IOC consensus statement: dietary supplements and the high-performance athlete

Nutritional Supplement Use in a UK High-Performance Swimming Club

The aim of this study was to observe the nutritional supplement practices of highly trained swimmers on a national talent pathway, since it is often reported that swimmers engage in widespread supplement use at the elite level. Thus, this study employed a validated supplement intake questionnaire with forty-four swimmers from a high-performance swimming club, which had three distinct talent stages: development (aged 11-14 years, n = 20), age-group (aged 13-17 years, n = 13), and national level (aged ≥ 16 years, n = 11). Ninety-eight percent of the interviewed swimmers reported using at least one supplement, with performance (34%) and recovery (19%) cited as the primary reasons. National swimmers used more total supplements (8.1 ± 3.4 supplements) compared to age-group (4.8 ± 2.0 supplements, p = 0.003, g = 1.17) and development (3.9 ± 1.7 supplements, p < 0.001, g = 1.69) swimmers, mostly because of a greater intake of ergogenic aids (2.4 ± 1.4 supplements vs. age-group: 0.5 ± 0.5 supplements, p < 0.001, g = 1.12; vs. development: 0.1 ± 0.2 supplements, p < 0.001, g = 1.81). Parents/guardians were the primary supplement informants of development swimmers (74%, p < 0.001, V = 0.50), whereas performance nutritionists informed ~50% of supplements used by age-group and national swimmers (p < 0.001, V = 0.51). Based on these results, supplement education and greater focus on basic sport nutrition practices may be required for parents/guardians at the development level. Moreover, further research is needed to support the high number of ergogenic aids used by national swimmers, with the efficacy of these supplements currently equivocal in the applied setting.

Effects of Acute Caffeine Ingestion on Cognitive Performance before and after Repeated Small-Sided Games in Professional Soccer Players: A Placebo-Controlled, Randomized Crossover Trial

Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg^-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg^-1) was detrimental.

Effect of 3 and 6 mg/kg of caffeine on fat oxidation during exercise in healthy active females

The aim of this study was to investigate the effect of 3 and 6 mg of caffeine per kg of body mass (mg/kg) on whole-body substrate oxidation during an incremental cycling exercise test in healthy active women. Using a double-blind placebo-controlled counterbalanced experimental design, 14 subjects performed three identical exercise trials after the ingestion of 3 or 6 mg/kg of caffeine or placebo. The exercise trials consisted of an incremental test on a cycle ergometer with 3-min stages at workloads from 30 to 70% of maximal oxygen uptake (VO2max). Substrate oxidation rates were measured by indirect calorimetry. During exercise, there was a significant effect of substance (F = 5.221; p = 0.016) on fat oxidation rate. In comparison to the placebo, 3 mg/kg of caffeine increased fat oxidation rates at 30 to 60% of VO2max (all p < 0.050) and 6 mg/kg at 30 to 50% of VO2max (all p < 0.050). There was also a significant effect of substance (F = 5.221; p = 0.016) on carbohydrate oxidation rate (F = 9.632; p < 0.001). In comparison to placebo, both caffeine doses decreased carbohydrate oxidation rates at 40 to 60% VO2max (all p < 0.050). The maximal rate of fat oxidation with placebo was 0.24 ± 0.03 g/min, which increased with 3 mg/kg to 0.29 ± 0.04 g/min (p = 0.032) and to 0.29 ± 0.03 with 6 mg/kg of caffeine (p = 0.042). Acute intake of caffeine improves the utilization of fat as a fuel during submaximal aerobic exercise in healthy active women with an effect of similar magnitude after the intake of 3 and 6 mg of caffeine per kg of body mass. Thus, the use of 3 mg/kg of caffeine would be more recommended than 6 mg/kg for women seeking increased fat utilization during submaximal exercise.

Importance of "meal first" strategy and effective situations of supplement use in elite athletes: Japan high performance sport center position stand

The "meal first" strategy is traditionally recommended for athletes' conditioning. However, the importance of the "meal first" principle has not been detailly well documented in athletes' lives. Supplement use has recently become a common part of athletes' diets, but unmonitored supplement use can cause negative consequences, such as anti-doping violations and health issues. Therefore, this review summarizes how the "meal first" strategy and planned supplement use are important for enhancing athletes' health and performance. We believe that the "meal first" strategy is beneficial in terms of the following aspects: (1) consumption of multi-nutrients and other functional components simultaneously; (2) positive effects on psychological well-being; (3) contribution to athletes' health by way of mastication; and (4) less risk for anti-doping violations. Before supplement use, we recommend that athletes first verify their basic factors (e.g., diet, training, and sleep), given that the benefits of supplements are examined and demonstrated with the control of those factors. Otherwise, athletes cannot obtain maximal benefits from the supplements. In contrast, there are situations in which supplements in athletes' lives can be advantageous, such as (1) nutrient deficiency due to ongoing dietary characteristics; (2) interruption of meals due to disease; (3) inaccessibility of quality food during athletic travel; (4) difficulty preparing food due to societal restrictions associated with disasters or infection outbreaks; (5) having a meal before, during, or after exercise is difficult; and (6) achieving targeted intake of performance-enhancing ingredients is not practical. In summary, we emphasize that the "meal first" strategy is recommended for athletes' conditioning, but there are several contexts when supplement use can be more useful in athletes' lives.

Effects of Nutrition Interventions on Athletic Performance in Soccer Players: A Systematic Review

BACKGROUND

More than 270 million participants and 128,893 professional players play soccer. Although UEFA recommendations for nutrition in elite football exist, implementing these guidelines among professional and semiprofessional soccer players remains suboptimal, emphasizing the need for targeted and individualized nutritional strategies to improve adherence to established recommendations.

METHODS

We conducted a comprehensive search in PubMed, Scopus, Web of Science, and clinical trial registers. Inclusion criteria focused on professional or semiprofessional soccer players, nutrition or diet interventions, performance improvement outcomes, and randomized clinical trial study types. We assessed quality using the Risk of Bias 2 (RoB 2) tool. We identified 16 eligible articles involving 310 participants. No nutritional interventions during the recovery period effectively improved recovery. However, several performance-based interventions showed positive effects, such as tart cherry supplementation, raw pistachio nut kernels, bicarbonate and mineral ingestion, creatine supplementation, betaine consumption, symbiotic supplements, and a high-carbohydrate diet. These interventions influenced various aspects of soccer performance, including endurance, speed, agility, strength, power, explosiveness, and anaerobic capacity.

CONCLUSIONS

Specific strategies, such as solutions with bicarbonate and minerals, high carbohydrate diets, and supplements like creatine, betaine, and tart cherry, can enhance the performance of professional soccer players. These targeted nutritional interventions may help optimize performance and provide the competitive edge required in professional soccer. We did not find any dietary interventions that could enhance recovery.

Effects of Dietary Nitrate Supplementation on Back Squat and Bench Press Performance: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis investigated the influence of dietary nitrate supplementation on resistance exercise performance according to the PRISMA guidelines. Searches were conducted on MEDLINE, PubMed, ScienceDirect, Scopus and SPORTDiscus databases up to April 2023. Inclusion criteria were adult resistance-trained males who supplemented with a nitrate-rich supplement and nitrate-deficient placebo to assess repetitions-to-failure (RTF), peak power, mean power, peak velocity, and/or mean velocity during back squat and bench press exercise. A random effects model was performed on six studies and showed that nitrate supplementation improved RTF (standardized mean difference [SMD]: 0.43, 95% confidence intervals [95% CI]: 0.156 to 0.699, p = 0.002), mean power (SMD: 0.40, 95% CI: 0.127 to 0.678, p = 0.004), and mean velocity (SMD: 0.57, 95% CI: 0.07 to 1.061, p = 0.025) but had no effect on peak power (SMD: 0.204, 95% CI: -0.004 to 0.411, p = 0.054) or peak velocity (SMD: 0.00, 95% CI: -0.173 to 0.173, p = 1.000) when back squat and bench press were combined. Subgroup analyses revealed that back squats were more likely to be enhanced and that a dosing regimen may influence the efficacy of nitrate supplementation. Overall, nitrate supplementation had a small beneficial effect on some aspects of resistance exercise performance, but there were limited studies available and the variability was large. Additional studies that focus on upper and lower body resistance exercise and nitrate dosage are required to elucidate the efficacy of dietary nitrate supplementation on resistance exercise performance.

