Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance
Abstract
Background Athletes may complete consecutive exercise sessions with limited recovery time between bouts (e.g. ≤ 4 h). Nutritional strategies that optimise post-exercise recovery in these situations are therefore important.Objective This two-part review investigated the effect of consuming carbohydrate (CHO) and protein with water (W) following exercise on subsequent athletic (endurance/anaerobic exercise) performance.Data sources Studies were identified by searching the online databases SPORTDiscus, PubMed, Web of Science and Scopus.Study eligibility criteria and interventions Investigations that measured endurance performance (≥ 5 min duration) ≤ 4 h after a standardised exercise bout (any type) under the following control vs. intervention conditions were included: Part 1: W vs. CHO ingested with an equal volume of W (CHO + W); and, Part 2: CHO + W vs. protein (PRO) ingested with CHO and an equal volume of W (PRO + CHO + W), where CHO or energy intake was matched.Study appraisal and synthesis methods Publications were examined for bias using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy.Results The quality assessment yielded a Rosendal score of 63 ± 9% (mean ± standard deviation). Part 1: 45 trials (n = 486) were reviewed. Ingesting CHO + W (102 ± 50 g CHO; 0.8 ± 0.6 g CHO kg-1 h-1) improved exercise performance compared with W (1.6 ± 0.7 L); %Δ mean power output = 4.0, 95% confidence interval 3.2-4.7 (I 2 = 43.9). Improvement was attenuated when participants were 'Fed' (a meal 2-4 h prior to the initial bout) as opposed to 'Fasted' (p = 0.012). Part 2: 13 trials (n = 125) were reviewed. Ingesting PRO + CHO + W (35 ± 26 g PRO; 0.5 ± 0.4 g PRO kg-1) did not affect exercise performance compared with CHO + W (115 ± 61 g CHO; 0.6 ± 0.3 g CHO·kg body mass-1 h-1; 1.2 ± 0.6 L); %Δ mean power output = 0.5, 95% confidence interval - 0.5 to 1.6 (I 2 = 72.9).Conclusions Athletes with limited time for recovery between consecutive exercise sessions should prioritise CHO and fluid ingestion to enhance subsequent athletic performance. PROSPERO REGISTRATION NUMBER: CRD42016046807.
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Co-ingesting protein with carbohydrate during recovery between two bouts of endurance exercise has shown small to moderate effects on subsequent performance compared with carbohydrate alone (e.g., improvements of ~1.6% in mean power output during cycling time trials and 0.6% in competitive running performance).
“co-ingesting protein with carbohydrate during recovery between two bouts of endurance exercise has shown small to moderate effects on subsequent performance compared with carbohydrate alone (e.g., improvements of ~ 1.6% in mean power output during cycling time trials and 0.6% in competitive running performance [87]”
From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [87]
Combining protein with carbohydrates during recovery periods shorter than 24 h likely has a small, but positive, effect on performance, ranging from 0.6 to 1.6%.
“combining protein with carbohydrates during recovery periods shorter than 24 h likely has a small, but positive, effect on performance, ranging from 0.6 to 1.6% [87]”
From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [87]
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Naderi, A., Rothschild, J. A., Santos, H. O., Hamidvand, A., Koozehchian, M. S., Ghazzagh, A., Berjisian, E., & Podlogar, T. (2025) · Sports Medicine · doi:10.1007/s40279-025-02213-6 · Cited by 43 · see citing works
“Taken together, combining protein with carbohydrates during recovery periods shorter than 24 h likely has a small, but positive, effect on performance, ranging from 0.6 to 1.6% [87].”
InfluentialCoingestion of Carbohydrate and Protein on Muscle Glycogen Synthesis after Exercise: A Meta-analysis
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- Authors
- McCartney, D., Desbrow, B., & Irwin, C.
- Affiliations
- Griffith University (AU)
- Corresponding author
- McCartney, Danielle
- Venue
- Sports Medicine
- Published
- 2017-11-02
- Volume
- 48
- Issue
- 2
- Pages
- 379-408
- ISSN
- 0112-1642 (ISSN-L)
- 1179-2035
- OpenAlex
- W2767173578
- Cited by
- 52
- References
- 80
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 3 · 2021: 10 · 2020: 6 · 2019: 6 · 2018: 2
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- post-exercise recovery, carbohydrate intake, protein intake, water intake, endurance performance, anaerobic performance, output power, sports nutrition, glycogen resynthesis, protein synthesis, muscle protein synthesis, muscle protein degradation, fatigue
- MeSH terms
- Adult, Animals, Child, Dietary Carbohydrates, Female, Humans, Male, Physical Endurance, Water, Exercise, Mice, Rats, Athletic Performance
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