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Impact of Varying Dosages of Fish Oil on Recovery and Soreness Following Eccentric Exercise

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Nutrients
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Fish oils (FOs) are rich in omega-3 long-chain polyunsaturated fatty acids, which have been purported to enhance recovery of muscular performance and reduce soreness post-exercise. However, the most effective FO dose for optimizing recovery remains unclear. The purpose of this investigation was to examine the effect of FO supplementation dosing on the recovery of measures of muscular performance, perceived soreness, and markers of muscle damage following a rigorous bout of eccentric exercise. Thirty-two college-aged resistance-trained males (~23.6 years, 71.6 kg, 172.1 cm) were supplemented with 2, 4, 6 g/day (G) FO or placebo (PL) for ~7.5 weeks. Following 7 weeks of supplementation, pre-exercise (PRE) performance assessments of vertical jump (VJ), knee extensor strength, 40-yard sprint, T-test agility, and perceived soreness were completed prior to a bout of muscle-damaging exercise and were repeated immediately post (IP), 1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Repeated measures analysis of variance indicated a treatment × time interaction (p < 0.001) for VJ and perceived soreness, but no group differences were observed at any time point. VJ returned to PRE (54.8 ± 7.9 cm) by 1H (51.8 ± 6.5 cm, p = 0.112) for 6G, while no other groups returned to baseline until 48H. Lower soreness scores were observed in 6G compared to PL at 2H (mean difference [MD] = 2.74, p = 0.046), at 24H (MD: 3.45, p < 0.001), at 48H (MD = 4.45, p < 0.001), and at 72H (MD = 3.00, p = 0.003). Supplementation with 6G of FO optimized the recovery of jump performance and muscle soreness following a damaging bout of exercise.
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nutrients
Article
Impact of Varying Dosages of Fish Oil on Recovery
and Soreness Following Eccentric Exercise
Trisha A. VanDusseldorp 1, * , Kurt A. Escobar 2, Kelly E. Johnson 3, Matthew T. Stratton 4,
Terence Moriarty 5, Chad M. Kerksick 6, Gerald T. Mangine 1, Alyssa J. Holmes 1,
Matthew Lee 1, Marvin R. Endito 7and Christine M. Mermier 7
1Department of Exercise Science and Sport Management, Kennesaw State University,
Kennesaw, GA 30144, USA; gmangine@kennesaw.edu (G.T.M.); alyssajh@hotmail.com (A.J.H.);
mlee120@students.kennesaw.edu (M.L.)
2Department of Kinesiology, California State University Long Beach, Long Beach, CA 90840, USA;
kurt.escobar@csulb.edu
3Department of Exercise and Sport Science, Coastal Carolina University, Conway, SC 29528, USA;
kjohns10@coastal.edu
4Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
matthew.stratton@ttu.edu
5Department of Kinesiology, University of Northern Iowa, Cedar Falls, IA, 50614, USA;
terence.moriarty@uni.edu
6
School of Health Sciences, Lindenwood University, St. Charles, MO 63301, USA; ckerksick@lindenwood.edu
7Department of Health, Exercise and Sports Sciences, University of New Mexico,
Albuquerque, NM 87131, USA; ray87323@yahoo.com (M.R.E.); cmermier@unm.edu (C.M.M.)
*Correspondence: tvanduss@kennesaw.edu; Tel.: +1-470-578-4266
Received: 16 June 2020; Accepted: 23 July 2020; Published: 27 July 2020


Abstract:
Fish oils (FOs) are rich in omega-3 long-chain polyunsaturated fatty acids, which have
been purported to enhance recovery of muscular performance and reduce soreness post-exercise.
However, the most eective FO dose for optimizing recovery remains unclear. The purpose of this
investigation was to examine the eect of FO supplementation dosing on the recovery of measures
of muscular performance, perceived soreness, and markers of muscle damage following a rigorous
bout of eccentric exercise. Thirty-two college-aged resistance-trained males (~23.6 years, 71.6 kg,
172.1 cm) were supplemented with 2, 4, 6 g/day (G) FO or placebo (PL) for ~7.5 weeks. Following
7 weeks of supplementation, pre-exercise (PRE) performance assessments of vertical jump (VJ), knee
extensor strength, 40-yard sprint, T-test agility, and perceived soreness were completed prior to a bout
of muscle-damaging exercise and were repeated immediately post (IP), 1-, 2-, 4-, 24-, 48-, and 72-h
(H) post-exercise. Repeated measures analysis of variance indicated a treatment
×
time interaction
(p<0.001) for VJ and perceived soreness, but no group dierences were observed at any time point.
VJ returned to PRE (54.8
±
7.9 cm) by 1H (51.8
±
6.5 cm, p=0.112) for 6G, while no other groups
returned to baseline until 48H. Lower soreness scores were observed in 6G compared to PL at 2H
(mean dierence [MD] =2.74, p=0.046), at 24H (MD: 3.45, p<0.001), at 48H (MD =4.45, p<0.001),
and at 72H (MD =3.00, p=0.003). Supplementation with 6G of FO optimized the recovery of jump
performance and muscle soreness following a damaging bout of exercise.
Keywords:
muscle damage; muscle recovery; omega-3 polyunsaturated fatty acids; fish oil;
eccentric exercise
1. Introduction
It is well known that exercise induces both mechanical and metabolic stress [
1
5
]. While those
who are accustomed to exercise will often recover from an exercise session with limited negative
Nutrients 2020,12, 2246; doi:10.3390/nu12082246 www.mdpi.com/journal/nutrients
Nutrients 2020,12, 2246 2 of 15
repercussions, those engaging in unaccustomed exercise or rigorous training (e.g., eccentric exercise)
often experience undesirable side eects. These may include impaired muscle function [
6
,
7
], such as
decreases in strength, range of motion, and soreness [
8
,
9
]. Such outcomes are often products of
immediate post-exercise morphological alterations in the activated musculature [
10
], as well as
increases in inflammation [
11
] and markers of oxidative damage [
12
,
13
]. Such physiological alterations
may delay recovery and decrease subsequent performance.
To facilitate faster recovery and maintain subsequent training session volumes, intensity,
and performance, individuals who exercise and train employ a range of recovery strategies [
14
],
including massage therapy [
15
], myofascial release [
16
], stretching [
17
], nonsteroidal
anti-inflammatories [
18
], compression garments [
19
], and cryotherapy/cryostimulation [
20
],
among others. While these recovery strategies have been shown to be successful in alleviating
some of the symptoms of skeletal muscle damage, nutritional strategies have also been proposed
to mitigate the negative eects that one may experience following a damaging/rigorous bout
of exercise [
21
]. One dietary strategy that has garnered interest is consumption of omega-3
(
ω
-3) long-chain polyunsaturated fatty acids (LCPUFAs) [
22
]. The discovery of
ω
-3 LCPUFA’s
pleiotropic eects on human health (e.g., cardioprotective [
23
25
], triglyceride lowering [
26
28
],
and anti-inflammatory [
29
31
]) have driven significant medical and public interest, but of late,
ω
-3
LCPUFAs have caught the exercise community’s attention.
ω
-3 LCPUFAs, hereinafter referred to as
ω
-3, are commonly obtained via the diet by consuming oily fish, such as tuna and salmon, and may
also be obtained via oral supplementation, such as fish oil (FO) soft-gel supplements.
Interest in the impact of the
ω
-3 on “recovery”, or more specifically eicosapentaenoic acid (EPA)
and docosahexaenoic acid (DHA) in the form of FO supplementation, have been investigated using
an array of interventions, spanning damaging eccentric contractions [
32
35
], exhaustive endurance
exercise [
36
], and immobilization [
37
], in trained and untrained men and women [
37
40
], with only
limited work completed in women [
35
,
40
42
]. Current data suggests, and as highlighted in a
comprehensive systematic review by Heileson and Funderburk (2020), that FO supplementation
likely enhances recovery and preserves strength following stressful exercise. More specifically,
and as it relates to this literature, the term recovery may be defined as positive modulation in
blood biomarkers associated with muscle damage and fatigue, reductions in muscle swelling or
soreness/pain, improvements in joints’ range of motion, and improvements, maintenance, or a decrease
in the reduction of muscular performance in the recovery period, such as jump height or muscular
strength. The positive influence of
ω
-3 on these outcome measures has mostly been attributed to the
anti-inflammatory and immunomodulatory properties conferred by these fatty acids [43].
To date, conflicting results are present regarding FO’s ability to enhance recovery, which may
be partially attributed to the varying dosages of FO implemented (i.e., 1.8–6.0 g/day), as well as the
length of supplementation. While data suggest several positive impacts of EPA and DHA obtained
from FO supplements on recovery, there has yet to be a consensus on the dosage. Further, to the best
of our knowledge, no study has compared dierent dosages of FO supplements on recovery from
very strenuous muscle-damaging exercise. Thus, a FO dose–response investigation is warranted and
needed. It has been suggested that the minimum eective dose to enhance recovery is a 2G FO dose for
at least four weeks [
22
], but more research is needed to fully examine this recommendation. Therefore,
we sought to contribute to the gap in the scientific literature by investigating the dose–response of FO
supplementation on recovery from damaging resistance exercise. More specifically, the purpose of
the investigation was to examine the eect of 7 weeks of 2G, 4G, and 6G of FO supplementation on
markers of recovery (muscular performance, perceived muscle soreness, markers of muscle damage)
following damaging eccentric exercise in both men and women.
Nutrients 2020,12, 2246 3 of 15
2. Materials and Methods
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-week
run in the supplementation period, 1 week involving familiarization testing at the beginning of the
week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they completed
the 72H time-point. A study overview can be found in Figure 1. The study was approved by the
University of New Mexico (UNM) Institutional Review Board (HRRC #15–192) and data were collected
in accordance with the Declaration of Helsinki.
Nutrients 2020, 12, x FOR PEER REVIEW 3 of 15
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-
week run in the supplementation period, 1 week involving familiarization testing at the beginning of
the week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they
completed the 72H time-point. A study overview can be found in Figure 1. The study was approved
by the University of New Mexico (UNM) Institutional Review Board (HRRC #15192) and data were
collected in accordance with the Declaration of Helsinki.
Figure 1. Study design overview. Participants (n = 32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo. = damaging bout of eccentric exercise; = perceived muscle soreness;
= blood collection for assessment of creatine kinase and lactate dehydrogenase; = muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n = 16; 23.8 ± 2.7 years 81.5 ± 9.9 kg, 175.7 ± 4.5 cm) and 16 females
(n = 16; 23.4 ± 3.1 years, 61.7 ± 7.2 kg, 170.4 ± 6.2 cm) completed the study (Table 1). Four males and
four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 35 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals were
apparently healthy without a history of disease or current medication use. Participants were screened
for supplementation use and only enrolled if they had not consumed fish oil supplements one-year
prior, creatine two months prior, and beta-alanine one month prior to study enrollment. They were
permitted to consume protein supplements and multivitamins during the 6-week run in the
supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year
prior to participation in the study. Of the nine participants who dropped out of the study, five (2
females, 3 males) removed themselves due to scheduling conflicts and four were removed for missing
5 or more days of supplementation (1 female and 4 males). Regarding dropouts from randomly
assigned groups, the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two,
Figure 1.
Study design overview. Participants (n =32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo.
Nutrients 2020, 12, x FOR PEER REVIEW 3 of 15
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-
week run in the supplementation period, 1 week involving familiarization testing at the beginning of
the week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they
completed the 72H time-point. A study overview can be found in Figure 1. The study was approved
by the University of New Mexico (UNM) Institutional Review Board (HRRC #15192) and data were
collected in accordance with the Declaration of Helsinki.
