Impact of Dietary Antioxidants on Sport Performance: A Review

Sports Medicine

Volumn 45, Issue 7, 2015, Pages 939-955

  Braakhuis, Andrea J ^a   Hopkins, Will G ^b  

^a UNIVERSITY OF AUCKLAND   (New Zealand)

^b VICTORIA UNIVERSITY   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLCYSTEINE; ALPHA TOCOPHEROL; ANTIOXIDANT; QUERCETIN; RESVERATROL; STILBENE DERIVATIVE;

ATHLETIC PERFORMANCE; BEET; BEVERAGE; DIET SUPPLEMENTATION; HUMAN; PHYSIOLOGY; SPIRULINA;

ACETYLCYSTEINE; ANTIOXIDANTS; ATHLETIC PERFORMANCE; BETA VULGARIS; BEVERAGES; DIETARY SUPPLEMENTS; HUMANS; QUERCETIN; SPIRULINA; STILBENES; VITAMIN E;

EID: 84931574754     PISSN: 01121642     EISSN: 11792035     Source Type: Journal    
DOI: 10.1007/s40279-015-0323-x     Document Type: Review

References (121)

1. Alessio HM. Exercise-induced oxidative stress. Med Sci Sports Exerc. 1993;25(2):218–24.
2. Sakellariou GK, Jackson MJ, Vasilaki A. Redefining the major contributors to superoxide production in contracting skeletal muscle: the role of NAD(P)H oxidases. Free Rad Res. 2014;48(1):12–29.
3. Finaud J, Lac G, Filaire E. Oxidative stress: relationship with exercise and training. Sports Med. 2006;36(4):327–58.
4. Richardson RS, Donato AJ, Uberoi A, et al. Exercise-induced brachial artery vasodilation: role of free radicals. Am J Appl Physiol. 2007;292(3):H1516–22.
5. Hurst RD, Wells RW, Hurst SM, et al. Blueberry polyphenolic suppress oxidative stress-induced skeletal muscle cell damage in vitro. Mol Nutr Food Res. 2009;53:1–11.
6. Gliemann L, Schmidt JF, Olesen J, et al. Resveratrol blunts the positive effects of exercise training on cardiovascular health in aged men. J Physiol. 2013;591(20):5047–59.
7. Gomez-Cabrera MC, Domenech E, Romagnoli M, et al. Oral administration of vitamin C decreases muscle mitochondrial biogenesis and hampers training-induced adaptations in endurance performance. Am J Clin Nutr. 2008;87:147–9.
8. Paulsen G, Cumming KT, Holden G, et al. Vitamin C and E supplementation hampers cellular adaptation to endurance training in humans: a double-blind randomized controlled trial. J Physiol. 2014;. doi:10.1113/jphysiol.2013.267419.
9. Ristow M, Zarse K, Oberbach A, et al. Antioxidants prevent health-promoting effects of physical exercise in humans. PNAS. 2009;106(21):8665–70.
10. Margonis K, Fatouros IG, Jamurtas AZ, et al. Oxidative stress biomarkers responses to physical overtraining: implications for diagnosis. Free Radic Biol Med. 2007;43(6):901–10.
11. Devasagayam TPA, Tilak JC, Bollor KK, et al. Free radicals and antioxidants in human health: currant status and future prospects. J Assoc Physicians India. 2004;52:794–804.
12. Avery NG, Kaiser JL, Sharman MJ, et al. Effects of Vitamin E supplementation on recovery from repeated bouts of resistance exercise. J Strength Cond Res. 2003;17(4):801–9.
13. Shafat A, Butler P, Jensen RL, Donnelly AE. Effects of dietary supplementation with vitamins C and E on muscle function during and after eccentric contractions in humans. Eur J Appl Physiol. 2004;93(1–2):196–202.
14. Dekkers JC, van Doornen LJP, Kemper HCG. The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage. Sports Med. 1996;21(3):213–38.
15. Sousa M, Teixeira VH, Soares J. Dietary strategies to recover from exercise-induced muscle damage. Int J Food Sci Nutr. 2014;65(2):151–63.
16. Powers SK, Jackson MJ. Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production. Physiol Rev. 2008;88(4):1243–76.
