The influence of carbohydrate and protein ingestion during recovery from prolonged exercise on subsequent endurance performance

Moringa oleifera leaf extracts improve exercise performance in young male adults: A pilot study

BACKGROUND

Moringa oleifera leaves are rich in bioactive substances.

PURPOSE

The purpose of this study was to evaluate the effects of Moringa oleifera leaf aqueous extract supplements on energy metabolism and antioxidant function in young male adults.

METHODS

Forty-four young male adults (26.3 ± 3.5 years) were randomly assigned to two groups: a supplement group (n = 23) receiving aqueous extract of Moringa oleifera leaves and a placebo group (n = 21). The supplementation period lasted for 30 days. Baseline measurements were taken at the beginning of the study, and further measurements were taken at the end of the supplementation period. Changes in upper- and lower-body strength, treadmill endurance, and certain blood biochemical parameters were evaluated.

RESULTS

After 30 days of supplementation, participants in the supplement group exhibited enhanced performance in push-ups and treadmill exhaustion tests compared to the placebo group. Levels of glucose, urea, malondialdehyde, and glutathione peroxidase activity in serum were also improved in the supplement group.

CONCLUSION

The findings suggest that Moringa oleifera leaf aqueous extracts have the potential to improve post-exercise energy metabolism and antioxidant function in young male adults.

Effects of the Timing of Carbohydrate Intake on Metabolism and Performance in Soccer Players

This study aims to provide information to improve the performance of athletes comparing the effects of carbohydrate-electrolyte intake before and during exercise on metabolism and performance in soccer players. The study had a single-blind cross-over design. Drust's protocol is a soccer-specific intermittent exercise test. The carbohydrate-electrolyte intake experiments were divided into three timings: first, pre-exercise; second, half-time; and third, mixed. Eight participants were included in the data analysis (age: 21.32 ± 1.19 years; BMI: 22.69 ± 1.91 kg/m2; height: 176.5 ± 7.52 cm; weight: 69.5 ± 9.18 kg; Vmax: 16.75 0.71 km/h). The results of the mixed test showed a significantly lower respiratory exchange ratio than those of the placebo and half-time tests (p < 0.05). The mixed test showed significantly more fat oxidation than the half-time test (p < 0.05). The running times are placebo (422.13 ± 133.44 s) and mixed (677.38 ± 217.75 s), and the distances are placebo (1577.25 ± 517.02 m) and mixed (2530.00 ± 832.71 m) (p < 0.05). The mixed test showed a significantly lower rating of perceived exertion than the placebo test (p < 0.05). Carbohydrate oxidation and heart rate showed no significant differences between the experiments (p > 0.05). The exercise protocol in this study showed the metabolic response of soccer players to intermittent high-intensity exercise and subsequent endurance exercise. In conclusion, it can be seen that the intake of carbohydrate-electrolytes improves the performance of soccer players, and the effect varies depending on the timing of carbohydrate-electrolyte intake.

Adding protein to a carbohydrate pre-exercise beverage does not influence running performance and metabolism

BACKGROUND

To analyze whether pre-exercise CHO+PRO vs. CHO intake distinctly influences running performance and metabolic biomarkers along a various of exercise intensities.

METHODS

In a randomized, double blind, counterbalanced, crossover and placebo control design, 10 middle distance runners were tested in 3 occasions. After 10 h of fasting, participants ingested isovolumic beverages (0.75+0.25g·BW^-1 of CHO+PRO, 1.0g·BW^-1 of CHO and placebo control) 30 min before a treadmill running incremental protocol of 4 min steps until exhaustion. Venous blood was collected at fasting, 30 min after beverage ingestion and after the 3^rd and 7^th running steps. Oxygen uptake-related variables, including respiratory exchange ratio, heart rate, plasma glucose, insulin, glucagon, free fatty acids, blood lactate concentrations, gastrointestinal discomfort and rate of perceived exertion were measured.

RESULTS

The addition of PRO to CHO had no influence on the measured variables, which did not differ between conditions along all incremental protocol intensities. The intake of CHO+PRO (compared to CHO) tended to decrease glycemia (106.5±21.3 vs. 113.6±26.5) and to increase insulinemia (14.4±15.1 vs. 12.7±10.8) at intensities close to maximum oxygen uptake.

CONCLUSIONS

The addition of PRO to a pre-exercise CHO beverage had no impact on running performance and related metabolic variables at a wide spectrum of exercise intensities.

The Effect of Co-Ingestion of Carbohydrate with Milk after Exercise in Healthy Women: Study Considering the Menstrual Cycle

This study aimed to assess the effects of co-ingestion of carbohydrate with milk (MILK) and isocaloric carbohydrate beverage (CHO) on post-exercise recovery and subsequent exercise capacity, considering the menstrual cycle. This study included 12 women with regular menstrual cycles who completed four test days, which started with glycogen-depleting exercise using a cycle ergometer in the early follicular phase (EF) and late follicular phase (LF), followed by 240 min of recovery from the ingestion of 200 mL of CHO or MILK every 30 min immediately after the exercise (POST0) until 210 min post-exercise. After 240 min, participants performed an exercise capacity test. Blood samples and breathing gas samples were collected before the exercise (PRE), POST0, and 120 (POST120) and 240 min after the end of exercise (POST240) to determine the concentrations of estradiol, progesterone, blood glucose, blood lactate, free fatty acid (FFA), and insulin and the respiratory exchange ratio, fat oxidation, and carbohydrate oxidation. The exercise time at exercise capacity test was not significantly different in terms of menstrual cycle phases and recovery beverages ingested. However, there was a significant positive correlation between the exercise capacity test and area under the curve (AUC) of FFA concentrations from POST0 to POST240 in each group (EF + CHO, p < 0.05; LF + CHO, p < 0.05; EF + MILK, p < 0.01; and LF + MILK, p < 0.05). The AUC of FFA from POST120 to POST240 showed no difference between EF (CHO and MILK) and LF (CHO and MILK). However, the AUC of FFA concentrations from POST120 to POST240 was significantly greater in MILK (EF and LF) than that in CHO (EF and LF) (p < 0.05). In active women, circulating substrates and hormone concentrations during short recovery post-exercise are not affected by the menstrual cycle. However, MILK may affect circulating substrates during recovery and the exercise capacity after recovery.

Short-Term Oral Quercetin Supplementation Improves Post-exercise Insulin Sensitivity, Antioxidant Capacity and Enhances Subsequent Cycling Time to Exhaustion in Healthy Adults: A Pilot Study

Aim

Quercetin has been reported to have antioxidant and anti-inflammatory properties on health promotion in human studies. The main purpose of this study was to investigate the effect of short-term oral quercetin supplementation on post-exercise whole-body energy metabolism. This study also aimed to determine the effects of supplementation on oxygen stress, inflammation, muscle damage, and high-intensity cycling exercise performance.

Method

Twelve healthy participants, physically active students, were recruited to perform a randomized, single-blind crossover study. All subjects completed 7-days of quercetin (quercetin:1,000 mg per day for 7-days) and placebo supplementation in a randomized order. Supplement/placebo was combined with exercise consisting of 70% V̇O_2max cycling for 60-min, followed by 3-h of recovery, then a subsequent single bout of cycling exercise with 75% V̇O_2max to exhaustion. Time to exhaustion, indicators of muscle damage, as well as blood and gaseous parameters relating to energy metabolism, oxidative stress, inflammatory response, respectively, were determined.

Results

The results showed that 7-day quercetin supplementation significantly attenuated the post-exercise glucose-induced insulin response, increased total antioxidant capacity (TAC) and superoxidase dismutase (SOD) activities, and mitigated malondialdehyde (MDA) levels during the recovery period (p < 0.05). While subsequent 75% V̇O_2max cycling performance was significantly improved after quercetin treatment and accompanied by lower responses of interleukin 6 and creatine kinase at 24-h. However, it’s noted that there were no significant responses in glucose, respiratory exchange rate, tumor necrosis factor-α (TNF-α), myoglobin, and high sensitivity C-reactive protein between quercetin and placebo trials.

