Influence of β-alanine supplementation on skeletal muscle carnosine concentrations and high intensity cycling capacity

24-Week β-alanine ingestion does not affect muscle taurine or clinical blood parameters in healthy males

PURPOSE

To investigate the effects of chronic beta-alanine (BA) supplementation on muscle taurine content, blood clinical markers and sensory side-effects.

METHODS

Twenty-five healthy male participants (age 27 ± 4 years, height 1.75 ± 0.09 m, body mass 78.9 ± 11.7 kg) were supplemented with 6.4 g day^-1 of sustained-release BA (N = 16; CarnoSyn™, NAI, USA) or placebo (PL; N = 9; maltodextrin) for 24 weeks. Resting muscle biopsies of the m. vastus lateralis were taken at 0, 12 and 24 weeks and analysed for taurine content (BA, N = 12; PL, N = 6) using high-performance liquid chromatography. Resting venous blood samples were taken every 4 weeks and analysed for markers of renal, hepatic and muscle function (BA, N = 15; PL, N = 8; aspartate transaminase; alanine aminotransferase; alkaline phosphatase; lactate dehydrogenase; albumin; globulin; creatinine; estimated glomerular filtration rate and creatine kinase).

RESULTS

There was a significant main effect of group (p = 0.04) on muscle taurine, with overall lower values in PL, although there was no main effect of time or interaction effect (both p > 0.05) and no differences between specific timepoints (week 0, BA: 33.67 ± 8.18 mmol kg^-1 dm, PL: 27.75 ± 4.86 mmol kg^-1 dm; week 12, BA: 35.93 ± 8.79 mmol kg^-1 dm, PL: 27.67 ± 4.75 mmol kg^-1 dm; week 24, BA: 35.42 ± 6.16 mmol kg^-1 dm, PL: 31.99 ± 5.60 mmol kg^-1 dm). There was no effect of treatment, time or any interaction effects on any blood marker (all p > 0.05) and no self-reported side-effects in these participants throughout the study.

CONCLUSIONS

The current study showed that 24 weeks of BA supplementation at 6.4 g day^-1 did not significantly affect muscle taurine content, clinical markers of renal, hepatic and muscle function, nor did it result in chronic sensory side-effects, in healthy individuals. Since athletes are likely to engage in chronic supplementation, these data provide important evidence to suggest that supplementation with BA at these doses for up to 24 weeks is safe for healthy individuals.

Ergogenic Effects of β-Alanine Supplementation on Different Sports Modalities: Strong Evidence or Only Incipient Findings?

Brisola, GMP and Zagatto, AM. Ergogenic effects of β-alanine supplementation on different sports modalities: strong evidence or only incipient findings? J Strength Cond Res 33(1): 253-282, 2019-β-Alanine supplementation is a popular nutritional ergogenic aid among the sports community. Due to its efficacy, already proven in the literature, to increase the intramuscular carnosine content (β-alanyl-L-histidine), whose main function is intramuscular buffering, β-alanine supplementation has become a nutritional strategy to improve performance, mainly in high-intensity efforts. However, although many studies present evidence of the efficacy of β-alanine supplementation in high-intensity efforts, discrepancies in outcomes are still present and the performance enhancing effects seem to be related to the specificities of each sport discipline, making it difficult for athletes/coaches to interpret the efficacy of β-alanine supplementation. Thus, this study carried out a review of the literature on this topic and summarized, analyzed, and critically discussed the findings with the objective of clarifying the current evidence found in the literature on different types of efforts and sport modalities. The present review revealed that inconsistencies are still found in aerobic parameters determined in incremental tests, except for physical working capacity at the neuromuscular fatigue threshold. Inconsistencies are also found for strength exercises and intermittent high-intensity efforts, whereas in supramaximal continuous mode intermittent exercise, the beneficial evidence is strong. In sports modalities, the evidence should be analyzed separately for each sporting modality. Thus, sports modalities that have strong evidence of the ergogenic effects of β-alanine supplementation are: cycling race of 4 km, rowing race of 2,000 m, swimming race of 100 and 200 m, combat modalities, and water polo. Finally, there is some evidence of slight additional effects on physical performance from cosupplementation with sodium bicarbonate.

Gene expression profile of muscle adaptation to high-intensity intermittent exercise training in young men

High-intensity intermittent exercise training (HIIT) has been proposed as an effective approach for improving both, the aerobic and anaerobic exercise capacity. However, the detailed molecular response of the skeletal muscle to HIIT remains unknown. We examined the effects of the HIIT on the global gene expression in the human skeletal muscle. Eleven young healthy men participated in the study and completed a 6-week HIIT program involving exhaustive 6–7 sets of 20-s cycling periods with 10-s rests. In addition to determining the maximal oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{{\rm{V}}}{\rm{O}}}_{2{\rm{\max }}}$$\end{document}V˙O2max), maximal accumulated oxygen deficit, and thigh muscle cross-sectional area (CSA), muscle biopsy samples were obtained from the vastus lateralis before and after the training to analyse the skeletal muscle transcriptome. The HIIT program significantly increased the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{{\rm{V}}}{\rm{O}}}_{2{\rm{\max }}}$$\end{document}V˙O2max, maximal accumulated oxygen deficit, and thigh muscle CSA. The expression of 79 genes was significantly elevated (fold-change >1.2), and that of 73 genes was significantly reduced (fold-change <0.8) after HIIT. Gene ontology analysis of the up-regulated genes revealed that the significantly enriched categories were “glucose metabolism”, “extracellular matrix”, “angiogenesis”, and “mitochondrial membrane”. By providing information about a set of genes in the human skeletal muscle that responds to the HIIT, the study provided insight into the mechanism of skeletal muscle adaptation to HIIT.

Exercise alters and β-alanine combined with exercise augments histidyl dipeptide levels and scavenges lipid peroxidation products in human skeletal muscle

Carnosine and anserine are dipeptides synthesized from histidine and β-alanine by carnosine synthase (ATPGD1). These dipeptides, present in high concentration in the skeletal muscle, form conjugates with lipid peroxidation products such as 4-hydroxy trans-2-nonenal (HNE). Although skeletal muscle levels of these dipeptides could be elevated by feeding β-alanine, it is unclear how these dipeptides and their conjugates are affected by exercise training with or without β-alanine supplementation. We recruited twenty physically active men, who were allocated to either β-alanine or placebo-feeding group matched for VO₂ peak, lactate threshold, and maximal power (W_max). Participants completed 2 weeks of conditioning phase followed by 1 week of exercise testing (CPET) and a single session followed by 6 weeks of high intensity interval training (HIIT). Analysis of muscle biopsies showed that the levels of carnosine and ATPGD1 expression were increased after CPET and decreased following a single session and 6 weeks of HIIT. Expression of ATPGD1 and levels of carnosine were increased upon β-alanine-feeding after CPET, while ATPGD1 expression decreased following a single session of HIIT. The expression of fiber type markers myosin heavy chain (MHC) I and IIa remained unchanged after CPET. Levels of carnosine, anserine, carnosine-HNE, carnosine-propanal and carnosine-propanol were further increased after 9 weeks of β-alanine supplementation and exercise training, but remained unchanged in the placebo-fed group. These results suggest that carnosine levels and ATPGD1 expression fluctuates with different phases of training. Enhancing carnosine levels by β-alanine feeding could facilitate the detoxification of lipid peroxidation products in the human skeletal muscle.

