Caffeine but not acetaminophen increases 4-km cycling time-trial performance

Caffeine and sport

Caffeine is a trimethylxanthine found in coffee and several other foods and beverages. Its stimulatory effects make it an interesting strategy to boost performance for athletic populations. Scientific evidence supports its efficacy to improve high-intensity endurance exercise, explosive and high-intensity efforts, resistance exercise, team sports and combat sports, though individual variation in the ergogenic response to caffeine exists. Supplementation can be taken in many forms including dissolved in water, via capsules, coffee, energy drinks and caffeinated gum; ingestion via capsules, dissolved in water or in caffeinated gum appear to be most effective. Variability in the exercise response following caffeine supplementation may be explained by genetic factors or habitual caffeine consumption. Caffeine is an excellent supplement for athletes looking to improve their exercise performance, though some consideration of side-effects and impact on sleep are warranted.

Can I Have My Coffee and Drink It? A Systematic Review and Meta-analysis to Determine Whether Habitual Caffeine Consumption Affects the Ergogenic Effect of Caffeine

OBJECTIVE

The aim was to quantify the proportion of the literature on caffeine supplementation that reports habitual caffeine consumption, and determine the influence of habitual consumption on the acute exercise response to caffeine supplementation, using a systematic review and meta-analytic approach.

METHODS

Three databases were searched, and articles screened according to inclusion/exclusion criteria. Three-level meta-analyses and meta-regression models were used to investigate the influence of habitual caffeine consumption on caffeine's overall ergogenic effect and within different exercise types (endurance, power, strength), in men and women, and in trained and untrained individuals. Sub-analyses were performed according to the following: acute relative dose (< 3, 3-6, > 6 mg/kg body mass [BM]); whether the acute caffeine dose provided was lower or higher than the mean daily caffeine dose; and the caffeine withdrawal period prior to the intervention (< 24, 24-48, > 48 h).

RESULTS

Sixty caffeine studies included sufficient information on habitual consumption to be included in the meta-analysis. A positive overall effect of caffeine was shown in comparison to placebo (standard mean difference [SMD] = 0.25, 95% confidence interval [CI] 0.20-0.30; p < 0.001) with no influence of relative habitual caffeine consumption (p = 0.59). Subgroup analyses showed a significant ergogenic effect when the caffeine dose was < 3 mg/kg BM (SMD = 0.26, 95% CI 0.12-0.40; p = 0.003) and 3-6 mg/kg BM (SMD = 0.26, 95% CI 0.21-0.32; p < 0.0001), but not > 6 mg/kg BM (SMD = 0.11, 95% CI - 0.07 to 0.30; p = 0.23); when the dose was both higher (SMD = 0.26, 95% CI 0.20-0.31; p < 0.001) and lower (SMD = 0.21, 95% CI 0.06-0.36; p = 0.006) than the habitual caffeine dose; and when withdrawal was < 24 h, 24-48 h, and > 48 h. Caffeine was effective for endurance, power, and strength exercise, with no influence (all p ≥ 0.23) of relative habitual caffeine consumption within exercise types. Habitual caffeine consumption did not modify the ergogenic effect of caffeine in male, female, trained or untrained individuals.

CONCLUSION

Habitual caffeine consumption does not appear to influence the acute ergogenic effect of caffeine.

What is the Effect of Paracetamol (Acetaminophen) Ingestion on Exercise Performance? Current Findings and Future Research Directions

In recent years, studies have explored the effects of paracetamol (acetaminophen) ingestion on exercise performance. However, due to the contrasting findings, there is still no consensus on this topic. This article provides an overview of the effects of paracetamol on endurance, sprinting, and resistance exercise performance. Studies have reported that paracetamol ingestion may be ergogenic for endurance performance. These effects occur when paracetamol is ingested 45-60 min before exercise and appear to be more pronounced in time-to-exhaustion versus time-trial tests. Besides endurance, paracetamol ingestion 30 min before exercise increases mean power during repeated cycling sprints in interval training involving repeated 30-s all-out bouts. Preliminary data on paracetamol ingestion also suggest: (a) improved endurance performance in the heat; (b) an improvement in single sprint performance, at least when paracetamol is ingested following exercise-induced fatigue; and (c) attenuation of the decline in muscular strength that occurs with repeated maximum contractions. An ergogenic effect of paracetamol is most commonly observed when a dose of 1500 mg is ingested 30-60 min before exercise. Despite these performance-enhancing effects, the aim of this article is not to promote paracetamol use, as side effects associated with its consumption and ethical aspects need to be considered before utilizing paracetamol as an ergogenic aid. Future research on this topic is still needed, particularly related to paracetamol dosing, timing of ingestion, and the effects of paracetamol in females and elite athletes.

Post-exercise Cold Water Immersion Does Not Improve Subsequent 4-km Cycling Time-Trial Compared With Passive and Active Recovery in Normothermia

