Oral Adenosine-5'-triphosphate (ATP) Administration Increases Postexercise ATP Levels, Muscle Excitability, and Athletic Performance Following a Repeated Sprint Bout

International society of sports nutrition position stand: β-hydroxy-β-methylbutyrate (HMB)

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on an analysis of the literature regarding the effects of β-Hydroxy-β-Methylbutyrate (HMB). The following 12 points have been approved by the Research Committee of the Society: 1. HMB is a metabolite of the amino acid leucine that is naturally produced in both humans and other animals. Two forms of HMB have been studied: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA appears to lead to increased appearance of HMB in the bloodstream when compared to HMB-Ca, though recent results are mixed. 2. The available safety/toxicity data suggest that chronic HMB-Ca and HMB-FA consumption are safe for oral HMB supplementation in humans up to at least one year. 3. There are no negative effects of HMB-Ca and HMB-FA on glucose tolerance and insulin sensitivity in humans. There may be improvements in glucose metabolism in younger adults. 4. The primary mode of action of HMB appears to be through its dual mechanism to enhance muscle protein synthesis and suppress muscle protein breakdown. HMB's activation of mTORC1 is independent of the leucine-sensing pathway (Sestrin2-GATOR2 complex). 5. HMB may help reduce muscle damage and promote muscle recovery, which can promote muscle growth/repair. HMB may also have anti-inflammatory effects, which could contribute to reducing muscle damage and soreness. 6. HMB consumption in close proximity to an exercise bout may be beneficial to increase muscle protein synthesis and attenuate the inflammatory response. HMB can provide a beneficial physiological effect when consumed both acutely and chronically in humans. 7. Daily HMB supplementation (38 mg/kg body weight) in combination with exercise training may improve body composition through increasing lean mass and/or decreasing fat mass with benefits in participants across age, sex, and training status. The most pronounced of these improvements in body composition with HMB have been observed in studies with robust resistance training programs and dietary control. 8. HMB may improve strength and power in untrained individuals, but its performance benefits in trained athletes are mixed and increase with an increase in study duration (>6 weeks). HMB's beneficial effects on athletic performance are thought to be driven by improved recovery. 9. HMB supplementation appears to potentially have a positive impact on aerobic performance, especially in trained athletes. The mechanisms of the effects are unknown. 10. HMB supplementation may be important in a non-exercising sedentary and aging population to improve muscle strength, functionality, and muscle quality. The effects of HMB supplementation with exercise are varied, but the combination may have a beneficial effect on the treatment of age-associated sarcopenia under select conditions. 11. HMB may be effective in countering muscle disuse atrophy during periods of inactivity due to illness or injury. The modulation of mitochondrial dynamics and lipid metabolism by HMB may be a potential mechanism for preventing disuse atrophy and aiding rehabilitation beyond HMB's effects on rates of muscle protein synthesis and degradation. 12. The efficacy of HMB in combination with certain nutrients may be enhanced under select conditions.

Acute Effect of Oral Adenosine Triphosphate (ATP) Supplementation on Muscular Performance in Trained Adults

INTRODUCTION

Adenosine Triphosphate is a molecule with the function of generating energy, where high levels are directly related to cellular and muscular health. Oral supplementation appears as a possibility to guarantee such levels, and is normally consumed in capsules, which can be acute or chronic.

OBJECTIVES

To verify the influence of a dose of ATP on muscular performance in adults.

METHODS

This is an acute, crossover, randomized, double-blind, placebo-controlled intervention study. 18 trained men were recruited, with an average age of 27.95 years. Two visits were made to the laboratory, where each of the protocols consisted of randomized supplementation of 400 mg of Peak ATP® or placebo, and 30 min later, five series were performed, where the first consisted of five repetitions and the following four of ten repetitions at 60° per second in knee extension and flexion on a Biodex® 4.0 isokinetic dynamometer, where the volunteers' muscle strength and resistance to fatigue were measured. For data analysis, data normality was assessed using Shapiro Wilk, the ANOVA repeated measures test with Bonferroni post hoc. To identify the size of the effect, the Cohen test was performed, and the statistical package used was SPSS 25 with an applied significance of p < 0.05.

