Rhodiola rosea supplementation on sports performance: A systematic review of randomized controlled trials.

The aim of this systematic review was to determine whether the supplementation with Rhodiola rosea (RR), an herb that has been used for centuries for its various properties, can have an effect on muscle damage and physical performance. The databases PubMed, Web of Science, and Cochrane Library were used to find studies published until March 2023. Randomized controlled trials, healthy participants, and no use of other supplements. The search strategy was conducted by two independent reviewers, and specific information was extracted from the selected studies. Thirteen studies were included with 263 participants (198 men and 65 women between 18 and 65 years old). Two studies followed acute supplementation, 5 chronic, and 6 combined both. The results were heterogenous, having 11 studies with some positive effects, while 2 studies show no effect in variables such as rating of perceive exertion, heart rate, antioxidant capacity, blood lactate, creatine kinase, or C-reactive protein. Two limitations were found, firstly, the difference between supplementation and exercise protocols, and secondly, the existence of unclear or high risk of bias in most of the studies included. Acute supplementation with RR has a positive effect on endurance performance and rating of perceived exertion (RPE). Chronic supplementation has a positive effect on anaerobic exercise performance, but not endurance exercise performance. Chronic supplementation may positively impact muscle damage during exercise. However, more high-quality studies are needed to firmly establish the clinical efficacy of RR.

Estimating fat-free mass in recreationally resistance-trained young men: Longitudinal and cross-sectional validation of different methods.

Several techniques exist to measure fat-free mass (FFM). Accordingly, this study is based on data from our recent trial comparing the sensitivity of the main field methods available with that of dual-energy X-ray absorptiometry (DXA) as reference and analyzing the cross-sectional accuracy of these field methods in recreationally resistance-trained males. We hypothesized that the use of these techniques would lead to varying estimates of FFM compared with DXA. Participants (N = 23; 21.4 ± 3.3 years) completed a 10-week resistance training plus diet intervention designed to optimize hypertrophy. FFM was determined by bioelectrical impedance analysis (BIA), 23 anthropometric equations, and DXA. After the intervention, FFM increased significantly according to BIA and most anthropometric estimates, but this increase was not detected by 2 anthropometric equations or by DXA. Only 1 of these 2 equations showed significant correlation with DXA and no standardized or significant differences to this reference method, although it did display significant heteroscedasticity. In our cross-sectional analysis, only 1 anthropometric equation gave rise to good accuracy as confirmed by DXA. Our findings indicate that the use of different techniques to assess FFM gains in response to a hypertrophic intervention yields different results. BIA with general embedded equations should not be used to monitor a young male adult's body composition. To monitor FFM over time, we would recommend the Dunne et al. equation (2) as the most sensitive field method, and to assess FFM cross-sectionally, equation (1) of these authors is the most accurate field method.

Antioxidant vitamin supplementation on muscle adaptations to resistance training: A double-blind, randomized controlled trial.

OBJECTIVES: The aim of this study was to examine whether antioxidant vitamin supplementation with vitamin C (VitC) and vitamin E (VitE) affects the hypertrophic and functional adaptations to resistance training in trained men. METHODS: This was a double-blind, randomized controlled trial in which participants were supplemented daily with VitC and VitE ( n = 12) or placebo ( n = 11) while completing a 10-wk resistance training program accompanied by a dietary intervention (300 kcal surplus and adequate protein intake) designed to optimize hypertrophy. Body composition (dual-energy x-ray absorptiometry), handgrip strength, and one-repetition maximum (1-RM), maximal force (F0), velocity (V0), and power (Pmax) were measured in bench press (BP) and squat (SQ) tests conducted before and after the intervention. To detect between-group differences, multiple-mixed analysis of variance, standardized differences, and qualitative differences were estimated. Relative changes within each group were assessed using a paired Student's t test. RESULTS: In both groups, similar improvements were produced in BP 1-RM , SQ 1-RM SQ, and BP F0 (P < 0.05) after the resistance training program. A small effect size was observed for BP 1-RM (d = 0.53), BP F0 (d = 0.48), and SQ 1-RM (d = -0.39), but not for SQ F0 (d = 0.03). Dominant handgrip strength was significantly increased only in the placebo group (P < 0.05). According to body composition data, a significant increase was produced in upper body fat-free mass soft tissue (FFMST; P < 0.05) in the placebo group, whereas neither total nor segmental FFMST was increased in the vitamin group. Small intervention effect sizes were observed for upper body FFSMT (d = 0.32), non-dominant and dominant leg FFMST (d = -0.39; d = -0.42). Although a significant increase in total body fat was observed in both groups (P < 0.05) only the placebo group showed an increase in visceral adipose tissue (P < 0.05), showing a substantial intervention effect (d = 0.85). CONCLUSIONS: The data indicated that, although VitC/VitE supplementation seemed to blunt upper body strength and hypertrophy adaptations to resistance training, it could also mitigate gains in visceral adipose tissue elicited by an energy surplus.

