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Larrosa M, Gil-Izquierdo A, González-Rodríguez LG, Alférez MJM, San Juan AF, Sánchez-Gómez Á, Calvo-Ayuso N, Ramos-Álvarez JJ, Fernández-Lázaro D, Lopez-Grueso R, López-León I, Moreno-Lara J, Domínguez-Balmaseda D, Illescas-Quiroga R, Cuenca E, López T, Montoya JJ, Rodrigues-de-Souza DP, Carrillo-Alvarez E, Casado A, Rodriguez-Doñate B, Porta-Oliva M, Santiago C, Iturriaga T, De Lucas B, Solaesa ÁG, Montero-López MDP, Benítez De Gracia E, Veiga-Herreros P, Muñoz-López A, Orantes-Gonzalez E, Barbero-Alvarez JC, Cabeza-Ruiz R, Carnero-Diaz Á, Sospedra I, Fernández-Galván LM, Martínez-Sanz JM, Martín-Almena FJ, Pérez M, Guerra-Hernández EJ, López-Samanes Á, Sánchez-Oliver AJ, Domínguez R. Nutritional Strategies for Optimizing Health, Sports Performance, and Recovery for Female Athletes and Other Physically Active Women: A Systematic Review. Nutr Rev 2024:nuae082. [PMID: 38994896 DOI: 10.1093/nutrit/nuae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
CONTEXT Despite the progress toward gender equality in events like the Olympic Games and other institutionalized competitions, and the rising number of women engaging in physical exercise programs, scientific studies focused on establishing specific nutritional recommendations for female athletes and other physically active women are scarce. OBJECTIVE This systematic review aimed to compile the scientific evidence available for addressing the question "What dietary strategies, including dietary and supplementation approaches, can improve sports performance, recovery, and health status in female athletes and other physically active women?" DATA SOURCES The Pubmed, Web of Science, and Scopus databases were searched. DATA EXTRACTION The review process involved a comprehensive search strategy using keywords connected by Boolean connectors. Data extracted from the selected studies included information on the number of participants and their characteristics related to sport practice, age, and menstrual function. DATA ANALYSIS A total of 71 studies were included in this review: 17 focused on the analysis of dietary manipulation, and 54 focused on the effects of dietary supplementation. The total sample size was 1654 participants (32.5% categorized as competitive athletes, 30.7% as highly/moderately trained, and 37.2% as physically active/recreational athletes). The risk of bias was considered moderate, mainly for reasons such as a lack of access to the study protocol, insufficient description of how the hormonal phase during the menstrual cycle was controlled for, inadequate dietary control during the intervention, or a lack of blinding of the researchers. CONCLUSION Diets with high carbohydrate (CHO) content enhance performance in activities that induce muscle glycogen depletion. In addition, pre-exercise meals with a high glycemic index or rich in CHOs increase CHO metabolism. Ingestion of 5-6 protein meals interspersed throughout the day, with each intake exceeding 25 g of protein favors anabolism of muscle proteins. Dietary supplements taken to enhance performance, such as caffeine, nitric oxide precursors, β-alanine, and certain sport foods supplements (such as CHOs, proteins, or their combination, and micronutrients in cases of nutritional deficiencies), may positively influence sports performance and/or the health status of female athletes and other physically active women. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD480674.
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Affiliation(s)
- Mar Larrosa
- Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Angel Gil-Izquierdo
- Research Group on Food and Nutrition (ALINUT), University of Alicante, 03690 Alicante, Spain
- Quality, Safety, and Bioactivity of Plant Foods Group, Department of Food Science and Technology, CEBAS-CSIC, University of Murcia, 30100 Murcia, Spain
| | - Liliana Guadalupe González-Rodríguez
- Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain
| | - María José Muñoz Alférez
- Department of Physiology (Faculty of Pharmacy, Cartuja University Campus), Institute of Nutrition and Food Technology "José Mataix", University of Granada, 18071 Granada, Spain
| | - Alejandro F San Juan
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences (INEF), Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Natalia Calvo-Ayuso
- Departamento de Enfermería y Fisioterapia, Campus de Ponferrada, Universidad de León, 24401 Ponferrada, Spain
| | - Juan José Ramos-Álvarez
- School of Sport Medicine, Department of Radiology, Rehabilitation and Physiotherapy, Complutense University Madrid, 28040 Madrid, Spain
| | - Diego Fernández-Lázaro
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Raúl Lopez-Grueso
- Facultad de Ciencias de la Salud, Universidad Isabel I, 09003 Burgos, Spain
| | - Inmaculada López-León
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Javier Moreno-Lara
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Diego Domínguez-Balmaseda
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Román Illescas-Quiroga
- Departamento de Enfermería y Fisioterapia, University of Alcala, 28805 Alcalá de Henares, Spain
| | - Eduardo Cuenca
- Academia de Guardias y Suboficiales de la Guardia Civil, 23440 Baeza, Spain
| | - Teba López
- Academia de Guardias y Suboficiales de la Guardia Civil, 23440 Baeza, Spain
| | - Juan José Montoya
- School of Sport Medicine, Department of Radiology, Rehabilitation and Physiotherapy, Complutense University Madrid, 28040 Madrid, Spain
| | - Daiana Priscila Rodrigues-de-Souza
- Departamento de Enfermería, Farmacología y Fisioterapia, 14004 Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - Elena Carrillo-Alvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences, University Ramon Llull, 08025 Barcelona, Spain
| | - Arturo Casado
- Centro de Investigación en Ciencias del Deporte, Universidad Rey Juan Carlos, 28943 Fuenlabrada, Spain
| | | | - Mireia Porta-Oliva
- Faculty of Food Technology, Autonomous University of Barcelona (UAB), Bellaterra, Spain
- FC Barcelona Medical Department, FC Barcelona, 08028 Barcelona, Spain
- Catalan School of Kinanthropometry, INEFC, 0838 Barcelona, Spain
| | - Catalina Santiago
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Támara Iturriaga
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Beatriz De Lucas
- Facultad de Ciencias de la Actividad Física, Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | | | | | - Elvira Benítez De Gracia
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio, 28691 Villanueva de la Cañada, Spain
| | - Pablo Veiga-Herreros
- Facultad de Ciencias de la Salud, Universidad Alfonso X El Sabio, 28691 Villanueva de la Cañada, Spain
| | - Alejandro Muñoz-López
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Eva Orantes-Gonzalez
- Department of Sports and Computer Science, Faculty of Sports, University of Pablo de Olavide, 41013 Seville, Spain
| | | | - Ruth Cabeza-Ruiz
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
| | - Ángel Carnero-Diaz
- Departamento de Educación Física y Deportiva, University of Seville, 41013 Seville, Spain
| | - Isabel Sospedra
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | - José Miguel Martínez-Sanz
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | - Margarita Pérez
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences (INEF), Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Eduardo J Guerra-Hernández
