), and the UK Clinical Trials Gateway were searched from inception to September 2020. Risk of bias and quality of evidence. Risk of bias was assessed using Cochrane Risk of Bias 2 tool. Quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Synthesis of results. Random effects models were used to determine the effect of polyphenol supplementation on recovery from EIMD. Data are presented as standardised mean differences (SMD) with 95% confidence intervals (CI). Results. Included studies. Twenty-five studies were included; 15 had a parallel, and 10 had a cross-over design. A total of 527 participants (male: n = 425; female: n = 102) were included in the meta-analysis. Synthesis of results. Consumption of polyphenol-rich foods, juices and concentrates accelerated recovery of MIVC immediately post-exercise (SMD = 0.23, 95% CI 0.04, 0.42; p = 0.02; low-quality evidence), 24 h (SMD = 0.39, 95% CI 0.15, 0.62; p = 0.001; low-quality evidence), 48 h (SMD = 0.48, 95% CI 0.28, 0.67; p < 0.001; moderate-quality evidence), 72 h (SMD = 0.29, 95% CI 0.11, 0.46; p = 0.001; low-quality evidence) and 96 h post-exercise (SMD = 0.50, 95% CI 0.16, 0.83; p = 0.004; very low-quality evidence). DOMS was reduced at 24 h (SMD = −0.29, 95% CI −0.47, −0.11; p = 0.002; low-quality evidence), 48 h (SMD = −0.28, 95% CI −0.46, −0.09; p = 0.003; low-quality evidence) and 72 h post-exercise (SMD = −0.46, 95% CI −0.69, −0.24; p < 0.001; very low-quality evidence). CMJ height was greater immediately post-exercise (SMD = 0.27, 95% CI 0.01, 0.53; p = 0.04; low-quality evidence), at 24 h (SMD = 0.47, 95% CI 0.11, 0.83; p = 0.01; very low-quality evidence), 48 h (SMD = 0.58, 95% CI 0.24, 0.91; p < 0.001; very low-quality evidence) and 72 h post-exercise (SMD = 0.57, 95% CI 0.03, 1.10; p = 0.04; very low-quality evidence). Polyphenol supplementation did not alter creatine kinase, c-reactive protein, and interleukin−6 at any time points. At 72 h post-exercise, protein carbonyls (SMD = −0.64, 95% CI −1.14, −0.14; p = 0.01) were reduced. Discussion. Limitations of evidence. Risk of bias was high for 10 studies and moderate for 15. Sensitivity analyses excluding the high risk of bias studies reduced the SMDs for MIVC and DOMS, and for CMJ effects at 24 and 48 h were no longer statistically significant. Interpretation. Consuming polyphenol-rich foods, juices and concentrates accelerated recovery of muscle function while reducing muscle soreness in humans. Maximal benefit occurred 48–72 h post-exercise, however, the certainty of the evidence was moderate to very low. Supplementation could be useful when there is limited time between competitive events and impaired recovery could negatively impact performance.

The effects of cocoa flavanols on indices of muscle recovery and exercise performance: a narrative review

Exercise-induced muscle damage (EIMD) is associated with oxidative stress and inflammation, muscle soreness, and reductions in muscle function. Cocoa flavanols (CF) are (poly)phenols with antioxidant and anti-inflammatory effects and thus may attenuate symptoms of EIMD. The purpose of this narrative review was to collate and evaluate the current literature investigating the effect of CF supplementation on markers of exercise-induced oxidative stress and inflammation, as well as changes in muscle function, perceived soreness, and exercise performance. Acute and sub-chronic intake of CF reduces oxidative stress resulting from exercise. Evidence for the effect of CF on exercise-induced inflammation is lacking and the impact on muscle function, perceived soreness and exercise performance is inconsistent across studies. Supplementation of CF may reduce exercise-induced oxidative stress, with potential for delaying fatigue, but more evidence is required for any definitive conclusions on the impact of CF on markers of EIMD.

Flavonoid Containing Polyphenol Consumption and Recovery from Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis

BACKGROUND

Flavonoid polyphenols are bioactive phytochemicals found in fruits and teas among other sources. It has been postulated that foods and supplements containing flavonoid polyphenols may enhance recovery from exercise-induced muscle damage (EIMD) through upregulation of cell signalling stress response pathways, particularly the nuclear factor erythroid 2-related factor 2 (NRF2) pathway.

OBJECTIVES

This study aims to investigate the ability of polyphenol treatments containing flavonoids to enhance recovery of skeletal muscle strength, soreness and creatine kinase post EIMD.

METHODS

Medline (Pubmed), Embase and SPORTdiscus were searched from inception to August 2020 for randomised placebo-controlled trials which assessed the impact of 6 or more days of flavonoid containing polyphenol ingestion on skeletal muscle recovery in the 96-h period following a single bout of EIMD. A total of 2983 studies were screened in duplicate resulting in 26 studies included for analysis. All meta-analyses were undertaken using a random-effects model.