Conclusion

Our findings concluded that 7-day oral quercetin supplementation enhances high-intensity cycling time to exhaustion, which may be due in part to the increase in whole-body insulin-stimulated glucose uptake and attenuation of exercise-induced oxygen stress and pro-inflammation. Therefore, quercetin may be considered an effective ergogenic aid for enhancing high-intensity cycling performance among young adults.

The Validity of Ultrasound Technology in Providing an Indirect Estimate of Muscle Glycogen Concentrations Is Equivocal

Researchers and practitioners in sports nutrition would greatly benefit from a rapid, portable, and non-invasive technique to measure muscle glycogen, both in the laboratory and field. This explains the interest in MuscleSound^®, the first commercial system to use high-frequency ultrasound technology and image analysis from patented cloud-based software to estimate muscle glycogen content from the echogenicity of the ultrasound image. This technique is based largely on muscle water content, which is presumed to act as a proxy for glycogen. Despite the promise of early validation studies, newer studies from independent groups reported discrepant results, with MuscleSound^® scores failing to correlate with the glycogen content of biopsy-derived mixed muscle samples or to show the expected changes in muscle glycogen associated with various diet and exercise strategies. The explanation of issues related to the site of assessment do not account for these discrepancies, and there are substantial problems with the premise that the ratio of glycogen to water in the muscle is constant. Although further studies investigating this technique are warranted, current evidence that MuscleSound^® technology can provide valid and actionable information around muscle glycogen stores is at best equivocal.

Assessing Overall Exercise Recovery Processes Using Carbohydrate and Carbohydrate-Protein Containing Recovery Beverages

We compared the impact of two different, but commonly consumed, beverages on integrative markers of exercise recovery following a 2 h high intensity interval exercise (i.e., running 70-80% V̇O2 max intervals and interspersed with plyometric jumps). Participants (n = 11 males, n = 6 females) consumed a chocolate flavored dairy milk beverage (CM: 1.2 g carbohydrate/kg BM and 0.4 g protein/kg BM) or a carbohydrate-electrolyte beverage (CEB: isovolumetric with 0.76 g carbohydrate/kg BM) after exercise, in a randomized-crossover design. The recovery beverages were provided in three equal boluses over a 30 min period commencing 1 h post-exercise. Muscle biopsies were performed at 0 h and 2 h in recovery. Venous blood samples, nude BM and total body water were collected before and at 0, 2, and 4 h recovery. Gastrointestinal symptoms and breath hydrogen (H2) were collected before exercise and every 30 min during recovery. The following morning, participants returned for performance assessment. In recovery, breath H2 reached clinical relevance of >10 ppm following consumption of both beverages, in adjunct with high incidence of gastrointestinal symptoms (70%), but modest severity. Blood glucose response was greater on CEB vs. CM (P < 0.01). Insulin response was greater on CM compared with CEB (P < 0.01). Escherichia coli lipopolysaccharide stimulated neutrophil function reduced on both beverages (49%). p-GSK-3β/total-GSK-3β was greater on CM compared with CEB (P = 0.037); however, neither beverage achieved net muscle glycogen re-storage. Phosphorylation of mTOR was greater on CM than CEB (P < 0.001). Fluid retention was lower (P = 0.038) on CEB (74.3%) compared with CM (82.1%). Physiological and performance outcomes on the following day did not differ between trials. Interconnected recovery optimization markers appear to respond differently to the nutrient composition of recovery nutrition, albeit subtly and with individual variation. The present findings expand on recovery nutrition strategies to target functionality and patency of the gastrointestinal tract as a prerequisite to assimilation of recovery nutrition, as well as restoration of immunocompetency.

Does the Nutritional Composition of Dairy Milk Based Recovery Beverages Influence Post-exercise Gastrointestinal and Immune Status, and Subsequent Markers of Recovery Optimisation in Response to High Intensity Interval Exercise?

This study aimed to determine the effects of flavored dairy milk based recovery beverages of different nutrition compositions on markers of gastrointestinal and immune status, and subsequent recovery optimisation markers. After completing 2 h high intensity interval running, participants (n = 9) consumed a whole food dairy milk recovery beverage (CM, 1.2 g/kg body mass (BM) carbohydrate and 0.4 g/kg BM protein) or a dairy milk based supplement beverage (MBSB, 2.2 g/kg BM carbohydrate and 0.8 g/kg BM protein) in a randomized crossover design. Venous blood samples, body mass, body water, and breath samples were collected, and gastrointestinal symptoms (GIS) were measured, pre- and post-exercise, and during recovery. Muscle biopsies were performed at 0 and 2 h of recovery. The following morning, participants returned to the laboratory to assess performance outcomes. In the recovery period, carbohydrate malabsorption (breath H₂ peak: 49 vs. 24 ppm) occurred on MBSB compared to CM, with a trend toward greater gut discomfort. No difference in gastrointestinal integrity (i.e., I-FABP and sCD14) or immune response (i.e., circulating leukocyte trafficking, bacterially-stimulated neutrophil degranulation, and systemic inflammatory profile) markers were observed between CM and MBSB. Neither trial achieved a positive rate of muscle glycogen resynthesis [-25.8 (35.5) mmol/kg dw/h]. Both trials increased phosphorylation of intramuscular signaling proteins. Greater fluid retention (total body water: 86.9 vs. 81.9%) occurred on MBSB compared to CM. Performance outcomes did not differ between trials. The greater nutrient composition of MBSB induced greater gastrointestinal functional disturbance, did not prevent the post-exercise reduction in neutrophil function, and did not support greater overall acute recovery.

The Effect of Ingesting Carbohydrate and Proteins on Athletic Performance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Endurance athletes participating in sporting events may be required to complete multiple training sessions a day or on successive days with a limited recovery time. Nutritional interventions that enhance the restoration of endogenous fuel stores (e.g., liver and muscle glycogen) and improve muscle damage repair have received a lot of attention. The purpose of this review is to investigate the effect of ingesting carbohydrate (CHO) and protein (PRO) on athletic performance. Studies were identified by searching the electronic databases PubMed and EMBASE. Random-effects meta-analyses were conducted to examine the intervention efficacy. A total of 30 randomized controlled trials (RCT), comprising 43 trials and 326 participants in total, were included in this review. The meta-analysis showed an overall significant effect in Time-To-Exhaustion (TTE) and Time-Trial (TT) performance, when ingesting carbohydrates and proteins (CHO-PRO) compared to CHO-only (p = 0.03 and p = 0.0007, respectively). A subgroup analysis demonstrated a significant effect in TTE by ingesting CHO-PRO compared to CHO, when supplements were provided during and/or following an exercise bout. CHO-PRO significantly improved TTE compared to CHO-only, when a long-term recovery (i.e., ≥8 h) was implemented (p = 0.001). However, no effect was found when the recovery time was short-term (i.e., ≤8 h). No significant effect was observed when CHO-PRO and CHO-only supplements were isocaloric. However, a significant improved TTE was evident with CHO-PRO compared to CHO-only, when the supplements were matched for carbohydrate content (p < 0.00001). In conclusion, co-ingesting carbohydrates and proteins appears to enhance TTE and TT performance compared to CHO-only and presents a compelling alternate feeding strategy for athletes.