Figure 1. Study design overview. Participants (n = 32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo. = damaging bout of eccentric exercise; = perceived muscle soreness;
= blood collection for assessment of creatine kinase and lactate dehydrogenase; = muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n = 16; 23.8 ± 2.7 years 81.5 ± 9.9 kg, 175.7 ± 4.5 cm) and 16 females
(n = 16; 23.4 ± 3.1 years, 61.7 ± 7.2 kg, 170.4 ± 6.2 cm) completed the study (Table 1). Four males and
four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 35 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals were
apparently healthy without a history of disease or current medication use. Participants were screened
for supplementation use and only enrolled if they had not consumed fish oil supplements one-year
prior, creatine two months prior, and beta-alanine one month prior to study enrollment. They were
permitted to consume protein supplements and multivitamins during the 6-week run in the
supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year
prior to participation in the study. Of the nine participants who dropped out of the study, five (2
females, 3 males) removed themselves due to scheduling conflicts and four were removed for missing
5 or more days of supplementation (1 female and 4 males). Regarding dropouts from randomly
assigned groups, the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two,
=damaging bout of eccentric exercise;
Nutrients 2020, 12, x FOR PEER REVIEW 3 of 15
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-
week run in the supplementation period, 1 week involving familiarization testing at the beginning of
the week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they
completed the 72H time-point. A study overview can be found in Figure 1. The study was approved
by the University of New Mexico (UNM) Institutional Review Board (HRRC #15192) and data were
collected in accordance with the Declaration of Helsinki.
Figure 1. Study design overview. Participants (n = 32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo. = damaging bout of eccentric exercise; = perceived muscle soreness;
= blood collection for assessment of creatine kinase and lactate dehydrogenase; = muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n = 16; 23.8 ± 2.7 years 81.5 ± 9.9 kg, 175.7 ± 4.5 cm) and 16 females
(n = 16; 23.4 ± 3.1 years, 61.7 ± 7.2 kg, 170.4 ± 6.2 cm) completed the study (Table 1). Four males and
four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 35 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals were
apparently healthy without a history of disease or current medication use. Participants were screened
for supplementation use and only enrolled if they had not consumed fish oil supplements one-year
prior, creatine two months prior, and beta-alanine one month prior to study enrollment. They were
permitted to consume protein supplements and multivitamins during the 6-week run in the
supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year
prior to participation in the study. Of the nine participants who dropped out of the study, five (2
females, 3 males) removed themselves due to scheduling conflicts and four were removed for missing
5 or more days of supplementation (1 female and 4 males). Regarding dropouts from randomly
assigned groups, the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two,
=perceived muscle soreness;
Nutrients 2020, 12, x FOR PEER REVIEW 3 of 15
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-
week run in the supplementation period, 1 week involving familiarization testing at the beginning of
the week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they
completed the 72H time-point. A study overview can be found in Figure 1. The study was approved
by the University of New Mexico (UNM) Institutional Review Board (HRRC #15192) and data were
collected in accordance with the Declaration of Helsinki.
Figure 1. Study design overview. Participants (n = 32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo. = damaging bout of eccentric exercise; = perceived muscle soreness;
= blood collection for assessment of creatine kinase and lactate dehydrogenase; = muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n = 16; 23.8 ± 2.7 years 81.5 ± 9.9 kg, 175.7 ± 4.5 cm) and 16 females
(n = 16; 23.4 ± 3.1 years, 61.7 ± 7.2 kg, 170.4 ± 6.2 cm) completed the study (Table 1). Four males and
four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 35 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals were
apparently healthy without a history of disease or current medication use. Participants were screened
for supplementation use and only enrolled if they had not consumed fish oil supplements one-year
prior, creatine two months prior, and beta-alanine one month prior to study enrollment. They were
permitted to consume protein supplements and multivitamins during the 6-week run in the
supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year
prior to participation in the study. Of the nine participants who dropped out of the study, five (2
females, 3 males) removed themselves due to scheduling conflicts and four were removed for missing
5 or more days of supplementation (1 female and 4 males). Regarding dropouts from randomly
assigned groups, the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two,
=blood collection for assessment of creatine kinase and lactate dehydrogenase;
Nutrients 2020, 12, x FOR PEER REVIEW 3 of 15
2.1. Experimental Approach
Utilizing a randomized placebo-controlled double-blind experimental design, participants were
randomly assigned to consume 2- (2G), 4- (4G), or 6- (6G) g/da of either FO or placebo (PL)
supplementation for ~7.5 weeks (8 participants per group (4 males and 4 females per group); a 6-
week run in the supplementation period, 1 week involving familiarization testing at the beginning of
the week and experimental testing at the end of the week, and three days of recovery testing). Muscle
soreness, venous blood (for the assessment of creatine kinase (CK) and lactate dehydrogenase (LDH),
and indices of muscle function were collected prior to eccentric exercise, as well as immediately post,
1-, 2-, 4-, 24-, 48-, and 72-h (H) post-exercise. Participants continued to supplement until they
completed the 72H time-point. A study overview can be found in Figure 1. The study was approved
by the University of New Mexico (UNM) Institutional Review Board (HRRC #15192) and data were
collected in accordance with the Declaration of Helsinki.
Figure 1. Study design overview. Participants (n = 32) were randomly assigned to consume 2, 4, or 6
g/day fish oil or placebo. = damaging bout of eccentric exercise; = perceived muscle soreness;
= blood collection for assessment of creatine kinase and lactate dehydrogenase; = muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n = 16; 23.8 ± 2.7 years 81.5 ± 9.9 kg, 175.7 ± 4.5 cm) and 16 females
(n = 16; 23.4 ± 3.1 years, 61.7 ± 7.2 kg, 170.4 ± 6.2 cm) completed the study (Table 1). Four males and
four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 35 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals were
apparently healthy without a history of disease or current medication use. Participants were screened
for supplementation use and only enrolled if they had not consumed fish oil supplements one-year
prior, creatine two months prior, and beta-alanine one month prior to study enrollment. They were
permitted to consume protein supplements and multivitamins during the 6-week run in the
supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year
prior to participation in the study. Of the nine participants who dropped out of the study, five (2
females, 3 males) removed themselves due to scheduling conflicts and four were removed for missing
5 or more days of supplementation (1 female and 4 males). Regarding dropouts from randomly
assigned groups, the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two,
=muscular
performance (vertical jump, 40-yard dash, T-test agility, maximal voluntary isometric contraction).
2.2. Participants
All participants were informed verbally as to the aims and risks of the study as well as provided
written informed consent prior to study enrollment and participation. A total of 41 men and women
were recruited for this research study. Participants were recruited via flyers, email announcements,
and word of mouth. Sixteen males (n =16; 23.8
±
2.7 years 81.5
±
9.9 kg, 175.7
±
4.5 cm) and 16 females
(n =16; 23.4
±
3.1 years, 61.7
±
7.2 kg, 170.4
±
6.2 cm) completed the study (Table 1). Four males
and four females made up each supplement group. Participants were defined as recreationally active:
Currently engaging in resistance exercise, 3–5 days per week, with a minimum of 3-H per week and
a maximum of 8-H per week and no more than 2-H of aerobic exercise per week. All individuals
were apparently healthy without a history of disease or current medication use. Participants were
screened for supplementation use and only enrolled if they had not consumed fish oil supplements
one-year prior, creatine two months prior, and beta-alanine one month prior to study enrollment.
They were permitted to consume protein supplements and multivitamins during the 6-week run
in the supplementation period but asked to discontinue for the final 1.5-weeks of the investigation.
Participants who consumed 2 servings or greater of fish per week on a consistent basis were also
excluded. Females were excluded if they had taken any form of hormonal contraception one year prior
Nutrients 2020,12, 2246 4 of 15
to participation in the study. Of the nine participants who dropped out of the study, five (2 females,
3 males) removed themselves due to scheduling conflicts and four were removed for missing 5 or more
days of supplementation (1 female and 4 males). Regarding dropouts from randomly assigned groups,
the placebo, 2G, 4G, and 6G groups each experienced dropouts; specifically, two, two, three, and two
individuals dropped out from their assigned groups, respectively. No adverse events were reported by
any of the participants at any time related to supplementation.
Table 1.
Participant descriptive for each supplement group. Participants were randomly assigned
(n =8/group; 4 males and 4 females per group) to their designated supplement group. No significant
dierences (p>0.05), as determined via a one-way analysis of variance, were noted between groups for
age, height, body mass, body fat percentage, or calorie or protein intake from day 42–day 52.
Participant Characteristics 2G 4G 6G Placebo
Age (year) 23.5 ±3.3 23.3 ±3.0 23.8 ±2.8 23.0 ±3.0
Height (cm) 170.9 ±6.9 172.9 ±4.7 173.8 ±7.6 173.6 ±6.2
Body Mass (kg) 76.1 ±14.2 69.7 ±15.9 72.8 ±13.5 67.9 ±10.7
Body Fat (%) 20.8 ±4.1 19.0 ±6.2 19.4 ±6.1 20.6 ±7.2
Calorie Intake
(kcal/day)-Familiarization-Experimental
Trial (Day 42–Day 52)
2363.25 ±489.13 2283.88 ±375.98 2050.88 ±552.04 2160.13 ±415.21
Protein Intake
(g/kg)-Familiarization-Experimental
Trial (Day 42–Day 52)
1.28 ±0.10 1.21 ±0.24 1.23 ±0.11 1.19 ±0.17
2.3. Visit 1: Initial Screening and Supplement Distribution
Following written informed consent and determination of study involvement, participants’ height
and body mass were assessed using a calibrated scale (Tanita Model #3101, Arlington Heights,
IL, USA
)
and stadiometer (Seca, Chino, CA, USA). Following this, the 3-site skinfold (Lange Skinfold Caliper,
Cambridge Scientific Industries, Cambridge, MD, USA) measurement was collected and body fat
percentage was determined using the sex-specific Jackson–Pollock 3-site skinfold technique [
44
,
45
] for
demographic purposes. All participants were then counseled on how to complete dietary food logs,
dietary recommendations, and physical activity logs, and were randomly assigned to a supplement
group, given their supplements, and then scheduled to return at the end of their 6-week supplementation
regimen (day 42) (Figure 1).
Supplementation and Diet
Participants ingested either 2G, 4G, or 6G of either FO (MusclePharm, MusclePharm, Denver,
CO, USA) or placebo (PL) (saower oil, MusclePharm) daily for ~7.5 weeks following visit 1. Each FO
capsule contained 400 mg of EPA and 300 mg of DHA, and provided a total FO dose of 1000 mg. Table 2
shows the EPA and DHA breakdown for each FO supplement group (divided into two doses per
day—morning and evening). Regardless of group, pills were the same shape, color, size, and texture.
Supplementation compliance was defined as consuming the assigned supplement on 47 of the 52
required days (~90%) and no missed supplements during the final 1.5-weeks of testing. Compliance
was checked by a member of the research team on a bi-weekly basis.
Participants were asked to maintain their normal dietary intake up until one week before
pre-testing (or day 49), with which a protein intake of 1.2 g/kg/day was recommended throughout the
remainder of the study. A registered dietician was made available to counsel individuals on protein
intake, if needed.
Nutrients 2020,12, 2246 5 of 15
Table 2.
Eicosapentaenoic acid and docosahexaenoic acid totals per day of supplementation for each
fish oil supplemented group.
