Nutrients. 2016 Aug; 8(8): 506.
Published online 2016 Aug 18. doi: 10.3390/nu8080506
PMCID: PMC4997419
Tom Clifford,1 Bram Berntzen,2 Gareth W. Davison,3 Daniel J. West,4 Glyn Howatson,1,5,* and Emma J. Stevenson4
Abstract
This
study examined the effects of beetroot juice (BTJ) on recovery between
two repeated-sprint tests. In an independent groups design, 20 male,
team-sports players were randomized to receive either BTJ or a placebo
(PLA) (2 × 250 mL) for 3 days after an initial repeated sprint test (20 ×
30 m; RST1) and after a second repeated sprint test (RST2), performed
72 h later. Maximal isometric voluntary contractions (MIVC),
countermovement jumps (CMJ), reactive strength index (RI), pressure-pain
threshold (PPT), creatine kinase (CK), C-reactive protein (hs-CRP),
protein carbonyls (PC), lipid hydroperoxides (LOOH) and the ascorbyl
free radical (A•−) were measured before, after, and at set
times between RST1 and RST2. CMJ and RI recovered quicker in BTJ
compared to PLA after RST1: at 72 h post, CMJ and RI were 7.6% and 13.8%
higher in BTJ vs. PLA, respectively (p < 0.05). PPT was 10.4% higher in BTJ compared to PLA 24 h post RST2 (p
= 0.012) but similar at other time points. No group differences were
detected for mean and fastest sprint time or fatigue index. MIVC, or the
biochemical markers measured (p > 0.05). BTJ reduced the
decrement in CMJ and RI following and RST but had no effect on sprint
performance or oxidative stress.
Keywords: beetroot juice, muscle damage, exercise recovery, repeated sprint exercise
1. Introduction
Repeated
sprint exercise (RSE), in which a number of short-duration maximal
effort sprints (2–6 s) are completed intermittently with brief recovery
periods (≤60 s), places a great deal of stress on the physiological and
musculoskeletal systems [1].
The high energy turnover during RSE induces significant metabolic
stress, triggering rapid perturbations in the nervous, immune, and
endocrine systems [1], as well as an increased formation of reactive oxygen species (ROS) [2].
In addition, the high-force eccentric muscle contractions required to
accelerate and decelerate during RSE places a great deal of mechanical
stress on the musculoskeletal system, particularly the quadriceps and
hamstring muscle groups [3].
It is therefore not surprising that team-sport players, who routinely
engage in RSE in training sessions and matches, often display symptoms
of muscle damage (i.e., muscle soreness and reduced muscle function)
that can persist for several days [4,5,6].
Because the typical time between training sessions and or matches is
often not sufficient for full recovery (≤72 h) athletes and coaches are
continually seeking strategies that could help minimise the negative
effects of muscle damage [7,8].
The
exact mechanisms to explain the causes of muscle damage after RSE are
not fully understood, but a host of factors such as muscle membrane
damage, sarcomere disorganization, excitation-contraction coupling
dysfunction, contractile protein degradation and inflammation are all
likely to play a role [9,10].
Furthermore, it has been suggested that the generation of ROS in the
days post-exercise, likely a consequence of inflammatory mediated repair
processes, might exacerbate the existing muscle damage by degrading
components of the cytosol that are integral to force production [11,12,13]. A number of studies have provided evidence of oxidative stress in the hours and days following RSE [2,6,14],
suggesting that the endogenous antioxidant system is unable to cope
with excess ROS production under these conditions. Thus, it would be
reasonable to assume that the prolonged decrement in muscle function
might be, at least in part, attributable to oxidative stress. This also
makes the expectation tenable that interventions attempting to combat
the excess production of ROS and control oxidative stress, such as
antioxidants, could help accelerate the rate of muscle recovery
following RSE.
While the nutritional antioxidants vitamin C and E have proven largely ineffective at attenuating muscle damage [15,16,17], there is growing support for the use of antioxidant-rich fruit and vegetable beverages as recovery aids [18].
Recently, we showed that supplementation with beetroot juice (BTJ)
attenuated some aspects of muscle damage following high intensity
plyometric exercise [19].
We proposed that one of the potential mechanisms by which of BTJ might
have attenuated EIMD in this study was via its antioxidant effects.
