Caffeine is ergogenic after supplementation of oral creatine monohydrate

Exploring the relationship between caffeine metabolism-related CYP1A2 rs762551 polymorphism and team sport athlete status and training adaptations

BACKGROUND

This study aimed to achieve a dual objective: to compare the frequencies of CYP1A2 rs762551 genotypes between team sport athletes and a control group, and to determine the association between the rs762551 polymorphism and changes in physical performance after a six-week training program among elite basketball players.

METHODS

The study encompassed an analysis of 504 individuals, comprising 320 athletes and 184 controls. For the Turkish cohort, DNA was isolated using the buccal swab method, and genotyping was conducted using the KASP technique. Performance assessments included the Yo-Yo IR2 and 30 m sprint tests. For Russian participants, DNA samples were extracted from peripheral blood, a commercial kit was used for DNA extraction, and genotyping of the rs762551 polymorphism was conducted using DNA microarray.

RESULT

Notably, a statistically significant linear decline in the prevalence of the CC genotype was observed with ascending levels of athletic achievement within team sports (sub-elite: 18.0%, elite: 8.2%, highly elite: 0%; p = 0.001). Additionally, the CA genotype was the most prevalent genotype in the highly elite group compared to controls (80.0% vs. 45.1%, p = 0.048). Furthermore, statistically significant improvements in Yo-Yo IR2 performance were noted exclusively among basketball players harboring the CA genotype (p = 0.048).

CONCLUSIONS

The study's findings indicate that the rs762551 CC genotype is a disadvantage in elite team sports, whereas the CA genotype provides an advantage in basketball performance.

Caffeine, but Not Creatine, Improves Anaerobic Power Without Altering Anaerobic Capacity in Healthy Men During a Wingate Anaerobic Test

There is a lack of evidence on the additional benefits of combining caffeine (CAF) and creatine (CRE) supplementation on anaerobic power and capacity. Thus, the aim of the present study was to test the effects of combined and isolated supplementation of CAF and CRE on anaerobic power and capacity. Twenty-four healthy men performed a baseline Wingate anaerobic test and were then allocated into a CRE (n = 12) or placebo (PLA; n = 12) group. The CRE group ingested 20 g/day of CRE for 8 days, while the PLA group ingested 20 g/day of maltodextrin for the same period. On the sixth and eighth days of the loading period, both groups performed a Wingate anaerobic test 1 hr after either CAF (5 mg/kg of body mass; CRE + CAF and PLA + CAF conditions) or PLA (5 mg/kg of body mass of cellulose; CRE + PLA and PLA + PLA conditions) ingestion. After the loading period, changes in body mass were greater (p < .05) in the CRE (+0.87 ± 0.23 kg) than in the PLA group (+0.13 ± 0.27 kg). In both groups, peak power was higher (p = .01) in the CAF (1,033.4 ± 209.3 W) than in the PLA trial (1,003.3 ± 204.4 W), but mean power was not different between PLA and CAF trials (p > .05). In conclusion, CAF, but not CRE ingestion, increases anaerobic power. Conversely, neither CRE nor CAF has an effect on anaerobic capacity.

Not Another Caffeine Effect on Sports Performance Study-Nothing New or More to Do?

The performance-enhancing potential of acute caffeine consumption is firmly established with benefits for many aspects of physical performance and cognitive function summarised in a number of meta-analyses. Despite this, there remains near exponential growth in research articles examining the ergogenic effects of caffeine. Many such studies are confirmatory of well-established ideas, and with a wealth of convincing evidence available, the value of further investigation may be questioned. However, several important knowledge gaps remain. As such, the purpose of this review is to summarise key knowledge gaps regarding the current understanding of the performance-enhancing effect of caffeine and justify their value for future investigation. The review will provide a particular focus on ten research priorities that will aid in the translation of caffeine's ergogenic potential to real-world sporting scenarios. The discussion presented here is therefore essential in guiding the design of future work that will aid in progressing the current understanding of the effects of caffeine as a performance enhancer.

Effect of Computational Method on Accumulated O2 Deficit

The aim of this study was to examine how relationships between exercise intensity and the rate of energy release established in different ways, affect the calculated O2 deficit accumulated during strenuous exercise. Aerobic energy release is readily measured by the O2 uptake, while anaerobic energy release is by definition independent of O2. The latter is not easily measured during strenuous exercise, but it can be estimated using the accumulated O2 deficit principle. We have calculated it using nine different approaches. Thirteen moderately trained persons (three women) volunteered to serve as subjects for cycle ergometry. Their maximal O2 uptake was 2.9 ± 0.6 mmol s−1 (x̄ ± s; 3.9 ± 0.8 LSTPD min−1). Our reference method (M0) is based on measuring the steady state O2 uptake at the end of at least ten bouts of 10 min of exercise at constant intensity, varying between 30 and 40% of that corresponding to the maximal O2 uptake and up to a power &gt;90% of the maximal O2 uptake, which is a rather time-consuming method. The outcomes of eight different simpler approaches have been compared with those of the reference method. The main result is that the accumulated O2 deficit calculated depends a great deal on the relationship used to calculate it. A protocol of stepwise increases in exercise intensity every 4 min appeared to work well. A gross efficiency method showed the poorest performance. Another important result is that at constant power the O2 uptake continued to increase beyond 4 min of exercise at all powers examined, also at powers well-below those corresponding to the lactate threshold. Finally, the O2 uptake during loadless pedaling was considerably higher than resting O2 uptake, and it appeared to follow a cubic function of the pedaling frequency. In conclusion, to obtain reliable values of the anaerobic energy release using the accumulated O2 deficit principle, reliable relationships between exercise intensity and O2 demand must be established.

Interaction Between Caffeine and Creatine When Used as Concurrent Ergogenic Supplements: A Systematic Review

There is some controversy regarding the interactions between creatine (CRE) and caffeine (CAF) supplements. The aim of this systematic review was to study whether such ergogenic interaction occurs and to analyze the protocol to optimize their synchronous use. The PubMed, Web of Science, MEDLINE, CINAHL, and SPORTDiscus databases were searched until November 2021 following the PRISMA guidelines. Ten studies were included. Three studies observed that CRE loading before an acute dose of CAF before exercise did not interfere in the beneficial effect of CAF, whereas one study reported that only an acute supplementation (SUP) of CAF was beneficial but not the acute SUP of both. When chronic SUP with CRE + CAF was used, two studies reported that CAF interfered in the beneficial effect of CRE, whereas three studies did not report interaction between concurrent SUP, and one study reported synergy. Possible mechanisms of interaction are opposite effects on relaxation time and gastrointestinal distress derived from concurrent SUP. CRE loading does not seem to interfere in the acute effect of CAF. However, chronic SUP of CAF during CRE loading could interfere in the beneficial effect of CRE.

