Postexercise Recovery
By Kelly Jones, MS, RD, CSSD, LDN
Today’s Dietitian
Vol. 26 No. 1 P. 30

A Review of a Three-Step Strategy That Gets the Job Done

Nearly every dietetics professional will see clients and patients to whom sports nutrition principles apply, so it’s critical to provide education and recommendations so they can achieve optimal exercise recovery. Whether working with individuals who are new to exercise, are training for their first 10K, are lifting weights regularly, or pride themselves as professional athletes, RDs should recommend the same nutrients to help them maximize their fueling plan to repair and reenergize after workouts.

Today’s Dietitian explores a three-pronged approach to optimal recovery after endurance training and competition, provides an overview of the nutrients needed, and suggests the best options for recovery beverages RDs can share with clients.

The ‘3 Rs’ of Recovery
According to Claire Shorenstein, MS, RD, CSSD, a distance runner and host of the Eat for Endurance podcast, “The postworkout period is a key opportunity to get much-needed energy into the body to help offset the deficit just created.” She says the duration, intensity, and type of workout will guide your discussion on how much and what type of meal, snack, or recovery products will be appropriate.

An easy way to help clients and patients recognize what nutrients they need for exercise recovery is to talk through the “3 Rs” of recovery: refuel, repair, and rehydrate. Variations in nutrient quantity and timing of intake that support the “3 Rs” may vary, so dietitians will need to take their client’s overall needs, goals, and eating patterns throughout the day into consideration. Individuals who engage in light-to-moderate activity levels may need to focus only on adjusting their main meal and snack times, so they serve as pre- and postworkout fueling opportunities. This allows them to eat in a time frame that supports their recovery without adding excess energy intake. More active individuals may need to include an extra snack or mini-meal in addition to their main meals and snacks to meet their nutrient needs and optimize recovery.

1. Refuel
The important nutrient to focus on when refueling is carbohydrate. While some clients and patients may have a complicated relationship with carbohydrates due to popular restrictive diets, this nutrient is the most efficient and preferred energy source for exercising muscles and the brain. Individuals who fear carbohydrates and/or engage in moderate-to-intense or lengthy strength and endurance training will need to understand the value of this nutrient throughout the day and after workouts. Carbohydrates are needed to replenish decreased or depleted postactivity glycogen stores to support the next activity. They’re also important to support normal blood sugar levels, which may decline during exercise, and provide the body with sufficient energy to spare protein from being used as the sole energy source.

2. Repair
Protein is a necessary nutrient for postexercise repair. Some individuals may focus only on protein, assuming a handful of nuts is adequate, and others may skip recovery nutrition altogether due to a busy schedule or lack of appetite. Ideally, clients will eat a moderate amount of protein (ie, 0.25 to 0.4 g/kg) within two hours of exercise, but those who exercise intensely will benefit from regularly ingesting protein closer to the end of their workout. To individualize recommendations for highly active clients, studies suggest consuming 0.25 to 0.4 g/kg of protein at a time, or an average of 20 to 40 g, no more than three to four hours between protein intake.1

3. Rehydrate
The third R of recovery, rehydrate, involves replacing not only fluids lost during exercise but also sodium, which supports fluid balance. Fluid loss that occurs within a given time can differ significantly among individuals due to genetic factors, and there are additional variations due to temperature and humidity, apparel, indoor vs outdoor training, altitude, and more. Average fluid losses per hour in athletes can vary between 15 and 65 oz. While it may not be practical or mentally healthy for all clients to weigh themselves before and after activity, they should drink an additional 16 to 24 oz of fluid for each pound lost during exercise. Sodium losses through sweat also can vary, with one liter of sweat containing anywhere between 200 and 2,000 mg of sodium.

When to Recommend Recovery Beverages
Suggesting clients eat solid foods with a glass of water may seem most appropriate to obtain carbohydrates, protein, sodium, and fluid, but this may not always be practical or desirable. And while many people have been told, “Don’t drink your calories,” it’s important to dispel this myth by recognizing the unique lifestyle and energy needs of athletes and highly active clients.

Student athletes, professional athletes, and average adults who prioritize fitness in their busy schedules may need convenient options, such as recovery beverages. Brooke Czarnecki, RDN, LD, a sports dietitian and run coach, recognizes this, saying that “Many athletes lead busy lifestyles and may find recovery beverages much more convenient to consume vs transporting and chewing food-based meals or snacks on the go.”

