Muscle soreness results from mechanical damage to the muscle and biochemical changes within muscle tissue. It is characterized by inflammation, pain, swelling, soreness/stiffness, and markers of muscle injury such as creatine kinase (CK) and lactate dehydrogenase (LDH) (10,39). There are several modalities often used in an attempt to mitigate soreness and inflammation including rest, massage, and active recovery, using foam rollers, submerging in a cold plunge, stretching, and of course, nutrition.
Although relatively few studies have examined omega-3 intake and modulation of exercise-induced inflammation, clinical and epidemiological research suggests that omega-3 intake may (a) decrease inflammatory markers, (b) increase blood flow by up to 36% during exercise, and (c) decrease symptoms of rheumatoid arthritis (morning stiffness, tender or swollen joints, and joint pain) (9).
In another study, 40 healthy untrained males (aged 18-35 years) supplemented for 14 days with a product containing 300 mg mixed tocopherols, 800 mg flavonoids, and 300 mg DHA (n = 20) or placebo (n = 20). On day 7, they performed an eccentric-only arm curl exercise, and the researchers measured exercise-induced markers of cell damage (CK and LDH) and the inflammatory mediators CRP and IL-6 at baseline, day 7 (eccentric exercise-induced injury), day 10, and day 14. Both groups experienced significant increases in pain, CK, and LDH, as well as a decreased range of motion for 3 days. There were significant group differences in IL-6 and CRP indicating that the supplement was effective in reducing markers of inflammation in this group of untrained males. However, from this study, it is impossible to say if DHA alone would make a difference (48).
Another study found that supplementation with 3.6 g/d of fish oil for 6 weeks had no effect on exercise-induced increases in leukocytes and CK compared with that of placebo (61). And a study in 22 women found no differences in measures of inflammation (cortisol, CK, IL-6, and TNF-alpha) after DOMS caused by maximal isokinetic eccentric contractions (30). A cross-sectional retrospective cohort study examining diet and grip strength in older men and women (aged 59-73 years) found that of all dietary factors examined, dietary fatty fish consumption was the most important. The authors concluded that this may be because of the anti-inflammatory actions of omega-3 fatty acids (50).
In addition to the health benefits attributed to fish oil consumption, these studies provide preliminary but mixed support that fish oil supplementation may be effective in offsetting the soreness and inflammation that result after intense damaging exercise.
In a randomized, placebo-controlled, crossover study, 14 male college students consumed 12 oz CherryPharm cherry juice (made with tart cherries) or placebo twice a day for 8 consecutive days. On the fourth day, they performed a bout of eccentric elbow flexion (2 × 20 maximum contractions). Isometric elbow flexion, strength, pain, muscle tenderness, and relaxed elbow angle were measured before and for 4 days after the eccentric exercise. Two weeks later, the protocol was repeated with the groups switched (those taking the cherry juice took the placebo and vice versa) and the opposite arm performed the eccentric exercise for the second bout. In the cherry juice trial, strength loss and pain were significantly decreased in comparison to placebo. Strength loss over the 4 days after the eccentric exercise was 4% with the cherry juice and 22% with the placebo. There were no significant between-group differences in relaxed elbow angle and muscle tenderness (11).
In one of the first studies on this beverage, 20 college students drank 12 oz either Diet Coke or Celsius and change in metabolism over a 3-hour period was measured. The study was then repeated with the groups switched. After reviewing the results from both trials, the researchers found that Diet Coke slightly increased metabolism but Celsius significantly raised metabolism for the 3 hours after consumption (37).
Athletes should incorporate functional foods and beverages into their diet based on their goals and overall diet. Though, all adult athletes (unless otherwise directed by their physician) should consider consuming fatty fish or fish oil supplements. Although there is no “dose” that we can prescribe to athletes based on the current body of literature, it is prudent to follow the American Heart Association (AHA) guidelines and consume a variety of fatty fish at least twice a week (for those without documented coronary heart disease). According to the AHA, prospective secondary prevention studies suggest that taking EPA + DHA ranging from 0.5 to 1.8 g/d (either as fatty fish or as supplements) significantly reduces deaths from heart disease and all causes. For ALA, a total intake of 1.5-3 g/d is considered beneficial (29). The adequate intake for total omega-3 fatty acids from ALA (a small percentage of ALA is broken down into EPA and DHA in the body) is 1.6 g/d in men and 1.1 g/d in females (1.4 for those who are pregnant and 1.3 for lactating women) (27).
Aside from consuming EPA and DHA, athletes may be able to mitigate soreness induced by exhaustive exercise such as cycling and running by choosing a carbohydrate-protein beverage in place of carbohydrate-only beverage (4). In addition, consuming anthocyanin-rich tart cherries or a minimally processed tart cherry juice may help decrease measures of inflammation and soreness. And finally, picking up a functional beverage or food with caffeine and consuming it after exercise will not only help an athlete stay alert but may also augment muscle glycogen resynthesis and decrease DOMS. How much caffeine? Try 5 mg per kilogram of body weight and no more than 250-300 mg/d to begin with. Doses of 250-300 mg or more per day may result in tachyarrhythmia (rapid irregular heartbeat) and difficulty sleeping. Pregnant women should definitely keep their caffeine consumption below 300 mg/d (16,28).
Nutrition can play a role in sport psychology by decreasing stress and enhancing focus and concentration. With increased functional food and beverage offerings in future years, it is important to ensure that the ingredients and/or finished product has sufficient research to support its recommendation. When it comes to an athlete's diet, it is prudent to consider current dietary intake and options available, including functional foods and beverages.
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