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Abstract

Concurrently with an exploding interest in the health benefits of a plant-based eating pattern is similar interest in how this pattern could affect athletic performance. In this state-of-the-art review we summarize the current best research on plant-based nutrition and supplements for athletic performance, emphasizing systematic reviews, randomized trials, and comparative studies. A plant-based eating pattern (little or no animal products) is non-inferior to an omnivore diet (no restrictions on meat, dairy, or other animal products) for athletic performance and for muscle protein synthesis when macronutrient content is similar. When sufficient total protein is consumed, plant-based sources are non-inferior to animal-based sources. Most athletes ideally need 1.2 to 2.0 grams/kg of body weight/day of protein, preferably split across 3-4 meals to optimize muscle protein synthesis and recovery. Supplements can offer small added benefits, with the strongest evidence for improved performance from caffeine, creatine, protein, and essential amino acids, and the strongest evidence for improved recovery from polyphenols, vitamin E, omega-3 fatty acids. We also discuss plant protein sources, special considerations for masters athletes, and other evidence-based supplements. Our goals are to highlight core principles of plant-based nutrition and supplements while also offering pragmatic advice for athletes of all ages and abilities.

Keywords

plant-based nutrition muscle protein synthesis lifestyle medicine ergogenic supplements athletic performance

“Dietary protein supplementation plus physical activity are the best ways to slow decline in muscle mass and strength.”

Introduction

Plant-based diets are increasingly recognized for their ability to enhance longevity, improve overall health, and reduce the prevalence of chronic disease. Over the past 2 decades, for example, “plant-based diet” has risen 5-fold as a search term on Google trends¹ and nearly 7-fold as a query in PubMed.² Similarly, plant-based food sales in the United States have grown from $3.9 billion in 2017 to $8.1 billion in 2023, driven by products mimicking the taste, texture, and functionality of conventional animal foods.³ There is a growing cadre of films and documentaries that advocate for plant-based diets, including Forks over Knives (2011), PlantPure Nation (2015), Eating You Alive (2016), What the Health (2017), and You are What you Eat: A Twin Experiment (2024).

Concurrently with a rise in general interest for plant-based diets there has been a tendency for elite athletes to embrace a vegan or whole-food plant-based (WFPB) eating pattern as part of a healthy lifestyle that may also enhance performance and recovery. Examples include Lewis Hamilton (Formula 1 racing), Scott Jurek (ultrarunning), Tia Blanco (surfing), Dotsie Bausch (speed cycling), Alex Morgan (soccer), Novak Djokovic (tennis), Hannah Teter (snowboarding), Morgan Mitchell (sprinting), Patrik Bouboumian (powerlifting), and Venus Williams (tennis).⁴ Films and documentaries exploring plant-based diets and athletic performance include From the Ground Up (2017), Running for Good (2018), and The Game Changers (2018). Books and articles have also addressed plant-based diets as alternatives to omnivorous diets for optimal athletic performance.^5-9

This state-of-the-art review offers a pragmatic, evidence-based approach, to plant-based nutrition and supplements to optimize athletic performance. Our intent is not to suggest that plant-based nutrition is essential for optimal performance, but rather to help athletes who choose to pursue a plant-based eating pattern be their best. We emphasize systematic reviews—which have increased dramatically over the past 5 years—recent randomized controlled trials (RCTs), and other comparative studies that may not have been included in published reviews. The material is relevant to adults of all athletic abilities and ages, with additional comments for masters athletes (aged 35 to 40 years or older). This discussion will not include nutrition strategies for specific activity types, as these occur under different physiological parameters that require unique dietary approaches, nor will we discuss using simple carbohydrates (e.g., energy gels, sports drinks) to enhance race-day performance.

Plant-Based Eating Patterns

Despite the rising interest in plant-based and vegetarian eating patterns, there is tremendous variability in how these terms are defined in the medical and nutritional literature.¹⁰ Therefore, it helps to define these terms clearly (Table 1) when considering not just their implications for health, in general, but more specifically for athletic endurance and recovery. Most research studies use a simple dietary dichotomy of plant-based (vegan, vegetarian) vs animal-based (omnivore, Western, standard American diet), but this fails to account for the potential variability in food quality in either pattern, especially with regards to ultra-processed foods (UPFs).

Table 1.

Definitions of Dietary (Eating) Patterns.^a

Term	Definition
Omnivore diet	A wide range of eating styles, without specific restrictions, which includes animal products (meat, diary, and eggs) and plant-based foods; humans are omnivores because they can digest and use animal and plant foods
Ultra-processed foods (UPFs)	Foods that are energy-dense and high in salt, additives, unhealthy fats, refined starches, and free sugars; UPFs are formulated to be attractive and to trigger the brain’s reward system and encourage excess eating, and they are often poor sources of protein, fiber, and micronutrients
Standard American diet (SAD)	Also called the Western diet, this omnivore eating pattern includes high sodium intake and excess calories from meats, added fats, processed foods, UPFs, and refined carbohydrates; the SAD typically lacks many nutrients found in fruits, vegetables, and whole grains
Plant-based (plant-predominant) diet	A dietary pattern in which foods of animal origin are totally or mostly excluded; can include flexitarian and vegetarian diets, depending on the amount of animal foods consumed
Vegetarian diet	A dietary pattern that excludes meat, meat-derived foods, and, to different extents, other animal products; variations include ovolactovegetarian (allows eggs and dairy) and semi-vegetarian (pescetarian allows fish, pollovegetarian allows chicken)
Vegan diet (strict vegetarian diet)	A dietary pattern that excludes all meat and animal products but can have varying qualities of plant foods, ranging from unhealthy UPFs or highly refined foods (including junk foods and sugar-sweetened beverages) to healthy whole-foods or minimally refined foods
Whole-food plant-based (WFPB) diet	A plant-based diet composed primarily of whole grains, vegetables, legumes, fruits, nuts, and seeds while avoiding or minimizing animal foods, refined foods, and ultra-processed foods; also referred to as a whole-food plant-predominant, or plant-forward, diet

^aIn the broadest terms, the eating patterns contrasted in this review are the omnivore diet, which includes the SAD and is often high in UPFs, and a plant-based eating pattern, which includes vegan, vegetarian, and whole-food plant-based diets., Definitions adapted from Hargreaves et al¹⁰.