Presleep Protein Supplementation Does Not Improve Recovery During Consecutive Days of Intense Endurance Training: A Randomized Controlled Trial

Recent studies demonstrate that protein ingestion immediately before sleep improves muscle recovery during the night following resistance exercise. Whether this feeding strategy benefits recovery from endurance training has yet to be established. The aim of this study was to investigate the effects of whey protein isolate ingested every night before sleep on subsequent performance and circulatory markers of muscular recovery during a week of intensified endurance training mimicking a training camp. In a parallel design, 32 trained runners underwent a 1-week intervention with a rigorously controlled diet (carbohydrate = 7.2 g·kg^-1·day^-1, protein = 1.8 g·kg^-1·day^-1, and fat = 1.0 g·kg^-1·day^-1) and exercise program (11 sessions) while receiving either a protein (0.5 g·kg^-1·day^-1) or carbohydrate (0.5 g·kg^-1·day^-1) beverage every night before sleep. Blood samples were obtained on the morning of Days 1, 4, 7, and 8 and analyzed for markers of muscle damage (creatine kinase, lactate dehydrogenase, and myoglobin). The postintervention 5-km time-trial performance was significantly impaired in both groups (11 ± 24 s, p < .01). Plasma creatine kinase (227% ± 221%, p < .01), lactate dehydrogenase (18% ± 22%, p < .01), and myoglobin (72% ± 62%, p < .01) increased gradually throughout the week with no difference between the groups (p > .05). In conclusion, the presleep protein ingestion did not reduce the decline in performance or ameliorate the rise of circulatory markers of muscle damage during a week of intensified training when compared with the isocaloric carbohydrate ingestion.

Performance Effects of Carbohydrate Ingestion Between Bouts of Intense Aerobic Interval Exercise

PURPOSE

This study tested whether CHO intake during a 2-h rest between exercise bouts improved performance in the subsequent bout.

METHODS

In a randomized, single-blinded, crossover design, 10 recreationally-active participants (23 ± 4 yr, 70.8 ± 6.6 kg, VO_2peak:47.0 ± 5.4 mL O₂·min^-1·kg body mass^-1) arrived at the lab post-prandial and completed 2 exercise bouts separated by 2-h rest. Bouts included 5 x 4-min intervals at ~80% VO_2peak separated by 2-min at ~40% VO_2peak and ended with an endurance trial (ET) to voluntary exhaustion at ~90% VO_2peak. During intervals 1 and 4 in each bout expired gases were collected and O₂ deficit was estimated. Immediately following bout-1, either a CHO (1.2 g CHO·kg body mass^-1) or placebo (PL) solution was consumed.

RESULTS

ET duration decreased in bout-2 vs. 1 in both conditions (P<0.01) but was ~35% longer in bout-2 with CHO vs. PL (Interaction, P=0.03; post-hoc, P=0.03). VO₂ increased during interval 4 vs. 1 in both bouts (P<0.01) but was unaffected by CHO (P≥0.58). O₂ deficit was unaffected by CHO (P=0.93), bout or interval (P≥0.15). Perceived exertion was higher in bout-2 vs. 1 (P<0.001) and reduced in intervals 2 and 4 in CHO (P≤0.01).

CONCLUSIONS

When rest between training sessions is 2 hours, athletes may improve subsequent performance by consuming CHO during recovery. Supported by NSERC, Canada.

Protein intake in the early recovery period after exhaustive exercise improves performance the following day

The aim of the present study was to investigate the effect of protein and carbohydrate ingestion during early recovery from exhaustive exercise on performance after 18-h recovery. Eight elite cyclists (V̇o2max: 74.0 ± 1.6 ml·kg−1·min−1) completed two exercise and diet interventions in a double-blinded, randomized, crossover design. Participants cycled first at 73% of V̇o2max (W73%) followed by 1-min intervals at 90% of V̇o2max until exhaustion. During the first 2 h of recovery, participants ingested either 1.2 g carbohydrate·kg−1·h−1 (CHO) or 0.8 g carbohydrate + 0.4 g protein·kg−1·h−1 (CHO + PROT). The diet during the remaining recovery period was similar for both interventions and adjusted to body weight. After an 18-h recovery, cycling performance was assessed with a 10-s sprint test, 30 min of cycling at W73%, and a cycling time trial (TT). The TT was 8.5% faster (41:53 ± 1:51 vs. 45:26 ± 1:32 min; P < 0.03) after CHO + PROT compared with CHO. Mean power output during the sprints was 3.7% higher in CHO + PROT compared with CHO (1,063 ± 54 vs. 1,026 ± 53 W; P = 0.01). Nitrogen balance in the recovery period was negative in CHO and neutral in CHO + PROT (−82.4 ± 11.5 vs. 7.0 ± 15.4 mg/kg; P < 0.01). In conclusion, TT and sprint performances were improved 18 h after exhaustive cycling by CHO + PROT supplementation during the first 2 h of recovery compared with isoenergetic CHO supplementation. Our results indicate that intake of carbohydrate plus protein after exhaustive endurance exercise more rapidly converts the body from a catabolic to an anabolic state than carbohydrate alone, thus speeding recovery and improving subsequent cycling performance.

NEW & NOTEWORTHY Prolonged high intensity endurance exercise depends on glycogen utilization and high oxidative capacity. Still, exhaustion develops and effective recovery strategies are required to compete in multiday stage races. We show that coingestion of protein and carbohydrate during the first 2 h of recovery is superior to isoenergetic intake of carbohydrate to stimulate recovery, and improves both endurance time-trial and 10-s sprint performance the following day in elite cyclists.

Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance

BACKGROUND

Athletes may complete consecutive exercise sessions with limited recovery time between bouts (e.g. ≤ 4 h). Nutritional strategies that optimise post-exercise recovery in these situations are therefore important.

OBJECTIVE

This two-part review investigated the effect of consuming carbohydrate (CHO) and protein with water (W) following exercise on subsequent athletic (endurance/anaerobic exercise) performance.

DATA SOURCES

Studies were identified by searching the online databases SPORTDiscus, PubMed, Web of Science and Scopus.

STUDY ELIGIBILITY CRITERIA AND INTERVENTIONS

Investigations that measured endurance performance (≥ 5 min duration) ≤ 4 h after a standardised exercise bout (any type) under the following control vs. intervention conditions were included: Part 1: W vs. CHO ingested with an equal volume of W (CHO + W); and, Part 2: CHO + W vs. protein (PRO) ingested with CHO and an equal volume of W (PRO + CHO + W), where CHO or energy intake was matched.

STUDY APPRAISAL AND SYNTHESIS METHODS

Publications were examined for bias using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy.

RESULTS

The quality assessment yielded a Rosendal score of 63 ± 9% (mean ± standard deviation). Part 1: 45 trials (n = 486) were reviewed. Ingesting CHO + W (102 ± 50 g CHO; 0.8 ± 0.6 g CHO kg^-1 h^-1) improved exercise performance compared with W (1.6 ± 0.7 L); %_Δ mean power output = 4.0, 95% confidence interval 3.2-4.7 (I ² = 43.9). Improvement was attenuated when participants were 'Fed' (a meal 2-4 h prior to the initial bout) as opposed to 'Fasted' (p = 0.012). Part 2: 13 trials (n = 125) were reviewed. Ingesting PRO + CHO + W (35 ± 26 g PRO; 0.5 ± 0.4 g PRO kg^-1) did not affect exercise performance compared with CHO + W (115 ± 61 g CHO; 0.6 ± 0.3 g CHO·kg body mass^-1 h^-1; 1.2 ± 0.6 L); %_Δ mean power output = 0.5, 95% confidence interval - 0.5 to 1.6 (I ² = 72.9).

CONCLUSIONS

Athletes with limited time for recovery between consecutive exercise sessions should prioritise CHO and fluid ingestion to enhance subsequent athletic performance. PROSPERO REGISTRATION NUMBER: CRD42016046807.