17. Urso ML, Clarkson PM. Oxidative stress, exercise, and antioxidant supplementation. Toxicology. 2003;189(1–2):41–54.
18. Cobley JN, McGlory C, Morton JP, et al. N-acetylcysteine’s attenuation of fatigue after repeated bouts of intermittent exercise: practical implications for tournamant situations. Int J Sport Nutr Exerc Metab. 2011;21(6):451–61.
19. Braakhuis AJ. Effect of vitamin C supplements on physical performance. Curr Sports Med Rep. 2012;11(4):180–4.
20. Simon-Schnass I, Pabst H. Influence of vitamin E on physical performance. Int J Vitam Nutr Res. 1988;58(1):49–54.
21. Nogueira L, Ramirez-Sanchez I, Perkins GA, et al. (−)-Epicatechin enhances fatigue resistance and oxidative capacity in mouse muscle. J Physiol. 2011;589(18):4616–31. doi:10.1113/jphysiol.2011.209924.
22. Stevenson D. Polyphenols as adaptogens—the real mechanism of the antioxidant effect? In: Rasooli PI, editor. Bioactive compounds in phyto medicine. Croatia: Intech Com. Ltd; 2012.
23. Wadley GD, McConell GK. Effect of nitric oxide synthase inhibition on mitochondrial biogenesis in rat skeletal muscle. J Appl Physiol. 2007;102(1):314–20.
24. Casuso R, Martínez-Amat A, Martínez-López E, et al. Ergogenic effects of quercetin supplementation in trained rats. J Int Soc Sports Nutr. 2013;10(1):1–7.
25. Hart N, Sarga L, Csende Z, et al. Resveratrol enhances exercise training responses in rats selectively bred for high running performance. Food Chem Toxicol. 2013;61:53–9.
26. Myburgh KH. Polyphenol supplementation: benefits for exercise performance or oxidative stress? Sports Med. 2014;44(Suppl 1):57–70.
27. 2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans. J Appl Physiol. 2009;107(4):1144–55.
28. Medved I, Brown MJ, Bjorksten AR, et al. N-acetylcysteine enhances muscle cysteine and glutathione availability and attenuates fatigue during prolonged exercise in endurance-trained individuals. J Appl Physiol. 2004;97(4):1477–85.
29. Sen CK, Atalay M, Hanninenn O. Exercise-induced oxidative stress: glutathione supplementation and deficiency. J Appl Physiol. 1994;77(5):2177–87.
30. McArdle WD, Katch FI, Katch VL. Essentials of exercise physiology. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 453.
31. Bell PG, Walshe IH, Davison GW, et al. Montmorency cherries reduce the oxidative stress and inflammatory responses to repeated days high-intensity stochastic cycling. Nutrients. 2014;6(2):829–43.
32. Pinna M, Roberto S, Milia R, et al. Effect of beetroot juice supplementation on aerobic response during swimming. Nutrients. 2014;6(2):605–15.
33. Davison GW, Hughes CM, Bell RA. Exercise and mononuclear cell DNA damage: the effects of antioxidant supplementation. Int J Sport Nutr Exerc Metab. 2005;15(5):480.
34. Mastaloudis A, Traber MG, Carstensen K, et al. Antioxidants did not prevent muscle damage in response to an ultramarathon run. Med Sci Sports Exerc. 2006;38(1):72–80.
35. Nieman DC, Henson DA, Maxwell KR, et al. Effects of quercetin and EGCG on mitochondrial biogenesis and immunity. Med Sci Sports Exerc. 2009;41(7):1467–75.
36. Utter AC, Nieman DC. Quercetin does not affect rating of perceived exertion in athletes during the Western States endurance run. Res Sports Med. 2009;17:71–83.
37. Watson T, Callister R, Taylor RD, et al. Antioxidant restriction and oxidative stress in short-duration exhaustive exercise. Med Sci Sports Exerc. 2005;37(1):63–71.
38. Senturk UK, Yalcin O, Gunduz F, et al. Effect of antioxidant vitamin treatment on the time course of hematological and hemorheological alterations after an exhausting exercise episode in human subjects. Am J Physiol. 2005;98(4):1272–9.
