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Awareness and Use of Caffeine by Athletes Competing at the 2005 Ironman Triathlon World Championships

Ben Desbrow and Michael Leveritt

This study assessed the knowledge, prevalence, and quantity of caffeine use by athletes competing at the 2005 Ironman Triathlon World Championships. Caffeine-related questionnaires were self-administered to 140 (105 male and 35 female, 40.3 ± 10.7 y) athletes representing 16 countries. Fifty of these athletes further consented to immediate post-race blood samples for analysis of plasma caffeine and paraxanthine using high-performance liquid chromatography (HPLC). Seventy-two percent of 70 athletes correctly identified caffeine as being an unrestricted substance in triathlon. The majority of athletes [125 (89%)] were planning on using a caffeinated substance immediately prior to or throughout the race. Cola drinks (78%), caffeinated gels (42%), coffee (usually pre-race) (37%), energy drinks (13%), and NoDoz tablets (9%) were the most popular caffeinated choices. Mean ± standard deviation (and range) post race plasma caffeine and paraxanthine levels were 22.3 ± 20 μmol/L (1.7 to 98.4) and 9.4 ± 6 μmol/L (1.8 to 28.9), respectively. Seven athletes (14%) finished with plasma caffeine levels > 40 μmol/L. Plasma values from elite athletes did not differ from age group competitors. Despite the prevalence of its consumption and the training experience of this athletic group, over one quarter of athletes remained either confused or uninformed about caffeine’s legality. Levels of plasma caffeine taken immediately post race indicated that athletes typically finish with quantities of caffeine that have been shown to improve endurance performance (i.e., ~ 20 μmol/L or a dose of > 3 mg/kg body weight).

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Well-Trained Endurance Athletes’ Knowledge, Insight, and Experience of Caffeine Use

Ben Desbrow and Michael Leveritt

This descriptive cross-sectional study assessed the perceptions, knowledge, and experiences of caffeine use by athletes competing at the 2005 Ironman Triathlon World Championships. Questionnaires were distributed to 140 athletes (105 men and 35 women, 40.3 ± 10.7 y old) representing 16 countries during prerace registration. A large proportion (73%) of these endurance athletes believe that caffeine is ergogenic to their endurance performance, and 84% believe it improves their concentration. The most commonly reported positive caffeine experiences related to in-competition use of cola drinks (65%) and caffeinated gels (24%). The athletes’ ability to accurately quantify the caffeine content of common food items was limited. The most popular sources of caffeine information were self-experimentation (16%), fellow athletes (15%), magazines (13%), and journal articles (12%). Over half the athletes (53%) could not identify an amount of caffeine required to improve their triathlon performance. Mean (± standard deviation) suggested doses were 3.8 (± 3) mg/kg body weight. Few side effects associated with taking caffeine during exercise were reported.

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Are Coaches of Female Athletes Informed of Relative Energy Deficiency in Sport? A Scoping Review

Jennifer Hamer, Ben Desbrow, and Chris Irwin

In the last decade, there has been greater appreciation of the harmful consequences of Relative Energy Deficiency in Sport (RED-S), particularly in adolescent female athletes. Coaches act as both important moderators in the development of the condition and as identifiers of athletes at risk. Research suggests that coaches lack knowledge on this topic. At present, it is unclear if RED-S education is incorporated into coach accreditation pathways. The aim of this scoping review was to describe the extent to which RED-S education is incorporated into the coach accreditation pathways of endurance sporting organizations. Five national sporting organizations (Cycling Australia, Athletics Australia, Swimming Australia, Triathlon Australia, and Rowing Australia) were contacted to participate. First, each sporting organization’s website was scoped, then semi-structured interviews were conducted online. One investigator transcribed each interview verbatim. Transcripts were analyzed for thematic content. Four of the sporting organizations provided little to no RED-S education. Rowing Australia delivered a program of RED-S content via an affiliated sports dietitian. The barriers identified for implementation of RED-S content were: limited time, resources, and coaches’ preexisting knowledge and beliefs. Based on these results, RED-S education is, indeed, lacking in some coach accreditation programs for endurance-based sporting organizations. Support for these organizations is required to overcome existing barriers and to facilitate inclusion of RED-S education within the coaching curriculum to support female athlete health.

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Drink-Flavor Change’s Lack of Effect on Endurance Cycling Performance in Trained Athletes

Ben Desbrow, Clare Minahan, and Michael Leveritt

This study investigated whether a change in beverage favor during endurance cycling improves subsequent performance. Eight trained male athletes (age 24.3 ± 3.9 y, weight 74.7 ± 6.0 kg, peak O2 uptake [VO2peak] 65.4 ± 5.4 mL·kg−1·min−1; mean ± SD) undertook 3 trials, with training and diet being controlled. Trials consisted of 120 min of steady-state (SS) cycling at ~70% VO2peak, immediately followed by a 7-kJ/kg time trial (TT). During exercise subjects were provided with fluids every 20 min. After 80 min of SS cycling subjects either continued drinking the same-favor sports drink or changed to an alternate favor—either an alternate-favor sports drink (AFSD) or cola. All beverages were carbohydrate and volume matched. Changing drink favor caused no significant change in TT time (sports drink 27:16 ± 03:12, AFSD 27:06 ± 03:16, cola 27:03 ± 02:42; min: s). The various favors produced no treatment effects on heart rate, blood glucose, or rating of perceived exertion throughout the SS exercise protocol. The influence of other taste variables such as palatability, bitterness, or timing of favor change on endurance-exercise performance requires more rigorous investigation.

