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Effects of Caffeine Ingestion on Exercise Testing: A Meta-Analysis

Mike Doherty and Paul M. Smith

This study used the meta-analytic approach to examine the effects of caffeine ingestion on exercise testing. Forty double-blind studies with 76 effect sizes (ES) met the inclusion criteria. The type of exercise test was classified as endurance, graded, or short-term. In comparison with placebo, caffeine improved test outcome by 12.3% (95% CI, 9.1 to 15.4), which was equivalent to an overall ES of 0.41 (95% CI, 0.31 to 0.51). Endurance exercise significantly improved test outcome (P < 0.05) more than either graded or short-term exercise. When exercise protocol was examined, time-to-exhaustion (Tlim) protocols had a significantly greater (P < 0.05) ES than either the graded or the non-Tlim protocol(s). The results from this meta-analysis confirm the ergogenic effects of caffeine, particularly for endurance testing that use Tlim protocols.

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Methodological and Statistical Quality in Research Evaluating Nutritional Attitudes in Sports

Rozalia Kouvelioti and George Vagenas

The assessment of dietary attitudes and behaviors provides information of interest to sports nutritionists. Although there has been little analysis of the quality of research undertaken in this field, there is evidence of a number of flaws and methodological concerns in some of the studies in the available literature. This review undertook a systematic assessment of the attributes of research assessing the nutritional knowledge and attitudes of athletes and coaches. Sixty questionnaire-based studies were identified by a search of official databases using specific key terms with subsequent analysis by certain inclusion–exclusion criteria. These studies were then analyzed using 33 research quality criteria related to the methods, questionnaires, and statistics used. We found that many studies did not provide information on critical issues such as research hypotheses (92%), the gaining of ethics approval (50%) or informed consent (35%), or acknowledgment of limitations in the implementation of studies or interpretation of data (72%). Many of the samples were nonprobabilistic (85%) and rather small (42%). Many questionnaires were of unknown origin (30%), validity (72%), and reliability (70%) and resulted in low (≤ 60%) response rates (38%). Pilot testing was not undertaken in 67% of the studies. Few studies dealt with sample size (2%), power (3%), assumptions (7%), confidence intervals (3%), or effect sizes (3%). Improving some of these problems and deficits may enhance future research in this field.

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Vegetarian and Omnivorous Nutrition—Comparing Physical Performance

Joel C. Craddock, Yasmine C. Probst, and Gregory E. Peoples

Humans consuming vegetarian-based diets are observed to have reduced relative risk for many chronic diseases. Similarly, regular physical activity has also been shown to assist in preventing, and reducing the severity of these conditions. Many people, including athletes, acknowledge these findings and are adopting a vegetarian-based diet to improve their health status. Furthermore, athletes are incorporating this approach with the specific aim of optimizing physical performance. To examine the evidence for the relationship between consuming a predominately vegetarian-based diet and improved physical performance, a systematic literature review was performed using the SCOPUS database. No date parameters were set. The keywords vegetarian OR vegan AND sport OR athlete OR training OR performance OR endurance were used to identify relevant literature. Included studies (i) directly compared a vegetarian-based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, and (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Seven randomized controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian-based diets and omnivorous mixed diets were identified when physical performance was compared. Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes. However, with only 8 studies identified, with substantial variability among the studies’ experimental designs, aims and outcomes, further research is warranted.

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Caffeine and Creatine Content of Dietary Supplements Consumed by Brazilian Soccer Players

