Current Evidence of Ergogenic and Post-Exercise Recovery Effects of Dietary Supplementation with Cordyceps militaris in Humans—A Narrative Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I would like to thank the authors for their contribution to this manuscript. The topic is interesting and relevant, and the manuscript provides valuable insights. I have several suggestions that I believe would further strengthen the scientific rigor and clarity of the paper:

1. Historical statement regarding Cordyceps consumption (Lines 86–88)
   The statement that the outstanding performance of Chinese runners in 1993 “may have been due to the consumption of mushrooms of Cordyceps spp.” does not appear to be supported by robust scientific evidence and may be considered speculative. Given the historical sensitivity and controversy surrounding this period, I recommend either removing this statement or clearly rephrasing it as a hypothesis, supported by appropriate references. If no reliable evidence is available, it would be more appropriate to omit it.

2. Molecular mechanisms section (Lines 417–430)
   The authors propose several molecular and cellular mechanisms to explain the observed effects. While these explanations are informative, the section would benefit greatly from a schematic illustration summarizing the proposed signaling pathways. A comprehensive molecular signaling diagram would help readers better understand the integrated mechanisms involved and improve the overall clarity of the manuscript.

3. Literature scope and consideration of meta-analysis
   The current manuscript appears to rely on a limited number of studies (e.g., five studies in Table 2), which may not provide a sufficiently comprehensive evidence base. The authors should consider expanding the literature search, potentially including relevant non-English publications (e.g., Chinese, Japanese, or other languages), as research on this compound may be more extensive in certain regions.
   Additionally, if sufficient data are available, the authors may consider conducting a meta-analysis to quantitatively synthesize the existing evidence. This would substantially strengthen the conclusions regarding the nutritional and performance-related effects of the compound.

4. Identification of active compounds
   The manuscript would benefit from a clearer discussion of the specific bioactive components responsible for the reported effects. Can the authors identify particular small molecules, peptides, or core active constituents based on existing literature or their own experimental data? Furthermore, are these active components also present in other nutritional supplements? A focused discussion of the core bioactive compounds and their uniqueness (or overlap with other supplements) would enhance the mechanistic depth of the paper.

5. Limitations section
   The manuscript would be strengthened by including a dedicated “Limitations” section. For example, the relatively small number of included studies may limit the strength of the conclusions. A transparent discussion of such limitations would improve the scientific balance and credibility of the manuscript.

6. Use of the term “brain-doping” (Line 717)
   The term “brain-doping supplements” requires clarification. The concept of “doping” is highly sensitive in the context of sport and carries strong regulatory and ethical implications. Associating a nutritional supplement with “doping” may lead to misunderstanding or unintended connotations. The authors should clarify what is meant by this term and consider replacing it with a more appropriate expression (e.g., “cognitive-enhancing supplements” or “neuroergogenic aids”), unless a regulatory classification is specifically being discussed.

7. Graphical abstract or summary figure
   I recommend that the authors include an overall graphical abstract or summary figure clearly illustrating the proposed mechanisms and functional effects of the compound. This would improve readability and scientific communication. The authors may consider examples such as DOI: 10.3390/nu15204441 as a reference for structure and presentation, and cite it where appropriate if relevant.

Overall, I believe that addressing these points will significantly enhance the clarity, rigor, and impact of the manuscript.

Author Response

Good morning,

Thank you for the review - please see the attachment with our answers. 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

General comment

The paper aims to summarize current research on the relationship between Cordyceps militaris supplementation and physical performance and post‑exercise recovery in healthy individuals. The topic is relevant, and the potential performance‑enhancing properties of C. militaris remain insufficiently explored. While the narrative review format allows for a broader discussion, the manuscript shifts toward an extensive description of the mushroom’s active compounds and industrial production considerations, rather than maintaining a clear focus on the evidence from human studies.

The balance of topics is not optimal, the manuscript places disproportionate emphasis on proposed future research directions regarding the ergogenic effects of C. militaris in humans. As the Authors themselves acknowledge, the review methodology has limitations. The literature search strategy is also inadequate; I provide specific suggestions for improving it in my detailed comments. In addition to these methodological issues, the reviewed studies themselves present several limitations (e.g., heterogeneity in bioactive components used as supplements, differences in participants’ training status, and variability in supplementation duration).

I recommend the manuscript for publication after major revision.

For clarity, I have organised my detailed notes according to the manuscript’s sections.

 

Abstract

A1: It should be mentioned in the very beginning what C. militaris is, namely, a parasitic fungus known for its medicinal properties, traditional uses, and potential health benefit.