Restoration of Muscle Glycogen and Functional Capacity: Role of Post-Exercise Carbohydrate and Protein Co-Ingestion

The importance of post-exercise recovery nutrition has been well described in recent years, leading to its incorporation as an integral part of training regimes in both athletes and active individuals. Muscle glycogen depletion during an initial prolonged exercise bout is a main factor in the onset of fatigue and so the replenishment of glycogen stores may be important for recovery of functional capacity. Nevertheless, nutritional considerations for optimal short-term (3–6 h) recovery remain incompletely elucidated, particularly surrounding the precise amount of specific types of nutrients required. Current nutritional guidelines to maximise muscle glycogen availability within limited recovery are provided under the assumption that similar fatigue mechanisms (i.e., muscle glycogen depletion) are involved during a repeated exercise bout. Indeed, recent data support the notion that muscle glycogen availability is a determinant of subsequent endurance capacity following limited recovery. Thus, carbohydrate ingestion can be utilised to influence the restoration of endurance capacity following exhaustive exercise. One strategy with the potential to accelerate muscle glycogen resynthesis and/or functional capacity beyond merely ingesting adequate carbohydrate is the co-ingestion of added protein. While numerous studies have been instigated, a consensus that is related to the influence of carbohydrate-protein ingestion in maximising muscle glycogen during short-term recovery and repeated exercise capacity has not been established. When considered collectively, carbohydrate intake during limited recovery appears to primarily determine muscle glycogen resynthesis and repeated exercise capacity. Thus, when the goal is to optimise repeated exercise capacity following short-term recovery, ingesting carbohydrate at an amount of ≥1.2 g kg body mass⁻¹·h⁻¹ can maximise muscle glycogen repletion. The addition of protein to carbohydrate during post-exercise recovery may be beneficial under circumstances when carbohydrate ingestion is sub-optimal (≤0.8 g kg body mass⁻¹·h⁻¹) for effective restoration of muscle glycogen and repeated exercise capacity.

Protein supplementation enhances cerebral oxygenation during exercise in elite basketball players

OBJECTIVE

The aim of the present study was to examine cerebral oxygenation during high-intensity exercise in elite basketball players who consumed supplements with different whey protein contents after a short postexercise recovery to determine whether changing whey protein content in carbohydrate-based supplementation influences cerebral hemodynamic response when the supplement was consumed during a 2-h recovery after a 1-h exercise challenge.

METHODS

This was a randomized, counterbalanced crossover study. Fifteen Division 1 collegiate basketball players (18-20 y) consumed 6.25 kcal/kg of either high-protein (36% protein in total calorie) or an isocaloric low-protein (12% protein in total calorie) control supplement in a carbohydrate-based drink immediately after a 1-h cycling (70% of maximal oxygen consumption [VO_2max]). After a 2-h rest, the athletes were challenged on a cycloergometer at 80% VO_2max. Blood perfusion (total hemoglobin) and oxygen saturation of frontal brain were continuously measured by near-infrared spectroscopy during the cycling.

RESULTS

Before the cycloergometer test, high-protein supplementation increased peak insulin response and lowered glucose increases during the recovery compared with the low-protein trial. High-protein supplementation enhanced increases in cerebral oxygen saturation (P < 0.01) and attenuated increases in cerebral blood perfusion (total hemoglobin; P < 0.01) during the cycloergometer exercise; and resulted in a 16% longer cycling time (from 474 ± 49 s to 553 ± 78 s, P < 0.05), compared with the low-protein trial.

CONCLUSION

Enhanced fatigue recovery after consumption of a high-protein supplement is associated with enhanced cerebral oxygenation against exercise challenge, which spares brain blood demand for periphery.

Protein intake during training sessions has no effect on performance and recovery during a strenuous training camp for elite cyclists

Background

Training camps for top-class endurance athletes place high physiological demands on the body. Focus on optimizing recovery between training sessions is necessary to minimize the risk of injuries and improve adaptations to the training stimuli. Carbohydrate supplementation during sessions is generally accepted as being beneficial to aid performance and recovery, whereas the effect of protein supplementation and timing is less well understood. We studied the effects of protein ingestion during training sessions on performance and recovery of elite cyclists during a strenuous training camp.

Methods

In a randomized, double-blinded study, 18 elite cyclists consumed either a whey protein hydrolysate-carbohydrate beverage (PRO-CHO, 14 g protein/h and 69 g CHO/h) or an isocaloric carbohydrate beverage (CHO, 84 g/h) during each training session for six days (25–29 h cycling in total). Diet and training were standardized and supervised. The diet was energy balanced and contained 1.7 g protein/kg/day. A 10-s peak power test and a 5-min all-out performance test were conducted before and after the first training session and repeated at day 6 of the camp. Blood and saliva samples were collected in the morning after overnight fasting during the week and analyzed for biochemical markers of muscle damage, stress, and immune function.

Results

In both groups, 5-min all-out performance was reduced after the first training session and at day 6 compared to before the first training session, with no difference between groups. Peak power in the sprint test did not change significantly between tests or between groups. In addition, changes in markers for muscle damage, stress, and immune function were not significantly influenced by treatment.

Conclusions

Intake of protein combined with carbohydrate during cycling at a training camp for top cyclists did not result in marked performance benefits compared to intake of carbohydrates when a recovery drink containing adequate protein and carbohydrate was ingested immediately after each training session in both groups. These findings suggest that the addition of protein to a carbohydrate supplement consumed during exercise does not improve recovery or performance in elite cyclists despite high demands of daily exhaustive sessions during a one-week training camp.

A multi-ingredient containing carbohydrate, proteins L-glutamine and L-carnitine attenuates fatigue perception with no effect on performance, muscle damage or immunity in soccer players

We investigated the effects of ingesting a multi-ingredient (53g carbohydrate, 14.5g whey protein, 5g glutamine, 1.5g L-carnitine-L-tartrate) supplement, carbohydrate only, or placebo on intermittent performance, perception of fatigue, immunity, and functional and metabolic markers of recovery. Sixteen amateur soccer players ingested their respective treatments before, during and after performing a 90-min intermittent repeated sprint test. Primary outcomes included time for a 90-min intermittent repeated sprint test (IRS) followed by eleven 15 m sprints. Measurements included creatine kinase, myoglobin, interleukine-6, Neutrophil; Lymphocytes and Monocyte before (pre), immediately after (post), 1h and 24h after exercise testing period. Overall, time for the IRS and 15 m sprints was not different between treatments. However, the perception of fatigue was attenuated (P<0.001) for the multi-ingredient (15.9±1.4) vs. placebo (17.8±1.4) but not for the carbohydrate (17.0±1.9) condition. Several changes in immune/inflammatory indices were noted as creatine kinase peaked at 24h while Interleukin-6 and myoglobin increased both immediately after and at 1h compared with baseline (P<0.05) for all three conditions. However, Myoglobin (P<0.05) was lower 1h post-exercise for the multi-ingredient (241.8±142.6 ng·ml^-1) and CHO (265.4±187.8 ng·ml^-1) vs. placebo (518.6±255.2 ng·ml^-1). Carbohydrate also elicited lower neutrophil concentrations vs. multi-ingredient (3.9±1.5 10⁹/L vs. 4.9±1.8 10⁹/L, P = 0.016) and a reduced (P<0.05) monocytes count (0.36±0.09 10⁹/L) compared to both multi-ingredient (0.42±0.09 10⁹/L) and placebo (0.42±0.12 10⁹/L). In conclusion, multi-ingredient and carbohydrate supplements did not improve intermittent performance, inflammatory or immune function. However, both treatments did attenuate serum myoglobin, while only carbohydrate blunted post-exercise leukocytosis.

Effects of protein in combination with carbohydrate supplements on acute or repeat endurance exercise performance: a systematic review

BACKGROUND

Protein supplements are consumed frequently by athletes and recreationally active adults for various reasons, including improved exercise performance and recovery after exercise. Yet, far too often, the decision to purchase and consume protein supplements is based on marketing claims rather than available evidence-based research.

OBJECTIVE

The purpose of this review was to provide a systematic and comprehensive analysis of the literature that tested the hypothesis that protein supplements, when combined with carbohydrate, directly enhance endurance performance by sparing muscle glycogen during exercise and increasing the rate of glycogen restoration during recovery. The analysis was used to create evidence statements based on an accepted strength of recommendation taxonomy.

