C. sinensis flavanones, mainly hesperidin and narirutin, have the potential to demonstrate significant impacts in elevating sports nutrition and performance.

A recent clinical trial reported that the intake of hesperidin alone or in combination with narirutin improved physical endurance/stamina, muscle performance, and reduced oxidative stress.¹³ Similarly, in amateur cyclists, hesperidin intake showed favorable changes in body composition by increasing muscle mass and reducing fat mass.³ Intake of C. sinensis fruit extract wherein 90% was hesperidin (360–450 mg/day for 8 weeks) also improved performance in 61 trained athletes, increasing their anaerobic power and speed in the Wingate test.¹⁴ Overdevest et al.¹⁵ reported that the intake of C. sinensis fruit extract containing 90% hesperidin (450 mg/day of hesperidin over a period of 4 weeks) increased absolute power output by 5% and reduced oxygen consumption in subjects while cycling, who were 19 in total. In another study by Martínez-Noguera et al.,¹⁶ the dose of 500 mg/day of hesperidin increased performance in anaerobic exercises, such as cycling, in 15 participants. Moreover, pre-exercise supplementation of 217 mg of hesperidin and 230 mg of narirutin per soccer player minimized oxidative stress and muscle damage during the Yo-Yo test while maintaining their performance.¹⁷ In another clinical trial, intake of 300 mL hesperidin and narirutin-rich orange juice for 12 days added valuable insights about exercise-induced physiological responses, particularly in combat sport athletes like those practicing Tarung Derajat. Intake reduced creatinine kinase levels and significantly impacted leukocyte count reduction post-training, suggesting an immunomodulatory or anti-inflammatory effect in response to exercise stress. These results strongly support the potential role of C. sinensis flavanones in enhancing athletic endurance, recovery, and physical performance.¹⁸

Elevating the endogenous defense system through the intake of antioxidant supplements may represent an effective non-invasive tool for mitigating or reducing oxidative stress during training. As noted earlier, exercise-induced oxidative stress damages cellular components.¹⁹ C. sinensis flavanones counteract this via enhanced antioxidant capacity (e.g., SOD ↑) and reduced lipid peroxidation.

In a recent study, Martínez-Noguera et al.¹³ investigated the impact of supplementing with hesperidin at a dose of 500 mg/day for 8 weeks in 20 cyclists. Results showed a considerable decrease in oxidative stress and an impressive increase in the superoxide dismutase (SOD) levels. Moreover, a decline was also observed in oxidative stress (AUC-GSSG) and inflammatory monocyte chemoattractant protein-1 (MCP1) markers during cycling performance tests. The intake of orange juice (750 mL), which delivers approximately 103 mg/L hesperidin and 15 mg/L narirutin, resulted in a notable decline in malondialdehyde (MDA) levels, from 2.4 to 1.5 µM, in overweight individuals, indicating a reduction in lipid peroxidation. Likewise, antioxidant capacity, as measured by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, improved from 8.8 to 26.5%.⁶ Added that, intake of orange juice (600 mL) in subjects with cardiovascular risk factors outlined increased plasma antioxidant markers, including Ferric Reducing Antioxidant Power (FRAP) (+84.6 µmol/L), Oxygen Radical Absorbance Capacity (ORAC) (+1.25 mmol/L), and β-cryptoxanthin (+0.23 µmol/L), depicting an enhancement of systemic antioxidant defense.²⁰ Also, hesperidin supplementation (500 mg/day) for 6 weeks in patients with type 2 diabetes improved total antioxidant capacity (TAC) from 0.7 to 0.8 mM.⁷ Moreover, pre-exercise supplementation of 217 mg of hesperidin and 230 mg of narirutin per soccer player minimized oxidative stress during the Yo-Yo test while maintaining their performance.¹⁷

The consistent improvements in oxidative stress biomarkers position C. sinensis flavanones as a matchless ingredient for athletes, health, and wellness formulations.

Prolonged or high-intensity exercise results in the release of pro-inflammatory cytokines, mainly IL-6, which stimulates the release of hepatic high-sensitivity C-reactive protein (hs-CRP) and may contribute to muscle damage and delayed recovery.²⁹ C. sinensis flavanones consistently exhibit anti-inflammatory activities across various human clinical trials. At a dose of 500 mg/day, multiple studies reported reductions in hs-CRP, TNF-α, and MCP1, key biomarkers of systemic inflammation and muscle damage. For instance, Martínez-Noguera et al.¹³ recorded a notable decline in MCP1 during cycling performance tests. Rizza et al.²⁶ observed reductions in hs-CRP (3.9–2.6 mg/L), serum amyloid A protein (7.3–5.6 mg/L), and soluble E-selectin (31–27 ng/mL). Similar effects were observed in a 12-week study by Yari et al.,²⁴ where hs-CRP levels decreased from 3691 to 2026 ng/dL and TNF-α levels decreased from 23 to 19 pg/mL. Homayouni et al.¹² reported comparable outcomes in patients with type 2 diabetes, with reductions in TNF-α (18.7–17 ng/mL), hs-CRP (1.9–1.1 mg/L), and IL-6 (8.3–7.4 ng/L) after 6 weeks. This dose-dependent consistency reinforces hesperidin’s potential as a reliable anti-inflammatory agent. Haidari et al.²⁷ found increases in adiponectin (~23%) and marked reductions in E-selectin (−18%), IL-6 (−68%), hs-CRP (−70%), and leptin (−50%), indicating cardiovascular and metabolic regulatory benefits. Meanwhile, Dourado and Cesar⁶ explored the impact of orange juice delivering 103 mg/L hesperidin and 15 mg/L narirutin for 8 weeks. Although the dose was lower, it still improved IL-12 production, i.e., a cytokine crucial for innate immunity. It decreased TNF-α (21.5–19.1 pg/mL) and hs-CRP (0.25–0.12 mg/dL), underscoring the functional value of C. sinensis flavanones in sports nutrition, health, and wellness.