UPFs can negatively impact the nutritional quality of any diet because they increase free sugars, total fats, and saturated fats, while reducing fiber, protein, vitamins and minerals.¹¹ This reduced quality is associated with increased risk of obesity, all-cause mortality, cardiovascular disease, type 2 diabetes, depressive symptoms, multiple sclerosis, Parkinson’s disease, and cognitive impairment.^12-14 To account for diet quality, investigators are increasingly using food indices to classify plant-based diets healthful or unhealthful, based largely on the amount of UPFs and meat. Using this approach, diets with a higher healthful plant index have lower mortality and chronic disease compared to an unhealthful pattern or a generic index.¹⁵

Some UPFs with simple sugars and carbohydrates can improve performance during athletic events with unique physiological conditions (e.g., long-distance running), but their adverse nutrition consequences on health overall limit their utility outside of specific physical activities. A survey of Australian recreational and professional athletes found that 95% consumed ultra-processed sports foods in the past 12 months, most often sports drinks and isolated protein supplements.¹⁶ Many enjoyed the convenience and performance benefits of these foods, but over half had some concern regarding their health impact. When athletes do consume ultra-processed sports foods, it is best to choose foods that limit artificial sweeteners, refined starches, unhealthy fats, and preservatives.

Although this review focuses on athletic performance, the benefits of a plant-based eating pattern on overall health also warrant emphasis. There is robust evidence from systematic reviews supporting associations of plant-based dietary patterns with reduced risk of stroke, coronary heart disease, cardiovascular disease, cognitive dysfunction, type 2 diabetes, cancer mortality, and all-cause mortality.^17-19 Additional benefits include a lower risk of chronic kidney disease, colorectal cancer, and reduced incidence of COVID-19 infection and severe episodes.^20-22 Substituting plant-based foods for animal-based foods (especially red or processed meat) is also associated with improved cardiometabolic health and reduced all-cause mortality and cardiovascular disease mortality.^23,24

A key concept for plant-based eating is that health can be influenced more by what you don’t eat than by what you do eat, with higher deaths for diets that are low in whole grains, fruits, nuts/seeds, vegetables, fiber, and legumes.²⁵ One exception is high sodium, a leading global cause of dietary mortality, but sugar, red meat, and processed meat have much smaller impacts on mortality and cardiovascular health.²⁵ These findings highlight the importance of “foods to eat in abundance” (Table 2) while moderating intake of plant-foods with a high caloric density and minimizing or avoiding UPFs, meat, and other animal products. Similar concepts are embodied in the vogue phrase “clean, anti-inflammatory diet,” but this designation is vague and may promote restrictive eating.¹⁰

Table 2.

Plant-Predominant Eating Pattern for Overall Health.

Food category	Food examples	Rationale	Comments
Foods to eat in abundance	Fruits, vegetables (raw, cooked, or frozen), whole grains, legumes,^a nuts, and seeds	Consistently anti-inflammatory foods that lower oxidative stress and are high in fiber, macronutrients, and micronutrients	Plant-forward eating patterns with whole or minimally processed foods are optimal for health but should be supplemented with vitamin B12 and omega-3 fatty acids (from algae)
Foods to eat in moderation	Oil (olive oil and seed oils), avocados, nut butter, seed butter, and dried fruits	Have high caloric density, mainly from fats or starches, which could lead to unwanted weight gain if portions are not monitored	Olive oil is a cornerstone of the Mediterranean diet; seed oils high in linoleic acid (soybean, sunflower, safflower, and corn oil) have lower all-cause and cardiovascular mortality
Foods that are discouraged	Refined carbohydrates,^c eggs, dairy, packaged baked goods, savory snacks, convenience foods, alcohol sugars,^b fried plant-foods, and plant-based meat or cheese alternatives^d	Pro-inflammatory foods that may impair body healing and recovery; vegan meat and cheese substitutes are ultra-processed with minimal fiber or nutritional value	Eggs and dairy often have a neutral health impact in studies, but have no fiber and may be high in fat; swapping plant-based oils for butter can reduce all-cause, cancer, and cardiovascular mortality; refined carbohydrates and baked goods produce glycemic spikes and eventual insulin resistance
Exceptions for athletic training and competition	Simple carbohydrates, including energy gels, sugar-sweetened beverages, and sports beverages	Regular fueling with simple carbohydrates can enhance performance, especially during activity over 60 minutes	Many gels and beverages are available, often with added salt and electrolytes; use of these products is beyond the scope of this review

DASH, Dietary Approaches to Stop Hypertension.

^aLegumes include chickpeas, soybeans (edamame, tofu, tempeh), peanuts (technically a legume, not a nut), and diverse varieties of peas (green, snow, sugar snap, or split), lentils (brown, green, red, yellow, black), and beans (black, kidney, pinto, navy, cannellini, adzuki, fava, and mung).

^bAlcohol sugars (xylitol, erythritol, mannitol, and sorbitol) are low calorie and have a low glycemic impact, but are processed sweeteners that may cause gas, bloating, and diarrhea; they are often found in “healthy” protein bars and cereals.

^cRefined carbohydrates include white flour, white rice, regular past, crackers, bagels and pizza crust (if not 100% whole wheat).

^dAn ever-growing scope of plant-based meat (beef, bacon, seafood, chicken, fish) and cheese alternatives is being heavily marketed to consumers, but these are typically unhealthy low-fiber, ultra-processed foods with a lengthy list of ingredients that includes sugars, oils, emulsifiers, preservatives, and flavorings.

Plant-Based Eating Patterns as an Alternative to Omnivore Diets for Athletic Performance

Table 3 summarizes the study characteristics and outcomes for systematic reviews and recent comparative studies of plant-based vs omnivore eating patterns for athletic performance. Included are 5 systematic reviews,^{27,29,30,32,37} 4 crossover trials,^26,33,34,38 and 6 cross-sectional studies.²⁸ Although the types of eating patterns vary among studies, we consider “plant-based” patterns as those centering meals around plant-based foods, minimizing the role of animal products, and “omnivore” patterns as those giving equal weight to plant and animal foods, or emphasizing animal products as the central components of meals. The study by Fisher³¹ from 1908 is included to show the long-standing relevance and interest in this topic.

Table 3.

Systematic Reviews and Recent Comparative Studies, Plant-Based vs Omnivore Eating Patterns for Athletic Performance.