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Beer as a Sports Drink? Manipulating Beer’s Ingredients to Replace Lost Fluid

Ben Desbrow, Daniel Murray, and Michael Leveritt


To investigate the effect of manipulating the alcohol and sodium content of beer on fluid restoration following exercise.


Seven male volunteers exercised on a cycle ergometer until 1.96 ± 0.25% body mass (mean± SD) was lost. Participants were then randomly allocated a different beer to consume on four separate occasions. Drinks included a low-alcohol beer (2.3% ABV; LightBeer), a low-alcohol beer with 25 mmol×L−1 of added sodium (LightBeer+25), a full-strength beer (4.8% ABV; Beer), or a full-strength beer with 25 mmol×L−1 of added sodium (Beer+25). Volumes consumed were equivalent to 150% of body mass loss during exercise and were consumed over a 1h period. Body mass and urine samples were obtained before and hourly for 4 hr after beverage consumption.


Significantly enhanced net fluid balance was achieved following the LightBeer+25 trial (–1.02 ± 0.35 kg) compared with the Beer (–1.59 ± 0.32 kg) and Beer+25 (–1.64 ± 0.28 kg) treatments. Accumulated urine output was significantly lower in the LightBeer+25 trial (1477 ± 485 ml) compared with the Beer+25 (2101 ± 482 ml) and Beer (2175 ± 372 ml) trials.


A low alcohol beer with added sodium offers a potential compromise between a beverage with high social acceptance and one which avoids the exacerbated fluid losses observed when consuming full strength beer.

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Personal Trainer Perceptions of Providing Nutrition Care to Clients: A Qualitative Exploration

Katelyn Barnes, Lauren Ball, and Ben Desbrow

Personal trainers are well placed to provide basic nutrition care in line with national dietary guidelines. However, many personal trainers provide nutrition care beyond their scope of practice and this has been identified as a major industry risk due to a perceived lack of competence in nutrition. This paper explores the context in which personal trainers provide nutrition care, by understanding personal trainers’ perceptions of nutrition care in relation to their role and scope of practice. Semistructured telephone interviews were conducted with 15 personal trainers working within Australia. Thematic analysis was used to identify key themes. All personal trainers reported to provide nutrition care and reported that nutrition care was an important component of their role. Despite this, many were unaware or uncertain of the scope of practice for personal trainers. Some personal trainers reported a gap between the nutrition knowledge they received in their formal education, and the knowledge they needed to optimally support their clients to adopt healthy dietary behaviors. Overall, the personal training context is likely to be conducive to providing nutrition care. Despite concerns about competence personal trainers have not modified their nutrition care practices. To ensure personal trainers provide nutrition care in a safe and effective manner, greater enforcement of the scope of practice is required as well as clear nutrition competencies or standards to be developed during training.

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An International Comparison of Nutrition Education Standards, Occupational Standards and Scopes of Practice for Personal Trainers

Katelyn Barnes, Lauren Ball, and Ben Desbrow

Personal trainers are well placed to provide nutrition care in line with their recommended scope of practice. However, providing nutrition care beyond their recommended scope of practice has been identified as an industry risk. The International Confederation of Registers for Exercise Professionals (ICREPs) have international standards for nutrition knowledge and skills that are recommended for all fitness professionals, including personal trainers. This study investigates whether the ICREPs standards align with i) national nutrition education standards and ii) national nutrition occupational standards and scopes of practice for personal trainers within ICREPs affiliated countries. Content analysis of each standard and/or scope of practice was undertaken to extract nutrition statements. Extracted statements were matched with nutrition components of the ICREPs standards to result in a score based on the number of aligned ICREPs knowledge and skills criteria. Ten countries, with 16 organizations, were identified as being involved in the development of national education standards, occupational standards, or scopes of practice for personal trainers. The educational and occupational standards varied widely among countries and had minimal alignment with the ICREPs standards. As such, the expected role of personal trainers in providing nutrition care appeared to differ between countries. Further work is required to support personal trainers to develop a level of knowledge and skills that enables the provision of safe, consistent, and effective nutrition care.