Effects of creatine and caffeine ingestion in combination on exercise performance: A systematic review

Creatine (CRE) and caffeine (CAF) have been used as ergogenic aids to improve exercise performance. The present study reviewed the current evidence supporting the additional use of CAF intake during or after the CRE loading on exercise performance. The search was carried out in eight databases, with the methodological quality of the studies assessed via the QualSyst tool. From ten studies that met the criteria for inclusion, six had strong, three moderate, and one weak methodological quality. CAF was ingested ∼1 h before the performance trial (5-7 mg.kg^-1) after a CRE loading period (5-6 days with 0.3 g.kg^-1.d^-1) in five studies, with the combination CAF + CRE providing additional ergogenic effect compared to CRE alone in three of these studies. Furthermore, CAF was ingested daily during the CRE loading protocol in five studies, with CAF showing additive benefits compared to CRE alone only in one study (3 g.d^-1 of CRE during 3 days + 6 mg.kg^-1 of CAF for 3 days). The combination CAF + CRE seems to provide additional benefits to exercise performance when CAF is acutely ingested after a CRE loading. There is, however, no apparent benefit in ingesting CAF during a CRE loading period.

Creatine Supplementation: An Update

ABSTRACT

Creatine is a popular and widely used ergogenic dietary supplement among athletes, for which studies have consistently shown increased lean muscle mass and exercise capacity when used with short-duration, high-intensity exercise. In addition to strength gains, research has shown that creatine supplementation may provide additional benefits including enhanced postexercise recovery, injury prevention, rehabilitation, as well as a number of potential neurologic benefits that may be relevant to sports. Studies show that short- and long-term supplementation is safe and well tolerated in healthy individuals and in a number of patient populations.

International society of sports nutrition position stand: caffeine and exercise performance

Following critical evaluation of the available literature to date, The International Society of Sports Nutrition (ISSN) position regarding caffeine intake is as follows: 1. Supplementation with caffeine has been shown to acutely enhance various aspects of exercise performance in many but not all studies. Small to moderate benefits of caffeine use include, but are not limited to: muscular endurance, movement velocity and muscular strength, sprinting, jumping, and throwing performance, as well as a wide range of aerobic and anaerobic sport-specific actions. 2. Aerobic endurance appears to be the form of exercise with the most consistent moderate-to-large benefits from caffeine use, although the magnitude of its effects differs between individuals. 3. Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. Minimal effective doses of caffeine currently remain unclear but they may be as low as 2 mg/kg body mass. Very high doses of caffeine (e.g. 9 mg/kg) are associated with a high incidence of side-effects and do not seem to be required to elicit an ergogenic effect. 4. The most commonly used timing of caffeine supplementation is 60 min pre-exercise. Optimal timing of caffeine ingestion likely depends on the source of caffeine. For example, as compared to caffeine capsules, caffeine chewing gums may require a shorter waiting time from consumption to the start of the exercise session. 5. Caffeine appears to improve physical performance in both trained and untrained individuals. 6. Inter-individual differences in sport and exercise performance as well as adverse effects on sleep or feelings of anxiety following caffeine ingestion may be attributed to genetic variation associated with caffeine metabolism, and physical and psychological response. Other factors such as habitual caffeine intake also may play a role in between-individual response variation. 7. Caffeine has been shown to be ergogenic for cognitive function, including attention and vigilance, in most individuals. 8. Caffeine may improve cognitive and physical performance in some individuals under conditions of sleep deprivation. 9. The use of caffeine in conjunction with endurance exercise in the heat and at altitude is well supported when dosages range from 3 to 6 mg/kg and 4-6 mg/kg, respectively. 10. Alternative sources of caffeine such as caffeinated chewing gum, mouth rinses, energy gels and chews have been shown to improve performance, primarily in aerobic exercise. 11. Energy drinks and pre-workout supplements containing caffeine have been demonstrated to enhance both anaerobic and aerobic performance.

Effect of Acute Caffeine Intake on the Fat Oxidation Rate during Exercise: A Systematic Review and Meta-Analysis

A number of previous investigations have been designed to determine the effect of acute caffeine intake on the rate of fat oxidation during exercise. However, these investigations have shown contradictory results due to the differences in the exercise protocols used or the co-ingestion of caffeine with other substances. Hence, to date, there is no consensus about the effect of caffeine on fat oxidation during exercise. The purpose of this study was to conduct a systematic review followed by a meta-analysis to establish the effect of acute intake of caffeine (ranging from 2 to 7 mg/kg of body mass) on the rate of fat oxidation during exercise. A total of 19 studies published between 1978 and 2020 were included, all of which employed crossover experimental designs in which the ingestion of caffeine was compared to a placebo. Studies were selected if the exercise intensity was consistent in the caffeine and placebo trials and if these were preceded by a fasting protocol. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean difference (SMD). The meta-analysis revealed that caffeine significantly (p = 0.008) increased the fat oxidation rate (SMD = 0.73; 95% CI = 0.19 to 1.27). This increment was consistent with a significant (p = 0.04) reduction of the respiratory exchange ratio (SMD = -0.33; 95% CI = -0.65 to -0.01) and a significant (p = 0.049) increase in the oxygen uptake (SMD = 0.23; 95% CI = 0.01 to 0.44). The results also showed that there was a dose-response effect of caffeine on the fat oxidation rate, indicating that more than 3.0 mg/kg is necessary to obtain a statistically significant effect of this stimulant on fat oxidation during exercise. Additionally, the ability of caffeine to enhance fat oxidation during exercise was higher in sedentary or untrained individuals than in trained and recreational athletes. In conclusion, pre-exercise intake of a moderate dose of caffeine may effectively increase fat utilization during aerobic exercise of submaximal intensity performed after a fasting period. However, the fitness level of the participant may modulate the magnitude of the effect of caffeine on fat oxidation during exercise.

Effect of Caffeine on Endurance Performance in Athletes May Depend on HTR2A and CYP1A2 Genotypes

Guest, NS, Corey, P, Tyrrell, PN, and El-Sohemy, A. Effect of caffeine on endurance performance in athletes may depend on HTR2A and CYP1A2 genotypes. J Strength Cond Res XX(X): 000-000, 2020-This investigation determined whether variation in the HTR2A (serotonin receptor) gene modifies the ergogenic effects of caffeine on endurance and further modifies performance by the CYP1A2 genotype. Male athletes (n = 100; 25 ± 4 years) completed 10-km cycling time trials under 3 conditions as follows: 0, 2, or 4 mg of caffeine per kg body mass. Using a randomized, double-blinded, placebo-controlled design, data were analyzed using analysis of covariance to compare changes in cycling time between placebo (0 mg·kg) and each caffeine dose and adjusted for the placebo trial and order of treatment. A significance of ρ ≤ 0.05 was used. Subjects were genotyped for HTR2A (rs6313) and CYP1A2 (rs762551). A significant caffeine-HTR2A interaction (p = 0.003) was observed; however, after adjustment for placebo trials, the interaction was no longer significant (p = 0.37). Because of the strong caffeine-CYP1A2 interaction (p < 0.0001) previously reported in these subjects, where the 4-mg dose resulted in divergent effects (slower and faster) on the 10-km cycling time, we conducted a simplified model to examine these same factors by the HTR2A genotype. The post hoc analysis excluded HTR2A CT heterozygotes and 2-mg·kg caffeine trials. Among CYP1A2 fast metabolizers alone, a significant difference (1.7 minutes; p = 0.006) was observed when comparing (4- vs. 0-mg·kg caffeine trials) between the HTR2A CC (n = 16; 2.4 minutes) and TT (n = 7; 0.7 minutes) genotypes. Our results show that 4-mg·kg caffeine improves performance in individuals with the HTR2A CC genotype but only in those who are also CYP1A2 AA fast metabolizers. This study was registered with clinicaltrials.gov (NCT02109783).

