Replenishing vital nutrients, rehydrating and restoring electrolyte balance, repairing damaged muscle tissue, and attenuating excessive inflammation accomplish these goals. Refueling Following vigorous exercise, athletes must consider when, what, and how much to eat and drink—important components of a recovery nutrition plan.

Because exercise sensitizes muscle tissue to certain hormones and nutrients, muscle is most responsive to nutrient intake during the first 30 minutes postexercise.

And although this metabolic window of opportunity diminishes as time passes, certain types of exercise, such as resistance training to the point of muscular fatigue, keep the window open for up to 48 hours.

Therefore, athletes must be cognizant of what they consume each day and when. Physical training takes place in succinct bouts, but the nutrition segment of a training program extends to all waking hours and must include the replenishment of several nutrients to promote postexercise recovery.

Glycogen Replenishment Glycogen, which is stored in the muscles, is the fuel source athletes must restore following strenuous training. Muscle glycogen is the predominant fuel source used during long bouts of aerobic exercise. In fact, aerobic performance is directly related to initial glycogen stores.

Once glycogen is depleted, the athlete will feel fatigued and performance will suffer. Anaerobic exercise also is fueled almost entirely by carbohydrates, according to Sally Hara, MS, RD, CSSD, CDE, of ProActive Nutrition in Kirkland, Washington.

The best way athletes can quickly replenish muscle glycogen is to consume 1. Urine color should be clear, and there should be a plentiful amount. Coaches can keep track of fluid losses by weighing athletes before and after training. For every pound of fluid lost, athletes should consume 20 to 24 oz of fluid.

Moreover, postworkout fluids or meals should contain sodium, particularly for athletes who lose large amounts of sodium through sweat. Repair and Build In addition to fluid and electrolyte losses, training increases circulating catabolic hormones to facilitate the breakdown of glycogen and fat for fuel.

These hormone levels remain high after exercise and continue to break down muscle tissue. Without nutrient intake, this catabolic cascade continues for hours postexercise, contributing to muscle soreness and possibly compromising training adaptations and subsequent performance.

To repair and build muscle, athletes must refuel with high-protein foods immediately following exercise, especially after resistance training. They should consume 20 to 40 g of protein that includes 3 to 4 g of leucine per serving to increase muscle protein synthesis.

In addition, whey is an optimal postworkout protein because of its amino acid composition and the speed of amino acid release into the bloodstream. What many athletes often overlook is the importance of carbohydrate intake for building and repairing muscle.

Carbohydrate can decrease muscle protein breakdown by stimulating insulin release. Resistance training athletes benefit from consuming carbohydrates and protein after strenuous workouts. Attenuating Excess Inflammation Athletes who get the required amounts of leucine-rich protein and carbohydrate immediately after exercise turn that crucial time period from a catabolic state to an anabolic state.

To help curb excessive inflammation and muscle soreness, researchers have examined various products and ingredients.

In particular, tart cherry juice and ginger fresh or heat treated have been found to decrease eccentric-exercise—induced inflammation and delayed onset muscle soreness. Specific Considerations While recovery nutrition has three primary goals, the manner in which these goals are achieved depends on the type of sport an athlete plays.

Based on sports science research, nutrition recommendations for athletes are divided into two categories: endurance sports and resistance training. A sports dietitian can develop individualized plans for each athlete, keeping in mind that plans may change based on training adaptations, changes in growth and body composition, injuries, illness, and training phase.

We educate them on their postlift needs during their individual nutrition consults. Many eat dinner postpractice at our training table or at the dining hall where a dietitian is available for live plate coaching as well. Importance of Sports Dietitians Sports dietitians play an essential role in helping athletes recover from training.

References 1. Ivy JL. Regulation of muscle glycogen repletion, muscle protein synthesis and repair following exercise. J Sports Sci Med. Casa DJ, Armstrong LE, Hillman SK, et al. J Athl Train. Bishop PA, Jones E, Woods AK.

