Based on the limited evidence available, there were no clear effects of carbohydrate (CHO) supplementation during and after endurance exercise on CHO and protein-specific metabolic responses during recovery.  

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

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• Quality Rating Summary
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• Worksheets
  • Cochran AJ, Little JP, Tarnopolsky MA, Gibala MJ. Carbohydrate feeding during recovery alters the skeletal muscle metabolic response to repeated sessions of high-intensity interval exercise in humans. J Appl Physiol. 2010; 108: 628-636.
  • Miller SL, Gaine PC, Maresh CM, Armstrong LE, Ebbeling CB, Lamont LS, Rodriguez NR. The effects of nutritional supplementation throughout an endurance run on leucine kinetics during recovery. Int J Sport Nutr Exer Metab. 2007; 17: 457-467.
  • Sousa M, Simoes HG, Campi de Castro C, Garcia Otaduy MC, Negrao CE, Rodrigues Pereira RM, Madsen K, and Rossi da Silva ME. Carbohydrate supplementation increases intramyocellular lipid stores in elite runners. Metabolism Clinical Experimental, 2012: 61: 1,189-1,196.

Based on the limited evidence available, there were no clear effects of carbohydrate (CHO) supplementation during and after endurance exercise on endurance performance in adult athletes during recovery.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Sousa M, Simoes HG, Campi de Castro C, Garcia Otaduy MC, Negrao CE, Rodrigues Pereira RM, Madsen K, and Rossi da Silva ME. Carbohydrate supplementation increases intramyocellular lipid stores in elite runners. Metabolism Clinical Experimental, 2012: 61: 1,189-1,196.

• Compared to ingestion of carbohydrate (CHO) alone, coingestion of CHO plus protein (PRO), together during the recovery period resulted in no difference in the rate of muscle glycogen re-synthesis
• Coingestion of PRO with CHO during the recovery period resulted in improved net PRO balance post-exercise
• The effect of coingestion of PRO with CHO on creatine kinase levels is inconclusive and shows no impact on muscle soreness post-exercise.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Beelen M, Van Kranenburg J, Senden JM, Kuipers H, Van Loon LJC. Impact of caffeine and protein on postexercise muscle glycogen synthesis. Med Sci Sports Exerc. 2012; 44 (4): 692-700.
  • Betts JA, Toone RJ, Stokes KA, Thompson D. Systemic indices of skeletal muscle damage and recovery of muscle function after exercise: effect of combined carbohydrate-protein ingestion. Appl Physiol Nutr Metab. 2009; 34: 773-784.
  • Betts JA, Williams C, Boobis L, Tsintzas K. Increased carbohydrate oxidation after ingesting carbohydrate with added protein. Med Sci Sports Exerc. 2008; 40(5): 903–912.
  • Ferguson-Stegall L, McCleave EL, Ding Z, Doerner III PG, Wang B, Liao YH, Kammer L, Liu Y, Hwang J, Dessard BM, Ivy JL. Postexercise carbohydrate–protein supplementation improves subsequent exercise performance and intracellular signaling for protein synthesis. J Strength Cond Res. 2011: 25(5): 1,210–1,224.  
     
  • Howath KR, Moreau NA, Phillips SM, Gibala MJ. Coingestion of protein with carbohydrate during recovery from endurance exercise stimulates skeletal muscle protein synthesis in humans. J Appl Physiol. 2009; 106: 1,394-1,401.
  • Miller SL, Gaine PC, Maresh CM, Armstrong LE, Ebbeling CB, Lamont LS, Rodriguez NR. The effects of nutritional supplementation throughout an endurance run on leucine kinetics during recovery. Int J Sport Nutr Exer Metab. 2007; 17: 457-467.
  • Nelson AR, Phillips SM, Stellingwerff T, Rezzi S, Bruce SJ, Breton I, Thorimbert A, Guy PA, Clarke J, Broadbent S, Rowlands DS. A protein-leucine supplement increases branched-chain amino acid and nitrogen turnover but not performance. Med Sci Sports Exerc. 2012; 44 (1): 57-68
  • Pritchett, K, Bishop P, Pritchett R, Green M, Katica C. Acute effects of chocolate milk and a commercial recovery beverage on postexercise recovery indices and endurance cycling performance. Appl Physiol Nutr Metab. 2009; 34: 1,017-1,022.
  • Rowlands DS, Wadsworth DP. Effect of high-protein feeding on performance and nitrogen balance in female cyclists. Med Sci Sports Exerc. 2011; 43 (1): 44-53.
  • Rowlands DS, Rossier K, Thorp RM, Graham DF, Timmons BW, Stannard SR, Tarnopolsky MA. Effect of dietary protein content during recovery from high-intensity cycling on subsequent performance and markers of stress, inflammation, and muscle damage in well-trained men. Appl Physiol Nutr Metab. 2008; 33: 39-51.
  • Rowlands DS, Thorp RM, Rossler K, Graam DF, Rockell MJ. Effect of protein-rich feeding on recovery after intense exercise. Int J Sport Nutr Exerc Metabol. 2007; 17: 521-543.
  • Tang JE, Manolakos JJ, Kujbida GW, Lysecki PJ, Moore DR, Phillips SM. Minimal whey protein with carbohydrate stimulates muscle protein synthesis following resistance exercise in trained young men. Appl. Physiol. Nutr. Metab. 2007; 32: 1,132-1,138.
  • Thomson JS, Ali A, Rowlands DS. Leucine-protein supplemented recovery feeling enhances Subsequent cycling performance in well-trained men. Appl Physiol Nutr Metab. 2011; 36 (2): 242-253