Study characteristics			Outcomes
Author year	Design	Population	Plant-based^a superior	Eating patterns equivalent	Omnivore^b superior
Baker 2019²⁶	Randomized crossover trial of Mediterranean diet 4 days vs typical Western diet 4 days	11 recreationally active adults	5-km run (6% faster)	Wingate cycle test, vertical jump, hand grip	None
Bianchi 2024²⁷	SR of 7 RCTs and comparative studies of Mediterranean diet vs omnivore diet	Professional and recreational athletes	Muscle power, strength, endurance; vertical jump, hand grip, shuttle run; oxidative stress and inflammation	Fat-free muscle mass, skeletal muscle mass	None
Boutros 2020²⁸	CSS comparing self-identified vegan vs omnivore diet for at least 2 years	56 women with 150-200 minutes aerobic activity weekly	VO₂ max (7% higher), submaximal endurance, time to exhaustion (39% higher)	BMI, body fat, lean body mass, muscle strength	None
Craddock 2016²⁹	SR 7 RCTs and 1 CSS of plant-based diet vs omnivore diet	Adults with varying activity levels	None	Resistance training; anaerobic or aerobic performance, immune function	None
Damasceno 2024³⁰	SR 10 RCTs, vegetarian diet vs omnivore diet	Athletes and adults (active and sedentary)	Aerobic performance (SMD 0.55), lower BMI (SMD -0.27)	Strength, power, and overall performance	None
Fisher 1908³¹	CSS of high-protein omnivore athletes vs low-protein vegetarian athletes and sedentary	49 male college students and other adults	Arm holding, deep knee bending	Leg raising	None
Hernández-Lougedo 2023³²	SR 6 RCTs or comparative studies of vegetarian diet vs omnivore diet	Physically active adults	None	VO₂ max, muscle power, sprint test, body composition	None
Isenmann 2023³³	Sequential crossover, 8 weeks omnivore diet then 8 weeks vegan diet	10 strength-trained adults on an omnivore diet	None	Leg press, bench press	None
Ishiwata 2024³⁴	Randomized crossover, pre-exercise plant- vs animal-based meal	11 healthy adult men	VO₂ max, brachial artery dilation, carotid-femoral pulse wave velocity	Femoral-ankle pulse wave velocity	None
Lynch 2016³⁵	CSS of vegetarians vs omnivores after 7-day monitoring	60 endurance runners, cyclists, triathletes	VO₂ max in females (13% higher)	VO₂ max in males, peak torque	None
Nebl 2019³⁶	CSS of vegans vs lacto-ovo vegetarians vs omnivores	76 adult recreational runners	None	Maximal power output, maximum lactate during exercise	None
Presti 2024³⁷	SR 8 RCTs and controlled studies of plant-based diet vs omnivore diet	Healthy adults <45 years	None	Aerobic capacity, power, endurance, fatigue, body composition	None
Roberts 2022³⁸	Randomized crossover, 8 weeks plant-based vs animal meat as part of healthy eating pattern	Recreational runners, resistance trainers	None	Timed 12-minute run, composite machine strength	None
Vasenina 2025³⁹	CSS study of vegan vs omnivore diet	20 athletes after downhill running	None	Recovery and muscle function for 72 hours	None
Wirnitzer 2018	CSS of self-identified vegetarian, vegan, or omnivore diet	245 recreational runners	None	Mental health, supplement intake, healthcare utilization	None

^aPlant-based diet: A dietary pattern in which foods of animal origin are totally or mostly excluded; can include flexitarian and vegetarian diets, depending on the amount of animal foods consumed (Table 1).

^bOmnivore diet: A wide range of eating styles, without specific restrictions, which emphasizes animal products (meat, diary, and eggs) but includes some plant-based foods (Table 1).

BMI, body mass index; CSS, cross-sectional study; RCT, randomized controlled trial; SMD, standardized mean difference (effect size); SR, systematic review, VO₂ max, maximal oxygen uptake.

These studies (Table 3) suggest that plant-based eating patterns are non-inferior to omnivore diets for overall athletic performance, with superior results for the plant-based groups in some studies for endurance, aerobic performance, oxidative stress, and VO₂ maximal oxygen uptake.^{26-28,30,31,34,35} None of the studies favored the omnivore diet. The diverse study designs, populations, and outcomes increase the generalizability of findings, but do introduce heterogeneity leading to a limited conclusion that plant-based eating patterns are non-inferior to omnivore diets when considering athletic performance. Moreover, these studies may potentially underestimate the benefits of a whole-food plant-based eating pattern because they did not consider the quality of the foods included (Table 2) as part of the study design or analysis.

Another limitation of these studies is that they only address physical performance and not other benefits of plant-based diets. For example, after reviewing 141 studies on dietary patterns and all-cause mortality, the U.S. Department of Agriculture found the best outcomes for diets with a high plant-based index, especially vegetables, legumes, fruit, nuts, and whole grains.⁴⁰ When meat was included, eating less red meat and processed meat was protective. Similarly, the odds of healthy aging—living to 70 years of age free of chronic diseases—increase with higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes and low-fat dairy products, whereas the odds are reduced by higher intakes of sodium, meat, or sugary beverages.⁴¹ Of relevance to athletes is the lower oxidative stress and systemic inflammation associated with plant-based diets, whereas diets high in UPFs or meat have elevated pro-inflammatory biomarkers.^42,43 Plant-based diets are also high in micronutrients that may enhance performance and facilitate athletic recovery.⁴⁴

A criticism of some plant-based diets is the high carbohydrate content (70-80%), but there is no consistent relationship of carbohydrate quantity to endurance or strength training outcomes.^45,46 Despite claims that a low-carbohydrate high-fat (ketogenic, paleo) diet could enhance aerobic capacity and muscle utilization of fats, comparative studies of endurance athletes show no impact of this eating pattern on aerobic capacity or exercise performance.⁴⁷ Carbohydrate quality is more important than quantity, with whole grains and fiber-rich foods offering the greatest health benefits.⁴⁸ An exception to complex carbohydrates would be for an energy boost during endurance sports from simple sugars,⁸ such as energy gels, bars, chews or quickly digested complex carbs from figs, dates, or pressed fruit bars.

Plant Protein as an Alternative to Animal Protein for Athletic Performance

Table 4 summarizes the study characteristics and outcomes for systematic reviews and recent comparative studies of plant vs animal protein for athletic performance. Included are 5 systematic reviews,^{51,52,54,59,60} 5 RCTs,^53,55-58 and 1 crossover trial⁵⁰ and 1 cohort study.⁴⁹ These studies suggest that plant protein is equivalent, or non-inferior, to animal protein for overall athletic performance when the total amount of protein consumed is similar. A few studies^51,58-60 reported better results with animal protein for some outcomes, but the one study⁶⁰ with performance-related outcomes found trivial effect sizes (standardized mean difference of 0.12 for change in athletic performance and 0.11 for change in strength). One systematic review of 19 RCTs found better results for plant protein regarding endurance performance, muscle damage, and exercise-induced metabolic blood circulating biomarkers.⁵⁹

Table 4.

Systematic Reviews and Recent Comparative Studies, Plant vs Animal Protein for Athletic Performance.