Exploring the Relationship between Micronutrients and Athletic Performance: A Comprehensive Scientific Systematic Review of the Literature in Sports Medicine

The aim of this systematic review is twofold: (i) to examine the effects of micronutrient intake on athletic performance and (ii) to determine the specific micronutrients, such as vitamins, minerals, and antioxidants, that offer the most significant enhancements in terms of athletic performance, with the goal of providing guidance to athletes and coaches in optimizing their nutritional strategies. The study conducted a systematic search of electronic databases (i.e., PubMed, Web of Science, Scopus) using keywords pertaining to micronutrients, athletic performance, and exercise. The search involved particular criteria of studies published in English between 1950 and 2023. The findings suggest that vitamins and minerals are crucial for an athlete's health and physical performance, and no single micronutrient is more important than others. Micronutrients are necessary for optimal metabolic body's functions such as energy production, muscle growth, and recovery, which are all important for sport performance. Meeting the daily intake requirement of micronutrients is essential for athletes, and while a balanced diet that includes healthy lean protein sources, whole grains, fruits, and vegetables is generally sufficient, athletes who are unable to meet their micronutrient needs due to malabsorption or specific deficiencies may benefit from taking multivitamin supplements. However, athletes should only take micronutrient supplements with the consultation of a specialized physician or nutritionist and avoid taking them without confirming a deficiency.

Nutrition, Training, Supplementation, and Performance-Enhancing Drug Practices of Male and Female Physique Athletes Peaking for Competition

ABSTRACT

Escalante, G, Barakat, C, Tinsley, GM, and Schoenfeld, BJ. Nutrition, training, supplementation, and performance-enhancing drug practices of male and female physique athletes peaking for competition. J Strength Cond Res XX(X): 000-000, 2023-The purpose of this descriptive investigation was threefold: (a) to assess the nutrition, training, supplement, and performance-enhancement drug practices of male and female physique competitors 30 days before competition; (b) to examine the specific water and macronutrient manipulation performed by competitors during the last 3 days before competition; and (c) to assess physiological responses to precontest preparation including body composition, body fluids, resting heart rate, and blood pressure. Competitors reported performing moderately high volume, moderate to high repetition, split-body resistance training programs performed on most days of the week; the programs included the use of a variety of advanced training methods. A majority of competitors included cardio to expedite fat loss, and most reported performing cardio in a fasted state despite a lack of objective evidentiary support for the practice. Competitors substantially restricted calories and consumed protein in amounts well above research-based guidelines (>3 g·kg-1·d-1); carbohydrate and lipid intake were highly variable. Water was substantially reduced in the final 3 days before competition. Competitors used a variety of dietary supplements throughout the study period, many of which are not supported by research. Both male and female competitors reported using performance enhancing drugs (∼48 and ∼38%, respectively) including testosterone derivatives, selective androgen receptor modulators, and human growth hormone. More research is warranted to elucidate safer and more effective peak week practices for physique competitors.

The Effect of Acute Pre-Workout Supplement Ingestion on Basketball-Specific Performance of Well-Trained Athletes

A pre-workout supplement's (PWS; 200 mg caffeine, 3.3 g creatine monohydrate, 3.2 g β-alanine, 6 g citrulline malate and 5 g branched chained amino acid (BCAA) per dose) acute effects on the alactic (jumping, sprinting, agility), lactic (Running-Based Anaerobic Sprint Test, RAST) and aerobic performance (Yo-Yo Intermittent Recovery Test Level 1, Yo-Yo IRL1 VO_2max) of well-trained basketball players was investigated in this double-blind placebo-controlled study. Thirty players (age 18-31 years, height 166-195 cm, weight 70.2-116.7 kg, body fat 10.6-26.4%) were allocated to pre-workout (PWS, n = 15) or placebo (PL, n = 15) groups. Half of the participants in each group performed the evaluations without PWS or PL, while the rest consumed PWS or PL 30 min before the assessments (1st trial) and vice versa (2nd trial). Significant improvements in counter-movement jump (CMJ) (PWS: 4.3 ± 2.1%; PL: 1.2 ± 1.0%), agility (PWS: -2.9 ± 1.8%; PL: 1.8 ± 1.7%), RAST average (PWS: 18.3 ± 9.1%; PL: -2.2 ± 2.0%), minimum power (PWS: 13.7 ± 8.9%; PL: -7.5 ± 5.9%), and fatigue index (PWS: -25.0 ± 0.9%; PL: -4.6 ± 0.6%) were observed in the PWS group vs. the PL group (p < 0.05). No differences were found regarding sprinting, aerobic performance, and blood lactate concentrations. Thus, although players' alactic and lactic anaerobic performance could be improved, peak power, sprinting and aerobic performance are not.

Advances in Nutrition, Dietary Supplements and Ergogenic Aids for Athletic Performance: Trends and Future Prospects

Sports nutrition is a scientific discipline that explores the relationship between nutrients and physical exercise performance [...].

Development of an Instrument to Evaluate the Intake of Liquids, Food and Supplements in Endurance Competitions: Nutritional Intake Questionnaire for Endurance Competitions-NIQEC

BACKGROUND

In the last few years endurance sports have experienced a great increase in the number of competitions and participants. Dietary-nutritional planning is key for performing well during such competitions. To date, there is no questionnaire expressly developed to be able to analyze the consumption of liquids, foods, and supplements, as well as gastrointestinal problems in these events. This study describes the development of the Nutritional Intake Questionnaire for Endurance Competitions (NIQEC).

METHODS

The study was composed in the following phases: (1) Bibliographic search for the most important nutrients, (2) focus groups (17 dietitian-nutritionists and 15 experienced athletes) and generation of items, (3) Delphi surveys, and (4) cognitive interviews.

RESULTS

After an initial shaping of the questionnaire with the items that emerged in the focus groups, their relevance was evaluated by means of the Delphi survey, which showed more than 80% approval for most items. Finally, the cognitive interviews indicated that the questionnaire was simple and complete for its purpose. The final NIQEC (n = 50 items) was divided in 5 sections: Demographic data; sports data; consumption of liquids, food and supplements before, during, and after the competition; gastrointestinal complaints, and dietary-nutritional planning for the competition.

CONCLUSIONS

The NICEQ is a useful tool that allows collecting information from participants on sociodemographic factors and gastrointestinal complaints, and estimating the intake of liquid, food, and supplements, for endurance competitions.

Low Energy Availability (LEA) and Hypertension in Black Division I Collegiate Athletes: A Novel Pilot Study

The purpose of this study was to investigate the relationship between low energy availability (LEA) and nutritional content with high blood pressure (HBP) in African American Division I athletes. Twenty-three D1 African American pre-season athletes were recruited to participate. HBP was defined as >120 systolic blood pressure (BP) and <80 diastolic BP. Athletes self-reported nutritional intake using a non-consecutive 3-day food recall which was then reviewed by a sports dietitian. LEA was evaluated as total energy intake-total daily energy expenditure (TDEE), which was predicted. Additionally, micronutrients were evaluated. A statistical analysis relied on Spearman correlation (R), standardized mean difference with 95% confidence interval, mean ± SD, and odds ratios (OR). Correlation values were categorized: 0.20-0.39 = low; 0.40-0.69 = moderate; 0.70-1.0 = strong. A moderate relationship was observed between HBP and LEA (R = 0.56) with 14/23 having HBP. Of the 14 athletes observed with HBP, 78.5% (11/14) were calorically deficient (-529 ± 695 kcal) with an OR of 7.2. Micronutrient intake deficiencies were ubiquitous among the 23 HBP athletes: poly-unsaturated fatty acid -29.6%; omega-3 -26.0%; iron -46.0%; calcium -25.1%; and sodium -14.2%, amongst others. LEA and micronutrient deficiencies may contribute to HBP in Black D1 athletes, which has been shown to be the most common modifiable risk factor to decrease the risk of sudden cardiac death.

Micronutrient supplement intakes among collegiate and masters athletes: A cross-sectional study

Objective

In our cross-sectional study, we evaluated micronutrient supplementation intake among Collegiate and Masters Athletes.

