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Background: It has been widely accepted that regular exercise represents an important factor to improve health; for the magnificent benefits you can get on the short term and long term. To pave the way for better performance in exercise by improving body strength and reducing risks of muscle injuries, intake of proper nutrients is vital. There are many types of nutrients found in our diets that are all necessary, yet some have additional values. Polyphenols are not only considered for their bioavailability profile, but for their antioxidant properties as well as their diverse beneficial actions. Aims and objectives: The intent of this review is to provide prevalent information on the effect of polyphenol-rich fruits and polyphenols supplements from different sources on exercise performance. Performance is usually modeled by strength, endurance, and recovery. The role of oxidative stress and free radicals in exercise performance will also be highlighted. Oxidative stress has been associated with decreased physical performance, muscular fatigue and muscle damage. Antioxidants supplementation of the diet may be one intervention to reduce exercise-induced oxidative stress in athletes. Conclusions: It has been demonstrated by several studies presented in this review that polyphenols have been shown to reduce oxidative stress biomarkers, increasing blood flow, increasing O2 gas supply, reducing muscle damage, and therefore improving recovery, endurance, and strength in physically active individuals.
Content may be subject to copyright.
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
- 135 - © 2017 DAR Publishers/The University of Jordan. All Rights Reserved.
* dean-pharmacy@meu.edu.jo or ealdujai@staffmail.ed.ac.uk
Received on 2/5/2017 and Accepted for Publication on
17/6/2017.
Polyphenolic-rich Fruits and Supplements Enhance Exercise Performance;
General Review
Hana R. Bajes 1 and Emad A S Al-Dujaili 1*
1 Faculty of Pharmacy, Middle East University, Amman, Jordan.
ABSTRACT
Background: It has been widely accepted that regular exercise represents an important factor to improve health; for the
magnificent benefits you can get on the short term and long term. To pave the way for better performance in exercise by
improving body strength and reducing risks of muscle injuries, intake of proper nutrients is vital. There are many types
of nutrients found in our diets that are all necessary, yet some have additional values. Polyphenols are not only considered
for their bioavailability profile, but for their antioxidant properties as well as their diverse beneficial actions.
Aims and objectives: The intent of this review is to provide prevalent information on the effect of polyphenol-rich fruits
and polyphenols supplements from different sources on exercise performance. Performance is usually modeled by
strength, endurance, and recovery. The role of oxidative stress and free radicals in exercise performance will also be
highlighted. Oxidative stress has been associated with decreased physical performance, muscular fatigue and muscle
damage. Antioxidants supplementation of the diet may be one intervention to reduce exercise-induced oxidative stress in
athletes.
Conclusions: It has been demonstrated by several studies presented in this review that polyphenols have been shown to
reduce oxidative stress biomarkers, increasing blood flow, increasing O2 gas supply, reducing muscle damage, and
therefore improving recovery, endurance, and strength in physically active individuals.
Keywords: Exercise performance; Endurance; Polyphenols; Berries; Pomegranate; Oxidative stress; Free radicals.
1. INTRODUCTION
Physical exercise, physical activity and nutritional
behaviour are now well considered to be essential
components of a healthy lifestyle. Whether it’s moderate
or exhaustive type of exercise; they both involve muscle
contractions and an increase in by-products and free
radicals. Moderate and regular exercise have been shown
to be useful in the prevention of cardiovascular disease,
metabolic syndrome, type II diabetes, and
neurodegenerative disease like Alzheimer’s and
Parkinson's disease1. Moreover, this type of exercise
maintains body fitness, body health and overall
enhancement of well being2. Protection against stressors
and adaptation responses might develop with moderate
regular exercising, which in turns plays a key role in the
prevention of chronic and degenerative diseases1.
Numerous studies have demonstrated the ability of
exercise training to stimulate positive adaptations in
skeletal muscles in adults of all ages. This includes
increased muscle strength, increased protein synthesis,
increased muscle mass, changes in myosin heavy-chain
composition, and increased proportion of satellite cells that
are precursors to skeletal muscle cells2. Individuals who
participate in regular exercise and physical activity have
profoundly lower rates of disability and an average life
expectancy approximately seven years longer than
sedentary individuals. As regular exercise maintains a
Polyphenolic-rich Fruits… Hana R. Bajes, Emad A S Al-Dujaili
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delicate balance between ROS and NO that keep a healthy
cardiovascular system, however, too much exercise is
detrimental and disturbs this balance. On the other hand,
sedentary life style induces vascular dysfunction3.
Some moderate exercisers progress to a further level
and become athletic and perform exhaustive exercise
including powerful cycling, swimming, running for long
durations and long distances as well as to cross training
and body muscle building. Beside the superior benefits
these athletes are experiencing the increased intensity may
produce additional stress on their muscles3,4. Consuming
functional and nutritive food containing antioxidants
would be inevitable when a healthy lifestyle and exercise
were followed. Diet that rich in antioxidants (substances
which remove free radicals by neutralizing them as a result
of metabolic reactions) would be essential to enhance
performance during exercise5,14,50,52. Plant polyphenols are
the most abundant antioxidants in diet.
The aim of this review is to study the effect of natural
fruits and products rich in antioxidants on the 3 main
aspects of exercise performance; Endurance, strength and
recovery. In addition, how each one of these is enhanced
by polyphenolic compounds, whether during different
types of workouts a person may do or regular exercise and
also the various polyphenolic fruits and sources.
Methods
The preparation of this general review followed several
steps: Identification of research question of how
polyphenolic rich products enhance exercise performance,
literature survey of relevant studies and eligible ones were
selected based on inclusion and exclusion criteria and then
organising the research according to 3 main exercise
activities; endurance, strength and recovery. This review
excluded non relevant studies whose participants were
smokers, on medications, physically handy-caped
individuals, and children. Full texts were verified against
the inclusion criteria whereby all young and adult females
and males, both healthy or with mild chronic diseases were
included. Also those non-smokers, physically active and
inactive individuals were included. Relevant data were
extracted and evaluated and this was made possible by
searching different search engines primarily PubMed
using relevant keywords.
Polyphenols Sources
Polyphenols are either synthetic or natural, and the latter
are the most bioactive compounds. Natural polyphenols
have been found in tea, cereals, medical plants, microalgae,
and edible and wild flowers. High content of polyphenols
was found in grape, pomegranate, olive, blueberry and other
berries, sweetsop, mango and citrus fruits. The highest
phenolic contents were found in Chinese toon bud,
loosestrife, penile leaf, cowpea, caraway, lotus root, sweet
potato leaf, soy bean (green), pepper leaf, ginseng leaf,
chives, and broccoli. In addition, the pigmented cereals,
such as black rice, red rice and purple rice, contained high
total phenolic contents. Salvia miltiorrhiza Bge. (danshen),
Polygonum multiflorum Thunb. (stem) (flowery knotweed),
Rhodiola sacra Fu (hongjingtian), Fraxinus rhynchophylla
Hance (ash), and Prunus persica (Linn) Batsch. (peach)
showed high contents of natural polyphenols among
medical plants. Rosa rugosa (rose), Limonium sinuatum
(myosotis), Pelargonium hortorum (geranium), Jatropha
integerrima (peregrina) and Osmanthus fragrans
(osmanthe) were found to have lots of natural polyphenols
among edible and wild flowers6.
Chemical classes of Polyphenols: Chemically,
polyphenols are usually composed of sugar residues linked
directly or indirectly to hydroxyl groups of the phenolic
compounds. It is common to find linkage with other
compounds, such as carboxylic and organic acids, amines,
lipids and association with other phenols. The number of
phenol rings is also used to subdivide polyphenols into
different groups. Several sub-classes, such as the phenolic
acids, flavonoids, stilbenes and lignans are shown in figure
1 below5,6. Polyphenols interact with important cellular
signal cascades including NFκB, MAPK and PI3K/Akt;
that are found to reduce adverse processes in inflammation
and atherogenesis11.
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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Figure 1. Chemical classes and subclasses of polyphenols49
Pomegranate: The majority of studies have used
pomegranate, or Punica granatum; is a shrub that
produces a red fruit, categorized as a berry. The skin of the
pomegranate is thick and inedible, but there are hundreds
of edible seeds called arils inside. The arils are what we
eat, either raw or processed into pomegranate juice.
Pomegranates contain Punicalagins which are extremely
powerful antioxidants and anti-inflammatory, found in the
juice and the peel. Pomegranates are studied relatively
more than any other fruit7. In a spectrophotometric
analysis, comparison between pomegranate juice, red
wine, blueberry juice, cranberry juice, orange juice and
green tea, it was found that pomegranate juice products
have the highest antioxidant capacity to neutralize free
radicals and to reduce LDL oxidation and inhibit cellular
oxidative stress in macrophages, with an antioxidant
activity three times higher than red wine and green tea8.
The significance of pomegranate juice is mainly due to its
relative high bioavailability compared to other
polyphenols such as resveratrol9 which makes it very
useful for medicinal purposes.