- Departamento de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Granada, 18011 Granada, Spain
| | - Álvaro López-Samanes
- Faculty of Human and Social Sciences, Universidad Pontificia Comillas, 28049 Madrid, Spain
| | - Antonio Jesús Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, 37203-202 Lavras, Brazil
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, University of Seville, 41013 Seville, Spain
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, 37203-202 Lavras, Brazil
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Montalvo-Alonso JJ, Ferragut C, del Val-Manzano M, Valadés D, Roberts J, Pérez-López A. Sex Differences in the Ergogenic Response of Acute Caffeine Intake on Muscular Strength, Power and Endurance Performance in Resistance-Trained Individuals: A Randomized Controlled Trial. Nutrients 2024; 16:1760. [PMID: 38892692 PMCID: PMC11174740 DOI: 10.3390/nu16111760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND This study assessed the impact of acute caffeine intake on muscular strength, power, and endurance performance between resistance-trained male and female individuals according to load in upper- and lower-body exercises. METHODS Here, 76 resistance-trained individuals (38 females, 38 males) participated in a study comparing caffeine and a placebo. Each received either 3 mg/kg of caffeine or a placebo 60 min before tests measuring muscular strength and power through bench press and back squat exercises at different intensities (25%, 50%, 75%, 90% 1RM). Muscular endurance at 65% 1RM was also assessed by performing reps until reaching task failure. RESULTS Compared to placebo, caffeine increased mean, peak and time to reach peak velocity and power output (p < 0.01, ηp2 = 0.242-0.293) in the muscular strength/power test in males and females. This effect was particularly observed in the back squat exercise at 50%, 75% and 90% 1RM (2.5-8.5%, p < 0.05, g = 1.0-2.4). For muscular endurance, caffeine increased the number of repetitions, mean velocity and power output (p < 0.001, ηp2 = 0.177-0.255) in both sexes and exercises (3.0-8.9%, p < 0.05, g = 0.15-0.33). CONCLUSIONS Acute caffeine intake resulted in a similar ergogenic effect on muscular strength, power, and endurance performance in upper- and lower-body exercises for male and female resistance-trained participants.
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Affiliation(s)
- Juan Jesús Montalvo-Alonso
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, 28801 Madrid, Spain; (J.J.M.-A.); (C.F.); (M.d.V.-M.); (D.V.)
| | - Carmen Ferragut
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, 28801 Madrid, Spain; (J.J.M.-A.); (C.F.); (M.d.V.-M.); (D.V.)
| | - Marta del Val-Manzano
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, 28801 Madrid, Spain; (J.J.M.-A.); (C.F.); (M.d.V.-M.); (D.V.)
| | - David Valadés
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, 28801 Madrid, Spain; (J.J.M.-A.); (C.F.); (M.d.V.-M.); (D.V.)
| | - Justin Roberts
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge CB1 1PT, UK;
| | - Alberto Pérez-López
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, 28801 Madrid, Spain; (J.J.M.-A.); (C.F.); (M.d.V.-M.); (D.V.)
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Wu W, Chen Z, Zhou H, Wang L, Li X, Lv Y, Sun T, Yu L. Effects of Acute Ingestion of Caffeine Capsules on Muscle Strength and Muscle Endurance: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1146. [PMID: 38674836 PMCID: PMC11054210 DOI: 10.3390/nu16081146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to explore the effects of acute ingestion of caffeine capsules on muscle strength and muscle endurance. We searched the PubMed, Web of Science, Cochrane, Scopus, and EBSCO databases. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval. Fourteen studies fulfilled the inclusion criteria. The acute ingestion of caffeine capsules significantly improved muscle strength (WMD, 7.09, p < 0.00001) and muscle endurance (WMD, 1.37; p < 0.00001), especially in males (muscle strength, WMD, 7.59, p < 0.00001; muscle endurance, WMD, 1.40, p < 0.00001). Subgroup analyses showed that ≥ 6 mg/kg body weight of caffeine (WMD, 6.35, p < 0.00001) and ingesting caffeine 45 min pre-exercise (WMD, 8.61, p < 0.00001) were more effective in improving muscle strength, with the acute ingestion of caffeine capsules having a greater effect on lower body muscle strength (WMD, 10.19, p < 0.00001). In addition, the acute ingestion of caffeine capsules had a greater effect in moderate-intensity muscle endurance tests (WMD, 1.76, p < 0.00001). An acute ingestion of caffeine capsules significantly improved muscle strength and muscle endurance in the upper body and lower body of males.
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Affiliation(s)
- Weiliang Wu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Zhizhou Chen
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Huixuan Zhou
- School of Sport Sciences, Beijing Sport University, Beijing 100084, China;
| | - Leiyuyang Wang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Xiang Li
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Yuanyuan Lv
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China;
| | - Tingting Sun
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
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Nuzzo JL, Pinto MD, Nosaka K, Steele J. Maximal Number of Repetitions at Percentages of the One Repetition Maximum: A Meta-Regression and Moderator Analysis of Sex, Age, Training Status, and Exercise. Sports Med 2024; 54:303-321. [PMID: 37792272 PMCID: PMC10933212 DOI: 10.1007/s40279-023-01937-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/05/2023]
Abstract
The maximal number of repetitions that can be completed at various percentages of the one repetition maximum (1RM) [REPS ~ %1RM relationship] is foundational knowledge in resistance exercise programming. The current REPS ~ %1RM relationship is based on few studies and has not incorporated uncertainty into estimations or accounted for between-individuals variation. Therefore, we conducted a meta-regression to estimate the mean and between-individuals standard deviation of the number of repetitions that can be completed at various percentages of 1RM. We also explored if the REPS ~ %1RM relationship is moderated by sex, age, training status, and/or exercise. A total of 952 repetitions-to-failure tests, completed by 7289 individuals in 452 groups from 269 studies, were identified. Study groups were predominantly male (66%), healthy (97%), < 59 years of age (92%), and resistance trained (60%). The bench press (42%) and leg press (14%) were the most commonly studied exercises. The REPS ~ %1RM relationship for mean repetitions and standard deviation of repetitions were best described using natural cubic splines and a linear model, respectively, with mean and standard deviation for repetitions decreasing with increasing %1RM. More repetitions were evident in the leg press than bench press across the loading spectrum, thus separate REPS ~ %1RM tables were developed for these two exercises. Analysis of moderators suggested little influences of sex, age, or training status on the REPS ~ %1RM relationship, thus the general main model REPS ~ %1RM table can be applied to all individuals and to all exercises other than the bench press and leg press. More data are needed to develop REPS ~ %1RM tables for other exercises.