Although the antioxidant effects of BTJ has received little attention in
the literature, findings from our previous work [20] and others [21,22]
suggest that its antioxidant capacity is markedly higher than other
vegetable juices, such as tomato and carrot juice, and also than several
other drinks considered to have a high antioxidant capacity such as
green tea, apple, cherry and cranberry juice [20,23,24].
The high antioxidant capacity of BTJ is due to the fact that several of
the phytonutrient compounds it contains have been shown to scavenge ROS
production in vitro and in vivo and subsequently limit cellular injury [25,26,27].
The most potent antioxidant molecules in BTJ are thought to be the
betalain pigments, which are responsible for beetroot’s violet colour [28].
The betalains, and betanin in particular, are very effective electron
donors that have been shown to not only attenuate ROS mediated injury
but also to upregulate endogenous antioxidant enzymes and stimulate host
defence [29,30,31,32].
In addition, BTJ is rich in nitrate, which, via its reduction to nitric
oxide (NO) might have indirect antioxidant effects by supressing the
accumulation of leukocytes [33], which are thought to be the main producers of ROS after muscle-damaging exercise [34]. Nonetheless, we failed to quantify oxidative stress in our aforementioned experiment [19]
to confirm or refute this posit. Furthermore, the aforementioned
findings were in recreationally active participants and therefore these
results might not be directly transferable to better trained athletic
populations.
To our knowledge, the
effects of BTJ on muscle damage and recovery after activity
incorporating RSE has not been investigated. Additionally, the
effectiveness of such an intervention on subsequent performance has not
been considered. Therefore, the main aim of this study was to examine
whether BTJ can attenuate losses in muscle function and performance
between two sport-specific repeated sprint tests (RST) performed 72 h
apart. We also examined the effects of BTJ on biochemical markers
associated with muscle damage, specifically oxidative stress, to try and
discern what role (if any) the antioxidant potential of BTJ has on
attenuating EIMD. Based on our previous findings [19],
we hypothesized that: (1) BTJ would attenuate muscle function deficits
and oxidative stress between and after the two repeated sprint tests;
and (2) that performance during the second sprint test would be
preserved with BTJ compared to a placebo.
2. Materials and Methods
2.1. Participants
Twenty male participants gave written informed consent for participation in this study (characteristics presented in Table 1). The sample size for this study was based on a priori power calculation. Based on a previous study [19],
with a power of 0.80 and two tailed α level set at 0.05, the minimum
number of participants required to detect an 8% difference in counter
movement jump (CMJ) performance between groups (SD: 6%) was estimated as
10 per group. We selected CMJ as our primary outcome measure because it
is believed to be the most sensitive test for detecting reductions in
neuromuscular function after RSE [35].
Our secondary outcomes included other markers of neuromuscular
function, repeated sprint performance, muscle pain, and biochemical
markers of inflammation, oxidative stress and muscle damage (specific
details in relevant sections below). All participants were collegiate
team-sports players, competing in either soccer (n = 10), rugby (n = 5), basketball (n = 2) hockey (n = 2) or handball (n
= 1) on a regular basis; all testing was performed at the end of the
competitive season (between March 2015 and June 2015). Participant’s
eligibility was assessed with a health screening questionnaire. None had
any known food allergies, were suffering from a musculoskeletal injury,
or had previous history of renal, gastrointestinal or cardiovascular
complications or any other contraindication to the study procedures. For
the 48 h prior to and throughout data collection, participants were
prohibited from consuming alcoholic beverages, and instructed to avoid
any strenuous exercise outside of the trial requirements. The study
protocol received ethical approval from the Faculty of Health and Life
Sciences ethics committee at Northumbria University. Approval was
granted on the 26 February 2015 and assigned the following project
identification code: HLSTC200115.
2.2. Experimental Design
This
study employed a double-blind, placebo controlled, independent groups
design. Participants were required to attend the laboratory for 6 visits
over a 2 week period. The first visit was to familiarise the
participants with the study procedures and randomly allocate them to
either a beetroot juice (BTJ) or an isocaloric placebo (PLA) group.