Methods

We conducted a cross-sectional study to assess micronutrient supplementation consumption in Collegiate and Masters Athletes, comparing sex and sport classification within each respective group. Micronutrient supplement consumption data were measured using a Food Frequency Questionnaire. A two-way analysis of variance was used to explore the differences among Collegiate and Masters Athletes' supplement intakes of the following vitamins and minerals: vitamins A, B6, B12, C, E, D, and calcium, folate, iron, magnesium niacin, riboflavin, selenium, thiamine, and zinc. When significant differences were found, a Bonferroni post hoc test was performed to identify specific group differences. The significance level was set a priori at p &lt; 0.05.

Results

A total of 198 athletes (105 females and 93 males) were included in the study. Participants were 36.16 ± 12.33 years of age. Collegiate male athletes had significantly greater vitamin A [1,090.51 ± 154.72 vs. 473.93 ± 233.18 mg retinol activity equivalents (RAE)/day] (p &lt; 0.036), folate [337.14 ± 44.79 vs. 148.67 ± 67.50 mcg dietary folate equivalents (DFE)/day] (p &lt; 0.027), and magnesium (65.35 ± 8.28 vs. 31.28 ± 12.48 mg/day) (p &lt; 0.031) intakes compared to Collegiate female athletes. Collegiate CrossFit Athletes (940.71 ± 157.54 mg/day) had a significantly greater vitamin C intake compared to Collegiate General Athletes (156.34 ± 67.79 mg/day) (p &lt; 0.005), Collegiate Triathletes (88.57 ± 148.53 mg/day) (p &lt; 0.027), Collegiate Resistance Training Athletes (74.28 ± 143.81 mg/day) (p &lt; 0.020), and Collegiate Powerlifters (175.71 ± 128.63 mg/day) (p &lt; 0.044). Masters females had significantly greater calcium intakes compared to Masters males (494.09 ± 65.73 vs.187.89 ± 77.23 mg/day, respectively) (p &lt; 0.002). Collegiate Runners (41.35 ± 6.53 mg/day) had a significantly greater iron intake compared to Collegiate Powerlifters (4.50 ± 6.53 mg/day) (p &lt; 0.024). Masters Swimmers (61.43 ± 12.10 mg/day) had significantly greater iron intakes compared to Masters General Athletes (13.97 ± 3.56 mg/day) (p &lt; 0.014), Masters Runners (17.74 ± 2.32 mg/day) (p &lt; 0.03), Masters Triathletes (11.95 ± 3.73 mg/day) (p &lt; 0.008), Masters CrossFit Athletes (15.93 ± 5.36 mg/day) (p &lt; 0.043), Masters Rowers (9.10 ± 3.36 mg/day) (p &lt; 0.003), and Masters Cyclists (1.71 ± 9.88 mg/day) (p &lt; 0.011). Masters Powerlifters (47.14 ± 9.65 mg/day) had significantly greater zinc intakes compared to Masters General Athletes (9.57 ± 2.84 mg/day) (p &lt; 0.015), Masters Runners (10.67 ± 1.85 mg/day) (p &lt; 0.017), Masters Triathletes (10.24 ± 2.98 mg/day) (p &lt; 0.020), Masters Rowers (9.33 ± 2.68 mg/day) (p &lt; 0.013), and Masters Cyclists (1.43 ± 7.88 mg/day) (p &lt; 0.019). There were no other significant differences among the other micronutrient supplement intakes between the sexes or among the sport classification.

Conclusion

We reported significant differences among female and male Collegiate and Masters Athletes. Additionally, we reported significant differences among Collegiate and Masters Athletes sport classifications. Further research should examine both dietary and micronutrient supplement intake among Collegiate and Masters Athletes to examine the extent that athletes exceed the Recommended Dietary Allowances (RDA), and the potential effects on health and performance.

Beetroot juice ingestion does not improve neuromuscular performance and match-play demands in elite female hockey players: a randomized, double-blind, placebo-controlled study

PURPOSE

Beetroot juice is a dietary supplement that contains high levels of inorganic nitrate (NO_3-) and that its intake has proven effective at increasing blood nitric oxide (NO) concentrations improving endurance performance. However, the effect of this supplement in team sport performance, especially in female athletes, has been barely studied. This study aimed to compare the acute effects of beetroot juice supplementation on neuromuscular performance and match-play demands in elite female field hockey players.

METHODS

Eleven elite female hockey players (22.8 ± 5.1 years) belonging to a bronze team medal in Eurohockey Club Champions Cup participated in this study. Participants were randomly divided into two groups undergoing a test battery with beetroot juice (70 mL, 6.4 mmol NO₃^-) or placebo (70 mL, 0.04 mmol NO₃^-) in two different days with one week between protocols. The neuromuscular test battery consisted of a countermovement jump, isometric handgrip strength (i.e., dominant hand), 20 m-sprint and repeated sprint ability test (RSA). Afterward, a simulated hockey match play (2 × 12.5 min) was performed and recorded by Global Positioning System (GPS).

RESULTS

No statistically significant improvements were observed in any physical parameters analysed comparing beetroot juice compared to placebo ingestion, countermovement jump (p = 0.776, ES = 0.16), isometric handgrip strength (p = 0.829; ES = - 0.08), 20 m sprint test (p = 0.227; ES = - 0.23), mean repeated sprint ability (p = 0.955, ES = 0.03) and in any physical match demands measured by GPS (p = 0.243-1.000; ES = 0.02-0.47).

CONCLUSION

Acute beetroot juice supplementation did not produce any statistically significant improvement in neuromuscular performance or match-play demands in elite female field hockey players.

TRIAL REGISTRATION

The study was registered in ClinicalTrials.gov with the following ID: NCT05209139. The study was retrospectively registered by 26 January 2022.

Is It Time for a Requiem for Creatine Supplementation-Induced Kidney Failure? A Narrative Review

Creatine has become one of the most popular dietary supplements among a wide range of healthy and clinical populations. However, its potential adverse effects on kidney health are still a matter of concern. This is a narrative review of the effects of creatine supplementation on kidney function. Despite a few case reports and animal studies suggesting that creatine may impair kidney function, clinical trials with controlled designs do not support this claim. Creatine supplementation may increase serum creatinine (Crn) concentration for some individuals, but it does not necessarily indicate kidney dysfunction, as creatine is spontaneously converted into Crn. Based on studies assessing kidney function using reliable methods, creatine supplements have been shown to be safe for human consumption. Further studies with people who have pre-existing kidney disease remain necessary.

Self-Declared and Measured Prevalence of Glucocorticoid Use in Polish Athletes

Glucocorticoids (GCs) are included in the list of prohibited substances and methods in sport published annually by the World Anti-Doping Agency (WADA). In its 2022 update, the WADA list prohibits all injectable routes of administration of GCs for use during in-competition periods. Previously, GCs were prohibited in-competition when administered by oral, intravenous, intramuscular, or rectal routes, but local injections (in addition to topical applications) were allowed. This study first investigated the prevalence of GC use by athletes in Poland, declared in 2130 doping control forms, and the related 2130 urine samples analysed at the Polish Anti-Doping Laboratory. Second, the validity of the analytical methodology to detect GCs was evaluated with the updated WADA requirement for substance-specific minimum reporting levels and considering the proposed washout periods. Despite the new regulation in place, the use of 30 different GC preparations were declared in a total of 162 occurrences (8% of the tests) with therapeutic purposes. Laboratory analyses resulted in the presence of GCs in 16 occurrences with only two samples with a concentration triggering an adverse analytical finding. Our study allowed us to confirm that the applied methodology for the determination of GCs in urine samples (ultra-high-performance liquid chromatography–tandem mass spectrometry) remains fully valid after the latter regulation change while the challenge to assess the timing and administration route for GCs persists.

Do Spanish Triathletes Consume Sports Supplements According to Scientific Evidence? An Analysis of the Consumption Pattern According to Sex and Level of Competition

Background: The use of sports supplements (SS) to improve sports performance is very common in athletes. In the case of triathletes, the physiological characteristics of the sport may require the use of certain SS. Although the consumption of SS is widespread in this sport, very few studies have investigated it thus far. The aim is to analyze the pattern of SS consumption by triathletes according to sex and the competitive level. Methodology: This is a descriptive cross-sectional study on the consumption and habitual use of SS of 232 Spanish-federated triathletes. Data were collected through a validated questionnaire. Results: Overall, 92.2% of the athletes consumed SS, but no significant differences were found in terms of competition level or sex. Yet, significant differences were found regarding the level of competition for total SS (p = 0.021), the total number of Group A supplements from the AIS classification (p = 0.012), and for the ergogenic aids (p = 0.003). The most-consumed SS were bars, sports drinks, sports gels, and caffeine (83.6%, 74.1%, 61.2%, and 46.6%, respectively). Conclusions: The consumption of SS by triathletes is high, and the number of SS consumed rises from the regional to the national and international levels. The four SS most consumed were included in category A of the AIS (greatest scientific evidence).