Effects of 4 weeks of β-alanine supplementation on aerobic fitness in water polo players

The purpose of the present study was to investigate the ergogenic effects of 4 weeks of β-alanine supplementation on peak oxygen uptake (V˙O2peak) and force associated with V˙O2peak (FV˙O2peak) during a tethered swimming graded exercise test, and a three-minute all-out effort (3min_ALL-OUT) in water polo players. Twenty-two male national competitive level water polo players were randomly assigned to receive either 4 weeks of β-alanine (n = 11) or a placebo (n = 11) (i.e., 4.8 g·day^-1 for 10 days, then6.4 g·day^-1 for 18 days, resulting in 163.2 g over 28 days). The participants performed the TS_GET and 3min_ALL-OUT before and after the supplementation period. There were no significant interaction effects between-groups for any variable, however, the magnitude-based inferences analyses showed a possibly beneficial effect (74%) of β-alanine supplementation on FV˙O2peak compared to placebo treatment (Δ% [post–pre] for Placebo group = -5.2%; Δ% [post–pre] for β-alanine group = +0.7%). Only the β-alanine group presented a significant reduction in V˙O2peak expressed in absolute values (PRE = 3.3±0.6L·min^-1; POST = 3.0±0.4L·min^-1; p = .021). Similarly, only the β-alanine group presented a significant increase in critical force (PRE = 51.2±10.4N; POST = 56.5±13.1N; p = .044) and a reduction in the curvature constant parameter (W'; PRE = 2998.0±1103.7N·s; POST = 2224.6±1058.9N·s; p = .049). Thus, we can conclude that 4 weeks of β-alanine supplementation presented mixed results in water polo players, indicating that this nutritional strategy may not be effective in improving parameters of the TS_GET and 3min_{ALL-OUT .}

β-Alanine Supplementation's Improvement of High-Intensity Game Activities in Water Polo

OBJECTIVES

To investigate whether 4 wk of β-alanine supplementation improves total distance covered, distance covered and time spent in different speed zones, and sprint numbers during a simulated water polo game.

DESIGN

Double-blind, parallel, and placebo controlled. A total of 11 male water polo players participated in the study, divided randomly into 2 homogeneous groups (placebo and β-alanine).

METHODS

The participants performed a simulated water polo game before and after the supplementation period (4 wk). They received 4.8 g·d^-1 of dextrose or β-alanine on the first 10 d and 6.4 g·d^-1 on the final 18 d.

RESULTS

Only the β-alanine group presented a significant improvement in total sprint numbers compared with the presupplementation moment (PRE = 7.8 [5.2] arbitrary units [a.u.]; POST = 20.2 [7.8] a.u.; P = .002). Furthermore, β-alanine supplementation presented a likely beneficial effect in improving total distance covered (83%) and total time spent (81%) in speed zone 4 (ie, speed ≥ 1.8 m·s^-1). There was no significant interaction effect (group × time) for any variable.

CONCLUSIONS

Four weeks of β-alanine supplementation slightly improved sprint numbers and had a likely beneficial effect on improving distance covered and time spent in speed zone 4 in a simulated water polo game.

Examination of a Multi-ingredient Preworkout Supplement on Total Volume of Resistance Exercise and Subsequent Strength and Power Performance

Bergstrom, HC, Byrd, MT, Wallace, BJ, and Clasey, JL. Examination of a multi-ingredient preworkout supplement on total volume of resistance exercise and subsequent strength and power performance. J Strength Cond Res 32(6): 1479-1490, 2018-This study examined the acute effects of a multi-ingredient preworkout supplement on (a) total-, lower-, and upper-body volume of resistance exercise and (b) the subsequent lower-body strength (isokinetic leg extension and flexion), lower-body power (vertical jump [VJ] height), upper-body power (bench throw velocity [BTv]), and cycle ergometry performance (critical power and anaerobic work capacity). Twelve men completed baseline strength and power measures before 2 experimental visits, supplement (SUP) and placebo (PL). The experimental visits involved a fatiguing cycling protocol 30 minutes after ingestion of the SUP or PL and 15 minutes before the beginning of the resistance exercise protocol, which consisted of 4 upper-body and 4 lower-body resistance exercises performed for 4 sets to failure at 75% 1 repetition maximum. The exercise volume for the total, lower, and upper body was assessed. The VJ height and BTv were measured immediately after the resistance exercise. Postexercise isokinetic leg extension and flexion strength was measured 15 minutes after the completion of a second cycling protocol. There was a 9% increase in the total-body volume of exercise and a 14% increase in lower-body volume of exercise for the SUP compared with the PL, with no effect on exercise volume for the upper body between the SUP and PL. The increased lower-body volume for the SUP did not result in greater lower-body strength and power performance decrements after exhaustive exercise, compared with the PL. These findings suggested the potential for the SUP to increase resistance exercise volume, primarily related to an increased lower-body volume of exercise.

Effects of β-alanine and sodium bicarbonate supplementation on the estimated energy system contribution during high-intensity intermittent exercise

The effects of β-alanine (BA) and sodium bicarbonate (SB) on energy metabolism during work-matched high-intensity exercise and cycling time-trial performance were examined in 71 male cyclists. They were randomised to receive BA + placebo (BA, n = 18), placebo + SB (SB, n = 17), BA + SB (BASB, n = 19), or placebo + placebo (PLA, n = 18). BA was supplemented for 28 days (6.4 g day^-1) and SB (0.3 g kg^-1) ingested 60 min before exercise on the post-supplementation trial. Dextrose and calcium carbonate were placebos for BA and SB, respectively. Before (PRE) and after (POST) supplementation, participants performed a high-intensity intermittent cycling test (HICT-110%) consisting of four 60-s bouts at 110% of their maximal power output (60-s rest between bouts). The estimated contribution of the energy systems was calculated for each bout in 39 of the participants (BA: n = 9; SB: n = 10; BASB: n = 10, PLA: n = 10). Ten minutes after HICT-110%, cycling performance was determined in a 30-kJ time-trial test in all participants. Both groups receiving SB increased estimated glycolytic contribution in the overall HICT-110%, which approached significance (SB: + 23%, p = 0.068 vs. PRE; BASB: + 18%, p = 0.059 vs. PRE). No effects of supplementation were observed for the estimated oxidative and ATP-PCr systems. Time to complete 30 kJ was not significantly changed by any of the treatments, although a trend toward significance was shown in the BASB group (p = 0.06). We conclude that SB, but not BA, increases the estimated glycolytic contribution to high-intensity intermittent exercise when total work done is controlled and that BA and SB, either alone or in combination, do not improve short-duration cycling time-trial performance.

Pharmacokinetics of β-Alanine Using Different Dosing Strategies

Introduction: The ergogenic response following long-term ingestion of β-alanine shows a high inter-individual variation. It is hypothesized that this variation is partially caused by a variable pharmacokinetic response induced by inferior dosing strategies. At this point most supplements are either taken in a fixed amount (× g), as is the case with β-alanine, or relative to body weight (× g per kg BW), but there is currently neither consensus nor a scientific rationale on why these or other dosing strategies should be used. The aim of this study is to objectify and understand the variation in plasma pharmacokinetics of a single oral β-alanine dose supplemented as either a fixed or a weight-relative dose (WRD) in an anthropometric diverse sample.

Methods: An anthropometric diverse sample ingested a fixed dose (1,400 mg) (n = 28) and a WRD of β-alanine (10 mg/kg BW) (n = 34) on separate occasions. Blood samples were taken before and at nine time points (up to 4 h) after β-alanine ingestion in order to establish a pharmacokinetic profile. Incremental area under the curve (iAUC) was calculated by the trapezoidal rule. Plasma β-alanine was quantified using HPLC-fluorescence.

Results: The variation coefficient (CV%) of the iAUC was 35.0% following ingestion of 1,400 mg β-alanine. Body weight explained 30.1% of the variance and was negatively correlated to iAUC (r = −0.549; p = 0.003). Interestingly, the CV% did not decrease with WRD (33.2%) and body weight was positively correlated to iAUC in response to the WRD (r = 0.488; p = 0.003).

