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Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Sports Nutrition".

Deadline for manuscript submissions: closed (15 September 2023) | Viewed by 46783

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Special Issue Editors

Prof. Dr. Sandro Massao Hirabara

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Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil
Interests: insulin resistance; skeletal muscle metabolism; cell signaling; mitochondrial function; dietary supplements; physical exercise
Special Issues, Collections and Topics in MDPI journals

Dr. Gabriel Nasri Marzuca Nassr

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Faculty of Medicine, Universidad de La Frontera, Temuco 4781176, Chile
Interests: physical therapy; rehabilitation; nutrition; nutritional supplements; cancer; physical exercise training; human performance
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Maria Fernanda Cury Boaventura

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Co-Guest Editor

Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 03342-000, Brazil
Interests: nutritional interventions; muscle physiology; muscle damage; inflammation; physical exercise; muscle recovery

Special Issue Information

Dear Colleagues,

The present Special Issue aims to join efforts towards the comprehension of the effects of nutrition and physical exercise on skeletal muscle physiology, injury, and recovery, using different experimental models (cells, animals, and humans) in both healthy and pathological conditions. Of particular interest, studies addressing cellular and molecular mechanisms involved in these processes, including energy metabolism, inflammatory pathways, oxidative stress regulation, mitochondrial function alteration, and gene expression control are welcome. We also welcome papers targeting the identification of cellular and molecular targets of nutritional interventions and physical exercise for the treatment and/or prevention of skeletal muscle injury and recovery.

Prof. Dr. Sandro Massao Hirabara
Prof. Dr. Gabriel Nasri Marzuca Nassr
Prof. Dr. Maria Fernanda Cury Boaventura
Guest Editors

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Keywords

physical exercise
nutritional intervention
inflammation
oxidative stress
metabolism
molecular targets

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Published Papers (11 papers)

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Editorial

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4 pages, 190 KiB

Open AccessEditorial

Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy

by Sandro Massao Hirabara, Gabriel Nasri Marzuca-Nassr and Maria Fernanda Cury-Boaventura

Nutrients 2024, 16(2), 293; https://doi.org/10.3390/nu16020293 - 18 Jan 2024

Cited by 1 | Viewed by 2675

Abstract

Interventional strategies involving nutrition and physical exercise have been widely proposed to positively modulate skeletal muscle function, in both physiological and pathological states, such as obesity, T2DM, inflammatory diseases, cardiovascular diseases, aging, and sarcopenia [...] Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

Research

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16 pages, 1765 KiB

Open AccessArticle

Spirulina Supplementation with High-Intensity Interval Training Decreases Adipokines Levels and Cardiovascular Risk Factors in Men with Obesity

by Rashmi Supriya, Maryam Delfan, Ayoub Saeidi, Seyedeh Somayeh Samaie, Maisa Hamed Al Kiyumi, Kurt A. Escobar, Ismail Laher, Katie M. Heinrich, Katja Weiss, Beat Knechtle and Hassane Zouhal

