Effect of Cocoa Products and Its Polyphenolic Constituents on Exercise Performance and Exercise-Induced Muscle Damage and Inflammation: A Review of Clinical Trials

Acute Dosing Strategy with Vistula Tart Cherries for Recovery of Strenuous Exercise-A Feasibility Study

Tart cherry (TC) consumption has become a popular nutritional strategy for recovery, particularly for the attenuation of markers associated with muscle damage. However, there are relatively few studies that have examined an acute dosing strategy. The aim of this pilot study was to explore the feasibility of using powdered Vistula TC for recovery following a bout of muscle-damaging exercise. Twenty-two recreationally active participants (mean ± SD age, stature, and mass were 23 ± 3 years old, 173 ± 10 cm, and 74 ± 17 kg, respectively) performed 40 (5 sets of 8 repetitions) maximal lengthening contractions of the elbow flexors. The participants were randomised to receive either a spray-dried TC extract or a calorie-matched placebo (12 TC, 10 placebo) for 4 days in total, starting on the day of exercise. Dependent measures of maximal voluntary contraction (MVC), muscle soreness (assessed via visual analogue scales; VAS), pain pressure threshold (PPT), range of motion (ROM), and upper arm limb girth were taken at baseline (pre), 24, 48, and 72 h post damaging exercise. There were significant changes over time among all the variables (MVC, VAS, PPT, ROM, and girth, p ≤ 0.014). There were no significant differences between the conditions for any of the variables (MVC, VAS, PPT, ROM, and girth, p > 0.3). The TC group did not recover at an accelerated rate compared to the placebo. This study provides initial insights into the use of powdered Vistula TC and its effect following strenuous (damaging) exercise bouts. Vistula TC did not improve recovery when taken acutely following a bout of damaging exercise to the elbow flexors.

Concomitant dual-site tDCS and dark chocolate improve cognitive and endurance performance following cognitive effort under hypoxia: a randomized controlled trial

Ten male cyclists were randomized into four experimental conditions in this randomized, cross-over, double-blind, and sham-controlled study to test the combined effect of acute dark chocolate (DC) ingestion and anodal concurrent dual-site transcranial direct current stimulation (a-tDCS) targeting M1 and left DLPFC on cognitive and whole-body endurance performance in hypoxia after performing a cognitive task. Two hours before the sessions, chocolate was consumed. After arriving at the lab, participants completed an incongruent Stroop task for 30 min in hypoxia (O2 = 13%) to induce mental fatigue, followed by 20 min of tDCS (2 mA) in hypoxia. Then, in hypoxia, they performed a time-to-exhaustion task (TTE) while measuring physiological and psychophysiological responses. Cognitive performance was measured at baseline, after the Stroop task, and during and after TTE. TTE in 'DC + a-tDCS' was significantly longer than in 'white chocolate (WC) + a-tDCS' and WC + sham-tDCS'. The vastus medialis muscle electromyography amplitude was significantly higher in 'DC + a-tDCS' and 'DC + sham-tDCS' than in 'WC + sh-tDCS'. During and after the TTE, choice reaction time was significantly lower in 'DC + a-tDCS' compared to 'WC + sh-tDCS'. Other physiological or psychophysiological variables showed no significant differences. The concurrent use of acute DC consumption and dual-site a-tDCS might improve cognitive and endurance performance in hypoxia.

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

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

Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients

The plant defence compound caffeine is widely consumed as a performance enhancer in a sporting context, with potential benefits expected in both physiological and psychological terms. However, although caffeine modestly but consistently improves alertness and fatigue, its effects on mental performance are largely restricted to improved attention or concentration. It has no consistent effect within other cognitive domains that are important to sporting performance, including working memory, executive function and long-term memory. Although caffeine's central nervous system effects are often attributed to blockade of the receptors for the inhibitory neuromodulator adenosine, it also inhibits a number of enzymes involved both in neurotransmission and in cellular homeostasis and signal propagation. Furthermore, it modulates the pharmacokinetics of other endogenous and exogenous bioactive molecules, in part via interactions with shared cytochrome P450 enzymes. Caffeine therefore enjoys interactive relationships with a wide range of bioactive medicinal and dietary compounds, potentially broadening, increasing, decreasing, or modulating the time course of their functional effects, or vice versa. This narrative review explores the mechanisms of action and efficacy of caffeine and the potential for combinations of caffeine and other dietary compounds to exert psychological effects in excess of those expected following caffeine alone. The review focusses on, and indeed restricted its untargeted search to, the most commonly consumed sources of caffeine: products derived from caffeine-synthesising plants that give us tea (Camellia sinensis), coffee (Coffea genus), cocoa (Theabroma cacao) and guaraná (Paullinia cupana), plus multi-component energy drinks and shots. This literature suggests relevant benefits to mental performance that exceed those associated with caffeine for multi-ingredient energy drinks/shots and several low-caffeine extracts, including high-flavanol cocoa and guarana. However, there is a general lack of research conducted in such a way as to disentangle the relative contributions of the component parts of these products.

