A Clinical Study of the Immediate and Delayed Effects of New Dietary Supplements on Exercise-Related Fatigue and the Inhibition of Delayed-Onset Muscle Soreness

Objective: In these studies, we examined the immediate and delayed effects of the health food called “Inner Power®” in healthy adults during and after physical exercise. Complex supplements contain branched chain amino acids (BCAAs), citric acid, L-carnitine, coenzyme Q10, zinc and various vitamins. Methods: Study I: The subjects were randomly divided into two groups, and subjected to cross-over study of oral administration to alternately in two phases, using complex supplements or a control food in each group. The oral ingestion of the test beverage 30 minutes before the load by quantitative bicycle ergometer, during and after exercise, and the blood concentration level of lactate, heart rate, fatigue were measured after exercise. Study II: we did a cross-over test in the same manner as study. Oral ingestion of the test beverage occurred 30 minutes before exercise, and was then followed by muscle endurance exercise. The measurement was carried out for muscle pain after exercise and muscle fatigue before and after exercise. Results: Study I: As the test substance effect, the fatigue and lactate levels were significantly different during and after the exercise. Study II: As the test substance effect, DOMS was significantly different at all days. Conclusions: We found that the consumption of complex supplements before exercise had an immediate recuperative effect on exercise-related fatigue and a lasting inhibitory effect on DOMS. ABBREVIATIONS BCAA: Branched Chain Amino Acids; NST: Nutrition Support Team; DOMS: Delayed-Onset Muscle Soreness; VAS: Visual Analogue Scale. INTRODUCTION The term rehabilitation is currently used extensively in the fields of healthcare and welfare, and its necessity and importance are generally well recognized. Nutritional support is also essential for the recovery of physical function through rehabilitation, and it is self-evident that an improvement in nutritional status is crucial for successful rehabilitation. Therefore, the importance of nutritional management and the operation of a nutrition support team (NST) in the field of rehabilitation has recently come to be widely acknowledged [1-3]. Japan boasts one of the world’s longest life expectancies and is becoming an aging society. Central Higashiguchi et al. (2014) Email: Ann Public Health Res 1(2): 1010 (2014) 2/6 However, support for living environments and social welfare has fallen behind, and the considerable number of elderly individuals who are unable to continue an independent lifestyle from the age of 70 years, thus approaching death after a period of physical frailty, is a growing social problem [4]. Multidisciplinary NST have been in operation in our hospital since July 2000, and for over 10 years, they have continuously been conducting nutritional screenings for all inpatients and rehabilitation for patients in need [5,6]. Nonetheless, we frequently encounter patients whose rehabilitation regimen must be interrupted because of severe fatigue and delayed-onset muscle soreness (DOMS). The reasons for these problems include the fact that many patients are frail elderly individuals with co morbidities and muscle strength that is already in decline before initiation of rehabilitation [7]. In order to conduct rehabilitation properly and achieve a favorable outcome, it is necessary to alleviate fatigue and DOMS in such patients throughout the course of rehabilitation. Some of the ingredients of various nutritional supplements and food products that are commercially available have been reported to be effective against fatigue and DOMS. One such component is branched-chain amino acids (BCAA), which inhibit the breakdown of protein in skeletal muscle under invasive conditions and promote protein synthesis [8,9]. Furthermore, consuming 4 g of BCAA before exercise is reported to promote recovery from muscle pain and fatigue after exercise [10]. Another component is citric acid, which plays a central role in energy metabolism as an intermediate in the tri carboxylic acid (TCA) cycle of carbohydrate metabolism [11,12]. Citric acid easily binds to calcium lactate that accumulates during fatigue and improves blood flow to fatigued sites by converting calcium lactate to lactic acid, thereby promoting recovery from fatigue [13]. However, reports on this topic focus on a single component, and very few studies have examined the effects of coenzyme Q10 (CoQ10) administration on recovery of physical function. CoQ10 is a key coenzyme that contributes to metabolic activity at the mitochondrial level. In addition, we found no studies examining the effects of complex nutrient administration on the activity and recovery of various physical functions. Therefore, in the present study, we examined these effects (both immediate and delayed) on healthy adults. MATERIALS AND METHODS We used “Inner Power®” as complex supplements and Glucose jelly as a control food. Inner Power®: Purchased from Otsuka Pharmaceutical Co., Ltd. Glucose jelly: Prepared at our hospital by the nutritional management unit as a placebo containing only carbohydrates with a calorie content equivalent to that of Inner Power® (Table 1). The subjects were blinded to treatment in this study. To ensure that they remained unaware of whether they were receiving complex supplements or a control food, we minimized the differences in appearance of the beverages by offering them to the subjects in paper cups. Study I: Immediate effect during exercise Subjects and research methods: A total of 20 healthy adults (15 men, 5 women; mean age, 24.8 ± 6 years; age range, 20–39 years) who consented to participate in this study were included. None of the subjects reported any medical history that could affect the results of this study. Study design and grouping: The subjects were randomly allocated to 2 groups, and were orally administered either complex supplements or a control food in a crossover study as follows. The first and second periods of the crossover study were termed Period 1 and Period 2, respectively. Ingestion of complex supplements was designated as IP, whereas ingestion of a control food was designated as GJ. Test schedule: The subjects orally ingested two sachets (250 g) of the test beverage 30 min before exercise. Measurements were obtained immediately before exercise, 3 and 6 min after the initiation of exercise, and 5 and 10 min after the completion of exercise. Period 2 was initiated one week after Period 1,and the beverage was switched accordingly;, the same exercise sessions and measurements were repeated (Figure 1). Description of the exercise: The exercise sessions involved quantitative loading on a bicycle ergometer (6 min at 100 W after 3 min of warm-up). Variables measured: We measured blood lactate levels, heart rate, and fatigue (Visual Analogue Scale: VAS). Study II: DOMS Subjects and research methods: A total of 12 healthy adults (8 men, 4 women; 30.9 ± 8.83 years; range, 21–48years) who consented to participate in this study. None of the subjects reported any medical history that could affect the results of the study. Study design and grouping was done in the same manner as study. Test schedule: The subjects orally ingested two sachets (250 g) of complex supplements or a control food 30 min before exercise. Measurements were obtained immediately before exercise and post day 1,2,3,4 of exercise. Period 2 was iniated one week after Period 1, and the beverage was switched accordingly; the same exercise sessions and measurements were repeated (Figure 2). Description of the exercise: Exercise involved repeated elbow flexion in a seated position. The elbow of the non-dominant Ingredients Content (per sachet) Inner Power Glucose jelly calories (kcal) 139 140 carbohydrates (g) 33 35 CoQ10 (mg) 30 – BCAA (mg) 2,500 – L-carnitine (mg) 50 – vitamin E (mg) 10 – B group vitamins (mg) 5 – zinc (mg) 3 – copper (mg) 0.3 – citric acid (mg) 1,000 – overall (g) 125 125 Table 1: Composition of Inner Power and glucose jelly. Central Higashiguchi et al. (2014) Email: Ann Public Health Res 1(2): 1010 (2014) 3/6 Beverage consumption Exercise load 30mim initiation 3min 6min (finish) After 5min After 10min 1 week Exercise load(Period 1) Exercise load(Period 2) Figure 1 Study I design. The subjects orally ingested the test beverage 30 min before physical exercise. Measurements were obtained immediately before and after exercise (Period 1). The beverage was switched after 6 days of rest (1 week from the last day of exercise), and the same exercise sessions and measurements were repeated (Period 2). Beverage consumption Exercise load 30mim