Vitamin E Does not Favor Recovery After Exercises: Systematic Review and Meta-analysis.

This review aimed to verify the effects of vitamin E supplementation on oxidative stress, inflammatory response, muscle damage, soreness, and strength in healthy adults after exercise. We searched the MEDLINE, EMBASE, SPORTDiscus, Cochrane CENTRAL, and Web of Science from inception to August 2023, with no language restrictions. We included randomized placebo-controlled trials evaluating the supplementation of vitamin E on the abovementioned outcomes after a bout of physical exercise in healthy participants (no restriction for publication year or language). Meta-analyses were conducted to compare vitamin E and placebo supplementations to obtain a 95% confidence interval (95%IC). Twenty studies were included (n=298 participants). The effect of supplementation was assessed between 0 h and 96 h after the exercise. Compared to placebo, vitamin E had no effects on lipid (95%IC= -0.09 to 0.42), protein (-2.44 to 3.11), SOD (-1.05 to 0.23), interleukin-6 (-0.18 to 1.16), creatine kinase (-0.33 to 0.27), muscle soreness (-1.92 to 0.69), and muscle strength (-1.07 to 0.34). Heterogeneity for the analyses on carbonyls, interleukin-6 (1 h and 3 h), and muscle soreness ranged between 70 to 94%. Supplementing with vitamin E should not be recommended to support the recovery process in healthy individuals after exercise, given the lack of efficacy in the analyzed variables following an exercise session.

Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players.

BACKGROUND: Beetroot juice (BRJ) contains various bioactive compounds suggested to be effective in improving athlete recovery. However, the number of studies evaluating the effects of BRJ on recovery and muscle soreness (MS) indicators in female athletes is limited. Therefore, the present study aimed to determine the effects of BRJ consumption on the performance recovery indicators and MS after exercise-induced muscle damage (EIMD) in female volleyball players. METHODS: Twelve young female volleyball players were evaluated in this study. We utilized a randomized, cross-over, and double-blind design during two phases with a 30-day interval (wash-out). During each phase, EIMD was performed first, followed by BRJ or placebo (PLA) supplementation for two days (eight servings of 50 mL). Recovery monitoring of performance indicators and MS was performed after EIMD. The results of wall-sit, V sit and reach (VSFT), vertical jump height (VJH), pressure pain threshold (PPT), and thigh swelling (Sw-T) tests were recorded 48 h after EIMD. Also, the Perceived Muscle Soreness was recorded using the visual analog scale (VAS) 12 (MS-12 h), 24 (MS-24 h), and 48 (MS-48 h) hours after EIMD. RESULTS: The data were analyzed using two-way repeated measures of ANOVA at p < 0.05. Compared to PLA, BRJ supplementation improves wall-sit performance after EIMD (p < 0.05), while reducing Sw-T and perceived muscle soreness (p < 0.05). However, no significant difference was observed between PLA and BRJ in VJH and VSFT performance after EIMD (p > 0.05). CONCLUSIONS: Our findings indicate that the consumption of BRJ in female volleyball players can be useful for improving some recovery indicators, such as muscle endurance, perceived muscle soreness, and tissue edema, after EIMD.

Dietary collagen peptides alleviate exercise-induced muscle soreness in healthy middle-aged males: a randomized double-blinded crossover clinical trial.