Their baseline maximal isometric voluntary contraction (MIVC) was used
to match the groups. The principal investigator was responsible for the
randomizing procedures. The next five visits were performed on
consecutive days in the same laboratory at the same time of day and were
preceded by an overnight fast. For the main trials, participants
performed two repeated sprint tests separated by 72 h (visit 2 = RST1
and visit 5 = RST2) (see Figure 1
for schematic outline). A range of dependent variables were taken pre,
30-min post, 24, 48 and 72 h after RST1, and 30-min post and 24 h after
RST2 to monitor recovery. On each occasion, dependent variables were
performed in the following order: pressure-pain threshold (PPT), venous
blood draw, CMJ, reactive strength index (RI) and MIVC. After completing
the post-exercise measures participants consumed 1 serving of their
allocated treatment, and returned to the lab 2.5 h post ingestion for a
further blood sample. Another treatment was taken with an evening meal,
and then at the same points (with breakfast and with an evening meal)
for the following 3 days. All data collection took place in the exercise
laboratories at Northumbria University.
2.3. Repeated Sprint Test
The
RST consisted of 20 maximal-effort 30 m sprints, interspersed by 30 s
of passive recovery. A 10 m deceleration zone was marked out at the end
of each 30 m sprint, in which participants were required to stop within;
the 30 s rest period commenced when participants had come to a halt.
The RST was adapted from previous studies that showed repeated sprints
with forced decelerations induce substantial muscle damage and fatigue
in team-sport trained participants [3,36,37].
Furthermore, the muscle damage induced by an analogous RST seems to
cause reductions in muscle function not different to those observed
after intermittent sport simulations [38] and competitive matches [39]. Before performing each RST, participants undertook a standardized warm up as previously described [3].
Briefly, participants completed 400 m of self-selected jogging, a
series of dynamic stretches, and sprints at 60% and 80% of maximal
effort. Participants were then given a further 5 min to complete their
own stretching. Timing gates (Brower Timing Systems, Draper, UT, USA)
were positioned at 0 and 30 m to record sprint times. Participants were
instructed to give maximal-effort for each sprint and were provided with
strong verbal encouragement throughout. All testing took place in an
air conditioned sprint track in similar environmental conditions.
2.4. Maximal Isometric Voluntary Contractions
MIVC of the right knee extensors was assessed as previously described [3,19].
Participants were seated and fitted to a portable strain gauge (MIE
Medical Research Ltd., Leeds, UK) via a plinth placed just above the
malleoli of the right ankle. In this positon, joint angle was adjusted
to 90° of knee flexion using a goniometer and marked to ensure
consistency across visits. Participants performed 3 maximal effort
isometric contractions, each lasting 3 s, and separated by 60 s seated
rest. The peak value in Newton’s (N) was used for analysis. Coefficient
of variation (CV) for this protocol in our lab was calculated as 1.1%.
2.5. Counter Movement Jump
CMJ
height was determined from flight time using an optical measurement
system (Optojump next, Bolzano, Italy). Participants started the
movement upright with hands fixed to their hips and after a verbal cue,
descended into a squat prior to performing a maximal effort vertical
jump. Participants performed 3 maximal efforts, separated by 30 s
standing recovery. Mean height (cm) was used for analysis. The CV for
this protocol in our lab was calculated as 2.1%.
2.6. Reactive Strength Index
Reactive
strength index (RI) was used to measure the impact of muscle damaging
exercise on participant’s ability to utilize the stretch shortening
cycle and perform explosive actions. In a similar fashion to previous
studies [40],
participants performed a drop jump from a 30 cm box and, upon landing,
immediately jumped vertically, with instructions to minimise ground
contact time while maximising jump height. RI was calculated as jump
height divided by ground contact time (cm/ms) recorded from an optical
measurement system (Optojump next). Participants performed 3 maximal
efforts separated by 30 s of passive (standing recovery) with the mean
height of the 3 jumps used for analysis. The CV for this protocol was
calculated as 1.9% in our lab.
2.7. Treatments and Dietary Control
Participants
consumed 2 bottles (250 mL per bottle) of their assigned treatment (BTJ
or PLA) on the day, 24, and 48 h after RST1 and 30-min post RST2,
equating to 8 servings in total. One bottle was consumed 30-min after
each trial, and one with an evening meal. The BTJ was supplied by Gs
Fresh Ltd., (Cambridgeshire, UK) and consisted of 99% beetroot juice
concentrate, nitrate and other phytonutrients; specific details of the
antioxidant capacity and phytonutrient content of this drink can be
found elsewhere [20].