Pomegranate fruit parts: Knowing which part of the
pomegranate contains the highest or lowest content of
polyphenolic compounds is an important issue to consider
when performing research studies. One of the studies was
done in 2011 on the juice, peel, and seed extracts of four
Turkish pomegranates, Punica granatum L. cultivars.
Interestingly, in all cultivars, the highest levels of total
phenolic content were obtained from the peel extracts. The
total phenolic content range was (1775.4 to 3547.8 mg
gallic acid equivalent GAE/L) among the cultivars.
However, the total phenolic content of pomegranate juice
and seed extract range was 784.4 to 1551.5 mg GAE/L and
117.0 to 177.4 mg GAE/L respectively. Among the 4
popular cultivars tested, “Lefan” cultivar displayed the
highest amount of the total phenolic content10.
Extraction of polyphenols: Efficient methods to safely
extract polyphenols using eco-friendly and cost efficient
Polyphenolic-rich Fruits… Hana R. Bajes, Emad A S Al-Dujaili
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methods are available. While mechanisms of the so called
green extractions vary between modern green extraction
techniques such as supercritical fluid extraction,
microwave-assisted extraction, ultrasound-assisted
extraction, pressurized liquid extraction, and pressurized
hot water extraction are alternatives to conventional
extraction methods for polyphenol extraction from natural
sources. The green methods offer some advantages over
the conventional methods, are more sustainable, fast,
convenient, and eco-friendly12.
Exercise Performance
Exercise performance is a multi-organ activity where
oxygen availability is a major contributor. In recent years,
it became well known that nitrate and polyphenols increase
exercise efficiency and therefore, pomegranate extract is
primarily investigated to study effect on blood flow, vessel
diameter, and exercise performance in active individual13.
Reactive Oxygen species (ROS): ROS causes tissue
damage by releasing free radicals. In a study published in
2013 investigating the correlation between antioxidants
and exercise performance, pomegranate polyphenols were
chosen among other polyphenols in green tea and dark
chocolate.2 Another study published by Al-Dujaili and co-
workers14 concluded that intake of pomegranate juice
attenuates exercise-induced oxidative stress, blood
pressure and urinary cortisol/cortisone ratio in human
adults where participants consumed either pomegranate
pure juice (500 mL/day containing total polyphenols of
1685 mg GAE/L) or placebo (water matched for total
energy) and all participants completed two 30 min
treadmill tests (50% Wmax) at baseline and after one week
of the intervention. As expected, PJ has alleviated ROS
that was induced by moderate to extraneous exercise and
reduced blood systolic and diastolic blood pressure
possibly due to the counter affect of enzymatic
antioxidants defence mechanism and 11β-HSD enzymes
that modulate the conversion of cortisol to cortisone14.
When trained runners subjected to exhaustive exercise,
it was suggested that considerable increase of ROS levels
was observed and that variations in oxygen consumed can
underestimate the real increase in free radical formation
during intensive exercise, as a result of the reduction of
mitochondrial control of cell respiration and the increase
in the formation of free radicals derived from non-
mitochondrial sources. It was also observed in a football
trained group an increase in plasma levels of low
molecular weight endogenous antioxidants (ascorbic acid,
uric acid, and α-tocopherol) compared to sedentary
subjects. This increase was attributed to mobilization of
the antioxidants from the tissues to the plasma, explaining
the improvement of the total plasma antioxidant status
after training15. In another study published in 201550 on the
effect of dark grape juice consumption on exercise-
induced oxidative stress in healthy adults aged 41 to 60
Years, the individuals aged 41 to 60 years old who
exercised regularly and consumed dark grape juice have
significantly increased the total phenolic and FRAP
urinary levels and caused a significant decrease in one
oxidative stress marker (TBARS). However, for the aged
matched non-exercisers, there was an increase in total
phenolics but did not appear to have a significant effect on
oxidative stress markers50.
VO2 max: Higher intensity exercise was reported to
produce optimal cardio vascular health. To investigate the
optimal intensity needed to reach this phenomenon, young
men were assigned to mild (25% VO2 max), medium (50%
VO2 max) or high intensity (75% VO2 max) exercise
regimens for 12 weeks. Both endothelium dependent and
independent vasodilation and markers of oxidative stress
were examined. The medium intensity exercise group
showed increased acetylcholine-mediated vasodilation in
the forearm microcirculation while no benefit was
observed in the mild and high intensity groups4. There has
been a correlation between the high activity of antioxidant
enzymes and the maximum oxygen consumed. Training
athletes have a higher superoxide-dismutase (SOD) and
catalyase (CAT) activity in skeletal muscles. Professional
and amateur cyclists have higher SOD activity in
erythrocytes than sedentary subjects. Due to this,
resistance training reduces oxidative damage due to the
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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increased mitochondrial antioxidant enzymes and a
reduction of the oxygen flow in the respiratory chain15.
To study the role played by antioxidants in increasing
blood flow to leg muscles and O2 consumption with
chronic obstructive pulmonary disease (COPD), a cocktail
of antioxidants was prepared for that purpose. The 16
patients with COPD and 16 healthy subjects performed
sub-maximal single-leg knee extensor exercise. The
participants had 2 split doses; the first dose consisted of
300 mg α-lipoic acid, 500 mg vitamin C, and 200 IU of
vitamin E, and the second dose consisted of the same
amounts of α-lipoic acid and vitamin C and 400 IU vitamin
E. These parameters, LBF (Doppler ultrasound), mean
arterial blood pressure, LVC (leg vascular conductance),
arterial O2 saturation, leg arterial-venous O2 difference,
and leg O2 consumption were evaluated under control
conditions and after AOC administration. Patients with
COPD exhibited evidence of reduced antioxidant capacity
relative to healthy subjects. Administration of the AOC
improved the redox balance in patients with COPD, with
little effect in healthy subjects. These favourable changes
in redox balance were accompanied by improved LBF and
LVC as well as increased skeletal muscle V
̇O2 during sub-
maximal KE exercise in patients with COPD, whereas
minimal effects were observed in healthy subjects. In
addition, arterial O2 saturation was improved at rest and
during exercise in patients with COPD after AOC
administration16. Muscle damage, muscle dysfunction, and
worn-out tendons and joints may result from exhaustive
exercise. High impact muscle contraction causes an
increase in the production of matrix metalloprotienase
(MMPs) in the skeletal muscles. MMPs are a family of
enzymes, zinc-dependant that plays a role in mediating
inflammation, remodelling and regeneration of skeletal
muscles5.
Pomegranate and Anaerobic Exercise: Exercise
performance could be accomplished by multiple factors
and the availability of oxygen gas partial pressure
contributes to a great deal. When the body depletes the
amount of oxygen gas available, it seeks refuge to
anaerobic. Therefore, some studies investigated how PE
supplementation affect anaerobic exercise and flow
mediated dilation (FMD), oxygen saturation, heart rate
(HR), and blood pressure (BP). Nineteen participants
ingested 1000mg of PE or PL performed ten six-second
maximal sprints with a load of 65 g/kg of body weight and
30 seconds of recovery in between rounds. Ergometer was
used to assess peak and average power. Ultrasound
measured brachial artery, vascular, pulse wave, and color
flow to determine blood flow and vessel diameter16. It was
found that peak power was significantly higher for the 5th
sprint number when supplemented with PE versus PL.
Vessel diameter was significantly greater at 30min post-
exercise and blood flow was significantly higher
immediately post exercise when PE was consumed. There
were no significant differences identified in oxygen
saturation, heart rate, or blood pressure. Results suggest
the possibility of enhanced exercise performance due to
increased diameter of vessels which caused better delivery
of oxygen and substrates to working skeletal muscle with
the use of PE16.
The effect of grape seeds and cranberry polyphenols
consumption on anaerobic cycling performance and
brachial artery flow-mediated dilation (FMD) was studied
in 2 parts of a study involved elite athletes in Canada19. In
the first part of the study, 8 males and females elite athletes
consumed either polyphenols from cranberries and grape
seeds (600 mg) or a polyphenol-free placebo drink. Those
who consumed the polyphenol-rich drink had a significant
rise in FMD compared to placebo with a peak at 60 min19.
In the second part, 12 elite male and female athletes
completed a 3-km time trial (TT) on an ergocycle on two
occasions in random order, either after consumption of 800
mg of polyphenols or a placebo. The study showed that
acute intake of the polyphenol extract had no impact on the
three-kilometer time trial but improved endothelial
function. However, plasma lactate levels were
significantly lower before and after the TT when subjects
consumed the polyphenols vs. placebo. Acute modification
of FMD at rest is suggested by intake of polyphenols from
cranberries and grape seeds, but this did not translate into
Polyphenolic-rich Fruits… Hana R. Bajes, Emad A S Al-Dujaili
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enhanced cycling anaerobic performance17.