DATA SOURCES

English language articles were searched with PubMed and Google Scholar using protein and supplements together with performance, exercise, competition, and muscle, alone or in combination as keywords. Additional articles were retrieved from reference lists found in these papers.

STUDY SELECTION

Inclusion criteria specified recruiting healthy active adults less than 50 years of age and evaluating the effects of protein supplements in combination with carbohydrate on endurance performance metrics such as time-to-exhaustion, time-trial, or total power output during sprint intervals. The literature search identified 28 articles, of which 26 incorporated test metrics that permitted exclusive categorization into one of the following sections: ingestion during an acute bout of exercise (n = 11) and ingestion during and after exercise to affect subsequent endurance performance (n = 15). The remaining two articles contained performance metrics that spanned both categories.

STUDY APPRAISAL AND SYNTHESIS METHODS

All papers were read in detail and searched for experimental design confounders such as energy content of the supplements, dietary control, use of trained or untrained participants, number of subjects recruited, direct measures of muscle glycogen utilization and restoration, and the sensitivity of the test metrics to explain the discrepant findings.

RESULTS

Our evidence statements assert that when carbohydrate supplementation was delivered at optimal rates during or after exercise, protein supplements provided no further ergogenic effect, regardless of the performance metric used. In addition, the limited data available suggested recovery of muscle glycogen stores together with subsequent rate of utilization during exercise is not related to the potential ergogenic effect of protein supplements.

LIMITATIONS

Many studies lacked ability to measure direct effects of protein supplementation on muscle metabolism through determination of muscle glycogen, kinetic assessments of protein turnover, or changes in key signaling proteins, and therefore could not substantiate changes in rates of synthesis or degradation of protein. As a result, the interpretation of their data was often biased and inconclusive since they lacked ability to test the proposed underlying mechanism of action.

CONCLUSIONS

When carbohydrate is delivered at optimal rates during or after endurance exercise, protein supplements appear to have no direct endurance performance enhancing effect.

Post-Exercise Protein Trial: Interactions between Diet and Exercise (PEPTIDE): study protocol for randomized controlled trial

BACKGROUND

Performing regular exercise is known to manifest a number of health benefits that mainly relate to cardiovascular and muscular adaptations to allow for greater oxygen extraction and utilization. There is increasing evidence that nutrient intake can affect the adaptive response to a single exercise bout, and that protein feeding is important to facilitate this process. Thus, the exercise-nutrient interaction may potentially lead to a greater response to training. The role of post-exercise protein ingestion in enhancing the effects of running-based endurance exercise training relative to energy-matched carbohydrate intervention remains to be established. Additionally, the influence of immediate versus overnight protein ingestion in mediating these training effects is currently unknown. The current protocol aims to establish whether post-exercise nutrient intake and timing would influence the magnitude of improvements during a prescribed endurance training program.

METHODS/DESIGN

The project involves two phases with each involving two treatment arms applied in a randomized investigator-participant double-blind parallel group design. For each treatment, participants will be required to undergo six weeks of running-based endurance training. Immediately post-exercise, participants will be prescribed solutions providing 0.4 grams per kilogram of body mass (g · kg(-1)) of whey protein hydrolysate plus 0.4 g · kg(-1) sucrose, relative to an isocaloric sucrose control (0.8 g · kg(-1); Phase I). In Phase II, identical protein supplements will be provided (0.4 + 0.4 g · kg(-1) · h(-1) of whey protein hydrolysate and sucrose, respectively), with the timing of ingestion manipulated to compare immediate versus overnight recovery feedings. Anthropometric, expired gas, venous blood and muscle biopsy samples will be obtained at baseline and following the six-week training period.

DISCUSSION

By investigating the role of nutrition in enhancing the effects of endurance exercise training, we will provide novel insight regarding nutrient-exercise interactions and the potential to help and develop effective methods to maximize health or performance outcomes in response to regular exercise.

TRIAL REGISTRATION

Current Controlled Trials registration number: ISRCTN27312291 (date assigned: 4 December 2013). The first participant was randomized on 11 December 2013.

Pre-exercise nutrition: the role of macronutrients, modified starches and supplements on metabolism and endurance performance

Endurance athletes rarely compete in the fasted state, as this may compromise fuel stores. Thus, the timing and composition of the pre-exercise meal is a significant consideration for optimizing metabolism and subsequent endurance performance. Carbohydrate feedings prior to endurance exercise are common and have generally been shown to enhance performance, despite increasing insulin levels and reducing fat oxidation. These metabolic effects may be attenuated by consuming low glycemic index carbohydrates and/or modified starches before exercise. High fat meals seem to have beneficial metabolic effects (e.g., increasing fat oxidation and possibly sparing muscle glycogen). However, these effects do not necessarily translate into enhanced performance. Relatively little research has examined the effects of a pre-exercise high protein meal on subsequent performance, but there is some evidence to suggest enhanced pre-exercise glycogen synthesis and benefits to metabolism during exercise. Finally, various supplements (i.e., caffeine and beetroot juice) also warrant possible inclusion into pre-race nutrition for endurance athletes. Ultimately, further research is needed to optimize pre-exercise nutritional strategies for endurance performance.

Effect of a special carbohydrate-protein bar and tomato juice supplementation on oxidative stress markers and vascular endothelial dynamics in ultra-marathon runners

It is well established that exercise induces excessive production of reactive species leading to oxidative stress, which has been implicated in oxidative damage of macromolecules, immune dysfunction, muscle damage and fatigue. The present study examined the effect of supplementation of ultra-marathon runners for a two-months-period with a special whey protein bar containing carbohydrates and protein in a specific ratio (1:1) (N=16), prepared using as starting material the by-products of cheese manufacturing, and supplementation with commercially available tomato juice (N=15). Thiobarbituric-acid reactive substances and protein carbonyls were significantly decreased in both supplementation groups, while a pronounced increased in reduced glutathione was observed in the protein bar group. Total anti-oxidant activity remained unchanged in both groups. Flow-mediated dilatation, used as an estimate of endothelial function, was increased in both groups, with a significant rise observed only in the tomato juice administration group. In conclusion, supplementation of ultra marathon runners for a two-months-period with a special protein bar and tomato juice significantly improved the oxidative status of the subjects, while tomato juice also improved vascular endothelial function in these athletes.

Exploring mechanisms of fatigue during repeated exercise and the dose dependent effects of carbohydrate and protein ingestion: study protocol for a randomised controlled trial

Background

Muscle glycogen has been well established as the primary metabolic energy substrate during physical exercise of moderate- to high-intensity and has accordingly been implicated as a limiting factor when such activity is sustained for a prolonged duration. However, the role of this substrate during repeated exercise after limited recovery is less clear, with ongoing debate regarding how recovery processes can best be supported via nutritional intervention. The aim of this project is to examine the causes of fatigue during repeated exercise bouts via manipulation of glycogen availability through nutritional intervention, thus simultaneously informing aspects of the optimal feeding strategy for recovery from prolonged exercise.

Methods/Design

The project involves two phases with each involving two treatment arms administered in a repeated measures design. For each treatment, participants will be required to exercise to the point of volitional exhaustion on a motorised treadmill at 70% of previously determined maximal oxygen uptake, before a four hour recovery period in which participants will be prescribed solutions providing 1.2 grams of sucrose per kilogram of body mass per hour of recovery (g.kg^-1.h^-1) relative to either a lower rate of sucrose ingestion (that is, 0.3 g.kg^-1. h^-1; Phase I) or a moderate dose (that is, 0.8 g.kg^-1.h^-1) rendered isocaloric via the addition of 0.4 g.kg^-1.h^-1 whey protein hydrolysate (Phase II); the latter administered in a double blind manner as part of a randomised and counterbalanced design. Muscle biopsies will be sampled at the beginning and end of recovery for determination of muscle glycogen resynthesis rates, with further biopsies taken following a second bout of exhaustive exercise to determine differences in substrate availability relative to the initial sample taken following the first exercise bout.

