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Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance

Abstract

Background

Athletes may complete consecutive exercise sessions with limited recovery time between bouts (e.g. ≤ 4 h). Nutritional strategies that optimise post-exercise recovery in these situations are therefore important.

Objective

This two-part review investigated the effect of consuming carbohydrate (CHO) and protein with water (W) following exercise on subsequent athletic (endurance/anaerobic exercise) performance.

Data Sources

Studies were identified by searching the online databases SPORTDiscus, PubMed, Web of Science and Scopus.

Study Eligibility Criteria and Interventions

Investigations that measured endurance performance (≥ 5 min duration) ≤ 4 h after a standardised exercise bout (any type) under the following control vs. intervention conditions were included: Part 1: W vs. CHO ingested with an equal volume of W (CHO + W); and, Part 2: CHO + W vs. protein (PRO) ingested with CHO and an equal volume of W (PRO + CHO + W), where CHO or energy intake was matched.

Study Appraisal and Synthesis Methods

Publications were examined for bias using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy.

Results

The quality assessment yielded a Rosendal score of 63 ± 9% (mean ± standard deviation). Part 1: 45 trials (n = 486) were reviewed. Ingesting CHO + W (102 ± 50 g CHO; 0.8 ± 0.6 g CHO kg−1 h−1) improved exercise performance compared with W (1.6 ± 0.7 L); %Δ mean power output = 4.0, 95% confidence interval 3.2–4.7 (I 2 = 43.9). Improvement was attenuated when participants were ‘Fed’ (a meal 2–4 h prior to the initial bout) as opposed to ‘Fasted’ (p = 0.012). Part 2: 13 trials (n = 125) were reviewed. Ingesting PRO + CHO + W (35 ± 26 g PRO; 0.5 ± 0.4 g PRO kg−1) did not affect exercise performance compared with CHO + W (115 ± 61 g CHO; 0.6 ± 0.3 g CHO·kg body mass−1 h−1; 1.2 ± 0.6 L); %Δ mean power output = 0.5, 95% confidence interval − 0.5 to 1.6 (I 2 = 72.9).

Conclusions

Athletes with limited time for recovery between consecutive exercise sessions should prioritise CHO and fluid ingestion to enhance subsequent athletic performance.

PROSPERO Registration Number

CRD42016046807.

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Notes

  1. 1.

    Web of Science (via Thomas Reuters) retrieved a comparatively large number of records [68,347 vs. ≤ 4789 records via each SPORTDiscus (via EBSCOhost), PubMed (MEDLINE) and Scopus] using the search strategy indicated above. To improve the efficiency of the study selection process, only those records categorised within the Sport Sciences field (3418 records) were retrieved from Web of Science.

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Acknowledgements

We thank all of the authors of the reviewed studies that provided raw experimental data for this investigation.

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All authors were involved in the conception and design of this review. DM and CI were responsible for collating manuscripts and retrieving data. DM conducted the analysis of the data. All authors contributed to the drafting and revising of the article, and the final approval of the published version of the manuscript.

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Correspondence to Danielle McCartney.

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Danielle McCartney, Ben Desbrow and Christopher Irwin have no conflicts of interest directly relevant to the content of this article.

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McCartney, D., Desbrow, B. & Irwin, C. Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance. Sports Med 48, 379–408 (2018). https://doi.org/10.1007/s40279-017-0800-5

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