Suelen Galante Inácio, Gustavo Vieira de Oliveira, and Thiago Silveira Alvares

Caffeine and creatine are ingredients in the most popular dietary supplements consumed by soccer players. However, some products may not contain the disclosed amounts of the ingredients listed on the label, compromising the safe usage and the effectiveness of these supplements. Therefore, the aim of this study was to evaluate the content of caffeine and creatine in dietary supplements consumed by Brazilian soccer players. The results obtained were compared with the caffeine content listed on the product label. Two batches of the supplement brands consumed by ≥ 50% of the players were considered for analysis. The quantification of caffeine and creatine in the supplements was determined by a high-performance liquid chromatography system with UV detector. Nine supplements of caffeine and 7 supplements of creatine met the inclusion criteria for analysis. Eight brands of caffeine and five brands of creatine showed significantly different values (p < .05) as compared with the values stated on the label. There were no significant differences between the two batches of supplements analyzed, except for one caffeine supplement. It can be concluded that caffeine and creatine dietary supplements consumed by Brazilian soccer players present inaccurate values listed on the label, although most presented no difference among batches. To ensure consumer safety and product efficacy, accurate information on caffeine and creatine content should be provided on all dietary supplement labels.

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The Effect of Nitrate Supplementation on Exercise Performance in Healthy Individuals: A Systematic Review and Meta-Analysis

Matthew W. Hoon, Nathan A. Johnson, Phillip G. Chapman, and Louise M. Burke

The purpose of this review was to examine the effect of nitrate supplementation on exercise performance by systematic review and meta-analysis of controlled human studies. A search of four electronic databases and cross-referencing found 17 studies investigating the effect of inorganic nitrate supplementation on exercise performance that met the inclusion criteria. Beetroot juice and sodium nitrate were the most common supplements, with doses ranging from 300 to 600 mg nitrate and prescribed in a manner ranging from a single bolus to 15 days of regular ingestion. Pooled analysis showed a significant moderate benefit (ES = 0.79, 95% CI: 0.23–1.35) of nitrate supplementation on performance for time to exhaustion tests (p = .006). There was a small but insignificant beneficial effect on performance for time trials (ES = 0.11, 95% CI: –0.16–0.37) and graded exercise tests (ES = 0.26, 95% CI: –0.10–0.62). Qualitative analysis suggested that performance benefits are more often observed in inactive to recreationally active individuals and when a chronic loading of nitrate over several days is undertaken. Overall, these results suggest that nitrate supplementation is associated with a moderate improvement in constant load time to exhaustion tasks. Despite not reaching statistical significance, the small positive effect on time trial or graded exercise performance may be meaningful in an elite sport context. More data are required to clarify the effect of nitrate supplementation on exercise performance and to elucidate the optimal way to implement supplementation.

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The Effects of Beta-Alanine Supplementation on Performance: A Systematic Review of the Literature

Jairus J. Quesnele, Michelle A. Laframboise, Jessica J. Wong, Peter Kim, and Greg D. Wells

Purpose:

To critically review the methodological quality and synthesize information from systematic reviews and high quality studies on the effects of beta alanine (BA) on exercise and athletic performance.

Methods:

A search strategy was developed in accordance with the standards for the reporting of scientific literature via systematic reviews. Five databases were thoroughly searched from inception to November 2012. Inclusion criteria were English language, human studies, used BA to increase exercise or athletic performance, systematic reviews or randomized controlled trials and were published in a peer-reviewed journal. Included studies were systematically graded for their methodological quality by rotating pairs of reviewers and the results were qualitatively synthesized.

Results:

One systematic review and 19 randomized trials were included in this review. There is one systematic review with several methodological weaknesses that limit the confidence in its results. There are moderate to high quality studies that appear to support that BA may increase power output and working capacity, decrease the feeling of fatigue and exhaustion, and have of positive effect on body composition and carnosine content. The reporting of side effects from BA supplementation in the athletic population was generally under-reported.

Conclusions:

There appears to be some evidence from this review that supplementation with BA may increase athletic performance. However, there is insufficient evidence examining the safety of BA supplementation and its side effects. It is therefore recommended to err on the side of caution in using BA as an ergogenic aid until there is sufficient evidence confirming its safety.