BACKGROUND: Post-exercise muscle soreness and fatigue can negatively affect exercise performance. Thus, it is desirable to attenuate muscle soreness and fatigue and promote recovery even for daily exercise habits aimed at maintaining or improving health. METHODS: This study investigated the effects of dietary collagen peptides (CPs) on post-exercise physical condition and fitness in healthy middle-aged adults unfamiliar with exercise. Middle-aged males (n = 20, 52.6 ± 5.8 years) received the active food (10 g of CPs per day) or the placebo food for 33 days in each period of the randomized crossover trial (registered at the University Hospital Medical Information Network Clinical Trials Registry with UMIN-CTR ID of UMIN000041441). On the 29th day, participants performed a maximum of five sets of 40 bodyweight squats. Muscle soreness as the primary outcome, fatigue, the maximum knee extension force during isometric muscle contraction of both legs, the range of motion (ROM), and the blood level of creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) were assessed before and after the exercise load. RESULTS: The analysis set was the per-protocol set (n = 18, 52.6 ± 6.0 years) for efficacy and the full analysis set (n = 19, 52.8 ± 5.9 years) for safety. The visual analog scale (VAS) of muscle soreness immediately after the exercise load was significantly lower in the active group than in the placebo group (32.0 ± 25.0 mm versus 45.8 ± 27.6 mm, p < 0.001). The VAS of fatigue immediately after the exercise load was also significantly lower in the active group than in the placebo group (47.3 ± 25.0 mm versus 59.0 ± 22.3 mm, p < 0.001). Two days (48 hours) afterthe exercise load, muscle strength was significantly higher in the active group than in the placebo group (85.2 ± 27.8 kg versus 80.5 ± 25.3 kg, p = 0.035). The level of CPK did not change over time. The level of LDH increased slightly but was not different between the groups. No safety-related issues were observed. CONCLUSIONS: These results showed that dietary CPs alleviated muscle soreness and fatigue and affected muscle strength after exercise load in healthy middle-aged males.

Effect of Massage Therapy with Lime (Citrus Aurantifolia) Essential Oil on the Recovery of Delayed Onset of Muscle Soreness in Athletes.

Background: Physical exercise is a systematic exercise to increase muscle strength achieve goals such as improving the athlete's physical and preventing injury. Athletes must do is massage therapy to prevent muscle fatigue and pain due to physical exercise or during competition. The increase of lactic acid levels affects the maximum working ability of muscle fibers, decreases physical performance, and is fatigue in which the onset of pain. Lime essential oil as a topical oil contains high ester substances that have pharmacological effects such as natural analgesic effects to relieve pain. Objective: The purpose of this study was to determine the effect of massage therapy with lime essential oil as a topical oil on the recovery of delayed-onset muscle soreness (DOMS) in athletes. Methods: The participants are boxing athletes, 30 men, 20-22 years old, and non-smokers. Participants were divided into three groups. The exercise group (E) was doing exercises and was not given massage therapy; the exercise massage (EM) group, namely, doing exercises and being massaged with ordinary lotion as a topical oil; and the EM lime (EMC) group did exercises and was given a massage with lime essential oil as the topical oil. Results: The results showed that there was a significant difference in the average levels of lactic acid (p = 0.000) and the athlete's pain intensity (p = 0.000) in the three groups, namely, the exercise group (E), the exercise and massage group (EM), and the exercise and massage with lime essential oil (EMC). Conclusion: This study finds that lime essential oil used as topical massage therapy oil is better for accelerating the DOMS.

Curcumin Attenuates Delayed-Onset Muscle Soreness and Muscle Function Deficits Following a Soccer Match in Male Professional Soccer Players.

PURPOSE: To examine the effects of acute curcumin (CURC) supplementation on recovery from a soccer match in male professional players. METHODS: In a randomized, placebo-controlled, crossover design, 11 players from the under-23 team of an English Premier League club (age 19 [1] y, body mass 79.4 [7.9] kg, height 180.8 [5.7] cm) consumed 500 mg of CURC or a control (medium-chain triglycerides) immediately and 12 and 36 hours after a 90-minute match. Countermovement jump height (CMJ), reactive strength index (RSI), delayed-onset muscle soreness (DOMS, 0-200 mm), and subjective well-being were measured before and 12, 36, and 60 hours postmatch. Global positioning systems measured external load during matches, and dietary intake was recorded across the testing period. RESULTS: External load and dietary intake did not differ between conditions (P ≥ .246). CURC attenuated deficits in CMJ (P ≤ .004) and RSI (P ≤ .001) and reduced DOMS (P ≤ .004) at all postmatch time points (except 60 h post for RSI). The greatest difference between control and CURC was 12 hours post for CMJ (P < .001, 1.91 [4.40] cm, 95% CI, 1.25 to 2.57, g = 0.36) and RSI (P = .003, 0.40 [0.41] AU, 95% CI, 0.17 to 0.63, g = 0.90) and 36 hours post for DOMS (P < .001, 47 [23] mm, 95% CI, -67 to -27, g = 2.12). CONCLUSIONS: CURC intake <36 hours after a soccer match attenuated DOMS and muscle function deficits, suggesting that CURC may aid recovery in professional male soccer players.