The PLA consisted of a low fruit containing (<1%) squash (Kia Ora,
Coca Cola Enterprises, Uxbridge, UK), flavourless protein powder (Arla
Foods, Amba, Denmark) and maltodextrin powder (Myprotein, Manchester,
UK) providing a negligible amount of phytochemicals and nitrate.
Treatments were closely matched for volume, macro-nutrient and energy
content, but differed in antioxidant capacity and nitrate content (see Table 2).
Participants were provided with food dairies to record their intake 24 h
prior to RST1 up until data collection was complete (24 h post RST2; 5
days in total). Average energy and macronutrient intake for each group
is presented in Table 3.
To comply with the double-blind, randomized design, drinks were
provided in identically masked bottles, only distinguished by a single
letter code. These were prepared by an individual not involved in data
collection. As detailed in a previous study [19],
due to the distinct taste of BTJ, the PLA was not matched for taste and
texture, only energy content. While others have used nitrate depleted
BTJ as a PLA so that the taste is the same, this is not a true PLA
because it will still contain many other bioactive constituents (i.e.,
phenolics and betalains) that, as outlined in the introduction, could
favourably affect recovery. Thus, this would not have been plausible in
the present study. Rather, in an attempt to overcome this, the
participants were not informed of what the specific drinks being
investigated were. The only information they received was that they were
antioxidant-containing drinks used for recovery. This ensured that the
participants did not know the overall aim of the study, eliminating any
bias based on pre-conceptions regarding BTJs potential ergogenic
effects. Additionally, because we employed an independent groups design,
participants were never aware of the taste/texture of the other
treatment under investigation.
2.8. Muscle Soreness
Site
specific muscle soreness was assessed with a handheld algometer (Wagner
Instruments, Greenwich, CT, USA). A cylindrical flat headed pad (1 cm
diameter) was applied with increasing pressure on the muscle belly at
three pre-marked sites: vastus lateralis, mid-way between the superior
aspect of the greater trochanter and head of the tibia, rectus femoris,
mid-way between the anterior patella and inguinal fold, and
gastrocnemius, most medial aspect of the calf at relaxed maximum girth.
The point at which the participant signified they felt pain was recorded
in N2 as pressure pain threshold (PPT). Sites were re-marked
on each visit to ensure consistency between recordings. The average of
two values from each site was used for analysis, unless the difference
between the two values was >10 N2 apart, in which case a third recording was taken, and the average of the two closest values used for analysis.
2.9. Blood Sampling
Venous
blood was obtained via venepuncture from a branch of the basilica vein
at the antecubital fossa. Samples were collected into di-potassium
ethylene diamine tetra-acetic acid (EDTA) (1 × 10 mL) and serum
vacutainers (1 × 10 mL). EDTA tubes were immediately centrifuged at
3000× g (4°) for 10 min, while serum tubes were allowed to clot
for 45 min before centrifugation. Plasma and serum supernatant was
aspirated into a series of aliquots and stored at −80 °C for later
analysis.
2.10. Biochemical Analysis
High
sensitivity C-reactive protein (hs-CRP) and creatine kinase (CK) were
measured in serum using an automated system based on an
electrochemiluminescence method (Roche Modular, Roche Diagnostics,
Indianapolis, IN, USA. The typical CV for this method is <2%. Plasma
protein carbonyls were measured using a commercially available assay kit
(Cayman Chemical, Ann Arbor, MI, USA). Lipid hyroperoxides (LOOH) were
measured in serum using the ferrous iron/xylenol orange (FOX) assay
(Wolff 1994). The FOX assay determines the susceptibility to
iron-induced LOOH formation in blood; consequently, the presence of iron
ions in the assay protocol might lead to slightly higher LOOH values
compared with other methods. Absorbance was read at 560 nm using a
spectrophotometer (U-2001, Hitachi, Berkshire, UK) (range 0–5 μmol·L−1).
