Nutrition and Muscle Recovery

Abstract

Exercise‐induced muscle damage (EIMD) is characterized by histopathologicalmuscle tissue changes that originate skeletal muscle damage [...]

Full text

nutrients
Editorial
Nutrition and Muscle Recovery
Juan Mielgo-Ayuso 1,2,* and Diego Fernández-Lázaro 3,4
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
Citation: Mielgo-Ayuso, J.;
Fernández-Lázaro, D. Nutrition and
Muscle Recovery. Nutrients 2021,13,
294. https://doi.org/10.3390/
nu13020294
Received: 4 December 2020
Accepted: 1 January 2021
Published: 20 January 2021
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1Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
2ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and
Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
3Department of Cellular Biology, Histology and Pharmacology, Faculty of Health Sciences, University of
Valladolid, Campus of Soria, 42003 Soria, Spain; diego.fernandez.lazaro@uva.es
4Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain
*Correspondence: jfmielgo@ubu.es
Exercise-induced muscle damage (EIMD) is characterized by histopathological muscle
tissue changes that originate skeletal muscle damage. The destruction of skeletal muscle
fibers causes an inflammatory response that decreases the athlete’s physical work capacity
and sports performance. Thus, muscle recovery becomes essential and has become a
priority for elite athletes in different sports modalities. To achieve optimal muscle recovery,
athletes often combine additional recovery strategies (biological, pharmacological, mechan-
ical, and nutritional) in the hope of improving physiological responses and competitive
performance. This extra preparation could contribute sensibly and legally to athletes to
adequately complement their training to obtain better performance or try “shortcuts” to
reach the sport’s elite in less time, with treatments and/or prohibited artificial methods
that improve their ability to achieve more extraordinary physical performance. Among
the strategies employed, the nutritional plan has a decisive influence on the stimulation
of muscle recovery. However, it is necessary to optimize the consumption of adequate
amounts of energy, nutrients, and liquids, establishing the correct frequency and associated
with the temporality of training and competition.
Furthermore, there are occasions when all these nutritional indications are insufficient,
and it becomes necessary to administer supplements to improve sports performance.
Dietary supplements are intended to complete and enhance the athlete’s diet, optimize
recovery during or after efforts, and increase the energy reserves needed to face strenuous
competitions. For this reason, in this Special Issue, Nutrition and Muscle Recovery, we
describe the most influential nutritional resources for promoting muscle anabolism. Studies
on proteins, amino acids, carbohydrates, antioxidants, and dietary supplements have
demonstrated their importance and effectiveness in muscle recovery. It is also essential
to take into account the guidelines on quantity, time, and composition of each of the
nutritional elements to maximize their effectiveness, taking into account the principle of
sports specificity.
Nutrients’ special edition has brought together various research manuscripts [
1
–
11
]
and a systematic review [
12
]. This Special Issue, entitled Nutrition and Muscle Recovery,
gathered 12 manuscripts [
1
–
12
]; one manuscript (8.3%) [
9
] was related to the analysis of
the coach’s social skills influencing the athlete’s eating habits. In this way, the essential role
of eating habits to attain sporting success is demonstrated. Trigueros et al. [
9
] included
1547 subjects, men and women in different team sports (soccer, basketball, volleyball, and
handball), and 127 trainers. The main results showed that the psychological disorders
derived from anxiety, stress, and depression directly influenced the patterns of unhealthy
eating. Thus, these findings stimulate the implementation of a favorable social environment
to develop nutritional strategies that encourage a diet that achieves optimal health for
athletes to succeed in the sport. Trigueros et al. [
9
] showed that coaches’ respectful and
understanding behavior with their athletes improves psychological and emotional well-
Nutrients 2021,13, 294. https://doi.org/10.3390/nu13020294 https://www.mdpi.com/journal/nutrients