Conclusion: Both dosing strategies evoked an equally high inter-individual variability in pharmacokinetic plasma profile. Strikingly, while body weight explained a relevant part of the variation observed following a fixed dose, correction for body weight did not improve the homogeneity in β-alanine plasma response. We suggest to put more effort into the optimization of easy applicable and scientifically justified personalized dosing strategies.

Exercise and β-alanine supplementation on carnosine-acrolein adduct in skeletal muscle

Previous studies have demonstrated that exercise results in reactive aldehyde production and that β-alanine supplementation increases carnosine content in skeletal muscle. However, little is known about the influence exercise and β-alanine supplementation have on the formation of carnosine-aldehydes. The goal of the present study was to monitor the formation of carnosine-aldehyde adducts, following high-intensity intermittent exercise, before and after β-alanine supplementation. Vastus lateralis biopsy samples were taken from 14 cyclists, before and after a 28 day β-alanine supplementation, following 4 bouts of a 30 s all-out cycling test, and carnosine and CAR-aldehyde adducts [carnosine-acrolein, CAR-ACR (m/z 303), carnosine-4-hydroxy-2-hexenal, CAR-HHE (m/z 341) and carnosine-4-hydroxy-2-nonenal, CAR-HNE (m/z 383)] were quantified by HPLC-MS/MS. β-alanine supplementation increased muscle carnosine content by ~50% (p = 0.0001 vs. Pre-Supplementation). Interestingly, there was a significant increase in post-exercise CAR-ACR content following β-alanine supplementation (p < 0.001 vs. post-exercise before supplementation), whereas neither exercise alone nor supplementation alone increased CAR-ACR formation. These results suggest that carnosine functions as an acrolein-scavenger in skeletal muscle. Such a role would be relevant to the detoxification of this aldehyde formed during exercise, and appears to be enhanced by β-alanine supplementation. These novel findings not only have the potential of directly benefiting athletes who engage in intensive training regimens, but will also allow researchers to explore the role of muscle carnosine in detoxifying reactive aldehydes in diseases characterized by abnormal oxidative stress.

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Lipid peroxidation generates electrophilic reactive aldehydes.

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β-Alanine supplementation increases muscle carnosine content in skeletal muscle.

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The carnosine-acrolein levels were higher in muscle following β-alanine supplementation in post-exercise.

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This acrolein-scavenger role for muscle carnosine may contribute to its ergogenic and therapeutic effects.

Comparison of sustained-release and rapid-release β-alanine formulations on changes in skeletal muscle carnosine and histidine content and isometric performance following a muscle-damaging protocol

β-alanine supplementation increases muscle carnosine content and improves anaerobic exercise performance by enhancing intracellular buffering capacity. β-alanine ingestion in its traditional rapid-release formulation (RR) is associated with the symptoms of paresthesia. A sustained-release formulation (SR) of β-alanine has been shown to circumvent paresthesia and extend the period of supply to muscle for carnosine synthesis. The purpose of this investigation was to compare 28 days of SR and RR formulations of β-alanine (6 g day^-1) on changes in carnosine content of the vastus lateralis and muscle fatigue. Thirty-nine recreationally active men and women were assigned to one of the three groups: SR, RR, or placebo (PLA). Participants supplementing with SR and RR formulations increased muscle carnosine content by 50.1% (3.87 mmol kg^-1ww) and 37.9% (2.62 mmol kg^-1ww), respectively. The change in muscle carnosine content in participants consuming SR was significantly different (p = 0.010) from those consuming PLA, but no significant difference was noted between RR and PLA (p = 0.077). Although participants ingesting SR experienced a 16.4% greater increase in muscle carnosine than RR, fatigue during maximal voluntary isometric contractions was significantly attenuated in both SR and RR compared to PLA (p = 0.002 and 0.024, respectively). Symptoms of paresthesia were significantly more frequent in RR compared to SR, the latter of which did not differ from PLA. Results of this study demonstrated that only participants consuming the SR formulation experienced a significant increase in muscle carnosine. Differences in the muscle carnosine response between these formulations may have practical significance for athletic populations in which small changes may have important implications on performance.

β-Alanine supplementation increased physical performance and improved executive function following endurance exercise in middle aged individuals

Background

Sarcopenia, a reduction in muscle mass and function seen in aging populations, may be countered by improving systemic carnosine stores via beta-Alanine (β-alanine) supplementation. Increasing systemic carnosine levels may result in enhanced anti-oxidant, neuro-protective and pH buffering capabilities. This enhancement should result in improved exercise capacity and executive function.

Methods

Twelve healthy adults (average age = 60.5 ± 8.6 yrs, weight = 81.5 ± 12.6 kg) were randomized and given either 2.4 g/d of β-alanine (BA) or Placebo (PL) for 28 days. Exercise capacity was tested via bouts on a cycle ergometer at 70% VO₂ peak. Executive function was measured by Stroop Tests 5 min before exercise (T1), immediately before exercise (T2), immediately following fatigue (T3), and 5 min after fatigue (T4). Lactate measures were taken pre/post exercise. Heart rate, Rating of Perceived Exertion (RPE) and VO₂ were recorded throughout exercise testing.

Results

PRE average time-to-exhaustion (TTE) for the PL and BA group were not significantly different (Mean ± SD; 9.4 ± 1.4mins vs 11.1 ± 2.4mins, respectively, P = 0.7). POST BA supplemented subjects cycled significantly longer than PRE (14.6 ± 3.8mins vs 11.1 ± 2.4mins, respectively, P = 0.04) while those given PL did not (8.7 ± 2.4mins vs 9.4 ± 1.4mins, respectively, P = 0.7). PL subjects were slower in completing the Stroop test POST at T4 compared to T3 (T3 = − 13.3 ± 8.6% vs T4 = 2.1 ± 8.3%, P = 0.04), while the BA group (T3 = − 9.2 ± 6.4% vs T4 = − 2.5 ± 3.5%, P = 0.5) was not. POST lactate production expressed a trend when comparing treatments, as the BA group produced 2.4 ± 2.6 mmol/L more lactate than the PL group (P = 0.06). Within group lactate production for BA (P = 0.4) and PL (P = 0.5), RPE (P = 0.9) and heart rate (P = 0.7) did not differ with supplementation.

Conclusion

BA supplementation increased exercise capacity and eliminated endurance exercise induced declines in executive function seen after recovery. Increased POST TTE coupled with similar PRE vs POST lactate production indicates an improvement in the ability of BA to extend exercise durations. Furthermore, by countering endurance exercise’s accompanying deficits in executive function, the aging population can maintain benefits from exercise with improved safety.

Combining Targeted Metabolites Analysis and Transcriptomics to Reveal Chemical Composition Difference and Underlying Transcriptional Regulation in Maca (Lepidium Meyenii Walp.) Ecotypes

Maca (Lepidium meyenii Walp.) is a traditional Andean crop with great potential for various sanitarian and medical functions, which is attracting increased research attention. The majority of previous Maca studies were focused on biochemistry and pharmacodynamics, while the genetic basis of its unique characteristics lagged due to a lack of genome information. The authors perform gas chromatography-mass spectrometry (GC/MS) analysis in the hypocotyls of three Maca ecotypes and identify 79 compounds. Among them, 62 compounds have distinct profiles among Maca ecotypes. To reveal the underlying regulatory mechanism of the chemical composition differences, de novo transcriptome sequencing is performed and the transcription profiles of three Maca ecotypes are comparatively analyzed. Functional analysis indicates several key pathways, including “starch and sucrose metabolism,” “phenylpropanoid biosynthesis,” “phenylalanine metabolism” and “plant-pathogen interaction,” are involved in regulating the chemical compositions of Maca. Combining metabolomics and transcriptomics analysis indicates transcription factors such as MYB and WRKY and mediators such as protein kinase and bifunctional inhibitors might be critical regulators of chemical composition in Maca. The transcriptome reference genome and differentially expressed genes (DEGs) obtained in this study might serve as an initial step to illustrate the genetic differences in nutrient component, secondary metabolites content, medicinal function and stress resistance in Maca.