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Affiliation(s)
- James L Nuzzo
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Matheus D Pinto
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Kazunori Nosaka
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - James Steele
- School of Sport, Health, and Social Sciences, Solent University, Southampton, UK
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Grgic J, Varovic D. Moderators of Caffeine's Effects on Jumping Performance in Females: A Systematic Review and Meta-Analysis. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:92-100. [PMID: 37191618 DOI: 10.1080/27697061.2023.2212740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
We aimed to perform a systematic review and meta-analysis of caffeine's effects on vertical jumping performance in females, with subgroup analyses for potential moderators, including phase of the menstrual cycle, testing time of day, caffeine dose, and test type. Fifteen studies were included in the review (n = 197). Their data were pooled in a random-effects meta-analysis of effect sizes (Hedges' g). In the main meta-analysis, we found an ergogenic effect of caffeine on jumping performance (g: 0.28). An ergogenic effect of caffeine on jumping performance was found when the testing was carried out in the luteal phase (g: 0.24), follicular phase (g: 0.52), luteal or follicular phase (g: 0.31), and when the phase was not specified (g: 0.21). The test for subgroup differences indicated that the ergogenic effects of caffeine were significantly greater in the follicular phase compared to all other conditions. An ergogenic effect of caffeine on jumping performance was found when the testing was carried out in the morning (g: 0.38), evening (g: 0.19), mixed morning or evening (g: 0.38), and when time was not specified (g: 0.32), with no subgroup differences. An ergogenic effect of caffeine on jumping performance was found when the dose was ≤3 mg/kg (g: 0.21), or >3 mg/kg (g: 0.37), with no subgroup differences. An ergogenic effect of caffeine on jumping performance was found in the countermovement jump test (g: 0.26) and squat jump test (g: 0.35), with no subgroup differences. In summary, caffeine ingestion is ergogenic for vertical jumping performance in females, and it seems that the magnitude of these effects is the largest in the follicular phase of the menstrual cycle.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Dorian Varovic
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
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Jagim AR, Harty PS, Tinsley GM, Kerksick CM, Gonzalez AM, Kreider RB, Arent SM, Jager R, Smith-Ryan AE, Stout JR, Campbell BI, VanDusseldorp T, Antonio J. International society of sports nutrition position stand: energy drinks and energy shots. J Int Soc Sports Nutr 2023; 20:2171314. [PMID: 36862943 PMCID: PMC9987737 DOI: 10.1080/15502783.2023.2171314] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 03/04/2023] Open
Abstract
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of energy drink (ED) or energy shot (ES) consumption on acute exercise performance, metabolism, and cognition, along with synergistic exercise-related performance outcomes and training adaptations. The following 13 points constitute the consensus of the Society and have been approved by the Research Committee of the Society: Energy drinks (ED) commonly contain caffeine, taurine, ginseng, guarana, carnitine, choline, B vitamins (vitamins B1, B2, B3, B5, B6, B9, and B12), vitamin C, vitamin A (beta carotene), vitamin D, electrolytes (sodium, potassium, magnesium, and calcium), sugars (nutritive and non-nutritive sweeteners), tyrosine, and L-theanine, with prevalence for each ingredient ranging from 1.3 to 100%. Energy drinks can enhance acute aerobic exercise performance, largely influenced by the amount of caffeine (> 200 mg or >3 mg∙kg bodyweight [BW-1]) in the beverage. Although ED and ES contain several nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES based on scientific evidence appear to be caffeine and/or the carbohydrate provision. The ergogenic value of caffeine on mental and physical performance has been well-established, but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. Consuming ED and ES 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance with doses >3 mg∙kg BW-1. Consuming ED and ES containing at least 3 mg∙kg BW-1 caffeine is most likely to benefit maximal lower-body power production. Consuming ED and ES can improve endurance, repeat sprint performance, and sport-specific tasks in the context of team sports. Many ED and ES contain numerous ingredients that either have not been studied or evaluated in combination with other nutrients contained in the ED or ES. For this reason, these products need to be studied to demonstrate efficacy of single- and multi-nutrient formulations for physical and cognitive performance as well as for safety. Limited evidence is available to suggest that consumption of low-calorie ED and ES during training and/or weight loss trials may provide ergogenic benefit and/or promote additional weight control, potentially through enhanced training capacity. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. Individuals should consider the impact of regular coingestion of high glycemic index carbohydrates from ED and ES on metabolic health, blood glucose, and insulin levels. Adolescents (aged 12 through 18) should exercise caution and seek parental guidance when considering the consumption of ED and ES, particularly in excessive amounts (e.g. > 400 mg), as limited evidence is available regarding the safety of these products among this population. Additionally, ED and ES are not recommended for children (aged 2-12), those who are pregnant, trying to become pregnant, or breastfeeding and those who are sensitive to caffeine. Diabetics and individuals with preexisting cardiovascular, metabolic, hepatorenal, and/or neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should exercise caution and consult with their physician prior to consuming ED. The decision to consume ED or ES should be based upon the beverage's content of carbohydrate, caffeine, and other nutrients and a thorough understanding of the potential side effects. Indiscriminate use of ED or ES, especially if multiple servings per day are consumed or when consumed with other caffeinated beverages and/or foods, may lead to adverse effects. The purpose of this review is to provide an update to the position stand of the International Society of Sports Nutrition (ISSN) integrating current literature on ED and ES in exercise, sport, and medicine. The effects of consuming these beverages on acute exercise performance, metabolism, markers of clinical health, and cognition are addressed, as well as more chronic effects when evaluating ED/ES use with exercise-related training adaptions.