Milk protein ingestion does not enhance recovery from muscle-damaging resistance exercise in untrained males and females: a randomized controlled trial.

Milk-based proteins are a common choice of post-exercise nutrition to enhance exercise recovery and adaptation. Peri-exercise milk protein ingestion may attenuate exercise-induced muscle damage (EIMD), which is a particular risk to untrained individuals. However, most research has been conducted with males, and due to potential sex differences in EIMD, research with both sexes is required. This parallel-group randomized controlled trial examined the impact of milk protein ingestion on recovery from EIMD. Untrained males and females performed a single bout of leg-based resistance exercise and consumed a milk protein (MILK-PRO: n = 4 males, n = 8 females) or isoenergetic control (CON: n = 4 males, n = 8 females) supplement over 4 days post-exercise (17 doses total). Maximum strength was assessed ≥3 wk pre- and 72 and 168 h post-exercise, and measures of leg circumference, range of motion, muscle soreness, pressure-pain threshold (PPT), and serum creatine kinase concentration ([CK]) were conducted pre-, immediately post-, and 24, 48, 72, and 168 h post-exercise. Resistance exercise induced mild muscle damage that was not attenuated with MILK-PRO relative to CON. Peak increases in [CK] and reductions in PPT were greater in males compared with females. Changes in other markers were comparable between sexes. We conclude that moderate resistance exercise in naïve individuals induces muscle damage without compromising muscle strength. We support sex differences in EIMD and emphasize the need for further research with both sexes. Milk protein ingestion was not beneficial for recovery from EIMD, thus alternative management strategies should be investigated. This trial was prospectively registered at ClinicalTrials.gov PRS (protocol ID: 290580A).

Supplementation with Whey Protein, but Not Pea Protein, Reduces Muscle Damage Following Long-Distance Walking in Older Adults.

Background: Adequate animal-based protein intake can attenuate exercise induced-muscle damage (EIMD) in young adults. We examined the effects of 13 days plant-based (pea) protein supplementation compared to whey protein and placebo on EIMD in active older adults. Methods: 47 Physically active older adults (60+ years) were randomly allocated to the following groups: (I) whey protein (25 g/day), (II) pea protein (25 g/day) or (III) iso-caloric placebo. Blood concentrations of creatine kinase (CK) and lactate dehydrogenase (LDH), and skeletal muscle mass, muscle strength and muscle soreness were measured prior to and 24 h, 48 h and 72 h after a long-distance walking bout (20−30 km). Results: Participants walked 20−30 km and 2 dropped out, leaving n = 15 per subgroup. The whey group showed a significant attenuation of the increase in EIMD at 24 h post-exercise compared to the pea and placebo group (CK concentration: 175 ± 90 versus 300 ± 309 versus 330 ± 165, p = p < 0.001). No differences in LDH levels, muscle strength, skeletal muscle mass and muscle soreness were observed across groups (all p-values > 0.05). Conclusions: Thirteen days of pea protein supplementation (25 g/day) does not attenuate EIMD in older adults following a single bout of prolonged walking exercise, whereas the whey protein supplementation group showed significantly lower post-exercise CK concentrations.

The impact of dietary protein supplementation on recovery from resistance exercise-induced muscle damage: A systematic review with meta-analysis.

BACKGROUND: It is unknown whether dietary protein consumption can attenuate resistance exercise-induced muscle damage (EIMD). Managing EIMD may accelerate muscle recovery and allow frequent, high-quality exercise to promote muscle adaptations. This systematic review and meta-analysis examined the impact of peri-exercise protein supplementation on resistance EIMD. METHODS: A literature search was conducted on PubMed, SPORTDiscus, and Web of Science up to March 2021 for relevant articles. PEDro criteria were used to assess bias within included studies. A Hedges' g effect size (ES) was calculated for indirect markers of EIMD at h post-exercise. Weighted ESs were included in a random effects model to determine overall ESs over time. RESULTS: Twenty-nine studies were included in the systematic review and 40 trials were included in ≥1 meta-analyses (16 total). There were significant overall effects of protein for preserving isometric maximal voluntary contraction (MVC) at 96 h (0.563 [0.232, 0.894]) and isokinetic MVC at 24 h (0.639 [0.116, 1.162]), 48 h (0.447 [0.104, 0.790]), and 72 h (0.569 [0.136, 1.002]). Overall ESs were large in favour of protein for attenuating creatine kinase concentration at 48 h (0.836 [-0.001, 1.673]) and 72 h (1.335 [0.294, 2.376]). Protein supplementation had no effect on muscle soreness compared with the control. CONCLUSION: Peri-exercise protein consumption could help maintain maximal strength and lower creatine kinase concentration following resistance exercise but not reduce muscle soreness. Conflicting data may be due to methodological divergencies between studies. Standardised methods and data reporting for EIMD research are needed.