Discussion

Phase I will inform whether a dose–response relationship exists between carbohydrate ingestion rate and muscle glycogen availability and/or the subsequent capacity for physical exercise. Phase II will determine whether such effects are dependent on glycogen availability per se or energy intake, potentially via protein mediated mechanisms.

Trial registration

ISRCTN87937960.

The ingestion of protein with a maltodextrin and fructose beverage on substrate utilisation and exercise performance

The study investigated the ingestion of maltodextrin, fructose, and protein on exogenous carbohydrate oxidation (CHOEXO) and exercise performance. Seven trained cyclists and (or) triathletes (maximal oxygen consumption, 59.20 ± 9.00 mL·kg−1·min−1) performed 3 exercise trials that consisted of 150 min of cycling at 50% maximal power output (160 ± 11 W), followed by a 60-km time trial. One of 3 beverages were randomly assigned during each trial and consumed at 15-min intervals: (i) 0.84 g·min−1 maltodextrin + 0.52 g·min−1 fructose + 0.34 g·min−1 protein (MD+F+P); (ii) 1.10 g·min−1 maltodextrin + 0.60 g·min−1 fructose (MD+F); or (iii) 1.70 g·min−1 maltodextrin (MD). CHOEXO and fuel utilisation were assessed via measurement of expired air 13C content and indirect calorimetry, respectively. Mean total CHO oxidation (CHOTOT) rates were 2.35 ± 0.18, 2.76 ± 0.08, and 2.61 ± 0.17 g·min−1 with MD, MD+F, and MD+F+P, respectively, although not significantly different. Peak CHOEXO rates with MD+F were significantly greater by 41.4% (p = 0.001) and 45.4% (p = 0.0001) compared with MD+F+P and MD, respectively (1.57 ± 0.22 g·min−1, 1.11 ± 0.08 g·min−1, and 1.08 ± 0.11 g·min−1, respectively). Performance times were 2.2% and 5.0% faster with MD+F compared with MD+F+P and MD, respectively; however, they were not statistically significant. Ingestion of an MD−fructose−protein commercial sports beverage significantly reduced peak and mean CHOEXO rates compared with MD+F, but did not significantly influence CHOTOT. The addition of protein to an MD+F beverage did not enhance performance times.

Protein supplementation for military personnel: a review of the mechanisms and performance outcomes

Protein supplement use is common among athletes, active adults, and military personnel. This review provides a summary of the evidence base that either supports or refutes the ergogenic effects associated with different mechanisms that have been proposed to support protein supplementation. It was clear that if carbohydrate delivery was optimal either during or after an acute bout of exercise that additional protein will not increase exercise capacity. Evidence was also weak to substantiate use of protein supplements to slow the increase in brain serotonin and onset of central fatigue. It was also evident that additional research is warranted to test whether the benefits of protein supplements for enhancing recovery of fluid balance after exercise will affect subsequent work in the heat. In contrast, with repeated exercise, use of protein supplementation was associated with reductions in muscle soreness and often a faster recovery of muscle function due to reductions in protein degradation. There was also good supportive evidence for long-term benefits of protein supplementation for gains in muscle mass and strength through accelerated rates of protein synthesis, as long as the training stimulus was of sufficient intensity, frequency, and duration. However, studies have not examined the impact of protein supplements under the combined stress of a military environment that includes repeated bouts of exercise with little opportunity for feeding and recovery, lack of sleep, and exposure to extreme environments. Both additional laboratory and field research is warranted to help provide evidence-based guidance for the choice of protein supplements to enhance soldier performance.

Recovery from cycling exercise: effects of carbohydrate and protein beverages

The effects of different carbohydrate-protein (CHO + Pro) beverages were compared during recovery from cycling exercise. Twelve male cyclists (VO(2peak): 65 ± 7 mL/kg/min) completed ~1 h of high-intensity intervals (EX1). Immediately and 120 min following EX1, subjects consumed one of three calorically-similar beverages (285-300 kcal) in a cross-over design: carbohydrate-only (CHO; 75 g per beverage), high-carbohydrate/low-protein (HCLP; 45 g CHO, 25 g Pro, 0.5 g fat), or low-carbohydrate/high-protein (LCHP; 8 g CHO, 55 g Pro, 4 g fat). After 4 h of recovery, subjects performed subsequent exercise (EX2; 20 min at 70% VO(2peak) + 20 km time-trial). Beverages were also consumed following EX2. Blood glucose levels (30 min after beverage ingestion) differed across all treatments (CHO > HCLP > LCHP; p < 0.05), and serum insulin was higher following CHO and HCLP ingestion versus LCHP. Peak quadriceps force, serum creatine kinase, muscle soreness, and fatigue/energy ratings measured pre- and post-exercise were not different between treatments. EX2 performance was not significantly different between CHO (48.5 ± 1.5 min), HCLP (48.8 ± 2.1 min) and LCHP (50.3 ± 2.7 min). Beverages containing similar caloric content but different proportions of carbohydrate/protein provided similar effects on muscle recovery and subsequent exercise performance in well-trained cyclists.

Effect of a special carbohydrate-protein cake on oxidative stress markers after exhaustive cycling in humans

Exercise has been associated with oxidative stress that is correlated with muscle fatigue and reduced exercise performance. The aim of this study was to examine the effects of a special cake (consisting of carbohydrate to whey protein 3.5:1) vs an isocaloric carbohydrate cake on biomarkers of oxidative stress in 9 males after exhaustive cycling. A randomized single-blind cross-over study was completed. They performed one trial involving a 2-h exercise on a cycle ergometer at 60-65% VO(2)max followed by a 4-h recovery and then a second trial involved an 1-h exercise at 60-65% VO(2)max which was increased at 95% VO(2)max (time trial). The subjects received 4 experimental or placebo cakes after the first trial (the first immediately after and then one every hour). Blood samples were collected at eight time intervals: pre-exercise, 30 min, 1.5 h and 4 h post-exercise, post time Trial, 1 h, 24 h and 48 h post time Trial. Thiobarbituric Acid Reactive Substances (TBARS), protein carbonyls, total antioxidant capacity (TAC), catalase and glutathione (GSH) were determined spectrophotometrically. The mean time to exhaustion did not differ upon cake consumption. Consumption of the special cake reduced TBARS significantly, but had no effect on other oxidative stress markers.

An investigative study into the influence of a commercially available carbohydrate-protein-electrolyte beverage on short term repeated exercise performance

BACKGROUND

The purpose of this study was to undertake an independent investigation into the effects of ingesting a carbohydrate-protein-electrolyte (CPE) beverage on repeated submaximal and time-trial cycling performance.

METHODS

Sixteen recreationally trained males (height: 1.76 ± 0.07 m; weight: 70.05 ± 7.90 kg; VO2max: 49.69 ± 4.19 ml.kg-1.min-1) performed two exercise trials separated by 7 days. Each trial comprised two bouts of 90 minutes exercise separated by a 2 hour recovery period. Each bout comprised 45 minutes exercise on a cycle-ergometer at 60%VO2max (ST), followed immediately by a 45 minute performance test (PT). Participants were randomly assigned an 8% CPE beverage or colour/taste matched placebo (PL) prior to each trial. Participants consumed 100 ml of the assigned beverage every 10 minutes during each ST, and 500 ml at 0 and 60 minutes into recovery (total caloric delivery per trial: 617.6 kcal for CPE and12.8 kcal for PL). Mean power output (W), speed (km.hr-1) and distance covered (km) were assessed throughout both trials. Expired air was sampled at 10 minute intervals throughout ST. Blood glucose and lactate were assessed during ST and recovery.