Dietary Arginine and Citrulline Supplements for Cardiovascular Health and Athletic Performance: A Narrative Review

The global market for nutritional supplements (NS) is growing rapidly, and the use of L-arginine (Arg), L-citrulline (Cit), and citrulline malate (CitMal) supplements has been shown to enhance cardiovascular health and athletic performance. Over the past decade, Arg, Cit, and CitMal supplements have received considerable attention from researchers in the field of exercise nutrition, who have investigated their potential effects on hemodynamic function, endothelial function, aerobic and anaerobic capacity, strength, power, and endurance. Previous studies were reviewed to determine the potential impact of Arg, Cit, and CitMal supplements on cardiovascular health and exercise performance. By synthesizing the existing literature, the study aimed to provide insight into the possible uses and limitations of these supplements for these purposes. The results showed that both recreational and trained athletes did not see improved physical performance or increased nitric oxide (NO) synthesis with 0.075 g or 6 g doses of Arg supplement per body weight. However, 2.4 to 6 g of Cit per day for 7 to 16 days of various NSs had a positive impact, increasing NO synthesis, enhancing athletic performance indicators, and reducing feelings of exertion. The effects of an 8 g acute dose of CitMal supplement were inconsistent, and more research is needed to determine its impact on muscle endurance performance. Based on the positive effects reported in previous studies, further testing is warranted in various populations that may benefit from nutritional supplements, including aerobic and anaerobic athletes, resistance-trained individuals, elderly people, and clinical populations, to determine the impact of different doses, timing of ingestion, and long-term and acute effects of Arg, Cit, and CitMal supplements on cardiovascular health and athletic performance.

Caffeine ingestion attenuates diurnal variation of lower-body ballistic performance in resistance-trained women

ABSTRACTThe present study investigates the effect of an acute intake of caffeine on the diurnal variation of neuromuscular performance in resistance-trained women. A total of 15 resistance-trained women participated in the current triple-blind, placebo-controlled, crossover experimental study. We assessed neuromuscular performance (i.e. ballistic (countermovement jump [CMJ] height and bench press throw [BPT] peak velocity), maximal strength (squat and bench press [BP] one-repetition maximum [1RM]), and strength-endurance [average velocity of the set during squat and number of repetitions-to-failure in BP]) four times at within 7 days. The participants ingested an acute dose of caffeine (3 mg/kg) or a placebo at 9-11 am and/or 17-19 pm. CMJ height (P = .016) and BP peak velocity (P = .012) were higher in the afternoon than in the morning. Compared to placebo, caffeine intake increased CMJ height by 3.1% in the morning and 1.6% in the afternoon (P = .035), but it had no effect on BPT peak velocity (P = .381). Maximal strength and strength-endurance performances were not affected by the time-of-day or caffeine intake (all P > .3). No significant interaction (time-of-day x substance) was observed in any of the above-mentioned outcomes (all P > .1). In conclusion, an acute dose of caffeine in the morning was effective to restore CMJ performance to levels found in the afternoon, while this effect was not observed neither in BPTpeak velocity nor in lower- and upper-body maximal strength and strength-endurance performance. Moreover, lower- and upper-body ballistic performance were greater in the afternoon than in the morning in resistance-trained women, while the acute intake of caffeine was only effective to increase CMJ height.HighlightsBallistic performance is probably higher in the afternoon than in the morning in resistance-trained women.An acute intake of caffeine is effective to increase countermovement jump performance.The ingestion of an acute dose of caffeine in the morning restored countermovement jump performance to levels found in the afternoon.

Consumption patterns of energy drinks in university students: A systematic review and meta-analysis

OBJECTIVES

Energy drink (ED) use is promoted to stimulate mental and/or physical activity, and their popularity has increased over the years, especially among young people. However, the use of EDs is often improper, and can induce adverse effects for human health. The purpose of this systematic review and meta-analysis was to analyze the literature to characterize the prevalence of ED consumption and motivations for use among undergraduate students. Furthermore, adverse effects and health-related behaviors associated with ED consumption were explored.

METHODS

This systematic review was carried out according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, and the PubMed, Scopus, and Web of Science databases were used for data research.

RESULTS

A total of 71 articles published between 2007 and 2021 met the inclusion criteria and were included in the review. The estimated overall prevalence of ED consumption was 42.9% in undergraduate students (95% confidence interval, 42.5%-43.3%), with significant heterogeneity among studies (Q test: P < 0.001; I² = 99.4%). The main reasons for use were engagement in study, projects or examinations, stay awake or alert, and physical activity/sport engagement. Sleep disturbance and increased heart rate or blood pressure were the most commonly reported adverse effects. ED consumption was frequently associated with alcohol use and smoking.

CONCLUSIONS

These findings suggest that the inappropriate use of EDs and related unhealthy behaviors should be identified early, and addressed through effective educational interventions.<END ABSTRACT>.

Dietary supplements and beverages: Knowledge, attitudes, and practices among semi-professional soccer players in KwaZulu-Natal, South Africa

Background

The ingestion of dietary supplements and beverages is prevalent in soccer, at the amateur and professional level. The absence of professional advice at non-professional level makes amateur soccer players susceptible to ingesting unsafe supplements.

Objectives

To determine the knowledge, attitudes and practices of ABC Motsepe League (semi-professional) players in KwaZulu-Natal regarding the use of dietary supplements and beverages.

Methods

Three hundred and forty-three soccer players participated in a cross-sectional study. Knowledge, attitudes and practices were determined using a questionnaire. Researchers visited twelve teams. On the day of the visit to each team, information sheets and questionnaires were given to participants. Questionnaires were collected immediately following completion. Descriptive statistics were used, including means and standard deviations, where applicable. Inferential statistics, Chi-square and binomial tests were used to analyse the results. Statistical significance was set at p < 0.05.

Results

Sports beverages were the most recommended and commonly used, followed by energy beverages. Dietary supplements were the least-known used. Participants used beverages and dietary supplements to assist in providing more energy (67%), improve health (65%) and improve performance (55%) (p<0.001). Seventy-three percent of participants lacked knowledge about the anti-doping policy (p<0.001), with 87% having never attended a workshop on the safe use of supplements and beverages, or anti-doping awareness campaigns (p<0.001). Thirty-eight percent had not heard of the South African Institute for Drug-Free Sport (SAIDS), and 84% were not familiar with the yearly updated World Anti-Doping Agency's (WADA) prohibited list (p<0.001). Of the 59% who did not take dietary supplements or beverages, 75% had insufficient information regarding them (p<0.001), 66% indicated that dietary supplements and beverages were costly (p=0.001), and 55% indicated they did not need dietary supplements and beverages (p=0.32).

Conclusion

There is a need for an educational programme on the safe use of dietary supplements, and sports and energy beverages among KwaZulu-Natal semi-professional soccer players.

The Use of Some Polyphenols in the Modulation of Muscle Damage and Inflammation Induced by Physical Exercise: A Review

Food bioactive compounds (FBC) comprise a vast class of substances, including polyphenols, with different chemical structures, and they exert physiological effects on individuals who consume them, such as antioxidant and anti-inflammatory action. The primary food sources of the compounds are fruits, vegetables, wines, teas, seasonings, and spices, and there are still no daily recommendations for their intake. Depending on the intensity and volume, physical exercise can stimulate oxidative stress and muscle inflammation to generate muscle recovery. However, little is known about the role that polyphenols may have in the process of injury, inflammation, and muscle regeneration. This review aimed to relate the effects of supplementation with mentation with some polyphenols in oxidative stress and post-exercise inflammatory markers. The consulted papers suggest that supplementation with 74 to 900 mg of cocoa, 250 to 1000 mg of green tea extract for around 4 weeks, and 90 mg for up to 5 days of curcumin can attenuate cell damage and inflammation of stress markers of oxidative stress during and after exercise. However, regarding anthocyanins, quercetins, and resveratrol, the results are conflicting. Based on these findings, the new reflection that was made is the possible impact of supplementation associating several FBCs simultaneously. Finally, the benefits discussed here do not consider the existing divergences in the literature. Some contradictions are inherent in the few studies carried out so far. Methodological limitations, such as supplementation time, doses used, forms of supplementation, different exercise protocols, and collection times, create barriers to knowledge consolidation and must be overcome.

