Antioxidant supplements for enhanced athletic recovery -
From the available evidence, the most likely mechanisms appear to be reduced exposure to or increased capacity to degrade ROS and reactive nitrogen species RNS as evidenced by reduced markers of oxidative damage [ 80 , 82 ] or increased antioxidant enzyme activity [ 74 ].
These responses seem to occur in parallel with enhanced vascular function possibly resulting in improved muscle perfusion and enhanced oxygen extraction [ 83 ]. The conflicting findings across studies with regard to the effects of polyphenol supplementation are most likely due to the differences in research design including: the supplement composition, timing and dose of supplementation variation in the studied population, and performance tasks employed and therefore differences in the predominant processes contributing to fatigue development.
The ergogenic effects of polyphenols seem to involve altered vascular function with augmentation of the measured increases in brachial artery diameter and blood flow after a 1 min occlusion, induced by pomegranate supplementation, which paralleled the ergogenic effects for performance [ 63 , 65 ].
Similarly, Richards et al. However, maximum cardiac output was not affected by EGCG, which therefore implies that the performance-enhancing effects were achieved via increased arterio-venous oxygen difference, i. improved oxygen extraction in the exercising muscle presumably coupled with better spatial distribution of muscle perfusion.
Goncalves et al. Functional capillary density capillaries with red cell flux , red blood cell velocity and time to peak velocity after 1 min arterial occlusion were all improved after grape juice supplementation, supporting the likelihood of better tissue perfusion after polyphenol supplementation, although this clearly needs to be directly tested in muscle.
The ergogenic effects of blackcurrant supplementation are also proposed to be dependent on vascular mechanisms, but until recently there has been limited empirical data to support this assertion.
Cook et al. These effects were accompanied by lower systolic and diastolic blood pressure and lower total peripheral resistance estimated via beat—beat finger blood pressure analysis. The most plausible mechanisms for these apparent vascular effects are either reduced generation of ROS or improved capacity to detoxify ROS via antioxidant systems.
Such reduced exposure to ROS will improve bioavailability of the potent vasodilator NO, due to reduced production of peroxynitrite via the reaction of superoxide and NO.
In vivo and in vitro evidence demonstrate that phenolic metabolites reduce NADPH oxidase activity, one of the key sources of superoxide production during exercise [ 47 ]. This is corroborated by the evidence that acute polyphenol supplementation protects against endurance exercise-induced oxidative damage.
Recreationally active participants experienced a reduced F2-isoprostane response to 2. Lyall et al. However, none of these studies included an assessment of exercise performance. In addition, there is evidence that chronic polyphenol consumption increases endogenous antioxidant system capacity via signalling through Nrf2 and antioxidant response element pathways see Sect.
Chronic polyphenol supplementation lowers exercise-induced oxidative stress, for instance g blueberries consumed every day for 6 weeks with g consumed 2 h prior to a 2. Fuster-Munoz et al. The ergogenic effects of polyphenols therefore seem to be underpinned by vascular and antioxidant mechanisms.
However, there is clearly a need for well-designed studies that measure exercise performance alongside robust measures of oxidative damage, antioxidant enzyme content and activity, inflammatory processes, macro- and micro-vascular function, and plasma phenolics to confirm these ergogenic effects and the mediators of these effects.
Exercise-induced muscle damage involves both mechanical and biochemical processes. There is subsequent disruption of calcium homeostasis with elevated resting calcium concentration [ 92 ], which may then contribute to further damage through activation of calcium sensitive proteases such as calpain resulting in increased proteolysis of susceptible proteins such as desmin and actin, thus worsening the ultrastructural damage [ 92 ].
In addition, there is increased generation of reactive oxygen species in an exercise intensity- and mode-dependent fashion [ 51 , 93 ], which will cause oxidative modification of proteins and other molecules resulting in altered function and damage.
Such processes will be particularly important contributing factors to the initial damage induced by high-intensity prolonged activities that do not involve eccentric muscle actions. This initial damage, whether mechanical or biochemical, triggers a potent inflammatory response with damaged fibres releasing pro-inflammatory cytokines, which serve as chemo-attractants for neutrophils and macrophages and activate ROS generating enzymes within the muscle [ 94 ].