Nutrients 2023, 15(23), 4891; https://doi.org/10.3390/nu15234891 - 23 Nov 2023

Cited by 8 | Viewed by 6267

Abstract

Adiposity, a state characterized by excessive accumulation of body fat, is closely linked to metabolic complications and the secretion of specific adipokines. This study explores the potential of exercise and Spirulina supplementation to mitigate these complications and modulate adipokine release associated with obesity. The primary objective of this investigation was to examine the impact of a 12-week regimen of high-intensity training combined with Spirulina supplementation on adipokine concentrations and lipid profiles in male individuals with obesity (N = 44). The participants were randomly distributed into four groups, each consisting of 11 participants: a control group (CG), a supplement group (SG), a training group (TG), and a training plus supplement group (TSG). The intervention comprised a 12-week treatment involving Spirulina supplementation (6 g capsule daily), a 12-week high-intensity interval training (HIIT) protocol with three sessions per week, or a combined approach. Following the interventions, metabolic parameters, anthropometric measurements, cardiorespiratory indices, and circulating adipokines [CRP, Sema3C, TNF-α, IL-6, MCP1, IL-8] were assessed within 48 h of the before and final training session. Statistical analyses revealed significant differences across all measures among the groups (p < 0.05). Notably, post hoc analyses indicated substantial disparities between the CG and the three interventional groups regarding body weight (p < 0.05). The combined training and supplementation approach led to noteworthy reductions in low-density lipoprotein (LDL), total cholesterol (TC), and triglyceride (TGL) levels (all p < 0.0001), coupled with an elevation in high-density lipoprotein–cholesterol (HDL-C) levels (p = 0.0001). Furthermore, adipokine levels significantly declined in the three intervention groups relative to the CG (p < 0.05). The findings from this 12-week study demonstrate that Spirulina supplementation in conjunction with high-intensity interval training reduced adipokine levels, improved body weight and BMI, and enhanced lipid profiles. This investigation underscores the potential of Spirulina supplementation and high-intensity interval training as a synergistic strategy to ameliorate obesity-related complications and enhance overall cardiometabolic well-being in obese males. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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15 pages, 1266 KiB

Open AccessArticle

Astaxanthin Supplementation Augments the Benefits of CrossFit Workouts on Semaphorin 3C and Other Adipokines in Males with Obesity

by Rashmi Supriya, Sevda Rahbari Shishvan, Movahed Kefayati, Hossein Abednatanzi, Omid Razi, Reza Bagheri, Kurt A. Escobar, Zhaleh Pashaei, Ayoub Saeidi, Shahnaz Shahrbanian, Sovan Bagchi, Pallav Sengupta, Maisa Hamed Al Kiyumi, Katie M. Heinrich and Hassane Zouhal

Nutrients 2023, 15(22), 4803; https://doi.org/10.3390/nu15224803 - 16 Nov 2023

Cited by 2 | Viewed by 2795

Abstract

Regular physical activity and the use of nutritional supplements, including antioxidants, are recognized as efficacious approaches for the prevention and mitigation of obesity-related complications. This study investigated the effects of 12 weeks of CrossFit training combined with astaxanthin (ASX) supplementation on some plasma adipokines in males with obesity. Sixty-eight males with obesity (BMI: 33.6 ± 1.4 kg·m⁻²) were randomly assigned into four groups: the control group (CG; n = 11), ASX supplementation group (SG; n = 11), CrossFit group (TG; n = 11), and training plus supplement group (TSG; n = 11). Participants underwent 12 weeks of supplementation with ASX or placebo (20 mg/day capsule daily), CrossFit training, or a combination of both interventions. Plasma levels of semaphorin 3C (SEMA3C), apelin, chemerin, omentin1, visfatin, resistin, adiponectin, leptin, vaspin, and RBP4 were measured 72 h before the first training session and after the last training session. The plasma levels of all measured adipokines were significantly altered in SG, TG, and TSG groups (p < 0.05). The reduction of resistin was significantly higher in TSG than in SG (p < 0.05). The plasma levels of omentin1 were significantly higher in both training groups of TG and TSG than SG (p < 0.05), although such a meaningful difference was not observed between both training groups (p > 0.05). Significant differences were found in the reductions of plasma levels of vaspin, visfatin, apelin, RBP4, chemerin, and SEMA3C between the SG and TSG groups (p < 0.05). The study found that a 12-week intervention using ASX supplementation and CrossFit exercises resulted in significant improvements in several adipokines among male individuals with obesity. Notably, the combined approach of supplementation and training had the most pronounced results. The findings presented in this study indicate that the supplementation of ASX and participation in CrossFit exercise have the potential to be effective therapies in mitigating complications associated with obesity and enhancing metabolic health. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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18 pages, 5672 KiB