No effect of a dairy-based, high flavonoid pre-workout beverage on exercise-induced intestinal injury, permeability, and inflammation in recreational cyclists: A randomized controlled crossover trial

BACKGROUND

Submaximal endurance exercise has been shown to cause elevated gastrointestinal permeability, injury, and inflammation, which may negatively impact athletic performance and recovery. Preclinical and some clinical studies suggest that flavonoids, a class of plant secondary metabolites, may regulate intestinal permeability and reduce chronic low-grade inflammation. Consequently, the purpose of this study was to determine the effects of supplemental flavonoid intake on intestinal health and cycling performance.

MATERIALS AND METHODS

A randomized, double-blind, placebo-controlled crossover trial was conducted with 12 cyclists (8 males and 4 females). Subjects consumed a dairy milk-based, high or low flavonoid (490 or 5 mg) pre-workout beverage daily for 15 days. At the end of each intervention, a submaximal cycling trial (45 min, 70% VO2max) was conducted in a controlled laboratory setting (23°C), followed by a 15-minute maximal effort time trial during which total work and distance were determined. Plasma samples were collected pre- and post-exercise (0h, 1h, and 4h post-exercise). The primary outcome was intestinal injury, assessed by within-subject comparison of plasma intestinal fatty acid-binding protein. Prior to study start, this trial was registered at ClinicalTrials.gov (NCT03427879).

RESULTS

A significant time effect was observed for intestinal fatty acid binding protein and circulating cytokines (IL-6, IL-10, TNF-α). No differences were observed between the low and high flavonoid treatment for intestinal permeability or injury. The flavonoid treatment tended to increase cycling work output (p = 0.051), though no differences were observed for cadence or total distance.

DISCUSSION

Sub-chronic supplementation with blueberry, cocoa, and green tea in a dairy-based pre-workout beverage did not alleviate exercise-induced intestinal injury during submaximal cycling, as compared to the control beverage (dairy-milk based with low flavonoid content).

Correlation of Delayed Onset Muscle Soreness and Inflammation Post-exercise Induced Muscle Damage

BACKGROUND: Delayed Onset Muscle Soreness (DOMS) is a common injury resulting from abnormal intensive training in athletes, mainly the result of training involving eccentric contractions. AIM: The aim of this study was to determine the correlation between the incidence of DOMS and HMGB1 as a marker of the occurrence of inflammation post Exercise Induces Muscle Damaged. METHOD: 28 male recreational students of Sports Science Department, Universitas Negeri Surabaya who met all inclusion and exclusion criteria participated in this study. Participants completed a muscle damaging exercise which consists of a 10x10 drop jump (DRP) and a bout of 40×15 m sprints with a 5 m deceleration zone (SPR) to obtain a muscle damage effect. In this study, the stretching in the exercise session was not given, this was done to get the DOMS effect after exercise. DOMS and HMGB1 was carry out 1 hour before the exercise, 12 hours after the exercise, 24 hours after the exercise and 48 hours after the exercise. RESULT: The result showed that there was a significant correlation (r=0.935, p<0.05) between DOMS and HMGB1 as a predictor of inflammation. The participants that were given EIMD eccentric exercise (DRP and SPR) showed the occurrence of DOMS and increasing of HMGB1. The result also showed that there was a correlation between DOMS and HMGB1. CONCLUSION: This study concluded that there was a correlation between DOMS and HMGB1 as a marker of inflammation as the result of the eccentric exercise of the exercise Induced Muscle Damage (EIMD).