Beneficial Impact of Semicarbazide-Sensitive Amine Oxidase Inhibition on the Potential Cytotoxicity of Creatine Supplementation in Type 2 Diabetes Mellitus

Creatine supplementation of the population with type 2 diabetes mellitus (T2DM) combined with an exercise program is known to be a possible therapy adjuvant with hypoglycemic effects. However, excessive administration of creatine leads to the production of methylamine which is deaminated by the enzyme semicarbazide-sensitive amine oxidase (SSAO) and as a result, cytotoxic compounds are produced. SSAO activity and reaction products are increased in the serum of T2DM patients. Creatine supplementation by diabetics will further augment the activity of SSAO. The current review aims to find a feasible way to ameliorate T2DM for patients who exercise and desire to consume creatine. Several natural agents present in food which are involved in the regulation of SSAO activity directly or indirectly are reviewed. Particularly, zinc-α2-glycoprotein (ZAG), zinc (Zn), copper (Cu), histamine/histidine, caffeine, iron (Fe), and vitamin D are discussed. Inhibiting SSAO activity by natural agents might reduce the potential adverse effects of creatine metabolism in population of T2DM.

Effects of caffeine on neuromuscular function in a non-fatigued state and during fatiguing exercise

NEW FINDINGS

What is the central question of the study? What are the effects of caffeine on neuromuscular function in a non-fatigued state and during fatiguing exercise? What is the main finding and its importance? In a non-fatigued state, caffeine decreased the duration of the silent period evoked by transcranial magnetic stimulation. Caffeine-induced reduction of inhibitory mechanisms in the central nervous system before exercise was associated with an increased performance. Individuals who benefit from caffeine ingestion may experience lower perception of effort during exercise and an accelerated recovery of M-wave amplitude postfatigue. This study elucidates the mechanisms of action of caffeine and demonstrates that inter-individual variability of its effects on neuromuscular function is a fruitful area for further work.

ABSTRACT

Caffeine enhances exercise performance, but its mechanisms of action remain unclear. In this study, we investigated its effects on neuromuscular function in a non-fatigued state and during fatiguing exercise. Eighteen men participated in this randomized, double-blind, placebo-controlled crossover trial. Baseline measures included plantarflexion force, drop jump, squat jump, voluntary activation of triceps surae muscle, soleus muscle contractile properties, M-wave, α-motoneuron excitability (H-reflex), corticospinal excitability, short-interval intracortical inhibition, intracortical facilitation, silent period evoked by transcranial magnetic stimulation (SP) and plasma potassium and caffeine concentrations. Immediately after baseline testing, participants ingested caffeine (6 mg·kg^-1 ) or placebo. After a 1-h rest, baseline measures were repeated, followed by a fatiguing stretch-shortening cycle exercise (sets of 40 bilateral rebound jumps on a sledge apparatus) until task failure. Neuromuscular testing was carried out throughout the fatigue protocol and afterwards. Caffeine enhanced drop jump height (by 4.2%) and decreased the SP (by 12.6%) in a non-fatigued state. A caffeine-related decrease in SP and short-interval intracortical inhibition before the fatiguing activity was associated with an increased time to task failure. The participants who benefitted from an improved performance on the caffeine day reported a significantly lower sense of effort during exercise and had an accelerated postexercise recovery of M-wave amplitude. Caffeine modulates inhibitory mechanisms of the CNS, recovery of M-wave amplitude and perception of effort. This study lays the groundwork for future examinations of differences in caffeine-induced neuromuscular changes between those who are deemed to benefit from caffeine ingestion and those who are not.

How does caffeine affect the athlete’s body?

The purpose of the research is to carry out a theoretical analysis and generalization of modern scientific and methodological literature on the problem of the caffeine impact intake on the body of athletes. The results of experimental researches indicate a positive effect of caffeine intake on the indices of the anaerobic tests results and on the speed-strength indices. It has also been found that caffeine in combination with creatine enhances each other’s actions and has a positive effect on endurance performance. When evaluating the effect of caffeine on the athlete’s body, it was found that caffeine affects the production of lactic acid. It turned out that lactic acid is formed even at rest, as a side effect of taking caffeine. It is found that caffeine inhibits the activity of the enzyme phosphodiesterase. It was found that caffeine increases the secretion of endomorphins and, due to this, has an analgesic effect.

Caffeine and sodium bicarbonate supplementation alone or together improve karate performance

Background

The ergogenic properties of acute caffeine (CAF) and sodium bicarbonate (NaHCO₃) ingestion on athletic performance have been previously investigated. However, each sport has unique physiological and technical characteristics which warrants optimizing supplementations strategies for maximizing performance. This study examined the effects of CAF and NaHCO₃ ingestion on physiological responses and rate of perceived exertion during a Karate-specific aerobic test (KSAT) in competitive karatekas.

Methods

In a double-blind, crossover, randomized placebo-controlled trial, eight Karatekas underwent five experimental conditions including control (CON), placebo (PLA), CAF, NaHCO₃, and CAF + NaHCO₃ before completing KSAT. Capsules containing 6 mg/kg BW CAF were consumed 50 min prior to a KSAT whilst 0.3 g/kg BW NaHCO₃ was consumed for 3 days leading to and 120, 90, and 60 min prior to a KSAT. Time to exhaustion (TTE), rate of perceived exertion (RPE), and blood lactate (BL) were measured before, immediately after and 3 min following KSAT.

Results

TTE was significantly greater following CAF, NaHCO₃, and CAF + NaHCO₃ consumption compared to PLA and CON. However, the differences between CAF, NaHCO₃, and CAF + NaHCO₃ were not statistically significant (p > 0.05). BL increased significantly from baseline to immediately after and 3 min following KSAT in all conditions (p < 0.01), while RPE at the end of KSAT was not significantly different between conditions (p = 0.11).

Conclusions

Karate practitioners may benefit from the ergogenic effects of CAF and NaHCO₃ when consumed separately or together.