RESULTS

Acute supplementation was unable to achieve significant improvements in muscle strength indicators. The supplement delays drops in strength as the exercise progresses in knee extension compared to the placebo.

CONCLUSIONS

An acute dose of 400 mg of ATP did not improve the volunteers' muscle strength indicators, but it was able to reduce fatigue levels as the exercise progressed, enabling greater performance for longer.

Early manifestation of hypophosphatemic rickets in goslings: a potential role of insufficient muscular adenosine triphosphate in motility impairment of early P-deficient geese

We aimed to determine the onset time of hypophosphatemic rickets and investigate the mechanism of motility impairment through adenosine triphosphate (ATP) production in goslings. Two hundred and sixteen 1-day-old male Jiangnan white geese were randomly divided into 3 groups, with 6 replicates and 12 geese per replicate. Birds were fed on 3 diets: a control diet (nonphytic phosphorus, NPP, 0.38%), a P-deficient diet (PD; NPP, 0.08%), and a high P diet (HP; NPP, 0.80%) for 14 d. Subsequently, all birds were shifted to the control diet for an additional 14 d. The cumulative incidence of lameness increased significantly (P < 0.01) starting on d 4, reaching over 80% on d 7 and 100% on d 12 in the PD group. Drinking and eating frequency decreased from d 4 and d 5, respectively, in the PD group compared to the other groups (most P < 0.01). The PD group exhibited shorter and narrower beaks, higher (worse) curvature scores of the beak and costochondral junctions, swelling caput costae, and dirtier feathers since d 4, in contrast to the control and HP groups (most P < 0.01). The HP had bigger (P < 0.05) beak and sternum sizes than the control groups on d 4 to 11. Leg muscle ATP levels were lower (P < 0.01 or 0.05) on d 4 to 11; in contrast, adenosine diphosphate (d 7-11) was higher in PD compared to the control (P < 0.05). Leg muscle ATP level had positive linear (R2 > 0.40) correlations (r > 0.60) with eating and drinking frequencies on d 7 and 11 (P < 0.01). Bone stiffness, feather cleanliness, and ATP levels recovered (P > 0.05) to the control level, whereas bone size did not recover (P < 0.05) in PD and HP after eating the control diet for 2 wk. The onset time of hypophosphatemic rickets was around 4 d in goslings, and insufficient leg muscle ATP was related to the impaired motility observed in early P-deficient geese.

Coenzyme Q10 Supplementation in Athletes: A Systematic Review

BACKGROUND

To summarize available evidence in the literature on the impacts of CoQ10 supplementation on metabolic, biochemical, and performance outcomes in athletes.

METHODS

Six databases, Cochrane Library (33 articles), PubMed (90 articles), Scopus (55 articles), Embase (60 articles), SPORTDiscus (1056 articles), and Science Direct (165 articles), were researched. After applying the eligibility criteria, articles were selected for peer review independently as they were identified by June 2022. The protocol for this systematic review was registered on PROSPERO (CRD42022357750).

RESULTS

Of the 1409 articles found, 16 were selected for this systematic review. After CoQ10 supplementation, a decrease in oxidative stress markers was observed, followed by higher antioxidant activity. On the other hand, lower levels of liver damage markers (ALT); Aspartate aminotransferase (AST); and Gamma-glutamyl transpeptidase (γGT) were identified. Finally, we found a reduction in fatigue indicators such as Creatine Kinase (CK) and an increase in anaerobic performance.

CONCLUSIONS

This systematic review concludes that supplementation with orally administered CoQ10 (30-300 mg) was able to potentiate plasma antioxidant activity and anaerobic performance, reducing markers linked to oxidative stress and liver damage in athletes from different modalities aged 17 years old and older.