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.

Branched-Chain Amino Acids Supplementation Does Not Accelerate Recovery after a Change of Direction Sprinting Exercise Protocol.

BCAAs supplementation has been widely used for post-exercise recovery. However, no evidence is currently available to answer the question of whether BCAAs supplementation can attenuate muscle damage and ameliorate recovery after a bout of change of direction (COD) sprinting, which is an exercise motion frequently used during team sport actions. This study aimed to assess the effect of BCAAs supplementation on muscle damage markers, subjective muscle soreness, neuromuscular performance, and the vascular health of collegiate basketball players during a 72 h recovery period after a standardized COD protocol. Participants orally received either BCAAs (0.17 g/kg BCAAs + 0.17 g/kg glucose) or placebo (0.34 g/kg glucose) supplementation before and immediately after a COD exercise protocol in a randomized, crossover, double-blind, and placebo-controlled manner. Creatine kinase increased immediately after exercise and peaked at 24 h, muscle soreness remained elevated until 72 h, whilst arterial stiffness decreased after exercise for both supplemented conditions. A negligibly lower level of interleukin-6 was found in the BCAAs supplemented condition. In conclusion, the results of this study do not support the benefits of BCAAs supplementation on mitigating muscle damage and soreness, neuromuscular performance, and arterial stiffness after COD for basketball players.

Omega-3 fatty acids enhance the beneficial effect of BCAA supplementation on muscle function following eccentric contractions.

Background: This study investigated the combined effect of branched-chain amino acids (BCAA) and fish oil (FO) on muscle damage caused by eccentric contractions (ECCs) of the elbow flexors, with a special focus on muscular function. Methods: Twenty-nine untrained male participants were enrolled in this double-blind, placebo-controlled, parallel study. The participants were randomly assigned to the placebo (PL) group (n = 9), BCAA supplement group (n = 10), and BCAA+FO supplement group (n = 10). The BCAA+FO group consumed eicosapentaenoic acid (EPA) 600 mg and docosahexaenoic acid (DHA) 260 mg per day for 8 weeks, while the BCAA and BCAA+FO groups consumed 9.6 g per day for 3 days prior to and until 5 days after ECCs. Participants performed six sets of 10 ECCs at 100% maximal voluntary contraction (MVC) using dumbbells. Changes in MVC torque, range of motion (ROM), muscle soreness using visual analog scales, upper circumference, muscle thickness, echo intensity, and serum creatine kinase (CK) were assessed before, immediately after, and 1, 2, 3, and 5 days after ECCs. Results: The MVC torque was significantly higher in the BCAA+FO group than in the PL group immediately after ECCs (p < 0.05) but not in the BCAA group. Both BCAA and BCAA+FO groups showed greater ROM and lower muscle soreness than the PL group (p < 0.05). CK was significantly lower in the BCAA group than in the PL group at 5 days after ECCs (p < 0.05). Conclusions: This study reveals that supplementation with BCAA and FO may favorably impact immediate recovery of peak torque production. Alternatively, in comparison to PL group, BCAA supplementation favorably reduces creatine kinase.

Mitochondria-targeted antioxidant supplementation does not affect muscle soreness or recovery of maximal voluntary isometric contraction force following muscle-damaging exercise in untrained men: a randomized clinical trial.