Supplementation EPA (mg) DHA (mg) Total EPA+DHA (mg)
2G FO 800 600 1400
4G FO 1600 1200 2800
6G FO 2400 1800 4200
FO =fish oil, G =grams per day, EPA =eicosapentaenoic acid, DHA =docosahexaenoic acid, mg =milligrams.
2.4. Visit 2: One-Repetition Maximum (1RM), Familiarization, and Diet Counseling
Following 6-weeks of supplementation, participants returned to the laboratory for one-repetition
maximum (1RM) and familiarization of muscle function indices. Participants were asked to bring their
dietary recall sheets (2 weekdays and 1 weekend day) for the past 6-weeks, as well as make note of
any changes to their training habits. A member of the research team also made a note of supplement
dosages missed, if applicable. Back squat 1RM was determined according to methods previously
described (Kraemer et al. 1995) using a Smith machine (Pro-Elite Strength Systems, Salt Lake City,
UT, USA). Following a 10-min self-selected dynamic warm-up, each participant completed a specific
warm-up that included one set of 8–10 repetitions at 50% of their estimated (est) 1RM), a second set
of 3–5 repetitions at
75% of 1RM
est
, and a third set of 1–3 repetitions at
90% of 1RM
est
. After the
warm-up, each participant’s 1RM was determined within 3 maximal one-repetition trials separated by
3–5 min of rest. Attempts was defined as successful when the participant reached a depth equal to 90
of knee flexion and returned to their starting position (i.e., knees and hips at full extension). Spotters
were present to provide verbal encouragement and spotting to ensure the safety of the subjects.
Following the 1RM assessment, participants were asked to rest for 10 min, and then completed
a thorough familiarization of the countermovement vertical jump (VJ), T-test agility, 40-yard (yd)
sprint, and maximal voluntary isometric contraction (MVIC) of the quadriceps at 120
of knee flexion
to eliminate any learning eects on test performance during data collection. During the 10 min of
rest, participants were familiarized with the visual analog scale used for the assessment of perceived
muscle soreness. Following the conclusion of the 1RM assessment and familiarization of performance
assessments, participants were counseled on maintaining their normal caloric intake, while adhering
to a protein intake of 1.2 g/kg/day throughout the remainder of the study. A registered dietician was
available for counsel if necessary. Participants were asked to return one week later to complete the
investigational protocol.
2.5. Visit 3: Investigational Protocol (Muscle-Damaging Exercise Visit)
Upon arrival to the laboratory, a phlebotomist collected the first (pre-exercise) of five blood
samples, followed by pre-exercise assessment (PRE) of perceived soreness, VJ, T-test agility, 40-yd
sprint, and MVIC. Participants then completed a 10-min self-selected dynamic warm-up followed
by the muscle-damaging squat exercise protocol. Following completion of the exercise protocol,
participants had their blood drawn, rated their current perceived muscle soreness, and completed all
measures of muscle performance testing, IP, 1-, 2-, 4-, 24-, 48-, and 72-H post-squat exercise.
Resistance Exercise Protocol
Participants completed eccentric squats (4-s lowering phase and 1-s upward phase) in order to
induce muscle damage. All participants completed the squat exercise: 10 sets of 8 repetitions, 70% 1RM
using a Smith machine. Three minutes of rest was permitted between sets. Following the 10th squat
set, participants completed 5 sets of 20 consecutive split jump-squats using only their body weight.
Two minutes of rest was permitted between sets. Following competition of set 5, the muscle-damaging
resistance exercise protocol was considered complete.
Nutrients 2020,12, 2246 6 of 15
2.6. Blood Collection, Perceived Soreness, and Muscle Performance Indices
2.6.1. Blood Collection and Assessments
Blood was collected pre-muscle-damaging exercise, IP, 1-, 2-, 4-, 24-, 48-, and 72-H post-exercise
for the collection of plasma. Blood samples were collected from the antecubital vein, centrifuged
at 1650
×
gfor 10 min, and stored at
80
C until analysis. As indirect markers of muscle damage,
plasma concentrations of CK and LDH were determined at pre-muscle-damaging exercise, 4-, 24-, 48-,
and 72-H. CK (Pointe Scientific, Canton, MI, USA) and LDH (Pars Azmoon Inc. Tehran, Iran) were
determined in duplicate using enzymatic assays according to the manufacturer’s guidelines.
2.6.2. Perceived Soreness
A paper-version visual analog scale was used to assess perceived soreness. Zero centimeters
represented no soreness, while 10 cm represented extreme soreness. Participants rated their perceived
soreness at all time-points (pre-exercise, IP, 1-, 2-, 4-, 24-, 48-, and 72-H).
2.6.3. Vertical Jump
Following appropriate determination of their standing height, the participant’s maximum
countermovement VJ was assessed using a Vertec device (Perform Better, West Warwick, RI, USA).
Participants were allowed three jumps, with the highest jump recorded and used for statistical analysis.
Two minutes of rest was given between attempts.
2.6.4. T-Test Agility Test
The T-test is used to measure agility. Participants began with both feet behind the tape line.
Participants were instructed to sprint forward (from the start cone) (10-yd) and touch a cone directly in
front of them, then lateral shue to the left (5-yd) and touch a second cone, then shue right (10 yd)
and touch a third cone, before shuing back, left, 5-yd to the middle, and backpedaling past the start
cone (5-yd) to finish the test. Two stopwatch timers (Pro survivor, 6013-3v, AccuSplit, Pleasanton, CA)
were used to measure the total time in seconds(s) from the start of the movement until the participant
crossed the finish line. An average of the two timers’ times was used for statistical analysis.
2.6.5. Forty-Yard Sprint
Participants were asked to sprint 40-yd as fast as possible in a straight line down a non-occupied
Terazzo Tile surface hallway. They were instructed to begin with their preferred foot forward and
placed on a line taped on the floor from a standing position. The same forward foot was used for
all test timepoints. Participants performed three sprints and an automatic digital timer linked to
sensors (Bower Timing Systems, Draper, UT) was placed at the 0- and 40-yd marks to assess the total
sprint time.
2.6.6. Maximal Voluntary Isometric Contraction
Using the Biodex System 4 (Shirley, NY, USA), participants’ MVIC strength of the dominant
limb knee extensor was assessed. Each participant’s Biodex chair position was kept standard for all
visits and attempts. The participant’s knee was placed at 120
of flexion. Three 5-s contractions were
completed with one minute of rest between attempts. The attempt resulting in the highest peak torque
(newton-meters) was recorded and used for statistical analysis.
2.7. Statistical Analysis
A one-way analysis of variance (ANOVA) was performed to determine between-group dierences
at baseline. To determine the eect of FO dosing, separate treatment (4 levels: PL, 2G, 4 G, 6G)
×
time
(8 levels: PRE, and IP, H, 2H, 4H, 24H, 48H, and 72H post-muscle-damaging exercise) ANOVA with
Nutrients 2020,12, 2246 7 of 15
repeated measures was completed on all performance measures (i.e., vertical jump height, T-test, 40-yd
sprint, and MVIC), CK, LDH, and perceived muscle soreness data. In the event of a significant F-ratio,
a repeated measures ANOVA with a Bonferonni correction was performed on each group separately
to determine the main eect of time and specific time dierences. Additionally, separate one-way
ANOVAs were performed at IP, 1H, 2H, 4H, 24H, 48H, and 72H to examine group dierences at each
time point followed by Tukey’s honestly significant dierence post-hoc analysis with any significant
F-ratio. All between-group dierences were further analyzed using eect sizes (
η2
: Partial eta squared).
Interpretations of the eect size were evaluated [
46
] at the following levels: Small eect (0.01–0.058),
medium eect (0.059–0.137), and large eect (>0.138). A criterion alpha level of p
0.05 was used to
determine statistical significance. All data are reported as mean
±
standard deviation. SPSS statistical
software (V. 24.0, Chicago, IL, USA) was used for all analyses.
3. Results
3.1. Performance Measures
A large dosing eect was observed in the interaction between treatment and time on VJ height
(F =2.66, p<0.001,
η2
=0.22). Post-hoc analysis indicated significant (p<0.001) main eects for time
for each group. At IP, VJ height was significantly reduced for PL (
17.4
±
6.0%, p<0.001), 2G (
13.9
±
6.9%, p=0.019), 4G (
12.4
±
6.5%, p=0.036), and 6G (
5.4
±
2.8%, p=0.022). However, VJ performance
recovered to PRE by 1 h for 6G (p=0.112), whereas it remained depressed (p<0.03) from PRE for all
other groups until 48H; an exception was noted for 2G at 4H (p=0.13). No group dierences were
observed at any specific time point. The changes in VJ performance are illustrated in Figure 2.
Nutrients 2020, 12, x FOR PEER REVIEW 7 of 15
3. Results
3.1. Performance Measures
A large dosing effect was observed in the interaction between treatment and time on VJ height
(F = 2.66, p < 0.001, η2 = 0.22). Post-hoc analysis indicated significant (p < 0.001) main effects for time
for each group. At IP, VJ height was significantly reduced for PL (17.4 ± 6.0%, p < 0.001), 2G (13.9 ±
6.9%, p = 0.019), 4G (12.4 ± 6.5%, p = 0.036), and 6G (5.4 ± 2.8%, p = 0.022). However, VJ performance
recovered to PRE by 1 h for 6G (p = 0.112), whereas it remained depressed (p < 0.03) from PRE for all
other groups until 48H; an exception was noted for 2G at 4H (p = 0.13). No group differences were
observed at any specific time point. The changes in VJ performance are illustrated in Figure 2.
Figure 2. Effect of fish oil supplementation dosing on the recovery of vertical jump height following
a bout of muscle-damaging exercise. (n = 32; n = 8 per group; data are presented as mean ± standard
deviation). * indicates statistical significance (p < 0.05) from PRE for a given fish oil dose; PRE = pre-
exercise; IP = immediate post-exercise; H = hour post-exercise; PL = placebo; G = grams per day; cm =
centimeters.
Although repeated measures ANOVA did not reveal any other significant (treatment x time)
interactions, a significant main effect for time was observed for MVIC (F = 43.68, p < 0.001, η2 = 0.61)
and a tendency was noted for the 40-yd sprint time to improve (F = 3.26, p = 0.072, η2 =0.10) (Tables 3
and 4). When the data were collapsed across groups, MVIC was significantly (all p < 0.001) reduced
from PRE (234 ± 66 Nm) at IP (185 ± 65 Nm), 1H (181 ± 57 Nm), 2H (185 ± 58 Nm), 4H (188 ± 60 Nm),
24H (194 ± 65 Nm), 48 H (206 ± 66 Nm), and 72H (223 ± 70 Nm). Likewise, when the 40-yd sprint time
data were collapsed across groups, significantly (p < 0.005) slower sprint times were observed at IP
(6.20 ± 0.69 s), 1H (6.10 ± 0.65 s), 2H (6.07 ± 0.60 s), 4H (6.13 ± 0.71 s), 24H (6.13 ± 0.78 s), 48H (6.26 ±
2.15 s), and 72H (5.76 ± 0.59 s) compared to PRE times (5.63 ± 0.48 s). Complete data for MVIC and
40-yd sprint can be found in Tables 3 and 4, respectively. No effects on T-test performance were
observed.
Table 3. Maximal voluntary isometric contraction of the dominant limb knee extensors for each group
at all time-points. All values are newton-meters (Nm). n = 8/group; 4 males and 4 females per group
2G
4G
6G
Placebo
40
45
50
55
60
65
70
PRE IP 1H 2H 4H 24H 48H 72H
Vertical jump height (cm)
PL
2G
4G
6G
*
*
*
*
*
****
*****
*
Figure 2.