Kylee Van Horn, RDN, owner of Fly Nutrition, a nutrition business specializing in nutrition coaching for endurance athletes in Carbondale, Colorado, says, “Recovery beverage drinks and powders can be easy to pack, are nonperishable, and travel well.”

Clients engaged in endurance activities may need to consume additional carbohydrate and sodium after training. “If clients are a heavy or salty sweater, products like sports drinks are helpful recovery beverages after a workout to quickly replenish electrolytes and rehydrate the body while offering quickly absorbed carbohydrates that replenish glycogen stores,” Van Horn says.

Postexercise Appetite Suppression
One reason dietitians should support the use of recovery beverages is because of the loss of appetite many athletes experience after training—known as postexercise appetite suppression. Athletes often experience loss of feeling hungry after a workout regardless of what their bodies need at the time for replenishment. Evidence shows that not only endurance training but also low-volume sprint intervals and long duration low-intensity exercise suppress the release of hunger hormones, such as ghrelin. Research in women is limited, but one study found that regardless of exercise intensity, hunger hormones were suppressed, and satiety hormones were increased after movement.2-4 “Having a beverage vs a food-based snack can help get recovery nutrients in without feeling the pressure of having to chew and force something solid down,” Van Horn says.

However, while athletes may not feel ready to eat or experience nausea, their bodies still may benefit from recovery nutrients. It’s critical to consume protein and carbohydrate to recover within two hours of training, and ideally much sooner, after muscles are stressed. In fact, studies have shown that delaying carbohydrate intake by two hours postexercise may reduce the amount stored as glycogen in the muscles by as much as 50%.5

If clients are resistant to recovery beverages, explore whether they often feel overly hungry later in their day. Most people who experience appetite suppression after training or competition agree that when hunger strikes, it comes on strong and suddenly. This is why it’s important for athletes or active individuals to avoid going too long without eating. If they wait until they’re ravenous, they’re less likely to prepare a balanced nutritious meal, choose healthful foods, and listen to their fullness cues. So, if they choose liquid nutrition when they know they need nourishment, they’ll be able to check off all the Rs of recovery and allow for better appetite regulation.

Recovery Beverage Recommendations
A wide variety of recovery beverages are on the market that RDs can recommend to clients and patients. But it’s important to discuss the value of carbohydrate, as many active individuals prioritize only protein postworkout. From milk and homemade protein smoothies to bottled single-serve beverages and powdered concoctions curated specifically to optimize recovery, there’s a beverage to suit all clients’ needs and budgets.

Dairy milk may be one of the most efficient and cost-effective beverages to provide carbohydrate, protein, fluid, and extra sodium for rehydration. Two servings (16 oz) of 1% milk will provide 26 g carbohydrate, 16 g protein, and 260 mg sodium. For endurance athletes and athletes with high training volume for organized or professional sports, chocolate milk may be a better option due to its higher carbohydrate content to better replenish muscle glycogen stores. Why milk? The unique proteins in dairy offer an ideal dose of essential amino acids and leucine to trigger muscle protein synthesis, and several studies have shown milk to be the most effective at postexercise rehydration.6,7

For individuals with milk allergies or an intolerance to dairy, soymilk is an effective alternative. It contains adequate amounts of essential amino acids and a comparable amount of protein.8,9 However, soymilk is much lower in carbohydrate, so a sweetened variety is best for people who need a recovery beverage. Compared with 16 oz of dairy milk, 16 oz of a lightly sweetened soymilk provides at least 20 g carbohydrate, 14 g protein, and at least 160 mg sodium.

Shorenstein recommends dairy or soymilk to her clients and encourages them to make a whole foods-based smoothie to add more nutrition. She suggests clients blend fruit, nut butter or seeds, dairy or nondairy yogurt alternatives, dairy milk or soymilk, and an optional vegetable like spinach. “You can also add some protein powder in addition to or in place of yogurt depending on your protein needs and food preferences,” Shorenstein says. The combination of these ingredients gives liquid recovery beverages a boost in nutrition that’s comparable to a meal, which is beneficial to those who need more than a small snack after a workout.

When athletes are on the go and don’t have time to make their own recovery beverages, they can buy them ready-made in stores. But since many shakes are lower in carbohydrate and protein, Shorenstein recommends clients eat a balanced meal with the beverage within one to two hours after training.