Nutritional priorities, practices and preferences of athletes and active individuals in the context of new product development in the sports nutrition sector

Introduction

Sports nutrition is a rapidly growing sector with increasing demand for evidence-based nutritional products to support competitive and healthy lifestyles. The product development process for novel foods should rely heavily on end-user engagement to facilitate future success, however there is a dearth of published information available. An understanding of the practices and self-reported nutritional priorities of athletes and active individuals is required for the development of new food products, facilitating evidence-based product formulation.

Methods

Participants were at least 18 years of age, actively participating in competitive sport or structured physical activity on at least two occasions per week. Participants were asked to undertake a comprehensive online survey assessing their nutritional practice, perceived nutritional priorities and preferences for product characteristics. Questions were developed on the basis of critical evaluation of the current scientific literature and the hosting of two scoping focus group sessions with prospective end-users.

Results

405 individuals (29 ± 9 years) completed this questionnaire. 295 participants reported active participation in competitive sport while the remaining 110 participants undertook structured physical activity exclusively. When asked to rank their top three most sought-after product claims in sports nutrition, "enhanced muscular recovery" was the most prioritised receiving 101 first choice preferences (25%) and 295 top 3 preferences. Fifty-eight percent of participants reported taking nutritional supplements. Caffeine containing functional foods (excluding caffeine supplements) were the most commonly used functional food group. A very low incidence of functional food usage was reported otherwise. When asked to rank the importance of various food product attributes, "nutritional profile" was ranked as the most important with rating of 3.37 ± 0.7 out of 4 followed by "taste" and "accessibility". Whole food nutritional products received the most first preference selections and most top 3 selections when presented with a number of popular performance and recovery products on the market.

Conclusions

The transition towards a food first approach in sports nutrition is vital for athletes and active individuals to achieve their goals; with the development of evidence-based functional foods, particularly with a focus on muscle recovery, endurance, and strength enhancement at the forefront for new food product design and innovation.

Acupoint Catgut Embedding Improves Lipid Metabolism in Exercise-Induced Fatigue Rats via the PPAR Signaling Pathway

To improve the phenomenon of exercise-induced fatigue that often occurs during horse racing, we previously studied the improvement in exercise tolerance by acupoint catgut embedding preconditioning in an exercise-induced fatigue rat model. We found that acupoint catgut embedding pretreatment effectively improved animal exercise tolerance. Here, by combining transcriptomics and metabolomics, we aimed to explore the underlying mechanisms of this improvement. We used blood biochemical detection combined with ELISA to detect triglyceride (TG), total cholesterol (TC), lactate dehydrogenase (LDH), high-density lipoprotein (HDL), alanine transaminase (ALT), aspartate aminotransferase (AST), and glucose (GLU), arachidonic acid (AA), and free fatty acid (FFA) content and found that acupoint embedding can correct FFA, AA, TG, LDH, and AST in the blood. We used RT-qPCR to measure the expression of genes in tissue from the quadriceps femoris muscle. We found that solute carrier family 27 member 2 (Slc27a2), fatty acid binding protein 1 (Fabp1), apolipoprotein C3 (Apoc3), and lipoprotein lipase (Lpl) genes in the peroxisome proliferator-activated receptor (PPAR) signaling pathway were important. The regulation of lipid metabolism through the PPAR signaling pathway was important for improving the exercise endurance of rats in our exercise-induced fatigue model. Therefore, we conclude that acupoint catgut embedding can not only promote body fat decomposition and reduce lactic acid accumulation but also promote the repair of tissue damage and liver damage caused by exercise fatigue. Acupoint catgut embedding regulates the PPAR signaling pathway by upregulating Lpl expression and downregulating Slc27a2, Fabp1, and Apoc3 expression to further improve body fat metabolism.

Effect of caffeine intake on fat oxidation rate during exercise: is there a dose-response effect?

PURPOSE

The effect of caffeine to enhance fat utilisation as fuel for submaximal aerobic exercise is well established. However, it is unknown whether this effect is dose dependent. The aim of this study was to investigate the effect of 3 and 6 mg of caffeine per kg of body mass (mg/kg) on whole-body substrate oxidation during an incremental cycling exercise test.

METHODS

In a double-blind, randomised, and counterbalanced experiment, 18 recreationally active males (maximal oxygen uptake [VO_2max] = 56.7 ± 8.2 mL/kg/min) performed three experimental trials after ingesting either 3 mg/kg of caffeine, 6 mg/kg of caffeine or a placebo (cellulose). The trials consisted of an incremental exercise test on a cycle ergometer with 3-min stages at workloads from 30 to 80% of VO_2max. Energy expenditure, fat oxidation rate, and carbohydrate oxidation rate were continuously measured by indirect calorimetry.

RESULTS

During exercise, there was significant effect of substance (F = 7.969; P = 0.004) on fat oxidation rate. In comparison to the placebo, the rate of fat oxidation was higher with 3 mg/kg of caffeine at 30, 40, 50 and 70% of VO_2max [all P < 0.050, effect sizes (ES) from 0.38 to 0.50] and with 6 mg/kg of caffeine at 30, 40, 50, 60 and 70% of VO_2max (all P < 0.050, ES from 0.28 to 0.76). Both 3 mg/kg (0.40 ± 0.21 g/min, P = 0.021, ES = 0.57) and 6 mg/kg of caffeine (0.40 ± 0.17 g/min P = 0.001, ES = 0.60) increased the maximal rate of fat oxidation during exercise over the placebo (0.31 ± 0.15 g/min). None of the caffeine doses produced any significant effect on energy expenditure or heart rate during exercise, while both caffeine doses reduced perceived fatigue at 80% of VO_2max (all P < 0.050, ES from 0.71 to 1.48).

CONCLUSION

The effect of caffeine to enhance fat oxidation during submaximal aerobic exercise is of similar magnitude with 3 and 6 mg of caffeine per kg of body mass. Thus, a dose of 3 mg of caffeine per kg of body mass would be sufficient to enhance fat utilisation as fuel during submaximal exercise.

Are the Consumption Patterns of Sports Supplements Similar among Spanish Mountain Runners?

BACKGROUND

The use of sports supplements (SS) to improve sports performance is widespread in all types of athletes, however, the specific characteristics of mountain races may require the use of certain SS. Despite being a sport where the consumption of SS seems widespread, few studies have been conducted in this regard. The objective of this study is to analyze the pattern of SS consumption of mountain runners in relation to the degree of scientific evidence, sex, and level of competition.

METHODS

Descriptive and cross-sectional study on the consumption and habitual use of SS of 357 federated mountain runners in Spain. Data were collected through a validated questionnaire.

RESULTS

From the total sample, 93.84% of the athletes stated that they consumed SS, with no differences observed based on the competitive level or in terms of sex; however, there were significant differences according to the competitive level in terms of the number of SS consumed, with consumption being greater at a higher competitive level (p = 0.009). The most consumed SS were sports bars (66.1%), sports drinks (60.5%), sports gels (52.9%), and caffeine (46.2%).

CONCLUSIONS

The consumption of SS in mountain races is high, and the number of SS consumed is higher as the competition level increases. The four SS most consumed by the participants in this study were all included in category A in the classification of the Australian Institute of Sport (AIS), this category is the one with the greatest scientific evidence.

A Comparison of Sodium Citrate and Sodium Bicarbonate Ingestion: Blood Alkalosis and Gastrointestinal Symptoms

This study compared the recommended dose of sodium citrate (SC, 500 mg/kg body mass) and sodium bicarbonate (SB, 300 mg/kg body mass) for blood alkalosis (blood [HCO3-]) and gastrointestinal symptoms (GIS; number and severity). Sixteen healthy individuals ingested the supplements in a randomized, crossover design. Gelatin capsules were ingested over 15 min alongside a carbohydrate-rich meal, after which participants remained seated for forearm venous blood sample collection and completion of GIS questionnaires every 30 min for 300 min. Time-course and session value (i.e., peak and time to peak) comparisons of SC and SB supplementation were performed using linear mixed models. Peak blood [HCO3-] was similar for SC (mean 34.2, 95% confidence intervals [33.4, 35.0] mmol/L) and SB (mean 33.6, 95% confidence intervals [32.8, 34.5] mmol/L, p = .308), as was delta blood [HCO3-] (SC = 7.9 mmol/L; SB = 7.3 mmol/L, p = .478). Blood [HCO3-] was ≥6 mmol/L above baseline from 180 to 240 min postingestion for SC, significantly later than for SB (120-180 min; p < .001). GIS were mostly minor, and peaked 80-90 min postingestion for SC, and 35-50 min postingestion for SB. There were no significant differences for the number or severity of GIS reported (p > .05 for all parameters). In summary, the recommended doses of SC and SB induce similar blood alkalosis and GIS, but with a different time course.