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Affiliation(s)
- Andrew R. Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI, USA
- Exercise & Sport Science, University of Wisconsin – La Crosse, La Crosse, WI, USA
| | - Patrick S. Harty
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO, USA
| | - Grant M. Tinsley
- Energy Balance and Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Chad M. Kerksick
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI, USA
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO, USA
| | - Adam M. Gonzalez
- Department of Allied Health and Kinesiology, Hofstra University, Hempstead, NY, USA
| | - Richard B. Kreider
- Exercise & Sport Nutrition Lab, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, USA
| | - Shawn M Arent
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Jeffrey R. Stout
- School of Kinesiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA
| | - Bill I. Campbell
- Performance & Physique Enhancement Laboratory, University of South Florida, Tampa, FL, USA
| | - Trisha VanDusseldorp
- Bonafede Health, LLC, JDS Therapeutics, Harrison, NY, USA
- Department of Health and Exercise Sciences, Jacksonville University, Jacksonville, FL, USA
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
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Haugen ME, Vårvik FT, Grgic J, Studsrud H, Austheim E, Zimmermann EM, Falch HN, Larsen S, van den Tillaar R, Bjørnsen T. Effect of isolated and combined ingestion of caffeine and citrulline malate on resistance exercise and jumping performance: a randomized double-blind placebo-controlled crossover study. Eur J Nutr 2023; 62:2963-2975. [PMID: 37450275 PMCID: PMC10468939 DOI: 10.1007/s00394-023-03212-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The aim of this study was to explore the isolated and combined effects of caffeine and citrulline malate (CitMal) on jumping performance, muscular strength, muscular endurance, and pain perception in resistance-trained participants. METHODS Using a randomized and double-blind study design, 35 resistance-trained males (n = 18) and females (n = 17) completed four testing sessions following the ingestion of isolated caffeine (5 mg/kg), isolated CitMal (12 g), combined doses of caffeine and CitMal, and placebo. Supplements were ingested 60 min before performing a countermovement jump (CMJ) test (outcomes included jump height, rate of force development, peak force, and peak power), one-repetition maximum (1RM) squat and bench press, and repetitions to muscular failure in the squat and bench press with 60% of 1RM. Pain perception was evaluated following the repetitions to failure tests. The study was registered at ISRCTN (registration number: ISRCTN11694009). RESULTS Compared to the placebo condition, isolated caffeine ingestion and co-ingestion of caffeine and CitMal significantly enhanced strength in 1RM bench press (Cohen's d: 0.05-0.06; 2.5-2.7%), muscular endurance in the squat (d: 0.46-0.58; 18.6-18.7%) and bench press (d: 0.48-0.64; 9.3-9.5%). However, there was no significant difference between isolated caffeine ingestion and caffeine co-ingested with CitMal, and isolated CitMal supplementation did not have an ergogenic effect in any outcome. No main effect of condition was found in the analysis for CMJ-derived variables, 1RM squat and pain perception. CONCLUSION Caffeine ingestion appears to be ergogenic for muscular strength and muscular endurance, while adding CitMal does not seem to further enhance these effects.
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Affiliation(s)
| | - Fredrik Tonstad Vårvik
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Henrik Studsrud
- Department of Sport Sciences and Physical Education, Nord University, Levanger, Norway
| | - Espen Austheim
- Department of Sport Sciences and Physical Education, Nord University, Levanger, Norway
| | | | | | - Stian Larsen
- Department of Sport Sciences and Physical Education, Nord University, Levanger, Norway
| | | | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
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8
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Ruple BA, Plotkin DL, Smith MA, Godwin JS, Sexton CL, McIntosh MC, Kontos NJ, Beausejour JP, Pagan JI, Rodriguez JP, Sheldon D, Knowles KS, Libardi CA, Young KC, Stock MS, Roberts MD. The effects of resistance training to near failure on strength, hypertrophy, and motor unit adaptations in previously trained adults. Physiol Rep 2023; 11:e15679. [PMID: 37144554 PMCID: PMC10161210 DOI: 10.14814/phy2.15679] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/09/2023] [Accepted: 04/06/2023] [Indexed: 05/06/2023] Open
Abstract
Limited research exists examining how resistance training to failure affects applied outcomes and single motor unit characteristics in previously trained individuals. Herein, resistance-trained adults (24 ± 3 years old, self-reported resistance training experience was 6 ± 4 years, 11 men and 8 women) were randomly assigned to either a low-repetitions-in-reserve (RIR; i.e., training near failure, n = 10) or high-RIR (i.e., not training near failure, n = 9) group. All participants implemented progressive overload during 5 weeks where low-RIR performed squat, bench press, and deadlift twice weekly and were instructed to end each training set with 0-1 RIR. high-RIR performed identical training except for being instructed to maintain 4-6 RIR after each set. During week 6, participants performed a reduced volume-load. The following were assessed prior to and following the intervention: (i) vastus lateralis (VL) muscle cross-sectional area (mCSA) at multiple sites; (ii) squat, bench press, and deadlift one-repetition maximums (1RMs); and (iii) maximal isometric knee extensor torque and VL motor unit firing rates during an 80% maximal voluntary contraction. Although RIR was lower in the low- versus high-RIR group during the intervention (p < 0.001), total training volume did not significantly differ between groups (p = 0.222). There were main effects of time for squat, bench press, and deadlift 1RMs (all p-values < 0.05), but no significant condition × time interactions existed for these or proximal/middle/distal VL mCSA data. There were significant interactions for the slope and y-intercept of the motor unit mean firing rate versus recruitment threshold relationship. Post hoc analyses indicated low-RIR group slope values decreased and y-intercept values increased after training suggesting low-RIR training increased lower-threshold motor unit firing rates. This study provides insight into how resistance training in proximity to failure affects strength, hypertrophy, and single motor unit characteristics, and may inform those who aim to program for resistance-trained individuals.