39. Davis MJ, Murphy AE, Carmichael MD, et al. Quercetin increases brain and muscle mitochondrial biogenesis and exercise tolerance. Am J Physiol. 2009;296(4):R1071–7.
40. Liping L, Li-an Q, Yiquan W, et al. Spirulina platensis extract supplementation attenuates oxidative stress in acute exhaustive exercise: a pilot study. Int J Phys Sci. 2011;6(12):2901–6.
41. Wu R-E, Huang W-C, Liao C-C, et al. Resveratrol protects against physical fatigue and improves exercise performance in mice. Molecules. 2013;18(4):4689–702.
42. Dolinsky VW, Jones KE, Sidhu RS, et al. Improvements in skeletal muscle strength and cardiac function induced by resveratrol during exercise training contribute to enhanced exercise performance in rats. J Physiol. 2012;590(11):2783–99.
43. Murase T, Haramizu S, Ota N, et al. Suppression of the aging-associated decline in physical performance by a combination of resveratrol intake and habitual exercise in senescence-accelerated mice. Biogerontology. 2009;10(4):423–34.
44. Hopkins WG, Marshall SW, Batterham AM, et al. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3–13.
45. Carr AJ, Hopkins WG, Gore CJ. Effects of acute alkolosis and acidosis on performance. Sports Med. 2011;41(10):801–14.
46. Hoon MW, Johnson NA, Phillip GC, Burke LB. The effect of nitrate supplementation on exercise performance in healthy individuals: a systematic review and meta-analysis. Int J Sport Nutr Exerc Metab. 2013;23(5):522–32.
47. Cermak NM, Res P, Stikens R, et al. No improvement in endurance performance following a single dose of beetroot juice. Int J Sport Nutr Exerc Metab. 2012;22(6):470–8.
48. Novelli GP, Bracciotti G, Falsini S. Spin-trappers and vitamin E prolong endurance to muscle fatigue in mice. Free Radic Biol Med. 1990;8(1):9–13.
49. Romano-Ely BC, Todd MK, Saunders MJ, et al. Effect of an isocaloric carbohydrate–protein–antioxidant drink on cycling performance. Med Sci Sports Exerc. 2006;38(9):1608–16.
50. Brigelius-Flohe R, Traber MG. Vitamin E: function and metabolism. FASEB J. 1999;13(10):1145–55.
51. Yfanti C, Akerström T, Nielsen S, et al. Antioxidant supplementation does not alter endurance training adaptation. Med Sci Sports Exerc. 2010;42(7):1388–95.
52. Devi SA, Prathima S. Subramanyam MVV. Dietary vitamin E and physical exercise: I. Altered endurance capacity and plasma lipid profile in ageing rats. Exp Gerontol. 2003;38(3):285–90.
53. Snider IP, Bazzarre TL, Murdoch SD, et al. Effects of coenzyme athletic performance system as an ergogenic aid on endurance performance to exhaustion. Int J Sports Nutr. 1992;2(3):272–86.
54. Keong CC, Singh HJ, Singh R. Effects of palm vitamin E supplementation on exercise-induced oxidative stress and endurance performance in the heat. J Sports Sci Med. 2006;5(4):629–39.
55. Oostenbrug GS, Mensink RP, Hardeman MR, et al. Exercise performance, red blood cell deformability, and lipid peroxidation: effects of fish oil and vitamin E. J Appl Physiol. 1997;83(3):746–52.
56. Kang SW, Hahn S, Kim J-K, et al. Oligomerized lychee fruit extract (OLFE) and a mixture of vitamin C and vitamin E for endurance capacity in a double blind randomized controlled trial. J Clin Biochem Nutr. 2012;50(2):106.
57. Lawrence J, Bower R, Riehl W, et al. Effects of alpha-tocopherol acetate on the swimming endurance of trained swimmers. Am J Clin Nutr. 1975;28(3):205–8.
58. Teixeira VH, Valente HF, Casal SI, et al. Antioxidants do not prevent postexercise peroxidation and may delay muscle recovery. Med Sci Sports Exerc. 2009;41(9):1752–60.
59. Larcombe SD, Tregaskes CA, Coffey JS, et al. The effects of short-term antioxidant supplementation on oxidative stress and flight performance in adult budgerigars Melopsittacus undulatus. J Exp Biol. 2008;211(17):2859–64.