Restricted blood supply to the muscles during strenuous exercise is thought to hinder muscle oxygenation.³⁰ For instance, it has been observed that restricted blood flow negatively affects the performance of speed skaters, as flow-mediated dilation (FMD) drops. A 1% increase in FMD is associated with a 9% decrease in heart risk. Dietary strategies, especially those rich in polyphenols, may be a helpful method to preserve endothelial health.^31,,32,33,34 C. sinensis flavanones intake also offers cardio-protective effects through improved endothelial function and reduced vascular inflammation. Clinical trials also highlight hesperidin’s anti-inflammatory and vascular benefits, particularly enhancing endothelial function and lowering markers of cardiovascular risk. In a 6-week trial involving 68 subjects, 450 mg/day hesperidin decreased the levels of major adhesion molecules, including soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and sP-selectin, which contribute to vascular inflammation.⁹ Morand et al.⁸ also observed improved postprandial endothelium-dependent microvascular reactivity in 24 healthy overweight individuals after daily consumption of orange juice with 292 mg of hesperidin and 47 mg of narirutin for 4 weeks. Rizza et al.²⁶ observed a significant improvement in FMD, a measure of endothelial function, in subjects with metabolic syndrome after taking 500 mg/day of hesperidin for 3 weeks.

Daily consumption of 750 mL orange juice (delivering 103 mg/L hesperidin and 15 mg/L narirutin) for 2 months caused a notable decline in triglycerides (from 89 to 84 mg/dL), total cholesterol (173 to 159 mg/dL), and low-density lipoprotein cholesterol (LDL-C) (104 to 93 mg/dL), representing an overall improvement in lipid profiles among overweight subjects.⁶ Likewise, Fidélix et al.²⁸ recorded similar results with an intake of 300 mL/day orange juice (delivering 73 mg hesperidin and 15 mg narirutin) for 2 months, causing a 16% reduction in LDL-C and a 30% drop in triglycerides from baseline. Collectively, data from the clinical trial position C. sinensis flavanones as a multi-target agent that positively influences lipid profile by integrating metabolic regulation with antioxidant and anti-inflammatory properties.

C. sinensis flavanones, including hesperidin and narirutin, have been clinically validated for their blood pressure-lowering properties. In a clinical trial involving 159 hypertensive participants, a dose of 600 mg per day of hesperidin, alongside 77.5 mg per day of narirutin, was able to reduce both systolic and diastolic blood pressure (DBP) by 7 mmHg, thereby achieving a reduction in pulse pressure.²¹ Likewise, separate research with 100 obese non-smoking participants with an administered dose of 582 mg of hesperidin along with 125 mg of narirutin for 12 weeks showed not only a decrease of 4 mmHg in systolic blood pressure (SBP) and 5 mmHg in DBP but also a decrease in Body mass index (BMI), waist circumference, and serum leptin levels.²² Furthermore, Morand et al.⁸ reported that a 292 mg dose of hesperidin and 47 mg of narirutin enriched orange juice consumed over a period of 4 weeks led to a reduction in the DBP in a group of 24 clinically examined healthy overweight men. Besides, Pla-Pagà et al.²³ reported a reduction in blood pressure levels and inflammatory markers in 159 subjects with hypertension after 12 weeks of treatment with a daily dose of 600 mg of hesperidin. Yari et al.²⁴ investigated the effects of a 12-week daily dose of 500 mg of hesperidin in a randomized interventional study on 49 subjects with metabolic syndrome, where the average decreases in systolic and diastolic pressure were 2.68 and 2 mmHg, respectively. Salden et al.⁹ highlighted the response of 68 overweight individuals to the consumption of 450 mg/day of hesperidin for 6 weeks, demonstrating a reduction of 5 mmHg in systolic and 2 mmHg in diastolic pressure. Another study involving 64 subjects with type 2 diabetes observed a reduction of 4 mmHg in systolic and 1.8 mmHg in diastolic blood pressure after 6 weeks of 500 mg/day hesperidin supplementation.¹² Furthermore, Schär et al.²⁵ reported a reduction of 3 mmHg in systolic and 5 mmHg in diastolic pressure after taking red orange juice containing 320 mg of hesperidin for 4 weeks in subjects at moderate risk for cardiovascular diseases. A short-term trial by Rizza et al.²⁶ reported that 24 subjects with metabolic syndrome showed lower SBP and improved endothelial function after 3 weeks of 500 mg/day of hesperidin, further validating C. sinensis flavanones as a natural and effective support for blood pressure regulation and cardiovascular wellness.