Pomegranate and Aerobic Exercise: Aerobic training
was suggested to improve the enzymatic antioxidant
activity in erythrocytes in basal state and in the recovery
period after exercise, along with the increase of muscle
blood flow and the mitochondrial aldehyde dehydrogenase
activity. This improvement could be responsible for the
significant decrease of lipid peroxidation index after
exercise in trained subjects. A study was done to explore
the antioxidant status of highly trained runners (128–230
km/week), moderate and low trained runner (26–70
km/week), and sedentary subjects.38 The results showed a
direct relationship between the weekly distance achieved
and the erythrocyte antioxidant enzymes activity. It was
found that trained marathon runners have higher levels of
Malondialdehyde (MDA) and conjugated dienes (CD) in
basal state than sedentary subjects. At the end of the half
marathon, trained subjects showed a significant increase in
the MDA and CD levels, however test values decreased in
the recuperation period (24–48 hours) to lower values. In
another study, Erythrocyte catalase activity and
glutathione reductase were shown to increase significantly
after 10 weeks of training15.
A study was performed to assess the effect of
pomegranate on aerobic exercise measuring blood flow,
time to exhaustion, and vessel diameter.13 Participants
performed a maximal oxygen consumption treadmill test
to determine peak velocity (PV), returned after 24–48 h
and ingested either PL or PE. Three treadmill runs to
exhaustion were performed at 90%, 100%, and 110% PV.
Blood flow was assessed immediately after each exercise
round and 30 min post-exercise (30min PEx). Compared
to PL, acute ingestion of PE (30 min before exercise)
seems to enhance vessel diameter and blood flow and
delay fatigue during exercise. The results indicated that PE
is an ergogenic for intermittent running, eliciting
beneficial effects on blood flow which is an important
factor of aerobic exercise13.
Studies on Endurance or stamina, Strength Exercise
and Recovery
Endurance Exercise
The capacity to remain active for a long period of time,
and withstand the physical stress, wear and tear before
becoming fatigued is referred to as stamina or endurance.
Fatiguing caused by accumulation of by-products of
metabolic pathways like magnesium, urea nitrogen,
creatine kinase, lactate, and reactive oxygen species
(ROS). Repetitive high intensity workout may overwhelm
the body systems and prevents detoxification18.
ROS/Oxidative stress: The role of Glutathione as an
antioxidant has been studied lately to a greater extent.
Some Endurance exercise studies have shown decreased
level of Glutathione but increased level of oxidized
Glutathione due to the oxidative stress exercise might have
caused. An increase in Glutathione reductase enzyme level
in serum has also been observed20. Oxidative stress has
been associated with decreased physical performance,
muscular fatigue, muscle damage, and overtraining.
Human body naturally occurring antioxidants are not
sufficient to neutralize high ROS levels; additional
antioxidants are necessary. However, not all studies have
shown the association between antioxidants and ROS in
reducing fatigue, muscle damage, and increased
performance following antioxidants intake21.
In 2013, a study was done using extra virgin olive oil
in rats. The rats were divided into three groups: (1) rats fed
with standard chow and not subjected to physical exercise;
(2) rats fed with standard chow and subjected to exhaustive
exercise; (3) rats fed with a diet rich in oleic acid, the major
component of extra-virgin olive oil, and subjected to
exhaustive exercise (running in a five-lane 10 inclined
treadmill at a speed of 30 m/min for 70–75 min). Oxidative
stress biomarkers were studied and antioxidant defences,
as well as histology and ultra-structure of the Quadriceps
femoris muscle (Rectus femoris). The results showed that
in group 3 rats, parameters indicating oxidative stress such
as hydroperoxides and thiobarbituric acid-reactive
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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substances decreased, parameters indicating antioxidant
defences of the body such as non-enzymatic antioxidant
capacity and Hsp70 expression increased, and R. femoris
muscle did not show histological and ultra-structural
alterations. Results of this study support the hypothesis
that extra-virgin oil can improve the body defence against
oxidative stress22.
Nitric Oxide: Endurance is made possible only if the
demand for elevated oxygen and energy substrates in
active skeletal muscle is met. To meet this high demand,
blood flow to working musculature is increased in a
process known as exercise hyperemia which affects blood
flow and nitric oxide (NO) and has been identified as a
vital contributor to the vasodilation observed after
exercise13. NO production includes a series of reactions
oxidizing L-arginine( a precursor) to L-citrulline and NO.
These reactions are catalyzed by NOS enzymes, and
require the presence of oxygen and L-arginine. In fact, a
number of studies have investigated the effects of arginine
and citrulline-based supplements on exercise performance.
This has led to speculation that L-citrulline-based
supplements may improve performance more effectively
than L-arginine, however, more research is needed to
evaluate the effects of L-citrulline supplementation on
blood flow and exercise performance. Another pathway
has been identified, in which nitrate (NO3) is reduced to
nitrite (NO2), and eventually to NO13.
Studies employing pomegranate and beetroot have also
shown to increase blood flow and vessel dilation. These
results indicate the enhancement done by NO production.
In studies conducted by Trexler and Melvin (2014)13, 23; 19
highly active men and women (Age: 22.2 ±2.2 yrs; Height:
174.8 ±10.7 cm; Body mass: 71.9±13.5kg) participated
and performed regular exercise for at least 2 months, and
were not on any prescription drugs or supplements that
might alter the results of the study. Pomegranate extract or
placebo (1000mg) was given to the participants, both PE
and PL (in a form of 500mg capsules). Each one of the 19
participants worked up 3 treadmill runs until exhaustion.
Runs were done at 90%, 100% and 110% peak velocity of
the treadmill, and the time to exhaustion was recorded for
each run. Blood pressure was measured and ultrasound
was used to measure blood flow and vessel diameter. PE
intake aided in the production of NO that caused
vasodilatation. This study has produced significant results
and shown that ingestion of the pomegranate extract was
found to significantly increase time to exhaustion, vessel
diameter and blood flow which result in delays of fatigue
and exhaustion in highly active athletes13,23. While
research with pomegranate juice has indicated improved
recovery from exercise as stated above, more research is
needed to investigate the effects of PE on exercise
recovery and the underlying mechanisms.
Recent studies have shown that dietary NO3
supplementation increased the circulating plasma [NO2],
and reduced the O2 cost of submaximal exercise in healthy
humans. Nitrate was ingested as part of a healthy diet;
vegetables are estimated to contain about 60_80% of the
daily NO3 intake in a western diet; green leafy vegetables
such as lettuce, spinach and beetroot are particularly rich
in NO3. Ingested inorganic NO3 is rapidly absorbed from
the intestines and a peak blood plasma NO3 observed 1
hour following NO3 ingestion. There is now evidence that
the muscle ATP turnover at a fixed work rate is reduced
and the mitochondrial phosphate/Oxygen ratio is increased
following NO3 supplementation, which suggests important
insights into the physiological bases for the reduced VO2
during exercise24. Nitrate (NO3) supplementation has also
been shown to improve exercise performance in both
healthy and patient populations. Thus, dietary NO3
supplementation may represent an effective method to
improve exercise efficiency and exercise tolerance in
humans. Therefore, an NO3- -rich diet may have numerous
cardiovascular and other health benefits including exercise
performance24. These results were supported by some
evidence that nitrate supplementation reduces the O2 cost
of endurance exercise and thus increasing the efficiency of
energy production24, 51. Other studies have revealed that
NO3 supplementation may reduce the muscle production
of ATP cost and increase the efficiency of mitochondrial
respiration24. These findings have practical implications in
Polyphenolic-rich Fruits… Hana R. Bajes, Emad A S Al-Dujaili
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enhancing sporting performance, and improving quality of
life in both athlete and elderly population.
To substantiate the above findings, a study in 201026,
investigated the effect of dietary supplementation with
sodium nitrate or placebo (NaCl) for 2 days before the
test (what is found in 100-300 g of a nitrate-rich
vegetable such as spinach or beetroot). The exercise tests
consisted of an incremental exercise to exhaustion with
combined arm and leg. The results showed a significant
reduction in VO2 max during maximal exercise using a
large active muscle mass and improved the energetic
function of the working muscles26. To prove the benefit,
a study was done, by Murphy and his Colleagues 27, to
examine whether whole beetroot consumption to increase
nitrate intake and improve endurance exercise
performance where 11 fit men and women underwent two
5-km treadmill trials in random sequence, one 75 minutes
after consuming baked beetroot (200g with-500mg
nitrate) and the other 75 minutes after consuming
cranberry relish as a placebo. It was found that mean
running velocity during the 5-km run tended to be faster
after beetroot consumption (12.3± 2.7 vs 11.9± 2.6
km/hour). During the last 1.1 miles of the 5-km run,
running velocity was 5% faster (12.7± 3.0 vs 12.1± 2.8
km/hour) in the beetroot trial. No differences in heart rate
were observed between trials; however, perceived
exertion was lower with beetroot. The authors concluded
that consumption of nitrate-rich whole beetroot improves
running performance in healthy adults, whereas nitrates
from other sources may have detrimental health effects27.
Lack of exercise and inactivity have an adverse effect
on endurance and overall well-being as shown in some
studies; one was done in 20054, where 16 healthy male
volunteers, spent 25 days of bed rest showed a 13%
reduction in femoral artery diameter. Another study4
showed impaired acetylcholine-mediated increase in
forearm blood flow after 13 days of bed rest, while others
have demonstrated that as little as 7 days of bed rest can
reduce basal blood flow and vasodilatation in the skin
microcirculation4. While these examples of in-activities
uniformly show a reduction in vasodilator capacity and
structural remodeling, they need to be interpreted with
caution as their extreme nature may not accurately
represent a “real life” sedentary human lifestyle.
