Endurance athletes commonly consume carbohydrate-electrolyte sports beverages during prolonged events. The benefits of this strategy are numerous—sports-beverage consumption during exercise can delay dehydration, maintain blood glucose levels, and potentially attenuate muscle glycogen depletion and central fatigue. Thus, it is generally agreed that carbohydrate-electrolyte beverages can improve endurance performance. A controversy has recently emerged regarding the potential role of protein in sports beverages. At least 3 recent studies have reported that carbohydrate-protein ingestion improves endurance performance to a greater extent than carbohydrate alone. In addition, carbohydrate-protein ingestion has been associated with reductions in markers of muscle damage and improved post exercise recovery. Although many of these muscle damage and recovery studies examined post exercise nutritional intake, recent evidence suggests that these benefits may be elicited with carbohydrate-protein consumption during exercise. These findings are intriguing and suggest that the importance of protein for endurance athletes has been underappreciated. However, 2 studies recently reported no differences in endurance performance between carbohydrate and carbohydrate-protein beverages. The varied outcomes may have been influenced by a number of methodological differences, including the amounts and types of carbohydrate or protein in the beverages, the exercise protocols, and the relative statistical power of the studies. In addition, although there are plausible mechanisms that could explain the ergogenic effects of carbohydrate-protein beverages, they remain relatively untested. This review examines the existing research regarding the efficacy of carbohydrate-protein consumption during endurance exercise. Limitations of the existing research are addressed, as well as potential areas for future study.
Matthew David Cook, Stephen David Myers, John Stephen Michael Kelly and Mark Elisabeth Theodorus Willems
Impaired glucose tolerance was shown to be present 48 hr following muscle-damaging eccentric exercise. We examined the acute effect of concentric and muscle-damaging eccentric exercise, matched for intensity, on the responses to a 2-hr 75-g oral glucose tolerance test (OGTT). Ten men (27 ± 9 years, 178 ± 7 cm, 75 ± 11 kg, VO2max: 52.3 ± 7.3 ml·kg-1·min-1) underwent three OGTTs after an overnight 12 hr fast: rest (control), 40-min (5 × 8-min with 2-min interbout rest) of concentric (level running, 0%, CON) or eccentric exercise (downhill running, –12%, ECC). Running intensity was matched at 60% of maximal metabolic equivalent. Maximal isometric force of m. quadriceps femoris of both legs was measured before and after the running protocols. Downhill running speed was higher (level: 9.7 ± 2.1, downhill: 13.8 ± 3.2 km·hr-1, p < .01). Running protocols had similar VO2max (p = .59), heart rates (p = .20) and respiratory exchange ratio values (p = .74) indicating matched intensity and metabolic demands. Downhill running resulted in higher isometric force deficits (level: 3.0 ± 6.7, downhill: 17.1 ± 7.3%, p < .01). During OGTTs, area-under-the-curve for plasma glucose (control: 724 ± 97, CON: 710 ± 77, ECC: 726 ± 72 mmol·L-1·120 min, p = .86) and insulin (control: 24995 ± 11229, CON: 23319 ± 10417, ECC: 21842 ± 10171 pmol·L-1·120 min, p = .48), peak glucose (control: 8.1 ± 1.3, CON: 7.7 ± 1.2, ECC: 7.7 ± 1.1 mmol·L-1, p = .63) and peak insulin levels (control: 361 ± 188, CON: 322 ± 179, ECC: 299 ± 152 pmol·L-1, p = .30) were similar. It was concluded that glucose tolerance and the insulin response to an OGTT were not changed immediately by muscle-damaging eccentric exercise.
Vitor Teixeira, Hugo Valente, Susana Casal, Franklim Marques and Pedro Moreira
Strenuous physical activity is known to generate reactive oxygen species to a point that can exceed the antioxidant defense system and lead to oxidative stress. Dietary intake of antioxidants, plasma enzymatic (superoxide dismutase, glutathione reductase [Gr], and glutathione peroxidase [GPx]) activities, nonenzymatic (total antioxidant status [TAS], uric acid, α-tocopherol, retinol, α-carotene, β-carotene, lycopene, and lutein + zeaxanthin) antioxidants, and markers of lipid peroxidation (thiobarbituricacid-reactive substances [TBARS]) and muscle damage (creatine kinase [CK]) were measured in 17 elite male kayakers and canoeists under resting conditions and in an equal number of age- and sex-matched sedentary individuals. Athletes showed increased plasma values of α-tocopherol (p = .037), α-carotene (p = .003), β-carotene (p = .007), and superoxide dismutase activity (p = .002) and a lower TAS level (p = .030). Antioxidant intake (α-tocopherol, vitamin C, and β-carotene) and plasmatic GPx, Gr, lycopene, lutein + zeaxanthin, retinol, and uric acid levels were similar in both groups. Nevertheless, TBARS (p < .001) and CK (p = .011) levels were found to be significantly higher in the kayakers and canoeists. This work suggests that despite the enhanced levels of antioxidants, athletes undergoing regular strenuous exercise exhibited more oxidative stress than sedentary controls.
