Coingestion of Carbohydrate and Protein on Muscle Glycogen Synthesis after Exercise: A Meta-analysis
Open accessAbstract
Introduction/Purpose: Evidence suggests that carbohydrate and protein (CHO-PRO) ingestion after exercise enhances muscle glycogen repletion to a greater extent than carbohydrate (CHO) alone. However, there is no consensus at this point, and results across studies are mixed, which may be attributable to differences in energy content and carbohydrate intake relative to body mass consumed after exercise. The purpose of this study was determine the overall effects of CHO-PRO and the independent effects of energy and relative carbohydrate content of CHO-PRO supplementation on postexercise muscle glycogen synthesis compared with CHO alone. Methods: Meta-analysis was conducted on crossover studies assessing the influence of CHO-PRO compared with CHO alone on postexercise muscle glycogen synthesis. Studies were identified in a systematic review from PubMed and Cochrane Library databases. Data are presented as effect size (95% confidence interval [CI]) using Hedges’ g . Subgroup analyses were conducted to evaluate effects of isocaloric and nonisocaloric energy content and dichotomized by median relative carbohydrate (high, ≥0.8 g·kg −1 ⋅h −1 ; low, <0.8 g·kg −1 ⋅h −1 ) content on glycogen synthesis. Results: Twenty studies were included in the analysis. CHO-PRO had no overall effect on glycogen synthesis (0.13, 95% CI = −0.04 to 0.29) compared with CHO. Subgroup analysis found that CHO-PRO had a positive effect (0.26, 95% CI = 0.04–0.49) on glycogen synthesis when the combined intervention provided more energy than CHO. Glycogen synthesis was not significant (−0.05, 95% CI = −0.23 to 0.13) in CHO-PRO compared with CON when matched for energy content. There was no statistical difference of CHO-PRO on glycogen synthesis in high (0.07, 95% CI = −0.11 to 0.22) or low (0.21, 95% CI = −0.08 to 0.50) carbohydrate content compared with CHO. Conclusion: Glycogen synthesis rates are enhanced when CHO-PRO are coingested after exercise compared with CHO only when the added energy of protein is consumed in addition to, not in place of, carbohydrate.
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The benefit of protein added to carbohydrate appears to occur only when protein is added to a suboptimal amount of carbohydrate (e.g., 0.3 g·kg−1·h−1 protein and 0.9 g·kg−1⋅h−1 carbohydrate).
“However, this benefit appears to occur only when protein is added to a suboptimal amount of carbohydrate (e.g., 0.3 g·kg⁻1·h⁻1 protein and 0.9 g·kg−1⋅h−1 carbohydrate) [85].”
From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [85]
The Conclusion proposes 0.9 g·kg−1·h−1 carbohydrate plus 0.3 g·kg−1·h−1 protein as a way to support overall postexercise recovery. But the Results found no significant glycogen-synthesis benefit in either the high- or low-carbohydrate subgroup, and the Discussion says the analysis does not establish that a benefit occurs only at lower carbohydrate intakes. The cited amounts are supported; the exclusive condition is not. (LLM, conf=0.87)
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- Authors
- MARGOLIS, L. M., ALLEN, J. T., HATCH-MCCHESNEY, A., & PASIAKOS, S. M.
- Affiliations
- U.S. Army Research Institute of Environmental Medicine (US)
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2020-08-24
- Volume
- 53
- Issue
- 2
- Pages
- 384-393
- ISSN
- 0195-9131 (ISSN-L)
- 1530-0315
- PMC
- PMC7803445
- OpenAlex
- W3080426560
- Cited by
- 31
- References
- 59
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 6
- FWCI
- 0.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- 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
- muscle glycogen synthesis, carbohydrate supplementation, protein supplementation, glycogen repletion
- MeSH terms
- Dietary Carbohydrates, Dietary Proteins, Glycogen, Humans, Exercise, Muscle, Skeletal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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