Antioxidative properties of phenolic compounds and their effect on oxidative stress induced by severe physical exercise

Extensive research has found strongly increased generation of reactive oxygen species, free radicals, and reactive nitrogen species during acute physical exercise that can lead to oxidative stress (OS) and impair muscle function. Polyphenols (PCs), the most abundant antioxidants in the human diet, are of increasing interest to athletes as antioxidants. Current literature suggests that antioxidants supplementation can effectively modulate these processes. This overview summarizes the actual knowledge of chemical and biomechanical properties of PCs and their impact as supplements on acute exercise-induced OS, inflammation control, and exercise performance. Evidence maintains that PC supplements have high potency to positively impact redox homeostasis and improve skeletal muscle's physiological and physical functions. However, many studies have failed to present improvement in physical performance. Eleven of 15 representative experimental studies reported a reduction of severe exercise-induced OS and inflammation markers or enhancement of total antioxidant capacity; four of eight studies found improvement in exercise performance outcomes. Further studies should be continued to address a safe, optimal PC dosage, supplementation timing during a severe training program in different sports disciplines, and effects on performance response and adaptations of skeletal muscle to exercise.

Chronic Consumption of Cocoa Rich in Procyanidins Has a Marginal Impact on Gut Microbiota and on Serum and Fecal Metabolomes in Male Endurance Athletes

Cocoa is used in the sports world as a supplement, although there is no consensus on its use. We investigated the effect of cocoa intake on intestinal ischemia (intestinal fatty acid-binding protein (I-FABP)), serum lipopolysaccharide (LPS) levels, gastrointestinal symptoms, and gut microbiota in endurance athletes during their training period on an unrestricted diet. We also performed a metabolomics analysis of serum and feces after a bout of exercise before and after supplementation. Cocoa consumption had no effect on I-FABP, LPS, or gastrointestinal symptoms. Cocoa intake significantly increased the abundance of Blautia and Lachnospira genera and decreased the abundance of the Agathobacter genus, which was accompanied by elevated levels of polyphenol fecal metabolites 4-hydroxy-5-(phenyl)-valeric acid and O-methyl-epicatechin-O-glucuronide. Our untargeted approach revealed that cocoa had no significant effects on serum and fecal metabolites and that its consumption had little impact on the metabolome after a bout of physical exercise.

Plant-derived nootropics and human cognition: A systematic review

Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.

The Combined Effects of 6 Weeks of Jump Rope Interval Exercise and Dark Chocolate Consumption on Antioxidant Markers in Obese Adolescent Boys

Research has shown that both dark chocolate and exercise training may have favorable effects on antioxidant function in obese cohorts. However, their combined effect has not been established. We assessed the influences of six weeks of dark chocolate consumption combined with jump rope exercise on antioxidant markers in adolescent boys with obesity. Fifty adolescent boys with obesity (age = 15 ± 1 years) were randomly assigned into one of four groups; jump rope exercise + white chocolate consumption (JW; n = 13), jump rope exercise + dark chocolate consumption (JD; n = 13), dark chocolate consumption (DC; n = 12), or control (C; n = 12). Two participants dropped out of the study. Participants in JW and JD groups performed jump rope exercise three times per week for six weeks. Participants in the DC and JD groups consumed 30 g of dark chocolate containing 83% of cocoa during the same period. Serum concentrations of superoxide dismutase (SOD), total antioxidant capacity (TAC), glutathione peroxidase (GPx), and thiobarbituric acid reactive substances (TBARS) were evaluated prior to and after the interventions. All 3 intervention groups noted significant (p < 0.01) increases in serum concentrations of TAC, SOD, and GPx from baseline to post-test. In contrast, all intervention groups showed significantly reduced serum concentrations of TBARS from pre- to post-test (p ≤ 0.01). Bonferroni post hoc analysis revealed that post-test serum concentrations of TAC in the JD group were significantly greater than C (p < 0.001), DC (p = 0.010), and JW (p < 0.001) groups. In addition, post-test serum concentrations of SOD in the JD group were significantly greater than C group (p = 0.001). Post-test serum concentrations of GPx in the JD group were significantly greater than C (p < 0.001), DC (p = 0.021), and JW (p = 0.032) groups. The post-test serum concentrations of TBARS in the JD group was significantly lower than C (p < 0.001). No other significant between-group differences were observed. The current study provides evidence that dark chocolate consumption in combination with jump rope exercise is more efficient in improving antioxidant capacity than dark chocolate consumption or jump rope exercise alone among obese adolescent boys.