Eect of fish oil supplementation dosing on the recovery of vertical jump height following a
bout of muscle-damaging exercise. (n =32; n =8 per group; data are presented as mean
±
standard
deviation)
.
* indicates statistical significance (p<0.05) from PRE for a given fish oil dose; PRE =
pre-exercise; IP =immediate post-exercise; H =hour post-exercise; PL =placebo; G =grams per day;
cm =centimeters.
Although repeated measures ANOVA did not reveal any other significant (treatment
×
time)
interactions, a significant main eect for time was observed for MVIC (F =43.68, p<0.001,
η2
=0.61)
Nutrients 2020,12, 2246 8 of 15
and a tendency was noted for the 40-yd sprint time to improve (F =3.26, p=0.072,
η2
=0.10) (Tables 3
and 4). When the data were collapsed across groups, MVIC was significantly (all p<0.001) reduced
from PRE (234
±
66 Nm) at IP (185
±
65 Nm), 1H (181
±
57 Nm), 2H (185
±
58 Nm), 4H (188
±
60 Nm),
24H (194
±
65 Nm), 48 H (206
±
66 Nm), and 72H (223
±
70 Nm). Likewise, when the 40-yd sprint
time data were collapsed across groups, significantly (p<0.005) slower sprint times were observed
at IP (6.20
±
0.69 s), 1H (6.10
±
0.65 s), 2H (6.07
±
0.60 s), 4H (6.13
±
0.71 s), 24H (6.13
±
0.78 s), 48H
(6.26
±
2.15 s), and 72H (5.76
±
0.59 s) compared to PRE times (5.63
±
0.48 s). Complete data for
MVIC and 40-yd sprint can be found in Tables 3and 4, respectively. No eects on T-test performance
were observed.
Table 3.
Maximal voluntary isometric contraction of the dominant limb knee extensors for each group
at all time-points. All values are newton-meters (Nm). n =8/group; 4 males and 4 females per group
Time Point 2G 4G 6G Placebo
PRE 233.26 ±63.45 221.76 ±50.21 250.74 ±85.51 230.95 ±70.36
IP 182.00 ±63.79 172.55 ±61.28 217.16 ±70.46 169.64 ±65.47
1H 182.41 ±51.02 174.56 ±54.36 196.23 ±64.08 169.25 ±65.89
2H 183.06 ±53.45 174.85 ±53.53 210.64 ±68.17 172.95 ±60.08
4H 189.03 ±42.78 171.20 ±56.02 222.51 ±79.28 170.38 ±62.35
24H 191.46 ±57.54 178.75 ±57.00 229.79 ±74.16 175.64 ±66.94
48H 204.10 ±59.57 196.05 ±65.85 231.13 ±73.67 191.59 ±68.22
72H 224.93 ±62.66 205.76 ±54.48 251.28 ±89.69 211.43 ±67.93
PRE =pre-exercise, IP =immediate post-exercise, H =hour, G =grams per day; data are presented as mean
±
SD.
Table 4.
Sprint (40-yd) time (s) for each group at all time-points. All values are seconds. n =8/group;
4 males and 4 females per group
Time Point 2G 4G 6G Placebo
PRE 5.69 ±0.38 5.63 ±0.55 5.51 ±0.41 5.68 ±0.61
IP 6.36 ±0.53 6.17 ±0.83 5.81 ±0.31 6.46 ±0.87
1H 6.25 ±0.57 6.03 ±0.64 5.74 ±0.39 6.38 ±0.84
2H 6.19 ±0.49 6.04 ±0.64 5.75 ±0.45 6.31 ±0.74
4H 6.19 ±0.50 6.04 ±0.61 5.73 ±0.43 6.56 ±1.02
24H 6.19 ±0.57 6.13 ±0.92 5.72 ±0.31 6.48 ±1.03
48H 5.93 ±0.37 5.90 ±0.70 5.68 ±0.32 6.27 ±0.92
72H 5.79 ±0.44 5.79 ±0.67 5.52 ±0.41 5.96 ±0.79
PRE =pre-exercise, IP =immediate post-exercise, H =hour, G =grams per day; data are presented as mean
±
SD).
3.2. Perceived Soreness
A large dosing eect was observed in the interaction between treatment and time on perceived
soreness (F =2.32, p<0.001,
η2
=0.20). At IP, perceived soreness was similar (p>0.05) to PRE-perceived
soreness for all groups, though perceived soreness tended to be elevated for PL (4.5
±
2.8 arbitrary units
(au), p=0.071) and 2G (3.4
±
2.2 au, p=0.093). Further, a dierence (p=0.024) was observed between
6G (1.5
±
1.3 au) and 4G (5.5
±
3.7 au). Subsequently, significant (p<0.05) perceived soreness score
elevations beginning at 1H and continuing through 48H were observed for PL and 4G; an exception
was noted for PL at 4H (p=0.147). For 2G, the perceived soreness score did not significantly rise until
24H (5.8
±
1.7 au, p<0.001), at which point it remained elevated through 48H (5.0
±
1.6 au, p<0.001).
For 6G, the perceived soreness score was significantly elevated at 4H (3.3
±
1.0 au, p<0.001) and
24H (4.4
±
1.9 au, p=0.009). Lower perceived soreness scores were reported for 4G compared to PL at
24H (mean dierence =2.38, p=0.023) and 72H (mean dierence: 2.38, p=0.025). Compared to 6G,
Nutrients 2020,12, 2246 9 of 15
greater perceived soreness scores were observed in PL at 2H (mean dierence =2.74, p=0.046), 24H
(mean dierence: 3.45, p<0.001), 48H (mean dierence =4.45, p<0.001), and 72H (mean dierence =
3.00, p=0.003). Lower perceived soreness scores for 6G were also noted when compared to 2G (mean
dierence =3.20, p=0.011) and 4G (mean dierence =2.74, p=0.034) at 48H. Other group dierences
were variable by time-point. The eect of fish oil dosing on perceived soreness is illustrated in Figure 3.
Nutrients 2020, 12, x FOR PEER REVIEW 9 of 15
Figure 3. Effect of fish oil supplementation dosing on perceived muscle soreness following resistance
exercise (mean ± SD). (n = 8/group; 4 males and 4 females per group). * Significant (p < 0.05) difference
from PRE. Significant (p < 0.05) difference between groups.
3.3. Indirect Markers of Muscle Damage
Group x time interactions were observed for CK (F = 2.63, p = 0.018, η2 = 0.22) and LDH (F = 4.00,
p < 0.001, η2 = 0.30) (Table 5). Significant (p < 0.05) main effects for time were observed for all dosage
groups in relation to PRE concentrations (CK and LDH). Compared to PL (CK: 1805 ± 2035 IU/L;
LDH: 410 ± 200 IU/L), CK tended (p = 0.055) to be lower at 72H for 6G (114 ± 21 IU/L) while LDH
tended to be lower for 6G at 24H (194 ± 49 IU/L) and 48H (198 ± 55 IU/L) before significantly (p =
0.005) lower concentrations were observed at 72H (131 ± 28 IU/L). At 24H, lower (p = 0.020) CK
concentrations were observed in 6G (545 ± 151 IU/L) compared to 2G (3021 ± 1753 IU/L). At 48H, CK
concentrations tended (p = 0.076) to be lower in 6G (261 ± 104 IU/L) compared to 4G (2188 ± 2110
IU/L). At 72H, lower (p = 0.005) LDH concentrations were observed in 6G compared to 2G (412 ± 135
IU/L).
Table 5. Creatine kinase (CK) and lactate dehydrogenase (LDH) blood values for each group at all
time-points. n = 8/group; 4 males and 4 females per group.
Baseline
PRE
2-HR
4-HR
24-HR
48-HR
72-HR
Creatine Kinase (IU/L)
PL
115.8 ± 70.5
116.1 ± 70.4
218.1 ± 67.9
355.8 ± 141.7
1751.9 ± 1397.3
1784.5 ± 1713.5
1804.9 ± 2034.8
2G
89.9 ± 44.1
89.6 ± 42.2
193.3 ± 93.9
427.6 ± 198.4
3020.6 ± 1753.4
2060.6 ± 1353.3
956.8 ± 692.7
4G
108.8 ± 59.2
101.9 ± 56.6
181.3 ± 72.4
435.8 ± 290.0
2058.0 ± 2217.7
2188.3 ± 2110.3
1371.1 ± 1309.9
6G
106.0 ± 17.0
102.9 ± 19.3
128.0 ± 58.8
285.1 ± 121.3
544.5 ± 150.8
261.1 ± 103.5
114.3 ± 21.1
Lactate Dehydrogenase (IU/L)
0
3
6
9
12
IP 1H 2H 4H 24H 48H 72H
Perceived muscle soreness (au)
PL
2G
4G
6G
*
*
*
*
*
*
**
*
*
*
*
*
Figure 3. Eect of fish oil supplementation dosing on perceived muscle soreness following resistance
exercise (mean
±
SD). (n =8/group; 4 males and 4 females per group). * Significant (p<0.05) dierence
from PRE. Significant (p<0.05) dierence between groups.
3.3. Indirect Markers of Muscle Damage
Group x time interactions were observed for CK (F =2.63, p=0.018,
η2
=0.22) and LDH (F =4.00,
p<0.001,
η2
=0.30) (Table 5). Significant (p<0.05) main eects for time were observed for all dosage
groups in relation to PRE concentrations (CK and LDH). Compared to PL (CK: 1805
±
2035 IU/L;
LDH: 410
±
200 IU/L), CK tended (p=0.055) to be lower at 72H for 6G (114
±
21 IU/L) while LDH
tended to be lower for 6G at 24H (194
±
49 IU/L) and 48H (198
±
55 IU/L) before significantly (p=0.005)
lower concentrations were observed at 72H (131
±
28 IU/L). At 24H, lower (p=0.020) CK concentrations
were observed in 6G (545
±
151 IU/L) compared to 2G (3021
±
1753 IU/L). At 48H, CK concentrations
tended (p=0.076) to be lower in 6G (261
±
104 IU/L) compared to 4G (2188
±
2110 IU/L). At 72H, lower
(p=0.005) LDH concentrations were observed in 6G compared to 2G (412 ±135 IU/L).
Table 5.
Creatine kinase (CK) and lactate dehydrogenase (LDH) blood values for each group at all
time-points. n =8/group; 4 males and 4 females per group.
Baseline PRE 2-HR 4-HR 24-HR 48-HR 72-HR
Creatine
Kinase (IU/L)
PL 115.8 ±70.5 116.1 ±70.4 218.1 ±67.9
355.8
±
141.7
1751.9 ±1397.3 1784.5 ±1713.5 1804.9 ±2034.8
2G 89.9 ±44.1 89.6 ±42.2 193.3 ±93.9
427.6
±
198.4
3020.6 ±1753.4 2060.6 ±1353.3 956.8 ±692.7
4G 108.8 ±59.2 101.9 ±56.6 181.3 ±72.4
435.8
±
290.0
2058.0 ±2217.7 2188.3 ±2110.3 1371.1 ±1309.9
6G 106.0 ±17.0 102.9 ±19.3 128.0 ±58.8
285.1
±
121.3
544.5 ±150.8 261.1 ±103.5 114.3 ±21.1
Nutrients 2020,12, 2246 10 of 15
Table 5. Cont.