Paul W.M. Marshall, Ric Lovell and Jason C. Siegler
Passive muscle tension is increased after damaging eccentric exercise. Hamstring-strain injury is associated with damaging eccentric muscle actions, but no research has examined changes in hamstring passive muscle tension throughout a simulated sport activity. The authors measured hamstring passive tension throughout a 90-min simulated soccer match (SAFT90), including the warm-up period and every 15 min throughout the 90-min simulation.
Passive hamstring tension of 15 amateur male soccer players was measured using the instrumented straight-leg-raise test. Absolute torque (Nm) and slope (Nm/°) of the recorded torque-angular position curve were used for data analysis, in addition to total leg range of motion (ROM). Players performed a 15-min prematch warm-up, then performed the SAFT90 including a 15-min halftime rest period.
Reductions in passive stiffness of 20–50° of passive hip flexion of 22.1−29.2% (P < .05) were observed after the warm-up period. During the SAFT90, passive tension increased in the latter 20% of the range of motion of 10.1−10.9% (P < .05) concomitant to a 4.5% increase in total hamstring ROM (P = .0009).
The findings of this study imply that hamstring passive tension is reduced after an active warm-up that includes dynamic stretching but does not increase in a pattern suggestive of eccentric induced muscle damage during soccer-specific intermittent exercise. Hamstring ROM and passive tension increases are best explained by improved stretch tolerance.
Nicholas D. Luden, Michael J. Saunders and M. Kent Todd
The authors investigated the effects of postexercise carbohydrate-protein-anti-oxidant (CHO+P+A) ingestion on plasma creatine kinase (CK), muscle soreness, and subsequent cross-country race performance. Twenty-three runners consumed 10 mL/kg body weight of CHO or CHO+P+A beverage immediately after each training session for 6 d before a cross-country race. After a 21-d washout period, subjects repeated the protocol with the alternate beverage. Post intervention CK (223.21 ± 160.71 U/L; 307.3 ± 312.9 U/L) and soreness (medians = 1.0, 2.0) were significantly lower after CHO+P+A intervention than after CHO, despite no differences in baseline measures. There were no overall differences in running performance after CHO and CHO+P+A interventions. There were, however, significant correlations between treatment differences and running mileage, with higher mileage runners having trends toward improved attenuations in CK and race performance after CHO+P+A intervention than lower mileage runners. We conclude that muscle damage incurred during training was attenuated with postexercise CHO+P+A ingestion, which could lead to performance improvements in high-mileage runners.
Jonathan D.C. Leeder, Ken A. van Someren, David Gaze, Andrew Jewell, Nawed I.K. Deshmukh, Iltaf Shah, James Barker and Glyn Howatson
This investigation aimed to ascertain a detailed physiological profile of recovery from intermittentsprint exercise of athletes familiar with the exercise and to investigate if athletes receive a protective effect on markers of exercise-induced muscle damage (EIMD), inflammation, and oxidative stress after a repeated exposure to an identical bout of intermittent-sprint exercise.
Eight well-trained male team-sport athletes of National League or English University Premier Division standard (mean ± SD age 23 ± 3 y, VO2max 54.8 ± 4.6 mL · kg−1 · min−1) completed the Loughborough Intermittent Shuttle Test (LIST) on 2 occasions, separated by 14 d. Maximal isometric voluntary contraction (MIVC), countermovement jump (CMJ), creatine kinase (CK), C-reactive protein (CRP), interleukin-6 (IL-6), F2-isoprostanes, and muscle soreness (DOMS) were measured before and up to 72 h after the initial and repeated LISTs.
MIVC, CMJ, CK, IL-6, and DOMS all showed main effects for time (P < .05) after the LIST, indicating that EIMD was present. DOMS peaked at 24 h after LIST 1 (110 ± 53 mm), was attenuated after LIST 2 (56 ± 39 mm), and was the only dependent variable to demonstrate a reduction in the second bout (P = .008). All other markers indicated that EIMD did not differ between bouts.
Well-trained games players experienced EIMD after exposure to both exercise tests, despite being accustomed to the exercise type. This suggests that well-trained athletes receive a very limited protective effect from the first bout.