Beneficial effects of dietary supplementation with green tea catechins and cocoa flavanols on aging-related regressive changes in the mouse neuromuscular system

Besides skeletal muscle wasting, sarcopenia entails morphological and molecular changes in distinct components of the neuromuscular system, including spinal cord motoneurons (MNs) and neuromuscular junctions (NMJs); moreover, noticeable microgliosis has also been observed around aged MNs. Here we examined the impact of two flavonoid-enriched diets containing either green tea extract (GTE) catechins or cocoa flavanols on age-associated regressive changes in the neuromuscular system of C57BL/6J mice. Compared to control mice, GTE- and cocoa-supplementation significantly improved the survival rate of mice, reduced the proportion of fibers with lipofuscin aggregates and central nuclei, and increased the density of satellite cells in skeletal muscles. Additionally, both supplements significantly augmented the number of innervated NMJs and their degree of maturity compared to controls. GTE, but not cocoa, prominently increased the density of VAChT and VGluT2 afferent synapses on MNs, which were lost in control aged spinal cords; conversely, cocoa, but not GTE, significantly augmented the proportion of VGluT1 afferent synapses on aged MNs. Moreover, GTE, but not cocoa, reduced aging-associated microgliosis and increased the proportion of neuroprotective microglial phenotypes. Our data indicate that certain plant flavonoids may be beneficial in the nutritional management of age-related deterioration of the neuromuscular system.

Effects of (-)-epicatechin on mitochondria

Mitochondrial dysfunction is observed in a broad range of human diseases, including rare genetic disorders and complex acquired pathologies. For this reason, there is increasing interest in identifying safe and effective strategies to mitigate mitochondrial impairments. Natural compounds are widely used for multiple indications, and their broad healing properties suggest that several may improve mitochondrial function. This review focuses on (-)-epicatechin, a monomeric flavanol, and its effects on mitochondria. The review summarizes the available data on the effects of acute and chronic (-)-epicatechin supplementation on mitochondrial function, outlines the potential mechanisms involved in mitochondrial biogenesis induced by (-)-epicatechin supplementation and discusses some future therapeutic applications.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

Açaí (Euterpe oleracea Mart.) seed extract improves aerobic exercise performance in rats

The purpose of this study was to examine whether the supplementation with an açai (Euterpe oleracea Mart.) seed extract (ASE) would affect the aerobic exercise performance in rats and correlate with the vascular function, muscle oxidative stress and mitochondrial biogenesis. Male Wistar rats were divided into five groups: Sedentary, Sedentary with chronic supplementation of ASE, Training, Training with chronic (200 mg/Kg/day intragastric gavage for 5 weeks) or acute (30 min before the maximal treadmill stress test (MST) supplementation with ASE. The exercise training was performed on a treadmill (30 min/day; 5 days/week) for 4 weeks. The chronic supplementation with ASE increased the exercise time (58%) and the running distance (129%) in relation to the MST, while the Training group increased 40% and 78% and the Training with acute ASE group increased 30% and 63%, respectively. The training-induced increase of ACh vasodilation was not changed by ASE, but the norepinephrine-induced vasoconstriction was reduced by chronic and acute supplementation with ASE. The increased levels of malondialdehyde in soleus muscle homogenates from the Training group was reduced only by chronic supplementation with ASE. The muscle antioxidant defense, NO₂ levels, and expression of the mitochondrial biogenesis-related proteins (PGC1α, SIRT-1, p-AMPK/AMPK, Nrf-2) were not different between Training and Sedentary groups, but all these parameters were increased in the Training with Chronic ASE compared with the Sedentary groups. In conclusion, chronic supplementation with ASE improves aerobic physical performance by increasing the vascular function, reducing the oxidative stress, and up-regulating the mitochondrial biogenesis key proteins.

A Critical Review on the Role of Food and Nutrition in the Energy Balance

The mass media has increasingly frequently suggested to the general population that specific foods or nutritional schemes are able to affect both human metabolism and energy expenditure, thus facilitating weight loss. This critical review is aimed at assessing available evidence on the roles of nutrients, food and dietary regimens in energy intake and energy expenditure. We queried the National Library of Medicine, the Cochrane Library, Excerpta Medica dataBASEand the Cumulative Index to Nursing and Allied Health Literature database, and a search strategy was performed by using database-specific subject headings and keywords. We found that available scientific evidence on these topics is scarce, and that the limited number of available studies often have poor methodological quality. Only a few foods show beneficial effects on metabolism and energy expenditure, as the human energy balance is complex and multifactorial. Finally, microbiota may interfere with the intake, use and expenditure of energy in the human body. Conclusive evidence is still lacking, and, at present, it is not possible to identify a food or a diet with a significant impact on human energy expenditure.