Baseline PRE 2-HR 4-HR 24-HR 48-HR 72-HR
Lactate
Dehydrogenase
(IU/L)
PL 108.3 ±52.6 109.5 ±46.7 167.3 ±74.7
193.9
±
106.8
401.2 ±165.3 423.3 ±186.2 410.0 ±200.3
2G 121.6 ±16.5 121.4 ±17.8 151.0 ±39.9
188.6
±
108.1
364.0 ±139.7 397.5 ±139.9 412.1 ±135.0
4G 167.6 ±87.5 149.6 ±70.7 197.1 ±73.2 210.3 ±79.5 376.1 ±212.5 375.9 ±233.9 237.7 ±180.1
6G 114.3 ±15.6 114.5 ±17.0 152.9 ±45.5 181.4 ±53.8 194.2 ±49.2 198.0 ±55.0 130.9 ±28.3
4. Discussion
This is the first study to examine the dose–response impact of FO supplementation on markers of
recovery following vigorous eccentric exercise. This is the second study with which our research group
has utilized lower body eccentric resistance exercise to induce skeletal muscle damage in order to study
recovery. Like a previous investigation [
47
], it appears from the significant time eects and magnitude
of responses that the exercise protocol adequately induced skeletal muscle damage, as indirectly
assessed by the post-exercise increases in participants’ CK and LDH concentrations, reductions in
muscular performance, and increases in perceived soreness. Thus, we are confident that we were able
to adequately examine the impact of dierent FO dosages on recovery.
To date, research on the role of FO on recovery from vigorous exercise has focused on a single
dosage (2G for example) compared to a placebo, with the exception of Jakeman et al. [
48
], who used
a single relative dose. With the previously published literature in mind, we aimed to explore 2-, 4-,
and 6G per day of FO supplementation, as it spans many of the dosages studied to date. The primary
finding from our research indicates that 6G of FO (2400 mg/day EPA and 1800 mg/day DHA) is most
eective for delaying perceived muscle soreness following a damaging bout of exercise and perceived
soreness at the 6G dose displayed lowered soreness ratings at all post-exercise time-points when
compared to all other supplementation groups. Further, 6G enhanced the recovery of VJ performance,
which was evident on the same day participants completed the damaging bout of eccentric exercise
(at 1H post) and throughout the entire 72H recovery period. While statistical significance was variable,
interestingly, 6G of FO tended to result in lower levels of markers of indirect muscle damage.
It is understood that the perception of soreness one experiences following unaccustomed
or vigorous exercise results from increased nociceptor signaling, specifically group III and IV
aerents [
49
,
50
]. More specifically, damaged skeletal muscle is infiltrated with inflammatory markers
(e.g., proinflammatory prostaglandins, histamines, kinins) and edema, which apply pressure to the
nociceptors [
49
51
]. Omega-3 fatty acids (i.e., EPA and DHA) found in FO supplements produce
anti-inflammatory and inflammation-resolving mediators (e.g., protectins, resolvins, maresins),
while simultaneously reducing the transcription of proinflammatory cytokine genes [
52
]. Thus,
FO supplements have the potential to reduce the perception of soreness by indirectly decreasing
nociceptor activation.
The literature to date has been published examining FO supplementation and perceived soreness
following damaging or vigorous exercise [
32
34
,
38
,
41
,
53
56
]. While a direct comparison is impossible
due to the array of damaging or vigorous exercise protocols that have been studied (e.g., eccentric
squat, bench stepping, eccentric exercise of the elbow flexors), our finding that 6G FO supplementation
reduces perceived soreness following a single bout of damaging exercise has been demonstrated in
previous research. Specifically, our results are in agreement with an investigation by
Tinsley et al. [33]
,
who examined 6G of FO supplementation compared to PL. It was noted that females, who were
untrained and consumed 6G FO, reported less muscle soreness at rest and during functional movements
of both the upper and lower body following vigorous resistance exercise (10 sets to failure, 50%
1RM—both elbow flexion and knee extension). It should be noted that the findings were not
statistically significant, but a 33% to 42% lower eect size for FO was noted in the post-exercise
period. One prominent dierence between the Tinsley et al. investigation and our study is that
we employed a seven-week run-in the supplementation period prior to inducing muscle damage,
Nutrients 2020,12, 2246 11 of 15
while their experimental design included supplementation for seven days prior to the damaging
exercise bout. To add, and in contrast to our findings, an investigation by McKinely-Barnard et al. [
40
]
found that 6G per day FO for 21 days resulted in higher perceived soreness ratings by young women 6-
and 24-H post-eccentric exercise when compared to PL. Interestingly, the investigation utilized the
same supplementation (FO and PL brands) as our study. While our results support the higher dosage
of 6G, the literature to date on this dose is variable.
Further, and importantly, previous research on FO dosages less than 6G has also yielded positive
outcomes on the perception of soreness. An investigation of untrained men consuming 1.8G FO for
30 days demonstrated significant decreases in delayed onset muscle soreness at 48 h post-eccentric
exercise (bench stepping) [
57
]. Similar results have also been noted by Jouris et al. [
32
] and Lembke
and colleagues [
35
], who found 3G FO for 7 days and 2.7G FO for 30 days, respectively, resulted
in significant decreases in perceived soreness. Overall, the majority of the literature to date tends
to support supplementation with FO from low (1.8G) to higher (6G) dosages per day to decrease
perceived soreness [32,33,35,38,53,54,56,57], though conflicting data do exist [34,41].
It has been highlighted that following the consumption of omega-3 fatty acids, omega-3 blood
profiles increase, often in a dose-dependent manner, within days [
58
,
59
]. However, the incorporation
of omega-3 fatty acids into skeletal muscle takes longer due to the slower fatty acid turnover in skeletal
muscle [
37
,
58
]. As such, and to the best of our knowledge, the literature to date on FO supplementation
and perception of soreness following vigorous training or skeletal muscle-damaging exercise ranges
from 1 to 8 weeks in both trained and untrained men and women, with results indicating that both short
and longer duration supplementation may positively impact the perception of soreness (i.e., lower it)
following vigorous/damaging bouts of exercise (for a recent review, please see [
22
]). While our results
positively support 7 weeks of supplementation with 6 g per day, compared with lesser dosages, we did
not investigate shorter time periods, and thus more research is warranted.
While previous research has indicated FO supplementation may attenuate losses in muscular
strength following vigorous exercise [
35
,
54
,
55
], our results do not support these findings, which is
similar to the majority of research to date [
34
,
40
,
41
,
53
,
55
]. It is thought that FO may reduce the amount
of damage assumed by the worked skeletal muscle and conserve strength and power production,
and thus muscular performance. As such, we examined participants’ dominant knee extensors’
MVIC, as well as more applied aspects of muscular performance testing (T-test agility, 40-yd dash,
and VJ). Our results indicated no meaningful impact of FO supplementation on MVIC, T-test agility,
and 40-yd dash performance. Interestingly, 6G of FO supplementation positively impacted VJ recovery,
an assessment of muscular power, at 24H post-exercise and throughout the remainder of the recovery
period. As the VJ assessment is an indirect test of very brief lower-body power production [
60
],
the simple decrease in perceived soreness in the 6G group may have contributed to these results.
Interestingly, our VJ recovery results are similar to that of Jakeman and colleagues [
60
], despite the vast
dierences in FO supplementation time periods and dierent FO supplement regimens. Specifically,
Jakeman et al. incorporated a single relative FO dose of either “high” (EPA 750 mg, DHA 50 mg) or
“low” (EPA 150 mg, DHA 100 mg) at a dose of 1 g per 10 kg of body mass immediately post-plyometric
exercise. Results from their investigation indicated that the decrement in VJ performance was ~4%
after 1H for the high-EPA group in comparison with the ~10% and ~15% decrements observed for
the control or low-EPA groups, respectively. The high-EPA group returned to within ~2% of the
baseline performance after 24H, in comparison with the control and low-EPA groups, whereby their VJ
performance was still ~4.4% and 3.8% below baseline at the 96H post-exercise time-point.
While our research is novel in that it is the first to examine the impact of dierent FO dosages
with the same EPA/DHA ratio on recovery from skeletal muscle-damaging exercise, there are a few
limitations to this research. We did not measure the increase in omega-3 fatty acid levels in the blood
or skeletal muscle. Further, in females, we did not control for the menstrual cycle phase, which may
have influenced our results. Lastly, our small sample size did not allow use to determine dierences
between sexes for dependent variables. This may have attributed to the lack of significant dierences
Nutrients 2020,12, 2246 12 of 15
noted between groups, especially for blood enzymes. However, our research is the first to employ
a comprehensive assessment of perceived soreness, muscular performance, and blood biomarkers
following prolonged supplementation of varying FO doses in both men and women, making this
research novel.
5. Conclusions
Based on the results of our investigation, we suggest exercising individuals undergoing vigorous
or unaccustomed exercise consume a higher dose of 6G per day (2400 mg EPA, 1800 mg DHA) in order
to reduce perceived soreness and improve acute power production in the recovery period.
The ideal dose of FO should continue to be researched in exercising men and women,
with appropriate caution towards high-dose FO and the potential inhibition of platelet function [
61
].
Further, future investigations should consider incorporating a comprehensive assessment of
inflammatory markers, as well as conducting acute and long-term FO supplementation periods
at dierent dosages, as well as dierent EPA and DHA ratios.
Author Contributions:
Conceptualization, T.A.V., C.M.K., and C.M.M.; methodology, T.A.V., K.A.E., K.E.J., M.T.S.,
T.M., C.M.K., and C.M.M.; formal analysis, T.A.V., G.T.M., A.J.H., M.L., and M.R.E.; investigation, T.A.V., K.A.E.,
K.E.J., M.T.S., T.M., and M.R.E.; resources, T.A.V, C.M.K., and C.M.M.; data curation, T.A.V., K.A.E., K.E.J., M.T.S.,
G.T.M., A.J.H., M.L., and M.R.E.; writing—original draft preparation, T.A.V, G.T.M., and K.E.J.; writing—review
and editing, T.A.V., K.A.E., K.E.J., M.T.S., T.M., C.M.K., G.T.M., A.J.H., M.L., M.R.E., and C.M.M.; supervision,
T.A.V., C.M.K, and C.M.M.; project administration, T.A.V.; funding acquisition, T.A.V., C.M.K, and C.M.M.
All authors have read and agreed to the published version of the manuscript.
Funding: International Society of Sports Nutrition and MusclePharm Grant.
Acknowledgments:
The authors would like to acknowledge MusclePharm
®
for donating the fish oil supplements
and placebo.
Conflicts of Interest: The authors declare no conflict of interest.
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©
2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).
... Tsuchiya et al. [34] reported that eight-week n-3 PUFA supplementation significantly reduced VAS scores on day 5 post-exercise compared to a placebo, bringing pain scores down to almost the pre-exercise level, while the placebo group showed little change. However, trials with shorter supplementation durations did not yield significant differences in DOMS [35][36][37]. VanDusseldorp et al. [35] investigated the impact of varying fish oil doses in resistance-trained individuals after 80 eccentric squats. Only the group receiving 6 g per day of supplementation exhibited lower DOMS at 2, 48 hours, and 72 hours post-exercise after seven weeks of supplementation. ...
... However, trials with shorter supplementation durations did not yield significant differences in DOMS [35][36][37]. VanDusseldorp et al. [35] investigated the impact of varying fish oil doses in resistance-trained individuals after 80 eccentric squats. Only the group receiving 6 g per day of supplementation exhibited lower DOMS at 2, 48 hours, and 72 hours post-exercise after seven weeks of supplementation. ...