Ascorbyl
free radical determination was quantified at room temperature using a
Bruker EMX series X-band EPR spectrometer (Bruker, Karlsruhe, Germany). 1
mL of plasma was mixed thoroughly with 1 mL of dimethyl sulfoxide
(DMSO) and slowly flushed into an aqua X multiple bore cavity cell. The
EMX parameter settings were frequency, 9.785 GHz; microwave power, 20
mW; modulation frequency, 100 kHz and modulation amplitude, 1.194 G. All
EPR spectra were subjected to 3 scans identically filtered and analysed
using WinEPR software (Version 3.2, Bruker WinEPR, Coventry, UK). The
average spectral peak-to-trough line amplitude was used to determine
free radical concentration.
2.11. Data Analysis
All
data are expressed as mean ± standard deviation (SD) and were analysed
using IBM SPSS Statistics 22 for Windows (Surrey, UK). Participant’s
food diaries (5 days) were analysed for macronutrient content using
dietary analysis software (Nutritics LTD, Dublin, Ireland). Differences
between participant group characteristics were analysed with an
independent samples t-test. CMJ, RI, MIVC and PPT were measured
using a mixed model ANOVA; 2 group levels (BTJ vs. PLA) by 7 time
levels (pre, post, 24, 48, 72, 73 and 96 h post RST1). The same ANOVA
was use to analyse all blood indices but with 2 additional time levels
(2.5 h post RST1 and 2.5 h post RS2). A separate ANOVA was used to
measure for differences between RST1 and RST2; 2 group levels (BTJ vs.
PLA) by 2 time levels (pre and post). In the event of a significant
interaction effect (group * time) Fisher LSD post hoc analysis was performed to locate where the significant differences occurred. Statistical significance was set at p < 0.05 prior to analyses. To estimate the magnitude of the supplements effects, Cohen’s d
effect sizes (ES) were calculated with the magnitude of effects
considered either small (0.20–0.49), medium (0.50–0.79) and large
(>0.80).
3. Results
There were no between group differences in age, height, mass or baseline MIVC strength (Table 1; p
> 0.05), indicating that the groups were well matched prior to
testing. Furthermore, there were no differences in participant’s energy
and macronutrient intake 24 h prior to and throughout the duration of
the study (Table 3; p > 0.05). No adverse effects were reported by the participants throughout the trial.
3.1. Repeated Sprints
RPE showed no bout (p = 0.925) or interaction effects (p = 0.584) between RST1 and RST2, indicating that perceived exertion was not different for both bouts (Table 4).
This was reflected in the sprint data, as fastest sprint time and
fatigue index were not different between repeated sprint bouts, showing
no main effects of time, bout, or bout * group interactions (p > 0.05). No group or group * bout interaction effects were present (p > 0.05).
3.2. Functional Measures
All tests of neuromuscular function (CMJ, MIVC, RI), and PPT, showed main effects for time (p
< 0.05), indicating that the RST induced muscle damage. Immediately
post RST1, CMJ height was reduced by 11.8% ± 8.9% and 9.6% ± 4.8% (of
baseline values) in the BTJ and PLA groups, respectively. A group effect
showed that CMJ height appeared to recover quicker in BTJ vs. PLA
throughout the remainder of the testing period (p = 0.048; Figure 2). Although no group*time interaction effects were present (p
= 0.176), there was a large effect size (1.86) at 72 h post RST1
whereby CMJ height in the BTJ group was 7.6% higher than the PLA group. A
group effect for RI (p = 0.030) showed that the maintenance of RI performance was also greater in BTJ vs. PLA throughout the trial (Figure 3).
As with CMJ, a large effect size (1.43) was evident at 72 h post RST1
where RI had returned to 95.8% ± 9.5% of baseline values in BTJ compared
to 82% ± 9.5% in PLA. There were no group effects for PPT (p = 0.368); however, an interaction effect was observed (p = 0.013; Figure 4). Post-hoc analysis revealed a group difference at 96 h post RST1 (p
= 0.012; ES = 0.57); in the BTJ group, PPT had recovered to 104.7% ±
12.5% of baseline values, while in the PLA group, PPT was 94.3% ± 18% of
baseline values. There were no significant group or interaction effects
for MIVC (p > 0.05).