Study characteristics			Outcomes
Author year	Design	Population	Plant superior	Protein sources equivalent	Animal superior
Hevia-Larraín 2021⁴⁹	Cohort comparing habitual vegans vs omnivores, plus soy or whey protein to reach 1.6 g/kg/d in 12 weeks of supervised resistance training	19 young men	None	Leg lean mass, rectus femoris and vastus lateralis cross-sectional area, vastus lateral muscle fiber type 1 and type 2, or leg press	None
Kritikos 2021⁵⁰	Randomized crossover trial of soy vs whey protein supplements 7 days	10 well-trained male soccer players	None	Delayed onset muscle soreness, creatine kinase, and other inflammatory markers	None
Lim 2021⁵¹	SR 16 RCT or randomized crossover studies of plant vs animal protein (food or supplement)	Trained and untrained adults, with or without other conditions	None	Muscle strength	Lean mass in adults <50 years (0.4 kg higher)
Lonnie 2020⁵²	SR 26 RCTs or randomized crossover studies of plant protein (isolate, concentrate, or hydrolysate) vs other protein or placebo	Adults with no restrictions on gender or health status	None	Muscle strength, appetite, glycemic outcomes, cardiovascular outcomes	None
Lynch 2020⁵³	RCT of soy vs whey protein, matched for leucine content, for 12 weeks with usual diet	61 recreationally active adults with no prior weight training	None	Total and lean body mass, peak leg extensor and flexor torque, vastus lateralis muscle thickness	None
Messina 2018⁵⁴	SR 9 RCTs and randomized crossover trials comparing soy vs non-soy (whey, beef, milk, or dairy) protein supplementation	266 adults with 6 or more weeks of resistance exercise training	None	Strength (soy vs whey protein and soy vs other proteins), lean body mass (soy vs whey protein and soy vs other proteins)	None
Monteyne 2021⁵⁵	RCT of 1.8 g/kg/d vegan vs animal protein for 3 days plus daily leg exercises	19 healthy, older adults	None	Myofibrillar protein synthesis rates in rested or exercised muscle (from muscle biopsies)	None
Monteyne 2023⁵⁶	RCT of 1.8 g/kg/d vegan vs animal protein plus daily leg exercises for 3 days (phase 1) then 10 weeks with a progressive resistance program (phase 2)	16 healthy young adults in phase 1; 22 healthy young adults in phase 2	None	Myofibrillar protein synthesis rates, change in lean muscle mass, change in thigh muscle volume, muscle fiber cross-sectional surface area, muscle strength	None
Singh 2024⁵⁷	RCT of pea vs whey protein supplements plus resistance training for 84 days	100 sedentary adults aged 30 to 59 years	None	Whole-body muscle strength, muscle mass, or immune function	None
Spoiler 2023⁵⁸	RCT of pea vs whey protein supplements 25 g/d vs iso-caloric placebo for 13 days	47 physically active adults 60 years or older with 20-30 km walk at day 10	None	Lactate dehydrogenase levels; muscle mass, strength, or soreness	Post-exercise creatine kinase (40% lower)
Zare 2023⁵⁹	SR 19 RCTs or randomized crossover trials of soy vs whey protein supplements	806 physically active adolescents or young adults, 14 to 39 years	Endurance performance, muscle damage, exercise-induced metabolic blood circulating biomarkers	Muscle mass, strength	Antioxidant capacity in long-term studies
Zhao 2024⁶⁰	SR 31 RCTs or randomized crossover studies of plant-based protein diet or supplements vs whey, beef, or milk protein	1116 healthy, non-obese adults aged 16 years or older	None	Strength (final value), endurance performance, muscle protein synthesis, athletic performance (final value)	Athletic performance (SMD 0.12), strength (SMD 0.11)

RCT, randomized controlled trial; SMD, standardized mean difference (effect size); SR, systematic review.

Skeletal muscle is regulated by an ebb and flow of muscle protein synthesis (MPS) and breakdown, determined largely by changes in protein intake and exercise status.⁶¹ Consuming protein before or after resistance exercise will stimulate MPS, which requires all 20 amino acids and is impaired by a shortage in one or more of the 9 essential amino acids.⁶² Despite claims that plant protein lacks essential amino acids relative to animal protein, plant proteins are not “missing” any of the 20 amino acids but their amino acid distribution profile can be less optimal when consumed in isolation. Lysine, for example, is suboptimal in grains and the sulfur-containing amino acids (methionine, cysteine) are slightly lower in legumes than for optimal human needs, which would be a problem when eating only rice and beans but not for a diverse plant-based diet.^8,63,64

Eating a variety of healthy plant foods (Table 2) provides adequate amounts of all essential amino acids for athletes and can satisfy the recommended protein intake.⁶⁵ Eating complementary foods, such as grains and legumes or legumes and nuts, is unnecessary if diverse plant proteins are consumed within the same 24-hour period.⁶³ Plant proteins are not only sufficient for complete protein nutrition, but compared to animal protein can be more ethical, affordable, offer greater food safety, and better meet consumer demand.⁶⁶ Despite historically lower protein digestibility ratings for plant vs animal proteins, these scores have significant limitations when applied to plant-based diets,^67,68 and do not show large enough differences to risk insufficient amino acid absorption for MPS.^64,69,70

Whereas vegetarians, in general, do not need to consume specific combinations of plant proteins in meals, an exception is after intense strength training where leucine and essential amino acids can facilitate optimal MPS.⁷¹ Leucine is the most potent amino acid for directly activating MPS, but most plant-based proteins are low in leucine content compared to animal sources.⁷² Combining complimentary plant-based proteins can help overcome this limitation (e.g., legumes and whole grains, soy foods and grains, legumes and nuts/seeds, or grains and nuts/seeds). Maximal MPS occurs after consuming 3 grams of leucine, either through whole-foods or a leucine supplement (capsules or powder), with or without essential amino acids.⁷² Leucine supplementation also benefits masters athletes (compared to younger individuals) and is discussed later under that section heading.

Protein Requirements, Spacing, Timing, and Sources

The recommended daily allowance (RDA) of protein intake for an average, sedentary adult is 0.8 g/kg, which is sufficient for unstressed states but is insufficient during energy restriction or resistance training.⁷³ The International Society of Sports Nutrition advises 1.4 to 2.0 g/kg/d of protein for most exercising individuals to achieve a positive, muscle protein balance, with the higher end of the range for power athletes seeking maximum endurance or strength.⁶² Others have found that exceeding 1.6 g/kg/d of protein during prolonged resistance training does not improve strength, muscle size, or muscle fibers.⁷⁴ Therefore, a target of 1.4 to 1.6 g/kg/d of protein would be reasonable for adults doing strenuous physical activity or endurance sports, 1.6 to 2.2 g/kg/d of protein for optimal muscle hypertrophy, and a range of 0.8 to 1.2 g/kg/d for more sedentary and less active individuals. The total amount of protein consumed, especially the content of essential amino acids, is what matters for performance, not the protein source (plant vs animal).

