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Nutrition, Exercise Metabolism and Recovery

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

Deadline for manuscript submissions: closed (15 August 2023) | Viewed by 77436

Special Issue Editors


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Guest Editor
Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Spain
Interests: muscle damage; exercise physiology; exercise testing; sports science; exercise performance; sport physiology; exercise biochemistry; muscle physiology; athletic injuries
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Guest Editor
School of Psychology and Sport Science, Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
Interests: high protein diets in trained athletes; nutrient/supplementation strategies to support exercise training and recovery; sports nutrition; exercise metabolism

Special Issue Information

Dear Colleagues,

There is current scientific interest in the interplay between dietary intake, functional supplementation, exercise metabolism and recovery. Whilst fat oxidation is typically greater in trained individuals, nutrition strategies to enhance fat utilisation during exercise is of importance particularly for sedentary, low active or recreationally active individuals. Additionally, dietary approaches to enhance metabolic flexibility and/or reduce oxidative stress holds significant relevance for cardio-metabolic health including obesity and diabetes reduction. Targeted use of various polyphenols, ‘calorie-restriction-mimetic’ nutrients, and dietary approaches e.g. time-restricted feeding, ketogenic diets, may have potential benefits in enhancing fat utilisation during and post exercise, and may support recovery adaptations promoting greater exercise adherence.

Furthermore, with interest in dietary strategies to support musculo-skeletal adaptations across the lifespan, there is also interest in novel protein-based and other nutrition approaches to enhance adaptations during the recovery period from exercise. For those undertaking unaccustomed or intensive training, combined with current interest in plant-based protein intake, greater awareness around functional nutrition strategies to facilitate exercise adaptations is warranted.

As the Guest Editors of the Special Edition ‘Nutrition, Exercise Metabolism and Recovery’, we invite you to submit a manuscript to Nutrients, one of the most-read and cited research journals in the category “Nutrition and Metabolism”. The objective of this special edition is to bring together researchers in the fields of sport and exercise nutrition, metabolism and recovery to explore novel nutrition approaches to enhance metabolic responses and adaptations to exercise, with a particular focus on low or recreationally active individuals. This could include as example: polyphenol and phytochemical supplementation, wholefood dietary interventions, targeted single nutrient or compound strategies. Within this special edition, we welcome experimental research, systematic and meta-analysis and narrative reviews which promote researcher discussion and collaboration around dietary and nutrients strategies to support exercise-based fuel use and recovery adaptations.

Dr. Juan Del Coso
Dr. Justin Roberts
Guest Editors

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Keywords

  • metabolism
  • recovery
  • polyphenols
  • protein
  • caffeine
  • essential fats
  • ketones
  • chrononutrition

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Published Papers (9 papers)