Nutrients 2021,13, 294 2 of 4
being, self-esteem, and confidence. In this way, the athletes can face sports practice stressors
and develop healthy eating habits that result in improvements in their sports performance.
Additionally, two research papers (16.6%) analyzed the nutritional composition of sports
foods [
3
,
6
] that allows the generation of individualized diets according to the athlete’s sports
performance and competitive performance. Martínez-Sanz et al. [
3
] generated a database that
reports foods’ composition concerning the portion sizes usually consumed by athletes and/or
commercial recommendation guidelines. Three hundred and twenty-two foods with a high
interest in sports practice and 18 registered trademarks that provided nutritional data were
analyzed. These foods were classified into seven categories: “sports drinks; sports gels; sports
bars; sports confectionery; protein powders; protein bars; and liquid foods.” In this way, a tool
was generated for the nutrition professionals that facilitates the athletes’ dietetic-nutritional
planning before, during, or after the training and/or competition. Mielgo-Ayuso et al. [
6
]
analyzed the associations between EIMD, cardiac stress (EICS), and the diets of marathon
runners in the seven days prior to a competition. The results showed that semi-elite marathon
athletes had higher levels of EIMD and EICS caused by the intake of meat in general, and
butter and fatty meat in particular. In contrast, the consumption of fish, vegetables, and olive
oil would exert a modulating effect on the EIMD and EICS [
6
]. With these results, appropriate
nutrition education programs could be created for all sports professionals to achieve adequate
health status to optimize sports performance.
In this Special Issue, two manuscripts (16.6%) [
7
,
8
] evaluated the comparative efficacy
of whey proteins vs. vegetable-based proteins on EIMD. In this sense, Nieman et al. [
7
]
evaluated comparatively, through a randomized trial, pea protein, serum protein, and
placebo on muscle damage, inflammation, delayed onset of muscle pain (DOMS), and
physical performance for five days after a 90-min high eccentric activity in a non-athletic,
non-obese male population. These authors report that three doses of 0.3 g/kg per day of
serum protein isolate during the five post-exercise days reduce muscle damage in the tested
population. On the other hand, pea protein consumption had a minor effect on EIMD
attenuation. Together, these data support using three doses of 0.3 g/kg per day of serum
protein isolate during five days of recovery from intensive eccentric exercise to reduce
serum levels of biomarkers of muscle damage in untrained men, with pea protein intake
having an intermediate effect. Only the increase in muscle fiber size, muscle strength, and
muscle recovery caused by pre-sleep serum protein intake was observed. However, both
proteins used in the study (whey protein and pea protein) showed no significant decreases
in DOMS and no increase in physical performance compared to placebo [
7
]. In this way,
Saracino et al. [
8
] investigated to compare whey vs. plant-based (alternative protein
sources) pre-sleep protein dietary supplementation on muscle recovery in 27 physically
active middle-aged men. The results showed that the consumption of 1.08
±
0.02 g/kg/day
of the protein showed no effect on harmful eccentric exercise over 72 h. Pre-sleep protein
intake, independent of protein source, did not mitigate muscle damage. For these reasons,
Saracino et al. [
8
] state that adequate protein intake per day (1.2–1.6 g/kg or 1.4–2.0 g/kg)
and a protein intake close to physical activity stimulate muscle recovery. In summary,
these two studies [
7
,
8
] show that the development of lean mass, increased strength, and
improved recovery are achieved through protein supplementation following the guidelines
established in their research.
Carbohydrate (CHO) supplements may improve sports performance in certain phys-
ical activities of varying intensity and duration. In addition, during endurance exercise,
CHO intake showed to delay neuromuscular fatigue and significantly improve physical
work capacity, depending on the dose used and modulate EIMD biomarkers. Three studies
(25%) [
5
,
10
,
11
] of this Special Issue, Nutrition and Muscle Recovery, investigated the effects
of CHO ingestion on physical performance (repeated sprint efforts) [
5
], neuromuscular
function [
10
], and EIMD markers [
11
]. A randomized, double-blind placebo-controlled
crossover trial of 15 recreational athletes found that CHO ingestion immediately before
and during short, maximal, and repeated sprint exercise does not influence performance
and it does not increase the quality of training [
5
]. These findings question CHO’s potential