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Evaluation of Food Provision and Nutrition Support at the London 2012 Olympic Games: The Opinion of Sports Nutrition Experts

Fiona Pelly, Nanna L. Meyer, Jeni Pearce, Sarah J. Burkhart, and Louise M. Burke

The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of postcompetition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

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Effects of Sodium Bicarbonate Ingestion on Anaerobic Performance: A Meta-Analytic Review

Larry G. Matson and Zung Vu Tran

Many researchers have investigated the effects of induced metabolic alkalosis, by ingestion of sodium bicarbonate, on anaerobic exercise performance. But the results have been inconsistent and often contradictory. The purpose of this review was to synthesize the varied findings using a meta-analytic approach. Twenty-nine investigations met our inclusion criteria. Results show that NaHCO 3 , ingestion clearly results in a more alkaline extracellular environment. The dosage, however, was only moderately related to the increase in pH and HCO3- . Overall, performance was enhanced but the range of effect sizes was large, -0.12 to 2.87. In studies that measured time to exhaustion, there was a mean 27±20% increase in duration. The treatment effect, however, was only weakly related to the degree of induced alkalosis. But in comparing the 19 studies that showed a positive treatment effect with the 16 that showed no effect, the former were associated with a greater increase in pH following ingestion of a somewhat larger dosage, and a greater decrease in pH with exercise.

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Isocaloric Carbohydrate Versus Carbohydrate-Protein Ingestion and Cycling Time-Trial Performance

Rebecca J. Toone and James A. Betts

This study was designed to compare the effects of energy-matched carbohydrate (CHO) and carbohydrate-protein (CHO-PRO) supplements on cycling time-trial performance. Twelve competitive male cyclists and triathletes each completed 2 trials in a randomized and counterbalanced order that were separated by 5–10 d and applied in a double-blind manner. Participants performed a 45-min variable-intensity exercise protocol on a cycle ergometer while ingesting either a 9% CHO solution or a mixture of 6.8% CHO plus 2.2% protein in volumes providing 22 kJ/kg body mass. Participants were then asked to cycle 6 km in the shortest time possible. Blood glucose and lactate concentrations were measured every 15 min during exercise, along with measures of substrate oxidation via indirect calorimetry, heart rate, and ratings of perceived exertion. Mean time to complete the 6-km time trial was 433 ± 21 s in CHO trials and 438 ± 22 s in CHO-PRO trials, which represents a 0.94% (CI: 0.01, 1.86) decrement in performance with the inclusion of protein (p = .048). However, no other variable measured in this study was significantly different between trials. Reducing the quantity of CHO included in a supplement and replacing it with protein may not represent an effective nutritional strategy when the supplement is ingested during exercise. This may reflect the central ergogenic influence of exogenous CHO during such activity.

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Influence of Beverage Temperature on Exercise Performance in the Heat: A Systematic Review

Catriona A. Burdon, Helen T. O’Connor, Janelle A. Gifford, and Susan M. Shirreffs

Purpose:

Increased core temperature (Tc), impaired cardiovascular function, and dehydration contribute to fatigue during prolonged exercise in the heat. Although many studies have examined mechanisms addressing these factors, few have investigated the effect of cold beverage temperature on thermoregulation and exercise performance in the heat.

Methods:

Citations from MEDLINE (Ovid), Sport Discus (EBSCOhost), AUSPORT and AusportMed (Informit), Web of Science, and SCOPUS were identified from the earliest record until September 2008 using the search terms drink temperature, beverage temperature, fluid temperature, water temperature, and cold fluid combined with body temperature and thermoregulation. To be included, studies needed to assess core or rectal temperature during exercise in moderate or hot environmental conditions. After quality rating was completed by two reviewers, the difference in mean Tc and exercise performance was calculated.

Results:

Ten studies meeting search inclusion criteria were available for analysis. Three were excluded because sufficient detail or statistical data were not reported. A meta-analysis was not performed because the studies were deemed too different to group. Three of the remaining 7 studies found modulated Tc with cold beverage consumption, and from the 4 that conducted exercise performance tests, performance improved by 10% with cold fluids.

Conclusion:

Cold fluid may attenuate Tc rise and improve exercise performance in the heat; however, study findings are mixed. Research using well-trained athletes and fluid-ingestion protocols replicating competition scenarios is required. Potential sensory effects of cold fluid in maintaining motivation also need to be assessed as a mechanism underpinning improved performance.