A2: The Abstract does not mention anything beyond the study and effect comparison of the C. militaris dietary supplementation in humans, it should be expanded to reflect the later sections of the manuscript.

 

Introduction

I1: The Introduction section is mainly about the background of the usage of the mushroom (and other „ergogenic” supplements) culturally and in sport specifically, its effects are only described anecdotally or vaguely. There should be at least a brief mention of the active ingredients of the mushroom to emphasize its complex nature and difficulty of the research surrounding the effects on sport performance.

I2: “Despite this advantage of Cordyceps spp., sports organizations, including the ISSN, IOC, and AIS, do not suggest the consumption of this mushroom in their statements or recommendations.” – is there any justification for this tendency, if so, please describe it.

 

Research selection criteria

R1: The selection process was mainly conducted manually, lacking established screening methods.

R2: “The following inclusion criteria were considered: (1) interventional studies in healthy individuals who were administered C. militaris; (2) studies in which participants had to perform exercises/were subjected to physical exertion; and (3) publications in English.” – were there non-English publications available in the topic? If so, nowadays the AI-aided translations could help in getting information from the papers. Are these publications consonant or dissonant with the publications discussed in the present review manuscript?

 

Ergogenic and post-exercise recovery effect of dietary supplementation with Cordyceps militaris in humans

E1: This section is too long, it should be shortened and focused on the main effects.

E2: The automatic screening method yielded only two studies with the specified criteria; the additional 3 studies were identified by manual searches. The original screening method should have been redesigned for better results and farther reach (publications not only in English may help this literature search extension).

 

Figures and Tables

F1: Figure 2: the figure does not accurately illustrate or clarify the screening process, it needs revision.

F2: Table 1: The table’s formatting is not easy to follow. The summarized studies should be at least referred to with author and publication year for easier understanding and retrievability along reading the text. Is there also a study with only 10 participants? If so, this publication should be excluded from the review.

F3: Table 2: Anew, the studies should be labelled with author and publication year. The table itself has repetitive columns that should have been summarized in a more transparent manner. The qualitative assessment does not determine the descriptive statements. For example, what is the definitive difference between “some limitations” and “adequate” rating of data completeness?

 

Indications for future studies on the ergogenic properties Cordyceps militaris in humans

In1: This section takes up around 40% of the manuscript (excluding references), which could necessitate the revision of the focus of the paper, beyond dietary supplementation of humans in hopes of positive ergogenic effects.

Author Response

Good morning,

Thank you for the review - please see the attachment with our answers. 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Ergogenic and post-exercise recovery effect of dietary supple-2 mentation with Cordyceps militaris in humans

General Comments

This review examines human intervention studies assessing the effects of Cordyceps militaris supplementation on exercise capacity and post-exercise recovery. Only a limited number of eligible studies were identified, encompassing heterogeneous populations, supplementation protocols, and outcome measures. Despite its breadth, the manuscript presents important conceptual, methodological, and structural shortcomings that substantially limit its scientific rigor and suitability for publication in its current form. The most critical issue concerns the misalignment between the stated review type and the applied methodology. Although the manuscript is repeatedly described as a narrative review, it incorporates several elements typically associated with systematic reviews, such as database searches, explicit inclusion and exclusion criteria, and a PRISMA-like flow diagram, without adhering to established methodological standards for either approach.

Furthermore, the human evidence base is extremely limited (five studies) and highly heterogeneous, yet a disproportionate portion of the manuscript is devoted to animal and in vitro research, as well as agricultural, genetic engineering, and industrial cultivation topics. Many of these sections are only tangentially related to ergogenic effects in humans. This imbalance results in speculative mechanisms and future possibilities overshadowing the actual human data. Overall, while the manuscript addresses a topic of potential interest, it requires major revision to improve methodological coherence, narrow and refocus its scope, rebalance the presentation of evidence, and more cautiously frame causal interpretations and practical implications.

Specific Comments

The title is clear and informative. However, given the very limited human evidence and the high risk of bias across the included studies, the wording may be overly affirmative. The authors should consider softening the title to better reflect the exploratory nature of the evidence (e.g., by adding expressions such as “current evidence,” “emerging evidence,” or “a narrative review of limited human studies”).

Abstract

The abstract conveys a level of evidentiary support that is not fully justified by the underlying data. Statements such as “current evidence suggests that C. militaris may exert ergogenic effects” should be more explicitly framed as tentative and hypothesis-generating. Although the abstract appropriately acknowledges several methodological limitations, the overall tone of the conclusions remains optimistic relative to the small and heterogeneous evidence base. In addition, the abstract describes the manuscript as a narrative review while simultaneously referring to a structured study identification process. This methodological inconsistency should be clearly addressed and resolved.