60. Kobayashi Y. Effect of vitamin E on aerobic work performance in man during exposure to hypoxic hypoxia [dissertation]. Albuquerque: University of New Mexico; 1974.
61. Magalhães J, Ascensão A, Marques F, et al. Effect of a high-altitude expedition to a Himalayan peak (Pumori, 7,161 m) on plasma and erythrocyte antioxidant profile. Eur J Appl Physiol. 2005;93(5–6):726–32.
62. Ilavazhagan G, Bansal A, Prasad D, et al. Effect of vitamin E supplementation on hypoxia-induced oxidative damage in male albino rats. Aviat Space Environ Med. 2001;72(10):899–903.
63. Bhagwat S, Haytowitz DB, Holden JM. USDA database for the flavonoid content of selected foods—release 3. Maryland: US Department of Agriculture; 2011. p. 1–156.
64. Kressler J, Millard-Stafford M, Warren GL. Quercetin and endurance capacity: a systematic approach and meta-analysis. Med Sci Sports Exerc. 2011;43(12):2396–404.
65. Goulet EDB, Asselin A, Lacerte G. A meta-analysis of the effect of quercetin supplementation on endurance performance and maximal oxygen consumption. Med Sci Sports Exerc. 2011;43(5):S294.
66. Pelletier DM, Lacerte GB. Effects of quercetin supplementation on endurance performance and maximal oxygen consumption: a meta-analysis. Int J Sport Nutr Exerc Metab. 2013;23(1):73–82.
67. Askari G, Ghiasvand R, Paknahad Z, et al. The effects of quercetin supplementation on body composition, exercise performance and muscle damage indices in athletes. Int J Prev Med. 2013;4(1):21–6.
68. Casuso RA, Martinez-Amat A, Martnez-Lopez EJ, et al. Ergogenic effects of quercetin supplementation in trained rats. J Int Soc Sports Nutr. 2013;10(3):1–7.
69. Daneshvar P, Hariri M, Ghiasvand R, et al. Effect of eight weeks of quercetin supplementation on exercise performance, muscle damage and body muscle in male badminton players. Int J Prev Med. 2013;4(Suppl 1):S53.
70. Darvishi L, Ghiasvand R, Hariri M, et al. Quercetin supplementation does not attenuate exercise performance and body composition in young female swimmers. Int J Prev Med. 2013;4(Suppl 1):S43–7.
71. MacRae HSE, Mefford KM. Dietary antioxidant supplementation with quercetin improves cycling time trial performance. Int J Sport Nutr Exerc Metab. 2006;16(4):405–19.
72. Cureton KJ, Tomporowski PD, Singhal A, et al. Dietary quercetin supplementation is not ergogenic in untrained men. J Appl Physiol. 2009;107(4):1095–104.
73. Nieman DC, Williams AS, Shanely RA, et al. Quercetin’s influence on exercise performance and muscle mitochondrial biogenesis. Med Sci Sports Exerc. 2010;42(2):338–45.
74. 2 max and endurance capacity. Int J Sport Nutr Exerc Metab. 2010;20(1):56–62.
75. Ganio MS, Armstrong LE, Johnson EJ, et al. Effect of quercetin supplementation on maximal oxygen uptake in men and women. Med Sci Sports Exerc. 2011;28(2):201–8.
76. Bigelman KA, Chapman DP, Freese EC, et al. Effects of six weeks of quercetin supplementation on physical performance in ROTC cadets. Mil Med. 2010;175(10):791–8.
77. Hart N, Sarga L, Csende Z, Koch LG, et al. Resveratrol attenuates exercise-induced adaptive responses in rats selectively bred for low running performance. Dose–Response. 2014;12(1):57–71.
78. Wootton-Beard PC, Moran A, Ryan L. Stability of the total antioxidant capacity and total polyphenol content of 23 commercially available vegetable juices before and after in vitro digestion measured by FRAP, DPPH, ABTS and Folin–Ciocalteu methods. Food Res Int. 2011;44(1):217–24.
79. Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose–response relationships. J Appl Physiol. 2013;115(3):325–36.
80. Lafay S, Jan C, Nardon K, et al. Grape extract improves antioxidant status and physical performance in elite male athletes. J Sports Sci Med. 2009;8(3):468–80.