Effects of Nitrate Supplementation on Muscle Strength and Mass: A Systematic Review.

ABSTRACT: Anderson, OK, Martinez-Ferran, M, Lorenzo-Calvo, J, Jiménez, SL, and Pareja-Galeano, H. Effects of nitrate supplementation on muscle strength and mass: a systematic review. J Strength Cond Res 36(12): 3562-3570, 2022-This systematic review examines the effect of dietary nitrate supplementation (SUP) on muscle strength and hypertrophy when combined with physical exercise. The databases PubMed, Web of Science, and MEDLINE were searched for full-text articles published between January 2000 and June 2020. For inclusion, studies had to report on the effects of SUP administered as acute or chronic doses together with a standardized exercise protocol on muscle strength and hypertrophy compared with placebo in healthy adults who were sedentary, physically active, or professional athletes. Twelve studies (1,571 subjects) were finally selected. In 5 studies, the SUP regime was acute, and in 7, it was chronic. SUP was nitrate-rich beetroot juice in 9 studies, a potassium nitrate capsule in 1, and increased dietary nitrate in 2. Ingested nitrate was 64-1,200 mg. Of the 12 studies, 6 observed an ergogenic effect of SUP compared with placebo. These findings indicate that muscle strength gains are possible provided the dose, format, frequency, period, and exercise test are appropriate. Best results were observed with a minimum acute dose of 400 mg of nitrate provided as beetroot juice/shot taken 2-2.5 hours before exercise involving low- and high-intensity muscle contractions. This SUP regime seems to improve muscle efficiency in terms of reduced phosphocreatine and energy costs (P-magnetic resonance spectroscopy) and improved time to exhaustion.

Effects of Acute Vitamin C plus Vitamin E Supplementation on Exercise-Induced Muscle Damage in Runners: A Double-Blind Randomized Controlled Trial.

Considering the existing controversy over the possible role of acute antioxidant vitamins in reducing exercise-induced muscle damage (EIMD), this doubled-blind, randomized and controlled trial aimed to determine whether supplementation with vitamins C and E could mitigate the EIMD in endurance-trained runners (n = 18). The exercise protocol involved a warm-up followed by 6 to 8 bouts of 1 km running at 75% maximum heart rate (HRmax). Two hours before the exercise protocol, participants took the supplementation with vitamins or placebo, and immediately afterwards, blood lactate, rate of perceived exertion and performance were assessed. At 24 h post-exercise, CK, delayed onset muscle soreness and performance were determined (countermovement jump, squat jump and stiffness test). The elastic index and vertical stiffness were calculated using a stiffness test. Immediately after the exercise protocol, all participants showed improved maximum countermovement jump, which only persisted after 24 h in the vitamin group (p < 0.05). In both groups, squat jump height was significantly greater (p < 0.05) immediately after exercise and returned to baseline values after 24 h. The elastic index increased in the vitamin group (p < 0.05), but not in the placebo group. In both groups, lactate levels increased from pre- to immediately post-exercise (p < 0.05), and CK increased from pre- to 24 h post-exercise (p < 0.05). No significant differences between groups were observed in any of the variables (p > 0.05). Vitamin C and E supplementation does not seem to help with EIMD in endurance-trained individuals.