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Research

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13 pages, 664 KiB  
Article
Estimated Energy Expenditures and Energy Intakes of International Female Rugby Sevens Players in Five Days of a Training Camp and Competition Preparation
by Christopher Curtis, Nicola Arjomandkhah, Carlton Cooke, Mayur K. Ranchordas and Mark Russell
Nutrients 2023, 15(14), 3192; https://doi.org/10.3390/nu15143192 - 19 Jul 2023
Cited by 2 | Viewed by 1842
Abstract
To understand the energy balance of international female rugby sevens (R7s) players in applied environments, this study estimated the energy intakes (EI) and total daily estimated energy expenditures (TDEE) during a five-day training camp (TRAIN) and phase of competition preparation (COMP) of equal [...] Read more.
To understand the energy balance of international female rugby sevens (R7s) players in applied environments, this study estimated the energy intakes (EI) and total daily estimated energy expenditures (TDEE) during a five-day training camp (TRAIN) and phase of competition preparation (COMP) of equal duration. Tri-axial accelerometer devices were worn throughout both scenarios to estimate TDEE, whereas EI was estimated via self-reported food diaries. Energy deficits of −47% (TDEETRAIN: 14.6 ± 1.6 MJ·day−1, EITRAIN: 7.7 ± 0.9 MJ·day−1, p ≤ 0.001, d = 5.1) and −50% (TDEECOMP: 15.5 ± 1.6 MJ·day−1, EICOMP: 7.7 ± 1.0 MJ·day−1, p ≤ 0.001, d = 5.7) were observed throughout TRAIN (n = 11; age: 25 ± 4 years, height: 170 ± 6 cm, weight: 71 ± 7 kg) and COMP (n = 8; age: 25 ± 3 years, height: 172 ± 5 cm, weight: 72 ± 6 kg), respectively. Carbohydrate intakes were below the lower range of sports nutrition recommendations in both TRAIN (−62%; 2.3 ± 0.3 g·kg−1 BM, p ≤ 0.001) and COMP (−60%; 2.4 ± 0.5 g·kg−1 BM, p ≤ 0.001). For protein (TRAIN: 1.7 ± 0.4 g·kg−1 BM, COMP: 1.5 ± 0.1 g·kg−1 BM), intakes met the lower range of recommendations. Fat intake exceeded recommendations of the percentage of total EI (COMP: 39 ± 5%). Accordingly, the dietary strategies of international female R7s players may warrant optimization, as carbohydrate and fat intakes were less than optimal when compared to current performance-based sports nutrition guidelines. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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11 pages, 742 KiB  
Article
The ADORA2A TT Genotype Is Associated with Anti-Inflammatory Effects of Caffeine in Response to Resistance Exercise and Habitual Coffee Intake
by Mohammad Rahman Rahimi, Ekaterina A. Semenova, Andrey K. Larin, Nikolay A. Kulemin, Edward V. Generozov, Beata Łubkowska, Ildus I. Ahmetov and Hadi Golpasandi
Nutrients 2023, 15(7), 1634; https://doi.org/10.3390/nu15071634 - 28 Mar 2023
Cited by 3 | Viewed by 4281
Abstract
Caffeine is an adenosine A2A receptor (ADORA2A) antagonist with ergogenic and anti-inflammatory effects. Previous studies have reported that the ADORA2A gene regulates glutamate metabolism and immune responses, with the ADORA2A rs5751876 TT genotype (with high sensitivity to caffeine) showing larger [...] Read more.
Caffeine is an adenosine A2A receptor (ADORA2A) antagonist with ergogenic and anti-inflammatory effects. Previous studies have reported that the ADORA2A gene regulates glutamate metabolism and immune responses, with the ADORA2A rs5751876 TT genotype (with high sensitivity to caffeine) showing larger ergogenic effect following caffeine ingestion. We therefore hypothesized that the TT genotype would be associated with greater anti-inflammatory effects of caffeine in response to exercise, and with higher coffee intake in physically active individuals. The aim of the present study was twofold: (1) to investigate the association of the ADORA2A variant with the anti-inflammatory effects of caffeine in response to intense resistance exercise (RE), and (2) to analyze the association of the rs5751876 with coffee intake in physically active individuals (n = 134). Fifteen resistance-trained athletes participated in a randomized, double-blind, placebo-controlled cross-over study, where they consumed 6 mg/kg of caffeine or placebo one hour prior to performing an RE protocol. Blood samples were taken immediately from