Muggeridge and collegues28 had done a study on eight
trained kayakers who performed trials of 15 min of
paddling at 60% of maximum work rate, five 10-s all-out
sprints, and a 1 km time trial. They ingested 70 ml nitrate-
rich concentrated beetroot juice (BR) or tomato juice
(placebo). VO2 during steady-state exercise was lower in
the BR trial than in the PL trial (p= 0.01), despite that, BR
ingestion appears to have no effect on repeated supra-
maximal sprint of kayaking performance28.
Urea nitrogen and Creatine kinase: The effect of
polyphenols on endurance using Amarkand tubers (21
species found all over India) was studied. Methanol
extracts of 4 Amrakand tubers species of the Dioscorea
bulbifera were assessed at 1 mg/ml concentration. All
species exhibited high content of polyphenols. D bulbifera
bulbils and E. ochreata significantly prolonged the
swimming endurance time of the female rats tested. Urea
nitrogen and Creatine kinase were significantly reduced by
treatment of D. bulbifera bulbils and E. ochreata as
compared to negative control. It was also found that D.
bulbifera bulbils effectively increased creatine (p<0.001),
lactate dehydrogenase (p < 0.01) and haemoglobin (p <
0.001) levels compared to negative control. D. bulbifera
bulbils and E. ochreata treatments were also significantly
increased glycogen content (p < 0.05, p < 0.01) and
lowered malondialdehyde levels (p < 0.001) in muscles
and in liver tissue19. This study could be considered to be
relevant since both urea and nitrogen and creatine kinase
are produced when muscles are inflamed and damaged
which indicates tissue damage that can be reversed by the
effect of polyphenols ingestion which contributes to better
stamina. More studies are needed to investigate the cellular
and molecular components of these findings to understand
the mechanisms of regulation of glucose transport genes or
through inflammatory pathways against fatigue and
exercise endurance.
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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VO2 max: A supplement contained Pomegranate Fruit
Extract was taken 30 minutes before each CrossFit
workout. Subjects also were given a whey protein and
carbohydrate supplement mixed with water and consumed
immediately after each CrossFit workout session. Twenty
nine participants were recruited to complete three varied
workouts per week. The study produced beneficial results
by increasing power (74.40%) of the participants and
maintaining VO2 max (78.16%)32. Further research should
be conducted to determine what other possible sport-
related benefits may be achieved with the proprietary
blend supplements such as recovery during extended
competition.
In order to achieve endurance after a strenuous
exercise, both pain and inflammation of the working
muscles need to be controlled. Studies have suggested the
protective action of tart cherry juice extract against
inflammation and pain. Thirty six male and eighteen
female runners ran an average of 26.3±2.5 km over a 24
hour period. The runners ingested 355 mL bottles of tart
cherry juice or placebo twice daily for 7 days before and
on the day of the race. Participants evaluated their pain
level on a VAS at baseline, before and after the race. It was
reported that runners who had cherry juice experienced
less muscular pain after the race compared to the ones who
had placebo33. In order to improve endurance of long
distance, studies have focused on possible beneficial
nutrients for athletes such as blackcurrant juice and extract
which are full of polyphenolic antioxidants34. Although
some of these polyphenols are lost during the juicing
procedure.
Other polyphenols: Untrained males who took green
tea extract for four weeks and exercise-induced oxidative
damage indicators were measured. After four weeks of
scheduled training and supplementation, muscular
endurance test was performed on upper and lower body.
The supplemented group had increased plasma total
polyphenols, antioxidant status, and decreased creatine
kinase activity 24-hours post-exercise29. Black current
extract was tested on 13 active males on high-intensity
intermittent running and post-running lactate responses
were estimated30. Active runners (age: 25±4 yrs, height:
1.82 ±0.07 m, body mass: 81±14 kg) were put on a
protocol of treadmill running to the point of exhaustion.
The runners consumed capsulated black current extract
(300 mg/day CurraNZ; containing 105 mg anthocyanin) or
placebo for 7 days. Blood samples containing lactate were
collected after 30 min post-exhaustion. The extract has
significantly increased total running distance by 10.6%,
with the distance during sprints increased by 10.8%. At
exhaustion, blood lactate tended to be higher for the extract
takers. As a result blackcurrant extract may improve
running performance in greater distances, and there was
higher lactate at exhaustion30. The relationship between
the amount of exercise-induced muscle damage and the
release of enzymes; creatine kinase (CK), aspartate
aminotransferase (AST), and lactate dehydrogenase (LD)
was examined in rats. The course of exercise elicited
histological damage only in the soleus muscle, and
significant plasma CK, AST, and LD elevations were
found immediately post-exercise both in male and female
rats. Moreover, the release of enzymes was significantly
greater in males than in females. An increase in the
exercise duration from 1.5 h to 2.5 h resulted in a
disproportional increase in both histological muscle
damage and muscle enzyme release31.
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Table 1. Summary of Studies on Endurance Exercise showing their brief results
No. Endurance Study Results notes
1 Labonte, K, et al18
Creatine Kinase, lactate, and reactive oxygen species (ROS).
Repetitive high intensity workout may overwhelm the body systems
and prevents detoxification
human
2 Kerksick, C. et al20 An increase in Glutathione reductase enzyme level in serum human
3 Konig, D, et al21 Oxidative stress has been associated with decreased physical
performance, muscular fatigue, muscle damage, and overtraining
human
4 Musumeci, G, et al.22 extra-virgin oil can improve the body defence against oxidative stress rats
5 Trexler, ET. Et al13
Melvin, M, et al. 23
NO has been identified as a vital contributor to the vasodilation
observed after exercise. Pomegranate extract was found to increase
time to exhaustion, vessel diameter and blood flow which result in
delays of fatigue and exhaustion in highly active athletes.
human
6 Lundberg, J, et al24 An NO3- -rich diet may have numerous cardiovascular and other health
benefits including exercise performance
human
7 Larsen, FJ, et al 26 A moderate dietary dose of nitrate showed a significant reduction in
VO2 max
human
8 Murphy, M.et al. 27 consumption of nitrate-rich whole beetroot improves running
performance in healthy adults.
human
9 Muggeridge, D, et al28 Beet root ingestion appears to have no effect on repeated supra-
maximal sprint of kayaking performance
human
10 Narkhede, A, et al 19 Urea nitrogen and Creatine kinase were significantly reduced by
treatment
human
11 Labonte, K, et al 18 Prolonged swimming endurance time of the female rats tested. Urea
nitrogen and Creatine kinase were significantly reduced.
rats
12 Outlaw, J, et al.32 Beneficial results by increasing power (74.40%) of the participants
and maintaining VO2 max (78.16% )
human
13 Kuehl, KS, et al.33 It was reported that runners who had cherry juice experienced less
muscular pain after the race compared to the ones who had placebo
human
14 Jurgoński, A , et al. 34 Cherry juice improved endurance human
15 Ewa Jówko.29 Green tea group had increased plasma total polyphenols, antioxidant
status, and decreased creatine kinase activity 24-hours post-exercise.
human
16 Perkins, IC, et al 30 Blackcurrant extract may improve running performance in greater
distances with higher lactate at exhaustion
human
17 Meulen, JH, et al.31
An increase in the exercise duration from 1.5 h to 2.5 h resulted in a
disproportional increase in both histological muscle damage and
muscle enzyme release
rats
Strength Exercise
Pomegranate: A study on humans was performed to
determine if polyphenol supplementation of ellagitannins
in pomegranate extract improves recovery of muscle
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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strength and soreness and diminished markers of
inflammation and cellular stress during the 4 day recovery
period after performing an aberrant exercise. Healthy
males were recruited and supplemented with PE or PL
(500mL were taken twice daily) at 12 hour intervals for the
9-day testing period. Subjects performed the eccentric
exercise round 15 min on the 5th day of the experiment,
after the pre-exercise measurements of isometric strength,
soreness test using a VAS of 0 to 10 scale. Profound
strength recovery improvement 48-72 hour after eccentric
exercise was determined when PE was supplemented,
muscle soreness was significantly reduced in the PE group
at 2 hour after exercise36.
Other polyphenols: Green tea possesses high amounts
of caffeine and catechin polyphenols. Green tea extract is
one of the most common herb that has been suggested to
affect weight loss and is now considered to be the fourth
most popular dietary supplement in the US34. Research
suggests that catechin polyphenols possess antioxidant
properties that are associated with decreased
cardiovascular disease and has also been shown to increase
energy expenditure by stimulating brown adipose tissue
thermogenesis which consequently improve lean body
mass. It was also demonstrated that green tea catechin
consumption enhanced the exercise-induced changes in
abdominal fat due the increase in building muscles29,37.
This was suggested to burn more fat and especially in the
abdominal area because it is considered to be the least
exercised part of the body causing further accumulation of
fat in this area.