Recovery from training: a brief review. J Strength Cond Res. Coyle EF, Coggan AR, Hemmert MK, Ivy JL. Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate.

J Appl Physiol. Glycogen resynthesis after exercise: effect of carbohydrate intake. Int J Sports Med. The methodology of this review was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Statement [ 41 ] and registered at the International Prospective Register of Systematic Reviews PROSPERO identification code: CRD before beginning the formal study selection process.

No other search restrictions were imposed. A final search was also conducted in March to capture any recent publications. One manuscript [ 42 ] was identified in this search for inclusion. Two investigators JC and CI independently screened potential studies to identify relevant texts.

Initially, all irrelevant titles were discarded. The remaining articles were then systematically screened for eligibility by abstract and full text. The decision to include or discard potential research studies was made between two investigators JC and CI.

Any discrepancies were resolved in consultation with a third investigator BD. The reference lists of all included studies were hand-searched for missing publications. Full details of the screening process are illustrated in Fig. PRISMA flow chart study selection methodology.

Full-text original research studies were published in English; all other documents were discarded. Schematic of the experimental protocol used in studies that were eligible for inclusion in the current review. Crosses X 1 and X 2 represent the pre-treatment and post-treatment needle biopsies, respectively.

Energy containing dietary constituents other than CHO and PRO e. alcohol, fat or ergogenic substances e. caffeine, creatine were administered post-exercise. Muscle glycogen concentrations were not measured by needle biopsy e.

nuclear magnetic resonance spectroscopy, ultrasound. Muscle glycogen data were not adequately reported i. mean ± standard deviation SD was not reported and could not be calculated. In the event that data were not adequately reported, the corresponding author was contacted via email in an attempt to retrieve the missing data.

Several publications identified via the literature search contained more than one intervention and control comparison that was eligible for inclusion. Separate trials derived from a single research study are denoted by the addition of a lower-case letter i. a—c to the citation.

The present systematic review and meta-analysis compared the intervention and control conditions via a two-part investigation: 1 CHO vs. control i. water or a non-nutritive placebo treatment and 2 PRO including isolated or mixed amino-acids AA , e. The primary research outcome in this investigation was the rate of muscle glycogen re-synthesis.

Where the rate of muscle glycogen re-synthesis was not reported directly or could not be calculated using raw data supplied by authors [ 26 , 28 , 45 , 46 , 47 ], but pre- and post-treatment muscle glycogen concentrations were known, the following methods were used to determine the missing values.

total amount of glycogen re-synthesised was calculated for the control and intervention conditions. where R is the mean correlation coefficient calculated using raw data derived from four CHO vs. The rate of muscle glycogen re-synthesis under each condition was then determined by dividing the total amount of glycogen re-synthesised i.

the mean and SD values by the length of the recovery period i. time between biopsies. Data were extracted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions Checklist of Items to Consider in Data Collection or Data Extraction [ 48 ] and entered into a Microsoft Excel spreadsheet.

Extracted data included 1 participant characteristics e. All statistical procedures were performed using SPSS, Version All other data are presented as mean ± SD unless stated otherwise. Meta-analyses were performed to determine the influence of 1 CHO vs.

CHO on the rate of muscle glycogen re-synthesis. Individual effect sizes were calculated as the raw mean difference i. Where the SD of this between-trial change was not reported directly or was unable to be calculated using raw data supplied by the authors [ 8 , 26 , 27 , 28 , 29 , 42 , 45 , 46 , 47 , 49 , 50 , 51 , 57 , 58 , 59 , 60 ], the missing value was imputed using the following formula [ 48 ]:.

In this case, R was approximated as 0. CHO trials [ 52 , 53 , 54 , 55 , 56 ]; the same R value of 0. control comparison as no raw data from these trials could be obtained to determine an independent value.