81. Oh J-K, Shin Y-O, Yoon J-H, et al. Effect of supplementation with Ecklonia cava polyphenol on endurance performance of college students. Int J Sport Nutr Exerc Metab. 2010;20(1):72–9.
82. Trinity JD, Pahnke MD, Trombold JR, et al. Impact of polyphenol antioxidants on cycling performance and cardiovascular function. Nutrients. 2014;6(3):1273–92.
83. Labonté K, Couillard C, Motard-Bélanger A, et al. Acute effects of polyphenols from cranberries and grape seeds on endothelial function and performance in elite athletes. Sports. 2013;1(3):55–68.
84. Dartsch PC. Antioxidant potential of selected Spirulina platensis preparations. Phytother Res. 2008;22(5):627–33.
85. Kalafati M, Jamurtas AZ, Nikolaidis MG, et al. Ergogenic and antioxidant effects of spirulina supplementation in humans. Med Sci Sports Exerc. 2010;42(1):142–51.
86. Hsueh-Kuan L, Chin-Cheng H, Jen-Jung H, et al. Preventive effects of Spirulina platensis on skeletal muscle damage under exercise-induced oxidative stress. Eur J Appl Physiol. 2006;98(2):220–6.
87. Matuszczak Y, Farid M, Jones J, et al. Effects of N-acetylcysteine on glutathione oxidation and fatigue during handgrip exercise. Muscle Nerve. 2005;32(5):633–8.
88. Borgstrom L, Kagedal B, Paulsen O. Pharmacokinetics of N-acetylcysteine in man. Eur J Clin Pharmacol. 1986;31(2):217–22.
89. Cobley J, McGlory C, Morton J, et al. N-acetylcysteine’s attenuation of fatigue after repeated bouts of intermittent exercise: practical implications for tournament situations. Int J Sport Nutr Exerc Metab. 2011;21(6):451–61.
90. +-pump activity and delays fatigue during prolonged exercise in humans. J Physiol. 2006;576(1):279–88.
91. Corn SD, Barstow TJ. Effects of oral N-acetylcysteine on fatigue, critical power, and W′ in exercising humans. Respir Physiol Neurobiol. 2011;178(2):261–8.
92. Trewin AJ, Petersen AC, Billaut F, et al. N-acetylcysteine alters substrate metabolism during high-intensity cycle exercise in well-trained humans. Appl Physiol Nutr Metab. 2013;38(12):1217–27.
93. Holdiness MR. Clinical pharmacokinetics of N-acetylcysteine. Clin Pharmacokinet. 1991;20(2):123–34.
94. Lagouge M, Argmann C, Gerhat-Hines Z, et al. Resveratrol improves mitochondrial function and protects against metabolic disease by activating SIRT1 and PGC-1alpha. Cell. 2006;127(6):1109–22.
95. Mayers JR, Iliff BW, Swoap SJ. Resveratrol treatment in mice does not elicit the bradycardia and hypothermia associated with calorie restriction. FASEB J. 2009;23(4):1032–40.
96. Lansley KE, Winyard PG, Bailey SJ, et al. Acute dietary nitrate supplementation improves cycling time trial performance. Med Sci Sports Exerc. 2011;43(6):1125–31.
97. Wilkerson DP, Hayward GM, Bailey SJ, et al. Influence of acute dietary nitrate supplementation on 50 mile time trial performance in well-trained cyclists. Eur J Appl Physiol. 2012;112:4127–34.
98. Wylie LJ, Mohr M, Krustrup P, et al. Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. Eur J Appl Physiol. 2013;113(7):1673–84.
99. Cermak NM, Gibala MJ, van Loon LJC. Nitrate supplementation’s improvement of 10-km time-trial performance in trained cyclists. Int J Sport Nutr Exerc Metabol. 2012;22(1):64–71.
100. Hoon MW, Jones AM, Johnson NA, et al. The effect of variable doses of inorganic nitrate-rich beetroot juice on simulated 2,000 m rowing performance in trained athletes. Int J Sports Physiol Perform. 2014;9(4):615–20.
101. Hoon MW, Hopkins WG, Jones AM, et al. Nitrate supplementation and high-intensity performance in competitive cyclists. Appl Physiol Nutr Metab. 2014;39(9):1043–9.