RESULTS

Distance covered during ST was significantly reduced with PL by 9.12% (20.18 ± 0.28 km in ST1 v 18.34 ± 0.36 km in ST2; P = 0.0001). With CPE, distance covered, power output and average speed were maintained between ST1 and ST2. Oxygen uptake was not significantly different between ST1 and ST2, or conditions. Respiratory exchange ratio (RER) values decreased from 0.98 ± 0.02 in ST1 to 0.91 ± 0.02 in ST2 for PL (P = 0.003), supporting reduced total carbohydrate oxidation rates (P = 0.007). Mean blood glucose was maintained in CPE across ST trials, and was significantly greater than PL in ST2 (4.77 ± 0.09 mmol.L-1 for CPE compared with 4.18 ± 0.06 mmol.L-1 for PL, P < 0.001). Mean distance during PT2 was 2.96 km (or 17.1%) further with CPE than PL (P = 0.003). Mean power significantly decreased across PT with PL (134.21 ± 4.79 W and 106.90 ± 3.25 W, respectively; P < 0.04).

CONCLUSIONS

The use of a CPE beverage improves short-term repeated exercise and subsequent performance compared to PL. Higher rates of carbohydrate oxidation, maintenance of plasma glucose, and decreased levels of fatigue may be beneficial for secondary bouts of performance and faster recovery turnover.

Building a beverage for recovery from endurance activity: a review

Recovery beverages are commonly used by endurance and team-sport athletes during the time between exercise sessions. Practical recommendations on the optimal nutrient composition of these drinks and timing of their consumption are therefore needed. This article summarizes research to date on the use of recovery beverages after aerobic activities and provides the following recommendations for practitioners on the optimal formula and timing of use for endurance and team-sport athletes. Current evidence suggests that, to maximize glycogen resynthesis, athletes should consume about 1.2 g carbohydrate per kilogram body weight as glucose and sucrose immediately after exercise and each hour thereafter for 4-6 hours postexercise. Alternatively, they may consume 0.8 g·kg(-1)·h(-1) in combination with 0.4 g·kg(-1)·h(-1) amino acids or protein. Liquids provide valuable fluids for rehydration, and an ideal recovery beverage should not only contain carbohydrate and protein but also contain electrolytes, including about 0.3-0.7 g sodium·per liter fluid to help restore sodium lost through sweat. Commercial beverages with this type of nutrient composition are effective, and recent work indicates that chocolate milk may be as effective as or superior to these in promoting recovery. Research regarding the effects of specific types of amino acids and antioxidants on recovery is mixed; thus, further investigation is needed before specific recommendations about these nutrients can be made. Future studies that include women and athletes representing a variety of sports, ages, and training levels and that use consistent methodology will lead to a better understanding of the effects of postexercise intake on recovery.

Carbohydrate-protein ingestion improves subsequent running capacity towards the end of a football-specific intermittent exercise

The majority of football players succumb to fatigue towards the end of the game. This study was designed to examine the influence of protein coingestion with carbohydrate (CHO) vs. an isocaloric CHO supplement on subsequent running capacity towards the end of a simulated football match. Six male amateur football players participated in 3 trials applied in a randomized cross-over experimental design. A laboratory-based, football-specific intermittent exercise was allocated for 75 min interspersed with a 15-min recovery, immediately followed by run time to fatigue (RTF) at 80% peak oxygen consumption. In each trial, prior to exercise and during half-time, participants randomly ingested a placebo (PLC), 6.9% CHO, or 4.8% CHO plus 2.1% protein (CHO-P) supplements matched for color and taste. CHO-P resulted in longer RTF (23.02 ± 5.27 min) than did CHO (16.49 ± 3.25 min) and PLC (11.00 ± 2.80 min) (p < 0.05). Blood glucose was higher in CHO-P at the point of fatigue (4.68 ± 0.64) compared with CHO and PLC (3.92 ± 0.29 and 3.66 ± 0.36, respectively; p < 0.05). Ratings of perceived exertion were lower in the CHO-P subjects at the onset of exercise and towards the end of intermittent exercise when compared with the PLC and CHO subjects (p < 0.05). When protein was added to a CHO supplement, subsequent running capacity following limited recovery from intermittent exercise was enhanced. This improvement suggests that protein coingestion may exert an ergogenic benefit upon endurance capacity during intermittent activity.

Effects of carbohydrate, branched-chain amino acids, and arginine in recovery period on the subsequent performance in wrestlers

Many athletes need to participate in multiple events in a single day. The efficient post-exercise glycogen recovery may be critical for the performance in subsequent exercise. This study examined whether post-exercise carbohydrate supplementation could restore the performance in the subsequent simulated wrestling match. The effect of branched-chain amino acids and arginine on glucose disposal and performance was also investigated. Nine well-trained male wrestlers participated in 3 trials in a random order. Each trial contained 3 matches with a 1-hr rest between match 1 and 2, and a 2-hr rest between match 2 and 3. Each match contained 3 exercise periods interspersed with 1-min rests. The subjects alternated 10-s all-out sprints and 20-s rests in each exercise period. At the end of match 2, 3 different supplementations were consumed: 1.2 g/kg glucose (CHO trial), 1 g/kg glucose + 0.1 g/kg Arg + 0.1 g/kg BCAA (CHO+AA trial), or water (placebo trial). The peak and average power in the 3 matches was similar in the 3 trials. After the supplementation, CHO and CHO+AA trial showed significantly higher glucose and insulin, and lower glycerol and non-esterified fatty acid concentrations than the placebo trial. There was no significant difference in these biochemical parameters between the CHO and CHO+AA trials. Supplementation of carbohydrate with or without BCAA and arginine during the post-match period had no effect on the performance in the following simulated match in wrestlers. In addition, BCAA and arginine did not provide additional insulinemic effect.

Carbohydrate-protein intake and recovery from endurance exercise: is chocolate milk the answer?

Postexercise carbohydrate intake has been shown to augment recovery from heavy aerobic exercise. The effects of carbohydrate and protein coingestion (CHO + Pro) have been investigated more recently, including the potential influences of chocolate milk. Some studies report that CHO + Pro beverages (including chocolate milk) enhance subsequent exercise performance versus carbohydrate beverages, although others have reported no positive effects. The putative efficacy of CHO + Pro could be due to influences on glycogen resynthesis, protein turnover, rehydration, attenuations in muscle disruption, or perhaps a combination of these factors. However, there are inconsistencies in the literature regarding the effects of CHO + Pro on these factors, and the mechanisms explaining potential influences of CHO + Pro are not defined clearly. Further research is required to address these limitations, but present evidence suggests that CHO + Pro beverages may positively influence recovery under some exercise conditions, and chocolate milk is likely a good recovery beverage for lactose-tolerant endurance athletes.

Effects of ingesting protein in combination with carbohydrate during exercise on endurance performance: a systematic review with meta-analysis

Coingestion of protein with carbohydrate has been shown to enhance muscle recovery, particularly after intense bouts of exercise. However, performance benefits of ingesting a protein-carbohydrate drink during exercise remains unclear. Therefore, we used a systematic review with meta-analysis to examine the influence of protein ingestion during exercise on subsequent endurance performance. Eleven qualifying studies were included that contained 3 time-trial and 8 time-to-exhaustion cycling protocols. Only 3 of these studies controlled for caloric content and contained an isocaloric trial. Of the 11, 4 reported significant differences between a control and protein trial; however, none of these were isocaloric studies. The 3 time-trial protocols showed no significant improvement with protein. The meta-analysis of the time-trial studies revealed no significant overall effect (p = 0.73), whereas meta-analysis of time-to-exhaustion studies revealed a significant effect (p = 0.008). Of the time-to-exhaustion trials, the isocaloric studies found no significant effect (p = 0.71), whereas the isocarbohydrate studies revealed a significant effect (p = 0.05). The average percent improvement with ingestion of protein was 9.0%. The isocarbohydrate studies reported an improvement of 10.5%, whereas the isocaloric studies revealed a 3.4% improvement. We conclude that compared to carbohydrate alone, coingestion of protein and carbohydrate during exercise demonstrated an ergogenic effect on endurance performance when assessed by time to exhaustion and also where supplements were matched for carbohydrate (isocarbohydrate). Thus, the ergogenic effect of protein seen in isocarbohydrate studies may be because of a generic effect of adding calories (fuel) as opposed to a unique benefit of protein. Further research is warranted before a clear conclusion can be drawn.