Unaccustomed exercise causes muscle damage resulting in loss of muscle function, which may be attributable to exercise-induced increases in skeletal muscle reactive oxygen species. This study examined the effect of mitochondria-targeted antioxidant supplementation on recovery of muscle function following exercise. Thirty-two untrained men received MitoQ (20 mg/day) or a placebo for 14 days before performing  300 maximal eccentric contractions of the knee extensor muscles of 1 leg. Muscle function was assessed using isokinetic dynamometry before, immediately after, and 24, 48, 72, and 168 hours after exercise. Muscle soreness was assessed using a visual analogue scale 24, 48, 72, and 168 hours after exercise. Blood samples were collected before, immediately after, and 2, 24, 48, 72, and 168 hours after exercise and urine samples were collected before and during the 48 hours after exercise. The reduction in maximal voluntary isometric contraction force and peak concentric torque following exercise was unaffected by MitoQ while recovery of peak eccentric torque was delayed in the MitoQ group. Exercise-induced increases in urine F2-isoprostanes were unaffected by MitoQ. MitoQ augmented exercise-induced increases in plasma creatine kinase levels, while plasma IL-6 was similar between groups. Muscle soreness was not affected by MitoQ. These results indicate that MitoQ does not attenuate post-exercise muscle soreness and may delay recovery of muscle function following eccentric exercise. Trial registration number: ACTRN12620001089921. Novelty: Post-exercise recovery of maximal voluntary isometric contraction force and peak concentric torque were unaffected by MitoQ. MitoQ delayed post-exercise recovery of peak eccentric torque. Post-exercise muscle soreness was unaffected by MitoQ.

Effectiveness of a combined New Zealand green-lipped mussel and Antarctic krill oil supplement on markers of exercise-induced muscle damage and inflammation in untrained men.

Green-lipped mussel oil (PCSO-524®) has been shown to attenuate signs and symptoms of exercise-induced muscle damage (EIMD), and krill oil has been shown to have a protective effect against cytokine-induced tissue degradation. The purpose of this study was to compare the effects of PCSO-524® and ESPO-572® (75% PCSO-524® and 25% krill oil) on signs and symptoms of EIMD. Fifty-one untrained men consumed 600 mg/d of PCSO-524® (n = 24) or ESPO-572® (n = 27) for 26 d prior to and 72 h following a downhill running bout. Delayed onset muscle soreness (DOMS), pressure pain threshold, limb swelling, range of motion (ROM), isometric torque, and blood markers of inflammation and muscle damage were assessed at baseline, 24, 48 and 72 h post-eccentric exercise. ESPO-572® was 'at least as good as' PCSO-524® and both blends were superior (p < 0.05) to placebo in lessening the increase in DOMS at 24, 48, 72 h. ESPO-572® and PCSO-524® were protective against joint ROM loss compared to placebo (p < 0.05) at 48 and 72 h. Notably, at 24 and 48 h, joint ROM was higher in the ESPO-572® compared to the PCSO-524® group (p < 0.05). No differences between the two blends for the other markers were found. ESPO-572® is 'at least as good' as PCSO-524® in reducing markers of muscle damage and soreness following eccentric exercise and was superior to PCSO-524® in protecting against the loss in joint ROM during recovery. Our data support the use of ESPO-572®, a combination of green-lipped mussel and krill oil, in mitigating the deleterious effects of EIMD.

Selected root plant supplementation reduces indices of exercise-induced muscle damage: A systematic review and meta-analysis.

This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular performance measures following muscle-damaging protocols. We included 25 studies (parallel and crossover design) with 353 participants and used the PEDro scale to appraise each study. Forest plots were generated to report on standardised mean differences (SMD) and p-values at 24 and 48 hours following the muscle-damaging protocols. The meta-analysis showed that the supplemental (SUPP) condition showed significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) and muscle soreness at 24 hours and 48 hours (p < 0.01) than the placebo (PLA) condition. The inflammatory markers were significantly lower for the SUPP condition than the PLA condition at 24 hours (p = 0.02), although no differences were identified at 48 hours (p = 0.40). There were no significant differences in muscular performance measures between the SUPP and PLA conditions at 24 hours and 48 hours (p > 0.05) post-exercise. According to our qualitative data, a number of studies reported a reduction in oxidative stress (e.g., malondialdehyde, superoxide dismutase) with a concomitant upregulation of anti-oxidant status, although other studies showed no effects. Accordingly, selected root plants minimised the level of several biomarkers of muscle damage, inflammation and muscle soreness during periods of exercise-induced muscle damage. However, the benefits of these supplements in ameliorating oxidative stress, increasing anti-oxidant status and accelerating recovery of muscular performance appears equivocal, warranting further research in these outcome measures.