Open AccessArticle

Effects of Creatine Supplementation on the Myostatin Pathway and Myosin Heavy Chain Isoforms in Different Skeletal Muscles of Resistance-Trained Rats

by Marianna Rabelo de Carvalho, Ellen Fernandes Duarte, Maria Lua Marques Mendonça, Camila Souza de Morais, Gabriel Elias Ota, Jair José Gaspar-Junior, Wander Fernando de Oliveira Filiú, Felipe Cesar Damatto, Marina Politi Okoshi, Katashi Okoshi, Rodrigo Juliano Oliveira, Paula Felippe Martinez and Silvio Assis de Oliveira-Junior

Nutrients 2023, 15(9), 2224; https://doi.org/10.3390/nu15092224 - 8 May 2023

Cited by 1 | Viewed by 3495

Abstract

Creatine has been used to maximize resistance training effects on skeletal muscles, including muscle hypertrophy and fiber type changes. This study aimed to evaluate the impact of creatine supplementation on the myostatin pathway and myosin heavy chain (MyHC) isoforms in the slow- and fast-twitch muscles of resistance-trained rats. Twenty-eight male Wistar rats were divided into four groups: a sedentary control (Cc), sedentary creatine supplementation (Cr), resistance training (Tc), and resistance training combined with creatine supplementation (Tcr). Cc and Tc received standard commercial chow; Cr and Tcr received a 2% creatine-supplemented diet. Tc and Tcr performed a resistance training protocol on a ladder for 12 weeks. Morphology, MyHC isoforms, myostatin, follistatin, and ActRIIB protein expressions were analyzed in soleus and white gastrocnemius portion samples. The results were analyzed using two-way ANOVA and Tukey’s test. Tc and Tcr exhibited higher performance than their control counterparts. Resistance training increased the ratio between muscle and body weight, the cross-sectional area, as well as the interstitial collagen fraction. Resistance training alone increased MyHC IIx and follistatin while reducing myostatin (p < 0.001) and ActRIIB (p = 0.040) expressions in the gastrocnemius. Resistance training induced skeletal muscle hypertrophy and interstitial remodeling, which are more evident in the gastrocnemius muscle. The effects were not impacted by creatine supplementation. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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12 pages, 289 KiB

Open AccessArticle

Different Effects of Cyclical Ketogenic vs. Nutritionally Balanced Reduction Diet on Serum Concentrations of Myokines in Healthy Young Males Undergoing Combined Resistance/Aerobic Training

by Pavel Kysel, Denisa Haluzíková, Iveta Pleyerová, Kateřina Řezníčková, Ivana Laňková, Zdeňka Lacinová, Tereza Havrlantová, Miloš Mráz, Barbora Judita Kasperová, Viktorie Kovářová, Lenka Thieme, Jaroslava Trnovská, Petr Svoboda, Soňa Štemberková Hubáčková, Zdeněk Vilikus and Martin Haluzík

Nutrients 2023, 15(7), 1720; https://doi.org/10.3390/nu15071720 - 31 Mar 2023

Cited by 4 | Viewed by 3205

Abstract

Myokines represent important regulators of muscle metabolism. Our study aimed to explore the effects of a cyclical ketogenic reduction diet (CKD) vs. a nutritionally balanced reduction diet (RD) combined with regular resistance/aerobic training in healthy young males on serum concentrations of myokines and their potential role in changes in physical fitness. Twenty-five subjects undergoing regular resistance/aerobic training were randomized to the CKD (n = 13) or RD (n = 12) groups. Anthropometric and spiroergometric parameters, muscle strength, biochemical parameters, and serum concentrations of myokines and cytokines were assessed at baseline and after 8 weeks of intervention. Both diets reduced body weight, body fat, and BMI. Muscle strength and endurance performance were improved only by RD. Increased musclin (32.9 pg/mL vs. 74.5 pg/mL, p = 0.028) and decreased osteonectin levels (562 pg/mL vs. 511 pg/mL, p = 0.023) were observed in RD but not in the CKD group. In contrast, decreased levels of FGF21 (181 pg/mL vs. 86.4 pg/mL, p = 0.003) were found in the CKD group only. Other tested myokines and cytokines were not significantly affected by the intervention. Our data suggest that changes in systemic osteonectin and musclin levels could contribute to improved muscle strength and endurance performance and partially explain the differential effects of CKD and RD on physical fitness. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