Neutrophil infiltration and activation occurs within 2 h of damage, generally peaking within 6—24 h and then rapidly decreasing [ 95 ]. Neutrophils are rich in enzymes such as NADPH oxidase, and release ROS and proteolytic enzymes that may exacerbate the initial muscle damage [ 96 ], but also facilitate regeneration by removal of debris and activation of satellite cells [ 97 ].
Shortly after neutrophil infiltration, macrophages derived from blood monocytes accumulate within the damaged tissue. Their role is to scavenge debris and apoptotic cells and in addition release a range of growth factors and other substances that trigger remodelling of extracellular matrix, contractile and vascular elements.
Two macrophage populations have been identified: M1 and M2. M1 macrophages are pro-inflammatory and infiltrate muscle in the early stages of damage, and have been linked to proliferation of satellite cells [ 98 ]. It has been suggested that phagocytosis of damaged myogenic cells by M1 macrophages triggers their conversion to M2 macrophages [ 99 ].
These M2 macrophages release anti-inflammatory cytokines transforming growth factor-β and interleukin 10 and release growth factors such as insulin-like growth factor 1 to support regeneration of the damaged tissue [ ].
The central involvement of ROS generation and inflammation within the muscle damage and healing process suggests that polyphenol supplementation will influence these processes and therefore the rate of recovery. Polyphenols have been shown to inhibit activity of key ROS-generating enzymes such as NADPH oxidase, serve as radical scavengers, and with chronic supplementation also enhance endogenous antioxidant capacity.
In addition, polyphenols have been shown to inhibit cyclo-oxygenase activity and suppress inflammation [ , , ]. There is now a growing body of evidence that suggests that fruit-derived polyphenol supplementation enhances restoration of muscle function and reduces soreness after intensive exercise Table 4.
The effects of Montmorency cherry supplementation on recovery of muscle function or exercise performance after intensive exercise have been investigated in nine published studies thus far, of which five studies found favourable effects [ , , , , ].
These studies involved recreationally active men [ ], recreational runners [ ] or trained athletes [ , , ], so unlike the acute performance effects of polyphenol supplementation, it seems that beneficial effects on recovery are accessible to both trained and less well-trained individuals.
Nor does the efficacy of the supplement seem to be influenced by the mode of exercise used to induce muscle damage, since different approaches or muscle groups were damaged in each of these studies intensive knee extensor resistance exercise [ ]; eccentric elbow flexor exercise [ ]; marathon running [ ]; high-intensity stochastic cycling [ ] or 90 min repeated high-intensity shuttle running [ ].
In these studies, Montmorency cherry was provided in the form of a juice drink, which was consumed morning and evening for at least 3 days prior to exercise, and provided at least mg polyphenols per day.
Conversely, in studies where recovery of muscle function or exercise performance was not enhanced [ , , , ], either a lower and presumably insufficient dose of Montmorency cherry was provided in powder form mg Montmorency cherry powder in a single dose [ ]; mg polyphenols split into two doses [ ] or the intensive exercise task did not induce a measurable decline in muscle strength [ ] or exercise performance [ ], thus by definition making it impossible to improve recovery.
As well as differences in dose and frequency of supplementation, it is possible that differences in post-harvest processing of cherries between juice and powder production may induce variation in the polyphenol blend, and thus contribute to the discrepancy in findings across studies utilising Montmorency cherry powder [ , ] versus juice [ , , , , , , ].
In summary, consumption of Montmorency cherry juice or concentrate providing mg polyphenols morning and evening for at least 3 days prior to exercise and during recovery has consistently been shown to improve recovery of muscle function.
Further studies are required to identify the optimal dose, frequency and duration of consumption. The effect of Montmorency cherry supplementation on muscle soreness after intensive exercise has been assessed in eight studies, and soreness measured using a visual analogue pain scale [ , , ] or pressure pain tolerance [ ] was reduced in half of these studies.
