Pycnogenol? for Sport Performances: eNOS and Beyond

Engaging in physical activities immediately triggers a number of physiological responses from our body (1). Blood sugar increases, fat burning in the adipose tissue is accelerated and sweating starts. While our central nervous system is stimulated, it releases hormones to regulate our brain’s blood and oxygen supplies. Our heart rate, blood flow and breathing rapidly accelerate too and to do so, the cardio-pulmonary system adjusts to allow more nutrients, energy and oxygen to muscle tissues, and avoid anaerobic build-up of lactic acid. Sufficient muscle oxygenation is facilitated by relaxed blood vessels and improved blood flow, which warrants aerobic energy generation. This increase in oxygen supply translates to acute oxidative stress due to higher production of free radicals in blood and muscles (2).

As a well-established and potent antioxidant, Pycnogenol? French maritime pine bark extract was shown to reduce oxidative stress levels that are increased during work-out (3,4). In addition, Pycnogenol? is described to stimulate the enzyme “endothelial nitric oxide synthase” (eNOS), which generates nitric oxide (NO) (5). NO normalizes blood pressure as well as blood platelet aggregability and contributes to improved blood flow by relaxing blood vessels. Another beneficial property of Pycnogenol? in the context of increased performance is the improved tissue perfusion by enhancement of microcirculation (6,7).

With these underlaying mechanisms, Pycnogenol? offers several natural and healthy ways to enhance sport endurance (3,4,8) and improve post-exercise recovery (9) not only in professional athletes but also in recreational sports people. Additionally, it was shown that Pycnogenol? can relieve joint discomfort (10-13) - a common side effect during or after certain physical activities – by exerting anti-inflammatory properties and by increasing the synthesis of collagen and hyaluronic acid (14-19).

Improved performance, endurance and post-exercise oxidative stress level

A double-blind crossover placebo-controlled study found that the endurance time of a group of recreational athletes was significantly increased after Pycnogenol? supplementation (8). For the measurements, the subjects performed on a treadmill with individual setting adjusted to 85% of a person’s maximal oxygen consumption, wearing headgear for respiratory tests. The 20 to 35 years old participants received 200 mg Pycnogenol? per day for 30 days. The endurance was evaluated by measuring the running time in seconds on the treadmill after 30 and after 60 days. The performance time of the Pycnogenol? group increased by 21 % compared to baseline and by 13% compared to placebo.

In another study, Pycnogenol? showed beneficial effects on physical fitness and oxidative stress levels during training and performance in untrained subjects and athletes (3). The efficacy of Pycnogenol? on the performance of 74 healthy subjects was assessed by the Army Physical Fitness Test (APFT). The test evaluated the subject’s performance based on their results in 3 events consisting of push-ups, sit-ups, and a 2-mile run. Pycnogenol? intake for 8 weeks significantly improved performance compared to a control group of 73 healthy subjects. The time to run 2 miles was decreased by 11% and the number of sit-ups and push-ups was increased by 23% and 12%, respectively. The improvement was significantly better compared to the control group. In addition, Pycnogenol? supplementation significantly reduced oxidative stress in the blood by 5.1% in men and 8.3% in women, compared to baseline. In the control subjects though, oxidative stress increased by 11.1% (men) and 7.2% (women).

Pycnogenol?’s antioxidant properties were once more shown in a double-blind, placebo-controlled cross-over study with 20 healthy male subjects (4). The participants were supplemented with a single dose of 200 mg Pycnogenol? per day for 2 weeks prior to an exercise trial. Before and one hour after the exercise test, a blood sample was taken to examine and compare the oxidative stress levels and other parameters of the subjects. 48 hours after the exercise, the oxidative stress, measured as MDA (malonaldehyde) was strongly reduced by 7.3% compared to the pre-exercise values. These changes were statistically significant compared to placebo, where the values were enhanced by 28.5%. These results confirm again the strong antioxidant properties of Pycnogenol? and its protection against the high post-exercise oxidative stress. Many more studies have shown that Pycnogenol? has potent antioxidant efficacy on lipids, DNA and proteins within the body and that it increases blood antioxidant capacity (20-27).

In the second part of the previous study, Pycnogenol? intake for 4 weeks improved the performance of 54 triathletes by reducing the overall triathlon time by 10.6% (3). The post-exercise levels of oxidative stress measured as plasma free radicals in the blood within 1 hour after the end of the triathlon were reduced by 26.7% in the Pycnogenol? group. This improvement of oxidative stress was statistically significant compared to controls and baseline levels. Additionally, the athletes reported 39.5% less post-training pain and 56.7% less cramps after supplementation with Pycnogenol?.

Improved recovery after exercise

The effect of 200 mg Pycnogenol? supplementation per day on cramps and muscular pain after training was examined in another study with healthy subjects for 4 weeks (9). 22 of the 45 subjects suffered from frequent muscle cramps and 23 were athletes with recurrent cramps during training or performance. The number of recorded cramp attacks in normal subjects was significantly reduced from an average of 4.8 events per week to 1.3 times at the end of the study. In athletes, the reduction of cramp events was even more important with a frequency of 8.6 times per week before supplementing Pycnogenol? to 2.4 at the end of the study. Additionally, the pain score of the cramps was reduced by 76% and 87%, respectively in healthy, untrained subjects and athletes, compared to the pain rated at the beginning of the study. The authors concluded that Pycnogenol? helps to reduce cramps, muscular pain at rest, and pain after and during exercise in normal subjects and in athletes prone to cramps.