19 pages, 3628 KiB

Open AccessArticle

Fish Oil Supplementation Improves the Repeated-Bout Effect and Redox Balance in 20–30-Year-Old Men Submitted to Strength Training

by Gustavo Barquilha, Cesar Miguel Momesso Dos Santos, Kim Guimaraes Caçula, Vinícius Coneglian Santos, Tatiana Geraldo Polotow, Cristina Vardaris Vasconcellos, José Alberto Fernandes Gomes-Santos, Luiz Eduardo Rodrigues, Rafael Herling Lambertucci, Tamires Duarte Afonso Serdan, Adriana Cristina Levada-Pires, Elaine Hatanaka, Maria Fernanda Cury-Boaventura, Paulo Barbosa de Freitas, Tania Cristina Pithon-Curi, Laureane Nunes Masi, Marcelo Paes Barros, Rui Curi, Renata Gorjão and Sandro Massao Hirabara

Nutrients 2023, 15(7), 1708; https://doi.org/10.3390/nu15071708 - 31 Mar 2023

Cited by 3 | Viewed by 2939

Abstract

Herein, we investigated the effect of fish oil supplementation combined with a strength-training protocol, for 6 weeks, on muscle damage induced by a single bout of strength exercise in untrained young men. Sixteen men were divided into two groups, supplemented or not with fish oil, and they were evaluated at the pre-training period and post-training period. We investigated changes before and 0, 24, and 48 h after a single hypertrophic exercise session. Creatine kinase (CK) and lactate dehydrogenase (LDH) activities, plasma interleukin-6 (IL-6) and C-reactive protein (CRP) levels, and the redox imbalance were increased in response to the single-bout session of hypertrophic exercises at baseline (pre-training period) and decreased during the post-training period in the control group due to the repeated-bout effect (RBE). The fish oil supplementation exacerbated this reduction and improved the redox state. In summary, our findings demonstrate that, in untrained young men submitted to a strength-training protocol, fish oil supplementation is ideal for alleviating the muscle injury, inflammation, and redox imbalance induced by a single session of intense strength exercises, highlighting this supplementation as a beneficial strategy for young men that intend to engage in strength-training programs. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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16 pages, 1992 KiB

Open AccessArticle

Changes in Blood Markers of Oxidative Stress, Inflammation and Cardiometabolic Patients with COPD after Eccentric and Concentric Cycling Training

by Mayalen Valero-Breton, Denisse Valladares-Ide, Cristian Álvarez, Reyna S. Peñailillo and Luis Peñailillo

Nutrients 2023, 15(4), 908; https://doi.org/10.3390/nu15040908 - 11 Feb 2023

Cited by 4 | Viewed by 2690

Abstract

Chronic obstructive pulmonary disease (COPD) patients manifest muscle dysfunction and impaired muscle oxidative capacity, which result in reduced exercise capacity and poor health status. This study examined the effects of 12-week eccentric (ECC) and concentric (CONC) cycling training on plasma markers of cardiometabolic health, oxidative stress, and inflammation in COPD patients. A randomized trial in which moderate COPD was allocated to ECC (n = 10; 68.2 ± 10.0 year) or CONC (n = 10; 71.1 ± 10.3 year) training groups. Participants performed 12-week ECC or CONC training, 2–3 sessions per week, 10 to 30 min per session. Before and after training, peak oxygen consumption, maximal power output (VO_2peak and PO_max), and time-to-exhaustion (TTE) tests were performed. Plasma antioxidant and oxidative markers, insulin resistance, lipid profile, and systemic inflammation markers were measured before and after training at rest. VO_2peak, PO_max and TTE remained unchanged after ECC and CONC. CONC induced an increase in antioxidants (p = 0.01), while ECC decreased antioxidant (p = 0.02) markers measured at rest. CONC induced lesser increase in oxidative stress following TTE (p = 0.04), and a decrease in insulin resistance (p = 0.0006) compared to baseline. These results suggest that CONC training induced an increase in insulin sensitivity, antioxidant capacity at rest, and lesser exercise-induced oxidative stress in patients with moderate COPD. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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14 pages, 1085 KiB