Creatine Supplementation Improves Phosphagen Energy Pathway During Supramaximal Effort, but Does Not Improve Anaerobic Capacity or Performance

This study aimed to investigate the effects of short-duration creatine monohydrate supplementation on anaerobic capacity (AC), anaerobic energy pathways, and time-to-exhaustion during high-intensity running. Fourteen healthy men underwent a graded exercise test (GXT) followed by a O_2max confirmation test, 5 submaximal efforts, and 4 supramaximal running bouts at 115% of V˙O_2max intensity (the first two supramaximal sessions were applied as familiarization trials) to measure the AC using two procedures; the maximum accumulated oxygen deficit (MAOD) and non-oxidative pathways energetics sum (AC_{[La-]+EPOCfast}). The investigation was conducted in a single-blind and placebo-controlled manner, with participants performing the efforts first after being supplemented with a placebo (dextrose 20 g⋅day^-1 for 5 days), and then, after a 7 day “placebo” washout period, they started the same procedure under creatine supplementation (20 g⋅day^-1 for 5 days. This order was chosen due to the prolonged washout of creatine. MAOD was not different between placebo (3.35 ± 0.65 L) and creatine conditions (3.39 ± 0.79 L; P = 0.58) and presented a negligible effect [effect size (ES) = 0.08], similar to, AC_{[La-]+EPOCfast} (placebo condition (3.66 ± 0.79 Land under creatine ingestion 3.82 ± 0.85 L; P = 0.07) presenting a small effect (ES = 0.20). The energetics from the phosphagen pathway increased significantly after creatine supplementation (1.66 ± 0.40 L) compared to the placebo condition (1.55 ± 0.42 L; P = 0.03). However, the glycolytic and oxidative pathways were not different between conditions. Furthermore, time to exhaustion did not differ between placebo (160.79 ± 37.76 s) and creatine conditions (163.64 ± 38.72; P = 0.49). Therefore, we can conclude that creatine supplementation improves the phosphagen energy contribution, but with no statistical effect on AC or time to exhaustion in supramaximal running.

Caffeine Supplementation and Physical Performance, Muscle Damage and Perception of Fatigue in Soccer Players: A Systematic Review

Soccer is a complex team sport and success in this discipline depends on different factors such as physical fitness, player technique and team tactics, among others. In the last few years, several studies have described the impact of caffeine intake on soccer physical performance, but the results of these investigations have not been properly reviewed and summarized. The main objective of this review was to evaluate critically the effectiveness of a moderate dose of caffeine on soccer physical performance. A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in the Medline/PubMed and Web of Science databases from January 2007 to November 2018. The search included studies with a cross-over and randomized experimental design in which the intake of caffeine (either from caffeinated drinks or pills) was compared to an identical placebo situation. There were no filters applied to the soccer players’ level, gender or age. This review included 17 articles that investigated the effects of caffeine on soccer-specific abilities (n = 12) or on muscle damage (n = 5). The review concluded that 5 investigations (100% of the number of investigations on this topic) had found ergogenic effects of caffeine on jump performance, 4 (100%) on repeated sprint ability and 2 (100%) on running distance during a simulated soccer game. However, only 1 investigation (25%) found as an effect of caffeine to increase serum markers of muscle damage, while no investigation reported an effect of caffeine to reduce perceived fatigue after soccer practice. In conclusion, a single and moderate dose of caffeine, ingested 5–60 min before a soccer practice, might produce valuable improvements in certain abilities related to enhanced soccer physical performance. However, caffeine does not seem to cause increased markers of muscle damage or changes in perceived exertion during soccer practice.

Improvement of Lower-Body Resistance-Exercise Performance With Blood-Flow Restriction Following Acute Caffeine Intake

PURPOSE

To examine the effects of acute caffeine (CAF) intake on physical performance in 3 sets of unilateral knee extensions with blood-flow restriction.

METHODS

In a double-blind crossover design, 22 trained men ingested 6 mg·kg^-1 of CAF or a placebo (PLA), 1 h prior to performing unilateral knee-extension exercise with blood-flow restriction until exhaustion (30% of 1 maximal repetition).

RESULTS

There was a significant difference in the number of repetitions between the CAF and PLA conditions in the first set (28.3 [5.3] vs 23.7 [3.2]; P = .005), second set (11.6 [3.1] vs 8.9 [2.9]; P = .03), and total repetitions performed across the 3 sets (44.5 [9.4] vs 35.0 [6.6]; P = .001). Blood lactate was also significantly different (P = .03) after exercise between the CAF (7.8 [1.1] mmol·L^-1) and PLA (6.0 [0.9] mmol·L^-1). In regard to pain perception, there was a difference between the CAF and PLA in the second (6.9 [1.5] vs 8.4 [1.4]; P = .04) and third sets (8.7 [0.4] vs 9.5 [0.6]; P = .01). No differences were found for perceived effort.

CONCLUSION

Acute caffeine intake increases performance and blood lactate concentration and reduces perception of pain in unilateral knee-extension exercise with blood-flow restriction.

Effects of Caffeine Ingestion on Anaerobic Capacity in a Single Supramaximal Cycling Test

The aim of this study was to verify the effects of caffeine on anaerobic capacity estimated by the sum of the estimated glycolytic [E_[La]] and phosphagen [E_PCr] metabolism based on blood lactate and excess post-oxygen consumption responses (AC_{[La-]+EPOCfast}). Fourteen male cyclists were submitted to a graded exercise test to determine the maximal oxygen uptake ( V ° O 2 m a x ) and intensity associated with   V ° O 2 m a x (i V ° O 2 m a x ). Subsequently, the participants performed two supramaximal efforts at 115% of i V ° O 2 m a x to determine the AC_{[La-]+EPOCfast}, after previous supplementation with caffeine (6 mg·kg^-1) or a placebo (dextrose), in a cross over, randomized, double blind, and placebo-controlled design. The time to exhaustion was higher in the caffeine (186.6 ± 29.8 s) than in the placebo condition (173.3 ± 25.3 s) (p = 0.006) and a significant correlation was found between them (r = 0.86; P = 0.00008). Significant differences were not found between AC_{[La-]+EPOCfast} values from the placebo (4.06 ± 0.83 L and 55.2 ± 5.7 mL·kg^-1) and caffeine condition (4.00 ± 0.76 L and 54.6 ± 5.4 mL·kg^-1); however, a significant correlation was observed only for AC_{[La-]+EPOCfast} expressed in absolute values (r = 0.74; p < 0.002). The E_[La] and E_PCr also presented no significant differences and they were significantly correlated (r = 0.82 and r = 0.55, respectively; p < 0.05). We conclude based on the overall comparison of mean values between two treatments that acute caffeine ingestion improves the time to exhaustion but does not affect anaerobic capacity estimation.

