Nutritional Interventions and Acupuncture‐Based Strategies for Exercise‐Induced Fatigue and Recovery: Mechanisms and Integrative Perspectives

Exercise‐induced fatigue (EIF) refers to a reduced capacity to sustain a specified level or intensity of physical activity and is generally regarded as a physiological warning signal following excessive exercise rather than a pathological state. It involves peripheral disturbances related to energy depletion, metabolite accumulation, oxidative stress, inflammation, and mitochondrial dysfunction, together with central changes involving neuroendocrine networks and the gut–brain axis. In this review, we synthesize evidence from nutritional interventions and acupuncture‐based strategies and outline a conceptual mechanistic framework relevant to EIF management. Nutritional approaches include macronutrient manipulation, vitamins, plant‐derived polyphenols and polysaccharides, traditional herbal extracts, probiotics, and fermented products. Acupuncture, electroacupuncture (EA), and transcutaneous electrical acupoint stimulation (TEAS) have been associated with regulation of autonomic function and hypothalamic–pituitary–adrenal axis activity, modulation of pain and affective circuits, and changes in skeletal muscle perfusion, mitochondrial function, and antioxidant and anti‐inflammatory signaling. We highlight partially overlapping biological targets, including the AMPK/PGC‐1α axis, Nrf2 and NF‐κB signaling pathways, and cytokine networks, and propose a conceptual model in which nutritional interventions are primarily linked to substrate availability and redox support, whereas acupuncture‐based strategies are primarily linked to neuroendocrine and inflammatory regulation, with both being associated with mitochondrial function and recovery‐related processes. Current evidence is limited by protocol heterogeneity, small sample sizes, sparse mechanistic biomarker profiling, and a predominance of animal studies. We therefore outline priorities for multi‐arm randomized controlled trials, standardization of EA/TEAS parameters, multi‐omics integration, and the development of individualized prescription models. Shared mechanistic features between nutritional and acupuncture‐based interventions may inform future hypothesis‐driven studies of EIF; however, whether combined use provides additive or synergistic clinical benefit remains unproven and requires rigorous validation.