102. Boorsma RK, Whitfield J, Spriet LL. Beetroot juice supplementation does not improve performance in elite 1500-m runners. Med Sci Sports Exerc. 2014. doi:10.1249/MSS.0000000000000364.
103. Glaister M, Pattison JR, Muniz-Pumares D, et al. Effects of dietary nitrate, caffeine, and their combination on 20 km cycling time-trial performance. J Strength Cond Res. 2014;46(12):2326–34.
104. Martin K, Smee D, Thompson KG, et al. Dietary nitrate does not improve repeated sprint performance. Int J Sports Physiol Perform. 2014. doi:10.1123/ijspp.2013-0384.
105. Sheets AJ, Snyder BS. Effects of acute dietary nitrate consumption on running performance in ‘real-world’ environment. Int J Exerc Sci Conf Proc. 2014. (p. Article 20).
106. Bailey SJ, Fulford J, Vanhatalo A, et al. Dietary nitrate supplementation enhances muscle contractile efficiency during knee-extensor exercise in humans. J Appl Physiol. 2010;109(1):135–48.
107. Masschelein E, Van Thienen R, Wang X, et al. Dietary nitrate improves muscle but not cerebral oxygenation status during exercise in hypoxia. J Appl Physiol. 2012;13(5):736–45.
108. Murphy M, Eliot K, Heuertz RM, et al. Whole beetroot consumption acutely improves running performance. J Acad Nutr Diet. 2012;112(4):548–52.
109. Vanhatalo A, Bailey SJ, Blackwell JR, et al. Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. Am J Physiol. 2010;299(4):R1121–31.
110. Bond H, Morton L, Braakhuis AJ. Dietary nitrate supplementation improves rowing performance in well-trained rowers. Int J Sport Nutr Exerc Metab. 2012;22(4):251–6.
111. Muggeridge DJ, Howe CCF, Spendiff O, et al. The effects of a single dose of concentrated beetroot juice on performance in trained flatwater kayakers. Int J Sport Nutr Exerc Metab. 2013;23(5):498–506.
112. Sadowska-Krepa E, Klapcinska B, Kimsa E, et al. Effects of supplementation with red grape skin polyphenolic extract and interval swimming test on the bllod antioxidant status in healthy men. Med Sport. 2008;12(1):1–7.
113. Eichenberger P, Mettler S, Arnold M, et al. No effects of three-week consumption of a green tea extract on time trial performance in endurance-trained men. Int J Vitam Nutr Res. 2010;80(1):54–64.
114. Skarpanska-Stejnborn A, Basta P, Pilaczynska-Szczesniak L. The influence of supplementation with the blackcurrant (Ribes nigrum) extract on selected prooxidative balance parameters in rowers. Stud Phys Cult Tour. 2006;13(2):51–8.
115. Braakhuis AJ, Hopkins WG, Lowe TE. Effects of dietary antioxidants on training and performance in female runners. Euro J Sport Sci. 2013;14(2):1–9.
116. Dean S, Braakhuis AJ, Paton C. The effects of EGCG on fat oxidation and endurance performance in male cyclists. Int J Sport Nutr Exerc Metab. 2009;19(6):624–44.
117. Sandhu J, Shenoy S. Efficacy of spirulina supplementation on isometric strength and isometric endurance of quadriceps in trained and untrained individuals—a comparative study. Ibnosina J Med Biomed Sci. 2009;2(2):79–83.
118. Matsumoto H, Takenami E, Iwasaki-Kurashige K, et al. Effects of blackcurrant anthocyanin intake on peripheral muscle circulation during typing work in humans. Eur J Appl Physiol. 2005;94(1):36–45.
119. 2 uptake kinetics and exercise tolerance in humans. Respir Physiol Neurobiol. 2011;175(1):121–9.
120. Reid MB, Stokić DS, Koch SM, et al. N-acetylcysteine inhibits muscle fatigue in humans. J Clin Invest. 1994;94(6):2468–74.
121. Medved I, Brown MJ, Bjorksten AR, et al. N-acetylcysteine infusion alters blood redox status but not time to fatigue during intense exercise in humans. J Appl Physiol. 2003;94(4):1572–82.