Impact of Genetic Variability on Physiological Responses to Caffeine in Humans: A Systematic Review

Emerging research has demonstrated that genetic variation may impact physiological responses to caffeine consumption. The purpose of the present review was to systematically recognize how select single nucleotide polymorphisms (SNPs) impact habitual use of caffeine as well as the ergogenic and anxiogenic consequences of caffeine. Two databases (PubMed and EBSCO) were independently searched using the same algorithm. Selected studies involved human participants and met at least one of the following inclusion criteria: (a) genetic analysis of individuals who habitually consume caffeine; (b) genetic analysis of individuals who underwent measurements of physical performance with the consumption of caffeine; (c) genetic analysis of individuals who underwent measurements of mood with the consumption of caffeine. We included 26 studies (10 randomized controlled trials, five controlled trials, seven cross-sectional studies, three single-group interventional studies and one case-control study). Single nucleotide polymorphisms in or near the cytochrome P450 (CYP1A2) and aryl hydrocarbon receptor (AHR) genes were consistently associated with caffeine consumption. Several studies demonstrated that the anxiogenic consequences of caffeine differed across adenosine 2a receptor (ADORA2A) genotypes, and the studies that investigated the effects of genetic variation on the ergogenic benefit of caffeine reported equivocal findings (CYP1A2) or warrant replication (ADORA2A).

The Role of Genetics in Moderating the Inter-Individual Differences in the Ergogenicity of Caffeine

Caffeine use is widespread among athletes following its removal from the World Anti-Doping Agency banned list, with approximately 75% of competitive athletes using caffeine. While literature supports that caffeine has a small positive ergogenic effect for most forms of sports and exercise, there exists a significant amount of inter-individual difference in the response to caffeine ingestion and the subsequent effect on exercise performance. In this narrative review, we discuss some of the potential mechanisms and focus on the role that genetics has in these differences. CYP1A2 and ADORA2A are two of the genes which are thought to have the largest impact on the ergogenicity of caffeine. CYP1A2 is responsible for the majority of the metabolism of caffeine, and ADORA2A has been linked to caffeine-induced anxiety. The effects of CYP1A2 and ADORA2A genes on responses to caffeine will be discussed in detail and an overview of the current literature will be presented. The role of these two genes may explain a large portion of the inter-individual variance reported by studies following caffeine ingestion. Elucidating the extent to which these genes moderate responses to caffeine during exercise will ensure caffeine supplementation programs can be tailored to individual athletes in order to maximize the potential ergogenic effect.

Practical Issues in Evidence-Based Use of Performance Supplements: Supplement Interactions, Repeated Use and Individual Responses

Current sports nutrition guidelines recommend that athletes only take supplements following an evidence-based analysis of their value in supporting training outcomes or competition performance in their specific event. While there is sound evidence to support the use of a few performance supplements under specific scenarios (creatine, beta-alanine, bicarbonate, caffeine, nitrate/beetroot juice and, perhaps, phosphate), there is a lack of information around several issues needed to guide the practical use of these products in competitive sport. First, there is limited knowledge around the strategy of combining the intake of several products in events in which performance benefits are seen with each product in isolation. The range in findings from studies involving combined use of different combinations of two supplements makes it difficult to derive a general conclusion, with both the limitations of individual studies and the type of sporting event to which the supplements are applied influencing the potential for additive, neutral or counteractive outcomes. The repeated use of the same supplement in sports involving two or more events within a 24-h period is of additional interest, but has received even less attention. Finally, the potential for individual athletes to respond differently, in direction and magnitude, to the use of a supplement seems real, but is hard to distinguish from normal day to day variability in performance. Strategies that can be used in research or practice to identify whether individual differences are robust include repeat trials, and the collection of data on physiological or genetic mechanisms underpinning outcomes.

The CYP1A2 -163C>A polymorphism does not alter the effects of caffeine on basketball performance

Purpose

The aim of this investigation was to analyze the influence of the genetic variations of the -163C>A polymorphism of the CYP1A2 gene on the ergogenic effects of caffeine in elite basketball players.

Methods

Nineteen elite basketball players (10 men and 9 women) ingested 3 mg⋅kg^-1 of caffeine or a placebo 60 min before performing 10 repetitions of the following series: the Abalakov jump test followed by the Change-of-Direction and Acceleration Test (CODAT). The players then competed in a 20-min simulated basketball game. Self-perceived performance and side effects were recorded by questionnaires after the trials. The effects of caffeine on basketball performance were established according to players’ CYP1A2 genotype (rs762551): AA homozygotes (n = 10) and C-allele carriers (n = 9).

Results

In the 10 repetitions, caffeine increased Abalakov jump height by a mean of 2.9±3.6% in AA homozygotes (p = 0.03) while this effect did not reach statistical significance for C-allele carriers (2.3 ± 6.8%; p = 0.33). Caffeine did not affect sprint time in the CODAT test in either genotype group but it increased the number of impacts performed during the simulated game in both AA homozygotes (4.1 ± 5.3%; p = 0.02) and C-allele carriers (3.3 ± 3.2%; p = 0.01). During the 24 h following the test, AA homozygotes tended to experience increased insomnia with caffeine while C-allele carriers did not present this effect. The remaining variables were unaffected by the genotype.

Conclusion

The CYP1A2 -163C>A polymorphism minimally altered the ergogenicity derived from the consumption of a moderate dose of caffeine in elite basketball players.

Co-ingestion of Nutritional Ergogenic Aids and High-Intensity Exercise Performance

Many sports involve repeated bouts of high-intensity exercise. High-intensity exercise is compromised, however, by the early onset of exercise-induced fatigue. Metabolic by-products, ion dysbalance and amount of phosphocreatine are considered the main peripheral causes of fatigue during high-intensity exercise. Intake of nutritional ergogenic aids is commonplace to enhance performance of high-intensity exercise by offsetting the potential mechanisms of fatigue. Creatine, probably one of the best known nutritional aids to enhance performance of high-intensity exercise, has convincingly substantiated its ergogenic potential. Although multi-ingredient supplements are now common, the justification for effectiveness is mostly based on observations with single intake of those ingredients. In this narrative review, the main focus is on the evidence of the effect of co-ingestion of ergogenic aids on performance of high intensity exercise for which the single intake has shown beneficial effects on high-intensity performance.

Repeated sprint ability is not enhanced by caffeine, arginine, and branched-chain amino acids in moderately trained soccer players

The aim was to investigate the effect of a dietary supplementation on the repeated sprint ability (RSA) performance in recreationally trained team sports athletes. Twelve young men underwent a RSA exercise protocol in five trials, in which participants ingested carbohydrates (CHO) plus caffeine (Caf), CHO plus arginine (Arg), CHO plus branched-chain amino acids (BCAA), CHO plus Caf, Arg, and BCAA (ALL), and CHO only. Heart rate, oxygen saturation, hematic lactate, ratings of perceived exertion, average sprint time, total time, best sprint time, peak power, and average power were taken. Data revealed no significant effects neither on physiological nor performance parameters with any of the supplements.