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Carbohydrate-Electrolyte Feedings and 1h Time Trial Cycling Performance

Ben Desbrow, Sally Anderson, Jennifer Barrett, Elissa Rao, and Mark Hargreaves

The effects of a commercial sports drink on performance in high-intensity cycling was investigated. Nine well-trained subjects were asked to complete a set amount of work as fast as possible (time trial) following 24 h of dietary (subjects were provided with food, energy 57.4 ± 2.4 kcal/kg and carbohydrate 9.1 ± 0.4 g/kg) and exercise control. During exercise, subjects were provided with 14 mL/kg of either 6% carbohydrate-electrolyte (CHO-E) solution or carbohydrate-free placebo (P). Results showed that subjects’ performances did not greatly improve (time, 62:34 ± 6:44 min:sec (CHO-E) vs. 62:40 ± 5:35 min:sec (P); average power output, 283.0 ± 25.0 W (CHO-E) vs. 282.9 ± 29.3 W (P), P > 0.05) while consuming the sports drink. It was concluded that CHO-E consumption throughout a 1-h time trial, following a pre-exercise dietary regimen designed to optimize glucose availability, did not improve time or power output to a greater degree than P in well-trained cyclists.

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A Nutrition Recovery Station Following Recreational Exercise Improves Fruit Consumption but Does Not Influence Fluid Recovery

Ben Desbrow, Katelyn Barnes, Caroline Young, Greg R. Cox, and Chris Irwin

Immediate postexercise access to fruit/fluid via a recovery “station” is a common feature of mass participation sporting events. Yet little evidence exists examining their impact on subsequent dietary intake. The aim of this study was to determine if access to fruit/water/sports drinks within a recovery station significantly alters dietary and fluid intakes in the immediate postexercise period and influences hydration status the next morning. 127 (79 males) healthy participants (M ± SD, age = 22.5 ± 3.5y, body mass (BM) = 73 ± 13kg) completed two self-paced morning 10km runs separated by 1 week. Immediately following the first run, participants were randomly assigned to enter (or not) the recovery station for 30min. All participants completed the alternate recovery option the following week. Participants recorded BM before and after exercise and measured Urine Specific Gravity (USG) before running and again the following morning. For both trial days, participants also completed 24h food and fluid records via a food diary that included photographs. Paired-sample t tests were used to assess differences in hydration and dietary outcome variables (Recovery vs. No Recovery). No difference in preexercise USG or BM change from exercise were observed between treatments (p’s > .05). Attending the recovery zone resulted in a greater total daily fluid (Recovery = 3.37 ± 1.46L, No Recovery = 3.16 ± 1.32L, p = .009) and fruit intake (Recovery = 2.37 ± 1.76 servings, No Recovery = 1.55 ± 1.61 servings, p > .001), but had no influence on daily total energy (Recovery = 10.15 ± 4.2MJ, No Recovery = 10.15 ± 3.9MJ), or macronutrient intakes (p > .05). Next morning USG values were not different between treatments (Recovery = 1.018 ± 0.007, No Recovery = 1.019 ± 0.009, p > .05). Recovery stations provide an opportunity to modify dietary intake which promote positive lifestyle behaviors in recreational athletes.

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Manipulations to the Alcohol and Sodium Content of Beer for Postexercise Rehydration

Ben Desbrow, Danielle Cecchin, Ashleigh Jones, Gary Grant, Chris Irwin, and Michael Leveritt

The addition of 25 mmol·L−1 sodium to low alcohol (2.3% ABV) beer has been shown to enhance post exercise fluid retention compared with full strength (4.8% ABV) beer with and without electrolyte modification. This investigation explored the effect of further manipulations to the alcohol and sodium content of beer on fluid restoration following exercise. Twelve male volunteers lost 2.03 ± 0.19% body mass (mean ± SD) using cycling-based exercise. Participants were then randomly allocated a different beer to consume on four separate occasions. Drinks included low alcohol beer with 25 mmol·L−1 of added sodium [LightBeer+25], low alcohol beer with 50 mmol·L−1 of added sodium [LightBeer+50], midstrength beer (3.5% ABV) [Mid] or midstrength beer with 25 mmolL−1 of added sodium [Mid+25]. Total drink volumes in each trial were equivalent to 150% of body mass loss during exercise, consumed over a 1h period. Body mass, urine samples and regulatory hormones were obtained before and 4 hr after beverage consumption. Total urine output was significantly lower in the LightBeer+50 trial (1450 ± 183 ml) compared with the LightBeer+25 (1796 ± 284 ml), Mid+25 (1786 ± 373 ml) and Mid (1986 ± 304 ml) trials (allp < .05). This resulted in significantly higher net body mass following the LightBeer+50 trial (-0.97 ± 0.17kg) compared with all other beverages (LightBeer+25 (-1.30 ± 0.24 kg), Mid+25 (-1.38 ± 0.33 kg) and Mid (-1.58 ± 0.29 kg), all p < .05). No significant changes to aldosterone or vasopressin were associated with different drink treatments. The electrolyte concentration of low alcohol beer appears to have more significant impact on post exercise fluid retention than small changes in alcohol content.