Recovery Nutrition: It s Not Just About Protein and Carbohydrates Anymore

7/7/2014 Aspects of exercise recovery  Regular intense physical training represents a stress to the body  Proper adaptation to that stress makes th...
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Aspects of exercise recovery  Regular intense physical training represents a stress to the body  Proper adaptation to that stress makes the body stronger  For the body’s successful adaptation to occur, raw materials (nutrients) must be readily available – Rest is also a critical factor

 Recovery from exercise might be described in two distinct time periods

Recovery Nutrition: It’s Not Just About Protein and Carbohydrates Anymore

– Acute (within hours and days of a training bout or competition) – Long-term (additive effects of multiple acute recovery periods over time)

 Recovery affects: – Ability to train and compete at a high level consistently – Ability of the athlete to avoid injuries and illness associated with inadequate long-term exercise recovery

Steve Hertzler, PhD, RD, LD Abbott Nutrition


Consequences of a hard workout

Metabolic state of the body after exercise

 Muscle cells in a catabolic state

 Muscle is catabolic

– Muscle protein breakdown exceeds muscle protein synthesis

– Insulin levels low; cortisol high – Muscle protein balance is negative

 Some degree of muscle cell damage has occurred  Muscle “gas tanks” are depleted  Muscle and body in general may be dehydrated

 Muscle has sustained some microtrauma – Cascade of events leading to delayed onset muscle soreness

 Hydration status of the muscle is often low  Fuel status of muscle cells is low (e.g., glycogen, intramuscular triglyceride)  Muscle cells are “primed” to take up and utilize glucose and amino acids soon after completion of exercise – Increased amount and translocation of glucose transporters (GLUT 4) to the cell membrane – Decreased inhibition of glycogen synthase by GSK3 – Increased amino acid transport into muscle cells

Source of photo:


Muscle net protein balance at rest and after resistance exercise (study done in fasting state)

Plasma insulin and cortisol responses to exercise in trained and untrained individuals End of exercise

• 6 racing cyclists and 6 untrained controls • Four 8-min exercise periods at 30, 45, 60, and 75% WorkMax • Last sample taken 5 min after exercise • Solid = trained, open = untrained

Without post-exercise feeding, negative muscle net protein balance persists!

Bloom SR et al. J Physiol 1976;258:1-18.

Phillips SM et al. Am J Physiol 1997;273:E99-E107. 5




Markers of power loss and muscle damage after eccentric exercise (downill running)

Muscle damage following eccentric exercise

Féasson L et al. J Physiol 2002;543:297-306

Féasson L et al. J Physiol 2002;543:297-306 7

Muscle glycogen content and glycogen synthase activity after exercise at different intensities


Nutritional goals for acute post-workout recovery  OVERALL GOAL: Get the body ready as soon as possible to undergo and give maximal effort to the next training session or competition  Nutritional strategies:

• Cycling exercise: 30 min at 75% Wmax followed by six 60-sec bouts at 125% Wmax • Wmax = maximum workload that Could be maintained for 6 min

– – – –

Replacement of muscle cell energy stores (mainly glycogen) Reverse catabolic state and reduce muscle protein breakdown Enhance and prolong muscle protein synthesis Decrease and repair exercise-induced muscle damage • Manage inflammation • Decrease free radical-associated muscle damage – Rehydrate the muscles and body in general

9 Sakamoto K et al. Biochem Biophys Res Comm 2004;319:419-425.


Nutrient timing: A key factor  Need to take advantage of the postexercise time period when the muscles are most receptive to nutrients!!  Ingestion of the appropriate nutrients and fluids as soon as possible after exercise helps to: – Reverse the catabolic phase and shift to anabolism • Rapidly replace glycogen • Decrease muscle protein breakdown • Increase muscle protein synthesis – Counteract free radical-mediated muscle damage • Potential for less delayed onset muscle soreness – Rehydrate muscles quickly






Timing of Postexercise Carbohydrate Ingestion and Glycogen Resynthesis (continued)

Effect of Carbohydrate and Protein on Muscle Glycogen During Recovery

P < .05


P < .05







Muscle Glycogen Storage, 1 mmol/kg wet weight

112 g CHO, 41 g protein 112 g CHO a


41 g protein







 Subjects ingested diet immediately and 2 hours after glycogen-depleting exercise; glycogen storage was assessed immediately and 4 hours postexercise

Muscle Glycogen Storage, 2 mmol/kg wet weight Subjects fed high carbohydrate diet with first meal delayed by 2 h vs. immediately post-exercise

1. Ivy JL, et al. J Appl Physiol. 1988;64(4):1480-1485. 2. Parkin JA, et al. Med Sci Sports Exerc. 1997;29(2):220-224.

a b Significantly faster compared with PRO (P < .05). Significantly faster compared with CHO (P < .05). Abbreviations: CHO, carbohydrate; Pro, protein. Zawadzki KM, et al. J Appl Physiol. 1992:72(5):1854-1859.


120-240 min



40-120 min


0-40 min


Effects of timing of carbohydrate and protein combination on protein synthesis post-exercise

Effects of Carbohydrate-Protein Combination on Muscle Glycogen Storage During Recovery

Muscle Glycogen Storage, mmol/L




Subjects fed carbohydrate (2 g/kg) after 70 min cycling immediately after or delayed 2 h after exercise

40 Muscle Glycogen Storage Rate, µmol/g pro/hour


Time Postexercise, hours

Time Postexercise, hours

Immediate feeding Delayed feeding (2 hours)

CHO-Pro: 80 g CHO, 28 g protein, 6 g fat HCHO: 108 g CHO, 6 g fat LCHO: 80 g CHO, 6 g fat









Healthy subjects fed 10 g protein, 8 g carbohydrate, 3 g fat either immediately after or 3 h after 60 min of moderate intensity exercise

 Subjects ingested diet immediately and 2 hours after glycogen-depleting exercise; glycogen storage was assessed immediately, at 20 and 40 minutes, and at 1, 2, 3, and 4 hours postexercise aSignificantly higher compared with HCHO (P = .013) and LCHO (P = .004). Abbreviations: CHO, carbohydrate; Pro, protein; HCHO, high carbohydrate; LCHO, low carbohydrate. Reprinted from Ivy JL, et al. J Appl Physiol. 2002;93(4):1337-1344.