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Affiliation(s)
| | | | | | | | | | | | | | - Jonathan P. Beausejour
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Jason I. Pagan
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Juan P. Rodriguez
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Daniel Sheldon
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Kevan S. Knowles
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Cleiton A. Libardi
- Department of Physical EducationFederal University of São CarlosSão CarlosBrazil
| | - Kaelin C. Young
- Biomedical SciencesPacific Northwest University of Health SciencesYakimaWashingtonUSA
| | - Matt S. Stock
- School of Kinesiology and Rehabilitation SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Michael D. Roberts
- School of KinesiologyAuburn UniversityAuburnAlabamaUSA
- Edward Via College of Osteopathic MedicineAuburnAlabamaUSA
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9
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Ruiz-Fernández I, Valadés D, Dominguez R, Ferragut C, Pérez-López A. Load and muscle group size influence the ergogenic effect of acute caffeine intake in muscular strength, power and endurance. Eur J Nutr 2023; 62:1783-1794. [PMID: 36840816 DOI: 10.1007/s00394-023-03109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
INTRODUCTION Although acute caffeine intake seems to improve muscular strength-power-endurance performance, there is scarce evidence evaluating upper vs lower-body exercises at different loads. Thus, this study aimed to examine the effects of acute caffeine intake on upper and lower-body muscular strength, power and endurance performance at different loads. METHODS Twenty resistance-trained athletes (male/female: 10/10; age: 23 ± 4 years; body mass: 70.6 ± 15.1) participated in a double-blind, placebo-controlled, cross-over and randomized study. Participants were provided with either 3 mg/kg of body mass of caffeine or maltodextrin (placebo). Sixty minutes after ingestion, they performed muscular strength and power assessment for bench press and back squat exercise at 25%, 50%, 75% and 90% 1-repetition-maximum (1RM), performing 3, 2, 1 and 1 repetitions respectively, followed by muscular endurance assessment for both exercises at 65% and 85% 1RM performing until task failure. Isometric handgrip, isometric mid-thigh pull and vertical jump tests were also performed. RESULTS In muscular strength and power, compared to placebo, caffeine improved mean velocity (P = 0.045; pη2 = 0.101), mean power (P = 0.049; pη2 = 0.189) and rate of force development (RFD, P = 0.032; pη2 = 0.216), particularly in back squat exercise at 75% and 90% 1RM where mean velocity increased by 5-7% (P = 0.48-0.038; g = 0.348-1.413), mean power by 6-8% (P = 0.050-0.032; g = 0.547-0.818) and RFD by 17-97% (P = 0.042-0.046; g = 1.436-1.196). No differences were found in bench press exercise. In muscular endurance, caffeine improved the number of repetitions in all exercises and loads (P = 0.003; pη2 = 0.206), but only in back squat exercise at 85% 1RM, caffeine increased mean and peak velocity (8-9%, P = 0.006-0.004; g = 2.029-2.075), mean and peak power (10-13%, P = 0.006-0.003; g = 0.888-1.151) and force peak (3%, P = 0.009; g = 0.247). CONCLUSIONS Acute caffeine intake (3 mg/kg) improved muscular strength, power and endurance performance, revealing a more pronounced effect at high-loads (≥ 75% 1RM) and in lower-body (back squat) than in upper-body exercise (bench press) according to muscle group size.
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Affiliation(s)
- Iván Ruiz-Fernández
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Ctra. Madrid-Barcelona km 33,600, 28871, Alcalá de Henares, Spain
| | - David Valadés
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Ctra. Madrid-Barcelona km 33,600, 28871, Alcalá de Henares, Spain
| | - Raúl Dominguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, Seville, Spain
| | - Carmen Ferragut
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Ctra. Madrid-Barcelona km 33,600, 28871, Alcalá de Henares, Spain.
| | - Alberto Pérez-López
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Ctra. Madrid-Barcelona km 33,600, 28871, Alcalá de Henares, Spain
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10
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López-Torres O, Rodríguez-Longobardo C, Capel-Escoriza R, Fernández-Elías VE. Ergogenic Aids to Improve Physical Performance in Female Athletes: A Systematic Review with Meta-Analysis. Nutrients 2022; 15:nu15010081. [PMID: 36615738 PMCID: PMC9823656 DOI: 10.3390/nu15010081] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Most intervention studies investigating the effects of ergogenic aids (EAs) on sports performance have been carried out in the male population. Thus, the aim of this systematic review and meta-analysis was to summarize the effects in the existing literature of EAs used by female athletes on performance. A literature research was conducted, and a descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 32 of the included articles, evaluating performance in strength, sprint, and cardiovascular capacity. A random-effects model and the standardized mean differences (SMD) ± 95% confidence intervals (CI) were reported. The results showed that caffeine helped to improve jumping performance, isometric strength values, and the number of repetitions until failure. Caffeine and sodium phosphate helped to improve sprint performance. Aerobic tests could be improved with the use of taurine, caffeine, and beta-alanine. No conclusive effects of beetroot juice, polyphenols, or creatine in improving aerobic performance were shown. In terms of anaerobic variables, both caffeine and sodium phosphate could help to improve repeated sprint ability. More studies are needed in female athletes that measure the effects of different EAs on sports performance, such as beetroot juice, beta-alanine or sodium phosphate, as the studies to date are scarce and there are many types of EA that need to be further considered in this population, such as creatine and taurine.
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Affiliation(s)
- Olga López-Torres
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Celia Rodríguez-Longobardo
- Social Sciences of Physical Activity, Sport and Leisure Department, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - Raquel Capel-Escoriza
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Raquel Wellness Instituto de Nutrición y Salud, 28050 Madrid, Spain
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11
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Santana O, Vieira-Cavalcante V, Caetano Paulo A, Rodacki C, Bertuzzi R, Lima-Silva AE, Cristina-Souza G. Caffeine reverts loss of muscular performance during the early-follicular phase in resistance-trained naturally menstruating women. J Sports Sci 2022; 40:1592-1601. [PMID: 35819352 DOI: 10.1080/02640414.2022.2094560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of this study was to compare the effects of caffeine ingestion on muscular performance during the early-follicular and mid-luteal phases of the menstrual cycle. Fourteen resistance-trained naturally menstruating women performed countermovement jump (CMJ), maximal voluntary isometric contraction (MVIC), one-repetition maximum (1-RM), and repetitions-to-failure (RF) at 80% of 1-RM in the half-squat exercise, in early-follicular and mid-luteal phases, after placebo or caffeine ingestion. The early-follicular and mid-luteal phases were identified via calendar-based counting method. The MVIC was lower in the early-follicular than mid-luteal phase (-6.2 ± 15.2 N, p < 0.05) and higher with caffeine than placebo ingestion regardless of the menstrual cycle phase (+16.8 ± 26.7 N, p < 0.05). The magnitude of gains (supplement x phase interaction, p < 0.026) in 1-RM, CMJ, and RF with caffeine ingestion was higher in the early-follicular (+16.6 ± 7.1 kg, +2.5 ± 1.6 cm, and +4.5 ± 2.6 repetitions, respectively) than in the mid-luteal phase (+7.7 ± 4.8 kg, +1.5 ± 2.0 cm, and +2.4 ± 3.1 repetitions, respectively). In conclusion, the greater ergogenic effect of caffeine during the early-follicular phase supports its use to mitigate the decline in muscular performance in this phase of the menstrual cycle.