Creatine, Lactate and branched amino acids: Omega-
3 supplements have been found to produce consistent
results as those with ellagitannins of pomegranate. A study
where participants received Omega-3 dietary
supplementation for 30 days prior to heavy eccentric
exercise, and some received a placebo supplement for the
same 30-day period. Forearm extensions performed with
the non-dominant arm to its maximum to induce muscle
soreness. VAS was used and recorded as a score from 0-
10 at intervals of 0, 24, 48, 72, and 96 hours. Both C-
reactive protein (CRP) and creatine kinase were measured,
as well as blood lactate levels that were immediately
analyzed after the exercise. It was found that at 72 and 96
hours there were significant differences between the two
groups in delayed onset of muscle soreness (DOMS).
Group 1 reported mean pain scores of 2.19 ± 1.92 vs. 4.36
± 3.17 in placebo (p = 0.031) at 72 hours and 1.63 ± 1.77
vs 3.17 ± 2.75 (p = 0.035) at 96 hours. Therefore dietary
intake of an omega-3 supplement leads to a higher N3
Index level and decreased DOMS in healthy individual39.
On the other hand, dried grape remains after pressing to
produce juice (pomace) was studied to investigate if its
potent antioxidant content applied in rats in vivo during
swimming exercise. Grape pomace extract (possesses in
vitro significant antioxidant properties) demonstrated high
capacity to remove the DPPH and ABTS radicals and
protected against Free Radical- Induced DNA Damage40.
Generally, it was suggested that endurance exercise was
able to influence muscle mass and muscle strength, yet the
effect seemed to diminish beyond the age of 70 years40.
Muscle strength requires variety of nutrients in
addition to antioxidants. A blend of branched chain amino
acids, quercetin, co-enzymated B-vitamins, creatine
monohydrate, alanyl-glutamine, and natural nitrate from
pomegranate and beet root extracts was prepared. Twenty
resistance-trained males were randomly assigned to
consume the blend or a placebo 30 minutes prior to
exercise. All had participated in an 8-week, 3-day per
week, resistance-training programme including leg press,
bench press, and bent-over rows. Muscle thickness of the
quadriceps was measured by Ultrasonography, Dual-
Energy X-ray Absorptiometry (DEXA) and lean body
mass, were determined. Blend supplementation resulted in
a significant (p<0.01) increase in bench press strength
(18.4% vs. 9.6%) compared with placebo after 4 and
8 weeks of training. There were no significant effect of
intake in leg press strength (p=0.08). But the blend
ingestion resulted in a significant increase in lean body
mass (7.8% vs. 3.6%) and quadriceps muscle thickness
(11.8% vs. 4.5%) compared with placebo42. Additional
research should investigate if supplementation with the
Polyphenolic-rich Fruits… Hana R. Bajes, Emad A S Al-Dujaili
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blend would result in better adaptations than intake with each of the ingredients alone.
Table 2. Summary of Studies on strength Exercise with their brief results
No. Strength Study Results Notes
1 Trombold, JR, et al9 ellagitannins in pomegranate extract improved recovery of
muscle strength and soreness and reduced markers of
inflammation and cellular stress
human
3 Ewa Jówko29
Maki, KC, et al 37
Green tea catechins consumption enhanced the exercise-induced
changes in abdominal fat due the increase in muscles building
human
4 Lembke, P, et al39 Omega-3 supplement lead to a higher N3 Index level and
decreased DOMS in healthy individual
human
5 Aristidis, S, et al40 Protected against Free Radical-Induced DNA damage human
6 Lowery, R, et al42 Blend ingestion resulted in a significant increase in lean body
mass and quadriceps muscle thickness
human
Exercise Recovery
Recovery after exercise depends on intensity of the
work exerted on muscle, and the extent at which muscle is
damaged. Many factors may play a role in muscle damage;
however the exact mechanism is not well understood yet.
Some explanation of this mechanism refers to the damage
to the ryanodine receptors of the sarcoplasmic reticulum
resulting in elevated intracellular calcium ion
concentration. Increased intracellular calcium may lead to
muscle damage through activation of calcium-dependent
proteolytic chemical pathways and increased muscle
protein degradation. Muscle damage causes inflammation
in the micro-environment recruiting neutrophils and
macrophages. These immune cells release ROS and NO
derivatives as well as pro-inflammatory cytokines.
Therefore, antioxidants, more specifically polyphenols
might be beneficial in fixing the damage.
Pomegranate: The effect of pomegranate juice on the
recovery of muscle soreness and biomarkers of muscle
damage after a weight lifting training was studied on 9
male elite weightlifters (age: 21±0.5 years, body mass:
80±9.5 kg, height 175±8.1cm). Supplements of 1500 ml
placebo or pomegranate juice were taken three times daily
in the 48 hour that preceded the two training sessions, in
addition to the 500 ml of each 1 hour before the training
sessions. Each 500mL of the given pomegranate juice
contained 2.56g of total polyphenol containing 292.6mg of
flavonoids, 1.08g of orthodiphenols, and 46.75mg of
flavonols. The training session consisted of 5 sets of
Olympic-Weightlifting exercises: snatch, squat and clean
and jerk. To assess the exertion of heavy lifting on
muscles, a scale of 6 (very light) to 20 (very hard) was used
where participants expressed their feelings of fatigue,
soreness, and comfort using this scale. The study showed
that consuming the pomegranate juice intake during
weightlifting training decreased the pain and delayed
responses of the muscle damage and inflammation, and
muscle soreness (knee flexor), accelerated the recovery
kinetic of the biological parameters, and improved the
weightlifting performance43. Given the small sample size,
further studies should verify these results using greater
sample size of athletes. Moreover, pain and soreness
expression can vary greatly from one person to another and
using such scale might widely be inaccurate.
Another study conducted on trained weight lifters and
has been found that 15 days of drinking pomegranate juice
(250 ml twice daily) improved the arm strength during the
period post exercise and reduced significantly the elbow
flexor muscle soreness for 48 and 72 hours post exercise.
However, isometric strength and muscle soreness in the
knee extensors were not significantly affected44. Dosage of
pomegranate supplement was found to be equally if not
Jordan Journal of Pharmaceutical Sciences, Volume 10, No. 3, 2017
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more important to consider in order to seek ultimate
benefit. This was tested by Machin et al45 and they showed
that either once-daily or twice-daily pomegranate juice
supplementation improved recovery of both leg and arm
muscles after an unconventional exercise.
Other polyphenols: A study tested the effect of a
cherry juice concentrate on recovery after intensive knee
extensor resistance training in individuals who were highly
active and well-trained, along with oxidative damage and
inflammation indicators. Participants were seated on the
knee extension machine, and consumed 30 mL twice per
day of either cherry juice concentrate or a fruit concentrate
placebo. Participants alternated between legs in each trial
and did 3 sets with 5 repetitions. Blood analysis,
biomechanical recording, and pressure pain threshold were
taken. Consumption of the cherry juice concentrate for 7
days before, the day of, and 2 days after completing a
round of intensive knee extensor resistance training
enhanced recovery of isometric muscle strength46. This
outcome was accompanied by a reduction in oxidative
stress presumably because of the anti-inflammatory and
antioxidative properties of polyphenols in cherries. It was
also found that tart cherry juice reduced muscle pain
during running33. In addition, polyphenols decreased
strength loss after damaging exercis31. Green tea extract
decreased respiratory exchange ratio during aerobic
exercise practiced after seven days of intake29.
Soy beverage consumption effect on recovery of
damaged tissues after training was also studied. Ten adult
males consumed a soy beverage (2 servings/day, 40g
protein and 44 mg of the isoflavone, genistein/day) for 3
weeks48. The plasma total antioxidant status values
increased in all participants. On the other hand, the 10
other males consumed a whey beverage (40g protein/day)
depressed plasma total antioxidant status values. Both soy
and whey consumption were also tested for their effects on
muscle tissue breakdown after a bout of strenuous aerobic
exercise, which is a form of oxidant stress. The bout was
performed before and after the 3 weeks study and soy
produced a lower rise in plasma creatine kinase activity;
an indicator of muscle tissue breakdown, whereas whey
produced a higher rise. Soy also reduced the post-exercise
rise in plasma myeloperoxidase, an indicator of
inflammatory oxidant stress. In addition, soy maintained,
while whey decreased, the post-exercise rise in plasma uric
acid which can be inversely proportional to oxidant
activity. These results provide evidence that soy can exert
antioxidant effects in people, particularly for exercise-
induced oxidative stress48.