Physical Condition and Risk of Hospitalization and Polypharmacy in Older Adults.

Hospitalization in older population leads to a decline in physical function, physical condition, and independency. However, a scarce number of studies has addressed the effect of being in good physical condition on the risk of hospitalization and polypharmacy in older people. Therefore, this study aims to examine the relationship between physical condition and other health factors, and the incidence of hospitalization and polypharmacy in Spanish older persons. For this cross-sectional study we recruited 102 institutionalized persons aged 80 years or older, who were being treated at three primary care centers. The data collected were number of hospitalizations and medications, dietary habits, nutrition status, quality of life, independence in activities of daily life, physical performance, and associated genotype data. Scoring higher in the tests Chair stand and 8-Foot Up-and-go was found associated with reduced risks of hospitalization (odds ratio [OR] = 0.45 [95% CI = 0.2-0.99]; OR 0.32 [95% CI = 0.12-0.86]) and polypharmacy (OR = 0.36 [95% CI = 0.16-0.8]; OR = 0.28 [95% CI = 0.1-0.78]). The number of medications was also lower in individuals with a greater aerobic capacity and activities of daily life independence (OR = 0.28 [95% CI = 0.1-0.78]; OR = 0.37 [95% CI = 0.16-0.82]). No associations were found with the remaining physical performance tests or other factors assessed. Our findings point to benefits of greater strength, balance, and aerobic capacity in terms of reducing the risk of hospitalization and polypharmacy.

Interaction Between Caffeine and Creatine When Used as Concurrent Ergogenic Supplements: A Systematic Review.

There is some controversy regarding the interactions between creatine (CRE) and caffeine (CAF) supplements. The aim of this systematic review was to study whether such ergogenic interaction occurs and to analyze the protocol to optimize their synchronous use. The PubMed, Web of Science, MEDLINE, CINAHL, and SPORTDiscus databases were searched until November 2021 following the PRISMA guidelines. Ten studies were included. Three studies observed that CRE loading before an acute dose of CAF before exercise did not interfere in the beneficial effect of CAF, whereas one study reported that only an acute supplementation (SUP) of CAF was beneficial but not the acute SUP of both. When chronic SUP with CRE + CAF was used, two studies reported that CAF interfered in the beneficial effect of CRE, whereas three studies did not report interaction between concurrent SUP, and one study reported synergy. Possible mechanisms of interaction are opposite effects on relaxation time and gastrointestinal distress derived from concurrent SUP. CRE loading does not seem to interfere in the acute effect of CAF. However, chronic SUP of CAF during CRE loading could interfere in the beneficial effect of CRE.

N-3 PUFA as an ergogenic supplement modulating muscle hypertrophy and strength: a systematic review.

There is growing evidence that suggests that n-3 polyunsaturated fatty acids (PUFA) may improve physical performance when combined with proper training through modulation of muscle hypertrophy, muscle strength, and delayed onset muscle soreness (DOMS). This systematic review aims to examine the effect and optimal dosage of n-3 PUFA supplementation on muscle hypertrophy, muscle strength, and DOMS when combined with physical exercise. The PubMed, Web of Science, MEDLINE Complete, CINAHL and SPORTDiscus databases were searched following the PRISMA guidelines. Randomized controlled trials performed with healthy humans were considered. Fifteen studies with a total of 461 individuals were included in this systematic review. All of them measured muscle function (short physical performance test, range of motion (ROM), electromechanical delay (EMD), muscle echo intensity or muscle quality) and DOMS. Fourteen studies evaluated muscle strength and only six assessed muscle hypertrophy. Our results demonstrated that n-3 PUFA does not improve muscle hypertrophy, muscle strength or skeletal muscle biomarkers of inflammation and muscle damage beyond the benefits obtained by the training itself. Nevertheless, n-3 PUFA improves DOMS recovery and muscle function (measured by ROM, EMD and muscle quality).

Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review.