Amino acids and sport: a true love story?

Among a plethora of dietary supplements, amino acids are very popular with athletes for several reasons (e.g., to prevent nutritional deficiency, improve muscle function, and decrease muscle damages) whose purpose is to improve performance. However, it is difficult to get a clear idea of which amino acids have real ergogenic impact. Here, we review and analyze the clinical studies evaluating specific amino acids (glutamine, arginine, leucine, etc.) in athletes. Only english-language clinical studies evaluating a specific effect of one amino acid were considered. Despite promising results, many studies have methodological limits or specific flaws that do not allow definitive conclusions. To date, only chronic β-alanine supplementation demonstrated an ergogenic effect in athletes. Much research is still needed to gain evidence-based data before any other specific amino acid can be recommended for use in athletes.

A Statistical Framework to Interpret Individual Response to Intervention: Paving the Way for Personalized Nutrition and Exercise Prescription

The concept of personalized nutrition and exercise prescription represents a topical and exciting progression for the discipline given the large inter-individual variability that exists in response to virtually all performance and health related interventions. Appropriate interpretation of intervention-based data from an individual or group of individuals requires practitioners and researchers to consider a range of concepts including the confounding influence of measurement error and biological variability. In addition, the means to quantify likely statistical and practical improvements are facilitated by concepts such as confidence intervals (CIs) and smallest worthwhile change (SWC). The purpose of this review is to provide accessible and applicable recommendations for practitioners and researchers that interpret, and report personalized data. To achieve this, the review is structured in three sections that progressively develop a statistical framework. Section 1 explores fundamental concepts related to measurement error and describes how typical error and CIs can be used to express uncertainty in baseline measurements. Section 2 builds upon these concepts and demonstrates how CIs can be combined with the concept of SWC to assess whether meaningful improvements occur post-intervention. Finally, section 3 introduces the concept of biological variability and discusses the subsequent challenges in identifying individual response and non-response to an intervention. Worked numerical examples and interactive Supplementary Material are incorporated to solidify concepts and assist with implementation in practice.

Effects of β-alanine supplementation during a 5-week strength training program: a randomized, controlled study

BACKGROUND

β-Alanine (BA) is a non-essential amino acid that has been shown to enhance exercise performance. The purpose of this investigation was to determine if BA supplementation improved the adaptive response to five weeks of a resistance training program.

METHODS

Thirty healthy, strength-trained individuals were randomly assigned to the experimental groups placebo (PLA) or BA. Over 5 weeks of strength training, subjects in BA took 6.4 g/day of BA as 8 × 800 mg doses each at least 1.5 h apart. The training program consisted of 3 sessions per week in which three different leg exercises were conducted as a circuit (back squat, barbell step ups and loaded jumping lunges). The program started with 3 sets of 40 s of work per exercise and rest periods between sets of 120 s in the first week. This training volume was then gradually built up to 5 sets of 20 s work/60 s rest in the fifth week. The work load during the program was set by one of the authors according to the individual's perceived effort the previous week. The variables measured were average velocity, peak velocity, average power, peak power, and load in kg in a back squat, incremental load, one-repetition maximum (1RM) test. In addition, during the rest period, jump ability (jump height and power) was assessed on a force platform. To compare data, a general linear model with repeated measures two-way analysis of variance was used.

RESULTS

Significantly greater training improvements were observed in the BA group versus PLA group (p = 0.045) in the variables average power at 1RM (BA: 42.65%, 95% CI, 432.33, 522.52 VS. PLA: 21.07%, 95% CI, 384.77, 482.19) and average power at maximum power output (p = 0.037) (BA: 20.17%, 95% CI, 637.82, 751.90 VS. PLA; 10.74%, 95% CI, 628.31, 751.53). The pre- to post training average power gain produced at 1RM in BA could be explained by a greater maximal strength gain, or load lifted at 1RM (p = 0.014) (24 kg, 95% CI, 19.45, 28.41 VS. 16 kg, 95% CI, 10.58, 20.25) and in the number of sets executed (p = 0.025) in the incremental load test (BA: 2.79 sets, 95% CI, 2.08, 3.49 VS. PLA: 1.58 sets, 95% CI, 0.82, 2.34).

CONCLUSIONS

β-Alanine supplementation was effective at increasing power output when lifting loads equivalent to the individual's maximal strength or when working at maximum power output. The improvement observed at 1RM was explained by a greater load lifted, or strength gain, in response to training in the participants who took this supplement.

The Effects of β-Alanine Supplementation on Muscle pH and the Power-Duration Relationship during High-Intensity Exercise

Purpose: To investigate the influence of β-alanine (BA) supplementation on muscle carnosine content, muscle pH and the power-duration relationship (i.e., critical power and W′).

Methods: In a double-blind, randomized, placebo-controlled study, 20 recreationally-active males (22 ± 3 y, V°O_2peak 3.73 ± 0.44 L·min⁻¹) ingested either BA (6.4 g/d for 28 d) or placebo (PL) (6.4 g/d) for 28 d. Subjects completed an incremental test and two 3-min all-out tests separated by 1-min on a cycle ergometer pre- and post-supplementation. Muscle pH was assessed using ³¹P-magnetic resonance spectroscopy (MRS) during incremental (INC KEE) and intermittent knee-extension exercise (INT KEE). Muscle carnosine content was determined using ¹H-MRS.

Results: There were no differences in the change in muscle carnosine content from pre- to post-intervention (PL: 1 ± 16% vs. BA: −4 ± 25%) or in muscle pH during INC KEE or INT KEE (P > 0.05) between PL and BA, but blood pH (PL: −0.06 ± 0.10 vs. BA: 0.09 ± 0.13) during the incremental test was elevated post-supplementation in the BA group only (P < 0.05). The changes from pre- to post-supplementation in critical power (PL: −8 ± 18 W vs. BA: −6 ± 17 W) and W′ (PL: 1.8 ± 3.3 kJ vs. BA: 1.5 ± 1.7 kJ) were not different between groups. No relationships were detected between muscle carnosine content and indices of exercise performance.

Conclusions: BA supplementation had no significant effect on muscle carnosine content and no influence on intramuscular pH during incremental or high-intensity intermittent knee-extension exercise. The small increase in blood pH following BA supplementation was not sufficient to significantly alter the power-duration relationship or exercise performance.

β-Alanine mediated inhibition of PTHR1suppresses the proliferation, invasion and tumorigenesis in metastatic human osteosarcoma U2OS cells

The present study was aimed to investigate the effect of β-alanine mediated inhibition of parathyroid hormone 1 receptor (PTHR1), suppresses the proliferation, invasion, and tumorigenesis in metastatic human osteosarcoma U2OS cells. Cell survival rate was reduced 96.54, 91.23, 84.62, 76.42 and 69.72% following incubation of β-alanine at 50-250 mM respectively. Annexin-V/propidium iodide (PI) staining showed a reduced level of viable cells (71.37%) at 250 mM of β-alanine. U2OS cell proliferation, adhesion, invasion, and migration were decreased following incubation with β-alanine. Matrix metalloproteinases-2/9 (MMP-2/9) mRNA expression was reduced, whereas tissue inhibitors of metalloproteinases-1/2 (TIMP-1/2) mRNA expression was increased remarkably. The mRNA and protein of PTHR1 were reduced in the cells following incubation with β-alanine. Vacuole membrane protein 1 (Vmp1) mRNA and protein were increased in the cells following incubation with β-alanine. In tunel assay, the number of PTHR1 positive cells was 67, 34 and 17 following incubation with β-alanine at 150, 200 and 250 mM respectively. Taking all these data together, it is concluded that β-alanine mediated inhibition of PTHR1 reduced the U2OS cell proliferation, invasion, migration, and tumorigenesis. Furthermore, the results indicated that the β-alanine induced expression of PTHR1 has a positive relationship with invasion and metastasis of osteosarcoma cells.