In addition to athletes who engage in high-intensity or endurance training, other individuals will benefit from higher levels of protein intake because of anabolic resistance states that reduce MPS by skeletal muscle tissue in response to dietary amino acids. Anabolic resistance can be related to obesity, older age (above 50 years), cancer, end-stage renal disease, and sedentary behavior, muscle disuse, or unilateral limb immobilization.⁷⁵ When individuals with these conditions seek to engage in physical activity, their increased protein needs can be met using protein-rich whole-foods, supplemental protein sources, and nutritional supplements.⁷⁶

Equally important as adequate protein consumption for MPS is how the intake is distributed, or spaced, throughout the day. The meal threshold for protein to stimulate MPS is related to age and activity, requiring about 15 grams if young and active, 20 grams if older and active, and 25+ grams if older and sedentary.⁷⁷ Although based mainly on studies of animal protein (egg, beef, whey), the cumulative evidence suggests a minimum protein threshold of 20 grams for MPS, with recommendations for 20 to 30 grams of protein with each meal.^78-80 Whereas some suggest the optimal timing for protein to stimulate MPS after exercise is within 2 hours for trained athletes, or within 24 hours if untrained,⁷⁷ others have found no consistent relationship of protein timing to MPS.⁸¹ In one RCT, a bolus of 100 grams of protein after resistance exercise enhanced MPS more than 25 grams, suggesting a dose-dependent response that may be underestimated in humans.⁸²

In contrast to the issue of how protein is distributed throughout the day, the timing of protein ingestion relative to a bout of exercise is of less importance. Protein supplementation before vs after exercise for at least 4 weeks in one systematic review⁸³ had no impact on improvements in lean body mass. Another systematic review⁸⁴ found no impact of protein given before vs after a resistance training session on improvements in muscle strength or hypertrophy. In this second review, total protein intake, not timing, was found to be the key factor for building muscle.

Excellent sources of plant-based proteins appear in Table 5, listed by increasing caloric content per gram. Legumes are high in protein as a percentage of weight, including soy (44%), lupin (42%), black lentils (33%), other (red, yellow, brown) lentils (28-29%), beans (22-28%), and chickpeas (5%).⁸⁵ Although nuts, seeds, whole grains, and nut butters provide protein, many are not listed in Table 5 because of their high caloric density, making them impractical as primary sources for many weight-conscious adults. In contrast, peanut and almond powder (defatted butters) are high-protein, low calorie supplements, as are hemp seeds and nutritional yeast. Nuts, seeds, and nut butter, however, are part of a healthy plant-based eating pattern (Table 2) and when consumed in moderation do not lead to weight gain.^86,87

Table 5.

Plant-Based Protein Sources.

Source	Cal/gram protein^a	Description	Nutrition 100 g (3.5 ounces)^b
Almond powder	6 complete	Prepared by pressing finely ground almonds to remove nearly all oil, then grinding into a fine powder; neutral taste great in oatmeal, cereal, smoothies, baked dishes, soups, sauces	57 g protein, 343 cal, 9 g fat, 14 g fiber
Lupini and fava bean pasta	7 complete	A pulsed pasta by Kaizen (Amherst, MA) from Lupini bean flour and fava bean protein; mild taste but firmer than wheat pasta	36 g protein, 232 cal, 7 g fat, 27 g fiber
Nutritional yeast	8 complete	A deactivated cooking yeast, forming flakes when dried and pasteurized, often used as a grated cheese alternative because of nutty, cheesy flavor	50 g protein, 400 cal, 0 g fat, 20 g fiber
Peanut powder	8 incomplete	Prepared by pressing roasted peanuts to remove nearly all oil, then grinding into a fine powder; mild peanut flavor great in oatmeal, cereals, stir-fried vegetables, baked dishes, smoothies	54 g protein, 420 cal, 12 g fat, 12 g fiber
Tofu (bean curd)	8 complete	Coagulated soy milk pressed into blocks of varying firmness; bland taste that takes on the flavor of other foods when cooked	10 g protein, 83 cal, 5 g fat, 1 g fiber
Edamame and mung bean pasta	8 complete	A pulsed pasta by Explore Cuisine (Red Bank, NJ) from edamame and mung bean flour; mild taste and soft texture; black bean version, made from black soybean flour, has similar nutrition content	43 g protein, 321 cal, 7 g fat, 25 g fiber
Tempeh	9 complete	Fermented soybeans that may be combined with other seeds or whole grains to form a firm, dense cake that is chewier and nuttier than tofu; can be sliced, crumbled or cubed for salads, stir fries, or sandwiches	21 g protein, 190 cal, 5 g fat, 7 g fiber
Spinach, cooked drained	10 incomplete	Excellent protein vs calories, but not a primary source of protein because extremely large volume needed; good adjunct to other sources	3 g protein, 23 cal, 0 fat, 2 fiber
Edamame (soybeans)	12 complete	Young soybeans that can be steamed, boiled, or dry-roasted and eaten as a snack or added to salads, soups, stir fries	12 g protein, 140 cal, 8 g fat, 5 g fiber
Lupini beans	13 complete	Yellow legume seeds of the genus Lupinus that are traditionally eaten as a pickled snack food, found in specialty food stores and some supermarkets; great in salads, soups, pasta, or as a stand-alone snack	13 g protein, 100 cal, 3 g fat, 3 g fiber
Kidney beans, cooked	16 incomplete	A versatile legume with a mild taste known for its red color and kidney-like shape; used in chilis, stews, salads, and many other dishes	8 g protein, 127 cal, 1 g fat, 7 g fiber
Black beans, cooked	16 incomplete	Also called turtle beans and frijoles negro; mild sweet flavor and satisfying texture; used in chilis, stews, salads, Mexican/Spanish dishes	7 g protein, 115 cal, 1 g fat, 7 g fiber
Chickpea pasta	17 incomplete	A pulsed pasta by Banza (Detroit, MI) from chickpea flour and pea starch; similar taste and texture to wheat pasta	20 g protein, 339 cal, 5 g fat, 13 g fiber
Hemp seed, hemp heart	18 complete	Belongs to the botanical class of cannabis sativa cultivars, but the seeds have little to no THC or CBD; hearts are soft, inner part of unshelled seed	32 g protein, 553 cal, 49 g fat, 4 g fiber
Pumpkin seeds	19 complete	The edible seed of a pumpkin or certain other cultivars of squash, also known as pepitas	30 g protein, 555 cal, 40 g fat, 5 g fiber
Garbanzo beans, cooked	20 incomplete	Also called chickpeas, they have a nutty, buttery flavor; used in curries, soups, salads, stews, tahini, falafel; liquid (aquafaba) is an egg substitute	8 g protein, 137 cal, 3 g fat, 6 g fiber
Lentils, cooked	20 incomplete	Lens-shaped seed with an earthy taste; used in curries, stews, soups, sauces (meat substitute), rice dishes	8 g protein, 166 cal, 7 g fat, 7 g fiber
Peanut butter	26 incomplete	Spread or food paste from ground, raw or dry-roasted peanuts, ideally without added sugar or other ingredients	24 g protein, 632 cal, 49 g fat, 4 g fiber

cal, calories; CBD, cannabidiol; g, gram; THC, tetrahydrocannabinol.