Levenhagen et al. Am J Physiol Endocrinol Metab 2001;280:E982-E993. 15

Nutrient timing and muscle hypertrophy and strength


Effects of supplement timing on body composition

 One of the best studies out there came from Cribb and Hayes (2006)  Study of 23 recreational bodybuilders (17 completed study)  All subjects participated in a 10-wk strength training program (4 workouts per week  Subjects randomized to 2 groups: – Supplement given immediately pre- and post-workout (Pre/Post, n=8) – Supplement given on morning and evening of training day (Mor/Eve, n=9)  Each supplement serving provided, for an 80-kg person: – 32 g protein – 34 g carbohydrate – 20 g)

 Go to for lots of downloadable information on sports nutrition  Email me at: [email protected]

– Don’t forget to factor in amounts already found in high quality protein foods

 Amounts of EPA + DHA in the range of 540-3000 mg/d have been helpful in a couple of studies  Taurine and natural antioxidants/anti-inflammatories from tart cherry and pomegranate juices can improve some indices of recovery and amounts/d are pretty reasonable 47




Summary table of studies of BCAA and exercise recovery Study

Subjects and Experimental Design

Exercise protocol

BCAA supplementation dose and frequency


Nosaka et al. (2006)

Experiment 1: 14 male students Experiment 2: 24 male students (~21 y, 60 kg) Double-blind crossover

900 bicep contraction/extensions over 30 min at 9% max isometric strength

Exp 1: No significant differences in muscle soreness/damage Exp 2: Plasma CK, aldolase, myoglobin, and muscle soreness significantly lower for BCAA vs. placebo

Koba et al. (2007)

8 male distance runners (20.4 y, 58 kg) in a 5-d training camp Double-blind crossover

25-km run

Exp 1: AA supplement (1.3 g BCAA) 30 min before and immediately after exercise [total = 2.6 g/d] Exp 2: • Ex day- 1.3 g BCAA before ex, immediately after ex, and at night [3.9 g BCAA/d total] • 1.3 g BCAA two times/d for 3 d after ex [2.6 g BCAA/d total], then 1 dose on 4th day after ex [1.3 g BCAA/d total] • Placebo was maltitol plus all non-AA ingredients of supplement • 4-6 g BCAA/d 3 d before the run • 2.36 g BCAA consumed pre and during run (total) • Placebo was dextrin


From pre-run to post-run, LDH increased to a significantly lesser degree for BCAA.


Summary table, continued

Sharp and Pearson (2010)

8 previously resistance trained males (22.9 y, 77.9 kg) Double-blind crossover

4 supervised intense resistance training sessions (8 whole body exercises; 3 x 6-8 RM at 80% 1-RM) each on separate days

Summary table, continued

BCAA taken for 3 wks prior to and during the resistance training (7 additional d; 28 d total) 6 caps morning and night (1.8 g leucine, 750 mg isoleucine, 750 mg valine, 2000 mg glutamine total). [3.3 g BCAA/d total] Placebo: 12 capsules of lactose 5 g BCAA/d (2:1:1 leucine:isoleucine:valine ) for 7 d prior to race Placebo: cellulose/dextrose mix

• Areces et al. (2014)

50 amateur marathon runners, personal best time = 3.25 h Independent groups design (25 BCAA, 25 placebo) 41-42 y; ~71 kg; 3 and 4 females in BCAA and control, respectively

• •

A marathon (42 km)


Coombes and McNaughton (2000)

Significant blunting of cortisol by BCAA during training days and over the 28 d Significant increase in testosterone by BCAA during the 28 d Significant decrease in creatine kinase during the 28 d

16 healthy males, 8 per group Independent groups design 21.3 y, 76.3 kg, VO2max 51.6 mL/kg/min

• •

Cycling at 70% VO2max for 120 min

Shimomura et al. (2010)

No treatment effects on countermovement jump variables pre vs. post- race No treatment effects on urinary myoglobin pre vs. post-race

12 healthy, untrained females Double-blind crossover design 22.2 y, 48.5 kg, 22.7% body fat

• •

7 sets (20 reps/set) of body weight squats (3 min rest between sets)

• •

6 g BCAA (1:1:1) twice/d for 2 wks prior to exercise [12 g BCAA/d total] 20 g BCAA given directly before AND after exercise [40 g BCAA/d total] No placebo, control subjects consumed normal diet

100 mg/kg BCAA (Ile:Leu:Val = 1:2.3:1.2) given 15 min before exercise Dose = 4.85 g for typical subject in study Placebo was equivalent amount of dextrin

Serum creatine kinase significantly lower for BCAA at 4 h, 24 h, 10 d, and 12 d postexercise Serum lactate dehydrogenase significantly lower for BCAA at 2 h, 3 h, 4 h, 24 h, day 10 and day 12 postexercise BCAA significantly reduced leg muscle soreness on days 2 and 3 postexercise BCAA prevented force decline in maximal leg voluntary contraction at day 3 postexercise (placebo had a 20% decline, P

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