RESULTS

The pooled results of these meta-analyses show flavonoid polyphenol treatments can enhance recovery of muscle strength by 7.14% (95% CI [5.50-8.78], P < 0.00001) and reduce muscle soreness by 4.12% (95% CI [- 5.82 to - 2.41] P = 0.00001), no change in the recovery of creatine kinase concentrations was observed.

CONCLUSION

These results indicate that ingestion of polyphenol treatments which contain flavonoids has significant potential to improve recovery of muscular strength and reduce muscle soreness in the 4-day period post EIMD. However, the characterisation of polyphenol dosage and composition of study treatments should be prioritised in future research to facilitate the development of specific guidelines for the inclusion of flavonoid-rich foods in the diet of athletes and active individuals.

Nutritional interventions for reducing the signs and symptoms of exercise-induced muscle damage and accelerate recovery in athletes: current knowledge, practical application and future perspectives

PURPOSE

This review provides an overview of the current knowledge of the nutritional strategies to treat the signs and symptoms related to EIMD. These strategies have been organized into the following sections based upon the quality and quantity of the scientific support available: (1) interventions with a good level of evidence; (2) interventions with some evidence and require more research; and (3) potential nutritional interventions with little to-no-evidence to support efficacy.

METHOD

Pubmed, EMBASE, Scopus and Web of Science were used. The search terms 'EIMD' and 'exercise-induced muscle damage' were individually concatenated with 'supplementation', 'athletes', 'recovery', 'adaptation', 'nutritional strategies', hormesis'.

RESULT

Supplementation with tart cherries, beetroot, pomegranate, creatine monohydrate and vitamin D appear to provide a prophylactic effect in reducing EIMD. β-hydroxy β-methylbutyrate, and the ingestion of protein, BCAA and milk could represent promising strategies to manage EIMD. Other nutritional interventions were identified but offered limited effect in the treatment of EIMD; however, inconsistencies in the dose and frequency of interventions might account for the lack of consensus regarding their efficacy.

CONCLUSION

There are clearly varying levels of evidence and practitioners should be mindful to refer to this evidence-base when prescribing to clients and athletes. One concern is the potential for these interventions to interfere with the exercise-recovery-adaptation continuum. Whilst there is no evidence that these interventions will blunt adaptation, it seems pragmatic to use a periodised approach to administering these strategies until data are in place to provide and evidence base on any interference effect on adaptation.

Acute Consumption of Varied Doses of Cocoa Flavanols Does Not Influence Exercise-Induced Muscle Damage

Polyphenol consumption has become a popular method of trying to temper muscle damage. Cocoa flavanols (CF) have attracted attention due to their high polyphenol content and palatability. As such, this study will investigate whether an acute dose of CF can aid recovery following exercise-induced muscle damage. The study was a laboratory-based, randomized, single-blind, nutrient-controlled trial involving 23 participants (13 females and 10 males). Participants were randomized into either control ∼0 mg CF (n = 8, four females); high dose of 830 mg CF (CF830, n = 8, five females); or supra dose of 1,245 mg CF (CF1245, n = 7, four females). The exercise-induced muscle damage protocol consisted of five sets of 10 maximal concentric/eccentric hamstring curls and immediately consumed their assigned drink following completion. To measure muscle recovery, maximal voluntary isometric contraction (MVIC) of the knee flexors at 60° and 30°, a visual analog scale (VAS), and lower-extremity function scale were taken at baseline, immediately, 24-, 48-, and 72-hr postexercise-induced muscle damage. There was a main effect for time for all variables (p < .05). However, no significant differences were observed between groups for all measures (p ≥ .17). At 48 hr, there were large effect sizes between control and CF1245 for MVIC60 (p = .17, d = 0.8); MVIC30 (p = .26, d = 0.8); MVIC30 percentage change (p = .24 d = 0.9); and visual analog scale (p = .25, d = 0.9). As no significant differences were observed following the consumption of CF, there is reason to believe that CF offer no benefit for muscle recovery when ingested acutely.

Keto-Adaptation and Endurance Exercise Capacity, Fatigue Recovery, and Exercise-Induced Muscle and Organ Damage Prevention: A Narrative Review

A ketogenic diet (KD) could induce nutritional ketosis. Over time, the body will acclimate to use ketone bodies as a primary fuel to achieve keto-adaptation. Keto-adaptation may provide a consistent and fast energy supply, thus improving exercise performance and capacity. With its anti-inflammatory and anti-oxidative properties, a KD may contribute to muscle health, thus preventing exercise-induced fatigue and damage. Given the solid basis of its potential to improve exercise capacity, numerous investigations into KD and exercise have been carried out in recent years. This narrative review aims to summarize recent research about the potential of a KD as a nutritional approach during endurance exercise, focusing on endurance capacity, recovery from fatigue, and the prevention of exhaustive exercise-induced muscle and organ damage.