Flavonoid Containing Polyphenol Consumption and Recovery from Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis

Background: Flavonoid polyphenols are bioactive phytochemicals found in fruits and teas among other sources. It has been postulated that foods and supplements containing flavonoid polyphenols may enhance recovery from exercise-induced muscle damage (EIMD) through upregulation of cell signalling stress response pathways, particularly the nuclear factor erythroid 2–related factor 2 (NRF2) pathway. Objectives: This study aims to investigate the ability of polyphenol treatments containing flavonoids to enhance recovery of skeletal muscle strength, soreness and creatine kinase post EIMD. Methods: Medline (Pubmed), Embase and SPORTdiscus were searched from inception to August 2020 for randomised placebo-controlled trials which assessed the impact of 6 or more days of flavonoid containing polyphenol ingestion on skeletal muscle recovery in the 96-h period following a single bout of EIMD. A total of 2983 studies were screened in duplicate resulting in 26 studies included for analysis. All meta-analyses were undertaken using a random-effects model. Results: The pooled results of these meta-analyses show flavonoid polyphenol treatments can enhance recovery of muscle strength by 7.14% (95% CI [5.50–8.78], P < 0.00001) and reduce muscle soreness by 4.12% (95% CI [− 5.82 to − 2.41] P = 0.00001), no change in the recovery of creatine kinase concentrations was observed. Conclusion: These results indicate that ingestion of polyphenol treatments which contain flavonoids has significant potential to improve recovery of muscular strength and reduce muscle soreness in the 4-day period post EIMD. However, the characterisation of polyphenol dosage and composition of study treatments should be prioritised in future research to facilitate the development of specific guidelines for the inclusion of flavonoid-rich foods in the diet of athletes and active individuals.