the arterial vein before, immediately after, and 15 min after RE for the analysis of inflammatory markers myeloperoxidase (MPO) and acetylcholinesterase (AChE). We found that the ADORA2A TT genotype carriers experienced lower exercise-induced inflammatory responses (p < 0.05 for AchE) when compared to the C allele carriers (i.e., CC/CT) one hour following the ingestion of caffeine. Furthermore, the ADORA2A TT genotype was positively associated with coffee intake (p = 0.0143; irrespective of CYP1A2 rs762551 polymorphism). In conclusion, we found that the ADORA2A gene polymorphism is associated with anti-inflammatory effects of caffeine in response to resistance exercise, as well as with habitual coffee intake in physically active individuals. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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20 pages, 1104 KiB  
Article
The Effect of a Hydroxytyrosol-Rich, Olive-Derived Phytocomplex on Aerobic Exercise and Acute Recovery
by Justin D. Roberts, Joseph B. Lillis, Jorge Marques Pinto, Havovi Chichger, Álvaro López-Samanes, Juan Del Coso, Rodrigo Zacca and Ashley G. B. Willmott
Nutrients 2023, 15(2), 421; https://doi.org/10.3390/nu15020421 - 13 Jan 2023
Cited by 5 | Viewed by 6840
Abstract
There is current scientific interest in naturally sourced phenolic compounds and their potential benefits to health, as well as the effective role polyphenols may provide in an exercise setting. This study investigated the chronic effects of supplementation with a biodynamic and organic olive [...] Read more.
There is current scientific interest in naturally sourced phenolic compounds and their potential benefits to health, as well as the effective role polyphenols may provide in an exercise setting. This study investigated the chronic effects of supplementation with a biodynamic and organic olive fruit water phytocomplex (OliPhenolia® [OliP]), rich in hydroxytyrosol (HT), on submaximal and exhaustive exercise performance and respiratory markers of recovery. Twenty-nine recreationally active participants (42 ± 2 yrs; 71.1 ± 2.1 kg; 1.76 ± 0.02 m) consumed 2 × 28 mL∙d−1 of OliP or a taste- and appearance-matched placebo (PL) over 16 consecutive days. Participants completed a demanding, aerobic exercise protocol at ~75% maximal oxygen uptake (V˙O2max) for 65 min 24 h before sub- and maximal performance exercise tests prior to and following the 16-day consumption period. OliP reduced the time constant (τ) (p = 0.005) at the onset of exercise, running economy (p = 0.015) at lactate threshold 1 (LT1), as well as the rating of perceived exertion (p = 0.003) at lactate turnpoint (LT2). Additionally, OliP led to modest improvements in acute recovery based upon a shorter time to achieve 50% of the end of exercise V˙O2 value (p = 0.02). Whilst OliP increased time to exhaustion (+4.1 ± 1.8%), this was not significantly different to PL (p > 0.05). Phenolic compounds present in OliP, including HT and related metabolites, may provide benefits for aerobic exercise and acute recovery in recreationally active individuals. Further research is needed to determine whether dose-response or adjunct use of OliP alongside longer-term training programs can further modulate exercise-associated adaptations in recreationally active individuals, or indeed support athletic performance. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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21 pages, 1371 KiB  
Article
The Impact of a Natural Olive-Derived Phytocomplex (OliPhenolia®) on Exercise-Induced Oxidative Stress in Healthy Adults
by Justin D. Roberts, Joseph Lillis, Jorge Marques Pinto, Ashley G. B. Willmott, Lata Gautam, Christopher Davies, Álvaro López-Samanes, Juan Del Coso and Havovi Chichger
Nutrients 2022, 14(23), 5156; https://doi.org/10.3390/nu14235156 - 4 Dec 2022
Cited by 2 | Viewed by 3268
Abstract
The role of natural polyphenols in reducing oxidative stress and/or supporting antioxidant mechanisms, particularly relating to exercise, is of high interest. The aim of this study was to investigate OliPhenolia® (OliP), a biodynamic and organic olive fruit water phytocomplex, rich in hydroxytyrosol [...] Read more.