Effects of β-Alanine Supplementation on Carnosine Elevation and Physiological Performance

β-Alanine is one of the more popular sport supplements used by strength/power athletes today. The popularity of β-alanine stems from its ability to enhance intracellular muscle-buffering capacity thereby delaying fatigue during high-intensity exercise by increasing muscle carnosine content. Recent evidence also suggests that elevated carnosine levels may enhance cognitive performance and increase resiliency to stress. These benefits are thought to result from carnosine's potential role as an antioxidant. This review will discuss these new findings including recent investigations examining β-alanine supplementation and increased resiliency to posttraumatic stress and mild traumatic brain injury. This review will focus on the physiology of carnosine, the effect of β-alanine ingestion on carnosine elevations, and the potential ergogenic benefits it has for competitive and tactical athletes.

No Effect of β-alanine on Muscle Function and Kayak Performance

PURPOSE

If β-alanine supplementation counteracts muscular fatigue development or improves athletic performance was investigated.

METHODS

Elite kayak rowers (10 men and 7 women) were supplemented with either 80 mg·kg body mass·d of β-alanine or placebo for 8 wk. Muscular fatigue development was investigated by applying a 2-min elbow flexor maximal voluntary contraction (MVC). EMG was recorded continuously, and voluntary activation was determined 30, 60, 90, and 115 s into the 2-min MVC. In addition, performance was evaluated as 1000-m and 5 × 250-m kayak ergometer rowing.

RESULTS

Force reduction during the 2-min MVC was similar before and after supplementation with β-alanine (30.9% ± 10.3% vs 36.0% ± 14.1%) and placebo (35.5% ± 7.7% vs 35.1% ± 8.0%). No time effect was apparent in voluntary activation during the 2-min MVC. In addition, there was no detectable effect of β-alanine supplementation on 1000-m kayak ergometer performance (β-alanine: 0.26% ± 0.02% vs placebo: -0.18% ± 0.02%) or accumulated 5 × 250-m time (β-alanine: -1.0% ± 0.3% vs placebo: -1.0% ± 0.2%). In 5 × 250 m, mean power output was reduced to a similar extent from first to fifth interval before and after supplementation with β-alanine (23% ± 11% vs 22% ± 10%) and placebo (26% ± 13% vs 20% ± 5%).

CONCLUSIONS

Two-minute MVC characteristics are unaffected by β-alanine supplementation in elite kayakers, and likewise, both a 1000-m kayak ergometer time trial lasting 4-5 min and a 5 × 250-m repeated sprint ability were unaltered by supplementation.

Influence of Skeletal Muscle Carnosine Content on Fatigue during Repeated Resistance Exercise in Recreationally Active Women

Carnosine is a naturally occurring intramuscular dipeptide that is thought to attenuate fatigue during high-intensity exercise. Carnosine content is influenced by various factors, including gender and diet. Despite research reporting that carnosine content is lower in women compared to men and lower in vegetarians compared to omnivores, no investigations have examined carnosine content in women based on dietary protein intake and its effect on muscle fatigue. Twenty recreationally active women were assigned to either a high (HI; n = 5), moderate (MOD; n = 10), or low (LO; n = 5) group based upon intramuscular carnosine content of the vastus lateralis. Each participant underwent two unilateral maximal voluntary isometric contractions (MVIC) of the knee extensors separated by an isokinetic exercise protocol consisting of five sets of 50 repeated maximal unilateral contractions. Magnitude-based inferences were used to analyze group differences. Percent decline in rate of force development and peak torque (PT) during the MVICs and changes in PT and mean torque during the muscle-fatiguing protocol were lower in HI compared to both MOD and LO. Additionally, absolute and relative dietary protein intake were greater in HI compared to MOD or LO. Results indicated that greater intramuscular carnosine content was reflective of greater dietary protein intake and that individuals with higher carnosine content displayed a greater attenuation of fatigue compared to those with lower carnosine.

Twenty-four Weeks of β-Alanine Supplementation on Carnosine Content, Related Genes, and Exercise

INTRODUCTION

Skeletal muscle carnosine content can be increased through β-alanine (BA) supplementation, but the maximum increase achievable with supplementation is unknown. No study has investigated the effects of prolonged supplementation on carnosine-related genes or exercise capacity.

PURPOSE

This study aimed to investigate the effects of 24 wk of BA supplementation on muscle carnosine content, gene expression, and high-intensity cycling capacity (CCT110%).

METHODS

Twenty-five active males were supplemented with 6.4 g·d of sustained release BA or placebo for a 24 wk period. Every 4 wk participants provided a muscle biopsy and performed the CCT110%. Biopsies were analyzed for muscle carnosine content and gene expression (CARNS, TauT, ABAT, CNDP2, PHT1, PEPT2, and PAT1).

RESULTS

Carnosine content was increased from baseline at every time point in BA (all P < 0.0001; week 4 = +11.37 ± 7.03 mmol·kg dm, week 8 = +13.88 ± 7.84 mmol·kg dm, week 12 = +16.95 ± 8.54 mmol·kg dm, week 16 = +17.63 ± 8.42 mmol·kg dm, week 20 = +21.20 ± 7.86 mmol·kg dm, and week 24 = +20.15 ± 7.63 mmol·kg dm) but not placebo (all P > 0.05). Maximal increases were +25.66 ± 7.63 mmol·kg dm (range = +17.13 to +41.32 mmol·kg dm), and absolute maximal content was 48.03 ± 8.97 mmol·kg dm (range = 31.79 to 63.92 mmol·kg dm). There was an effect of supplement (P = 0.002) on TauT; no further differences in gene expression were shown. Exercise capacity was improved in BA (P = 0.05) with possible to almost certain improvements across all weeks.

CONCLUSIONS

Twenty-four weeks of BA supplementation increased muscle carnosine content and improved high-intensity cycling capacity. The downregulation of TauT suggests it plays an important role in muscle carnosine accumulation with BA supplementation, whereas the variability in changes in muscle carnosine content between individuals suggests that other determinants other than the availability of BA may also bear a major influence on muscle carnosine content.

Six weeks of β-alanine supplementation did not enhance repeated-sprint ability or technical performances in young elite basketball players

Supplementation with β-alanine plays an important role as a precursor of carnosine, the most effective intramuscular buffer, and has been seen as a potential ergogenic aid, especially for high-intensity modalities such as basketball. Thus, the aim of the present study was to investigate the effects of 6 weeks of β-alanine supplementation on repeated sprint ability (RSA) and technical performances in young elite Brazilian basketball players. In total, 27 young basketball players (17±1 years) were randomized into a β-alanine group (Gβ - 6.4 g day^-1 of β-alanine) and a placebo group (GP - 6.4 g day^-1 of dextrose). Before and after the supplementation period the athletes performed a RSA test composed of ten 30 m sprints with two 180° changes of direction interspaced by 30 s of recovery. During the recovery period (i.e., after the sprints) the athletes performed a countermovement jump (CMJ) and a set of three free throws. After 48 h they performed a Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1). Both groups increased the distance covered in the Yo-Yo IR1 after the supplementation period ( p = 0.001). On the other hand, both groups presented impairment in RSA time-performance (total time, best time, and mean time, p ≤ 0.04), while no significant changes were observed for technical task performances (i.e., CMJ and free throws) ( p ≥ 0.07). No between-group interactions were observed for any variable measured ( p ≥ 0.31). Thus, 6 weeks of β-alanine supplementation did not improve RSA or technical performances in young elite basketball players.

