Effects of vitamin C on oxidative stress, inflammation, muscle soreness, and strength following acute exercise: meta-analyses of randomized clinical trials

Abstract

Background

Vitamin C (ascorbic acid) seems to attenuate the overproduction of reactive species during and after exercises. Yet, no meta-analysis has summarized the magnitude of this effect. The objective of this study was to systematically review the effects of vitamin C supplementation on oxidative stress, inflammatory markers, damage, soreness, and the musculoskeletal functionality after a single bout of exercise.

Methods

Major electronic databases were searched, from inception to September 2019, for placebo-controlled randomized clinical trials (RCTs) that evaluated the effects of vitamin C supplementation on oxidative stress parameters, inflammation markers, muscle damage, muscle soreness, and muscle functionality after a single bout of exercise in healthy volunteers. Random-effects modelling was used to compare mean changes from pre- to postexercise in participants that were supplemented with vitamin C versus placebo. Data were reported as standard mean difference (SMD) and 95% confidence interval (CI).

Results

A total of 18 RCTs, accounting for 313 participants (62% males, median age = 24 years) were included. Vitamin C supplementation reduced lipid peroxidation immediately (SMD = − 0.488; 95% CI = − 0.888 to − 0.088), 1 h (SMD = − 0.521; 95% CI = − 0.911 to − 0.131) and between 1 and 2 h (SMD = − 0.449; 95% CI = − 0.772 to − 0.126) following exercise. Exercise induced interleukin-6 (IL-6) response was attenuated 2 h (SMD = − 0.764; 95% CI = − 1.279 to − 0.248) and between 1 and 2 h (SMD = − 0.447; 95% CI = − 0.828 to − 0.065) after exercise. No effects of vitamin C supplementation were found on creatine kinase (CK), C-reactive protein (CRP), cortisol levels, muscle soreness, and muscle strength.

Conclusion

Vitamin C supplementation attenuates the oxidative stress (lipid peroxidation) and inflammatory response (IL-6) to a single bout of exercise.

Registration

PROSPERO (CRD42018094222).

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Acknowledgements

The authors thank the Postgraduate Program in Functional Rehabilitation. We would also like to thank the authors who kindly provided additional information needed for the analysis.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001 and the Foundation for Research Support of the State of Rio Grande do Sul—FAPERGS—Public Notice 05/2017—Master.

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Correspondence to Luis Ulisses Signori.

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Righi, N.C., Schuch, F.B., De Nardi, A.T. et al. Effects of vitamin C on oxidative stress, inflammation, muscle soreness, and strength following acute exercise: meta-analyses of randomized clinical trials. Eur J Nutr 59, 2827–2839 (2020). https://doi.org/10.1007/s00394-020-02215-2

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Keywords

  • Ascorbic acid
  • Athlete
  • Exercise
  • Healthy volunteers
  • Inflammation
  • Oxidative stress