Beneficial effects on joint function

Joint discomfort during or after sports can be very disturbing. Pycnogenol? can relieve joint discomfort by exerting its anti-inflammatory properties directly in the liquid surrounding the joints (14-18). Additionally, Pycnogenol? shows abilities to increase the synthesis of collagen and hyaluronic acid, important components of articular cartilage, the shock absorber of the joint (19).

Pycnogenol? has been shown to act beneficially in patients presenting with joint problems (10-13). In a study with 55 patients suffering from osteoarthritis, a joint cartilage damaging condition, the level of an inflammatory marker was significantly decreased by 72% and the oxidative stress levels were decreased by 30% (10). These results confirm previous findings that regular intake of Pycnogenol? leads to a potent decrease of pro-inflammatory markers like NF-κB and COX-enzymes, as well as a decline in matrix metallopeptidases (MMP) enzymes, that are responsible for destroying cartilage in joints (14-18).

A pilot randomized, double-blind and placebo-controlled study with 37 patients with joint cartilage damage showed that Pycnogenol? intake for 3 months led to improved joint discomfort, with a significant reduction of 43% in self-reported discomfort, 35% in stiffness and 52% in physical function compared to placebo controls (11).

In another double-blind, placebo controlled, randomized study, 100 patients with mild to moderate osteoarthritis in the knee were supplemented with 150 mg Pycnogenol? per day for 3 months (12). The results of this study confirmed the previous findings of decreased discomfort (by 21.4%), reduction of stiffness in the knee (by 20%) and improved ability to perform daily activities (by 19.6%), in comparison with placebo-controlled subjects.

In most cases, joint pain is due to damage to the articular cartilage. Hyaluronic acid contributes to the resistance to compression in cartilage. A clinical study with 20 healthy volunteers demonstrated that Pycnogenol? intake for 4 weeks increased gene expression of hyaluronic acid synthase, an enzyme critically involved in the synthesis of hyaluronic acid by 44% (19). In addition, the study revealed a noticeable increase in gene expression involved in collagen de novo synthesis. These results are backed up by the finding of a strong increase of the concentration of Pycnogenol?’s metabolites in the synovial fluid, surrounding articular cartilage in the joints in osteoarthritis patients (18,28). In this way, the active ingredients of Pycnogenol? act directly where they are needed and exert their anti-inflammatory effects. This comprehensively explains how Pycnogenol? contributes to restoring health in the damaged joint.

Enhanced endothelial function by induction of NO generation

It has been shown that physical activity is associated with sustained increases in endothelial nitric oxide (NO) production capacity (29). In the endothelium, NO contributes to optimal blood flow by relaxing the walls of the blood vessels and thus playing a key role for coordinating vascular response to exercise (5).

In a double-blind, placebo-controlled study with 16 healthy volunteers, the effect of Pycnogenol? on endothelium dependent vasodilatation by measuring forearm blood flow in response to increasing doses of acetylcholine was investigated (5). After 2 weeks of supplementation with Pycnogenol?, the ability to generate NO in response to increasing doses of acetylcholine was increased by up to 46% compared to baseline. The effect was significant compared to the placebo subjects. Furthermore, the enhanced NO synthesis facilitated by Pycnogenol? was shown to control blood platelet aggregability which help to keep blood viscosity within a healthy physiological range (30).

In patients with coronary artery disease, the effect of Pycnogenol? on endothelial function was investigated by measuring “flow-mediated dilation” in the upper arm artery (20). For this method, the expansion of the artery in response to an increase in the shear stress associated with blood flow is measured. An 8-week randomized, placebo-controlled, crossover, double-blind study showed an improvement in flow-mediated dilation by 32% in the Pycnogenol? group, while it deteriorated slightly in the placebo patients.

In several other clinical studies, Pycnogenol? was shown to improve endothelial function, thus relieving capillary constriction, owed to enhanced generation of vasodilating nitric oxide (20,31-34). It was furthermore shown that the metabolites - molecules that are produced during digestion of Pycnogenol? - are taken up directly by endothelial cells and thus can be effective directly where they are needed (35,36). The results of these investigations show a beneficial effect of Pycnogenol? on blood flow and tissue perfusion in healthy individuals.

Improved blood microcirculation

Several clinical studies have shown that Pycnogenol? improves blood microcirculation and tissue perfusion (6,7). Application of specific sensors to the skin of the legs demonstrated increased oxygen (O2) levels by 19.6% and decreased carbon dioxide (CO2) levels by 9.4% after supplementation of Pycnogenol? for 6 weeks (6). This finding suggests that Pycnogenol? improves tissue perfusion and thus supports lasting aerobic muscle activity during physical exercise. In a randomized, double-blinded, placebo-controlled study, the microcirculation in the fingernails of 60 patients with coronary artery disease was determined by measuring the diameter of micro vessels (7). In 53.8% of the patients supplemented with Pycnogenol?, the microcirculation was improved, compared to only 34% in patients with placebo treatment. This shows that Pycnogenol? supplementation strengthens the microcirculatory perfusion system and contributes to an ameliorated blood flow and improved oxygenation of muscles.

Learn more...

Pycnogenol? French maritime pine bark extract is a safe, natural and evidence-based solution for sports, which offers multiple benefits for both professional athletes and sports enthusiasts, including reduced post-workout cramps, muscle and joint soreness, boosted endurance and performance, and improved blood flow and oxidative stress levels.

For more information, please visit www.pycnogenol.com

Article written by Dr. Franziska Weichmann , Manager of Scientific Communications and Product Development at Horphag Research

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