Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Dec 25;18(1):103.
doi: 10.3390/ijerph18010103.

The 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates

Affiliations
Review

The 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates

Diego A Bonilla et al. Int J Environ Res Public Health. .

Abstract

Post-exercise recovery is a broad term that refers to the restoration of training capacity. After training or competition, there is fatigue accumulation and a reduction in sports performance. In the hours and days following training, the body recovers and performance is expected to return to normal or improve. ScienceDirect, PubMed/MEDLINE, and Google Scholar databases were reviewed to identify studies and position declarations examining the relationship between nutrition and sports recovery. As an evidence-based framework, a 4R's approach to optimizing post-exercise recovery was identified: (i) Rehydration-a fundamental process that will depend on the athlete, environment and sports event; (ii) Refuel-the consumption of carbohydrates is not only important to replenish the glycogen reserves but also to contribute to the energy requirements for the immune system and tissue reparation. Several bioengineered carbohydrates were discussed but further research is needed; (iii) Repair-post-exercise ingestion of high-quality protein and creatine monohydrate benefit the tissue growth and repair; and (iv) Rest-pre-sleep nutrition has a restorative effect that facilitates the recovery of the musculoskeletal, endocrine, immune, and nervous systems. Nutritional consultancy based on the 4R's is important for the wise stewardship of the hydration, feeding, and supplementation strategies to achieve a timely recovery.

Keywords: carbohydrate conformation; muscle soreness; physiological adaptation; protein synthesis; rehydration; sleep hygiene.

PubMed Disclaimer

Conflict of interest statement

D.A.B. serves as a Science Product Manager for a company of dietary supplements in Europe (MTX Corporation®), has acted as scientific consultant for MET-Rx in Colombia, and is current member of the “Creatine in Health” scientific advisory board for Creapure®-AlzChem Tostberg GmbH. R.B.K. has conducted a number of industry sponsored on sport nutrition related nutrients, has served as a paid consultant and received honorariums to speak at conferences by industry, and currently serves as chair of the “Creatine in Health” scientific advisory board for Creapure®-AlzChem Tostberg GmbH. A.P.-I. and A.O.-M. declare no conflict of interest. This review does not constitute endorsement by the authors and/or the institution concerning the nutrients reviewed.

Figures

Figure 1
Figure 1
The time course of exercise-induced adaptations. Transient changes in metabolite sensing and signaling during/after exercise drive to gene transcription of early genes, myogenic regulators, genes of carbohydrate metabolism, lipid mobilization, transport and oxidation, mitochondrial metabolism and oxidative phosphorylation, and transcriptional regulators of gene expression and mitochondrial biogenesis [13]. DNA methylation is a regulatory point for transcription and may have a certain influence, although the current evidence suggest that exercise adaptations are regulated to a greater extent at the post-transcriptional level [14]. The time course changes following exercise have been described previously [15,16].
Figure 2
Figure 2
The 4R’s framework of nutritional strategies to optimize post-exercise recovery in athletes.
Figure 3
Figure 3
Isomaltulose and trehalulose production. Synthesis of the non-starch slowly digestible sucrose isomers by the isomaltulose synthase (PDB ID: 1M53) and trehalulose synthase (PDB ID: 1ZJA). Minor products of the reaction are represented by faint text. Blood glucose and insulin levels in humans after oral administration of these carbohydrates rise slower and reach lower maxima than after sucrose administration [60]. After hydrolysis of these disaccharides by the human small intestinal mucosal enzymes, fructose and glucose are metabolized as typical for these monosaccharides.
Figure 4
Figure 4
Molecular structures of common cyclodextrins and schematic representation of highly branched cyclic dextrin (HBCD). (A). Chemical structure of the α-, β- and γ-cyclodextrins, which contain 6, 7 or 8 glucose units, respectively. Image taken and modified from [86]. (B). The conical shape representation of cyclodextrins. These molecules have a truncated cone shape with a hydrophilic external surface (due to the hydroxyl groups on the C2, C3 and C6 atoms) and a hydrophobic cavity (due to the inner hydrogens (H3 and H5) pointing inward) [87]. Cyclodextrins have different water solubility: α- and γ-cyclodextrins have a relatively high solubility (145 and 232 g·L−1), whereas the β-type is much less soluble in water (18.5 g·L−1). Image taken and modified from [88]. (C). The schematic representation of HBCD is shown. Open circles represent glucose units while grey-filled circles are those conforming the main centered ring. Lines and arrows are α-(1→4) and α-(1→6) glycosidic bonds, respectively. Image taken from [89].

Similar articles

Cited by

References

    1. Leveille C.F., Mikhaeil J.S., Turner K.D., Silvera S., Wilkinson J., Fajardo V.A. Mitochondrial cristae density: A dynamic entity that is critical for energy production and metabolic power in skeletal muscle. J. Physiol. 2017;595:2779–2780. doi: 10.1113/JP274158. - DOI - PMC - PubMed
    1. Nielsen J., Gejl K.D., Hey-Mogensen M., Holmberg H.-C., Suetta C., Krustrup P., Elemans C.P.H., Ørtenblad N. Plasticity in mitochondrial cristae density allows metabolic capacity modulation in human skeletal muscle. J. Physiol. 2017;595:2839–2847. doi: 10.1113/JP273040. - DOI - PMC - PubMed
    1. Hughes D.C., Ellefsen S., Baar K. Adaptations to Endurance and Strength Training. Cold Spring Harb. Perspect. Med. 2018:8. doi: 10.1101/cshperspect.a029769. - DOI - PMC - PubMed
    1. Lambert M.I. Training, Adaptations. In: Mooren F.C., editor. Encyclopedia of Exercise Medicine in Health and Disease. Springer; Berlin/Heidelberg, Germany: 2012. pp. 854–856.
    1. Sundberg C.W., Fitts R.H. Bioenergetic basis of skeletal muscle fatigue. Curr. Opin. Physiol. 2019;10:118–127. doi: 10.1016/j.cophys.2019.05.004. - DOI - PMC - PubMed

Publication types