Evaluating the effects of PeakATP® supplementation on visuomotor reaction time and cognitive function following high-intensity sprint exercise

The purpose of this study was to examine the effects of 14-days adenosine 5'-triphosphate (ATP) supplementation (PeakATP®) on reaction time (RT), multiple object tracking speed (MOT), mood and cognition. Twenty adults (22.3 ± 4.4 yrs., 169.9 ± 9.5 cm, 78.7 ± 14.6 kg) completed two experimental trials in a double-blind, counter-balanced, crossover design. Subjects were randomized to either PeakATP® (400 mg) or placebo (PLA) and supplemented for 14-days prior to each trial. During each trial, subjects completed a three-minute all-out test on a cycle ergometer (3MT), with measures of visuomotor RT [Dynavision D2 Proactive (Mode A) and Reactive (Mode B) tasks], MOT (Neurotracker), mood (Profile of Mood States Questionnaire; POMS) and cognition (Automated Neuropsychological Assessment Metrics; ANAM) occurring before (PRE), immediately post (IP) and 60 min post-3MT (60P). Subjects ingested an acute dose of the assigned supplement 30 min prior to completing PRE assessments for each trial. Trials were separated by a 14-day washout period. PeakATP® significantly attenuated declines in hits (p = 0.006, ηp2 = 0.235) and average RT (AvgRT, p = 0.006, ηp2 = 0.236) in Mode A, significantly improved AvgRT (p = 0.039, ηp2 = 0.174) in Mode B, and significantly reduced the total number of misses (p = 0.005, ηp2 = 0.343) in Mode B. No differences between treatments were noted for MOT, POMS or ANAM variables. In conclusion, these results indicate that PeakATP® maintains proactive RT and improves reactive RT following high-intensity sprint exercise suggesting that supplemental ATP may mitigate exercise induced cognitive dysfunction.

Effects of adenosine receptor overexpression and silencing in neurons and glial cells on lifespan, fitness, and sleep of Drosophila melanogaster

A single adenosine receptor gene (dAdoR) has been detected in Drosophila melanogaster. However, its function in different cell types of the nervous system is mostly unknown. Therefore, we overexpressed or silenced the dAdoR gene in eye photoreceptors, all neurons, or glial cells and examined the fitness of flies, the amount and daily pattern of sleep, and the influence of dAdoR silencing on Bruchpilot (BRP) presynaptic protein. Furthermore, we examined the dAdoR and brp gene expression in young and old flies. We found that a higher level of dAdoR in the retina photoreceptors, all neurons, and glial cells negatively influenced the survival rate and lifespan of male and female Drosophila in a cell-dependent manner and to a different extent depending on the age of the flies. In old flies, expression of both dAdoR and brp was higher than in young ones. An excess of dAdoR in neurons improved climbing in older individuals. It also influenced sleep by lengthening nighttime sleep and siesta. In turn, silencing of dAdoR decreased the lifespan of flies, although it increased the survival rate of young flies. It hindered the climbing of older males and females, but did not change sleep. Silencing also affected the daily pattern of BRP abundance, especially when dAdoR expression was decreased in glial cells. The obtained results indicate the role of adenosine and dAdoR in the regulation of fitness in flies that is based on communication between neurons and glial cells, and the effect of glial cells on synapses.

The Effects of Two Weeks of Oral PeakATP® Supplementation on Performance during a Three-Minute All out Test

