Suplementação de ácido ascórbico na resposta inflamatória e funcionalidade musculoesquelética após exercícios físicos: uma revisão sistemática

Abstract

Regular exercise promotes health benefits, but can acutely result in muscle damage and decreased functionality. Ascorbic acid supplementation has been used to alleviate these symptoms. In this sense, the aim of the study was to systematically review the effects of ascorbic acid supplementation on inflammatory response, pain and musculoskeletal functionality after physical exercise in healthy volunteers. The search was performed in the MEDLINE (PubMed), Cochrane CENTRAL, EMBASE, Sport Discus and Web of Science databases, with the descriptors “Adult”, “Healthy volunteers”, “Athletes”, “Exercise” and “Ascorbic acid”. We included randomized, placebo-controlled clinical trials evaluating the effects of ascorbic acid supplementation on inflammatory response, pain, and musculoskeletal functionality following physical exercise by healthy volunteers. Random effects model was used to compare pre- and post-supplementation changes in ascorbic acid and placebo. Data were reported as standard mean difference (SMD) and 95% confidence interval (CI). Of the 1,161 studies found, 18 were included, with a sample of 313 participants, with a median of 24 years. Ascorbic acid supplementation immediately reduced lipoperoxidation (SMD = -0.488; 95% CI = -0.888 to -0.088; p = 0.017), 1h (SMD = SMD = -0.521; 95% CI = -0.911 to -0.131; p = 0.009) and 1h and 2h (SMD = -0,449; 95% CI = -0,772 to -0,126; p = 0,006) after the exercises. There was also a reduction in IL-6 levels 2h (SMD = -0.764; 95% CI = -1.279 to - 0.248; p = 0.004) and between 1 and 2h (SMD = -0.447; 95% CI = -0.828 to -0.065; p = 0.022). The other inflammatory markers (creatine kinase and C-reactive protein), cortisol level, pain and muscle strength showed no difference between ascorbic acid supplementation and placebo. In conclusion, there is evidence of small and moderate effect size that ascorbic acid supplementation reduces oxidative stress (lipoperoxidation) and inflammatory response (IL-6) after acute exercise in healthy volunteers.