CYP1A2 Genotype Variations Do Not Modify the Benefits and Drawbacks of Caffeine during Exercise: A Pilot Study

Previous investigations have determined that some individuals have minimal or even ergolytic performance effects after caffeine ingestion. The aim of this study was to analyze the influence of the genetic variations of the CYP1A2 gene on the performance enhancement effects of ingesting a moderate dose of caffeine. In a double-blind randomized experimental design, 21 healthy active participants (29.3 ± 7.7 years) ingested 3 mg of caffeine per kg of body mass or a placebo in testing sessions separated by one week. Performance in the 30 s Wingate test, visual attention, and side effects were evaluated. DNA was obtained from whole blood samples and the CYP1A2 polymorphism was analyzed (rs762551). We obtained two groups: AA homozygotes (n = 5) and C-allele carriers (n = 16). Caffeine ingestion increased peak power (682 ± 140 vs. 667 ± 137 W; p = 0.008) and mean power during the Wingate test (527 ± 111 vs. 518 ± 111 W; p < 0.001) with no differences between AA homozygotes and C-allele carriers (p > 0.05). Reaction times were similar between caffeine and placebo conditions (276 ± 31 vs. 269 ± 71 milliseconds; p = 0.681) with no differences between AA homozygotes and C-allele carriers. However, 31.3% of the C-allele carriers reported increased nervousness after caffeine ingestion, while none of the AA homozygotes perceived this side effect. Genetic variations of the CYP1A2 polymorphism did not affect the ergogenic effects and drawbacks derived from the ingestion of a moderate dose of caffeine.

Caffeine ingestion after rapid weight loss in judo athletes reduces perceived effort and increases plasma lactate concentration without improving performance

The objective of this study was to examine the effect of caffeine on judo performance, perceived exertion, and plasma lactate response when ingested during recovery from a 5-day weight loss period. Six judokas performed two cycles of a 5-day rapid weight loss procedure to reduce their body weight by ~5%. After weigh-in, subjects re-fed and rehydrated over a 4-h recovery period. In the third hour of this "loading period", subjects ingested a capsule containing either caffeine (6 mg·kg-1) or placebo. One hour later, participants performed three bouts of a judo fitness test with 5-min recovery periods. Perceived exertion and plasma lactate were measured before and immediately after each test bout. Body weight was reduced in both caffeine and placebo conditions after the weight loss period (-3.9% ± 1.6% and -4.0% ± 2.3% from control, respectively, p < 0.05). At three hours after weigh-in, body weight had increased with both treatments but remained below the control (-3.0% ± 1.3% and -2.7% ± 2.2%). There were no significant differences in the number of throws between the control, caffeine or placebo groups. However, plasma lactate was systemically higher and perceived exertion lower in the subjects who ingested caffeine compared to either the control or placebo subjects (p < 0.05). In conclusion, caffeine did not improve performance during the judo fitness test after a 5-day weight loss period, but reduced perceived exertion and increased plasma lactate.

Efeito da ingestão de cafeína no desempenho em corrida de 200 metros rasos

O objetivo do estudo foi analisar a influência da cafeína no desempenho dos 200 metros rasos (200 m). Dezessete indivíduos fisicamente ativos (21,5 ± 2,15 anos; 175,9 ± 5,5 cm; 74,1 ± 10,04 kg) executaram em dias diferentes duas performances de 200m. Uma hora antes do teste foi ingerido de modo duplo-cego e randomizado cápsula gelatinosa contendo cafeína (6mg.kg-1) ou placebo. Foram analisados o tempo final dos 200 m rasos e o lactato sanguíneo ([La]; repouso, pré-aquecimento e pós-teste). A ingestão de cafeína diminuiu significantemente o tempo no desempenho dos 200m em relação ao placebo (27,398 ± 1,626 vs. 27,596 ± 1,714 s, respectivamente) e aumentou as [La] pré-aquecimento (1,236 ± 0,497 vs 1,064 ± 0,330 mM) sem modificações na [La] pico. Assim, podemos concluir que a ingestão de cafeína exerceu efeito ergogênico no desempenho com característica anaeróbia, nos indivíduos ativos avaliados neste estudo. Contudo a ausência de modificação na [La] pico indica que essa melhora não parece estar relacionada a um maior fluxo glicolítico.

The effect of caffeine ingestion on field hockey skill performance following physical fatigue

This study examined the impact of caffeine ingestion on field hockey skill performance following high-intensity fatigue. Thirteen male hockey players (mean age = 21.1 ± 1.2 years) performed hockey sprint dribble and ball handling tests at rest and after a bout of total body fatigue (90% maximal capacity) following caffeine (5 mg kg(-1)) or placebo ingestion. Sprint dribble times were slower postfatigue compared with rest but were significantly faster postfatigue with caffeine compared with postfatigue with placebo ingestion (P < 0.01). Ball handling scores were higher at rest compared with postfatigue, but scores postfatigue were higher following caffeine than placebo ingestion (P < 0.01). Rating of perceived exhaustion (RPE) was lower (P < 0.01) and readiness to invest physical (P < 0.01) and mental effort (P = 0.01) were significantly higher in the caffeine condition. Caffeine ingestion may therefore be effective in offsetting decrements in skilled performance associated with fatigue.

The influence of a CYP1A2 polymorphism on the ergogenic effects of caffeine

Background

Although caffeine supplementation improves performance, the ergogenic effect is variable. The cause(s) of this variability are unknown. A (C/A) single nucleotide polymorphism at intron 1 of the cytochrome P450 (CYP1A2) gene influences caffeine metabolism and clinical outcomes from caffeine ingestion. The purpose of this study was to determine if this polymorphism influences the ergogenic effect of caffeine supplementation.

Methods

Thirty-five trained male cyclists (age = 25.0 ± 7.3 yrs, height = 178.2 ± 8.8 cm, weight = 74.3 ± 8.8 kg, VO₂max = 59.35 ± 9.72 ml·kg^-1·min^-1) participated in two computer-simulated 40-kilometer time trials on a cycle ergometer. Each test was performed one hour following ingestion of 6 mg·kg^-1 of anhydrous caffeine or a placebo administered in double-blind fashion. DNA was obtained from whole blood samples and genotyped using restriction fragment length polymorphism-polymerase chain reaction. Participants were classified as AA homozygotes (N = 16) or C allele carriers (N = 19). The effects of treatment (caffeine, placebo) and the treatment × genotype interaction were assessed using Repeated Measures Analysis of Variance.

Results

Caffeine supplementation reduced 40 kilometer time by a greater (p < 0.05) magnitude in AA homozygotes (4.9%; caffeine = 72.4 ± 4.2 min, placebo = 76.1 ± 5.8 min) as compared to C allele carriers (1.8%; caffeine = 70.9 ± 4.3 min, placebo = 72.2 ± 4.2 min).

Conclusions

Results suggest that individuals homozygous for the A allele of this polymorphism may have a larger ergogenic effect following caffeine ingestion.