In addition, trials were individually excluded to examine the influence of their removal on the overall effect estimate. Weighted mean treatment effects were calculated using random-effect models, where trials were weighted by the inverse variance for the change in the outcome measure i.

rate of muscle glycogen re-synthesis. Restricted maximum likelihood, random-effects simple meta-regression analyses were performed to determine whether the magnitude of difference in the rate of muscle glycogen re-synthesis between treatments was influenced by: 1 dose of CHO provided relative and absolute ; 2 pre-treatment muscle glycogen concentrations i.

magnitude of energy difference between treatments ; 8 PRO source i. whole PRO vs. At least 10 data points were required for a variable to qualify for meta-regression analysis. Regression analyses were examined for influential cases and outliers i. The literature search initially identified 25 eligible investigations.

However, four of these had to be excluded because the muscle glycogen data 1 could not be extracted or retrieved [ 13 ]; 2 were the same as those reported in an earlier publication [ 64 ] that was already included [ 50 ]; 3 incorporated the results of one participant that did not complete both treatments i.

Results of the quality assessment are shown in Supplementary Table S1. Eight [ 8 , 26 , 28 , 42 , 45 , 46 , 50 ] used cycling and two [ 49 , 51 ] used resistance training as the mode of glycogen-depleting exercise. The mean relative CHO intake was 1.

Characteristics of the included trials are summarised in Table 1. The magnitude and statistical significance of the effect were stable during sensitivity analyses where trials were removed MG Δ re-synthesis rate ranged from Findings were also comparable when alternative correlation coefficients were used Supplementary Table S2.

Forest plot displaying the effect of CHO vs. control non-nutrient treatment on rate of muscle glycogen re-synthesis during short-term recovery. The size of the squares is proportional to the weight of the study. A positive effect estimate indicates greater rate of muscle glycogen replenishment with CHO than control.

Simple meta-regression analyses identified a significant, positive association between the mean difference in muscle glycogen re-synthesis rate and the interval of CHO administration, such that studies providing CHO more frequently i. No significant associations were identified between the mean difference in muscle glycogen re-synthesis rate and any other contextual factors Table 2.

Seventeen [ 27 , 28 , 29 , 47 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ] used cycling and two [ 52 , 53 ] used running as the mode of glycogen-depleting exercise.

The mean relative intake of CHO was 0. The mean relative PRO intake was 0. Characteristics of the included trials are summarised in Table 3. Findings were also comparable when alternative correlation coefficients were used Supplementary Table S3. CHO on rate of muscle glycogen re-synthesis during short-term recovery.

There were no significant relationships identified between the mean difference in rate of muscle glycogen re-synthesis and any of the contextual factors explored using meta-regression.

Results of the meta-regression analyses are summarised in Table 4. Overall, a beneficial effect of ingesting CHO compared to water or non-nutritive placebo treatment was observed on the rate of muscle glycogen re-synthesis.

However, co-ingestion of CHO with PRO conferred no additional benefit compared to CHO ingested alone.

Furthermore, the interval of CHO administration was found to be an influential factor on the rate of muscle glycogen re-synthesis. The current meta-analysis suggests that muscle glycogen re-synthesis rate is enhanced during short-term post-exercise recovery when CHO is consumed compared to control water or non-nutritive placebo treatment.

Except for one trial [ 45 ], all individual effect estimates indicated a beneficial effect of CHO. It is worth noting that the amount of CHO consumed is not controlled in this comparison.

More frequent CHO administration may enhance muscle glycogen re-synthesis rate by prolonging the elevation of plasma glucose and insulin concentrations [ 7 ].

Nonetheless, the results of this meta-analysis suggest that frequent consumption of CHO i. at least hourly should be a priority for athletes attempting to optimise short-term muscle glycogen replenishment. No correlation was observed between the dose of CHO both relative and total consumed during post-exercise recovery and rate of muscle glycogen re-synthesis Table 2.

Consequently, we were unable to determine the dose of CHO required to optimise the rate of muscle glycogen re-synthesis. As a result, we could not perform multiple meta-regression due to the limited number of trials and control for the interval of CHO administration; therefore, this may have prevented the detection of a relationship between CHO dose and muscle glycogen re-synthesis rate.