The role of natural polyphenols in reducing oxidative stress and/or supporting antioxidant mechanisms, particularly relating to exercise, is of high interest. The aim of this study was to investigate OliPhenolia® (OliP), a biodynamic and organic olive fruit water phytocomplex, rich in hydroxytyrosol (HT), for the first time within an exercise domain. HT bioavailability from OliP was assessed in fifteen healthy volunteers in a randomized, double-blind, placebo controlled cross-over design (age: 30 ± 2 yrs; body mass: 76.7 ± 3.9 kg; height: 1.77 ± 0.02 m), followed by a separate randomized, double-blinded, cohort trial investigating the short-term impact of OliP consumption (2 × 28 mL∙d−1 of OliP or placebo (PL) for 16-days) on markers of oxidative stress in twenty-nine recreationally active participants (42 ± 2 yrs; 71.1 ± 2.1 kg; 1.76 ± 0.02 m). In response to a single 28 mL OliP bolus, plasma HT peaked at 1 h (38.31 ± 4.76 ng∙mL−1), remaining significantly elevated (p < 0.001) until 4 h. Plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and HT were assessed at rest and immediately following exercise (50 min at ~75% V˙O2max then 10 min intermittent efforts) and at 1 and 24 h post-exercise, before and after the 16-day supplementation protocol. Plasma HT under resting conditions was not detected pre-intervention, but increased to 6.3 ± 1.6 ng·mL−1 following OliP only (p < 0.001). OliP demonstrated modest antioxidant effects based on reduced SOD activity post-exercise (p = 0.016) and at 24 h (p ≤ 0.046), and increased GSH immediately post-exercise (p = 0.009) compared with PL. No differences were reported for MDA and CAT activity in response to the exercise protocol between conditions. The phenolic compounds within OliP, including HT, may have specific antioxidant benefits supporting acute exercise recovery. Further research is warranted to explore the impact of OliP following longer-term exercise training, and clinical domains pertinent to reduced oxidative stress. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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13 pages, 1508 KiB  
Article
Biomarker Changes in Oxygen Metabolism, Acid-Base Status, and Performance after the Off-Season in Well-Trained Cyclists
by Francisco Javier Martínez Noguera, Cristian Marín-Pagán, Linda H. Chung and Pedro E. Alcaraz
Nutrients 2022, 14(18), 3808; https://doi.org/10.3390/nu14183808 - 15 Sep 2022
Cited by 2 | Viewed by 1866
Abstract
During the off-season, cyclists reduce their volume and intensity of training in order to recover the body from the high workload during the competitive season. Some studies have examined the effects of the off-season on cardiovascular, metabolic, and performance levels but have not [...] Read more.
During the off-season, cyclists reduce their volume and intensity of training in order to recover the body from the high workload during the competitive season. Some studies have examined the effects of the off-season on cardiovascular, metabolic, and performance levels but have not evaluated oxygen metabolism, acid-base status, and electrolytes in cyclists. Therefore, our main objective was to analyze these markers in the off-season period (8 weeks) via finger capillary blood gasometry in well-trained cyclists. We found an increase in oxygen saturation (sO2) and oxyhemoglobin (O2Hb) (p ≤ 0.05) and a decrease in fat oxidation at maximum fat oxidation (FatMax) (p ≤ 0.05). In addition, we observed a decreasing trend of VO2 in the ventilatory threshold 2 (VT2) and maximum oxygen consumption (VO2MAX) (p ≤ 0.06) after the off-season in well-trained cyclists. Negative correlations were found between the pre–post off-season differences in the VO2 at ΔFatMax and ΔHCO3 (bicarbonate ion) and between power generated at the ΔeFTP (functional power threshold) and the ΔVO2MAX with the pH (r ≥ −0.446; p ≤ 0.05). After the off-season period, well-trained cyclists had increased markers of oxygen metabolism, decreased fat oxidation at low exercise intensities, and decreased VO2 at the VT2 and VO2MAX. Relationships were found between changes in the ΔeFTP and VO2MAX with changes in the pH and between the pH and HCO3 with changes in La. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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Review