There is no clear pattern to explain this variation across studies: in two studies favourable effects on both recovery of muscle strength and soreness were evident [ , ]; in others favourable effects on muscle function but not soreness were observed [ , ]; and Beals et al.
Lastly, Kuehl et al. Suppression of inflammation induced by muscle damage is the proposed mechanism by which polyphenol supplementation may attenuate muscle soreness [ ].
At present measures of serum markers of inflammation are available for some but not all studies, and there seems to be no relationship between reduced soreness after Montmorency cherry supplementation and serum markers of inflammation. Levers et al. Howatson et al.
Therefore, the absence of polyphenol effects in these studies is unsurprising. By definition, soreness is a highly subjective measure even when pressure pain tolerance is measured using an algometer, hence although important for athlete performance it is difficult to reliably and objectively quantify.
The quantification of inflammation within the damaged muscle itself, alongside measures of muscle soreness, could be an important step forward in understanding the effects of polyphenols. Pomegranate juice consumption has also been shown to enhance recovery of elbow flexor [ , , ], and knee extensor [ ] muscle function after intensive exercise in recreationally active men.
However, Trombold et al. In contrast, Machin et al. Only Trombold et al. Trombold et al. Serum markers of inflammation were measured in only one study [ ], and there were no effects of pomegranate supplementation.
However, as observed for Montmorency cherry supplementation studies, damage to a relatively small muscle group elbow flexors was not sufficient to induce any change in serum IL6 or CRP, hence it is unsurprising that polyphenol effects were not detectable.
Blueberry supplementation consumed in the form of a smoothie on the day of exercise mg polyphenols and during 2 days of recovery mg polyphenols per day enhanced recovery of knee extensor strength after unilateral eccentric exercise in recreationally active women, but did not reduce muscle soreness or serum IL6 although there was a strong tendency for reduced oxidative modification of serum proteins protein carbonyls [ ].
Conversely, Peschek et al. However, this finding in this randomised crossover trial is confounded by the use of downhill running to induce muscle damage, with all second trials likely to be affected by repeated bout effect, irrespective of treatment [ ]. With the exception of McCormick et al. Serum markers of oxidative damage TBARS, MDA, lipid hydroperoxides, F2-isoprostanes, protein carbonyls, nitrotyrosine were measured in five of the nine studies that found favourable effects of polyphenol supplementation on recovery of muscle function.
Oxidative damage was suppressed either significantly TBARS [ ]; protein carbonyls [ ] or there was a strong non-statistically significant trend lipid hydroperoxides [ ]; protein carbonyls [ ] or in only one study there was no effect lipid hydroperoxides [ ].
As described earlier Sect. Tart cherry juice consumption has been shown to increase hepatic superoxide dismutase and glutathione peroxidase activity in mice [ ]. Supplementation with anthocyanins isolated from purple sweet potato increased Nrf2 gene expression and Nrf2 nuclear translocation in rat liver [ ].
Charles et al. This was achieved both via reduced reactive oxygen species generation as well as increased endogenous antioxidant enzyme gene expression. Dark chocolate supplementation for 3 months has also been shown to enhance superoxide dismutase and catalase expression in muscle of patients with heart failure and type 2 diabetes [ 48 ], and more recently has been shown to reduce carbonylation of proteins within skeletal muscle of healthy adults [ ].
In contrast, McLeay et al. Blueberry supplementation has been shown to suppress neutrophil NADPH oxidase activity [ 14 ], one of the key sources of superoxide production, which may contribute to the observed effects.
A range of polyphenols have been shown to inhibit superoxide producing enzymes, such as NADPH oxidase and xanthine oxidase for review, see Maraldi [ 47 ]. Polyphenols have been shown to inhibit cyclo-oxygenase activity COX1 and COX2 in similar fashion to non-steroidal anti-inflammatory drugs, and there is extensive in vitro and in vivo evidence of anti-inflammatory effects of polyphenols for review see Peluso et al.
The important and complex contribution of inflammatory pathways to the healing and remodelling process suggests the anti-inflammatory effects of polyphenols may be a key component of the mechanisms of action.
