Effects of molecular hydrogen supplementation on fatigue and aerobic capacity in healthy adults: A systematic review and meta-analysis

Abstract

Background: Fatigue is oftentimes induced by high-intensity exercise potentially via the exceeded amount of reactive oxygen species, leading to diminished functions (e.g., aerobic capacity) and increased risk of injuries. Studies indicate that molecular hydrogen (H₂), with antioxidant and anti-inflammatory properties, may be a promising strategy to alleviate fatigue and improve aerobic capacity. However, such effects have not been comprehensively characterized.

Objective: To systematically assess the effects of in taking H₂ on fatigue and aerobic capacity in healthy adults.

Methods: The search was conducted in August 2022 in five databases. Studies with randomized controlled or crossover designs that investigated the rating of perceived exertion (RPE), maximal oxygen uptake (VO_2max), peak oxygen uptake (VO_2peak), and endurance performance were selected. The data (mean ± standard deviation and sample size) were extracted from the included studies and were converted into the standardized mean difference (SMD). Random-effects meta-analyses were performed. Subgroup analysis was used to analyze potential sources of heterogeneity due to intervention period, training status, and type of exercise.

Results: Seventeen publications (19 studies) consisting of 402 participants were included. The pooled effect sizes of H₂ on RPE (SMD_pooled = -0.38, 95%CI -0.65 to -0.11, p = 0.006, I ² = 33.6%, p = 0.149) and blood lactate (SMD_pooled = -0.42, 95% CI -0.72 to -0.12, p = 0.006, I ² = 35.6%, p = 0.114) were small yet significant with low heterogeneity. The pooled effect sizes of H₂ on VO_2max and VO_2peak (SMD_pooled = 0.09, 95% CI -0.10 to 0.29, p = 0.333, I ² = 0%, p = 0.998) and endurance performance (SMD_pooled = 0.01, 95% CI -0.23 to 0.25, p = 0.946, I ² = 0%, p > 0.999) were not significant and trivial without heterogeneity. Subgroup analysis revealed that the effects of H₂ on fatigue were impacted significantly by the training status (i.e., untrained and trained), period of H₂ implementation, and exercise types (i.e., continuous and intermittent exercises).

Conclusions: This meta-analysis provides moderate evidence that H₂ supplementation alleviates fatigue but does not enhance aerobic capacity in healthy adults.

Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022351559.

Keywords: aerobic capacity; fatigue; maximal oxygen uptake; molecular hydrogen; rating of perceived exertion.