^aComplete protein contains all 9 essential amino acids in adequate quantities needed by the human body to support protein synthesis.

^bData from USDA FoodData Central (fdc.nal.usda.gov) or manufacturer’s nutrition label.

Pulsed pastas, made from gluten-free legume flours, are a nutrient-dense source of protein and fiber with a low glycemic index.⁸⁸ Some of the highest protein pasta alternatives are made from edamame, chickpeas, lupini beans, or mung beans (Table 5). There is an ever-growing variety of plant-based protein and energy bars marketed to athletes, the best of which lack highly processed sources such as soy protein isolate (heavily refined), soy protein concentrate (slightly less refined), and wheat protein isolate (nearly pure gluten protein). Less processed, and potentially healthier, plant protein isolates are derived from peas, hemp, potatoes, brown rice, and pumpkin seeds. The best protein bars also minimize added sugars, regardless of whether they are “natural” (e.g., agave, maple syrup, coconut sugar) or alcohol-based.

Supplements with Proven Benefits

Dietary supplements can play a small role in an athlete’s sports nutrition plan by helping meet nutritional goals and by potentially enhancing health, performance, and resistance to injury.⁸⁹ As their name suggests, they should “supplement,” not replace, an otherwise healthy eating pattern with adequate recovery and an appropriate training regimen. There is a broad spectrum of diverse supplements promoted for their ergogenic (performance enhancing) properties, but only a relative few have strong enough supporting evidence, based on RCTs or systematic reviews, to support their use and efficacy. Evidence-based supplements for optimal athletic performance and recovery are summarized in Table 6 and discussed further in this section.

Table 6.

Evidence-Based Supplements for Optimal Athletic Performance and Recovery.

Supplement	Mechanism of action	Best for	Dose	Comments
Caffeine^90-93	Works in brain to increase arousal and to decrease perceived exertion and muscle pain	Exercise for 20 to 250 minutes, muscle strength, muscular endurance power, jumping performance, speed or sprinting	3 to 6 mg/kg about 60 minutes prior to exercise	Benefits not related to age or to baseline caffeine intake (habituation); doses higher than 9 mg/kg do not increase performance but may cause nausea, anxiety, insomnia, or restlessness
Creatine mono-phosphate^90,94-104	Increases phosphocreatine in type II muscle for faster regeneration of ATP to sustain high-intensity efforts longer	High-intensity resistance and interval training, lasting 30 seconds to 2.5 minutes; may lower exercise-induced muscle damage; no benefits for endurance	3 to 5 g/day, with or without 7 day loading phase	Potentially greater benefits for vegetarians (creatine ingested primarily in milk, red meat, and fish) and older athletes (increased strength and lean body mass); no adverse effects other than water retention with 3 to 5 pounds increase in body weight
Nitrate (beetroot juice)^105-114	Enhances type II muscle fiber function and blood flow to muscles and oxygen uptake	Explosive exercise (sprinting, cycling, weight-lifting) less than 60 minutes; no impact on endurance performance in trained athletes	400 to 80 mg nitrate (70-140 mL juice) 2 to 3 hours prior to exercise	Beetroot has dietary nitrate converted to nitric oxide in the stomach, leading to vasodilation and enhanced blood flow to muscles
Sodium bicarbonate^89,90,115	Buffers lactic acid by rise in pH of 0.1, which may help postpone fatigue	Sustained, high-intensity exercise up to 6 minutes; no benefits after 10 minutes	0.3 g/kg 60 to 180 minutes prior to exercise	Most studies performed in men; may not benefit highly trained athletes
Beta-alanine^89,90,116	Intracellular buffering agent that increases skeletal muscle carnosine	Minor increase in tasks up to 10 minutes, with peak effect at 1 to 4 minutes; no benefits after 10 minutes	3 to 6 g/day for 2 to 4 weeks	Smaller benefits found in trained athletes compared to untrained individuals
Omega-3 fatty acids^117-121	Anti-inflammatory effects, enhanced muscle protein synthesis and anabolic signaling pathways	Increasing muscle strength and reducing delayed onset muscle soreness, especially in untrained athletes	250 to 1000 mg/d of EPA and DHA (algae or fish oil); 1.1 to 1.6 g/d of ALA (plant sources)	ALA is common in plant-based diets, but it is not converted efficiently to the key omega-3 fatty acids, DHA and EPA; therefore, an algae-based supplement is recommended for vegetarians
Vitamin E¹²²	Antioxidant and anti-inflammatory effects by helping maintain cell membrane integrity	Exercise-induced muscle damage and oxidative stress; reduces post-exercise creatine kinase and lactate dehydrogenase	400 IU daily	Benefits most pronounced with daily dosage under 500 IU and in trained athletes
Polyphenols^123-126	Secondary plant metabolites with antioxidant and anti-inflammatory properties	Endurance athletes seeking potential small performance improvements; enhancing recovery and reducing soreness after exercise	500 to 1000 mg quercetin supplement daily for 1 to 6 weeks	A diverse, plant-based diet provides adequate polyphenols, but quercetin (a plant flavanol) is available as a supplement; may not benefit sprint, strength or team sport performance
Supplemental protein	Stimulates MPS, improves muscle mass and strength, and aerobic capacity	All athletes to meet protein goals, which may be difficult to achieve if only consuming whole plant foods	Most often 10 to 20 grams of protein	Available in powder, capsules, and nutrition bars; greatest impact on MPS when combined with resistance exercise, especially masters athletes
Essential amino acids^127-129	Induce higher MPS than intact protein because absorbed without digestion and rapidly enter peripheral circulation	Stimulating and enhancing MPS, and possibly increasing strength and physical performance, especially in older adults and masters athletes	3 to 15 grams, within 1 hour before or after exercise	Especially useful prior to exercise in a fasted state or with inadequate time to digest intact protein (2 to 3 hours); often combined with caffeine in supplements

ALA, alpha-linolenic acid; ATP, adenosine triphosphate; DHA, docosahexaenoic acid; EPA, eicosatetraenoic acid; MPS, muscle protein synthesis.