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14 pages, 2028 KiB  
Review
Hydration, Hyperthermia, Glycogen, and Recovery: Crucial Factors in Exercise Performance—A Systematic Review and Meta-Analysis
by Olga López-Torres, Celia Rodríguez-Longobardo, Rodrigo Escribano-Tabernero and Valentín E. Fernández-Elías
Nutrients 2023, 15(20), 4442; https://doi.org/10.3390/nu15204442 - 19 Oct 2023
Cited by 4 | Viewed by 4218
Abstract
Hyperthermia accelerates dehydration and can lead to a glycolysis malfunction. Therefore, to deeply understand the relationship between dehydration and hyperthermia during exercise, as well as in the recovery time, there might be important factors to improve athletic performance. A systematic review was carried [...] Read more.
Hyperthermia accelerates dehydration and can lead to a glycolysis malfunction. Therefore, to deeply understand the relationship between dehydration and hyperthermia during exercise, as well as in the recovery time, there might be important factors to improve athletic performance. A systematic review was carried out in different databases using the words “hydration” OR “dehydration” AND “glycogen” OR “glycogenesis” OR “glycogenolysis” AND “muscle” OR “muscle metabolism” OR “cardiovascular system” and adding them to the “topic section” in Web of Science, to “Title/Abstract” in PubMed and to “Abstract” in SPORTDiscus. A total of 18 studies were included in the review and 13 in the meta-analysis. The free statistical software Jamovi was used to run the meta-analysis (version 1.6.15). A total sample of 158 people was included in the qualitative analysis, with a mean age of 23.5 years. Ten studies compared muscle glycogen content after hydration vs. remaining dehydrated (SMD −4.77 to 3.71, positive 80% of estimates, \hat{\mu} = 0.79 (95% CI: −0.54 to 2.12), z = 1.17, p = 0.24, Q-test (Q(9) = 66.38, p < 0.0001, tau2 = 4.14, I2 = 91.88%). Four studies examined the effect of temperature on postexercise muscle glycogen content (SMD −3.14 to −0.63, 100% of estimates being negative, \hat{\mu} = −1.52 (95% CI: −2.52 to −0.53), (z = −3.00, p = 0.003, Q-test (Q(3) = 8.40, p = 0.038, tau2 = 0.68, I2 = 66.81%). In conclusion, both hyperthermia and dehydration may contribute to elevated glycogenolysis during exercise and poor glycogen resynthesis during recovery. Although core and muscle hyperthermia are the key factors in glycogen impairments, they are also directly related to dehydration. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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16 pages, 4339 KiB  
Review
Research Trends in the Effect of Caffeine Intake on Fat Oxidation: A Bibliometric and Visual Analysis
by Jorge Gutiérrez-Hellín, Juan Del Coso, Mário C. Espada, Víctor Hernández-Beltrán, Cátia C. Ferreira, David Varillas-Delgado, Nuria Mendoza Laiz, Justin D. Roberts and José M. Gamonales
Nutrients 2023, 15(20), 4320; https://doi.org/10.3390/nu15204320 - 10 Oct 2023
Cited by 6 | Viewed by 5016
Abstract
In the last few decades, numerous studies pertaining to research groups worldwide have investigated the effects of oral caffeine intake on fat oxidation at rest, during exercise, and after exercise. However, there is no bibliometric analysis to assess the large volume of scientific [...] Read more.
In the last few decades, numerous studies pertaining to research groups worldwide have investigated the effects of oral caffeine intake on fat oxidation at rest, during exercise, and after exercise. However, there is no bibliometric analysis to assess the large volume of scientific output associated with this topic. A bibliometric analysis of this topic may be used by researchers to assess the current scientific interest in the application of caffeine as a nutritional strategy to augment fat oxidation, the journals with more interest in this type of publication, and to draw international collaborations between groups working in the same area. For these reasons, the purpose of this study was to assess the research activity regarding oral caffeine intake and fat oxidation rate in the last few decades by conducting a bibliometric and visual analysis. Relevant publications from 1992 to 2022 were retrieved from the Web of Science (WoS) Core Collection database. Quantitative and qualitative variables were collected, including the number of publications and citations, H-indexes, journals of citation reports, co-authorship, co-citation, and the co-occurrence of keywords. There were 182 total publications, while the number of annual publications is saw-shaped with a modest increase of 11.3% from 2000 to 2009 to 2010 to 2019. The United States was the country with the highest number of publications (24.17% of the total number of articles), followed by the Netherlands (17.03%). According to citation analyses, the average number of citations per document is 130, although there are 21 documents that have received more than 100 citations; the most cited document reached 644 citations. These citation data support the overall relevance of this topic in the fields of nutrition and dietetics and sport sciences that when combined harbored 85.71% of all articles published in the WoS. The most productive author was Westerterp-Plantenga with 16 articles (8.79% of the total number of articles). Nutrients was the journal that published the largest number of articles on this topic (6.59% of the total number of articles). Last, there is a tendency to include keywords such as “performance”, “carbohydrate”, and “ergogenic aid” in the newer articles, while “obesity”, “thermogenic”, and “tea” are the keywords more commonly included in older documents. Although research into the role of caffeine on fat oxidation has existed since the 1970s, our analysis suggests that the scientific output associated with this topic has progressively increased since 1992, demonstrating that this is a nutritional research area with a strong foundational base of scientific evidence. Based on the findings of this bibliometric analysis, future investigation may consider focusing on the effects of sex and tolerance to caffeine to widen the assessment of the effectiveness of oral caffeine intake as a nutritional strategy to augment the use of fat as a fuel, as these terms rarely appear in the studies included in this analysis. Additionally, more translational research is necessary as the studies that investigate the effect of oral caffeine intake in ecologically valid contexts (i.e., exercise training programs for individuals with excessive adiposity) are only a minor part of the studies on this topic. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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Other