Open AccessArticle

Chronic Low or High Nutrient Intake and Myokine Levels

by Ana Paula Renno Sierra, Antônio Alves Fontes-Junior, Inês Assis Paz, Cesar Augustus Zocoler de Sousa, Leticia Aparecida da Silva Manoel, Duane Cardoso de Menezes, Vinicius Alves Rocha, Hermes Vieira Barbeiro, Heraldo Possolo de Souza and Maria Fernanda Cury-Boaventura

Nutrients 2023, 15(1), 153; https://doi.org/10.3390/nu15010153 - 29 Dec 2022

Cited by 3 | Viewed by 3275

Abstract

Inadequate nutrient availability has been demonstrated to be one of the main factors related to endocrine and metabolic dysfunction. We investigated the role of inadequate nutrient intakes in the myokine levels of runners. Sixty-one amateur runners participated in this study. The myokine levels were determined using the Human Magnetic Bead Panel from plasma samples collected before and after the marathon. Dietary intake was determined using a prospective method of three food records. The runners with lower carbohydrate and calcium intakes had higher percentages of fat mass (p < 0.01). The runners with a sucrose intake comprising above 10% of their energy intake and an adequate sodium intake had higher levels of BDNF (p = 0.027 and p = 0.031). After the race and in the recovery period, the runners with adequate carbohydrate intakes (g/kg) (>5 g/kg/day) had higher levels of myostatin and musclin (p < 0.05). The runners with less than 45% of carbohydrate of EI had lower levels of IL-15 (p = 0.015) and BNDF (p = 0.013). The runners with higher cholesterol intakes had lower levels of irisin (p = 0.011) and apelin (p = 0.020), and those with a low fiber intake had lower levels of irisin (p = 0.005) and BDNF (p = 0.049). The inadequate intake influenced myokine levels, which promoted cardiometabolic tissue repair and adaptations to exercise. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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Review

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20 pages, 3368 KiB

Open AccessReview

Endothelial Glycocalyx Preservation—Impact of Nutrition and Lifestyle

by Paula Franceković and Lasse Gliemann

Nutrients 2023, 15(11), 2573; https://doi.org/10.3390/nu15112573 - 31 May 2023

Cited by 5 | Viewed by 4533

Abstract

The endothelial glycocalyx (eGC) is a dynamic hair-like layer expressed on the apical surface of endothelial cells throughout the vascular system. This layer serves as an endothelial cell gatekeeper by controlling the permeability and adhesion properties of endothelial cells, as well as by controlling vascular resistance through the mediation of vasodilation. Pathogenic destruction of the eGC could be linked to impaired vascular function, as well as several acute and chronic cardiovascular conditions. Defining the precise functions and mechanisms of the eGC is perhaps the limiting factor of the missing link in finding novel treatments for lifestyle-related diseases such as atherosclerosis, type 2 diabetes, hypertension, and metabolic syndrome. However, the relationship between diet, lifestyle, and the preservation of the eGC is an unexplored territory. This article provides an overview of the eGC’s importance for health and disease and describes perspectives of nutritional therapy for the prevention of the eGC’s pathogenic destruction. It is concluded that vitamin D and omega-3 fatty acid supplementation, as well as healthy dietary patterns such as the Mediterranean diet and the time management of eating, might show promise for preserving eGC health and, thus, the health of the cardiovascular system. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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15 pages, 1612 KiB