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Affiliation(s)
- Ottavio Santana
- Human Performance Research Group, Federal University of Technology Parana, Curitiba, Brazil
| | | | - Anderson Caetano Paulo
- Physical and Sports Training, Health and Performance Research Group (TFESP), Federal University of Technology Parana, Curitiba, Brazil
| | - Cintia Rodacki
- Human Performance Research Group, Federal University of Technology Parana, Curitiba, Brazil.,Physical and Sports Training, Health and Performance Research Group (TFESP), Federal University of Technology Parana, Curitiba, Brazil
| | - Romulo Bertuzzi
- Endurance Performance Research Group (GEDAE-USP), University of Sao Paulo, Sao Paulo, Brazil
| | | | - Gislaine Cristina-Souza
- Human Performance Research Group, Federal University of Technology Parana, Curitiba, Brazil.,Nutrition and Exercise Research Group, State University of Minas Gerais, Minas Gerais, Brazil
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12
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Does caffeine ingestion affect the lower-body post-activation performance enhancement in female volleyball players? BMC Sports Sci Med Rehabil 2022; 14:93. [PMID: 35614511 PMCID: PMC9131637 DOI: 10.1186/s13102-022-00488-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
Background Post-activation performance enhancement (PAPE) is a physiological phenomenon that acutely improves voluntary muscular performance following a conditioning activity. A large and growing body of literature has investigated different strategies to induce a PAPE stimulus; however, little attention has been given to whether acute caffeine ingestion could augment the effect of PAPE on subsequent performance. This study evaluated the acute effects of caffeine ingestion and back squat conditioning activity on subsequent countermovement jump (CMJ) performance in female semi-professional volleyball players. Methods Fourteen resistance-trained female volleyball players (26 ± 3 years) performed 3 different testing conditions in randomized order: where each ingested 6 mg/kg of caffeine (CAF) or placebo (PLAC) and performed a single set of back squats at 80%1RM until mean movement velocity dropped by 10% as the conditioning activity or a control (CTRL) condition where participants did not ingest any supplement and did not perform the conditioning activity. CMJ height was examined at baseline and in 2 min intervals until 10 min postconditioning activity. Furthermore, due to the wide inter-individual variation in optimal recovery time of PAPE response, the baseline and best post-conditioning activity performance were also analyzed. Results The Friedman test revealed a significant difference in jump height within CTRL (p = 0.002) and CAF (p = 0.001) conditions, but no significant difference was found within the PAP condition. The post hoc showed a significant decrease in jump height in 8th min in CTRL condition (p = 0.022, effect size [ES] = −0.31), a significant increase in jump height in 2nd min in CAF condition (p = 0.013, ES = 0.3), without differences in PLAC condition in comparison to baseline values. Moreover, a significant jump height increases from baseline to best performance post conditioning activity value for CAF (p = 0.001, ES = 0.39) and PLAC (p = 0.001, ES = 0.3) condition, but no significant difference was found for the CTRL condition. Conclusions The single set of heavy-loaded back squats with controlled velocity used as a conditioning activity in the current study enhanced subsequent CMJ performance in female volleyball players with no additional effect of caffeine.
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13
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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. Sports Med 2022; 52:2209-2220. [PMID: 35536449 DOI: 10.1007/s40279-022-01685-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 01/04/2023]
Abstract
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.
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Dietary Supplements for Athletic Performance in Women: Beta-Alanine, Caffeine, and Nitrate. Int J Sport Nutr Exerc Metab 2022; 32:311-323. [PMID: 35196646 DOI: 10.1123/ijsnem.2021-0176] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
Beta-alanine, caffeine, and nitrate are dietary supplements generally recognized by the sport and exercise science community as evidence-based ergogenic performance aids. Evidence supporting the efficacy of these supplements, however, is greatly skewed due to research being conducted primarily in men. The physiological differences between men and women, most notably in sex hormones and menstrual cycle fluctuations, make generalizing male data to the female athlete inappropriate, and potentially harmful to women. This narrative review outlines the studies conducted in women regarding the efficacy of beta-alanine, caffeine, and nitrate supplementation for performance enhancement. Only nine studies on beta-alanine, 15 on caffeine, and 10 on nitrate in healthy women under the age of 40 years conducted in normoxia conditions were identified as relevant to this research question. Evidence suggests that beta-alanine may lower the rate of perceived exertion and extend training bouts in women, leading to greater functional adaptations. Studies of caffeine in women suggest the physiological responder status and caffeine habituation may contribute to caffeine's efficacy, with a potential plateau in the dose-response relationship of performance enhancement. Nitrate appears to vary in influence based on activity type and primary muscle group examined. However, the results summarized in the limited literature for each of these three supplements provide no consensus on dosage, timing, or efficacy for women. Furthermore, the literature lacks considerations for hormonal status and its role in metabolism. This gap in sex-based knowledge necessitates further research on these ergogenic supplements in women with greater considerations for the effects of hormonal status.
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15
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Lie HC, Anderssen S, Rueegg CS, Raastad T, Grydeland M, Thorsen L, Stensrud T, Edvardsen E, Larsen MH, Torsvik IK, Bovim LP, Götte M, Lähteenmäki PM, Kriemler S, Larsen HB, Fridh MK, Ørstavik K, Brun H, Matthews I, Hornset E, Ruud E. The Physical Activity and fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an international, mixed-methods study (Preprint). JMIR Res Protoc 2021; 11:e35838. [PMID: 35258456 PMCID: PMC8941432 DOI: 10.2196/35838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. Objective The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). Methods The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year after treatment completion will be recruited in follow-up care clinics in Norway, Denmark, Finland, Germany, and Switzerland. All participants will participate in WP 1, of which approximately 150, 40, and 30 will be recruited to WP 2, WP3, and WP 4, respectively. The reference material for WP 1 is available from existing studies, whereas WP 2 will recruit healthy controls. PA levels will be measured using ActiGraph accelerometers and self-reports. Validated questionnaires will be used to assess health behaviors, fatigue, and quality of life. Physical fitness will be measured by a cardiopulmonary exercise test, isometric muscle strength tests, and muscle power and endurance tests. Limiting factors will be identified via neurological, pulmonary, and cardiac evaluations and the assessment of body composition and muscle size. Semistructured, qualitative interviews, analyzed using systematic text condensation, will identify the perceived barriers to and facilitators of PA for survivors of childhood cancer. In WP 4, we will evaluate the feasibility of a 6-month personalized PA intervention with the involvement of local structures. Results Ethical approvals have been secured at all participating sites (Norwegian Regional Committee for Medical Research Ethics [2016/953 and 2018/739]; the Oslo University Hospital Data Protection Officer; equivalent institutions in Finland, Denmark [file H-19032270], Germany, and Switzerland [Ethics Committee of Northwestern and Central Switzerland, project ID: 2019-00410]). Data collection for WP 1 to 3 is complete. This will be completed by July 2022 for WP 4. Several publications are already in preparation, and 2 have been published. Conclusions The PACCS study will generate high-quality knowledge that will contribute to the development of an evidence-based PA intervention for young survivors of childhood cancer to improve their long-term care and health. We will identify physiological, psychological, and social barriers to PA that can be targeted in interventions with immediate benefits for young survivors of childhood cancer in need of rehabilitation. International Registered Report Identifier (IRRID) DERR1-10.2196/35838