β-Alanine intercede metabolic recovery for amelioration of human cervical and renal tumors

β-Alanine is a non-essential amino acid and presents as a major component of various sports supplements. It is a non-proteogenic amino acid, formed in vivo by degradation of carnosine, anserine, balenine, and dihydrouracil. The present study was aimed at investigating the anti-tumor effects of β-alanine in renal and cervical tumor cells. Sulforhodamine-B assay and flow cytometric analysis were used to measure cell viability. Lactate dehydrogenase (LDH) expression was analyzed using FITC-conjugated fluorescent antibody. The cellular adenosine triphosphate (ATP) content was measured using bioluminescence method. Cell migration was determined by the simple standard-scratch method. β-Alanine reduced renal and cervical cell growth significantly. Percentage of inhibition of renal and cervical tumor cells was increased at higher concentration of β-alanine. LDH expression and ATP content were significantly reduced in renal and cervical tumor cells in a dose-dependent manner. Renal and cervical tumor cell migration were significantly reduced following 10 and 100 mM of β-alanine treatment. In our study, β-alanine exerts no significant effect on normal MDCK cells except a marginal effect at the highest concentration (100 mM). In summary, our experimental data suggest that β-alanine may be a potential anti-tumor agent exhibiting several anti-cancer effects in renal and cervical tumor cells.

Nutrition and Supplementation in Soccer

Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition).

"Nutraceuticals" in relation to human skeletal muscle and exercise

Skeletal muscles have a fundamental role in locomotion and whole body metabolism, with muscle mass and quality being linked to improved health and even lifespan. Optimizing nutrition in combination with exercise is considered an established, effective ergogenic practice for athletic performance. Importantly, exercise and nutritional approaches also remain arguably the most effective countermeasure for muscle dysfunction associated with aging and numerous clinical conditions, e.g., cancer cachexia, COPD, and organ failure, via engendering favorable adaptations such as increased muscle mass and oxidative capacity. Therefore, it is important to consider the effects of established and novel effectors of muscle mass, function, and metabolism in relation to nutrition and exercise. To address this gap, in this review, we detail existing evidence surrounding the efficacy of a nonexhaustive list of macronutrient, micronutrient, and "nutraceutical" compounds alone and in combination with exercise in relation to skeletal muscle mass, metabolism (protein and fuel), and exercise performance (i.e., strength and endurance capacity). It has long been established that macronutrients have specific roles and impact upon protein metabolism and exercise performance, (i.e., protein positively influences muscle mass and protein metabolism), whereas carbohydrate and fat intakes can influence fuel metabolism and exercise performance. Regarding novel nutraceuticals, we show that the following ones in particular may have effects in relation to 1) muscle mass/protein metabolism: leucine, hydroxyl β-methylbutyrate, creatine, vitamin-D, ursolic acid, and phosphatidic acid; and 2) exercise performance: (i.e., strength or endurance capacity): hydroxyl β-methylbutyrate, carnitine, creatine, nitrates, and β-alanine.

β-alanine supplementation improves in-vivo fresh and fatigued skeletal muscle relaxation speed

Purpose

In fresh muscle, supplementation with the rate-limiting precursor of carnosine, β-alanine (BA), results in a decline in muscle half-relaxation time (HRT) potentially via alterations to calcium (Ca²⁺) handling. Accumulation of hydrogen cation (H⁺) has been shown to impact Ca²⁺ signalling during muscular contraction, carnosine has the potential to serve as a cytoplasmic regulator of Ca²⁺ and H⁺ coupling, since it binds to both ions. The present study examined the effect of BA supplementation on intrinsic in-vivo isometric knee extensor force production and muscle contractility in both fresh and fatigued human skeletal muscle assessed during voluntary and electrically evoked (nerve and superficial muscle stimulation) contractions.

Methods

Twenty-three males completed two experimental sessions, pre- and post- 28 day supplementation with 6.4 g.day⁻¹ of BA (n = 12) or placebo (PLA; n = 11). Isometric force was recorded during a series of voluntary and electrically evoked knee extensor contractions.

Results

BA supplementation had no effect on voluntary or electrically evoked isometric force production, or twitch electromechanical delay and time-to-peak tension. There was a significant decline in muscle HRT in fresh and fatigued muscle conditions during both resting (3 ± 13%; 19 ± 26%) and potentiated (1 ± 15%; 2 ± 20%) twitch contractions.

Conclusions

The mechanism for reduced HRT in fresh and fatigued skeletal muscle following BA supplementation is unclear. Due to the importance of muscle relaxation on total energy consumption, especially during short, repeated contractions, BA supplementation may prove to be beneficial in minimising contractile slowing induced by fatigue.

Trial registration

The trial is registered with Clinicaltrials.gov, ID number NCT02819505.

Monitoring carnosine uptake by RAW 264.7 macrophage cells using microchip electrophoresis with fluorescence detection

Carnosine, a dipeptide found in a variety of tissues, is believed to possess antioxidant properties. It serves as a scavenger of reactive nitrogen and oxygen species (RNOS), which are important stress mediators of pro-inflammatory conditions and can lead to macrophage activation. In this study, intracellular concentrations of carnosine in murine RAW 264.7 macrophage cells were determined using microchip electrophoresis with laser-induced fluorescence detection following derivatization with naphthalene-2,3-dicarboxaldehyde and cyanide. The method was linear from 25 nM to 5 μM with a limit of detection in cell lysate samples of 65 nM. Using the method of standard additions, the basal intracellular content of carnosine in macrophage cells was determined to be 0.079 ± 0.02 nmol/106 cells. The uptake of carnosine by these cells was then investigated under both physiological and pro-inflammatory conditions. There was a 2.8-fold increase in carnosine uptake for macrophages exposed to lipopolysaccharide and interferon-γ prior to incubation, compared to the controls. This suggests that macrophages may use carnosine uptake as a defense mechanism under pro-inflammatory conditions. Future studies will investigate the role of the carnosine transporter in carnosine uptake and its possible correlation with cell morphological changes observed after stimulation.

Are Dietary Supplements and Nutraceuticals Effective for Musculoskeletal Health and Cognitive Function? A Scoping Review

OBJECTIVE

The aim of our scoping review was to summarize the state of the art regarding micronutrients in order to identify which of them might effectively improve health status in the areas typically impaired in older people: bone, skeletal muscle, and cognitive function.

DESIGN

Scoping review.

METHODS

The Italian Study Group on Healthy Aging by Nutraceuticals and Dietary Supplements (HANDS) performed this scoping review, based on the following steps: doing a list of micronutrients related with musculoskeletal or cognitive functions, included in dietary supplements and nutraceuticals commercialized in Italy; planning a research on PubMed, according to an evidence-based approach, in order to the most relevant positive study for each micronutrient into each of the three areas involved (bone, skeletal muscle and cognitive function); identifying the micronutrients effective in maintaining or achieving an adequate health status in older people, specifying the effective and safe daily doses, according to the selected studies.

RESULTS

In literature we found 12 relevant positive studies (1 international society guidelines/recommendations, 1 systematic review, 7 randomized controlled trials, and 3 prospective cohort studies). We showed that only 16 micronutrients resulted to have appropriate scientific evidences in terms of improving musculoskeletal health and/or cognitive function in older people: beta-alanine, calcium, creatine, fluorides, leucine, magnesium, omega-3 fatty acids, potassium, vitamin B6, vitamin B9, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K2, and zinc.

CONCLUSION

This scoping review showed that selected micronutrients in adequate doses might have an ancillary role in musculoskeletal health and cognitive functions in older people.