Exogenous ATP has been shown to increase total weight lifted during resistance training interventions and attenuate fatigue during repeated Wingate assessments. However, the influence of exogenous ATP on single bout maximal effort performance has yet to be examined. The purpose of this study was to investigate the effects of PeakATP^® supplementation on performance during a 3-min all-out test (3MT). Twenty adults (22.3 ± 4.4 years, 169.9 ± 9.5 cm, 78.7 ± 14.6 kg) completed two identical 3MT protocols in a double-blind, counter-balanced, crossover design. Participants were randomized to either PeakATP^® (400 mg·day^-1) or placebo (PLA) treatments and consumed their assigned supplement for 14 days and ingested an acute dose 30 min before each 3MT. A 14-day wash-out period was completed between each supplementation period and subsequent 3MT. Peak power, time to peak power, work above end power, end power, and fatigue index were assessed during each 3MT. Dependent t-tests and Hedge's g effect sizes were used to assess differences between treatments. No significant differences were observed between treatments for 3MT performance (p > 0.05). These findings indicate that 3MT performance was not significantly impacted by PeakATP^® supplementation. This may be due in part to the continuous nature of the 3MT as disodium ATP has been shown to be beneficial for repeated bout activities.

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.

Dose Response of Acute ATP Supplementation on Strength Training Performance

Background: Chronic oral ATP supplementation benefits cardiovascular health, muscular performance, body composition, and recovery while attenuating muscle breakdown and fatigue. A single 400 mg dose of oral ATP supplementation improved lower body resistance training performance and energy expenditure in recreational resistance trained males, however, the minimal effective dose is currently unknown.

Materials and Methods: Twenty recreationally trained men (age 28.6 ± 1.0 years, body mass 81.2 ± 2.0 kg, height 175.2 ± 1.4 cm, 1RM 141.5 ± 5.0 kg) consumed a single dose of either 400 mg, 200 mg, or 100 mg ATP (PEAK ATP^®, TSI USA LLC, Missoula, MT, USA) or a placebo in a randomized, placebo-controlled crossover design, separated by a one week wash out between treatments. After warm-up, participants performed 4 sets of half-squats using free-weights until movement failure separated by 2 mins of rest between sets.

Results: In comparison to placebo, 400 mg ATP significantly increased the number of set 1 repetitions (+13%, p = 0.04), and numerically increased total repetitions (+7%, p = 0.19) and total weight lifted (+6%, p = 0.22). 200 mg ATP numerically increased set 1 repetitions (+4% p = 0.47), while 100 mg ATP showed no improvements over placebo. 100 mg ATP (−4%, p < 0.05) and 400 mg ATP (−4%, p = 0.11) decreased the perceived rate of exertion compared to placebo.

Conclusions: In this study, the effective minimal dose of acute oral ATP supplementation during resistance exercise to increase performance was determined to be 400 mg, while as little as 100 mg showed improvements in perceived exertion.

Cystic fibrosis improves COVID-19 survival and provides clues for treatment of SARS-CoV-2

Systemic pools of ATP are elevated in individuals homozygous for cystic fibrosis (CF) as evidenced by elevated blood and plasma ATP levels. This elevated ATP level seems to provide benefit in the presence of advanced solid tumors (Abraham et al., Nature Medicine 2(5):593-596, 1996). We published in this journal a paper showing that IV ATP can elevate the depleted ATP pools of advanced cancer patients up to levels found in CF patients with subsequent clinical, biochemical, and quality of life (QOL) improvements (Rapaport et al., Purinergic Signalling 11(2): 251-262, 2015). We hypothesize that the elevated ATP levels seen in CF patients may be benefiting CF patients in another way: by improving their survival after contracting COVID-19. We discuss here the reasoning behind this hypothesis and suggest how these findings might be applied clinically in the general population.

How to Increase Muscle Mass in Critically Ill Patients: Lessons Learned from Athletes and Bodybuilders

PURPOSE OF REVIEW

Decades of research on nutrition and exercise on athletes and bodybuilders has yielded various strategies to promote anabolism and improve muscle health and growth. We reviewed these interventions in the context of muscle loss in critically ill patients.