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Affiliation(s)
- Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sigmund Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Elisabeth Edvardsen
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Marie Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Lars Peder Bovim
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Miriam Götte
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics III, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Päivi Maria Lähteenmäki
- Department of Pediatric and Adolescent Hematology/Oncology, Turku University Hospital, University of Turku, Turku, Finland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Health Science, The University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kristin Ørstavik
- Department of Neurology, Section for Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
| | - Henrik Brun
- Department of Pediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Iren Matthews
- Department of Paediatric Allergy and Pulmonology, Oslo University Hospital, Oslo, Norway
| | - Else Hornset
- Norwegian Childhood Cancer Society, Oslo, Norway
| | - Ellen Ruud
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Grgic J, Mikulic P. Effects of caffeine on rate of force development: A meta-analysis. Scand J Med Sci Sports 2021; 32:644-653. [PMID: 34861076 DOI: 10.1111/sms.14109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/18/2021] [Accepted: 12/01/2021] [Indexed: 01/04/2023]
Abstract
This review aimed to conduct a meta-analysis of studies examining the effects of caffeine on rate of force development (RFD). Ten databases were searched to find relevant studies. Risk of bias (RoB) of the included studies was evaluated. Data were analyzed in a random-effects meta-analysis. Eleven studies with "some concerns" regarding RoB were included. In the main meta-analysis, there was a significant ergogenic effect of caffeine ingestion on RFD (Hedges' g = 0.37; 95% confidence interval [CI]: 0.21, 0.52; p < 0.0001). An ergogenic effect of caffeine was also found on RFD during resistance exercises (Hedges' g = 0.49; 95% CI: 0.30, 0.67; p < 0.0001), but not during the countermovement jump test (Hedges' g = 0.18; 95% CI: -0.02, 0.39; p = 0.08), with a significant difference between the subgroups (p = 0.03). Small-to-moderate (3-5 mg/kg; Hedges' g = 0.25; 95% CI: 0.09, 0.41; p = 0.002) and moderate-to-high caffeine doses (6-10 mg/kg) enhanced RFD (Hedges' g = 0.57; 95% CI: 0.30, 0.85; p < 0.0001), even though the effects were larger with higher caffeine doses (p = 0.04). Overall, caffeine ingestion increases RFD, which is relevant given that RFD is commonly associated with sport-specific tasks. From a practical perspective: (1) individuals interested in the acute enhancement of RFD in resistance exercise may consider supplementing with caffeine; and (2) given that evaluation of RFD is most commonly used for testing purposes, caffeine ingestion (3-10 mg/kg 60 min before exercise) should be standardized before RFD assessments.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Pavle Mikulic
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
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Karayigit R, Koz M, Sánchez-Gómez A, Naderi A, Yildirim UC, Domínguez R, Gur F. High Dose of Caffeine Mouth Rinse Increases Resistance Training Performance in Men. Nutrients 2021; 13:3800. [PMID: 34836058 PMCID: PMC8617760 DOI: 10.3390/nu13113800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 01/18/2023] Open
Abstract
Caffeine mouth rinsing (CMR) has been shown to enhance exercise performance. However, no studies have analyzed the effects of different dosages of CMR on muscular performance. Therefore, the purpose of this study was to examine the effects of different dosages of CMR on strength (bench press 1 repetition maximum (1-RM)) and muscular endurance (60% of 1-RM repetitions to failure) in resistance-trained males. Fourteen resistance-trained males (age: 23 ± 2 years, height: 179 ± 3 cm, body mass: 83 ± 4 kg, BMI: 17 ± 2 kg/m2) completed four conditions in random order. The four conditions consisted of a mouth rinse with 25 mL solutions containing either 1% (250 mg) of CMR (low dose of CMR: LCMR), 2% (500 mg) of CMR (moderate dose of CMR: MCMR), 3% (750 mg) of CMR (high dose of CMR: HCMR) and sweetened water (placebo: PLA) for 5 s prior to a bench press strength and muscular endurance test. Maximal strength, muscular endurance, heart rate (HR) and ratings of perceived exertion (RPE) were recorded for each condition. There were no significant differences in strength (p = 0.30) and HR (p = 0.83) between conditions. HCMR significantly increased muscular endurance performance (p = 0.01) and decreased RPE values (p = 0.01). In conclusion, CMR did not affect bench press 1-RM strength performance, but muscular endurance responses to CMR seems to be dose-dependent.
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Affiliation(s)
- Raci Karayigit
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (M.K.); (U.C.Y.)
| | - Mitat Koz
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (M.K.); (U.C.Y.)
| | - Angela Sánchez-Gómez
- Department of Nursing Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, 14000 Córdoba, Spain;
| | - Alireza Naderi
- Department of Sport Physiology, Boroujerd Branch, Islamic Azad University, Boroujerd 6915136111, Iran;
| | - Ulas Can Yildirim
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (M.K.); (U.C.Y.)
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, 41013 Sevilla, Spain
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, Lavras 37200-000, Brazil
| | - Fatih Gur
- Faculty of Sport Science, Pamukkale University, Pamukkale, Denizli 20000, Turkey;
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Jones L, Johnstone I, Day C, Le Marquer S, Hulton AT. The Dose-Effects of Caffeine on Lower Body Maximal Strength, Muscular Endurance, and Rating of Perceived Exertion in Strength-Trained Females. Nutrients 2021; 13:3342. [PMID: 34684343 PMCID: PMC8539274 DOI: 10.3390/nu13103342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 01/22/2023] Open
Abstract
Caffeine supplementation has shown to be an effective ergogenic aid enhancing athletic performance, although limited research within female populations exists. Therefore, the aim of the investigation was to assess the effect of pre-exercise caffeine supplementation on strength performance and muscular endurance in strength-trained females. In a double-blind, randomised, counterbalanced design, fourteen strength-trained females using hormonal contraception consumed either 3 or 6 mg·kg-1 BM of caffeine or placebo (PLA). Following supplementation, participants performed a one-repetition maximum (1RM) leg press and repetitions to failure (RF) at 60% of their 1RM. During the RF test, rating of perceived exertion (RPE) was recorded every five repetitions and total volume (TV) lifted was calculated. Repeated measures ANOVA revealed that RF (p = 0.010) and TV (p = 0.012) attained significance, with pairwise comparisons indicating a significant difference between 3 mg·kg-1 BM and placebo for RF (p = 0.014), with an effect size of 0.56, and for 6 mg·kg-1 BM (p = 0.036) compared to the placebo, with an effect size of 0.65. No further significance was observed for 1RM or for RPE, and no difference was observed between caffeine trials. Although no impact on lower body muscular strength was observed, doses of 3 and 6 mg·kg-1 BM of caffeine improved lower body muscular endurance in resistance-trained females, which may have a practical application for enhancing resistance training stimuli and improving competitive performance.
