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Charles S. Urwin, Dan B. Dwyer, and Amelia J. Carr

Sodium citrate induces alkalosis and can provide a performance benefit in high-intensity exercise. Previous investigations have been inconsistent in the ingestion protocols used, in particular the dose and timing of ingestion before the onset of exercise. The primary aim of the current study was to quantify blood pH, blood bicarbonate concentration and gastrointestinal symptoms after ingestion of three doses of sodium citrate (500 mg⋅kg-1, 700 mg⋅kg-1 and 900 mg⋅kg-1). Thirteen participants completed four experimental sessions, each consisting of a different dose of sodium citrate or a taste-matched placebo solution. Blood pH and blood bicarbonate concentration were measured at 30-min intervals via analysis of capillary blood samples. Gastrointestinal symptoms were also monitored at 30-min intervals. Statistical significance was accepted at a level of p < .05. Both measures of alkalosis were significantly greater after ingestion of sodium citrate compared with placebo (p < .001). No significant differences in alkalosis were found between the three sodium citrate doses (p > .05). Peak alkalosis following sodium citrate ingestion ranged from 180 to 212 min after ingestion. Gastrointestinal symptoms were significantly higher after sodium citrate ingestion compared with placebo (p < .001), while the 900 mg.kg-1 dose elicited significantly greater gastrointestinal distress than 500 mg⋅kg-1 (p = .004). It is recommended that a dose of 500 mg⋅kg-1 of sodium citrate should be ingested at least 3 hr before exercise, to achieve peak alkalosis and to minimize gastrointestinal symptoms before and during exercise.

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Vitor de Salles Painelli, Rafael Pires da Silva, Odilon Marques de Oliveira Junior, Luana Farias de Oliveira, Fabiana Braga Benatti, Tobias Rabelo, João Paulo Limongi França Guilherme, Antonio Herbert Lancha Junior, and Guilherme Giannini Artioli

We investigated the effects of low- and high-dose calcium lactate supplementation on blood pH and bicarbonate (Study A) and on repeated high-intensity performance (Study B). In Study A, 10 young, physically active men (age: 24 ± 2.5 years; weight: 79.2 ± 9.45 kg; height: 1.79 ± 0.06 m) were assigned to acutely receive three different treatments, in a crossover fashion: high-dose calcium lactate (HD: 300 mg·kg−1 body mass), low-dose calcium lactate (LD: 150 mg·kg−1 body mass) and placebo (PL). During each visit, participants received one of these treatments and were assessed for blood pH and bicarbonate 0, 60, 90, 120, 150, 180, and 240 min following ingestion. In Study B, 12 young male participants (age: 26 ± 4.5 years; weight: 82.0 ± 11.0 kg; height: 1.81 ± 0.07 m) received the same treatments of Study A. Ninety minutes after ingestion, participants underwent 3 bouts of the upper-body Wingate test and were assessed for blood pH and bicarbonate 0 and 90 min following ingestion and immediately after exercise. In Study A, both HD and LD promoted slight but significant increases in blood bicarbonate (31.47 ± 1.57 and 31.69 ± 1.04 mmol·L−1, respectively) and pH levels (7.36 ± 0.02 and 7.36 ± 0.01, respectively), with no effect of PL. In Study B, total work done, peak power, mean power output were not affected by treatments. In conclusion, low- and high-dose calcium lactate supplementation induced similar, yet very discrete, increases in blood pH and bicarbonate, which were not sufficiently large to improve repeated high-intensity performance.

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Jason C. Siegler, Amelia J. Carr, William T. Jardine, Lilia Convit, Rebecca Cross, Dale Chapman, Louise M. Burke, and Megan Ross

to our knowledge; these buffering agents have not been comprehensively profiled in terms of their capacity to influence fluid retention prior to exercise. In conditions where both buffering supplementation and hyperhydration may benefit performance, such as beginning a “long-finish” earlier in an

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Ronald J. Maughan, Louise M. Burke, Jiri Dvorak, D. Enette Larson-Meyer, Peter Peeling, Stuart M. Phillips, Eric S. Rawson, Neil P. Walsh, Ina Garthe, Hans Geyer, Romain Meeusen, Luc van Loon, Susan M. Shirreffs, Lawrence L. Spriet, Mark Stuart, Alan Vernec, Kevin Currell, Vidya M. Ali, Richard G.M. Budgett, Arne Ljungqvist, Margo Mountjoy, Yannis Pitsiladis, Torbjørn Soligard, Uğur Erdener, and Lars Engebretsen

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete’s health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete’s health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

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Wim Derave and Kevin D. Tipton

Many athletes use dietary supplements, with use more prevalent among those competing at the highest level. Supplements are often self-prescribed, and their use is likely to be based on an inadequate understanding of the issues at stake. Supplementation with essential micronutrients may be useful when a diagnosed deficiency cannot be promptly and effectively corrected with food-based dietary solutions. When used in high doses, some supplements may do more harm than good: Iron supplementation, for example, is potentially harmful. There is good evidence from laboratory studies and some evidence from field studies to support health or performance benefits from appropriate use of a few supplements. The available evidence from studies of aquatic sports is small and is often contradictory. Evidence from elite performers is almost entirely absent, but some athletes may benefit from informed use of creatine, caffeine, and buffering agents. Poor quality assurance in some parts of the dietary supplements industry raises concerns about the safety of some products. Some do not contain the active ingredients listed on the label, and some contain toxic substances, including prescription drugs, that can cause health problems. Some supplements contain compounds that will cause an athlete to fail a doping test. Supplement quality assurance programs can reduce, but not entirely eliminate, this risk.

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International Olympic Committee Expert Group on Dietary Supplements in Athletes

marginal gains be explored. A few specific supplements may offer performance benefits to some athletes, but their use requires careful evaluation. Supplements supported by good evidence of efficacy, in at least some exercise models, include carbohydrate, protein, caffeine, creatine, specific buffering

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Charles S. Urwin, Rodney J. Snow, Dominique Condo, Rhiannon Snipe, Glenn D. Wadley, and Amelia J. Carr

Performance of high-intensity (> 90% VO 2 max) and/or short-duration (< 420 s) exercise may be partially limited by blood acidosis (decreased blood pH and blood bicarbonate concentration ([HCO 3 − ]); Carr et al., 2011 ). Sodium citrate and sodium bicarbonate are frequently used buffering agents

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William H. Gurton, Steve H. Faulkner, and Ruth M. James

and performed >4 hours of cycling-based training per week, had cycled for >2 years, and had not ingested buffering agents in the previous 6 months. Ethical approval was gained from the human ethics committee at Nottingham Trent University. Participants signed informed consent prior to data collection

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Nathan Philip Hilton, Nicholas Keith Leach, Melissa May Craig, S. Andy Sparks, and Lars Robert McNaughton

performed regular exercise training (≥ 3 day/week) for at least 2 years and were free of GI-related disorders. The exclusion criteria included those with hypertension or renal impairment or those following a salt-restricted diet, and no participants were ingesting buffering agents or medications at the time

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Gary J. Slater, Jennifer Sygo, and Majke Jorgensen

performance may be enhanced if buffering capacity can be increased through the ingestion of acute buffering agents such as sodium bicarbonate. This may be especially relevant for the longer duration (400 m) sprints characterized by substantial acid–base disturbances. More recently, there has been significant