Polyphenol Supplementation and Antioxidant Status in Athletes: A Narrative Review

Antioxidants in sports exercise training remain a debated research topic. Plant-derived polyphenol supplements are frequently used by athletes to reduce the negative effects of exercise-induced oxidative stress, accelerate the recovery of muscular function, and enhance performance. These processes can be efficiently modulated by antioxidant supplementation. The existing literature has failed to provide unequivocal evidence that dietary polyphenols should be promoted specifically among athletes. This narrative review summarizes the current knowledge regarding polyphenols' bioavailability, their role in exercise-induced oxidative stress, antioxidant status, and supplementation strategies in athletes. Overall, we draw attention to the paucity of available evidence suggesting that most antioxidant substances are beneficial to athletes. Additional research is necessary to reveal more fully their impact on exercise-induced oxidative stress and athletes' antioxidant status, as well as optimal dosing methods.

Evaluation of Supplement Use in Sport Climbers at Different Climbing Levels

The lack of specific recommendations on the use of supplements for sport climbers may be the reason for their misuse by athletes of this discipline. This study aimed to evaluate choices of dietary supplementation, the reasons for taking them, and the source of information on supplementation among sport climbers at different levels. In addition, how climbers subjectively evaluated the impact of their diets in supporting selected aspects of climbing training was evaluated. We enrolled 110 regular sport climbers (40 women and 70 men) from Wroclaw, Poland, who completed a validated questionnaire, assessing their use of dietary supplements, attitudes towards the influence of diet on sports performance, and climbing level. Their anthropometric measurements were also collected. Participants regarded diet as an important element of sports performance. Sport climbers indicated the Internet to be the main source of information on supplements. Health maintenance and improvement of recovery were the most frequently chosen reasons for taking dietary supplements. The most common supplements were isolated protein, vitamin C, vitamin D, magnesium, and amino acid blends. However, participants rarely used supplements suggested as beneficial for sport climbing performance. Therefore, developing recommendations for supplementation in sport climbing and promoting this should be an elementary part of the preparation for climbing training.

Dietary Intake, Body Composition and Performance of Professional Football Athletes in Slovenia

This is the first study to examine the nutritional status of professional Slovenian football players. This study aimed to analyze the dietary intake of elite football players during their preparation phase of the season and to investigate whether there is a relationship between energy and macronutrient intake with body composition and physical performance. Twenty-three footballers completed a three-day dietary and physical activity diary and underwent body composition measurements via bioelectrical impedance vector analysis (BIVA). Fifteen participants also took part in the Cooper treadmill test to assess their physical performance in correlation with their nutritional intake. Football players had an energy intake that was significantly too low for their needs, reflecting low energy availability. The average carbohydrate (CHO) intake was below the Union of European Football Associations (UEFA) recommendations, i.e., <4 g CHO/kg body weight (BW). Additionally, players had adequate intakes of protein and fat, and inadequate intakes of saturated fat, fiber, calcium and vitamin D. There was a positive correlation between protein intake and lean body mass. Additionally, a negative correlation was observed between body fat mass and carbohydrate intake as well as between performance with the percentage of energy intake from fat. Results of this study highlight what aspects of nutrition might be improved upon in professional football players to maximize performance, longevity and body composition of athletes, as well as the necessity of a nutritionist role in this process.

Personality Determinants of Eating Behaviours among an Elite Group of Polish Athletes Training in Team Sports

The nutritional behaviours of athletes are determined by environmental and individual factors. The aim of the research was to analyse the personality determinants of the eating behaviour among an elite group of Polish athletes training in team sports. The research was conducted among 213 athletes, using a proprietary validated nutritional behaviour questionnaire and the Neuroticism Extraversion Openness-Personality Inventory-Revised (NEO-PI-R Personality Inventory). Statistical analysis was performed with the use of Pearson's linear and Spearman's signed rank correlation coefficients, as well as multiple regression evaluation, assuming the significance level of α = 0.05. It was shown that the overall index of proper eating behaviour increased with increasing neuroticism (r = 0.132) and decreased with increasing openness to experience (r = -0.143). When assessing individual nutritional behaviours, it was indicated, among others, that with increasing neuroticism, athletes more often avoided energy drinks (R = 0.173), and with increasing extraversion, they more frequently consumed vegetables at least twice a day (R = 0.154). At the same time, the consumption of raw vegetables (R = -0.153), 2-3 portions of vegetables and fruit per day (R = -0.157) and the limitation of sweet and salty snacks (R = -0.152) decreased along with an increase in openness. On the other hand, with increasing conscientiousness, the regular consumption of meals (R = 0.186), dairy products (R = 0.143) and the reduction of sweet and salty snacks (R = 0.148) increased. The model built on the basis of the Big Five personality traits explained, to a very large extent (approx. 99%), variance concerning the general index of normal eating behaviour among athletes. The predictive significance of the personality traits presented in the Big Five model was demonstrated in relation to the quality of nutritional choices among Polish athletes competitively training in team sports, which may be used to personalise the dietary education of athletes.

Do Triathletes Periodize Their Diet and Do Their Mineral Content, Body Composition and Aerobic Capacity Change during Training and Competition Periods?

The triathlon is a demanding endurance multisport, which may strongly affect the nutritional status of athletes. The aim of this study was to find whether there are any differences in energy value and nutrient intake, body mass and body composition, aerobic performance and hair mineral status between training and competition periods and to assess whether there is a link between hair mineral content and physical capacity and nutrition. This observational study covered 20 triathletes aged 32 ± 7 years. The results of our study indicated performance improvement during the competition period (longer time to exhaustion (p = 0.025) and lower maximal oxygen uptake at the ventilatory threshold (%VO_{2max_VT}; p = 0.047)). However, no differences were recorded in nutrition and body composition between two training vs. competition periods. There was a significant depletion in hair iron content during the competition period (p = 0.010). Furthermore, there were significant relationships between hair calcium content and absolute maximal oxygen uptake and %VO_{2max_VT} during the training period. It is necessary to introduce nutritional education in the group of triathletes focused on exercise-oriented nutritional periodization following the requirements of the training and competition periods, thus preventing the risk of nutrient deficiencies.

The Evaluation of Videos about Branched-Chain Amino Acids Supplements on YouTube™: A Multi-Approach Study

Branched-chain amino acids (BCAAs) are one of the most controversial ergogenic aids in terms of effectiveness and safety. This study aimed to evaluate the quality and reliability of BCAA supplements related to English videos on YouTube^™ and to synthesize with the sentiment-emotion analysis of comments on videos. The content analysis of the information on videos was evaluated with the use of DISCERN, Journal of American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). In addition, word cloud and sentiment and emotional analysis of comments in videos were performed with the R package. As a result, the mean ± standard error values of DISCERN, JAMA, and GQS scores of all videos were 29.27 ± 1.97, 1.95 ± 0.12, and 2.13 ± 0.17, respectively. It was found that advertisement-free videos have a significantly higher DISCERN and GQS score than advertisement-included videos (p < 0.05). A moderately significant positive correlation was determined between DISCERN score of video content and the positive sentiment of video comments (rs: 0.400, p = 0.002). In conclusion, it was determined that BCAA-related YouTube^™ videos have mostly very poor quality in terms of content and that videos with higher quality may receive positive comments from viewers according to the DISCERN instrument.

