Abstract
BACKGROUND: Pomegranate supplementation has been shown to reduce oxidative stress and inflammation, with some evidence suggesting it may accelerate recovery from exercise-induced muscle damage (EIMD), including metabolic, mechanical, and neuromuscular recovery. OBJECTIVES: This systematic review and meta-analysis aimed to investigate the effects of pomegranate supplementation on markers of EIMD. METHODS: A systematic search of Scopus, PubMed, and Web of Science up to January 2024 identified studies evaluating pomegranate supplementation and exercise recovery. Studies involving athletes and nonathletes aged 18-55 were included. Weighted mean differences (WMDs) were calculated for EIMD markers. Study quality was assessed using a modified physiotherapy evidence database scale. This review was registered with the International Prospective Register of Systematic Reviews (ID: CRD42024536905). RESULTS: Ten studies were included in the meta-analysis. Pomegranate supplementation did not significantly affect markers of metabolic recovery, including myoglobin (WMD: -1.344 ng/mL; 95% confidence interval (CI): -4.11, 1.42 ng/mL, P = 0.342) and creatine kinase (WMD: -11.990 U/L; 95% CI: -28.64, 4.66 U/L, P = 0.158), or neuromuscular recovery, as indicated by lactate concentrations (WMD: -0.093 mmol/L; 95% CI: -0.39, 0.21 mmol/L, P = 0.546). Muscle soreness also remained unchanged (WMD: 0.999; 95% CI: -0.18, 2.17, P = 0.097). However, a significant reduction in lactate dehydrogenase amounts (WMD: -21.152 U/L; 95% CI: -39.29, -3.01 U/L, P = 0.022) immediately postexercise suggests a short-term protective effect against mechanical muscle damage. CONCLUSIONS: Pomegranate supplementation does not appear to enhance overall recovery markers for EIMD but may offer short-term benefits for mechanical muscle damage. Standardizing supplementation regimens, dosages, and exercise protocols is crucial to better understand the potential benefits of pomegranate supplementation in EIMD recovery.