Furthermore, the limited number of trials may have prevented the detection of a relationship between muscle glycogen concentration immediately post-exercise and the rate of muscle glycogen re-synthesis Table 2.

This exploration was of interest because it has previously been hypothesised to have a positive influence i. The current meta-analysis suggests that co-ingestion of PRO with CHO during short-term post-exercise recovery provides no additional benefit to nor does it impair the rate of muscle glycogen re-synthesis compared to consuming CHO alone.

This finding was preserved when contextual factors were explored using meta-regression analysis Table 4. It is also consistent with results from previous meta-analyses indicating that co-ingestion of PRO with CHO during short-term recovery does not improve short-term muscle glycogen re-synthesis [ 67 ] or subsequent exercise performance [ 68 ].

This result may be due to the co-ingestion of PRO in the context of sub-optimal CHO intake i. It was suspected this result was due to a large insulinemic response by PRO in combination with CHO, despite inadequate ingestion of the latter.

Some research reports a greater insulinemic response when PRO specifically, containing the AA leucine and phenylalanine is co-ingested with CHO [ 4 , 7 , 30 , 69 ], which has made this an area of interest.

This strategy may allow a total reduction in the amount of nutrition needed to stimulate an equivalent insulin response, thus, potentially permitting lower caloric intake while maintaining adequate glycogen re-synthesis.

This may be an effective strategy in athletes who are trying to reduce energy consumption e. to make a specific weight division , but need rapid glycogen recovery to maintain subsequent training performance, as well as promote muscle growth and development. However, this strategy is not supported in other trials [ 27 , 53 ].

The difference amongst trials may be attributed to methodological factors, such as the timing and type of PRO provided e. insulinemic- vs. non-insulinemic-stimulating AA , the mode of exercise performed e.

cycling vs. running , and the interval in which muscle tissue was collected between trials i. the length of recovery. In this trial [ 56 ], a mixture of AA were provided, although only in a relatively small dose 0. The authors hypothesised that the lower rate of muscle glycogen re-synthesis observed in the PRO trial may be due to AA triggering protein synthesis, resulting in glucose being oxidised to support the energy requirement for this process in place of glycogen storage [ 56 ].

Nonetheless, while the overall effect of our analysis suggests that co-ingesting PRO with CHO does not provide any benefit beyond that of CHO alone to muscle glycogen restoration even when CHO intake is suboptimal , it is important to recognise that PRO remains critical for many physiological recovery processes e.

muscle repair. This finding contrasts the results of the present study Table 4. The discrepancy between findings may be due to a number of factors. Firstly, different effect estimates were used between studies; we reported the mean difference for ease of interpretation [ 70 ], whereas Margolis et al.

Secondly, studies employing 13 C-MRS techniques to determine muscle glycogen concentration were included in the previous study, while our results are based on studies using muscle tissue samples for glycogen analysis as a means of reducing methodological heterogeneity.

Finally, one study [ 56 ] was omitted from the previous meta-analysis without clear explanation and a number of trials [ 27 , 47 , 54 ] that were part of a parallel design were also excluded; in contrast, we included trials from a single study that provided PRO from different sources.

As a result, direct comparison of findings between the two meta-analyses is difficult and each should be interpreted on their individual merits. This review does contain several limitations. Firstly, only studies with accessible full-text articles written in English were included.

Secondly, the relatively limited number of trials included in the present meta-analysis prevented a comprehensive exploration of other factors e.

The low number of female participants included in original investigations 9. CHO, respectively also precluded the exploration of sex as an influential factor on the rate of muscle glycogen re-synthesis. Thus, despite the plethora of research investigating the effect of CHO intake on muscle glycogen re-synthesis, opportunities for further research remain.

Results of the present review suggest that individuals with limited opportunity for nutritional recovery between consecutive bouts of exercise e. Co-ingesting PRO with CHO does not appear to enhance the rate of muscle glycogen re-synthesis, nor is it detrimental.