RECENT FINDINGS

For critically ill patients, ensuring optimum protein intake is important, potentially using a whey-containing source and supplemented with vitamin D and leucine. Agents like hydroxyl β-methylbutyrate and creatine can be used to promote muscle synthesis. Polyunsaturated fatty acids stimulate muscle production as well as have anti-inflammatory properties that may be useful in critical illness. Adjuncts like oxandralone promote anabolism. Resistance training has shown mixed results in the ICU setting but needs to be explored further with specific outcomes. Critically ill patients suffer from severe proteolysis during hospitalization as well as persistent inflammation, immunosuppression, and catabolism syndrome after discharge. High protein supplementation, ergogenic aids, anti-inflammatories, and anabolic adjuncts have shown potential in alleviating muscle loss and should be used in intensive care units to optimize patient recovery.

Topical Review: The Top Five Peripheral Vision Tools in Sport

SIGNIFICANCE

This study summarizes the empirical evidence on the use of peripheral vision for the most-researched peripheral vision tools in sports.

The objective of this review was to explain if and how the tools can be used to investigate peripheral vision usage and how empirical findings with these vision tools might be transferred to sports situations. The data sources used in this study were Scopus, ScienceDirect, and PubMed. We additionally searched the manufacturers' Web pages and used Google Scholar to find full texts that were not available elsewhere. Studies were included if they were published in a peer-reviewed journal, were written in English language, and were conducted in a sports context. From the 10 searched tools, we included the 5 tools with most published studies. In our topical search, we identified 93 studies for the five most-used peripheral vision tools. Surprisingly, none of these studies used eye-tracking methods to control for the use of peripheral vision. Best "passive" control is achieved by tools using (foveal) secondary tasks (Dynavision D2 and Vienna Test System). Best transfer to sports tasks is expected for tools demanding action responses (FitLight, Dynavision D2). Tools are likely to train peripheral monitoring (NeuroTracker), peripheral reaction time (Dynavision D2, Vienna Test System), or peripheral preview (FitLight), whereas one tool did not show any link to peripheral vision processes (Nike SPARQ Vapor Strobe).

Mechanisms of Physical Fatigue and its Applications in Nutritional Interventions

Physical fatigue during exercise can be defined as an impairment of physical performance. Multiple factors have been found contributing to physical fatigue, including neurotransmitter-mediated defense action, insufficient energy supply, and induction of oxidative stress. These mechanistic findings provide a sound theoretical rationale for nutritional intervention since most of these factors can be modulated by nutrient supplementation. In this review, we summarize the current evidence regarding the functional role of nutrients supplementation in managing physical performance and propose the issues that need to be addressed for better utilization of nutritional supplementation approach to improve physical performance.

Subchronic (90-Day) repeated dose toxicity study of disodium adenosine-5'-triphosphate in rats

Adenosine-5'-triphosphate (ATP) is the primary source of energy for cells and oral supplementation with ATP offers numerous different health benefits, including the regulation of blood flow and muscle contraction. In this study, ATP, disodium salt, was administered by gavage to rats for 90 consecutive days at doses of 0 (control), 500, 1000, and 2000 mg kg BW^-1·d^-1 (n = 10 per sex/group). Subchronic administration of ATP was well tolerated at all dose levels. Body weights and feed consumption body weight gains were similar between ATP-treated and control rats. Minor differences were seen in hematology and blood chemistry; however, these changes were not dose related and therefore not of biological or toxicological significance. Only one difference was observed in absolute organ weights, females of the high dose had increased kidney and increased relative kidney and liver weights; however, these differences were not seen in males nor appeared to be dose related. No biological or toxicological significant differences were observed in thyroid function or urine analysis. The incidence of histopathological lesions was low and similar between treated and control groups. Based upon these findings, the no-observed-adverse-effect level (NOAEL) was determined to be ≥ 2000 mg kg BW^-1·d^-1, which was the highest dose tested.

Supplements with purported effects on muscle mass and strength

PURPOSE

Several supplements are purported to promote muscle hypertrophy and strength gains in healthy subjects, or to prevent muscle wasting in atrophying situations (e.g., ageing or disuse periods). However, their effectiveness remains unclear.