Ten Days of Curcumin Supplementation Attenuates Subjective Soreness and Maintains Muscular Power Following Plyometric Exercise.

Curcumin has become a popular product used to decrease inflammation and enhance recovery from exercise. PURPOSE: To determine the effects of curcumin supplementation on delayed onset muscle soreness and muscle power following plyometric exercise. METHODS: Participants (n = 22; five females, 17 males) consumed either curcumin (500 mg) or placebo twice daily for 10 days (6 days pre, day of and 3 days post exercise). Participants completed 5 x 20 drop jumps on day 7. Blood sampling and recovery tests were assessed at pre-supplementation, 24-hours and immediately pre-exercise, and immediately post-, 24, 48 and 72-hours post-exercise. Blood markers included serum creatine kinase (CK) and erythrocyte sedimentation rate (ESR), while soreness was measured during a squat and post vertical jump. RESULTS: Both groups experienced muscle damage post-exercise with elevated CK (403 ± 390 ul; p < 0.01), soreness with squatting (38 ± 29 mm; p < 0.01), and vertical jump (36 ± 30 mm; p < 0.01). Soreness was greater in placebo vs. curcumin 48 h and 72 h post-exercise (p < 0.01); however, CK was not significantly different between groups (p = 0.28) despite being >200 IU·L-1 greater 24 hr post exercise in placebo vs. curcumin. ESR was significantly greater immediately post-exercise (6.3 ± 5.6 vs. 3.4 ± 2.6 mm/hr; p = 0.03), however these were within the normal range for this test and not significantly different between groups (p = 0.25). Vertical jump decreased over time in the placebo, but not curcumin group (19.8 ± 4.8 vs. 21.4 ± 3.2 in; p = 0.01). CONCLUSION: These data suggest curcumin reduces soreness and maintains muscular power following plyometric exercise.

Effects of Beetroot Supplementation on Recovery After Exercise-Induced Muscle Damage: A Systematic Review.

CONTEXT: Beetroots have antioxidant and anti-inflammatory properties, which may help attenuate inflammation and oxidative stress, enhancing recovery from exercise-induced muscle damage (EIMD). OBJECTIVE: To evaluate the effects of beetroot supplementation on oxidative stress, inflammation, and recovery after EIMD. DATA SOURCES: SPORTDiscus, PubMed, Web of Science, and Scopus databases were searched, and hand-searching was performed by looking to relevant studies that were cited in other studies. STUDY SELECTION: For a study to be included in this review, the following inclusion criteria had to be met: (1) research conducted with human participants, (2) original articles in peer-reviewed publications, (3) original studies that had investigated beetroot supplementation intervention on muscle damage and recovery, (4) research conducted with 1 control/placebo group, and (5) articles published from inception to October 2020. STUDY DESIGN: Systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Two of the 4 authors independently extracted data and assessed the methodological quality of the articles with the PEDro scale. All discrepancies were resolved through a consensus meeting. RESULTS: A total of 9 studies were included in this review. The methodological quality of the included studies ranged from moderate to high. Most of the studies found a better recovery of functional variables and muscle soreness, but improvements in markers of muscle damage, inflammation, and oxidative stress were not reported. CONCLUSION: The existing evidence suggests that a short-term beetroot supplementation has the potential to accelerate recovery of functional measures and muscle soreness, but further research is needed to clarify if a longer supplementation period (with some days before exercise and some days after) could also promote recovery of markers of muscle damage, inflammation, and oxidative stress.

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).

Effects of omega-3 supplementation on muscle damage after resistance exercise in young women: a randomized placebo-controlled trial.