The interval of CHO administration appears to be an important factor that may influence the magnitude of effect CHO has on the rate of muscle glycogen re-synthesis.

Murray B, Rosenbloom C. Fundamentals of glycogen metabolism for coaches and athletes. Nutr Rev. Article PubMed PubMed Central Google Scholar. Casey A, Mann R, Banister K, Fox J, Morris PG, Macdonald IA, et al. Effect of carbohydrate ingestion on glycogen resynthesis in human liver and skeletal muscle, measured by 13C MRS.

Am J Phys. CAS Google Scholar. Johnson NA, Stannard SR, Thompson MW. Muscle triglyceride and glycogen in endurance exercise implications for performance. Sports Med. Article PubMed Google Scholar. Alghannam AF, Gonzalez JT, Betts JA.

Restoration of muscle glycogen and functional capacity: role of post-exercise carbohydrate and protein co-ingestion. Burke LM, van Loon LJC, Hawley JA. Postexercise muscle glycogen resynthesis in humans. J Appl Physiol. Article CAS PubMed Google Scholar. Ivy JL. Regulation of muscle glycogen repletion, muscle protein synthesis and repair following exercise.

J Sports Sci Med. PubMed PubMed Central Google Scholar. Jentjens R, Jeukendrup AE. Determinants of post-exercise glycogen synthesis during short-term recovery. Ivy JL, Lee MC, Brozinick JT Jr, Reed MJ. Muscle glycogen storage after different amounts of carbohydrate ingestion.

Trommelen J, Beelen M, Pinckaers PJM, Senden JM, Cermak NM, van Loon LJC. Fructose coingestion does not accelerate postexercise muscle glycogen repletion. Med Sci Sports Exerc. Blom PCS, Hostmark AT, Vaage O, Kardel KR, Maehlum S. Effect of different postexercise sugar diets on the rate of muscle glycogen-synthesis.

Aulin KP, Soderlund K, Hultman E. Muscle glycogen resynthesis rate in humans after supplementation of drinks containing carbohydrates with low and high molecular masses.

Eur J Appl Physiol. Article Google Scholar. Parkin JAM, Carey MF, Martin IK, Stojanovska L, Febbraio MA. Muscle glycogen storage following prolonged exercise: effect of timing of ingestion of high glycemic index food. Ivy JL, Katz AL, Cutler CL, Sherman WM, Coyle EF.

Muscle glycogen-synthesis after exercise - effect of time of carbohydrate ingestion. Keizer HA, Kuipers H, van Kranenburg G, Geurten P. Influence of liquid and solid meals on muscle glycogen resynthesis, plasma fuel hormone response, and maximal physical working capacity. Int J Sports Med.

Reed MJ, Brozinick JT Jr, Lee MC, Ivy JL. Muscle glycogen storage postexercise: Effect of mode of carbohydrate administration. Battram DS, Shearer J, Robinson D, Graham TE. Caffeine ingestion does not impede the resynthesis of proglycogen and macroglycogen after prolonged exercise and carbohydrate supplementation in humans.

Burke LM, Collier GR, Broad EM, Davis PG, Martin DT, Sanigorski AJ, et al. Effect of alcohol intake on muscle glycogen storage after prolonged exercise. Cheng IS, Huang SW, Lu HC, Wu CL, Chu YC, Lee SD, et al. Oral hydroxycitrate supplementation enhances glycogen synthesis in exercised human skeletal muscle.

Br J Nutr. Impey SG, Hammond KM, Naughton R, Langan-Evans C, Shepherd SO, Sharples AP, et al. Whey protein augments leucinemia and postexercise p70S6K1 activity compared with a hydrolyzed collagen blend when in recovery from training with low carbohydrate availability.

Int J Sport Nutr Exerc Metab. Pedersen DJ, Lessard SJ, Coffey VG, Churchley EG, Wootton AM, Ng T, et al. High rates of muscle glycogen resynthesis after exhaustive exercise when carbohydrate is coingested with caffeine. Ruby BC, Gaskill SE, Slivka D, Harger SG.