Caffeine intake improves intense intermittent exercise performance and reduces muscle interstitial potassium accumulation

The effect of oral caffeine ingestion on intense intermittent exercise performance and muscle interstitial ion concentrations was examined. The study consists of two studies (S1 and S2). In S1, 12 subjects completed the Yo-Yo intermittent recovery level 2 (Yo-Yo IR2) test with prior caffeine (6 mg/kg body wt; CAF) or placebo (PLA) intake. In S2, 6 subjects performed one low-intensity (20 W) and three intense (50 W) 3-min (separated by 5 min) one-legged knee-extension exercise bouts with (CAF) and without (CON) prior caffeine supplementation for determination of muscle interstitial K(+) and Na(+) with microdialysis. In S1 Yo-Yo IR2 performance was 16% better (P < 0.05) in CAF compared with PLA. In CAF, plasma K(+) at the end of the Yo-Yo IR2 test was 5.2 ± 0.1 mmol/l with no difference between the trials. Plasma free fatty acids (FFA) were higher (P < 0.05) in CAF than PLA at rest and remained higher (P < 0.05) during exercise. Peak blood glucose (8.0 ± 0.6 vs. 6.2 ± 0.4 mmol/l) and plasma NH(3) (137.2 ± 10.8 vs. 113.4 ± 13.3 μmol/l) were also higher (P < 0.05) in CAF compared with PLA. In S2 interstitial K(+) was 5.5 ± 0.3, 5.7 ± 0.3, 5.8 ± 0.5, and 5.5 ± 0.3 mmol/l at the end of the 20-W and three 50-W periods, respectively, in CAF, which were lower (P < 0.001) than in CON (7.0 ± 0.6, 7.5 ± 0.7, 7.5 ± 0.4, and 7.0 ± 0.6 mmol/l, respectively). No differences in interstitial Na(+) were observed between CAF and CON. In conclusion, caffeine intake enhances fatigue resistance and reduces muscle interstitial K(+) during intense intermittent exercise.

The effects of a high dosage of creatine and caffeine supplementation on the lean body mass composition of rats submitted to vertical jumping training

BACKGROUND

The influences of creatine and caffeine supplementation associated with power exercise on lean body mass (LBM) composition are not clear. The purpose of this research was to determine whether supplementation with high doses of creatine and caffeine, either solely or combined, affects the LBM composition of rats submitted to vertical jumping training.

METHODS

Male Wistar rats were randomly divided into 8 groups: Sedentary (S) or Exercised (E) [placebo (Pl), creatine (Cr), caffeine (Caf) or creatine plus caffeine (CrCaf)]. The supplemented groups received creatine [load: 0.430 g/kg of body weight (BW) for 7 days; and maintenance: 0.143 g/kg of BW for 35 days], caffeine (15 mg/kg of BW for 42 days) or creatine plus caffeine. The exercised groups underwent a vertical jump training regime (load: 20 - 50% of BW, 4 sets of 10 jumps interspersed with 1 min resting intervals), 5 days/wk, for 6 weeks. LBM composition was evaluated by portions of water, protein and fat in the rat carcass. Data were submitted to ANOVA followed by the Tukey post hoc test and Student's t test.

RESULTS

Exercised animals presented a lower carcass weight (10.9%; P = 0.01), as compared to sedentary animals. However, no effect of supplementation was observed on carcass weight (P > 0.05). There were no significant differences among the groups (P > 0.05) for percentage of water in the carcass. The percentage of fat in the group SCr was higher than in the groups SCaf and ECr (P < 0.05). A higher percentage of protein was observed in the groups EPl and ECaf when compared to the groups SPl and SCaf (P < 0.001). The percentage of fat in the carcass decreased (P < 0.001), while those of water and protein increased (P < 0.05) in exercised animals, compared to sedentary animals. Caffeine groups presented reduced percentage of fat when compared to creatine supplemented groups (P < 0.05).

CONCLUSIONS

High combined doses of creatine and caffeine does not affect the LBM composition of either sedentary or exercised rats, however, caffeine supplementation alone reduces the percentage of fat. Vertical jumping training increases the percentages of water and protein and reduces the fat percentage in rats.

Energy drinks: a review of use and safety for athletes

Energy drinks have increased in popularity in adolescents and young adults; however, concerns have been raised regarding the ingredients in energy drinks and their potential negative effects on health. Caffeine, the most physiologically active ingredient in energy drinks, is generally considered safe by the US Food and Drug Administration (FDA), although adverse effects can occur at varying amounts. Guarana, which contains caffeine in addition to small amounts of theobromine, theophylline, and tannins, is also recognized as safe by the FDA, although it may lead to caffeine toxicity when combined with caffeine. The amount of ginseng in energy drinks is typically far below the amount used as a dietary supplement, and is generally considered safe. Taurine, an intracellular amino acid, has been reported to have positive inotropic effects; however, this claim is not supported by research. Most energy drinks also contain sugar in an amount that exceeds the maximum recommended daily amount. Young athletes are increasingly using energy drinks because of the ergogenic effects of caffeine and the other ingredients found in these beverages. Energy drinks combined with alcohol are also gaining popularity in young adults, which poses significant concerns about health risks. Other health concerns related to consumption of energy drinks include case reports of seizures and cardiac arrest following energy drink consumption and dental enamel erosion resulting from the acidity of energy drinks.

Caffeine use in sports: considerations for the athlete

The ergogenic effects of caffeine on athletic performance have been shown in many studies, and its broad range of metabolic, hormonal, and physiologic effects has been recorded, as this review of the literature shows. However, few caffeine studies have been published to include cognitive and physiologic considerations for the athlete. The following practical recommendations consider the global effects of caffeine on the body: Lower doses can be as effective as higher doses during exercise performance without any negative coincidence; after a period of cessation, restarting caffeine intake at a low amount before performance can provide the same ergogenic effects as acute intake; caffeine can be taken gradually at low doses to avoid tolerance during the course of 3 or 4 days, just before intense training to sustain exercise intensity; and caffeine can improve cognitive aspects of performance, such as concentration, when an athlete has not slept well. Athletes and coaches also must consider how a person's body size, age, gender, previous use, level of tolerance, and the dose itself all influence the ergogenic effects of caffeine on sports performance.

The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial

There is little published data in relation to the effects of caffeine upon cycling performance, speed and power in trained cyclists, especially during cycling of approximately 60 s duration. To address this, eight trained cyclists performed a 1 km time-trial on an electronically braked cycle ergometer under three conditions: after ingestion of 5 mg x kg-1 caffeine, after ingestion of a placebo, or a control condition. The three time-trials were performed in a randomized order and performance time, mean speed, mean power and peak power were determined. Caffeine ingestion resulted in improved performance time (caffeine vs. placebo vs. control: 71.1 +/- 2.0 vs. 73.4 +/- 2.3 vs. 73.3 +/- 2.7 s; P = 0.02; mean +/- s). This change represented a 3.1% (95% confidence interval: 0.7-5.6) improvement compared with the placebo condition. Mean speed was also higher in the caffeine than placebo and control conditions (caffeine vs. placebo vs. control: 50.7 +/- 1.4 vs. 49.1 +/- 1.5 vs. 49.2 +/- 1.7 km x h-1; P = 0.0005). Mean power increased after caffeine ingestion (caffeine vs. placebo vs. control: 523 +/- 43 vs. 505 +/- 46 vs. 504 +/- 38 W; P = 0.007). Peak power also increased from 864 +/- 107 W (placebo) and 830 +/- 87 W (control) to 940 +/- 83 W after caffeine ingestion (P = 0.027). These results provide support for previous research that found improved performance after caffeine ingestion during short-duration high-intensity exercise. The magnitude of the improvements observed in our study could be due to our use of sport-specific ergometry, a tablet form and trained participants.