Introduction

The broad historical and cultural context is well written and includes a relevant discussion of ergogenic aids and institutional frameworks (IOC, ISSN, AIS). Nevertheless, this section is overly long and partially unfocused, particularly in the passages addressing ancient mushroom use and aggression. Some historical and anecdotal content does not clearly advance the scientific rationale of the review.

In addition, the distinction between Cordyceps sinensis and C. militaris should be introduced earlier and articulated more clearly. The authors are encouraged to streamline historical anecdotes and more explicitly define the specific knowledge gap in human exercise research, rather than broadly discussing Cordyceps spp.

Methods and Research/Study Selection Criteria

Conceptual inconsistency: The manuscript is described as a narrative review, yet it incorporates database-specific search strategies, explicit inclusion and exclusion criteria, and a PRISMA-style flow diagram. Such elements are neither required nor commonly used in narrative reviews, creating conceptual confusion and raising concerns regarding methodological rigor.

Lack of formal risk-of-bias assessment: The authors explicitly state that no validated risk-of-bias tool (e.g., RoB 2) was applied, while still making qualitative judgments about methodological quality and bias. This approach lacks transparency and limits reproducibility.

Search date inconsistency: The literature search is reported as extending up to September 10, 2025, which appears inconsistent with the manuscript’s submission timeline and should be clarified.

Overall, the authors should clearly reframe the manuscript either as a systematic or scoping review, with appropriate methodological standards, or remove PRISMA-related elements and present it as a true narrative review based on a descriptive, non-exhaustive approach. In addition, the rationale for not using a formal risk-of-bias assessment tool should be more rigorously justified, or such a tool should be adopted.

Results / Description of Included Studies

Table 1 is detailed and informative, and the authors appropriately acknowledge the substantial heterogeneity and methodological weaknesses across the included studies. However, several important issues warrant attention. First, multiple outcomes are reported without baseline data, which precludes meaningful within- or between-group interpretation. Second, some numerical values appear to have been digitized from graphical representations, introducing additional uncertainty regarding data accuracy. Third, multi-ingredient supplements (e.g., PeakO2®) are repeatedly discussed, yet interpretations and conclusions are at times implicitly attributed to C. militaris alone.

The authors should explicitly distinguish findings derived from single-ingredient interventions from those involving multi-ingredient formulations, both in the narrative text and in the tables. In addition, narrative emphasis should be avoided for outcomes that cannot be statistically or methodologically substantiated.

Qualitative Assessment of Studies

The authors appropriately acknowledge that none of the studies have high methodological quality and the transparency regarding lack of trial registration is commendable.

However, the qualitative assessment remains subjective and loosely defined. Labels such as “moderate” or “limited” methodological quality are used without standardized thresholds.

Suggestions: Adopt a validated qualitative framework, and/or reframe this section as a descriptive limitations analysis, avoiding quasi-quantitative judgments.

Mechanistic Sections (Bioactive Compounds, Cultivation, Genetic Engineering)

These sections are disproportionately long relative to their relevance for evaluating ergogenic effects in humans. A substantial portion of the content—including discussions on CRISPR-based strain modification, fermentation optimization, and industrial scalability—is peripheral to sports nutrition and human performance. In addition, mechanistic inferences derived from animal and in vitro studies are not consistently framed as hypothesis-generating. The authors should substantially condense these sections, clearly distinguish speculative mechanisms from evidence directly applicable to athletes, and avoid implying translational relevance in the absence of supporting human data.

Discussion

The authors consistently acknowledge study limitations, and the discussion is well referenced and scientifically literate. Nevertheless, the section frequently reiterates descriptive results rather than providing a critical synthesis of the findings. Greater emphasis should be placed on integrating and comparing the included studies with the existing literature, highlighting consistencies, discrepancies, and plausible explanations for divergent results. In addition, the balance of the discussion tends to favor speculative future applications over a rigorous appraisal of the current human evidence. The authors should reinforce a more critical tone throughout the section and clearly state that, based on the available data, no firm ergogenic recommendations can be made at present.

Conclusions

The authors appropriately call for better-designed trials; however, certain expressions (e.g., “promising nutritional component”) may still overstate the level of certainty supported by the current evidence. The authors are encouraged to further soften the language to more accurately reflect the exploratory nature and limitations of the available human data.

Comments on the Quality of English Language

The English should be revised to improve clarity, flow, and consistency.