Caffeine (Table 6) works in the brain to increase arousal and decrease perceived exertion and muscle pain.⁹⁰ An umbrella review⁹¹ of 21 meta-analyses found consistent small to moderate improvements in exercise performance after caffeine ingestion, with the largest impact on aerobic tests of endurance. The most common regimen was 3 to 6 mg/kg of caffeine (about 2 cups of coffee) 60 minutes before exercise. A subsequent systematic review of 21 randomized, crossover trials compared caffeine (3 to 9 mg/kg) vs placebo in primarily male runners, finding small to moderate benefits on time to exhaustion and time to complete endurance trials.⁹² Although many caffeine trials use doses of 3 mg/kg or higher, a systematic review of 12 RCTs using lower doses of 0.9 to 2.0 mg/kg found small to moderate improvements in resistance exercise performance, suggesting that this lower dose (1 to 2 cups of coffee) does not diminish the benefits.⁹³

Creatine (Table 6) is ingested mainly from animal products (milk, red meat, fish, and chicken) and then stored in fast-twitch muscle, where it enhances strength, muscle mass, and possibly endurance.⁹⁰ Creatine is one of the most studied sports supplements, leading to its colloquial designation as a “cheap, legal, and effective” steroid because, like steroids, it improves strength and muscle mass but without the attendant risks.^94-98 There may also be some benefits of creatine for recovery from exercise-induced muscle damage^99,100 but the impact on endurance performance is unclear,^96,101 with some studies suggesting a small to trivial negative effect on maximal oxygen uptake, VO₂ max.¹⁰² Creatine monohydrate is the preferred form for supplementation, with or without a loading phase, and is equally safe and effective for men and women who participate in diverse athletic activities.^103,104

Beetroot (Table 2) is rich in nitrate that is converted in the stomach to nitric oxide, which can enhance exercise performance through skeletal muscle vasodilation with improved oxygen uptake and perfusion.¹⁰⁵ Two systematic reviews of acute (2 to 3 hours before exercise) or chronic beetroot supplementation found improved explosive exercise (sprinting, cycling, weight-lifting).^106,107 Another 6 systematic reviews found small, but significant, improvements in time-to-exhaustion and endurance (cardiorespiratory) exercise capacity, with the highest benefits for less-trained or non-athletes in time trials and open-ended tests.^108-113 A final review of trials using acute or chronic beetroot supplementation found no improvement in peak or mean power output, but studies were heterogenous and beetroot dosages were low.¹¹⁴

Sodium bicarbonate and beta-alanine (Table 6) do not impact endurance performance but may enhance high-intensity and short-burst exercise, especially in untrained athletes.^115,116 Untrained athletes may also benefit more from omega-3 fatty acids (Table 6) because of less delayed onset muscle soreness,^117,118 but benefits are inconclusive for performance and for trained athletes.^119-121 Conversely, trained athletes preferentially benefit from a daily low dose of vitamin E (Table 6) to reduce exercise-induced muscle damage and oxidative stress.¹²² Polyphenols (Table 6) also aid recovery because of antioxidant and anti-inflammatory properties,^123,124 which, similar to beetroot, increase gastric nitric oxide.¹²⁵ Polyphenols are found in foods (cocoa, berries, beetroot, blackcurrants, pomegranates, cherries) and concentrated fruit supplements (berries, blackcurrant, watermelon), with quercetin (plant flavonol supplement) having the greatest performance impact (about 3%) in RCTs.¹²⁶

A systematic review of 35 RCTs comparing different dietary supplements to placebo for strength and conditioning training, found that protein supplementation resulted in the greatest improvement in muscular strength, with a moderate to large effect size.¹³⁰ Similarly, when endurance-trained athletes are randomized to protein supplementation vs placebo in proximity to exercise, the protein group has greater improvements in lean muscle mass, time trial performance, and aerobic capacity (peak oxygen uptake, peak workload power).¹³¹ With regards to specific types of protein, a systematic review of 31 studies found that plant-based protein supplements (soy, rice, pea, potato, corn, mung bean, fava bean) improved athletic performance and muscle strength in healthy individuals compared to the no- or low-protein ingestion group (small effect size); however, animal protein (whey, beef, milk protein) was slightly more beneficial than plant protein (trivial to small effect size).¹³²

A recreational athlete consuming diverse, plant-based protein sources (Table 5) in sufficient quantities is unlikely to benefit from essential amino acid (EAA) supplementation (Table 6), except for exercise in a fasted state with insufficient time to digest protein foods. Oral, free-form EAAs taken within 60 minutes of activity induce a greater increase in MPS than intact protein, because they do not require digestion for absorption and they enter the peripheral circulation rapidly, with a robust increase in EAA plasma concentrations.¹²⁷ In young, healthy adults EAAs have not resulted in performance benefits, but do improve post-prandial plasma amino acid availability¹²⁸ and when consumed with whey protein have a greater impact on MPS than whey protein alone.¹²⁹ As noted in the next section, EAAs have greater benefits for older adult athletes.

Considerations for Masters Athletes

Master athletes are 35 years or older (40 years in some publications) who seek optimal performance in competitive sports.^133,134 Synonyms include older athletes, mature athletes, and aged athletes. Aging significantly impacts athletic ability and performance, with reduced oxygen uptake (10% decline/decade in VO₂ max after age 30 years), reduced skeletal muscle mass (10% decline/decade in muscle fibers and strength), lower metabolism (2% to 5% decline/decade after age 25 years), reduced bone density (osteopenia, osteoporosis), reduced height (0.5” decrease/decade after age 40 years), and reduced vitamin D production (75% decrease from age 20 to 70 years).^90,134 Maintaining a high exercise-training stimulus and optimal nutrition with advancing age can limit the decline in endurance performance.^134,135

Dietary protein supplementation plus physical activity are the best ways to slow decline in muscle mass and strength (sarcopenia).¹³⁶ Masters athletes, however, have reduced protein synthesis and need more protein to preserve mass and function, which is best achieved with 1.6 to 1.8 g/kg/d of protein over 3 eating events.^90,137 As noted previously, exercise stimulates MPS that is optimized by eating protein-dense foods (Table 5) 90-120 minutes before exercise or by taking an EAA supplement (Table 6) 15-30 minutes prior to exercise.⁹⁰ An overview of 5 systematic reviews of resistance training in older adults found that in all analyses added protein resulted in greater increases in lean body mass and muscle mass compared to training alone.¹³⁸ In contrast to younger adults, EAA supplements for masters athletes have more consistent benefits for physical and functional performance.^139,140

Masters athletes aged 50 and older can enhance MPS with leucine supplements because of anabolic resistance related to aging and sarcopenia. As noted previously, leucine is key regulator of post-prandial MPS, but this effect has been most consistently observed for older adults.¹⁴¹ A systematic review of 38 RCTs found that a leucine administered one hour before or after resistance exercise (typically as 3 grams of isolated protein or with essential amino acids) had a small to moderate benefit for MPS in older, but not younger, adults.¹⁴² Similarly, another systematic review concluded that high-dose leucine supplementation over 12 weeks did not impact muscle mass or strength in young, resistance-trained men who consumed adequate dietary protein.¹⁴³