Beetroot Juice Produces Changes in Heart Rate Variability and Reduces Internal Load during Resistance Training in Men: A Randomized Double-Blind Crossover

Beetroot juice (BJ) has been used as a sport supplement, improving performance in resistance training (RT). However, its effect on the modulation of the autonomic nervous system has not yet been widely studied. Therefore, the objective of this randomized double-blind crossover study was to assess the effect of acute BJ supplementation compared to placebo in blood pressure (BP), heart rate (HR), heart rate variability (HRV) and internal load during RT measure as Root Mean Square of the Successive Differences between adjacent RR intervals Slope (RMSSD and RMSSD-Slope, respectively). Eleven men performed an incremental RT test (three sets at 60%, 70% and 80% of their repetition maximum) composed by back squat and bench press with. HR, HRV and RMSSD-Slope were measured during and post exercise. As the main results, RMSSD during exercise decrease in the BJ group compared to placebo (p = 0.023; ES = 0.999), there were no differences in RMSSD post-exercise, and there were differences in RMSSD-Slope between groups in favor of the BJ group (p = 0.025; ES = 1.104) with a lower internal load. In conclusion, BJ supplementation seems to be a valuable tool for the reduction in the internal load of exercise during RT measured as RMSSD-Slope while enhancing performance.

Nutritional Practices and Body Composition of South African National-Level Spinal Cord-Injured Endurance Hand Cyclists

Nutritional practices and body composition of para-athletes can impact their health and athletic performance. There is a paucity of research on the nutritional practices, including dietary and supplement intake, body composition and bone health of spinal cord-injured (SCI) endurance hand cyclists. This study assessed the body composition and dietary and supplement intake of 12 national-level SCI endurance hand cyclists (age: 44.0 ± 9.3 years). Bone mineral density (BMD) was assessed in a sub-sample of participants (n = 4) using dual-energy x-ray absorptiometry (DXA). Estimated body fat percentage was healthy (18.4 ± 5.1%) and lumbar spine BMD for the sub-sample was adequate, however hip BMD was low (Z-score and/or T-scores < −2). Carbohydrate intake for male and female participants was below the recommended intake (3.8 (2.9−4.1) and 2.4 (2.0−2.7) g/kg BW, respectively). Overall protein intake was adequate, whilst fat intake was high for both males and females (39.7 (37.7−41.6) and 42.1 (39.0−45.3)% of total energy, respectively). The reported intakes for a few key micronutrients were also below the recommended dietary allowance (RDA) and/or adequate intake (AI) for males (vitamin D, calcium). The prevalence of supplement use before, during, and after training was 40%, 100%, and 60%, respectively. In conclusion, the hand cyclists could benefit from nutritional guidance to match their daily carbohydrate intake with exercise requirements and optimise their fat intake. Optimal vitamin D and calcium intake is also important especially in the light of poor bone health below the lesion level.

High Doses of Caffeine Increase Muscle Strength and Calcium Release in the Plasma of Recreationally Trained Men

The effects of acute caffeine supplementation on muscular strength remain unclear. We examined the effects of two different doses of caffeine on muscle strength and calcium in plasma compared to placebo using a crossover, randomized, double-blind, placebo-controlled design. Twenty-one (n = 21) recreationally resistance-trained participants were randomly assigned into three experimental conditions: 6 mg·kg bw−1 of caffeine (CF6); 8 mg·kg bw−1 of caffeine (CF8); or placebo (PLA), with a 7-day washout period between conditions. Muscular strength assessments were made for both upper (bench press) and lower body muscles (squat and deadlift). Calcium release in plasma was measured on five different occasions. Bench press (CF8: 100.1 ± 1.9 kg; PLA: 94.2 ± 2.5 kg), deadlift (CF8: 132.8 ± 3.5 kg; PLA: 120.7 ± 5.7 kg), and squat (CF8: 130.1 ± 4.9 kg; PLA 119.4 ± 5.4 kg) strength were all significantly (p < 0.001) improved in CF8 compared to PLA. Calcium release in plasma was significantly increased in CF8, whereas no changes were observed in CF6 or PLA. Overall, 8 mg·kg bw−1 of caffeine appears to be an effective dose to optimize upper and lower body muscular strength and calcium release in recreationally trained participants.

Influence of Beetroot Juice Ingestion on Neuromuscular Performance on Semi-Professional Female Rugby Players: A Randomized, Double-Blind, Placebo-Controlled Study

PURPOSE

Beetroot juice (BRJ) is considered an ergogenic aid with good to strong evidence for improving human performance in sport modalities with similar demands to rugby. However, most of the studies were realized in male athletes with limited evidence in female athletes. Thus, the aim of this study was to explore the acute ingestion of BRJ in female rugby players.

METHODS

Fourteen semi-professional female rugby players (25.0 ± 3.7 years) belonging to a team from the First Spanish Female Rugby Division participated in this study. Participants were randomly divided into two groups that realized a neuromuscular battery after BRJ (140mL, 12.8 mmol NO₃^-) or placebo (PLAC, 140 mL, 0.08 mmol NO₃^-) ingestion on two different days separated by one week between protocols. The neuromuscular test battery consisted of a countermovement jump (CMJ), isometric handgrip strength (i.e., dominant), 10-m and 30-m sprint, agility t-test and Bronco test. Afterwards, participants reported a rate of perception scale (6-20 points) and side effects questionnaire associated with BRJ or PLAC ingestion.

RESULTS

Statistically significant improvements were observed in CMJ (7.7%; p = 0.029; ES = 0.62), while no differences were reported in dominant isometric handgrip strength (-1.7%; p = 0.274; ES = -0.20); 10-m and 30-m sprint (0.5-0.8%; p = 0.441-0.588; ES = 0.03-0.18); modified agility t-test (-0.6%; p = 0.503; ES = -0.12) and Bronco test (1.94%; p = 0.459; ES = 0.16).

CONCLUSIONS

BRJ ingestion could improve neuromuscular performance in the CMJ test, while no differences in sprint (10-m and 30-m sprint test), agility, isometric handgrip strength and endurance performance (i.e., Bronco test) were reported.

Analysis and Screening of Commercialized Protein Supplements for Sports Practice

Recent years have seen a rise in the popularity of the consumption of sports-related supplements. However, the hypothesis is raised that it is necessary to analyze the quality aspects of these supplements in relation to the information provided on the label, to avoid associated risks and obtain the greatest possible benefit from their consumption. Therefore, the aim of this study has been to carry out an analysis or screening of the protein supplements that are currently marketed in Spain. We analyzed the labels of 52 protein sports supplements available both in physical stores and online. The analysis consisted of addressing three relevant aspects considering the labeling: (a) the legislative framework in which the supplements are marketed, (b) the quality of the protein, and (c) the presence of other ingredients according to the specifications of the label. In the legislative context, there do not seem to be any specific regulations to guarantee consumer protection, which can lead to unfair practices and misleading advertising. Most of the supplements analyzed to comply with the requirements of their current regulations. However, claims about their benefits that are not allowed under European legislation have been found in some of them. Regarding composition and according to label information, the supplements have been found to provide a sufficient dose of protein in terms of recommended protein intake per serving. Regarding the presence of other ingredients and according to the information on the label, most of them, except for egg supplements, contain other ingredients. Colostrum was also found in one of the supplements evaluated. The conclusions of the study reveal that, due to a lack of knowledge or misleading advertising practices, supplements are often not used properly. The information provided is essential for both professionals and consumers to avoid the risks associated with consumption, such as unintentional doping, interactions between ingredients that reduce the quality of the supplement, and consumption of supplements inappropriately, among others.

Effect of Omega-3 Polyunsaturated Fatty Acids Intake on Eosinophil Airway Inflammation in University Athletes

Background

Though athletes have a high risk of respiratory disorders, effective prevention has not yet to be identified. Omega-3 (n-3) polyunsaturated fatty acids (PUFA) have some practical anti-inflammatory effects in allergy, and therefore may reduce airway inflammation in athletes. This study aimed to assess whether n-3 PUFA intake affects airway inflammation in university athletes.

Methods

Twenty-three males were divided into three groups: 1) the eosinophilic airway inflammation group (I_PUFA group; fractional exhaled nitric oxide (FeNO ≥ 25 ppb, n = 10); 2) the non-eosinophilic airway inflammation group (N_PUFA group; FeNO < 25 ppb, exhaled carbon dioxide (eCO) ≥ 3.6 ppm, n = 5); and 3) the control group (FeNO < 25 ppb, eCO < 3.6 ppm, n = 8). Participants took supplements containing 260 mg of docosapentaenoic acid and 600 mg of eicosapentaenoic acid (EPA) daily for 3 weeks. Baseline measurements of FeNO, respiratory impedance, respiratory function, dietary intake (food frequency questionnaires), and blood tests were performed. FeNO and respiratory impedance were measured weekly, and the rest were measured after 3 weeks.