Author Response

Good morning,

Thank you for the review - please see the attachment with our answers. 

Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

This manuscript addresses a relevant and timely topic in sports nutrition, namely the potential ergogenic and recovery effects of Cordyceps militaris supplementation in humans. The attempt to synthesize the currently limited human evidence and to discuss underlying bioactive compounds and mechanisms is valuable and of potential interest to both researchers and practitioners. The paper is generally well structured and grounded in existing literature; however, several methodological and interpretative aspects require clarification and strengthening—particularly regarding the review design, risk-of-bias assessment, and the handling of heterogeneity across included studies. Overall, the manuscript has a solid foundation but would benefit from targeted revisions to improve methodological transparency, analytical rigor, and balance in the interpretation of findings before it can be considered for publication.

TITLE

Line comments

- “effect”  should be plural (“effects”).

- Specify study type (narrative/systematic) to avoid methodological ambiguity.

Suggestion

“Ergogenic and post-exercise recovery effects of Cordyceps militaris supplementation in humans: a narrative review”

ABSTRACT

Background: clear but slightly promotional in tone.

Objective: good; however, type of review not specified.

Methods: lacks methodological detail (screening framework, bias assessment).

Results: descriptive but mixes outcomes and interpretations.

Limitations: appropriately mentioned but should be earlier.

Conclusion: somewhat assertive relative to weak evidence base.

INTRODUCTION

L43–56

Historical background excessive; limited relevance to current sports nutrition science.

L63–70

Ethnomedicine context useful but should link to biochemical mechanisms earlier.

L71–79

EU regulatory statement needs precision and citation clarity.

L85–90

Reference to Chinese runners anecdotal; risk of narrative bias.

L92–100

Rationale for review present but not sharply defined.

METHODS

Search strategy

- Databases appropriate.

- Search terms too broad; reproducibility limited.

- Boolean structure not reported.

Missing

- PRISMA compliance.

- protocol registration.

Inclusion/exclusion criteria

- Clear and aligned with topic.

- “healthy individuals” undefined.

- no specification of study design hierarchy.

- age cut-offs not operationalized.

Study selection & extraction

- Independent reviewers appropriate.

- No kappa/inter-rater reliability.

- Extraction process insufficiently detailed.

RESULTS – STUDY SELECTION

Flow description

- Transparent but not PRISMA-structured.

- Reasons for exclusion insufficiently detailed.

- Overlap in exclusion categories.

INCLUDED STUDIES

Five studies analized: very small evidence base with  high heterogeneity in:

- supplementation dose

- duration

- athlete level

- outcome types.

Table 1

Is Comprehensive but overly dense. Moreover, it should be improved the formatting and check the values.

DISCUSSION

Evidence presented as generally favorable despite: small samples, inconsistent outcomes. However, needed stronger caution in interpretation.

STRENGTHS & LIMITATIONS SECTION

Limitations

- Should include: lack of RoB tool e small sample meta-base.

FUTURE DIRECTIONS

Improvement

- Should prioritize: standardized extracts; dose-response trials; athlete-specific cohorts and, acute vs chronic supplementation.

BIOACTIVE COMPOUNDS SECTIONS

- Translational gap from animals to humans insufficiently emphasized.

Ergothioneine

- Section slightly disproportionate relative to review scope.

Phenylalanine

- Interesting but marginally relevant to core ergogenic narrative.

CULTIVATION METHODS SECTION

Too technical relative to nutrition focus and could be shortened or moved to supplementary material.

CONCLUSIONS

Should emphasize: insufficient human evidence; need for RCTs and uncertainty in efficacy.

 

 

 

Author Response

Good morning,

Thank you for the review - please see the attachment with our answers. 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Since this article references the following text, it is recommended to add it to the list of cited references. DOI: 10.3390/nu15204441，10.1016/j.jff.2023.105702

Reviewer 2 Report

Comments and Suggestions for Authors

The Authors followed most of my suggestions and comments, and corrected / completed the manuscript.

I suggest the revised manuscript for publication.

Reviewer 3 Report

Comments and Suggestions for Authors

I sincerely thank the authors for thoughtfully addressing my suggestions and recommendations. The revised manuscript has improved substantially. Therefore, I recommend its acceptance for publication.

Reviewer 4 Report

Comments and Suggestions for Authors

The authors have carefully considered and satisfactorily addressed all the concerns and suggestions provided in the previous review. The revisions have enhanced the overall quality, coherence, and methodological clarity of the manuscript. As a result, the paper has been significantly improved and is now suitable for publication.