Effects of Four Weeks of β-Alanine Supplementation on Repeated Sprint Ability in Water Polo Players

The purpose of this study was to investigate the effect of four weeks of β-alanine supplementation on repeated sprint ability in water polo players. Twenty-two male water polo players participated in the study, divided randomly into two homogeneous groups (placebo and β-alanine groups). The study design was double-blind, parallel and placebo controlled. Before and after the supplementation period (28 days), the athletes performed two specific repeated sprint ability tests interspaced by a 30-minute swimming test. Participants received 4.8g∙day-1 of the supplement (dextrose or β-alanine) on the first 10 days and 6.4g∙day-1 on the final 18 days. There was no significant group-time interaction for any variable. The qualitative inference for substantial changes demonstrated a likely beneficial effect in the β-alanine group (β-alanine vs placebo) for mean time (6.6±0.4s vs 6.7±0.4s; 81% likely beneficial), worst time (6.9±0.5s vs 7.1±0.5s; 78% likely beneficial) and total time (39.3±2.5s vs 40.4±2.5s; 81% likely beneficial) in the first repeated sprint ability set and for worst time (7.2±0.6s vs 7.5±0.6s; 57% possible beneficial) in the second repeated sprint ability set. Further, was found substantial change for total time for both repeated sprint ability tests (80.8±5.7s vs 83.4±5.6s; 52% possible beneficial). To conclude, four weeks of β-alanine supplementation had a likely beneficial effect in the first set of repeated sprint ability tests and a possible beneficial effect for worst time in the second set performed in a specific protocol in water polo players.

Limitations in intense exercise performance of athletes - effect of speed endurance training on ion handling and fatigue development

Mechanisms underlying fatigue development and limitations for performance during intense exercise have been intensively studied during the past couple of decades. Fatigue development may involve several interacting factors and depends on type of exercise undertaken and training level of the individual. Intense exercise (½-6 min) causes major ionic perturbations (Ca²⁺ , Cl^- , H⁺ , K⁺ , lactate^- and Na⁺ ) that may reduce sarcolemmal excitability, Ca²⁺ release and force production of skeletal muscle. Maintenance of ion homeostasis is thus essential to sustain force production and power output during intense exercise. Regular speed endurance training (SET), i.e. exercise performed at intensities above that corresponding to maximum oxygen consumption (V̇O2, max ), enhances intense exercise performance. However, most of the studies that have provided mechanistic insight into the beneficial effects of SET have been conducted in untrained and recreationally active individuals, making extrapolation towards athletes' performance difficult. Nevertheless, recent studies indicate that only a few weeks of SET enhances intense exercise performance in highly trained individuals. In these studies, the enhanced performance was not associated with changes in V̇O2, max and muscle oxidative capacity, but rather with adaptations in muscle ion handling, including lowered interstitial concentrations of K⁺ during and in recovery from intense exercise, improved lactate^- -H⁺ transport and H⁺ regulation, and enhanced Ca²⁺ release function. The purpose of this Topical Review is to provide an overview of the effect of SET and to discuss potential mechanisms underlying enhancements in performance induced by SET in already well-trained individuals with special emphasis on ion handling in skeletal muscle.

β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis of the evidence on the effects of β-alanine supplementation on exercise capacity and performance.

DESIGN

This study was designed in accordance with PRISMA guidelines. A 3-level mixed effects model was employed to model effect sizes and account for dependencies within data.

DATA SOURCES

3 databases (PubMed, Google Scholar, Web of Science) were searched using a number of terms ('β-alanine' and 'Beta-alanine' combined with 'supplementation', 'exercise', 'training', 'athlete', 'performance' and 'carnosine').

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Inclusion/exclusion criteria limited articles to double-blinded, placebo-controlled studies investigating the effects of β-alanine supplementation on an exercise measure. All healthy participant populations were considered, while supplementation protocols were restricted to chronic ingestion. Cross-over designs were excluded due to the long washout period for skeletal muscle carnosine following supplementation. A single outcome measure was extracted for each exercise protocol and converted to effect sizes for meta-analyses.

RESULTS

40 individual studies employing 65 different exercise protocols and totalling 70 exercise measures in 1461 participants were included in the analyses. A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. Meta-regression demonstrated that exercise duration significantly (p=0.004) moderated effect sizes. Subgroup analyses also identified the type of exercise as a significant (p=0.013) moderator of effect sizes within an exercise time frame of 0.5-10 min with greater effect sizes for exercise capacity (0.4998 (95% CI 0.246 to 0.753)) versus performance (0.1078 (95% CI -0.201 to 0.416)). There was no moderating effect of training status (p=0.559), intermittent or continuous exercise (p=0.436) or total amount of β-alanine ingested (p=0.438). Co-supplementation with sodium bicarbonate resulted in the largest effect size when compared with placebo (0.43 (95% CI 0.22 to 0.64)).

SUMMARY/CONCLUSIONS

β-alanine had a significant overall effect while subgroup analyses revealed a number of modifying factors. These data allow individuals to make informed decisions as to the likelihood of an ergogenic effect with β-alanine supplementation based on their chosen exercise modality.

Carnosine and anserine homeostasis in skeletal muscle and heart is controlled by β-alanine transamination

KEY POINTS

Using recombinant DNA technology, the present study provides the first strong and direct evidence indicating that β-alanine is an efficient substrate for the mammalian transaminating enzymes 4-aminobutyrate-2-oxoglutarate transaminase and alanine-glyoxylate transaminase. The concentration of carnosine and anserine in murine skeletal and heart muscle depends on circulating availability of β-alanine, which is in turn controlled by degradation of β-alanine in liver and kidney. Chronic oral β-alanine supplementation is a popular ergogenic strategy in sports because it can increase the intracellular carnosine concentration and subsequently improve the performance of high-intensity exercises. The present study can partly explain why the β-alanine supplementation protocol is so inefficient, by demonstrating that exogenous β-alanine can be effectively routed toward oxidation.

ABSTRACT

The metabolic fate of orally ingested β-alanine is largely unknown. Chronic β-alanine supplementation is becoming increasingly popular for improving high-intensity exercise performance because it is the rate-limiting precursor of the dipeptide carnosine (β-alanyl-l-histidine) in muscle. However, only a small fraction (3-6%) of the ingested β-alanine is used for carnosine synthesis. Thus, the present study aimed to investigate the putative contribution of two β-alanine transamination enzymes, namely 4-aminobutyrate-2-oxoglutarate transaminase (GABA-T) and alanine-glyoxylate transaminase (AGXT2), to the homeostasis of carnosine and its methylated analogue anserine. We found that, when transfected into HEK293T cells, recombinant mouse and human GABA-T and AGXT2 are able to transaminate β-alanine efficiently. The reaction catalysed by GABA-T is inhibited by vigabatrin, whereas both GABA-T and AGXT2 activity is inhibited by aminooxyacetic acid (AOA). Both GABA-T and AGXT2 are highly expressed in the mouse liver and kidney and the administration of the inhibitors effectively reduced their enzyme activity in liver (GABA-T for vigabatrin; GABA-T and AGXT2 for AOA). In vivo, injection of AOA in C57BL/6 mice placed on β-alanine (0.1% w/v in drinking water) for 2 weeks lead to a 3-fold increase in circulating β-alanine levels and to significantly higher levels of carnosine and anserine in skeletal muscle and heart. By contrast, specific inhibition of GABA-T by vigabatrin did not affect carnosine and anserine levels in either tissue. Collectively, these data demonstrate that homeostasis of carnosine and anserine in mammalian skeletal muscle and heart is controlled by circulating β-alanine levels, which are suppressed by hepatic and renal β-alanine transamination upon oral β-alanine intake.