The addition of fenugreek extract Trigonella foenum-graecum to glucose feeding increases muscle glycogen resynthesis after exercise. Amino Acids. Slivka D, Cuddy J, Hailes W, Harger S, Ruby B. Glycogen resynthesis and exercise performance with the addition of fenugreek extract 4-hydroxyisoleucine to post-exercise carbohydrate feeding.

Tsai TW, Chang CC, Liao SF, Liao YH, Hou CW, Tsao JP, et al. Effect of green tea extract supplementation on glycogen replenishment in exercised human skeletal muscle. Tsao JP, Liao SF, Korivi M, Hou CW, Kuo CH, Wang HF, et al.

Oral conjugated linoleic acid supplementation enhanced glycogen resynthesis in exercised human skeletal muscle. J Sports Sci. Vandoorne T, De Smet S, Ramaekers M, Van Thienen R, De Bock K, Clarke K, et al. Intake of a ketone ester drink during recovery from exercise promotes mTORC1 signaling but not glycogen resynthesis in human muscle.

Front Physiol. Tarnopolsky MA, Bosman M, MacDonald JR, Vandeputte D, Martin J, Roy BD. Postexercise protein-carbohydrate and carbohydrate supplements increase muscle glycogen in men and women. van Hall G, Saris WHM, van de Schoor PAI, Wagenmakers AJM. The effect of free glutamine and peptide ingestion on the rate of muscle glycogen resynthesis in man.

van Hall G, Shirreffs SM, Calbet JAL. Muscle glycogen resynthesis during recovery from cycle exercise: no effect of additional protein ingestion. van Loon LJC, Saris WHM, Kruijshoop M, Wagenmakers AJM.

Maximizing postexercise muscle glycogen synthesis: carbohydrate supplementation and the application of amino acid or protein hydrolysate mixtures. Am J Clin Nutr. Betts J, Williams C. Short-term recovery from prolonged exercise. Potgieter S.

Sport nutrition- A review of the latest guidelines for exercise and sport nutrition from the American College of Sport Nutrition, the International Olympic Committee and the International Society for Sports Nutrition.

S Afr J Clin Nutr. Google Scholar. Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine Joint Position Statement.

Nutrition and Athletic Performance. CAS PubMed Google Scholar. Hickner RC, Fisher JS, Hansen PA, Racette SB, Mier CM, Turner MJ, et al.

Muscle glycogen accumulation after endurance exercise in trained and untrained individuals. Doyle JA, Sherman WM, Strauss RL. Effects of eccentric and concentric exercise on muscle glycogen replenishment.

Casey A, Short AH, Hultman E, Greenhaff PL. Glycogen resynthesis in human muscle-fiber types following exercise-induced glycogen depletion. J Physiol-London. Article CAS PubMed PubMed Central Google Scholar. Piehl K. Time course for refilling of glycogen stores in human muscle fibres following exercise-induced glycogen depletion.

Acta Physiol Scand. Glycogen storage and depletion in human skeletal muscle fibres. Vollestad NK, Blom PCS, Gronnerod O. Resynthesis of glycogen in different muscle fibre types after prolonged exhaustive exercise in man.

Bonen A, Ness GW, Belcastro AN, Kirby RL. Mild exercise impedes glycogen repletion in muscle. Zachwieja JJ, Costill DL, Pascoe DD, Robergs RA, Fink WJ. Influence of muscle glycogen depletion on the rate of resynthesis. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.

Preferred reporting items for systematic review and meta-analysis protocols PRISMA-P statement. Syst Rev. Cheng AJ, Chaillou T, Kamandulis S, Subocius A, Westerblad H, Brazaitis M, et al.

Carbohydrates do not accelerate force recovery after glycogen-depleting followed by high-intensity exercise in humans. Scand J Med Sci Sports. Greene J, Louis J, Korostynska O, Mason A.