Effects of chocolate milk consumption on markers of muscle recovery following soccer training: a randomized cross-over study

Background

The efficacy of chocolate milk (CM) as a recovery beverage following a period of increased training duration (ITD) was studied in intercollegiate soccer players.

Methods

13 subjects completed one week of normal 'baseline' training followed by four days of ITD. After each day of ITD, subjects received either a high-carbohydrate (504 kcal; CHO: 122 g; 2 g Fat) or isocaloric CM (504 kcal; 84 g CHO; 28 g Pro; 7 g Fat) recovery beverage. Serum creatine kinase (CK), myoglobin (Mb), muscle soreness, fatigue ratings and isometric quadriceps force (MVC) were obtained prior to ITD, and following 2- and 4-days of ITD. Performance tests (T-drill, vertical jump) were performed within training sessions. Treatments were administered in a randomly counterbalanced protocol, and subjects repeated the procedures with the alternate beverage following a two-week washout period.

Results

Mean daily training time and HR increased (p < 0.05) between baseline training and ITD, with no differences between treatments. No treatment*time effects were observed for Mb, muscle soreness, fatigue ratings and MVC. However, serum CK was significantly lower (p < 0.05) following four days of ITD with CM (316.9 ± 188.3 U·L^-1) compared to CHO (431.6 ± 310.8 U·L^-1). No treatment differences were observed for the performance tests.

Conclusions

Post-exercise CM provided similar muscle recovery responses to an isocaloric CHO beverage during four-days of ITD. Future studies should investigate if the attenuated CK levels observed with CM have functional significance during more demanding periods of training.

Energy and macronutrient requirements for physical fitness in exercising subjects

Optimal nutritional intakes are critical for health- and skill-related physical fitness. This review details the effect of energy restriction and supplementation on physical fitness, discusses the optimal chronic macronutrient intakes for physical fitness in exercising subjects and finally overviews the impact of short-term intakes of carbohydrate and protein, before, during and after exercise, on physical fitness of athletes. The present standings highlight that it is essential that health care givers personalize nutritional advice to meet the specific needs of exercising individuals while applying the described recommendations. It reminds the difficulty of providing straight nutritional recommendations for physical fitness on the basis of evidence-based medicine.

The effects of a pre-workout supplement containing caffeine, creatine, and amino acids during three weeks of high-intensity exercise on aerobic and anaerobic performance

Background

A randomized, single-blinded, placebo-controlled, parallel design study was used to examine the effects of a pre-workout supplement combined with three weeks of high-intensity interval training (HIIT) on aerobic and anaerobic running performance, training volume, and body composition.

Methods

Twenty-four moderately-trained recreational athletes (mean ± SD age = 21.1 ± 1.9 yrs; stature = 172.2 ± 8.7 cm; body mass = 66.2 ± 11.8 kg, VO₂max = 3.21 ± 0.85 l·min^-1, percent body fat = 19.0 ± 7.1%) were assigned to either the active supplement (GT, n = 13) or placebo (PL, n = 11) group. The active supplement (Game Time^®, Corr-Jensen Laboratories Inc., Aurora, CO) was 18 g of powder, 40 kcals, and consisted of a proprietary blend including whey protein, cordyceps sinensis, creatine, citrulline, ginseng, and caffeine. The PL was also 18 g of powder, 40 kcals, and consisted of only maltodextrin, natural and artificial flavors and colors. Thirty minutes prior to all testing and training sessions, participants consumed their respective supplements mixed with 8-10 oz of water. Both groups participated in a three-week HIIT program three days per week, and testing was conducted before and after the training. Cardiovascular fitness (VO₂max) was assessed using open circuit spirometry (Parvo-Medics TrueOne^® 2400 Metabolic Measurement System, Sandy, UT) during graded exercise tests on a treadmill (Woodway, Pro Series, Waukesha, WI). Also, four high-speed runs to exhaustion were conducted at 110, 105, 100, and 90% of the treadmill velocity recorded during VO₂max, and the distances achieved were plotted over the times-to-exhaustion. Linear regression was used to determine the slopes (critical velocity, CV) and y-intercepts (anaerobic running capacity, ARC) of these relationships to assess aerobic and anaerobic performances, respectively. Training volumes were tracked by summing the distances achieved during each training session for each subject. Percent body fat (%BF) and lean body mass (LBM) were assessed with air-displacement plethysmography (BOD POD^®, Life Measurement, Inc., Concord, CA).

Results

Both GT and PL groups demonstrated a significant (p = 0.028) increase in VO₂max from pre- to post-training resulting in a 10.3% and 2.9% improvement, respectively. CV increased (p = 0.036) for the GT group by 2.9%, while the PL group did not change (p = 0.256; 1.7% increase). ARC increased for the PL group by 22.9% and for the GT group by 10.6%. Training volume was 11.6% higher for the GT versus PL group (p = 0.041). %BF decreased from 19.3% to 16.1% for the GT group and decreased from 18.0% to 16.8% in the PL group (p = 0.178). LBM increased from 54.2 kg to 55.4 kg (p = 0.035) for the GT group and decreased from 52.9 kg to 52.4 kg in the PL group (p = 0.694).

Conclusion

These results demonstrated improvements in VO₂max, CV, and LBM when GT is combined with HIIT. Three weeks of HIIT alone also augmented anaerobic running performance, VO₂max and body composition.

Systemic indices of skeletal muscle damage and recovery of muscle function after exercise: effect of combined carbohydrate–protein ingestion

Previous studies indicate that exercise-induced muscle damage may be attenuated when protein is included in a carbohydrate recovery supplement. This study was designed to examine systemic indices of muscle damage, inflammation, and recovery of muscle function, following strenuous exercise, with ingestion of either carbohydrate alone or a carbohydrate–protein mixture. Seventeen highly trained volunteers participated in 2 trials in a randomized order, separated by approximately 9 weeks. Each trial involved 90 min of intermittent shuttle-running, either with ingestion of a 9% sucrose solution during and for 4 h after (1.2 g·kg–1 body mass·h–1) or with the same solution plus 3% whey protein isolate (0.4 g·kg–1 body mass·h–1). Blood was sampled throughout and 24 h after each trial to determinate the systemic indices of muscle damage and inflammation. An isokinetic dynamometer was used to establish reliable baseline measurements of peak isometric torque for knee and hip flexors and extensors, which were then followed-up at 4-, 24-, 48-, and 168-h postexercise. The exercise protocol resulted in significantly elevated variables indicative of muscle damage and inflammation, while peak isometric torque was immediately reduced by 10%–20% relative to baseline, across all muscle groups tested. However, none of these responses varied in magnitude or time-course between the treatments, or between participants’ first and second trials. The addition of whey protein isolate to a dietary carbohydrate supplement ingested during and for 4 h following strenuous exercise did not attenuate systemic indices of muscle damage or inflammation, nor did it restore muscle function more rapidly than when the carbohydrate fraction was ingested alone.

Improved endurance capacity following chocolate milk consumption compared with 2 commercially available sport drinks

This study examined the effects of 3 recovery drinks on endurance performance following glycogen-depleting exercise. Nine trained male cyclists performed 3 experimental trials, in a randomized counter-balanced order, consisting of a glycogen-depleting trial, a 4-h recovery period, and a cycle to exhaustion at 70% power at maximal oxygen uptake. At 0 and 2 h into the recovery period, participants consumed chocolate milk (CM), a carbohydrate replacement drink (CR), or a fluid replacement drink (FR). Participants cycled 51% and 43% longer after ingesting CM (32 ± 11 min) than after ingesting CR (21 ± 8 min) or FR (23 ± 8 min). CM is an effective recovery aid after prolonged endurance exercise for subsequent exercise at low-moderate intensities.