METHODS

This review summarizes the available evidence on the beneficial impacts of several popular supplements on muscle mass or strength.

RESULTS

Among the supplements tested, nitrate and caffeine returned sufficient evidence supporting their acute beneficial effects on muscle strength, whereas the long-term consumption of creatine, protein and polyunsaturated fatty acids seems to consistently increase or preserve muscle mass and strength (evidence level A). On the other hand, mixed or unclear evidence was found for several popular supplements including branched-chain amino acids, adenosine triphosphate, citrulline, β-Hydroxy-β-methylbutyrate, minerals, most vitamins, phosphatidic acid or arginine (evidence level B), weak or scarce evidence was found for conjugated linoleic acid, glutamine, resveratrol, tribulus terrestris or ursolic acid (evidence level C), and no evidence was found for other supplements such as ornithine or α-ketoglutarate (evidence D). Of note, although most supplements appear to be safe when consumed at typical doses, some adverse events have been reported for some of them (e.g., caffeine, vitamins, α-ketoglutarate, tribulus terrestris, arginine) after large intakes, and there is insufficient evidence to determine the safety of many frequently used supplements (e.g., ornithine, conjugated linoleic acid, ursolic acid).

CONCLUSION

 In summary, despite their popularity, there is little evidence supporting the use of most supplements, and some of them have been even proven ineffective or potentially associated with adverse effects.

Oral adenosine 5'-triphosphate supplementation improved hemodynamic and autonomic parameters after exercise in hypertensive women

The aim of this study was to verify the autonomic modulation and blood pressure after adenosine-5'-triphosphate (ATP) supplementation associated to acute aerobic exercise in hypertensive women. Eleven hypertensive women (age, 61.8±5.0 years) completed a randomized, double blind trial: ATP supplement condition (ATP=400 mg) or placebo. After 30 min of supplementation or placebo intake, the subjects performed 30 min of aerobic exercise (70%-75% of maximum heart rate). The autonomic modulation was assessed by heart rate variability during rest and recovery (postexercise until 30 min of recovery), the square root of the mean squared difference between adjacent RR intervals (RMSSD), standard deviation of successive values (SDNN), low frequency (LF) and high frequency (HF) were measured. The blood pressure (systolic blood pressure [SBP] and diastolic blood pressure, mmHg) were recorded at rest, immediately postexercise, post-10, post-20, and post-30 min after exercise. For RMSSD, there was statistically significant difference during recovery, with higher RMSSD for ATP compared to placebo (rest=16.4±8.5 vs. placebo=11.6±4.0; ATP=18.5±9.7 msec; P=0.020). When analyzing the delta (recovery minus rest), the RMSSD (ATP=2.1± 7.2 msec vs. placebo=-4.7±7.5 msec; P=0.009), LF (ATP=-19.8±122.7 vs. placebo=-94.1±200.2 msec2; P=0.02), and SDNN (ATP=-2.8±12.2 msec vs. placebo=-10.6±10.5 msec; P=0.010) were higher for ATP than placebo. Furthermore, there was a greater postexercise hypotension at 20 min for ATP (SBP: ATP=-13.2±8.4 mmHg vs. placebo=-6.1±9.9 mmHg; P=0.006). Acute ATP supplementation promoted greater postexercise hypotension for systolic blood pressure and induced faster recovery of heart rate variability in hypertensive women.

ISSN exercise & sports nutrition review update: research & recommendations

Background

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words ‘sport nutrition’. Consequently, staying current with the relevant literature is often difficult.

Methods

This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation and oversight; 2.) How dietary supplements are legally regulated in the United States; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of nutritional approaches to augment skeletal muscle hypertrophy and the potential ergogenic value of various dietary and supplemental approaches.

Conclusions

This updated review is to provide ISSN members and individuals interested in sports nutrition with information that can be implemented in educational, research or practical settings and serve as a foundational basis for determining the efficacy and safety of many common sport nutrition products and their ingredients.