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Affiliation(s)
| | | | | | | | - Andrew T. Hulton
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK; (L.J.); (I.J.); (C.D.); (S.L.M.)
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Effects of Caffeine on Resistance Exercise: A Review of Recent Research. Sports Med 2021; 51:2281-2298. [PMID: 34291426 DOI: 10.1007/s40279-021-01521-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 02/06/2023]
Abstract
In the last few years, a plethora of studies have explored the effects of caffeine on resistance exercise, demonstrating that this field of research is growing fast. This review evaluates and summarizes the most recent findings. Given that toxic doses of caffeine are needed to increase skeletal muscle contractility, the binding of caffeine to adenosine receptors is likely the primary mechanism for caffeine's ergogenic effects on resistance exercise. There is convincing evidence that caffeine ingestion is ergogenic for (i) one-repetition maximum, isometric, and isokinetic strength; and (ii) muscular endurance, velocity, and power in different resistance exercises, loads, and set protocols. Furthermore, there is some evidence that caffeine supplementation also may enhance adaptations to resistance training, such as gains in strength and power. Caffeine ingestion is ergogenic for resistance exercise performance in females, and the magnitude of these effects seems to be similar to that observed in men. Habitual caffeine intake and polymorphisms within CYP1A2 and ADORA2A do not seem to modulate caffeine's ergogenic effects on resistance exercise. Consuming lower doses of caffeine (e.g., 2-3 mg/kg) appears to be comparably ergogenic to consuming high doses of caffeine (e.g., 6 mg/kg). Minimal effective doses of caffeine seem to be around 1.5 mg/kg. Alternate caffeine sources such as caffeinated chewing gum, gel, and coffee are also ergogenic for resistance exercise performance. With caffeine capsules, the optimal timing of ingestion seems to be 30-60 min before exercise. Caffeinated chewing gums and gels may enhance resistance exercise performance even when consumed 10 min before exercise. It appears that caffeine improves performance in resistance exercise primarily due to its physiological effects. Nevertheless, a small portion of the ergogenic effect of caffeine seems to be placebo-driven.
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Ergogenic Effects of Acute Caffeine Intake on Muscular Endurance and Muscular Strength in Women: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115773. [PMID: 34072182 PMCID: PMC8199301 DOI: 10.3390/ijerph18115773] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
This meta-analysis aimed to explore the effects of caffeine ingestion on muscular endurance and muscular strength in women. Five databases were searched to find relevant studies. A random-effects meta-analysis of standardized mean differences (SMD) was performed for data analysis. Subgroup meta-analyses explored the effects of caffeine on upper-body and lower-body muscular endurance and muscular strength. Eight crossover placebo-controlled studies were included in the review. In the main meta-analysis that considered data from all included studies, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.25; p = 0.027) and muscular strength (SMD = 0.18; p < 0.001). In a subgroup analysis that considered only upper-body exercises, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.20; p = 0.007) and muscular strength (SMD = 0.17; p < 0.001). In a subgroup analysis that considered only lower-body exercises, there was no significant difference between caffeine and placebo for muscular endurance (SMD = 0.43; p = 0.092) or muscular strength (SMD = 0.16; p = 0.109). The main finding of this meta-analysis is that caffeine ingestion has a significant ergogenic effect on muscular endurance and muscular strength in women. The effects reported in this analysis are similar to those previously observed in men and suggest that women may use caffeine supplementation as an ergogenic aid for muscular performance. Future research is needed to explore the effects of caffeine on lower-body muscular endurance and muscular strength in this population.
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Barreto G, Grecco B, Merola P, Reis CEG, Gualano B, Saunders B. Novel insights on caffeine supplementation, CYP1A2 genotype, physiological responses and exercise performance. Eur J Appl Physiol 2021; 121:749-769. [PMID: 33403509 DOI: 10.1007/s00421-020-04571-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/23/2020] [Indexed: 01/13/2023]
Abstract
Caffeine is a popular ergogenic aid due to its primary physiological effects that occur through antagonism of adenosine receptors in the central nervous system. This leads to a cascade of physiological reactions which increases focus and volition, and reduces perception of effort and pain, contributing to improved exercise performance. Substantial variability in the physiological and performance response to acute caffeine consumption is apparent, and a growing number of studies are implicating a single-nucleotide polymorphism in the CYP1A2 gene, responsible for caffeine metabolism, as a key factor that influences the acute responses to caffeine ingestion. However, existing literature regarding the influence of this polymorphism on the ergogenic effects of caffeine is controversial. Fast caffeine metabolisers (AA homozygotes) appear most likely to benefit from caffeine supplementation, although over half of studies showed no differences in the responses to caffeine between CYP1A2 genotypes, while others even showed either a possible advantage or disadvantage for C-allele carriers. Contrasting data are limited by weak study designs and small samples sizes, which did not allow separation of C-allele carriers into their sub-groups (AC and CC), and insufficient mechanistic evidence to elucidate findings. Mixed results prevent practical recommendations based upon genotype while genetic testing for CYP1A2 is also currently unwarranted. More mechanistic and applied research is required to elucidate how the CYP1A2 polymorphism might alter caffeine's ergogenic effect and the magnitude thereof, and whether CYP1A2 genotyping prior to caffeine supplementation is necessary.
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Affiliation(s)
- Gabriel Barreto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo (Sao Paulo, SP, BR), University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246903, Brazil
| | - Beatriz Grecco
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo (Sao Paulo, SP, BR), University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246903, Brazil
| | - Pietro Merola
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo (Sao Paulo, SP, BR), University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246903, Brazil
| | | | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo (Sao Paulo, SP, BR), University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246903, Brazil.,Food Research Center, University of São Paulo, São Paulo, Brazil
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo (Sao Paulo, SP, BR), University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246903, Brazil. .,Institute of Orthopaedics and Traumatology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil.
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