Percentage
changes in counter movement jump (CMJ) height between repeated sprint
tests (RST1 and RST2). * Represents group difference (beetroot juice
(BTJ) vs. placebo (PLA); p < 0.05). Values are mean ± SD (n = 10 per group).
Percentage
changes in reactive strength index (RI) between repeated sprint tests
(RST1 and RST2). * Represents group difference (beetroot juice (BTJ) vs.
placebo (PLA); p < 0.05). Values are mean ± SD (n = 10 per group).
3.3. Biochemical Indices
Serum
concentrations of hs-CRP remained close to baseline values throughout
the trial, showing no time, group or interaction effects (p > 0.05). Serum CK showed main effects for time (p < 0.001), with the greatest increases observed 2.5 and 24 h post RST1 and RST2 in both groups (p > 0.05; Table 5). However, no group of interaction effects were observed (p > 0.05). A main effect for time was observed for serum LOOH (p
< 0.001); LOOH was elevated immediately and at 2.5 h post-RST1 in
both groups before returning to baseline 24 h post. A transient increase
in LOOH was also evident at 75 h (2.5 h post RST2) but by 96 h had
recovered to pre-exercise values. No group or interaction effects were
present for LOOH (p > 0.05). Protein carbonyls, a common
measure of protein oxidation, remained largely unchanged after both
sprint bouts and showed no group or interaction effects (p > 0.05). Likewise, A•−, as measured by EPR, showed no time, group or interaction effects throughout the trial (p > 0.05).
4. Discussion
The
main finding of the present study was that beetroot juice, when
compared to a placebo, was able to accelerate the recovery of CMJ and RI
performance and reduce pain after a muscle-damaging RST, but had no
influence on sprint performance. Markers of systemic oxidative stress or
other biochemical indices associated with muscle damage were unaffected
by beetroot juice supplementation.
In both the BTJ and
PLA groups CMJ and RI significantly decreased after RST1, indicating
the presence of muscle damage; however, both CMJ and RI recovered
quicker with BTJ (vs. PLA) during the following +96 h (Figure 2 and Figure 3,
respectively). This was most evident at 72 h after the first sprint
bout (RST1), whereby CMJ and RI were still significantly lower than
baseline values, but restored close to pre-exercise values in BTJ group.
These findings are consistent with our previous work, in which we
reported 3 days of BTJ supplementation enhanced the recovery of CMJ
performance 72 h after plyometric activity [19].
Interestingly,
although BTJ appeared to enhance the recovery of the dynamic muscle
function (CMJ and RI), isometric strength (MIVC) was unaffected by BTJ
supplementation. As previously suggested [19],
perhaps this discrepancy can be explained by the different movement
patterns (i.e., static vs. dynamic function) and specific abilities each
test measures (power vs. isometric strength). Both CMJ and RI are
arguably more ecologically valid tests of functional recovery than MIVC,
particularly for team-sports players as their movement patterns more
closely reflect the activity required for performance [35].
We initially hypothesized that sprint performance would be reduced in
RST2 compared to RST1; a consequence of muscle damage, and that this
reduction would be attenuated with BTJ supplementation. However,
contrary to our hypothesis, aside from a non-significant decrease in
average sprint time (Table 3),
sprint performance was largely unaffected in RST2 compared to RST1. The
reductions in muscle function were not different ≤24 h after both
sprints tests though, suggesting that the participants did not become
accustomed to the sprint test after the first bout. Additionally, BTJ
had no influence on any aspect of sprint performance, although perhaps
our ability to detect any differences between groups was limited by the
lack of change in performance between the two sprint tests. Nonetheless,
the fact that sprint performance was unchanged seems to contrast with
other studies who reported sprint times to still be slower than
pre-exercise values up to 72 h after an RST similar to the present study
[36,41,42].
Because the muscle-damaging RST was fairly similar between these
studies (in fact, the one in the present study was designed to be more
challenging), perhaps the divergent findings between these studies and
the present one is due, in large part, to the different training status
of the participants. The participants in the present study were
experienced team-sports players who regularly perform RSE as part of
training and matches and, thus, may have been less vulnerable to
prolonged decrements in sprint performance than recreationally active
participants tested in some of the other studies [41,42].