Nutrients 2021,13, 294 3 of 4
ergogenic value for longer durations’ anaerobic performance than previously observed in
other studies. McMahon et al. [
5
] provide some useful findings for prescribing CHO intakes
for the athlete to perform practical performance-enhancing training. The CHO intake may
not have been used to increase adenosine triphosphate (ATP) turnover, thus, improving
anaerobic cycling performance compared to placebo. This type of CHO ingestion does not
appear to provide any ergogenic benefits [
5
]. Two studies [
10
,
11
] from the same research
group examined and compared the effects of high CHO intake (120 g/h) in terms of CHO
intake recommendation (90 g/h) and regular CHO intake performed by ultra-endurance
athletes (60 g/h) during a mountain marathon, on neuromuscular function, high intensity
run capacity recovery, and EIMD in marathon elite runners. This research group [
10
,
11
]
showed, for the first time, that the intake of CHO higher than currently recommended
(up to 120 g/h) during an endurance test positively stimulates long-term neuromuscu-
lar recovery and modulates the decline in sports performance 24 h after the end of the
mountain marathon and constitutes a suitable strategy for modulating EIMD [
10
,
11
]. These
studies [
10
,
11
] provide new evidence on carbohydrate consumption in elite athletes with
results that modify previous results that establish the intestinal absorption limit at 90 g/h
through small bowel carriers. The 120 g/h of CHO does not produce adverse reactions in
the gastrointestinal tract. To achieve this, athletes must be trained to perform the maximum
possible individual intake of CHO (up to 120 g/h). The mixture of CHO in a ratio of
glucose and fructose of 2:1 could be considered an optimal composition to ingest high
CHO amounts (up to 120 g/h) [10,11].
Nutritional supplements were studied in four studies (33.2%) in this Special Is-
sue [
1
,
2
,
4
,
12
]. Bazzucchi et al. [
1
] and Martin-Rincon et al. [
4
] have studied the effect of
polyphenols on muscle recovery, EIMD, and muscle pain, with quercetin (Q) in monother-
apy and quercetin plus Zynamite
®
(mango leaf extract), respectively. Q is a flavonol-
type polyphenol and Zynamite
®
is a natural polyphenol; both have antioxidant and
anti-inflammatory attributes that may stop EIMD and promote muscle recovery [
1
,
4
]. The
supplementation with Q (1 gr/d) for 14 days following a double-blind crossover study
design improve recovery from EIMD, the deterioration of neuromuscular function, and
modulated the increase in muscular biomarkers such as creatine kinase (CK) and lactate-
dehydrogenase (LDH) [
1
] in healthy men. Similarly, an only dose before 60 min the exercise
(140 mg Zynamite
®
plus 140 mg quercetin), followed by after 3 extra-doses every 8 h
allowed modulates EIMD and stimulates the recovery of muscle performance [
4
]. Recovery
of muscle strength and performance after intense exercise is enhanced by polyphenol
supplementation, probably due to protection against oxidative damage that prevents post-
exercise muscle soreness. These effects impact the redox process and factors acting at the
central nervous system level by eliminating free radicals involved in nociception [1,4].
Athletes often turn to nutritional supplements such as proteins and amino acids
to keep health and increase sports performance to the maximum. The proteins and
amino acids represent the most consumed ergogenic aids. In this Special Issue, two
manuscripts [
2
,
12
] described the effect of two amino acid supplementation strategies on
sports performance. Fernandez-Landa et al. [
2
] created one of a small number of research
studies of the additional effect level of amino acid mixing (creatine monohydrate (CrM) and
β
-hydroxy
β
-methylbutyrate (HMB)); also, they have identified whether their effects are
synergistic in professional rowers. The main findings of these authors [
2
] are that the mix-
ture of CrM plus HMB has a highly synergistic effect on anaerobic performance evaluated
on 4 mmol and 8 mmol blood lactate concentration. The results of this research have an
immediate practical application as the supplementation for 10 weeks HMB (3 g/day) plus
CrM (0.04 g/kg/day) improves sports performance. Furthermore, this represents a novel
way of evaluating supplementation strategies’ real effect from the research perspective.
There is only one review in this special volume. This is a systematic review and
meta-analysis [
12
] to estimate the impacts of arginine (Arg) supplementation on sport
performance. It additionally investigates the effective dose and timing of Arg. Eighteen
randomized controlled clinical trials investigated Arg supplementation on the potential

Nutrients 2021,13, 294 4 of 4
effect on aerobic and anaerobic performance tests. The meta-analysis results determined
that the acute administration of Arg at 0.15 g/kg (10–11 g) 60–90 min prior to exercise
stimulates substantial improvements in both aerobic and anaerobic exercise capacity. After
chronic administration of Arg 1.5 to 2 g/day for 4 to 7 or more doses (10 to 12 g/day for 8
weeks), different relevant results showed improvements in athletic performance [
12
]. All
studies in this systematic review and meta-analysis included Arg in monotherapy. This
prevents the evaluation of possible additive effects with other ergo-nutritional supplements,
such as the study developed by Fernandez-Landa et al. [2].
The diversity of articles published in the Special Issue Nutrition and Muscle Recovery
highlights the role of diet, healthy behavior, nutritional strategies, and dietary supplements
on muscle recovery to improve sports performance and/or reduce fatigue in sport.
Author Contributions:
J.M.-A. and D.F.-L. wrote the editorial. All authors have read and agreed to
the published version of the manuscript.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.
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