The effect of caffeine ingestion on 8 km run performance in a field setting

The aim of this study was to assess the effect of caffeine ingestion on 8 km run performance using an ecologically valid test protocol. A randomized double-blind crossover study was conducted involving eight male distance runners. The participants ran an 8 km race 1 h after ingesting a placebo capsule, a caffeine capsule (3 mg x kg(-1) body mass) or no supplement. Heart rate was recorded at 5 s intervals throughout the race. Blood lactate concentration and ratings of perceived exertion were recorded after exercise. A repeated-measures analysis of variance (ANOVA) identified a significant treatment effect for 8 km performance time (P < 0.05); caffeine resulted in a mean improvement of 23.8 s (95% confidence interval [CI] = 13.1 to 34.5 s) in 8 km performance time (1.2% improvement, 95% CI = 0.7 to 1.8%). In addition, a two-way (time x condition) repeated-measures ANOVA identified a significantly higher blood lactate concentration 3 min after exercise during the caffeine trial (P < 0.05). We conclude that ingestion of 3 mg . kg(-1) body mass of caffeine can improve absolute 8 km run performance in an ecologically valid race setting.

Caffeine administration results in greater tension development in previously fatigued canine muscle in situ

In isolated single skeletal myocytes undergoing long-term fatiguing contractions, caffeine (CAF) can result in nearly immediate restoration of generated tension to near-prefatigue levels by increasing Ca2+ release via activation of sarcoplasmic reticulum release channels. This study tested whether arterial CAF infusion (>5 mm) would cause a similar rapid restoration of tetanic isometric tension during contractions to fatigue in perfused canine hindlimb muscle in situ. Tetanic contractions were elicited by electrical stimulation (200 ms trains, 50 Hz, 1 contraction s(-1)), and biopsies were taken from the muscle at rest and during contractions: (1) following the onset of fatigue (tension approximately 60% of initial value); and (2) following CAF administration. Resting muscle ATP, PCr and lactate contents were 25.2 +/- 0.4, 76.9 +/- 3.3 and 14.4 +/- 3.3 mmol (kg dry weight)(-1), respectively. At fatigue, generated tetanic tension was 61.1 +/- 6.9% of initial contractions. There was a small but statistically significant recovery of tetanic tension (64.9 +/- 6.6% of initial value) with CAF infusion, after which the muscle showed incomplete relaxation. At fatigue, muscle ATP and PCr contents had fallen significantly (P < 0.05) to 18.1 +/- 1.1 and 18.9 +/- 2.1 mmol (kg dry weight)(-1), respectively, and lactate content had increased significantly to 27.7 +/- 5.4 mmol (kg dry weight)(-1). Following CAF, skeletal muscle ATP and PCr contents were significantly lower than corresponding fatigue values (15.0 +/- 1.3 and 10.9 +/- 2.2 mmol (kg dry weight)(-1), respectively), while lactate was unchanged (22.2 +/- 3.9 mmol (kg dry weight)(-1)). These results demonstrate that caffeine can result in a small, but statistically significant, recovery of isometric tension in fatigued canine hindlimb muscle in situ, although not nearly to the same degree as seen in isolated single muscle fibres. This suggests that, in this in situ isolated whole muscle model, alteration of Ca2+ metabolism is probably only one cause of fatigue.

Disorders of Fuel Metabolism: Medical Complications Associated with Starvation, Eating Disorders, Dietary Fads, and Supplements

Disorders of fuel metabolism as they relate to abnormal fuel intake,abnormal fuel expenditure, and dietary supplements are the focus of this article. The emergency physician should be aware of the medical complications that can occur as a result of starvation states,eating disorders, fad diets, hypermetabolic states, and ergogenic aids. Knowledge and understanding of the complications associated with these disorders will facilitate the diagnosis and management of patients who present to the emergency department with any of the disorders reviewed.

Effects of caffeine ingestion on rating of perceived exertion during and after exercise: a meta-analysis

The purpose of this study was to use the meta-analytic approach to examine the effects of caffeine ingestion on ratings of perceived exertion (RPE). Twenty-one studies with 109 effect sizes (ESs) met the inclusion criteria. Coding incorporated RPE scores obtained both during constant load exercise (n=89) and upon termination of exhausting exercise (n=20). In addition, when reported, the exercise performance ES was also computed (n=16). In comparison to placebo, caffeine reduced RPE during exercise by 5.6% (95% CI (confidence interval), -4.5% to -6.7%), with an equivalent RPE ES of -0.47 (95% CI, -0.35 to -0.59). These values were significantly greater (P<0.05) than RPE obtained at the end of exercise (RPE % change, 0.01%; 95% CI, -1.9 to 2.0%; RPE ES, 0.00, 95% CI, -0.17 to 0.17). In addition, caffeine improved exercise performance by 11.2% (95% CI; 4.6-17.8%). Regression analysis revealed that RPE obtained during exercise could account for approximately 29% of the variance in the improvement in exercise performance. The results demonstrate that caffeine reduces RPE during exercise and this may partly explain the subsequent ergogenic effects of caffeine on performance.

Caffeine lowers perceptual response and increases power output during high-intensity cycling

The aim of this study was to determine the effects of caffeine ingestion on a 'preloaded' protocol that involved cycling for 2 min at a constant rate of 100% maximal power output immediately followed by a 1-min 'all-out' effort. Eleven male cyclists completed a ramp test to measure maximal power output. On two other occasions, the participants ingested caffeine (5 mg. kg(-1)) or placebo in a randomized, double-blind procedure. All tests were conducted on the participants' own bicycles using a Kingcycle test rig. Ratings of perceived exertion (RPE; 6-20 Borg scale) were lower in the caffeine trial by approximately 1 RPE point at 30, 60 and 120 s during the constant rate phase of the preloaded test (P <0.05). The mean power output during the all-out effort was increased following caffeine ingestion compared with placebo (794+/-164 vs 750+/-163 W; P=0.05). Blood lactate concentration 4, 5 and 6 min after exercise was also significantly higher by approximately 1 mmol. l(-1) in the caffeine trial (P <0.05). These results suggest that high-intensity cycling performance can be increased following moderate caffeine ingestion and that this improvement may be related to a reduction in RPE and an elevation in blood lactate concentration.