Purpose The aim of this systematic review is to analyze the scientific evidence in relation to neuromuscular adaptations to physical exercise in vegetarians versus omnivores. Methods A thorough literature search of randomized clinical trials was conducted in PubMed, Embase, CENTRAL (Cochrane), CINAHL, SPORTDiscus, and Web of Science without limitation of the starting date until June of 2021. Trials were eligible for inclusion if they measured the effect of diet (vegetarian or vegan versus omnivorous) of physical activity practitioners on neuromuscular adaptations, such as strength, power, endurance, and muscle hypertrophy. Results Eleven studies were selected, most performed with males. The intervention period ranged from one 1 to 12 weeks, and four studies supplement creatine. No statistically significant difference was observed for most parameters, only one study found difference in the strength where it was significantly higher for the vegetarian diet group. Of the studies that had creatine supplementation in one, the peak power output was greater for the mixed diet than for vegetarians, and in the other, vegetarians had total work performance greater than omnivores. Conclusion Vegetarian plus creatine and ovolactovegetarian diets seem to have no inferiority compared to the omnivorous diet in relation to neuromuscular adaptations to exercise, but caution still required for other vegetarian diets which that may not provide adequate amounts of protein and micronutrients.
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