Yoshiharu Shimomura, Asami Inaguma, Satoko Watanabe, Yuko Yamamoto, Yuji Muramatsu, Gustavo Bajotto, Juichi Sato, Noriko Shimomura, Hisamine Kobayashi and Kazunori Mawatari
The authors examined the effect of branched-chain amino acid (BCAA) supplementation on squat-exercise-induced delayed-onset muscle soreness (DOMS) using 12 young, healthy, untrained female participants. The experiment was conducted with a crossover double-blind design. In the morning on the exercise-session day, the participants ingested either BCAA (isoleucine:leucine:valine = 1:2.3:1.2) or dextrin at 100 mg/kg body weight before the squat exercise, which consisted of 7 sets of 20 squats/set with 3-min intervals between sets. DOMS showed a peak on Days 2 and 3 in both trials, but the level of soreness was significantly lower in the BCAA trial than in the placebo. Leg-muscle force during maximal voluntary isometric contractions was measured 2 d after exercise (Day 3), and the BCAA supplementation suppressed the muscle-force decrease (to ~80% of the value recorded under the control conditions) observed in the placebo trial. Plasma BCAA concentrations, which decreased after exercise in the placebo trial, were markedly elevated during the 2 hr postexercise in the BCAA trial. Serum myoglobin concentration was increased by exercise in the placebo but not in the BCAA trial. The concentration of plasma elastase as an index of neutrophil activation appeared to increase after the squat exercise in both trials, but the change in the elastase level was significant only in the placebo trial. These results suggest that muscle damage may be suppressed by BCAA supplementation.
Kelle F. T. Veggi, Marco Machado, Alexander J. Koch, Sandro C. Santana, Sedison S. Oliveira and Michael J. Stec
We examined the effects of creatine supplementation on the response to repeated bouts of resistance exercise.
Young men (24.1 ± 5.2 yr) were divided into Creatine (CM, n = 9) and Placebo (PL, n = 9) groups. On day (D) 1 and D15, subjects performed four sets of bicep curls at 75% 1-RM to concentric failure. On D8-D13, subjects consumed either 20g/d creatine monohydrate or placebo. Muscle soreness and elbow joint range of motion (ROM) were assessed on D1-D5 and D15-D19. Serum creatine kinase activity (CK) was assessed on D1, D3, D5, D15, D17, and D19.
The first exercise bout produced increases in muscle soreness and CK, and decreases in ROM in both groups (p < .001). The second bout produced lesser rises in serum CK, muscle soreness, and a lesser decrease in ROM (bout effect, p < .01 for all), with greater attenuation of these damage markers in CM than PL. CK levels on D17 were lower (+110% over D15 for CM vs. +343% for PL), muscle soreness from D15–19 was lower (–75% for CM vs. –56% for PL compared with first bout), and elbow ROM was decreased in PL, but not CM on D16 (p < .05 for all).
Creatine supplementation provides an additive effect on blunting the rise of muscle damage markers following a repeated bout of resistance exercise. The mechanism by which creatine augments the repeated bout effect is unknown but is likely due to a combination of creatine’s multifaceted functions.
Tom Clifford, Will Abbott, Susan Y. Kwiecien, Glyn Howatson and Malachy P. McHugh
It is well established that a soccer match can induce muscle damage that persists for several days. 1 – 3 Typically, this muscle damage manifests as increased feelings of muscle soreness (MS) and a reduced force-generating capacity, both of which can increase the risk of injury 4 and negatively
Renato Evangelista, Rafael Pereira, Anthony C. Hackney and Marco Machado
To compare differences between two different rest interval lengths between sets on the volume completed, muscle damage and muscle soreness during a resistance exercise bout.
Twenty-eight healthy sedentary men (18 ± 1 y old) volunteered to participate in this study and were divided into the 1 min (1RI; n = 14) or 3 min (3RI; n = 14) rest interval length between sets. They were submitted to maximal voluntary isometric contraction strength (MVC) and then performed a resistance exercise protocol constituted for three sets of biceps curl at 40% of MVC with 1 min (1RI group) or 3 min (3RI group) interval length between sets. Each bout was performed to voluntary fatigue and the workout volume completed was calculated. Subjects provided blood samples before each bout, and at 24, and 48 h following exercise to evaluate serum CK activity. Muscle soreness was analyzed through visual analog scale, which was presented to subjects before frst bout, immediately after exercise protocol and at 24, and 48 h following exercise.
The results demonstrated that the subjects with longer rest intervals provide greater workout volume as expected, but there were no differences in serum CK activity and muscle soreness between groups.
Training with highvolume, low-intensity resistance training, exercising with short rest intervals does not appear to present any additional challenge to recovery in untrained subjects.