Ten of the reviewed studies included serum markers of inflammation, with polyphenol-induced reductions in serum IL6 response to intensive exercise in five studies [ 34 , , , , ]. However, muscle soreness was attenuated in only one of these studies [ ], whilst recovery of muscle function was enhanced in both studies where isometric force and inflammatory marker data were available [ , ].
In four studies [ , , , ], there was no effect of polyphenol supplementation on serum markers of inflammation; however, the exercise protocol employed did not induce elevation in any serum markers in these studies. In the remaining studies, polyphenol supplementation did not affect serum markers of inflammation despite enhanced recovery of muscle function [ ] and reduced soreness [ ].
The reliance on proxy serum markers of inflammation does not provide sufficient sensitivity to understand processes taking place within the damaged muscle itself.
This point was clearly confirmed by Jajtner [ ], since supplementation with a proprietary blend of green and black tea polyphenols suppressed IL8 protein expression in human skeletal muscle after intensive exercise, but there was no effect on circulating IL8 concentration.
Myburgh et al. PCO treated rats exhibited reduced neutrophil activation on day 1, normal magnitude but earlier macrophage response and earlier satellite cell activation. However, equivalent data from studies with human participants are not yet available. There is some evidence to suggest that Montmorency cherry [ , ] and Jerte valley [ , ] cherry supplementation improves sleep quality assessed via accelerometry and sleep questionnaire , which may also contribute to the observed benefits for recovery.
Modulation of the pro-inflammatory cytokine response to exercise has been suggested as one possible mechanism by which sleep quality may be improved, as well as the melatonin content of cherries. However, in these studies supplements were consumed in the morning and evening whereas melatonin supplements are normally prescribed to be consumed prior to sleep, and in addition the dose provided by cherries is relatively low 85 µg vs.
More human in vivo studies are needed to verify the somniferous effects of Montmorency cherry and other polyphenols and improve understanding of the mechanism.
The existing literature is flawed by a number of limitations that preclude the identification of optimal polyphenol dosing strategies for desired outcomes and also constrain understanding of the mechanisms of action. A key challenge in utilising natural fruit-derived supplements is that the polyphenol blend is influenced by the plant species, growing conditions and post-harvest processing.
As a consequence, the polyphenol content of supplements will vary from batch to batch, but relatively few of the published studies provide detailed composition of the batch specific polyphenol blend consumed. This is essential for future work to ensure the accuracy of dose response data and hence our ability to identify optimal polyphenol doses and blends.
Dietary controls are a further factor worthy of consideration. Several of the reviewed studies incorporated some element of dietary polyphenol restriction [ 11 , 64 , 67 , 80 , 82 , , , ], in attempts to reduce the background noise that may be introduced by variation in dietary polyphenol intake, but which may also maximise the effects produced by polyphenol supplementation.
Accuracy is also influenced by the known proclivity for under- and over-reporting of food intake using diet diaries. For this reason and to ensure the ecological validity of the data, it would seem that superimposing polyphenol supplementation onto the backdrop of habitual diet is the most appropriate approach.
Polyphenol chemistry is highly complex, but to date, studies in which the recovery and performance effects of polyphenol supplementation have been assessed have not included quantification of the plasma phenolics.
Such measurements may allow identification of the bioactive metabolites and inform optimisation of the polyphenol blends consumed. Our understanding of the mechanisms by which polyphenols exert favourable effects on performance and recovery is limited by the dearth of data on processes occurring within muscle.
Published studies have relied upon proxy markers within serum to inform understanding of the antioxidant and anti-inflammatory processes that seem likely to underpin the beneficial effects observed. As described recently by Close et al. Certainly, blood markers are a poor surrogate for direct analysis of muscle tissue.
To further progress understanding, studies incorporating muscle biopsies are needed that allow direct assessment of signalling via Nrf2 and ARE pathways and changes in antioxidant enzyme activity in muscle after polyphenol supplementation.