Compared to younger adults, creatine supplementation (Table 6) offers greater benefits for masters athletes, especially for those with a plant-based eating patterns and lower baseline creatine stores.¹⁴⁴ Systematic reviews demonstrate increased strength, muscle mass, and skeletal muscle health from creatine use by older adults, independent of creatine loading, maintenance dosage, or frequency, with no adverse events.^97,98 Benefits are enhanced when creatine is combined with exercise and resistance training.^145,146 Beyond physical performance, creatine used by older adults may improve memory, especially for vegetarians.^147,148

Limitations

Despite the robust, and rapidly growing, evidence based of research regarding plant-based diets and athletic performance, there are some limitations to consider when moving from evidence to practice:

• Definitions of plant-based diets vary among studies, making it difficult to recommend a specific eating pattern; rather, the principles in Table 2 should be applied when making food choices

• The bottom-line conclusion that plant-based diets are non-inferior to omnivore diets for athletic performance should be reassuring to athletes who choose a plant-based eating pattern, but this “non-inferior” finding for performance should not be extrapolated to overall health and mortality, for which evidence conclusively shows benefits of a high-quality plant-based eating pattern

• Macronutrient needs are important for athletic importance but not always discussed or explicitly matched in research studies, which could make it difficult to interpret results of plant-based vs omnivore diets or even healthful vs unhealthful plant-based diets

• Plant-protein is non-inferior to animal protein for overall athletic performance, but regarding overall health plant-protein is higher in fiber and lower in salt, oil, and cholesterol; substituting animal-protein with plant-protein should not impact performance but may improve overall health

• Total calories were not considered in this review, but for body composition the overall caloric intake must be adjusted to match goals (e.g., muscle hypertrophy vs fat loss); the best approach is usually to emphasis fiber-rich foods and lean protein sources while avoid UPFs and other calorie-dense foods

• Ideal protein requirements for maximal muscle hypertrophy and strength (e.g., bodybuilders) may be up to 2.2 g/kg/d,¹⁴⁹ because the total daily intake of dietary protein is the most crucial factor influencing MPS.

Conclusions

The current evidence base for a plant-based eating pattern and athletic performance (Table 3) strongly suggests that this pattern is equivalent, or at least non-inferior, to an omnivore diet. Similarly, plant-protein is equivalent, or at least non-inferior, to animal protein for MPS when enough protein is consumed (Table 4). All plant-based eating patterns, however, are not healthy, so athletes must be judicious in choosing foods to maximize the anti-inflammatory impact (Table 2). We can draw other conclusions based on our current evidence base (Table 7), but uncertainties exist that will diminish as new research blossoms. We therefore recommend that athletes stay alert for new RCTs, systematic reviews, and other trustworthy evidence, while using the advice in this review as a starting point for best practice in plant-based nutrition.

Table 7.

Take-Home Messages on Plant-Based Nutrition and Supplements for Optimal Athletic Performance.

Take-home message	Comments
A whole-food, plant-based diet (Table 1) can enhance health, longevity, and athletic performance, with an eating pattern composed primarily of whole grains, vegetables, legumes, fruits, nuts, and seeds	Synonyms included a whole-food plant-predominant or plant-forward diet, recognizing that some animal products can still be consumed; however, highly or ultra-processed foods should be minimized or avoided, along with added salt, oils, or sugars (Table 2)
Plant-based eating patterns are non-inferior to omnivore diets for overall athletic performance, with superior results for the plant-based groups in some studies regarding maximal oxygen intake	This equivalence is supported by many systematic reviews, randomized trials, and other comparative research studies (Table 3); although plant-based diets are anti-inflammatory, there is no evidence of a clinically measurable or important effect on recovery after exercise or injury
Plant protein is equivalent, or non-inferior, to animal protein for muscle protein synthesis, despite claims that plant protein is less digestible or may lack essential amino acids	This equivalence is supported by many systematic reviews, randomized trials, and other comparative research studies (Table 4); there is no need to combine plant foods to create complete proteins if diverse protein sources (Table 5) are consumed in a 24-hour period
Optimal athletic performance requires 1.2 to 2.0 g/kg/d or protein, with maximal muscle protein synthesis when as 20-30 grams/meal and within 2 hours after exercise	Exceeding 1.6 g/kg/d of protein may not benefit recreational or non-elite athletes; the minimum threshold for muscle protein synthesis of 20 grams of ingested protein suggests the best outcomes if protein is concentrated at meals rather than spread out during the day in smaller amounts
Dietary supplements can play a small role in an athlete’s sports nutrition plan, but only a few have strong enough evidence from high-quality research studies to support their regular use (Table 6)	There are many supplements with false, misleading, or unsubstantiated claims beyond biased or anecdotal comments; be highly selective regarding supplements and always remember they cannot make up for unhealthy eating patterns (Table 2) or faulty training routines
Caffeine and creatine (Table 6) are 2 of the most widely studied, safe, effective, and evidence-based supplements for enhancing athletic performance	Creatine, found primarily in animal products, may preferentially benefit athletes with a plant-based eating pattern and therefore low dietary creatine intake
Essential amino acids (Table 6) are useful when exercising in a fasted state or when there is inadequate time to digest protein foods	Essential amino acids do not require digestion and can therefore readily enter the bloodstream to promote muscle protein synthesis; beyond this ability for rapid absorption, there are no benefits for overall performance
Masters athletes, age 35 and older, benefit from the anti-inflammatory aspects of a healthy, plant-based diet, and benefit more than younger athletes from creatine and essential amino acid supplements	Masters athletes are in a continual state of muscle mass decline (sarcopenia) that is minimized by resistance training, enhanced protein intake, creatine supplementation, and essential amino acids, all of which stimulate muscle protein synthesis
Research evidence as to what constitutes the optimal plant-based diet and supplements for athletic performance is evolving rapidly, with new studies, trials, and systematic reviews published regularly	The recommendations in this state-of-the-art summary article reflect the best evidence as of May 2025, but athletes should be alert for new publications, especially randomized trials and systematic reviews, to fine tune and optimize their own nutrition and training

Footnotes

Declaration of Conflicting Interest

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Richard M. Rosenfeld, Director of Guidelines and Quality, American College of Lifestyle Medicine; Jonathan P. Bonnet, published 2 editions of the Lifestyle Medicine Handbook and the Foundations of Lifestyle Medicine Board Review Course, Guidepoint expert consultant, and have received funding and support from the Ardmore Institute of Health; Samantha Zinman, none.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Richard M. Rosenfeld

Jonathan P. Bonnet

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Pencharz

Lemon

. Indicator amino acid-derived estimate of dietary protein requirement for male bodybuilders on a nontraining day is several-fold greater than the current recommended dietary allowance. J Nutr. 2017;147:850-857. doi:10.3945/jn.116.236331