Coingestion of carbohydrate (CHO) plus protein (PRO), together during the recovery period resulted in no clear influence on subsequent strength or sprint power.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Betts JA, Toone RJ, Stokes KA, Thompson D. Systemic indices of skeletal muscle damage and recovery of muscle function after exercise: effect of combined carbohydrate-protein ingestion. Appl Physiol Nutr Metab. 2009; 34: 773-784.
  • Cockburn E, Stevenson E, Hayes P, Robson-Ansley P, Howatson G. Effects of milk-based carbohydrate-protein supplement timing on the attenuation of exercise-induced muscle damage. Appl Physiol Nutr Metab. 2010; 35: 270-277.
  • Green MS, Corona BT, Doyle JA, Ingalls CP. Carbohydrate-protein drinks do not enhance recovery from exercise-induced muscle injury. Int J Sport Nutr Exerc Metab. 2008; 18 (1): 1-18.
  • Nelson AR, Phillips SM, Stellingwerff T, Rezzi S, Bruce SJ, Breton I, Thorimbert A, Guy PA, Clarke J, Broadbent S, Rowlands DS. A protein-leucine supplement increases branched-chain amino acid and nitrogen turnover but not performance. Med Sci Sports Exerc. 2012; 44 (1): 57-68
  • Pritchett, K, Bishop P, Pritchett R, Green M, Katica C. Acute effects of chocolate milk and a commercial recovery beverage on postexercise recovery indices and endurance cycling performance. Appl Physiol Nutr Metab. 2009; 34: 1,017-1,022.
  • Rowlands DS, Wadsworth DP. Effect of high-protein feeding on performance and nitrogen balance in female cyclists. Med Sci Sports Exerc. 2011; 43 (1): 44-53.
  • Rowlands DS, Rossier K, Thorp RM, Graham DF, Timmons BW, Stannard SR, Tarnopolsky MA. Effect of dietary protein content during recovery from high-intensity cycling on subsequent performance and markers of stress, inflammation, and muscle damage in well-trained men. Appl Physiol Nutr Metab. 2008; 33: 39-51.
  • Rowlands DS, Thorp RM, Rossler K, Graam DF, Rockell MJ. Effect of protein-rich feeding on recovery after intense exercise. Int J Sport Nutr Exerc Metabol. 2007; 17: 521-543.
  • Thomson JS, Ali A, Rowlands DS. Leucine-protein supplemented recovery feeling enhances Subsequent cycling performance in well-trained men. Appl Physiol Nutr Metab. 2011; 36 (2): 242-253
  • Vieillevoye S, Poortmans JR, Duchateau J, Carpentier A, Effects of a combined essential amino acids/carbohydrate supplementation on muscle mass, architecture and maximal strength following heavy-load training. European Journal of Applied Physiology, 2010; 110: 479-488.

Ingesting protein during the recovery period (post-exercise) led to accelerated recovery of static force and dynamic power production during the delayed onset muscle soreness (DOMS) period and more repetitions performed subsequent to intense resistance training.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Etheridge T, Philp A, Watt PW. A single protein meal increases recovery of muscle function following an acute eccentric exercise bout. Appl Physiol Nutr Metab. 2008; 33: 483-488.
  • Hoffman J, Ratamess N, Tranchina C, Rashti S, Kang J, Faigenbaum A. Effect of a proprietary protein supplement on revcovery indices following resistance exercise in strength/power athletes. Amino Acids, 2010; 38: 771-778.

Ingesting protein (approximately 20g to 30g total protein, or approximately 10g of essential amino acids, EAAs) during exercise or the recovery period (post-exercise) led to increased whole body and muscle protein synthesis as well as improved nitrogen balance.  

 

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.