Chocolate milk significantly reduced serum lactate levels compared to other recovery drinks: A comprehensive systematic review and meta-analysis of randomized controlled trials

Chocolate milk (CM) is a widely used recovery beverage among athletes due to its favorable nutritional profile and hydration properties. However, its effects on different recovery markers after exercise remain unclear. This study aimed to systematically review and meta-analyze randomized controlled trials (RCTs) assessing CM’s impact on recovery indices. A comprehensive search of Web of Science, PubMed, Embase, and Scopus databases was conducted up to April 2025 for RCTs administering CM to healthy adults post-exercise. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for outcomes including body weight, serum creatine kinase (CK), lactate, myoglobin, cortisol, plasma glucose, and insulin. Subgroup, sensitivity, meta-regression, and dose-response analyses were performed to explore heterogeneity sources and moderator effects. Sixteen RCTs (200 participants) were included in the systematic review, and 12 RCTs (140 participants) were analyzed quantitatively. CM showed no significant effect on body weight (WMD: 0.18 kg, 95% CI: -0.10 to 0.47, P=0.20) or serum CK (WMD: -52.40 U/L, 95% CI: -129.27 to 24.48, P=0.18) compared to other recovery drinks. However, CM significantly reduced serum lactate levels (WMD: -0.75 mmol/L, 95% CI: -1.19 to -0.31, P=0.01), particularly in endurance athletes and U.S.-based studies. Additionally, CM decreased cortisol levels in studies conducted in the USA (WMD: -400.54 pmol/L, 95% CI: -937.21 to -347.56, P<0.001). CM provides similar recovery benefits compared to other drinks but significantly lowers serum lactate. Further RCTs are needed to clarify optimal dosing strategies and assess its effects on additional recovery biomarkers • Chocolate milk (CM) significantly reduced serum lactate after exercise, suggesting enhanced metabolic recovery and more efficient clearance of fatigue-related byproducts. • No significant effect of chocolate milk on body weight and serum creatine kinase, indicating comparable recovery benefits to other drinks without influencing hydration-related weight changes or muscle damage markers. • Greater lactate reduction was observed in endurance athletes, supporting CM’s utility in sports with high aerobic demands. • Overall, our findings highlight CM as a practical, widely accessible, and cost-effective recovery aid that matches or outperforms commercial beverages in certain domains while reducing fatigue-related metabolites. • More RCTs are needed to confirm effects on cortisol, myoglobin and glycemic markers.