... In another clinical trial, 2, 4, and 6 g of n-3 PUFA supplementation for seven weeks did not outperform placebo in restoring the MVC of knee extensors and 40-yard sprint time [35]. Only 6 g of supplementation could restore vertical jump height to pre-injury status from one hour post-exercise, while lower doses of n-3 PUFA supplementation did not outperform placebo, suggesting the effect of a higher dose of fish oil in improving muscle performance. ...
... Evidence suggests n-3 can influence key exercise recovery markers, including Creactive protein (CRP) [32][33][34], interleukin 6 (IL-6) [34][35][36], and tumor necrosis factor-alpha (TNF-α) [35,37], which are inflammatory markers; creatine kinase (CK) [34,[37][38][39], a muscle damage marker; and various oxidative stress markers [40][41][42][43]. ...
... Several studies evaluated the effects of n-3 supplementation on muscle damage and recovery post-exercise, with varying results [33][34][35][37][38][39]41,45,46]. One study reported a significant reduction in CK levels post-exercise with supplementation (600 mg EPA + 260 mg DHA) [38]. ...
... Another found that green-lipped mussel oil (~58 mg EPA + 44 mg DHA) significantly attenuated CK post-exercise, further highlighting the benefits of n-3 for reducing muscle damage markers [37]. Finally, a study assessing different amounts of n-3 observed the most significant reduction in CK levels in the 6000 mg group, compared to the placebo, 2000 mg, and 4000 mg groups post-exercise, further demonstrating decreased markers of muscle damage following n-3 supplementation [39]. ...
Article
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Background/Objectives: Omega-3 fatty acids (n-3), recognized for their anti-inflammatory and brain health benefits, are being studied to enhance cognitive function, aid physical recovery, and reduce injury rates among military service members (SMs). Given the unique demands faced by this tactical population, this systematic review aims to evaluate the evidence of n-3 to support physical and mental resilience and overall performance. Methods: This review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and includes articles that assessed n-3 status or implemented n-3 interventions in relation to physical and cognitive performance, recovery, and injury outcomes (2006 to 2024). Of the 1606 articles yielded in screening through Covidence, 755 were irrelevant, leaving 226 studies for full-text eligibility. Of those 226 studies, 165 studies were excluded, and 61 studies were included in this review. Results: The results highlighted evidence-based findings in five key areas where omega-3 fatty acids are being evaluated to benefit military service members. These key areas include cardiopulmonary function, exercise recovery, cognitive function, injury recovery, and strength and power. While existing research suggests promising benefits, the most significant evidence was seen with cardiopulmonary function, exercise recovery, and cognitive function. Conclusions: Current research is promising and shows potential benefits, but the results are inconclusive and inconsistent. Future research is needed to determine optimal n-3 status, dose, and possibly type of n-3 across the various performance outcomes. Understanding these gaps in research will be essential to creating evidence-based n-3 guidelines for optimal performance of SMs.
... Another study demonstrated that subjective muscle soreness (as measured using VAS following a 60 minutes of downhill treadmill running) was decreased with four weeks of daily supplementation with an ω-3 PUFA supplement containing both EPA (2,145 mg) and DHA (858 mg) at 24-hours postexercise when compared to placebo in young healthy males [105]. Furthermore, Lembke et al. [106] and Vandusseldorp et al. [111] showed participants reported DOMS was lower for up to 96 hours post-exercise in an ω-3 PUFA supplemented group versus placebo. Finally, a study done in rugby athletes supplementing with ω-3 PUFA demonstrated that lower body muscle soreness had a moderate beneficial effect during recovery when compared to a placebo supplement [100]. ...
... Rajabi et al. [108] showed that the daily ingestion of two grams of ω-3 PUFA for one month maintained leg press muscle strength in young healthy adults compared to a reduction for those receiving placebo. Furthermore, 7.5 weeks of ω-3 PUFA supplementation (6 g/d, containing 2.000 mg EPA and 1,800 mg DHA) reduced muscle damage 60 minutes after performing eccentric squat exercises, as measured by the maintenance of vertical jump performance which was similar to pre-supplementation levels [111]. Heileson et al. [103] also observed that the daily ingestion of four grams of DHA and EPA for seven weeks improved leg press muscle strength compared to placebo in young males. ...
... A number of studies have assessed the effects of ω-3 PUFA supplementation with EPA and/or DHA on indices of skeletal muscle soreness (delayed onset muscle soreness [DOMS]), performance (strength and/or power output), range of motion (ROM), indirect measures of damage (creatine kinase [CK], lactate dehydrogenase [LDH]), and inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]) following exercise-induced muscle damage (EIMD)[100][101][102][103][104][105][106][107][108][109][110][111][112]. Collectively, results across studies suggest that DOMS may be reduced with ω-3 PUFA supplementation. ...
Research
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Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of the literature surrounding the effects of long-chain omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on exercise performance, recovery, and brain health. This position stand is intended to provide a scientific foundation for athletes, dietitians, trainers, and other practitioners regarding the effects of supplemental ω-3 PUFA in healthy and athletic populations. The following conclusions represent the official position of the ISSN: Athletes may be at a higher risk for ω-3 PUFA insufficiency. Diets rich in ω-3 PUFA, including supplements, are effective strategies for increasing ω-3 PUFA levels. ω-3 PUFA supplementation, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been shown to enhance endurance capacity and cardiovascular function during aerobic-type exercise. ω-3 PUFA supplementation may not confer a muscle hypertrophic benefit in young adults. ω-3 PUFA supplementation in combination with resistance training may improve strength in a dose- and duration-dependent manner. ω-3 PUFA supplementation may decrease subjective measures of muscle soreness following intense exercise. ω-3 PUFA supplementation can positively affect various immune cell responses in athletic populations. Prophylactic ω-3 PUFA supplementation may offer neuroprotective benefits in athletes exposed to repeated head impacts. ω-3 PUFA supplementation is associated with improved sleep quality. ω-3 PUFA are classified as prebiotics; however, studies on the gut microbiome and gut health in athletes are currently lacking.
... Five studies [16,17,35,37,38] were considered "excellent quality" and 8 [33,34,36,[39][40][41][42][43] as "very good quality" according to McMaster [30] (Table 1). Also, according to the PEDro scale [31], 10 studies [16,17,[34][35][36][37][38][39][40]42,44] had a rating of "excellent quality" and 3 studies [33,41,43] of "good quality" ( Table 2). ...
... Five studies [16,17,35,37,38] were considered "excellent quality" and 8 [33,34,36,[39][40][41][42][43] as "very good quality" according to McMaster [30] (Table 1). Also, according to the PEDro scale [31], 10 studies [16,17,[34][35][36][37][38][39][40]42,44] had a rating of "excellent quality" and 3 studies [33,41,43] of "good quality" ( Table 2). ...
... Five studies [16,17,35,37,38] were considered "excellent quality" and 8 [33,34,36,[39][40][41][42][43] as "very good quality" according to McMaster [30] (Table 1). Also, according to the PEDro scale [31], 10 studies [16,17,[34][35][36][37][38][39][40]42,44] had a rating of "excellent quality" and 3 studies [33,41,43] of "good quality" ( Table 2). Table 3 shows the results of the RoB assessment tool [32] applied to the studies in this review. ...
Article
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Omega-3 is a family of n-3 polyunsaturated fatty acids (PUFAs), which have been used to treat a wide variety of chronic diseases, due mainly to their antioxidant and anti-inflammatory properties, among others. In this context, omega-3 could be post-exercise recovery agent and sports supplement that could improve performance by preserving and promoting skeletal muscle mass and strength. No conclusive evidence, however, exists about the potential effects of omega-3 on post-exercise biomarkers and sports performance in physically healthy adults. Based on the PRISMA in Exercise, Rehabilitation, Sports Medicine, and Sports Science (PERSiST) guidelines, we systematically reviewed studies indexed in Web of Science, Scopus, and Medline to assess the effects of omega-3 on post-exercise inflammation, muscle damage, oxidant response, and sports performance in physically healthy adults. The search was performed on original articles published in the last 10 years up to 5 May 2024, with a controlled trial design in which omega-3 supplementation was compared with a control group. Among 14,971 records identified in the search, 13 studies met the selection criteria. The duration of the interventions ranged from 1 day to 26 weeks of supplementation and the doses used were heterogeneous. Creatine kinase (CK) and lactate dehydrogenase (LDH) were significantly higher (p < 0.05) in the control group in 3 of the 4 studies where these markers were analyzed. C-reactive protein (CRP) was significantly higher (p < 0.05) in the control group of 2 of the 13 studies where this marker was analyzed. The delayed onset muscle soreness (DOMS) gave mixed results. Interleukin 6 (IL-6) showed improvements with supplementation, but tumor necrosis factor-α (TNF-α) displayed no differences. The consumption of n-3 PUFAs improved some indicators of oxidative stress such as reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio. Additional evidence is needed to establish clear recommendations regarding the dose and length of n-3 PUFA supplements. These may benefit the post-exercise inflammatory response, mitigate muscle damage, and decrease oxidative stress caused by exercise. However, studies did not evaluate omega-3 status at baseline or following supplementation and therefore the observations must be treated with caution
... Because of the differing formulations of EPA and DHA within trials, it is difficult to ascertain whether EPA or DHA alone is causing the observed effects or if EPA and DHA work synergistically or antagonistically. Although recent investigations have delved into the dose-response relationship of LC omega-3 PUFA and recovery from EIMD (9,10), no studies have characterized the effect of EPA and DHA individually on functional skeletal muscle outcomes. Although EPA and DHA seem to exert similar effects on inflammatory markers (11), the recovery effects associated with EPA and DHA may be due to their incorporation into the skeletal muscle phospholipid. ...
... The sample size estimation for this project was 28-36, justified by a priori power analysis in G*power using a target effect size of f = 0.25, an alpha of 0.05, and a power of 0.80, which determined that 28 subjects (7 per group) were required for participation. Our sample size estimation was similar to previous investigations (9,10,22). Individuals were excluded if they had current and/or history of any musculoskeletal or neuromuscular disorders, had any self-reported illness or conditions that may interfere with the study parameters or put the participant at significant risk, had a body fat percentage >26%, had aVO 2max ≥ 55 mL·kg −1 ·min −1 , or reported the use of fish oil supplements within the past 6 months or fish intake ≥2 servings per week. According to a thorough review of downhill running protocols by Bontemps et al. (23), the magnitude of EIMD is attenuated in endurance trained individuals, hence our requirement for aVO 2max < 55 mL·kg −1 ·min −1 . ...
... On visit 3, participants performed an eccentrically biased aerobic exercise test followed by a plyometrics component adapted from two separate protocols (9,29). On a modified treadmill positioned to be downhill at a grade of 16%, participants ran for 20 min at 70%VO 2max . ...