Background: We investigated whether a brief cold water immersion between two cycling time trials (TT) improves the performance of the latter compared with passive and active recovery in normothermic conditions (~20°C). Methods: In Experiment 1 10 active participants (4 women) completed two 4-km TT (Ex1 and Ex2, each preceded by a 12 min moderate-intensity warm-up) separated by a 15 min recovery period consisting of: (a) passive rest (PAS) or (b) 5 min cold water immersion at 8°C (CWI-5). In Experiment 2, 13 different active males completed the same Ex1 and Ex2 bouts separated by a 15 min recovery consisting of: (a) PAS, (b) 10 min cold water immersion at 8°C (CWI-10) or (c) 15 min of moderate-intensity active recovery (ACT). Results: In both experiments, the time to complete the 4-km TT-s was not different (P > 0.05, ES = 0.1) among the trials neither in Ex1 (Experiment 1: PAS: 414 ± 39 s; CWI-5: 410 ± 39 s; Experiment 2: PAS: 402 ± 41 s; CWI-10: 404 ± 43 s; ACT: 407 ± 41 s) nor Ex2 (Experiment 1: PAS: 432 ± 43 s; CWI-5: 428 ± 47 s; Experiment 2: PAS: 418 ± 52 s; CWI-10: 416 ± 57 s; ACT: 421 ± 50 s). In addition, in all conditions, the time to complete the time trials was longer (P < 0.05, ES = 0.4) in Ex2 than Ex1. Core temperature was lower (P < 0.05) during the majority of Ex2 after CW-5 compared with passive rest (Experiment 1) and after CWI-10 compared with PAS and ACT (Experiment 2). Perceived exertion was also lower (P < 0.05) at mid-point of Ex2 after CWI-5 compared with PAS (Experiment 1) as well as overall lower during the CWI-10 compared with PAS and ACT conditions (Experiment 2). Conclusion: A post-exercise 5-10 min cold water immersion does not influence subsequent 4-km TT performance in normothermia, despite evoking reductions in thermal strain.

Effects of Paracetamol (Acetaminophen) Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis

Several studies explored the effects of paracetamol (acetaminophen) ingestion on endurance performance, but their findings are conflicting. Therefore, this review aimed to conduct a meta-analysis examining the effects of paracetamol ingestion on endurance performance. Five databases were searched to find relevant studies. The PEDro checklist was used to assess the methodological quality of the included studies. Data reported in the included studies were pooled in a random-effects meta-analysis. A total of ten studies with good or excellent methodological quality were included in the meta-analysis (pooled n = 141). All included studies had a randomized, double-blind, crossover design. In the main meta-analysis, there was no significant difference between the effects of placebo and paracetamol on endurance performance (Cohen's d = 0.09; 95% confidence interval (CI): -0.04, 0.22; p = 0.172). However, an ergogenic effect was found when we considered only the studies that provided paracetamol 45 to 60 min before exercise (Cohen's d = 0.14; 95% CI: 0.07, 0.21; p < 0.001). In a subgroup analysis that focused on time-to-exhaustion tests, there was a significant ergogenic effect of paracetamol ingestion (Cohen's d = 0.19; 95% CI: 0.06, 0.33; p = 0.006). There was no significant difference between placebo and paracetamol in a subgroup analysis that focused on time trial tests (Cohen's d = 0.05; 95% CI: -0.12, 0.21; p = 0.561). In conclusion, paracetamol ingestion appears to enhance performance (a) in time-to-exhaustion endurance tests and (b) when consumed 45 to 60 min before exercise.

No additive effect of acetaminophen when co-ingested with caffeine on cycling performance in well-trained young men

We investigated the effect of caffeine and acetaminophen on power output during a 6-min performance test, peripheral fatigue, and muscle protein kinase A (PKA) substrate phosphorylation. Fourteen men [age (means ± SD): 26 ± 6 yr; V̇o_2max: 63.9 ± 5.0 mL·min^-1·kg^-1] completed four randomized trials with acetaminophen (1,500 mg), caffeine (5 mg·kg body wt^-1), combined caffeine and acetaminophen (caffeine + acetaminophen), or placebo. Mean power output during the 6-min performance test (placebo mean: 312 ± 41 W) was higher with caffeine (+5 W; 95% CI: 1 to 9; P = 0.017) and caffeine + acetaminophen (+6 W; 95% CI: 0 to 12; P = 0.049) than placebo, but not with acetaminophen (+1 W; 95% CI: -4 to 7; P = 0.529). Decline in quadriceps maximal isometric voluntary torque immediately after the performance test was lower (treatment × time; P = 0.035) with acetaminophen (-40 N·m; 95% CI: -53 to -30; P < 0.001) and caffeine + acetaminophen (-44 N·m; 95% CI: -58 to -30; P < 0.001) than placebo (-53 N·m; 95% CI: -71 to -39; P < 0.001) but was similar with caffeine (-54 N·m; 95% CI: -69 to -38; P < 0.001). Muscle phosphocreatine content decreased more during the performance test (treatment × time; P = 0.036) with caffeine + acetaminophen (-55 mmol·kg dry wt^-1; 95% CI: -65 to -46; P < 0.001) than placebo (-40 mmol·kg dry wt^-1; 95% CI: -52 to -24; P < 0.001). Muscle net lactate accumulation was not different from placebo (+85 mmol·kg dry wt^-1; 95% CI: 60 to 110; P < 0.001) for any treatment (treatment × time; P = 0.066), being +75 mmol·kg dry wt^-1 (95% CI: 51 to 99; P < 0.001) with caffeine, +76 mmol·kg dry wt^-1 (95% CI: 58 to 96; P < 0.001) with acetaminophen, and +103 mmol·kg dry wt^-1 (95% CI: 89 to 115; P < 0.001) with caffeine + acetaminophen. Decline in muscle ATP and glycogen content and increase in PKA substrate phosphorylation was not different between treatments (treatment × time; P > 0.1). Thus, acetaminophen provides no additive performance enhancing effect to caffeine during 6-min maximal cycling. In addition, change in PKA activity is likely not a major mechanism of performance improvement with caffeine.NEW & NOTEWORTHY Here, we show that acetaminophen does not provide additive performance improvement to caffeine during a 6-min cycling ergometer performance test, and that acetaminophen does not improve performance on its own. Neither substance affects peripheral fatigue, muscle glycolytic energy production, or phosphorylation of muscle proteins of importance for ion handling. In contrast to previous suggestions, increased epinephrine action on muscle cells does not appear to be a major contributor to the performance enhancement with caffeine.