Muscle damage induced by exercise may have several consequences such as delayed-onset muscle soreness, a side-effect of the release of free radicals during oxidative stress. To mitigate the oxidative stress cascade, the oral intake of antioxidants has been assessed by several research groups. This review examines whether supplementation with vitamin C and/or vitamin E is able to prevent or attenuate delayed-onset muscle soreness after eccentric exercise. The PubMed, Web of Science, Medline, and Embase databases were searched to identify studies meeting the inclusion criteria: primary randomized control trials, healthy male and female participants aged 16-80 years, and an intervention consisting of the intake of vitamin C and/or vitamin E without other supplements plus a controlled eccentric exercise regimen. Further requirements were the measurement of muscle soreness or markers of delayed-onset muscle soreness. All original full-text articles in English or translated into English published from January 2000 to June 2020 were considered for this review. Fourteen studies were finally identified, including 280 participants, 230 men, and 50 women aged 16-30 years. All participants were healthy individuals with different starting levels of physical activity. Supplementation was acute in two studies and chronic in 12, and its consisted of vitamin C in eight studies, vitamin E in two studies, and both in four studies. Only in 3 of the 14 studies was muscle soreness found to be significantly reduced in response to vitamin C and/or vitamin E supplementation at all time points when compared to the placebo group. Despite some studies showing the beneficial effects of chronic supplementation with these vitamins on muscle soreness manifesting 24-72 h after eccentric exercise, the evidence is so far insufficient to confirm that the intake of antioxidant vitamins is able to minimize delayed-onset muscle soreness in this context.

Vitamin D and cardiovascular health.

The principal source of vitamin D in humans is its biosynthesis in the skin through a chemical reaction dependent on sun exposure. In lesser amounts, the vitamin can be obtained from the diet, mostly from fatty fish, fish liver oil and mushrooms. Individuals with vitamin D deficiency, defined as a serum level of 25 hydroxyvitamin D < 20 ng/dl, should be supplemented. Vitamin D deficiency is a prevalent global problem caused mainly by low exposure to sunlight. The main role of 1,25 dihydroxyvitamin D is the maintenance of calcium and phosphorus homeostasis. However, vitamin D receptors are found in most human cells and tissues, indicating many extra-skeletal effects of the vitamin, particularly in the immune and cardiovascular (CV) systems. Vitamin D regulates blood pressure by acting on endothelial cells and smooth muscle cells. Its deficiency has been associated with various CV risk factors and appears to be linked to a higher mortality and incidence of CV disease (CVD). Several mechanisms have been proposed relating vitamin D deficiency to CV risk factors such as renin-angiotensin-aldosterone system activation, abnormal nitric oxide regulation, oxidative stress or altered inflammatory pathways. However, in the latest randomized controlled trials no benefits of vitamin D supplementation for CVD have been confirmed. Although more work is needed to establish the protective role of vitamin D in this setting, according to current evidences vitamin D supplements should not be recommended for CVD prevention.

Do Antioxidant Vitamins Prevent Exercise-Induced Muscle Damage? A Systematic Review.

Free radicals produced during exercise play a role in modulating cell signaling pathways. High doses of antioxidants may hamper adaptations to exercise training. However, their benefits are unclear. This review aims to examine whether vitamin C (VitC) and/or vitamin E (VitE) supplementation (SUP) prevents exercise-induced muscle damage. The PubMed, Web of Science, Medline, CINAHL, and SPORTDiscus databases were searched, and 21 articles were included. Four studies examined the effects of acute VitC SUP given pre-exercise: in one study, lower CK levels post-exercise was observed; in three, no difference was recorded. In one study, acute VitE SUP reduced CK activity 1 h post-exercise in conditions of hypoxia. In three studies, chronic VitE SUP did not reduce CK activity after an exercise session. Chronic VitE SUP did not reduce creatine kinase (CK) concentrations after three strength training sessions, but it was effective after 6 days of endurance training in another study. Chronic SUP with VitC + E reduced CK activity post-exercise in two studies, but there was no such effect in four studies. Finally, three studies described the effects of chronic VitC + E SUP and long-term exercise, reporting dissimilar results. To conclude, although there is some evidence of a protective effect of VitC and/or VitE against exercise-induced muscle damage, the available data are not conclusive.

Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits.

While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.