In
addition, the fact that CMJ and RI were still significantly depressed
at 72 h post RST1, but sprint performance was not, suggests that there
is dissociation between these tests of dynamic muscle function (CMJ and
RI) and repeated sprint ability. Indeed, previous literature appears to
be equivocal on how well sprint and jump tests correlate. Some studies
demonstrate that the time course of recovery for CMJ and sprint
performance are not different after muscle-damaging RSE [36,41,42], while others agree with the present study [35,39,43],
and have found that reductions in CMJ are more prolonged than sprint
decrements. A recent study attempted to address this issue by comparing
CMJ, drop jumps (DJ) and a 20 m sprint test after intermittent exercise
and concluded that sprint performance seemed to recover more rapidly
than both CMJ and DJ performance, both of which were still below
pre-exercise values 72 h post-exercise [35].
This led the authors to suggest that CMJ and DJ are more sensitive
tests of prolonged changes in neuromuscular function, which could
provide and explanation for the dissociation between the jump and sprint
tests in the present study.
Due to the fact that oxidative stress has been associated with muscle damage after eccentric-heavy exercise [14,44], and that beetroot and its constituents have been shown to act as antioxidants [25,29],
we hypothesized that BTJ could attenuate muscle damage by protecting
cells against oxidative stress. However, our findings do not support
this contention. We found no evidence that BTJ attenuated oxidative
stress as both indirect markers (LOOH and PC) and a direct marker of
free radical production (A•−) were not different between the BTJ and PLA groups at all-time points (Table 5).
These data are in contrast to a number of previous studies that found
antioxidant-rich food supplements reduced oxidative stress after high
intensity sprint exercise [14,45,46].
However, unlike these studies, we did not find any evidence of
oxidative stress throughout the trial, apart from an increase in LOOH
immediately post and 2.5 h post both sprint tests (Table 5).
The modest increase in these markers was unexpected, as previous
studies reported large systemic elevations in oxidative stress up to 48 h
after high intensity intermittent cycling exercise [2,14]
an activity which, in comparison to running, typically results in less
oxidative stress because of the absence of an extensive eccentric
component [34].
The divergent findings in oxidative stress response between the present
and aforementioned studies could, therefore, be explained by the
different biochemical markers examined and/or analytical techniques
used. Jowko and colleagues [14]
for instance, noted systemic increases in total antioxidant capacity
(TAC), superoxide dismutase and glutathione peroxidase (GPX) 24 h after
exercise and Bogdanis and colleagues [2] noted increases in TAC, PC and GPX; thus, neither study measured LOOH or A•− formation, as in the present study. Although this study and [2]
both measured PC, different analytical methods were used, which could
account for the discrepant results. Nonetheless, EPR spectroscopy is
considered a valid and sensitive method for direct detection of
excessive free radical production [47,48],
and the fact that we found no evidence of an increase in our data
perhaps draws into question the reliability of the indirect biomarkers
in other studies using a similar protocol.
The fact
that muscle damage was clearly evident in the days after both RST tests
but oxidative stress was not, suggests that muscle damage occurred
independent of any systemic changes in oxidative stress. This would
perhaps suggest that ROS have a limited role in the muscle damage
process post-exercise. However, it cannot be ruled out that oxidative
stress occurred, but was confined predominately to muscle cells and
surrounding tissues. Unfortunately, we did not measure muscle samples in
our study, and as such, this supposition is speculative. A recent
review however, concluded that skeletal muscle is a prime producer of
ROS following exercise; so, intuitively, oxidative stress would be
expected to be greater in muscle than perhaps the circulation [49].
We recognize that the inability to obtain muscle biopsy samples for
oxidative stress measures could be considered a limitation of this
study. Alternatively, the muscle damage we observed could have been
unrelated to oxidative stress. Instead, the muscle damage could have
been caused by other biochemical changes within muscle, such as
increased inflammation and calpain activity [50,51] or damage to components involved in the excitation-contraction coupling pathway, as previously suggested [52].
Serum
CK concentrations, incorporated as a surrogate marker of sarcolemma
damage, were not different in both groups after exercise (Table 5). The increase in CK after the RST was similar to previous reports [3,42], as was the lack of a suppressive effect with an antioxidant-rich food beverage [19,23,45]. These data suggest that improved sarcolemma integrity cannot explain the enhanced rate of recovery by BTJ in this study.
