The 4R’s Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates Several nutritional strategies may be used to optimize post-exercise recovery. The amount, composition, and timing for the consumption of fluids, electrolytes, macronutrients, antioxidants and/or supplements depend on the type of sport, the time between sessions, the level of preparation of the athlete, the convenience of the strategy, among other factors. There is not a single protocol to apply in post-exercise recovery. Based on the available evidence, we have identified a mnemonic entitled the 4R’s which stands for Rehydrate, Refuel, Repair, and Rest. These four R’s are not intending to replace the current methodologies or to establish a novel rigid paradigm in this regard, but to represent a strategic application of the nutritional strategies that should be taken into account during the recovery process. Taking into account the allostasis model, it is important to consider that each R represents a factor with tremendous influence on the allostatic response and the allostatic load that will impact the exercise-induced adaptions and recovery.

Rehydrate—It is necessary to guarantee the post-exercise consumption of at least 150% of the weight lost during the event (~1.5 L·kg⁻¹) accompanied by sodium (if a faster replacement is required).

Refuel—The combined use of carbohydrates and proteins is a good strategy to replenish glycogen while contributing to tissue repair. Although new bioengineered formulations have been developed and introduced to the market, the source of macronutrients for men and women may be diverse and need not be limited to exclusively commercial sport nutrition products as long as an adequate amount of carbohydrates is provided at multiple intervals during post-exercise recovery [157]. Special attention should be paid to non-starch slowly digestible carbohydrates that have not been widely studied, such as trehalulose.

Repair—The ingestion of high-quality protein stimulates post-exercise net muscle protein anabolism and might contribute to faster tissue growth and repair. The use of certain supplements such as creatine monohydrate, tart cherry, beetroot juice, and possible ashwagandha might help to enhance recovery.

Rest—Optimal sleeping time and quality are necessary to benefit the allostatic response after exercise. Pre-sleep casein protein ingestion seems to be an effective strategy to boost the muscle adaptive response during a resistance exercise training program but more research is needed in endurance athletes.

#science #chiropractor #chiropractic #research #education #evidence based #patient centered #interprofessional #collaborative #rehabilitation #public health #spinal health #musculoskeletal health #ethics #pain #function #disability #QOL #knowledgetranslation