Results

There was a significant decrease in FeNO levels from baseline at 2 and 3 weeks in the I_PUFA group (54.7 ± 8.5 ppb vs. 45.1 ± 9.1 and 45.4 ± 7.7 ppb; mean ± standard error (SE), P < 0.05). After 3 weeks, FeNO levels remained unchanged in the N_PUFA and control groups, and respiratory impedance and function remained unchanged in all groups. Blood EPA levels significantly increased in the I_PUFA and N_PUFA groups (I_PUFA, 27.7 ± 16.9 vs. 52.1 ± 12.3 µg/mL; N_PUFA, 20.8 ± 8.7 vs. 70.4 ± 36.1 µg/mL; mean ± standard deviation (SD), P < 0.05). No changes were observed in dietary intake over the 3 weeks.

Conclusions

n-3 PUFA supplementation for 3 weeks reduced airway inflammation in athletes with FeNO levels ≥ 25 ppb.

Anti-Doping Knowledge of Students Undertaking Bachelor's Degrees in Sports Sciences in Spain

In Spain, students pursuing a career in athletic training, physical education, or scientific evaluation of sports enroll in a bachelor’s degree in sports sciences. This degree provides knowledge and skills in a broad array of sports settings and promotes research-based interdisciplinary knowledge. However, the student’s syllabus rarely includes specific academic training on anti-doping regulations or doping prevention. The purpose of this study was to assess the anti-doping knowledge of the students undertaking a bachelor’s degree in sports sciences in Spanish universities. One thousand two hundred and thirty-three bachelor students in sport science (907 males, 322 females, and 4 participants with non-binary sex) from 26 Spanish universities completed a validated questionnaire about general anti-doping knowledge. The questionnaire is an adapted version of the Play True Quiz of the World Anti-Doping Agency and contains 37 multiple-choice questions. The score obtained in the questionnaire was transformed into a 0−100-point scale. The questionnaire was distributed among students within each university by a faculty member and it was filled out online. Students obtained a score of 65.8 ± 10.10 points (range = 32−92 points). There was an effect of the course in the score obtained (p < 0.001). Students of the first course (63.6 ± 9.5 points) had lower scores than the remaining courses (p < 0.037) while the students of the fourth course obtained the highest scores (68.7 ± 9.5 points; p < 0.019). The students with an itinerary on sports performance were the respondents with the highest anti-doping knowledge (67.2 ± 10.2) points, followed by the students with an itinerary on health (66.7 ± 9.5 points). The knowledge of basic anti-doping rules and doping prevention strategies of the bachelor students in sports sciences in Spain was suboptimal. Increasing doping prevention information in the syllabus of the bachelor’s degree in sports sciences is essential as these future professionals will directly work with populations at risk of doping.

Development of a Caffeine Content Table for Foods, Drinks, Medications and Supplements Typically Consumed by the Brazilian Population

Background: The lack of a national table informing the caffeine contents in foods, drinks, dietary supplements, and medications sold in Brazil added to the noncompulsory disclosure of caffeine contents on labels of food products makes it difficult to estimate caffeine consumption in the Brazilian population. Therefore, this study aimed to develop the Brazilian Caffeine Content Table (BraCaffT). Methods: A systematic search for caffeine levels in foods, drinks, recipes, supplements, and medications was performed through a literature review, afterward collecting data from the United States Department of Agriculture Food Data Central, information from manufacturers’ and websites, and the Brazilian official medication guide. Subsequently, data systematization was performed in a spreadsheet with standardized values presented in mg of caffeine per 100 g or 100 mL of food or drink and a capsule or pill for medications and some dietary supplements. Results: The BraCaffT presents 57 items, divided into 11 categories: coffees, teas and infusions, cocoa powder, chocolates, cocoa-based beverages, desserts, soft drinks, energy drinks, guaraná powder, dietary supplements, and medications. Conclusions: The BraCaffT emerges as an instrument of great relevance and wide applicability in clinical contexts, in academic research, and as a database for the Brazilian population to better understand the amounts of caffeine in foods, drinks, dietary supplements, and medications consumed daily favoring a safe intake.

Oral Branched-Chain Amino Acids Supplementation in Athletes: A Systematic Review

Branched-chain amino acids (BCAAs) are oxidized in the muscle and result in stimulating anabolic signals—which in return may optimize performance, body composition and recovery. Meanwhile, among athletes, the evidence about BCAA supplementation is not clear. The aim of this study was to review the effects of BCAAs in athletic populations. The research was conducted in three databases: Web of Science (all databases), PubMed and Scopus. The inclusion criteria involved participants classified both as athletes and people who train regularly, and who were orally supplemented with BCAAs. The risk of bias was individually assessed for each study using the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). From the 2298 records found, 24 studies met the inclusion criteria. Although BCAAs tended to activate anabolic signals, the benefits on performance and body composition were negligible. On the other hand, studies that included resistance participants showed that BCAAs attenuated muscle soreness after exercise, while in endurance sports the findings were inconsistent. The protocols of BCAA supplements differed considerably between studies. Moreover, most of the studies did not report the total protein intake across the day and, consequently, the benefits of BCAAs should be interpreted with caution.

Prevalence, patterns, and attitude regarding dietary supplement use in Saudi Arabia: Data from 2019

Dietary supplements are products containing dietary elements including vitamins, minerals, amino acids, herbs, or botanicals. They can aid consumers with low dietary intake and quality, as well as those with high demands, by boosting nutritious value. A cross-sectional study was conducted among adults living in Saudi Arabia aged between 18–60 years old using online self-administered questionnaire. Information regarding sociodemographic characteristics, use and type of dietary supplements, and attitude toward and patterns of dietary supplement use was collected. The chi-square test, Pearson correlations, and the independent t-test were used. In total, 531 participants (115 men and 416 women) were included. Approximately half of the participants (51.8%, n = 275) used dietary supplements. Participants who were using dietary supplements were significantly younger (29.16 ± 9.32 years), more highly educated (85.5%, n = 235), and worked in the health sector (63.7%, n = 100). Herbal supplement use was associated with older age and female sex. Single mineral supplements were used more frequently by married, female, pregnant, or breastfeeding participants and those not working in the health sector. Fatty supplements were used more frequently by participants with a higher level of education. Regarding the attitude toward dietary supplement use, women, single participants, and health care workers showed a significant positive attitude. In-depth investigation into the amount of and reasons for dietary supplement use in the health sector is required. Additionally, educating pregnant and breastfeeding women on the importance of dietary supplements is necessary.

Dietary Supplement Use of Turkish Footballers: Differences by Sex and Competition Level

This study aimed to evaluate the consumption of dietary supplements (DS) and to determine related topics in Turkish football players of different sexes and competition levels. A total of 117 footballers (79 males and 38 females) completed a specific survey regarding DS consumption in athletes. The type of DS ingested was classified based on the level of scientific evidence by the Australian Institute of Sport (AIS): group A (high level of scientific evidence), group B (DS that could have a positive effect, but require more evidence), group C (evidence is against their use), and group D (prohibited substances). After a Kolmogorov−Smirnov test, a t-test or Mann−Whitney U test was performed for quantitative variables, while Pearson’s chi-square and odds ratio (with the confidence interval) were performed for qualitative variables. Of the sample, 87.2% reported having consumed DS, with a higher consumption rate in males (males: 93.7%, females: 73.7%; p = 0.006; OR = 5.3 [1.7−16.8]) and professional players (professional: 98.2%, non-professional: 77.4%; p < 0.001; OR = 7.9 [1.2−52.3]). Males and professional players consume more sports foods (p < 0.001), performance supplements (p < 0.001), and total group A supplements (p < 0.001) compared to females and non-professionals. In addition, males consume more medical supplements (p = 0.012) and total group C supplements (p < 0.001) than female footballers. The most consumed DS were sports drinks (63.2%), magnesium (52.1%), vitamin C (51.3%), vitamin D (46.2%), caffeine (38.5%), sports bars (37.6%), whey protein (28.2%), meat protein (25.6%), vitamin E (24.8%), and omega-3 fatty acids (24.8%). The supplement consumption was higher in male and professional footballers. According to the AIS classification, there were significant differences in the consumption of sports foods, medical supplements, performance supplements, and the total number of group A and group C supplements according to sex, and there were significant differences in the consumption of sports foods, performance supplements, and the total number of group A supplements according to competition level.