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24 pages, 17894 KiB  
Systematic Review
β-Alanine Supplementation in Combat Sports: Evaluation of Sports Performance, Perception, and Anthropometric Parameters and Biochemical Markers—A Systematic Review of Clinical Trials
by Diego Fernández-Lázaro, Emma Marianne Fiandor, Juan F. García, Natalia Busto, Mirian Santamaría-Peláez, Eduardo Gutiérrez-Abejón, Enrique Roche and Juan Mielgo-Ayuso
Nutrients 2023, 15(17), 3755; https://doi.org/10.3390/nu15173755 - 28 Aug 2023
Cited by 4 | Viewed by 4649
Abstract
β-alanine does not have an ergogenic effect by itself, but it does as a precursor for the synthesis of carnosine in human skeletal muscle. β-alanine and carnosine together help improve the muscles’ functionality, especially in high-intensity exercises such as combat sports. Therefore, β-alanine [...] Read more.
β-alanine does not have an ergogenic effect by itself, but it does as a precursor for the synthesis of carnosine in human skeletal muscle. β-alanine and carnosine together help improve the muscles’ functionality, especially in high-intensity exercises such as combat sports. Therefore, β-alanine could be considered a nutritional ergogenic aid to improve sports performance in combat athletes. We aimed to critically review clinical trial evidence on the impact of β-alanine supplementation on sports performance, perception, and anthropometric parameters, as well as circulating biochemical markers in combat athletes. This systematic review was conducted following the specific methodological guidelines of the Preferred Report Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), the PICOS question model, the Critical Review Form of McMaster, and the PEDro scale. Furthermore, the Cochrane risk-of-bias assessment tool was used. The search was carried out in the SCOPUS, Web of Science (WOS), and Medline (PubMed) databases for studies published from the beginning of the database until July 31, 2023. Of the 41 registers identified, only 7 met the established criteria and were included in this systematic review. Overall, performance parameters related to strength, power, total exercise work capacity, and combat-specific parameters were significantly improved (p < 0.05). Perception parameters increased non-significantly (p > 0.05). Regarding biochemical parameters, carnosine increased significantly (p < 0.05), pH decreased non-significantly (p > 0.05), and the results for blood bicarbonate and blood lactate were heterogeneous. Finally, there was a non-significant (p > 0.05) improvement in the anthropometric parameters of lean mass and fat mass. β-alanine supplementation appears to be safe and could be a suitable nutritional ergogenic aid for combat athletes. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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15 pages, 1721 KiB  
Systematic Review
The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis
by Ryan Burke, Alec Piñero, Max Coleman, Adam Mohan, Max Sapuppo, Francesca Augustin, Alan A. Aragon, Darren G. Candow, Scott C. Forbes, Paul Swinton and Brad J. Schoenfeld
Nutrients 2023, 15(9), 2116; https://doi.org/10.3390/nu15092116 - 28 Apr 2023
Cited by 11 | Viewed by 43666
Abstract
The purpose of this paper was to carry out a systematic review with a meta-analysis of randomized controlled trials that examined the combined effects of resistance training (RT) and creatine supplementation on regional changes in muscle mass, with direct imaging measures of hypertrophy. [...] Read more.
The purpose of this paper was to carry out a systematic review with a meta-analysis of randomized controlled trials that examined the combined effects of resistance training (RT) and creatine supplementation on regional changes in muscle mass, with direct imaging measures of hypertrophy. Moreover, we performed regression analyses to determine the potential influence of covariates. We included trials that had a duration of at least 6 weeks and examined the combined effects of creatine supplementation and RT on site-specific direct measures of hypertrophy (magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound) in healthy adults. A total of 44 outcomes were analyzed across 10 studies that met the inclusion criteria. A univariate analysis of all the standardized outcomes showed a pooled mean estimate of 0.11 (95% Credible Interval (CrI): −0.02 to 0.25), providing evidence for a very small effect favoring creatine supplementation when combined with RT compared to RT and a placebo. Multivariate analyses found similar small benefits for the combination of creatine supplementation and RT on changes in the upper and lower body muscle thickness (0.10–0.16 cm). Analyses of the moderating effects indicated a small superior benefit for creatine supplementation in younger compared to older adults (0.17 (95%CrI: −0.09 to 0.45)). In conclusion, the results suggest that creatine supplementation combined with RT promotes a small increase in the direct measures of skeletal muscle hypertrophy in both the upper and lower body. Full article
(This article belongs to the Special Issue Nutrition, Exercise Metabolism and Recovery)
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