Nutritional Strategies to Modulate Intracellular and Extracellular Buffering Capacity During High-Intensity Exercise

Intramuscular acidosis is a contributing factor to fatigue during high-intensity exercise. Many nutritional strategies aiming to increase intra- and extracellular buffering capacity have been investigated. Among these, supplementation of beta-alanine (~3–6.4 g/day for 4 weeks or longer), the rate-limiting factor to the intramuscular synthesis of carnosine (i.e. an intracellular buffer), has been shown to result in positive effects on exercise performance in which acidosis is a contributing factor to fatigue. Furthermore, sodium bicarbonate, sodium citrate and sodium/calcium lactate supplementation have been employed in an attempt to increase the extracellular buffering capacity. Although all attempts have increased blood bicarbonate concentrations, evidence indicates that sodium bicarbonate (0.3 g/kg body mass) is the most effective in improving high-intensity exercise performance. The evidence supporting the ergogenic effects of sodium citrate and lactate remain weak. These nutritional strategies are not without side effects, as gastrointestinal distress is often associated with the effective doses of sodium bicarbonate, sodium citrate and calcium lactate. Similarly, paresthesia (i.e. tingling sensation of the skin) is currently the only known side effect associated with beta-alanine supplementation, and it is caused by the acute elevation in plasma beta-alanine concentration after a single dose of beta-alanine. Finally, the co-supplementation of beta-alanine and sodium bicarbonate may result in additive ergogenic gains during high-intensity exercise, although studies are required to investigate this combination in a wide range of sports.

Beneficial Effects of New Zealand Blackcurrant Extract on Maximal Sprint Speed during the Loughborough Intermittent Shuttle Test

New Zealand blackcurrant (NZBC) extract has been shown to enhance high-intensity intermittent treadmill running. We examined the effects of NZBC extract during the Loughborough Intermittent Shuttle Test (LIST) which involves 5 × 15 min blocks with intermittent 15-m maximal sprints, interspersed by moderate and high-intensity running to simulate team sport activity, and a subsequent run to exhaustion. Thirteen males (age: 22 ± 1 year, V˙O2max: 50 ± 5 mL·kg⁻¹·min⁻¹) participated in three indoor sessions (T: 24 ± 3 °C, humidity: 52% ± 9%). In the first session, a multistage fitness test was completed to determine peak running speed and estimate V˙O2max. Participants consumed NZBC extract in capsules (300 mg·day⁻¹ CurraNZ™) or placebo (PL) (300 mg·day⁻¹ microcrystalline cellulose M102) for seven days in a double-blind, randomized, cross-over design (wash-out at least seven days). NZBC extract did not affect average 15-m sprint times in each block. NZBC reduced slowing of the fastest sprint between block 1 and 5 (PL: 0.12 ± 0.07 s; NZBC: 0.06 ± 0.12 s; p < 0.05). NZBC extract had no effect on heart rate, vertical jump power, lactate and time to exhaustion (PL: 13.44 ± 8.09 min, NZBC: 15.78 ± 9.40 min, p > 0.05). However, eight participants had higher running times to exhaustion when consuming NZBC extract. New Zealand blackcurrant extract may enhance performance in team sports with repeated maximal sprints.

Effects of 28-Day Beta-Alanine Supplementation on Isokinetic Exercise Performance and Body Composition in Female Masters Athletes

Beta-alanine (BA) supplementation increases exercise performance due to increases in the intramuscular lactate buffer, carnosine. Females are more sensitive to these increases and results are further pronounced in trained individuals. Baseline intramuscular carnosine levels also naturally decrease with age; therefore, trained older females may experience augmented benefits from BA supplementation. However, the ability of BA to increase lower-body isokinetic strength (ISO) in female masters athletes (MA) is unknown. The purpose of this study was to examine the longitudinal effects of BA supplementation on ISO, handgrip strength (HG), and body composition in female MA cyclists. Twenty-two subjects participated in this double-blind randomized study. Subjects were randomized into 2 groups (placebo [PLA] = 8 g dextrose; BA = 800 mg + 8 g dextrose) and supplemented 4 times per day for 28 days. ISO, HG, and body composition were evaluated at baseline and at the same day/time each week over the 28-day intervention. No differences existed between groups at baseline or at the 7, 14, and 21 days time points for any variables (p > 0.05). When evaluating ISO (isokinetic) after 28 days, total work performed during the final third of the assessment (24.0 vs. -16.8% change) in flexion and average peak torque (5.4 vs. 2.9% change) in extension were significantly increased from baseline in BA compared with PLA (p ≤ 0.05). No differences existed for HG or body composition after supplementation. Twenty-eight days of BA supplementation increased peak torque and work completed, indicating BA improves lower-body exercise performance in female MA.

Nitrate Intake Promotes Shift in Muscle Fiber Type Composition during Sprint Interval Training in Hypoxia

Purpose: We investigated the effect of sprint interval training (SIT) in normoxia, vs. SIT in hypoxia alone or in conjunction with oral nitrate intake, on buffering capacity of homogenized muscle (βhm) and fiber type distribution, as well as on sprint and endurance performance.

Methods: Twenty-seven moderately-trained participants were allocated to one of three experimental groups: SIT in normoxia (20.9% F_iO₂) + placebo (N), SIT in hypoxia (15% F_iO₂) + placebo (H), or SIT in hypoxia + nitrate supplementation (HN). All participated in 5 weeks of SIT on a cycle ergometer (30-s sprints interspersed by 4.5 min recovery-intervals, 3 weekly sessions, 4–6 sprints per session). Nitrate (6.45 mmol NaNO₃) or placebo capsules were administered 3 h before each session. Before and after SIT participants performed an incremental VO_2max-test, a 30-min simulated cycling time-trial, as well as a 30-s cycling sprint test. Muscle biopsies were taken from m. vastus lateralis.

Results: SIT decreased the proportion of type IIx muscle fibers in all groups (P < 0.05). The relative number of type IIa fibers increased (P < 0.05) in HN (P < 0.05 vs. H), but not in the other groups. SIT had no significant effect on βhm. Compared with H, SIT tended to enhance 30-s sprint performance more in HN than in H (P = 0.085). VO_2max and 30-min time-trial performance increased in all groups to a similar extent.

Conclusion: SIT in hypoxia combined with nitrate supplementation increases the proportion of type IIa fibers in muscle, which may be associated with enhanced performance in short maximal exercise. Compared with normoxic training, hypoxic SIT does not alter βhm or endurance and sprinting exercise performance.

Metabolic consequences of β-alanine supplementation during exhaustive supramaximal cycling and 4000-m time-trial performance

The present study investigated the effects of β-alanine supplementation on the resultant blood acidosis, lactate accumulation, and energy provision during supramaximal-intensity cycling, as well as the aerobic and anaerobic contribution to power output during a 4000-m cycling time trial (TT). Seventeen trained cyclists (maximal oxygen uptake = 4.47 ± 0.55 L·min(-1)) were administered 6.4 g of β-alanine (n = 9) or placebo (n = 8) daily for 4 weeks. Participants performed a supramaximal cycling test to exhaustion (equivalent to 120% maximal oxygen uptake) before (PreExh) and after (PostExh) the 4-week supplementation period, as well as an additional postsupplementation supramaximal cycling test identical in duration and power output to PreExh (PostMatch). Anaerobic capacity was quantified and blood pH, lactate, and bicarbonate concentrations were measured pre-, immediately post-, and 5 min postexercise. Subjects also performed a 4000-m cycling TT before and after supplementation while the aerobic and anaerobic contributions to power output were quantified. β-Alanine supplementation increased time to exhaustion (+12.8 ± 8.2 s; P = 0.041) and anaerobic capacity (+1.1 ± 0.7 kJ; P = 0.048) in PostExh compared with PreExh. Performance time in the 4000-m TT was reduced following β-alanine supplementation (-6.3 ± 4.6 s; P = 0.034) and the mean anaerobic power output was likely to be greater (+6.2 ± 4.5 W; P = 0.035). β-Alanine supplementation increased time to exhaustion concomitant with an augmented anaerobic capacity during supramaximal intensity cycling, which was also mirrored by a meaningful increase in the anaerobic contribution to power output during a 4000-m cycling TT, resulting in an enhanced overall performance.