Table 3. Summary of Studies on Exercise Recovery with their brief results
No. Recovery study Results Notes
1 Ammar , A, et al.43 Pomegranate juice decreased the pain and delayed responses of the muscle
damage, inflammation, muscle soreness, accelerated the recovery kinetic of
the biological parameters, and improved the weightlifting performance
human
2 Trombold, JR, et al 44 Pomegranate juice improved the arm strength and reduced significantly the
elbow flexor muscle soreness.
human
3 Machin, D , et al45
Pomegranate juice supplementation improved recovery of both leg and arm
muscles after an unconventional exercise
human
4 Bowtell, JL, et al46 Cherry concentrate enhanced recovery of isometric muscle strength. human
5 Kuehl et al 33 Tart cherry juice reduced muscle pain during running, and polyphenols
decreased strength loss after damaging exercise
human
6 Ewa Jówko29 Green tea extract decreased respiratory exchange ratio during aerobic exercise
practiced after seven days of intake
human
7 Rossi, A, et al 48 Soy can exert antioxidant effects in people after exercise-induced oxidative
stress human
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Conclusion
The majority of studies showed the benefits of
polyphenols intake on exercise performance. However,
such effect of polyphenols should be further elucidated and
still needs further research, and thus, more investigations
need to be carried out in human bio-systems in addition to
in virto and/or animals studies to obtain more scientific and
applicable results. Polyphenolic compounds from different
sources can enhance fitness modelled in better endurance,
strength, and recovery after exercise. However, many of
these enhancements occurred in combination with other
non polyphenolic nutrients, like proteins and
carbohydrates.
Acknowledgements
The authors would like to acknowledge the support of
Middle East University for publication and production of
this review.
Abbreviations
ABTS: Azino-bis-benzothiazoline-sulphonic acid is a
substrate for peroxidase enzyme; BP: Blood pressure;
DPPH: Diphenyl-picrylhydrazyl method; FRAP: Ferric
reducing anti-oxidant power; FMD: flow mediated
dilation; GAE/L: Gallic Acid Equivalence/liter; HR: Heart
rate; HPLC–DAD: high-performance liquid
chromatography with Diode –Array Detection; LDL: low
density lipoprotein; MMPs: matrix metalloproteinase; NO:
Nitrogen Oxide; PE: pomegranate extract; pomegranate
juice: PJ; PL: Placebo; ROS: Reactive Oxygen species;
SPO2: Oxygen saturation; VAS: Visual analogue scale;
VO2 max: maximal oxygen consumption.
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ﻳﺋاذﻐﻟا تﻼﻣﻛﻣﻟاو ﻪﻛاوﻔﻟا كﻟوﻧﻳﻔﻳﻟوﺑﻟا تﺎﺑﻛرﻣﺑ ﺔﻳﻧﻐﻟا ءادأ زﻳزﻌﺗنﻳرﻣﺗﻟا
ﺔﻣﺎﻋ ﺔﻌﺟارﻣ
ﻠﻳﺟدﻟا دﺎﻣﻋ ،سﺟﺎﺑ ﻊﻳﺑر ءﺎﻧﻫ
1
1
ندرﻷا ،نﺎﻣﻋ ،طﺳوﻷا قر ا ﺔﻌﻣﺎﺟ ،ﺔﻟدﻳﺻﻟا ﺔﻳﻠﻛ.
صـﺧﻠﻣ
ً
ﻼﻣﺎﻋ ﻝﺛﻣﺗ مﺎظﺗﻧﺎﺑ ﺔﻳﺿﺎﻳرﻟا نﻳرﺎﻣﺗﻟا ﺔﺳرﺎﻣﻣ نأ ﻊﺳاو قﺎطﻧ ﻰﻠﻋ ﻝوﺑا نﻣ
ً
ﺎﻣﻬﻣ ﻝوﺻ ؛ﺔﺣﺻﻟا نﻳﺳﺣﺗﻟﻠﻋ ﺔﻌﺋار دﺋاوﻓ ﻠﻋ ﻝوﺻا كﻧﻛﻣﻳﻲﻓ ﺎﻬﻳ مﺳﺟﻟا ةو نﻳﺳﺣﺗ ﻝﻼﺧ نﻣ ﺔﺿﺎﻳرﻟا ﺔﺳرﺎﻣﻣ ﻲﻓ ﻝﺿﻓأ ءادﻷ قﻳرطﻟا دﻳﻬﻣﺗﻟ .ﻝﻳوطﻟاو رﻳﺻﻘﻟا ىدﻣﻟا
،تﻼﺿﻌﻟا تﺎﺑﺎﺻإ رطﺎﺧﻣ نﻣ دﺣﻟاو ﻝوﺎ ﺔﺑﺳﺎﻧﻣﻟا ﺔﻳﺋاذﻐﻟا رﺻﺎﻧﻌﻟا نﻣ ﺔﻳﻣﻛ دﻌﺗ تﺎﻳذﻐﻣﻟا عاوﻧأ نﻣ دﻳدﻌﻟا كﺎﻧﻫ .يو ﻳ ﺣ رﻣأ ،ﺔﻳرورﺿ ﻲﻫ ﻲﺗﻟاو ﺎﻧﻳدﻟ ﺔﻳﺋاذﻐﻟا تﺎﺑﺟوﻟا ﻲﻓ ةدوﺟوﻣﻟا طﻘﻓ رظﻧﻳ وﻧﻳﻔﻳﻟوﺑﻟا .ﺔﻳﻓﺎﺿإ مﻳﻗ ﻰﻠﻋ يو ﺗ ﺣ ﻳ ﺎﻬﺿﻌﺑ نﻛﻟو ﺔﻋوﻧﺗﻣﻟا ةدﻳﻔﻣﻟا تاءارﺟﻹا كﻟذﻛو ةدﺳﻛﻸﻟ ةدﺎﺿﻣﻟا ﺎﻬﺻﺋﺎﺻﺧﻟ نﻛﻟو ،ﻲﺻﺧﺷﻟا ﻲﺟوﻟوﻳﺑﻟا رﻓاوﺗﻟا.
:فدﻬﻟا ﻳﻓوﺗ وﻫ ضارﻌﺗﺳﻻا اذﻫ نﻣ ضر ﻐ ﻟ ا رﻳﺛﺄﺗ نﻋ ةدﺋﺎﺳ تﺎﻣوﻠﻌﻣ رﻪﻛاوﻔﻟا ﻟوا تﻼﻣﻛﻣﻟاو ﻝوﻧﻳﻔﻳﻟوﺑﻟﺎﺑ ﺔﻳﻧﻐﻟا نﻣ ﻝوﻧ
شﺎﻌﺗﻧﻻاو ،ﻝﻣﺣﺗﻟا ﻰﻠﻋ ةردﻘﻟاو ،ةوﻘﻟا ﻝﻼﺧ نﻣ ءادﻷا مﻳﻣﺻﺗ مﺗﻳ ﺎﻣ ةدﺎﻋو .ﺔﻳﺿﺎﻳرﻟا نﻳرﺎﻣﺗﻟا ءادأ ﻰﻠﻋ ﺔﻔﻠﺗﺧﻣ ردﺎﺻﻣ.
ﻼﺧﻟاﺔﺻ: ﺔﺟﻳﺗﻧﺎﻣﻟ رﻬظأﻪﺗ وﻧﻳﻔﻳﻟوﺑﻟا نأ نﻳﺑﺗ ،ضارﻌﺗﺳﻻا اذﻫ ﻲﻓ ﺔﻣدﻘﻣﻟا تﺎﺳاردﻟا نﻣ دﻳدﻌﻟا رﺷؤﻣﻟا نﻣ دﺣﻠﻟ ﺔﻳوﻳﺣﻟا تا
زﺎﻏ تادادﻣإ ةدﺎﻳزو ،مدﻟا قﻓدﺗ ةدﺎﻳزو ،يدﺳﻛﺄﺗﻟا دﺎﻬﺟﻹا
2
O ﻰﻠﻋ ةردﻘﻟاو ،شﺎﻌﺗﻧﻻا نﻳﺳﺣﺗ ﻲﻟﺎﺗﻟﺎﺑو ،تﻼﺿﻌﻟا فﻠﺗ نﻣ دﺣﻟاو ،ﺎﻳدﺳﺟ نﻳطﺷﻧﻟا دارﻓﻷا ﻲﻓ ةو او ،ﻝﻣﺣﺗﻟا.
تﺎﻣﻠﻛﻟا ﺔﻟادﻟا :ﻳر ﻣ ﺗ ﻟ ا ءادأ،ن ﻝﻣﺣﺗﻟا ةردﻗ، نﺎﻣرﻟا، ﻝوﻧﻳﻔﻳﻟوﺑﻟا، ﻷاﺳﻛ،ةد ةرﺣﻟا در او ا.
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ثﺣﺑﻟا مﻼﺗﺳا ﺦﻳرﺎﺗ 2/5/2017 ﻪﻟوﺑﻗ ﺦﻳرﺎﺗو رﺷﻧﻠﻟ17/6/2017.
... Moreover, these levels maintain body fitness, body health, and overall enhancement of well-being. Assurance against stressors and adjustment reactions might be generated with direct regular workout, which plays an essential role in anticipation of continual and degenerative infectious diseases [2]. ...
... Numerous studies have demonstrated exercise training's ability to induce positive adaptations in skeletal muscles in adults of all ages [1,3,4]. This incorporates the expansion of each muscle quality, protein blend, and muscle mass, in addition to changes in myosin heavychain composition, increment mitochondria biogenesis, fortification of myocellular signaling for mitochondrial biogenesis, and an expanded extent of obsequious cells that are precursors to skeletal muscle cells [2,5]. ...