BACKGROUND: Omega-3 is a nutritional strategie that have been used to recover muscles from exercise-induced muscle damage in a preventive perspective. AIM: To verify whether omega-3 (ω-3) supplementation after a session of resistance exercise facilitates muscle recovery in women undergoing a balanced diet. METHODS: This clinical trial was registered under the number NCT02839525. Thirty healthy women (22.2 ± 3.3 years) participated in this double-blinded, placebo-controlled trial. They were randomly distributed into ω-3 (n=15) and placebo (n=15) groups. They ingested ω-3 fish oil (3200 mg/day) or placebo (olive oil) at the dinner after the exercise bout (10 sets of 10 unilateral eccentric contractions in a knee extension chair), as well as at lunch for the three subsequent days. In addition, both groups followed a balanced diet along the four days. Muscle soreness and maximal isometric and isokinetic voluntary contractions were assessed immediately before, and 24, 48, and 72 hours after the resistance exercise. MAIN FINDINGS: There was no significant group-time interaction for any outcome. Participants presented increased levels of muscle soreness and reduced muscle strength capacity along the three days after exercise. There was no difference between placebo and ω-3 groups. CONCLUSION: Supplementation of ω-3 fish oil for three days after resistance exercise provided no additional benefits compared to placebo supplementation on recovery of healthy young women following a balanced diet.

The Effect of Nitrate-Rich Beetroot Juice on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention Trials.

This systematic review and meta-analysis of randomized controlled trials examined whether dietary nitrate supplementation attenuates exercise-induced muscle damage (EIMD) and is reported according to the PRISMA guidelines. Medline and SPORTDiscus databases were searched from inception to June 2020. Inclusion criteria were studies in adult humans consuming inorganic nitrate before and after exercise and that measured markers implicated in the etiology of EIMD (muscle function, muscle soreness, inflammation, myocellular protein efflux, oxidative stress, range of motion) <168 h post. The Cochrane Collaboration risk of bias two tool was used to critically appraise the studies; forest plots were generated with random-effects models and standardized mean differences (SMD). Nine studies were included in the systematic review and six in the meta-analysis. All studies were rated to have some concerns for risk of bias. All trials in the meta-analysis provided nitrate as beetroot juice, which accelerated isometric strength recovery 72 h post-exercise (SMD: 0.54, p = 0.01) and countermovement jump performance 24-72 h post-exercise (SMD range: 0.75-1.32, p < 0.03). Pressure pain threshold was greater with beetroot juice 48 (SMD: 0.58, p = 0.03) and 72 h post-exercise (SMD: 0.61, p = 0.02). Beetroot juice had no effect on markers of oxidative stress and creatine kinase (p > 0.05), but c-reactive protein was higher vs. placebo at 48 h post-exercise (SMD: 0.55, p = 0.03). These findings suggest that nitrate-rich beetroot juice may attenuate some markers of EIMD, but more large-scale controlled trials in elite athletes are needed.

The effect of branched-chain amino acid on muscle damage markers and performance following strenuous exercise: a systematic review and meta-analysis.

This systematic review and meta-analysis determined whether the ergogenic effects of branched-chain amino acids (BCAA) ameliorated markers of muscle damage and performance following strenuous exercise. In total, 25 studies were included, consisting of 479 participants (age 24.3 ± 8.3 years, height 1.73 ± 0.06 m, body mass 70.8 ± 9.5 kg, females 26.3%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the BCAA and placebo conditions at 24 and 48 hours following muscle-damaging exercises, using standardised mean differences and associated p-values via forest plots. Our meta-analysis demonstrated significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) at 48 hours post-exercise (standardised mean difference [SMD] = -0.41; p < 0.05) for the BCAA than placebo conditions, whilst muscle soreness was significant at 24 hours post-exercise (SMD = -0.28 ≤ d ≤ -0.61; p < 0.05) and 48 hours post-exercise (SMD = -0.41 ≤ d≤ -0.92; p < 0.01). However, no significant differences were identified between the BCAA and placebo conditions for muscle performance at 24 or 48 hours post-exercise (SMD = 0.08 ≤ d ≤ 0.21; p > 0.05). Overall, BCAA reduced the level of muscle damage biomarkers and muscle soreness following muscle-damaging exercises. However, the potential benefits of BCAA for muscle performance recovery is questionable and warrants further investigation to determine the practicality of BCAA for ameliorating muscle damage symptoms in diverse populations. PROSPERO registration number: CRD42020191248. Novelty: BCAA reduces the level of creatine kinase and muscle soreness following strenuous exercise with a dose-response relationship. BCAA does not accelerate recovery for muscle performance.