Open AccessReview

The Role of Omega-3 Polyunsaturated Fatty Acids and Their Lipid Mediators on Skeletal Muscle Regeneration: A Narrative Review

by Sebastian Jannas-Vela, Alejandra Espinosa, Alejandro A. Candia, Marcelo Flores-Opazo, Luis Peñailillo and Rodrigo Valenzuela

Nutrients 2023, 15(4), 871; https://doi.org/10.3390/nu15040871 - 8 Feb 2023

Cited by 15 | Viewed by 7128

Abstract

Skeletal muscle is the largest tissue in the human body, comprising approximately 40% of body mass. After damage or injury, a healthy skeletal muscle is often fully regenerated; however, with aging and chronic diseases, the regeneration process is usually incomplete, resulting in the formation of fibrotic tissue, infiltration of intermuscular adipose tissue, and loss of muscle mass and strength, leading to a reduction in functional performance and quality of life. Accumulating evidence has shown that omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and their lipid mediators (i.e., oxylipins and endocannabinoids) have the potential to enhance muscle regeneration by positively modulating the local and systemic inflammatory response to muscle injury. This review explores the process of muscle regeneration and how it is affected by acute and chronic inflammatory conditions, focusing on the potential role of n-3 PUFAs and their derivatives as positive modulators of skeletal muscle healing and regeneration. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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Other

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17 pages, 2867 KiB

Open AccessSystematic Review

Effectiveness of Whey Protein Supplementation during Resistance Exercise Training on Skeletal Muscle Mass and Strength in Older People with Sarcopenia: A Systematic Review and Meta-Analysis

by Iván Cuyul-Vásquez, José Pezo-Navarrete, Cristina Vargas-Arriagada, Cynthia Ortega-Díaz, Walter Sepúlveda-Loyola, Sandro Massao Hirabara and Gabriel Nasri Marzuca-Nassr

Nutrients 2023, 15(15), 3424; https://doi.org/10.3390/nu15153424 - 2 Aug 2023

Cited by 10 | Viewed by 6194

Abstract

Objective: To determine the effectiveness of whey protein (WP) supplementation during resistance exercise training (RET) vs. RET with or without placebo supplementation on skeletal muscle mass, strength, and physical performance in older people with Sarcopenia. Methods: Electronic searches in the PubMed, Embase, Scopus, Web of Science, LILACS, SPORTDiscus, Epistemonikos, and CINAHL databases were performed until 20 January 2023. Randomized clinical trials conducted on sarcopenic adults aged 60 or older were included. The studies had to compare the effectiveness of the addition of supplements based on concentrated, isolated, or hydrolyzed whey protein during RET and compare it with RET with or without placebo supplementation on skeletal muscle mass and strength changes. The study selection process, data extraction, and risk of bias assessment were carried out by two independent reviewers. Results: Seven randomized clinical trials (591 participants) were included, and five of them provided data for quantitative synthesis. The overall pooled standardized mean difference (SMD) estimate showed a small effect size in favor of RET plus WP for skeletal muscle mass according to appendicular muscle index, with statistically significant differences compared with RET with or without the placebo group (SMD = 0.24; 95% CI, 0.05 to 0.42; p = 0.01; I² = 0%, p = 0.42). The overall pooled mean difference (MD) estimate showed a significant difference of +2.31 kg (MD = 2.31 kg; 95% CI, 0.01 to 4.6; p = 0.05; I² = 81%, p < 0.001) in handgrip strength in the RET plus WP group compared with the RET group with or without placebo. The narrative synthesis revealed discordance between the results of the studies on physical performance. Conclusions: WP supplementation during RET is more effective in increasing handgrip strength and skeletal muscle mass in older people with Sarcopenia compared with RET with or without placebo supplementation. However, the effect sizes were small, and the MD did not exceed the minimally important clinical difference. The quality of the evidence was low to very low according, to the GRADE approach. Further research is needed in this field. Full article

(This article belongs to the Special Issue Nutrition and Exercise Interventions on Skeletal Muscle Physiology, Injury and Recovery: From Mechanisms to Therapy)

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