... The consumption of nutritional and functional food containing antioxidants would be combined with exercise and a healthy lifestyle. Antioxidants-rich diet and substances that remove free radicals by neutralizing them would be essential to enhance performance during exercise [2]. ...
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Bioenergetics is the study of energy flow between biological systems and the surroundings and is measured quantitatively. Energy flow can be affected by many variables, including lifestyle and exercise, where exercise comes in different types; endurance and resistance training play significant roles in enhancing bioenergetics and promoting health. In addition, a supplementary diet supports recovery and energy production. This review aims to study the effect of endurance training, resistance training, and supplement intake on the muscle cell's bioenergetics. As a conclusion of the information presented in this mini-review, it was found that resistance, endurance training, and supplements can increase mitochondrial biogenesis, fat oxidation, myofibril synthesis, and increase VO2 max.
... As early as 668 BC the ancient Greeks reportedly used mushrooms, dried figs and various wine concoctions to enhance sporting performance [3]. More recently, there has been a growing research focus into bioactive fruit and vegetable compounds that might improve cardiovascular health [4] and physical performance [5,6] benefits. In particular, an emergent body of evidence suggests that dietary anthocyanins and (poly)phenols might improve physiological aspects of physical performance in recreational and well-trained athletic populations [7,8]. ...
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Background: Food high in (poly)phenolic compounds, such as anthocyanins, have the potential to improve exercise recovery and exercise performance. Haskap berries are rich in anthocyanins, but no research has examined the potential to improve human performance. The aim of this study was to determine the influence of Haskap berry on parameters of endurance running performance. Methods: Using a double-blind, placebo controlled, independent groups design, 30 male recreational runners (mean ± SD age, 33 ± 7 years; stature, 178.2 ± 7.2 cm; mass, 77.7 ± 10.6 kg; V˙O2peak, 52.2 ± 6.6 mL/kg/min) volunteered to participate. Following familiarisation, volunteers visited the laboratory twice (separated by seven days) to assess submaximal, maximal and 5 km time trial running performance. After the first visit, volunteers were randomly assigned to consume either the Haskap berry intervention or an isocaloric placebo control. Results: There were modest changes in heart rate and V˙O2 at submaximal intensities (p < 0.05). Time to exhaustion during the V˙O2peak test was longer in the Haskap group by 20 s (p = 0.031). Additionally, 5 km time trial performance was improved in the Haskap group by ~21 s (p = 0.016), which equated to a 0.25 km/h increase in mean running speed compared to the placebo control; this represented a >2% improvement in running performance. Conclusions: The application of this newly identified functional food to athletes has the capacity to improve endurance running performance.
... In addition to its delicious taste as a fruit, its medicinal properties such as antioxidant, anticancer, antiinflammatory and antibacterial activities have drawn the attention and the interest of many researchers of different countries. The pomegranate seed oils and the fruit are rich in phenolic compounds with strong antioxidant activity 41 43 . Another study showed effective inhibition of pomegranate extracts against most of the selected strains which were isolated from patients' oral cavities 44 . ...
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The diversity in Jordan’s flora due to its geographical areas make is well noted in the scientific literature. The challenge of disease and death caused by infectious diseases like viruses and bacteria, and as infectious diseases evolve and pathogens develop resistance to existing pharmaceuticals, the search for new novel leads, possibly with different modes of action, against bacterial and viral diseases has intensified in recent years. The intent of this review is to provide prevalent information on the antibacterial and antiviral potential in medicinal plants in Jordan, mode of action, type of viruses and bacteria, and phytochemical contents. It has been demonstrated by several studies presented in this review that medicinal plants in Jordan are rich in phytochemicals and possess antiviral and antibacterial properties.
... This may have impact upon an individual's health and further their ability to engage in strenuous exercise, which is an important training consideration for both competitive and non-competitive athletes (31). The inclusion of "functional foods, " drinks and supplements rich in potential antioxidants (e.g., polyphenols) has therefore been experimentally incorporated into sports training strategies with mixed success (32)(33)(34). A major consideration for the inclusion of a potential exercise-targeted functional food is that not only must it manage the detrimental aspects of exercise but ideally it should also complement the health and ergonomic adaptive benefits of exercise. ...
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Background: Regular exercise is essential to a healthy lifestyle but evokes an oxidative and inflammatory stress. Depending upon its intensity and duration this can result in either beneficial adaptive changes or underlying tissue damage that impacts upon long-term health and individual sporting training schedules. Functional foods containing plant bioactives have potential to support exercise through management of the detrimental aspects of exercise and complement ergonomic adaptive benefits. Aim: Previously we reported that a single consumption of a 3.2 mg/kg New Zealand blackcurrant anthocyanin-rich extract (BAE) 1 h before a 30 min rowing exercise attenuated moderate exercise-mediated oxidative stress and supported innate immunity. Here we evaluate whether the efficacy of a single consumption of BAE 1 h prior to exercise is changed after extended daily BAE consumption for 5 weeks. Results: On week 1, a single consumption of BAE 1 h before a 30 min row mediated a significant (p < 0.05) 46% reduction in post-exercise-induced malondialdehyde (MDA) by 2 h compared to a 30% reduction in the placebo group. Similar efficacy was observed 5 weeks later after daily consumption of BAE. In addition, daily BAE consumption for 5 weeks improved the efficacy to (a) resolve acute inflammation, and (b) increased plasma IL-10, salivary beta-defensin 2 (BD2) and secretory IgA. Although no change in plasma antioxidant capacity was detected, a significant (p < 0.009) positive correlation between plasma IL-10 and plasma antioxidant capacity (R2 = 0.35) was observed on week 6 after 5 week BAE consumption suggesting IL-10 influences antioxidant properties. Using a differentiated myotubule cell-line revealed that whilst IL-10 had no direct antioxidant neutralizing action, longer-term exposure (24 h) attenuated 2,2′-Azobis(2-amidinopropane) dihydrochloride (AAPH)-induced myotubule oxidative stress, supporting a putative role for IL-10 in the modulation of cellular antioxidant systems. Conclusions: Daily consumption of BAE for 5 weeks serves to enhance the exercise recovery effectiveness of a single consumption of BAE and promotes beneficial/protective antioxidant/anti-inflammatory cellular events that facilitate exercise recovery.
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Abstract Background: Oxidative stress is exacerbated in overweight and obese individuals after acute exercise compared with their non-obese counterparts. Antioxidant supplementation of the diet may be one intervention to reduce exercise-induced oxidative stress in this vulnerable population. The aim of this study was to investigate whether polyphenol-rich pomegranate juice attenuates post-exercise oxidative stress and contributors to oxidative stress (glucocorticoids) and blood pressure in healthy overweight subjects. Method: Males and females participated in a randomized placebo controlled parallel pilot-study (mean BMI: 26.7 ± 6.6 kg/m2). Two groups of (n = 12) participants received either pomegranate pure juice (500 mL/day containing total polyphenols of 1685 mg GAE/L) or placebo (water matched for total energy) and all participants completed two standardized 30 min treadmill tests (50% Wmax) at baseline and after one week of the intervention. Results: Exercise induced lipid peroxidation (MDA) was lower following pomegranate juice consumption compared with placebo (31.2 ± 10.6 to 26.5 ± 9.8 MDA μmole/day) after 1 week (P = 0.035). Urinary free cortisol was reduced from 179.4 ± 53.2 to 125.6 ± 43.5 nmole/24h which was significant (p = 0.042). In addition, there was a statistically significant increase in urinary free cortisone: from 112.2 ± 40.4 to 187.6 ± 90.2 nmole/24 h (p = 0.045), and a significant decrease in the urinary free cortisol/cortisone ratio (p=0.009) from 1.6 ± 1.1 to 0.67 ± 0.55 following one week of pomegranate juice intake. Pomegranate juice consumption was also found to decrease systolic blood pressure pre-exercise (136.7 ± 11.7 to 131.8 ± 8.8 mmHg (p=0.007), and post-exercise from 158.8 ± 15.8 to 148.1 ± 12.3 mmHg (p < 0.01) and diastolic blood pressure (86.3 ± 10.6 to 82.5 ± 6.8 mmHg (p = 0.04) and 103.1 ± 12.5 to 93.9 ± 11.5 mmHg (p = 0.001), pre and post exercise, respectively. Correlation results between the change in Cortisol/cortisone ratio with the effect on blood pressure showed a negative significant association post pomegranate juice intake (p = 0.028 for systolic and p = 0,008 for diastolic BP). There were no changes in lipid peroxidation or blood pressure following placebo treatment. Conclusions: These findings suggest that pomegranate juice consumption prior to an acute bout of moderate intensity exercise may alleviate blood pressure and exercise-induced oxidative stress in the overweight and obese population. Keywords: Pomegranate juice; Blood Pressure; Glucocorticoids; Exercise; Oxidative Stress
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Purpose The aim of this study was to investigate the effect of natural Pomegranate juice supplementation on performance and acute and delayed responses of muscle soreness and biomarkers of muscle damage after a weightlifting training session. Methods Nine elite weightlifters (21±0.5 years) performed two Olympic-Weightlifting-sessions after either placebo (PLA) or natural pomegranate juice (POMj) supplementations. Heart rate, blood pressure and blood samples (hematological parameters, muscle damage and C-reactive protein (CRP)) were collected at rest, 3min and 48h after each session. Weightlifting performance, RPE, and DOMS were also assessed after each training session. Results T-test showed higher performance (+8.30%) and lower RPE values (-4.37%) using POMj supplementation (p<0.05) in comparison with PLA. For the DOMS values, a significant improvement (13.4%) was shown only for the knee extensors (p<0.01) using the POMj. Compared to PLA condition, POMj attenuated the acute (i.e., 3min) increase of systolic blood pressure (SBP), HR, CK and LDH (p<0.05; -4.46%, -1.81%, -8.75%, -1.64%, respectively) and blunted the significant increase of ASAT, PAL and CRP (p>0.05). Additionally, during the 48h following the training session, POMj improved the recovery kinetic of SBP (p<0.01, 7.97%), CK (p<0.001, 11.34%), LDH (p<0.05, 7.30%) and ASAT (p<0.05, 6.77%). Indeed, the present study showed that 48h of recovery associated to natural POMj supplementation was sufficient to reach the resting values of the selected muscle damage markers after intensive training session. Conclusion Natural POMj seems to ameliorate the capacity to adhere to an intensive training program. Therefore, elite weightlifters are advised to use natural POMj during intensive training program and competition to accelerate muscle recovery.