Article
Purpose Long-chain omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may enhance recovery from exercise-induced muscle damage (EIMD). However, it is unclear if the effects are due to EPA, DHA, or both. The purpose of this investigation was to examine the effect of EPA + DHA, EPA and DHA compared to placebo (PL) on muscular recovery. Methods Thirty males were randomized to 4 g·d ⁻¹ EPA + DHA (n = 8), EPA (n = 8), DHA (n = 7), or PL (n = 7). Following 7-weeks supplementation, a downhill running (20-min, 70% VO 2 max, -16% gradient) plus jumping lunges (5x20 reps, 2-min rest intervals) muscle damage protocol was performed. Indices of muscle damage, soreness, muscle function, and inflammation were measured at baseline and throughout recovery. The omega-3 index (O3i, %EPA + %DHA in erythrocytes) was used to track tissue EPA and DHA status. Results After supplementation, the O3i was significantly higher than PL in all experimental groups ( p < .001). Leg press performance was lower in the PL group at 24H compared to EPA ( p = .019) and at 72H for EPA ( p = .004) and DHA ( p = .046). Compared to PL, muscle soreness was lower in the DHA ( p = .015) and EPA ( p = .027) groups at 48H. Albeit non-significant, EPA + DHA tended to attenuate muscle soreness ( d = 1.37) and leg strength decrements ( d = 0.75) compared to PL. Jump performance and power metrics improved more rapidly in the EPA and DHA groups (time effects: p < .001). Measures of inflammation, range of motion, and muscle swelling were similar between groups ( p > .05). Conclusions Compared to PL, 4 g·d ⁻¹ of EPA or DHA for 52 days improves certain aspects of recovery from EIMD. EPA + DHA did not clearly enhance recovery. Equivalent dosing of EPA + DHA may blunt the performance effects observed in EPA or DHA alone.
... org). All (VanDusseldorp et al. 2018(VanDusseldorp et al. , 2020Visconti et al. 2021) research team members involved with data collection were blinded to participant group information. All participants were thoroughly familiarized with the study design; specifically, the diet and physical activity log requirements, timing, and procedures of blood collection, 1RM protocol, exercise trial, and supplementation regimen. ...
... A standardized bout of resistance exercise involving ten sets of eight repetitions at 70% 1RM squats using a Smith machine (Pro-Elite Strength Systems, Salt Lake City, UT) was completed by all participants. The protocol used has demonstrated a consistent induction of muscle damage in resistance-trained males (VanDusseldorp et al. 2018(VanDusseldorp et al. , 2020Visconti et al. 2021). Moreover, post-exercise responses of this protocol has been shown to be affected by the BCAA supplementation used in this study (VanDusseldorp et al. 2018). ...
Article
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Purpose Autophagy and heat shock protein (HSP) response are proteostatic systems involved in the acute and adaptive responses to exercise. These systems may upregulate sequentially following cellular stress including acute exercise, however, currently few data exist in humans. This study investigated the autophagic and HSP responses to acute intense lower body resistance exercise in peripheral blood mononuclear cells (PBMCs) with and without branched-chain amino acids (BCAA) supplementation. Methods Twenty resistance-trained males (22.3 ± 1.5 yr; 175.4 ± .7 cm; 86.4 ± 15.6 kg) performed a bout of intense lower body resistance exercise and markers of autophagy and HSP70 were measured immediately post- (IPE) and 2, 4, 24, 48, and 72 h post-exercise. Prior to resistance exercise, 10 subjects were randomly assigned to BCAA supplementation of 0.22 g/kg/d for 5 days pre-exercise and up to 72 h following exercise while the other 10 subjects consumed a placebo (PLCB). Results There were no difference in autophagy markers or HSP70 expression between BCAA and PLCB groups. LC3II protein expression was significantly lower 2 and 4 h post-exercise compared to pre-exercise. LC3II: I ratio was not different at any time point compared to pre-exercise. Protein expression of p62 was lower IPE, 2, and 4 h post-exercise and elevated 24 h post-exercise. HSP70 expression was elevated 48 and 72 h post-exercise. Conclusions Autophagy and HSP70 are upregulated in PBMCs following intense resistance exercise with autophagy increasing initially post-exercise and HSP response in the latter period. Moreover, BCAA supplementation did not affect this response. Graphical Abstract
... The association between exercise-induced muscle damage and EPA and DHA supplementation has been fairly well researched [27,85,86]. In doses varying from 0.54 to 4.20 g EPA + DHA administered daily for between 7 and 70 days, EPA and DHA principally reduce muscle soreness regardless of dose, duration or the muscle-damage model employed [27,71,[87][88][89][90][91][92][93][94][95]. In a field-based study in rugby union players, Black et al. observed that EPA + DHA supplementation reduced fatigue after 20 days and reduced muscle soreness that coincided with an improved jump [71]. ...
... Unlike muscle soreness, the preservation of power and strength may be dose-dependent. For example, Van Dusseldorp et al. provided participants with 1.40, 2.80 or 4.20 g EPA + DHA per day for about 52 days before and during exercise-induced muscle damage [93]. Interestingly, the highest-dose group experienced the fastest recovery in jump height (1 h) and strength (72 h). ...
Article
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Fatty fish, which include mackerel, herring, salmon and sardines, and certain species of algae (e.g., Schizochytrium sp., Crytthecodiniumcohnii and Phaeodactylumtricornutum) are the only naturally rich sources of the omega-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are the most biologically active members of the n-3 PUFA family. Limited dietary sources and fluctuating content of EPA and DHA in fish raise concerns about the status of EPA and DHA among athletes, as confirmed in a number of studies. The beneficial effects of EPA and DHA include controlling inflammation, supporting nervous system function, maintaining muscle mass after injury and improving training adaptation. Due to their inadequate intake and beneficial health-promoting effects, athletes might wish to consider using supplements that provide EPA and DHA. Here, we provide an overview of the effects of EPA and DHA that are relevant to athletes and discuss the pros and cons of supplements as a source of EPA and DHA for athletes.
... In the present study, participants ingested four capsules of omega-3 supplement produced in Lugano, Switzerland by the Vivatune company. Each capsule contains 1000 mg of fish oil, which includes 500 mg of EPA and 100 mg of DHA [38]. Additionally, participants consumed 30 g of whey protein supplement powder manufactured by the Karen company in Tehran, Iran, dissolved in 150 mL of water [39]. ...
Article
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Background: Adequate nutrition is crucial for athletes to enhance performance and recovery. This study investigates the acute effects of omega-3 and whey protein supplementation before and after exercise-induced muscle damage (EIMD) on lower-body strength, explosive power, and delayed-onset muscle soreness (DOMS) in female futsal players. Method: A randomized, cross-over, placebo-controlled, double-blind study involved 15 female futsal players (Age: 22.93 ± 0.54 years; Height: 159.60 ± 1.16 cm; Weight: 56.95 ± 1.79 kg). Participants completed three conditions: pre-EIMD (1000 mg fish oil, 30 g whey protein, 2 h before EIMD), post-EIMD (same supplementation, within 2 h after EIMD), and placebo (PLA, 2 g starch). EIMD involved 200 vertical jumps with 15% body-weighted vests. Metrics including Sargent jump height (VJH), thigh swelling (Sw-T), pressure pain threshold (PPT), V-sit and reach flexibility test (VSFT), range of motion (ROM), relative peak torque (RPT), average power (AP), and maximal voluntary isometric contraction (MVIC) were recorded 48 h post-EIMD. DOMS was assessed via a visual analog scale (VAS) multiple times. A one-week washout period was employed. Results: Pre-EIMD supplementation significantly increased VJH (p = 0.001) compared to PLA and Post-EIMD (p = 0.033). MVIC45° improved significantly in Pre-EIMD vs. PLA (p = 0.001). Improvements were observed in muscle strength metrics, with significant increases in APflx60°/s (pre-EIMD vs. PLA, p = 0.001; pre-EIMD vs. post-EIMD, p = 0.008), APext60°/s (Pre-EIMD vs. PLA, p = 0.030), and APext180°/s (Post-EIMD vs. PLA, p = 0.023). DOMS was lower in both Pre-EIMD and Post-EIMD conditions immediately and at 12 h post-EIMD (p = 0.009; p = 0.030) than PLA. No significant differences were found in Sw-T, PPT, VSFT, ROM, or APflx180°/s. Conclusions: Acute omega-3 and whey protein supplementation, particularly before EIMD, improves strength and power and reduces DOMS in female futsal players. Supplement timing may be critical for optimizing recovery and performance in high-demand sports.
... Research has demonstrated the positive impact of omega-3 PUFAs on relieving muscle soreness and improving the recovery time of muscle performance [24]. A recent trial investigated the efficacy of omega-3-rich fish oil as a reliever for muscle soreness [55]. The authors supplemented 41 resistance-trained individuals with either 2.0, 4.0, or 6.0 g/day doses of fish oil and assessed them over a series of seven weeks. ...
Preprint
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Omega-3 polyunsaturated fatty acids (PUFAs) play a critical yet underappreciated role in muscle health, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Through a review of current literature, we analyze the effects of these nutrients on muscle protein synthesis, mass, strength, and recovery. Studies demonstrate that omega-3 PUFAs enhance muscle protein synthesis via the mTOR pathway and possess anti-inflammatory properties that may reduce muscle damage and atrophy, particularly in older adults. Their potential to improve muscle function and mitigate exercise-induced damage is also reviewed, highlighting relevance for athletes and active individuals. Further research on optimal dosages and long-term effects of omega-3 supplementation is needed, providing a basis for future studies and practical recommendations for leveraging these nutrients to support muscle health.
Article
The objective was to study the effectiveness of fish oil (FO) and ozonated fish oil (OFO) on the intensity of lipid peroxidation (LPO) processes and the antioxidant system of the blood during physical activity «to failure». Methods and materials. The animals were divided into 4 groups of 12 rats. Saline was administered orally to control animals (group 1). Rats (group 2) were fed fish oil (dose 35 mg/kg), rats of group 3 – ozonated fish oil (dose 35 mg / kg, ozonide number 3000), group 4 – ozonated fish oil (dose 35 mg/kg, ozonide number 1500). Physical activity was modelated the method of forced swimming of rat «to failure» with a load of 10 % of body weight. The state of the LPO system was assessed by the concentration of malondialdehyde (MDA) in erythrocytes and the level of diene conjugates (DC), triene conjugates (TC) and Schiff bases (SH) in the blood plasma. The state of the antioxidant system was determined by the activity of catalase in the blood plasma. Results. Physical activity had an increase in DC, TC, OR in the blood plasma, an increase in the MDA content in erythrocytes, which was accompanied by a gradual increase in catalase activity in the blood plasma. The administration of FO against the background of physical activity determined less pronounced lipid peroxidation, while the introduction of OFO with an ozonide number of 3000 determined the most pronounced lipid peroxidation compared to the control. The lowest oxidative effect of physical compounds was recorded with the introduction of OFO with an ozonide number of 1500. Conclusions. Oral administration of OFO with an ozonide number of 1500 during physical exercise of significant intensity inhibited the development of oxidative stress against the background of high antioxidant activity of the blood to a greater extent than the use of FO.
Article
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A recent randomized controlled trial (RCT), the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), reported that high-dose marine omega-3 fatty acids (OM3) significantly reduce cardiovascular disease (CVD) outcomes, yet the mechanisms responsible for this benefit remain unknown. To test the hypothesis that high-dose OM3 is anti-atherosclerotic, we performed a systematic review and meta-analysis of RCT of high-dose OM3 on atherosclerosis. The protocol of this systematic review was registered with PROSPERO (CRD42019125566). PubMed, Embase, Cochran Central Register for Controlled Trials, and Clinicaltrials.gov databases were searched using the following criteria: adult participants, high-dose OM3 (defined as ≥3.0 g/day, or in Japan 1.8 g/day and purity ≥90%) as the intervention, changes in atherosclerosis as the outcome, and RCTs with an intervention duration of ≥6 months. A random-effects meta-analysis was used to pool estimates across studies. Among the 598 articles retrieved, six articles met our criteria. Four RCTs evaluated atherosclerosis in the coronary and two in the carotid arteries. High-dose OM3 significantly slowed the progression of atherosclerosis (standardized mean difference −1.97, 95% confidence interval −3.01, −0.94, p < 0.001). The results indicate that anti-atherosclerotic effect of high-dose OM3 is one potential mechanism in reducing CVD outcomes demonstrated in the REDUCE-IT trial.