Because
we found no changes in oxidative stress between groups, the beneficial
effects of BTJ on the recovery of CMJ and RI cannot be attributed to an
antioxidant effect of the juice. This suggests that mechanisms other
than antioxidant effects were possibly involved. It was beyond the scope
of this study to examine the role of other mechanisms by which BTJ
could attenuate muscle damage, but owing to the seemingly pleotropic
nature of phenolic and betalainic compounds and NO, there are a number
of possible candidates. For instance, other effects associated with
phenolic compounds and NO donors akin to BTJ are anti-inflammatory [25,33]
and regenerative, in so far as they appear to have a regulatory role in
phagocytosis and promote satellite cell proliferation in skeletal
muscle [53,54,55].
Increasing in vivo NO availability has also demonstrated additional
biochemical effects that, conceivably, could contribute to improved
functional recovery after exercise, such as reduced calpain activity [56], increased muscle blood flow [57,58], and enhanced muscle power potential, possibly via improved Ca2+ handing [59,60].
Thus, there are a number of potential mechanisms that could explain why
BTJ supplementation was able to enhance the recovery of muscle
function, independent of antioxidant effects. However, since none of
these mechanisms were measured per se, we can only speculate
the role, if any, that they may have had in the present study’s
findings. The potential role and their relative contributory effects
require further exploration.
Participants in the BTJ group reported a significantly higher PPT than the PLA group 24 h after the second sprint test (Figure 4).
Reduced muscle pain when antioxidant-rich food supplements are taken
after muscle-damaging exercise has been reported by our group [19] and others [61].
The mechanism by which BTJ might attenuate muscle pain is unclear
however. Previous reports suggest that the betalains in beetroot are
responsible for its analgesic effects, most likely via an
anti-inflammatory related mechanism [26,62].
The possibility that an anti-inflammatory mechanism would be involved
is supported by data that suggests muscle pain after exercise may stem
from the release of inflammatory and noxious stimuli (i.e., bradykin and
nerve growth factor) due to tears at the extracellular matrix [63,64]. Perhaps BTJ acts to dampen inflammatory responses or desensitize pain receptors, as has been suggested with ginger [65] and curcumin supplements [66]; however, whatever the precise mechanisms, they are likely to occur at the skeletal muscle level.
It
is also unclear why BTJ only improved PPT 24 h after RST2 in the
present study and not at earlier time points, as was shown in our
earlier work [19].
A previous study did observe greater reductions in pain scores after
participants took betalain-rich beetroot supplements for 5–10 days
compared to 1 day [26],
which, coupled with our data, suggests that the analgesic effects of
BTJ might be augmented with longer-term dosage regimens. Such a
possibility needs to be investigated in future studies.
In
conclusion, this study demonstrates that consuming BTJ for 4 days after
a muscle damaging RST attenuated muscle pain and decrements in dynamic
muscle function, as measured by CMJ and RI. These effects did not
translate to improved recovery of isometric strength or sprint
performance however. These data suggest BTJ could be applied as a
post-exercise recovery strategy to attenuate losses in some aspects of
dynamic muscle function in team-sports players between bouts of repeated
sprint exercise; however, because sprint performance was unchanged, how
transferable these findings are to real-world team-sport competition is
unclear. Future studies are needed to clarify the underlying cellular
mechanisms, as the beneficial effects of BTJ were shown to be unrelated
to systemic changes in oxidative stress or other biochemical markers of
muscle damage.
Acknowledgments
The authors wish to thank all the participants for their hard work and commitment displayed throughout testing.
Author Contributions
T.C.,
G.H., D.J.W., E.J.S. conceived and designed the experiments; T.C. and
B.B. performed the experiments; T.C. and B.B. analyzed the data; G.W.D.
performed biochemical analysis; T.C., G.H., D.J.W., E.J.S., G.W.D. wrote
the paper.
Conflicts of Interest
This
study was funded as part of a doctoral degree that receives financial
support from Gs Fresh Ltd. The funders supplied the supplements used in
this study but had no role in the conception of the study, its design,
preparation, analysis and writing of the manuscript. The authors declare
no conflict of interest.
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