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Background: Amarkand tubers are routinely used by many Indian tribes as a specialized food for health and longevity but so far there is no scientific evidence for their activities. Taxonomically, Amarkand belong to genera Eulophia and Dioscorea. Methods: In this communication, comparative antifatigue potential of Amarkand was analyzed using forced swimming model in rats and evaluated using biomarkers of physical fatigue. Results: Methanol extracts of tubers of D. bulbifera, E. ochreata, E. leghapanensis and bulbils of D. bulbifera exhibited rich polyphenolic content. D. bulbifera bulbils and E. ochreata significantly prolonged the swimming endurance time. Creatine kinase and urea nitrogen were significantly reduced by treatment of D. bulbifera bulbils and E. ochreata as compared to negative control. D. bulbifera bulbils effectively increased creatine (p < 0.001), lactate dehydrogenase (p < 0.01) and hemoglobin (p < 0.001) compared to negative control. D. bulbifera bulbils and E. ochreata treatments significantly increased glycogen (p < 0.05, p < 0.01) and lowered malondialdehyde levels (p < 0.001) in muscles and in liver tissue compared to negative control. Conclusion: These results indicate that a treatment with D. bulbifera bulbils and tubers of E. ochreata facilitates aerobic glucose metabolism and endurance by improving various impairments associated with fatigue.
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Dietary supplementation with pomegranate juice improves isometric strength recovery after unaccustomed eccentric exercise. The purpose of this study was to determine if there is a dose response effect of pomegranate juice supplementation after eccentric exercise isometric strength recovery. Forty-five nonresistance trained, recreationally active men were assigned once-daily pomegranate juice, twice-daily pomegranate juice, or placebo supplementation. On day four of supplementation, 20 min of downhill running and 40 maximal eccentric elbow flexion repetitions were performed. Isometric knee extensor and elbow flexor strength, muscular soreness, and serum myoglobin concentrations were measured prior to exercise and 2, 24, 48, 72, and 96 h after exercise. Throughout the postexercise time period, while isometric knee extensor and elbow flexor strength were similar between once-daily and twice-daily pomegranate juice supplementation groups, isometric strength was significantly higher in pomegranate juice groups than placebo. Knee extensor soreness, elbow flexor soreness, and myoglobin increased in response to exercise but were similar between groups. It is apparent that pomegranate juice supplementation improves strength recovery in leg and arm muscles following eccentric exercise; however, no dose response effect was present. We conclude that once-daily pomegranate juice supplementation is not different from twice-daily supplementation in regards to strength recovery after eccentric exercise.
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The consequence of elevated oxidative stress on exercising skeletal muscle blood flow, and the transport and utilization of oxygen (O2) in patients with chronic obstructive pulmonary disease (COPD) is not well understood. This study examined the impact of an oral antioxidant cocktail (AOC) on leg blood flow (LBF) and O2 consumption during dynamic exercise in 16 patients with COPD and 16 healthy subjects. Subjects performed submaximal (3W, 6W, and 9W) single-leg knee extensor exercise (KE) while LBF (Doppler ultrasound), mean arterial blood pressure, leg vascular conductance (LVC), arterial O2 saturation, leg arterial-venous O2 difference, and leg O2 consumption (direct Fick) were evaluated under control conditions (CTRL) and after AOC administration. AOC administration increased LBF (3W: 1604±100 vs 1798±128; 6W: 1832±109 vs 1992±120; 9W: 2035±114 vs 2187±136 ml/min, P<0.05, CTRL vs AOC, respectively), LVC, and leg O2 consumption (3W: 173±12 vs 210±15; 6W: 217±14 vs 237±15; 9W: 244±16 vs 260±18 ml O2/min, P<0.05, CTRL vs AOC, respectively) during exercise in COPD, while no effect was observed in the healthy subjects. In addition, the AOC afforded a small, but significant, improvement in arterial O2 saturation only in the patients with COPD. Thus, these data demonstrate a novel, beneficial role of AOC administration on exercising LBF, O2 consumption, and arterial oxygen saturation in patients with COPD, implicating oxidative stress as a potential therapeutic target for impaired exercise capacity in this population. Copyright © 2015, American Journal of Physiology - Heart and Circulatory Physiology.
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During exercise, the demand for oxygen and energy substrates is elevated in active skeletal muscle. Supplements with high nitrate and polyphenol content have been shown to increase nitric oxide production and enhance exercise efficiency. The current randomized, double-blind, placebo-controlled, crossover study aimed to investigate the acute effects of pomegranate extract on blood flow, vessel diameter, and exercise performance in active individuals. Methods Nineteen men and women (Mean ± SD; Age: 22.2 ± 2.2 yrs; Height: 174.8 ± 10.7 cm; Body mass: 71.9 ± 13.5 kg) performed a graded exercise treadmill test to volitional exhaustion to determine maximal oxygen consumption and peak velocity (PV). Treatment order was randomly assigned. Participants returned after 24-48 hours, and ingested two, 500mg capsules of either placebo (PL; 95% maltodextrin, 5% purple carrot and hibiscus for color) or pomegranate extract (PE; 1000 mg, TRUE Pomegranate Extract [NITRO2GRANIT™], Stiebs Nature Elevated, Madera, CA) with 6 oz. of water. Brachial artery blood flow was assessed using a GE logiq-e B-mode ultrasound (GE Healthcare, Wisconsin, USA) at baseline and 30 minutes post ingestion (30PI). In random order, subjects performed three treadmill runs to exhaustion at 90%, 100%, and 110%PV to determine critical velocity (CV), anaerobic running capacity (ARC), and time to exhaustion (TTE). Blood flow was assessed immediately after and 30 minutes after each exercise bout. A vitality scale was completed 30PI of PE or PL; a visual analog (pain) scale (VAS) was completed 30PI and immediately post exercise. After a 7-10 day washout period, participants repeated the same procedures, ingesting the opposite supplement. Separate mixed factorial ANOVAs were performed for blood flow, vessel diameter, CV, ARC, TTE, VAS, and vitality scale questions. Consent to publish the results was obtained from all participants. Results Blood flow was significantly augmented 30PI of PE in comparison to PL (p=0.033). Vessel diameter was significantly larger following 30 minutes post exercise with PE (p=0.036). Ingestion of the PE was found to significantly augment TTE at 90%PV (p=0.009) and 100% PV (p=0.027). On the vitality scale, the following statement, "At this moment I feel alive and vital" was found to be significantly greater 30PI of PE compared to PL (p=0.037). Conclusions Acute ingestion of PE 30 minutes prior to exercise may enhance vessel diameter, blood flow, and improve exercise tolerance. Results of the current study indicate that PE is an ergogenic aid for submaximal running, eliciting beneficial effects on blood flow.
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We examined how intake of polyphenols modifies brachial artery flow-mediated dilation (FMD) at rest, and cycling anaerobic performance, in elite athletes. In the first randomized cross-over study, FMD was measured over a three-hour period on two occasions in eight elite male and female athletes after acute consumption of either polyphenols from cranberries and grape seeds (600 mg) or a polyphenol-free placebo drink. Consumption of the polyphenol-rich drink led to a significant increase in FMD compared to placebo (p = 0.02), with a peak at 60 min. In a second study, 12 elite male and female athletes completed a three-kilometer time trial (TT) on an ergocycle on two occasions in random order, either after consumption of 800 mg of polyphenols or a placebo. Acute intake of the polyphenol extract had no impact on the three-kilometer time trial completion. However, plasma lactate levels were significantly lower before and after the TT when subjects consumed the polyphenols vs. placebo (p < 0.05). Results suggest that polyphenols from cranberries and grape seeds acutely modifies FMD at rest in elite athletes but this does not translate into enhanced cycling anaerobic performance.