Article
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Background This study aimed to investigate the effect of supplementation of fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the damage of the biceps brachii after eccentric contractions (ECCs) of the elbow flexors, particularly focusing on muscle stiffness. Methods Sixteen men were included in this double-blind, placebo-controlled, parallel design study and the participants were randomly assigned to the EPA and DHA supplement group (EPA, n = 8) and placebo group (PL, n = 8). They consumed either EPA 600 mg and DHA 260 mg per day or placebo supplement for 8 weeks prior to exercise. Moreover, they performed six sets of 10 ECCs at 100% maximal voluntary contraction (MVC) using a dumbbell. Changes in MVC torque, range of motion (ROM), upper arm circumference, muscle soreness, muscle echo intensity, and muscle stiffness were assessed before exercise; immediately after exercise; and 1, 2, and 5 days after exercise. Results MVC torque and ROM were significantly higher in the EPA group than in the PL group after ECCs (p < 0.05). Muscle soreness, upper arm circumference, and muscle echo intensity were significantly higher in the PL group than in the EPA group after ECCs (p < 0.05). In addition, muscle stiffness at 150° was significantly higher in the PL group than in the EPA group immediately after ECCs (p < 0.05). Conclusion The present study showed that EPA and DHA supplementation has a positive role in inhibiting muscle stiffness after ECCs. Trial registration This trial (UMIN000028165) was registered on 10th/July/2017.
Article
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Omega‐3 (n‐3) fatty acid supplementation enhances muscle protein synthesis and muscle size. Whether n‐3 fatty acid supplementation attenuates human muscle disuse atrophy is unknown. We determined the influence of n‐3 fatty acid supplementation on muscle size, mass, and integrated rates of myofibrillar protein synthesis (MyoPS) following 2 wk of muscle disuse and recovery in women. Twenty women (BMI = 23.0 ± 2.3 kg/m², age = 22 ± 3 yr) underwent 2 wk of unilateral limb immobilization followed by 2 wk of return to normal activity. Starting 4 wk prior to immobilization, participants consumed either 5 g/d of n‐3 fatty acid or an isoenergetic quantity of sunflower oil (control). Muscle size and mass were measured pre‐ and postimmobilization, and after recovery. Serial muscle biopsies were obtained to measure integrated (daily) MyoPS. Following immobilization, the decline in muscle volume was greater in the control group compared to the n‐3 fatty acid group (14 vs. 8%, P < 0.05) and was not different from preimmobilization at recovery in the n‐3 fatty acid group; however, it was still lower in the control group (P < 0.05). Muscle mass was reduced in the control group only (P < 0.05). MyoPS was higher in the n‐3 group compared with the control group at all times (P < 0.05). We conclude that n‐3 fatty acid supplementation attenuates skeletal muscle disuse atrophy in young women, which may be mediated by higher rates of MyoPS.—McGlory, C., Gorissen, S. H. M., Kamal, M., Bahniwal, R., Hector, A. J., Baker, S. K., Chabowski, A., Phillips, S. M. Omega‐3 fatty acid supplementation attenuates skeletal muscle disuse atrophy during two weeks of unilateral leg immobilization in healthy young women. FASEB J. 33, 4586–4597 (2019). www.fasebj.org
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Exercise-induced muscle damage (EIMD) is typically caused by unaccustomed exercise and results in pain, soreness, inflammation, and reduced muscle function. These negative outcomes may cause discomfort and impair subsequent athletic performance or training quality, particularly in individuals who have limited time to recover between training sessions or competitions. In recent years, a multitude of techniques including massage, cryotherapy, and stretching have been employed to combat the signs and symptoms of EIMD, with mixed results. Likewise, many varied nutritional and supplementation interventions intended to treat EIMD-related outcomes have gained prominence in the literature. To date, several review articles have been published that explore the many recovery strategies purported to minimize indirect markers of muscle damage. However, these articles are very limited from a nutritional standpoint. Thus, the purpose of this review is to briefly and comprehensively summarize many of these strategies that have been shown to positively influence the recovery process after damaging exercise. These strategies have been organized into the following sections based on nutrient source: fruits and fruit-derived supplements, vegetables and plant-derived supplements, herbs and herbal supplements, amino acid and protein supplements, vitamin supplements, and other supplements.
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The influence of nutrition has the potential to substantially affect physical function and body metabolism. Particular attention has been focused on omega-3 polyunsaturated fatty acids (n-3 PUFAs), which can be found both in terrestrial features and in the marine world. They are responsible for numerous cellular functions, such as signaling, cell membrane fluidity, and structural maintenance. They also regulate the nervous system, blood pressure, hematic clotting, glucose tolerance, and inflammatory processes, which may be useful in all inflammatory conditions. Animal models and cell-based models show that n-3 PUFAs can influence skeletal muscle metabolism. Furthermore, recent human studies demonstrate that they can influence not only the exercise and the metabolic response of skeletal muscle, but also the functional response for a period of exercise training. In addition, their potential anti-inflammatory and antioxidant activity may provide health benefits and performance improvement especially in those who practice physical activity, due to their increased reactive oxygen production. This review highlights the importance of n-3 PUFAs in our diet, which focuses on their potential healthy effects in sport.
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This study investigated the effect of branched-chain amino acid (BCAA) supplementation on recovery from eccentric exercise. Twenty males ingested either a BCAA supplement or placebo (PLCB) prior to and following eccentric exercise. Creatine kinase (CK), vertical jump (VJ), maximal voluntary isometric contraction (MVIC), jump squat (JS) and perceived soreness were assessed. No significant (p > 0.05) group by time interaction effects were observed for CK, soreness, MVIC, VJ, or JS. CK concentrations were elevated above baseline (p < 0.001) in both groups at 4, 24, 48 and 72 hr, while CK was lower (p = 0.02) in the BCAA group at 48 hr compared to PLCB. Soreness increased significantly from baseline (p < 0.01) in both groups at all time-points; however, BCAA supplemented individuals reported less soreness (p < 0.01) at the 48 and 72 hr time-points. MVIC force output returned to baseline levels (p > 0.05) at 24, 48 and 72 hr for BCAA individuals. No significant difference between groups (p > 0.05) was detected for VJ or JS. BCAA supplementation may mitigate muscle soreness following muscle-damaging exercise. However, when consumed with a diet consisting of ~1.2 g/kg/day protein, the attenuation of muscular performance decrements or corresponding plasma CK levels are likely negligible.
Article
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Objective: The aim of this study was to test the hypothesis that 8-week eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation improves peripheral muscle performance by concentric contractions (CONs) of elbow flexors in humans. Methods: Sixteen healthy men were randomly administered with EPA and DHA supplement (EPA, n = 8) or placebo (PL, n = 8) by a double-blind method. The EPA group was administered EPA-rich fish oil, containing 600 mg EPA and 260 mg DHA per day for 8 weeks. The subjects performed 5 sets of 6 maximal CONs of elbow flexors. The work output and peak torque were assessed during exercise. Changes in the maximal voluntary isometric contraction torque, range of motion (ROM), upper arm circumference, muscle fatigue by rating of perceived exertion, transverse relaxation time, cross-sectional area (CSA), and lactate in blood were also assessed before, immediately after, and 1 day after exercise. Results: The work output during CONs in the EPA group was greater than that in the placebo group at the fifth set (EPA group; 94.0 ± 11.7%, placebo group; 82.5 ± 11.7%, p < 0.05). In addition, ROM in the EPA group was significantly greater than that in the placebo group immediately after exercise (p < 0.05). The increase of CSA in the EPA group was significantly smaller than that in the placebo group immediately after exercise (p < 0.05). Conclusions: The present study suggests that the reduction of muscle work output caused by 30 CONs can be attenuated by an 8-week EPA and DHA supplementation. In addition, EPA and DHA supplementation can cause inhibition for reduction of ROM and increase of CSA after CONs.
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Exercise-induced muscle damage (EIMD) is associated with muscle soreness or discomfort and a marked decline of muscle strength during the first 12-72 hours post-exercise [1]. Furthermore, EIMD leads to the onset of an inflammatory response that is associated with the activation of leukocytes, muscle oedema, deterioration of muscle function, delayed-onset of muscle soreness (DOMS), and several intracellular events that aim to restore the integrity and function of the affected muscle [2]. Oxidative stress, on the other hand, indicates a condition where the cellular production of pro-oxidant molecules exceeds the ability of the antioxidant system to reduce reactive oxygen or nitrogen species (RONS). Research indicates that oxidative stress is evident following muscle damaging exercise [3]. Perturbations in oxidative stress seem to have a potent role in the adaptation process following EIMD. The purpose of this Special Issue of Antioxidants was to highlight recent developments on the field of EIMD and its association with inflammation and oxidative stress. Three review papers and five articles with original data were published.
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Context: Military personnel are subjected to physiologically stressful environments during combat and its associated training. Evidence suggests that fish oil-derived n-3 polyunsaturated fatty acids (FO n-3 PUFAs) may affect military personnel's performance by promoting or preserving lean body mass, strength, and power, while enhancing recovery from training-associated muscle damage. Objective: Following PRISMA guidelines, this systematic review assessed the evidence for FO n-3 PUFA supplementation across various military-relevant outcomes related to physical performance in healthy adult populations. Data sources: The PubMed, Embase, and the CINAHL databases were searched along with references lists of selected articles and reviews. Data extraction: Eighteen trials were assessed for bias, and descriptive data were extracted. Data analysis: Of the 18 studies included, 12 trials favored FO n-3 PUFA supplementation in ≥ 1 of the performance outcomes. Conclusion: Overall, FO n-3 PUFA supplementation likely preserves strength and very likely enhances recovery from physiological stress in young, healthy adults. However, FO n-3 PUFAs' role in promoting or preserving lean body mass or promoting strength is unclear and warrants additional investigation. Systematic review registration: PROSPERO registration no. CRD42020152786.
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Evidence suggests that omega-3 fatty acid supplementation could reduce muscle soreness and maintain muscle function following eccentric exercise-induced muscle damage. The aim of this applied field study was to investigate the effectiveness of consuming a protein-based supplement containing 1546 mg of omega-3 polyunsaturated fatty acid (PUFA) (551 mg eicosapentaenoic acid (EPA) and 551 mg docosahexaenoic acid (DHA)) twice daily (FO) compared to a protein-based placebo (P) on muscle soreness, countermovement jump (CMJ) performance and psychological well-being in 20 professional Rugby Union players during 5 weeks of pre-season training. Players completed a 5-point-Likert soreness scale with 5 indicating “no soreness” and a questionnaire assessing fatigue, sleep, stress and mood each morning of training, plus they performed CMJ tests once or twice per week. Data were analysed using magnitude-based inferential statistics and are presented as percent beneficial/trivial/harmful. On day 35, there was a likely (% beneficial/trivial/harmful: 94/5/1) moderate (0.75, standardized mean difference (SMD)) beneficial effect of FO vs. P on the change in lower body muscle soreness compared with day 0 (FO: −3.8 ± 21.7%; P: −19.4 ± 11.2%). There was a likely (92/7/0) moderate (SMD: 0.60) beneficial effect of FO vs. P on CMJ performance (change from baseline to day 35, FO: +4.6 ± 5.9%; P: −3.4 ± 8.6%). From day 20, a moderate beneficial effect of FO on fatigue was observed. In terms of practical relevance, the moderate beneficial effect of adding fish oil to a protein-based supplement on muscle soreness translated into the better maintenance of explosive power in elite Rugby Union players during pre-season training.