The controversy with regard to antioxidant vitamin supplementation and training adaptation continues, with evidence of no effect [ ] or attenuation of adaptation [ ]. It is clear that ROS and inflammatory pathways are implicated in the cell-signalling pathways that drive training adaptation, so it is plausible that if these signals are suppressed by antioxidant supplementation, ergolytic effects will result.
However, in contrast to antioxidant vitamins and minerals, the antioxidant effects of polyphenols do not seem to arise from radical scavenging but rather from up-regulation of endogenous antioxidant systems.
Different effects might therefore be anticipated between vitamins and polyphenols; however, there is a lack of empirical data.
Taub et al. A small number of training studies with human participants have been performed with isolated resveratrol supplementation with largely detrimental consequences either for performance [ , , , ] or cellular level [ , ] adaptation.
However, no studies have yet been published in which the effects of a fruit-derived blend of polyphenols on training adaptation have been investigated. From a practical perspective, this review provides data to allow sport nutrition and sport science practitioners to make recommendations to coaches and athletes regarding the efficacy of polyphenols to improve performance and aid recovery from their chosen sport or training discipline.
The results from several studies suggest that acute and chronic polyphenol supplementation is associated with an improvement of performance with no reported adverse side effects. Additionally, it appears that supplementation with fruit-derived polyphenols will assist in the recovery of muscle function and reduce muscle soreness following intensive exercise.
In particular, athletes participating in sports that involve time trials cycling and repeated sprints field and court sports may experience performance gains when ingesting an acute dose of polyphenols 1—2 h prior to competition or supplementing polyphenols chronically 1—6 weeks prior to competition.
Similarly, athletes participating in training sessions that involve the completion of repeated sprints 6—30 s and repeated high-intensity interval training bouts may consider supplementing with polyphenols as improvements during training may translate to sporting performance although this remains to be experimentally demonstrated.
Whilst research supports the use of polyphenols in conjunction with high-intensity training, there is currently a lack of evidence to support its use in conjunction with resistance training. Consumption of g blueberries, g blackcurrants or g Montmorency cherries would approximately provide this dose [ 3 ].
In summary, there is growing evidence that acute and chronic supplementation with fruit-derived polyphenols may enhance exercise performance, with the mechanisms most likely to be related to antioxidant and vascular effects.
However, this research is at an early stage and more work is required to optimise dosing strategies and to determine the specific modes, intensities and durations of exercise for which ergogenic effects may be achieved.
There is a larger body of evidence that suggests that chronic polyphenol consumption enhances recovery from intensive exercise. More research is still required to identify the optimal dose and blend of polyphenols to support recovery, and ideally future studies will measure processes within muscle as well as plasma phenolic concentrations so that the specific bioactive compounds and the mechanisms of action can be identified.
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Stem cells. Jump to navigation. Taking antioxidant supplements to reduce muscles soreness after exercise could have almost no effect, according to a new Cochrane Review.
Listen to the podcast from the lead author. In a new review published in the Cochrane Library , researchers looked at the evidence from 50 studies. These all compared high-dose antioxidant supplementation with a placebo and their participants all engaged in strenuous exercise that was sufficient to cause muscle soreness.
Of the participants included in the review, nearly nine out of ten of these were male and most participants were recreationally active or moderately trained. The researchers found that high dose antioxidant supplementation, thus in excess of the normal recommended daily dose for antioxidants, does not appear to reduce muscle soreness early on after exercise or at one, two, three or four days after exercise.
At all times, the slight differences in the average pain scores found for participants taking supplements compared with those taking placebos were smaller than the difference that people would consider important or even notice.
Only nine studies reported on adverse effects and only two found adverse effects. The evidence for muscle soreness is considered to be 'moderate' or 'low' quality. This was mainly because the majority of studies had aspects that could have affected the reliability of their results and in some cases because of variation in the results of the studies.
Dr Mayur Ranchordas, senior lecturer in sport and nutrition and exercise metabolism at Sheffield Hallam said: "Many people take antioxidant supplements or antioxidant-enriched foods before and after exercise in the belief that these will prevent or reduce muscle soreness after exercise.
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