Van Horn recommends Orgain Nutritional Shakes, which are premixed beverages, and GU Roctane Protein Recovery Drink Mix, which are portable powder packets clients can mix with water, milk, or a milk alternative. “Each of them has a mix of carbohydrate and protein to help promote both muscle repair and glycogen replenishment,” Van Horn says. They also provide sodium to aid in rehydration and are different from protein powders or protein drinks due to their carbohydrate content. Czarnecki recommends Skratch Recovery Sport Drink Mix. While it’s lower in protein with an emphasis on carbohydrates for endurance athletes, she suggests mixing the powder with milk for additional carbohydrate and protein. Other recovery powders clients can mix with a variety of liquids to cater to taste preferences and nutrient needs include those from Klean Athlete and Tailwind.

Other Considerations for Recovery Beverages
While there are many good products from which to choose, not all beverages and powders marketed for recovery are created equal. RDs must be aware that supplements can be poorly regulated, and athletes who are eligible for drug testing should consume only sports products regulated as nutrition products. Or, if products are regulated as supplements, they should have NSF Certified for Sport or Informed Sport Certification. These third-party certifications ensure products don’t contain banned substances, including anabolic steroids or prescription drugs. These are standards many sports performance dietitians consider for all active clients, whether or not they’re eligible for drug testing.

It’s also important for dietitians to ask new clients what beverages and powders they’re already using and review labels to ensure the products are appropriate. Some protein shakes marketed for recovery contain little to no carbohydrate but only protein to be used as an energy source, which may compromise recovery.

Sports drinks should contain both carbohydrate and sodium. The sports drink Prime is trendy among teens and young adults but essentially is a flavored bottled beverage with little carbohydrate and sodium. Similarly, Body Armor has become a popular option, but it lacks sodium. Like Body Armor, Czarnecki says athletic individuals drink coconut water, but it’s missing the amount of carbohydrate needed for glycogen replenishment and is almost void of sodium.

Bottom Line
Postexercise recovery beverages are an important part of many fitness routines, as they help repair and refuel the body quickly and efficiently. These beverages may be most helpful for those who experience postexercise appetite suppression or have a busy, on-the-go lifestyle. When counseling clients, dietitians should discuss the “3 Rs” of recovery, the nutrients they need, the role recovery beverages play in their fitness routines, and what brands to recommend.

Dietitians should keep in mind that while all recovery beverages should include carbohydrate, protein, and sodium, in addition to fluid, the amount of nutrients needed may vary greatly from person to person. So RDs should take each individual client’s needs, goals, preferences, and budget into consideration while providing education and making recommendations.

— Kelly Jones, MS, RD, CSSD, LDN, is a board-certified specialist in sports dietetics. She consults with national sports organizations and is a media and nutrition communications expert. Her private practice works with individuals and groups and offers resources to support the performance of athletes at every level. Jones also founded and oversees Student Athlete Nutrition.

 

References
1. Jäger R, Kerksick CM, Campbell BI, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2017;14:20.

2. Howe SM, Hand TM, Manore MM. Exercise-trained men and women: role of exercise and diet on appetite and energy intake. Nutrients. 2014;6(11):4935-4960.

3. Holliday A, Blannin AK. Very low volume sprint interval exercise suppresses subjective appetite, lowers acylated ghrelin, and elevates GLP-1 in overweight individuals: a pilot study. Nutrients. 2017;9(4):362.

4. Howe SM, Hand TM, Larson-Meyer DE, Austin KJ, Alexander BM, Manore MM. No effect of exercise intensity on appetite in highly-trained endurance women. Nutrients. 2016;8(4):223.

5. Jentjens R, Jeukendrup A. Determinants of post-exercise glycogen synthesis during short-term recovery. Sports Med. 2003;33(2):117-144.

6. Shirreffs SM, Watson P, Maughan RJ. Milk as an effective post-exercise rehydration drink. Br J Nutr. 2007;98(1):173-180.

7. Maughan R, Watson P, Cordery PAA, et al. A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. Am J Clin Nutr. 2016;103(3):717-723.

8. Lynch HM, Buman MP, Dickinson JM, Ransdell LB, Johnston CS, Wharton CM. No significant differences in muscle growth and strength development when consuming soy and whey protein supplements matched for leucine following a 12 week resistance training program in men and women: a randomized trial. Int J Environ Res Public Health. 2020;17(11):3871.

9. Shenoy S, Dhawan M, Singh Sandhu J. Four weeks of supplementation with isolated soy protein attenuates exercise-induced muscle damage and enhances muscle recovery in well trained athletes: a randomized trial. Asian J Sports Med. 2016;7(3):e33528.