Effect of Pre-Exercise Caffeine Intake on Endurance Performance and Core Temperature Regulation During Exercise in the Heat: A Systematic Review with Meta-Analysis

BACKGROUND

Heat is associated with physiological strain and endurance performance (EP) impairments. Studies have investigated the impact of caffeine intake upon EP and core temperature (C_T) in the heat, but results are conflicting. There is a need to systematically determine the impact of pre-exercise caffeine intake in the heat.

OBJECTIVE

To use a meta-analytical approach to determine the effect of pre-exercise caffeine intake on EP and C_T in the heat.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Four databases and cross-referencing.

DATA ANALYSIS

Weighted mean effect summaries using robust variance random-effects models for EP and C_T, as well as robust variance meta-regressions to explore confounders.

STUDY SELECTION

Placebo-controlled, randomized studies in adults (≥ 18 years old) with caffeine intake at least 30 min before endurance exercise ≥ 30 min, performed in ambient conditions ≥ 27 °C.

RESULTS

Respectively six and 12 studies examined caffeine's impact on EP and C_T, representing 52 and 205 endurance-trained individuals. On average, 6 mg/kg body mass of caffeine were taken 1 h before exercises of ~ 70 min conducted at 34 °C and 47% relative humidity. Caffeine supplementation non-significantly improved EP by 2.1 ± 0.8% (95% CI - 0.7 to 4.8) and significantly increased the rate of change in C_T by 0.10 ± 0.03 °C/h (95% CI 0.02 to 0.19), compared with the ingestion of a placebo.

CONCLUSION

Caffeine ingestion of 6 mg/kg body mass ~ 1 h before exercise in the heat may provide a worthwhile improvement in EP, is unlikely to be deleterious to EP, and trivially increases the rate of change in C_T.

Effects of Caffeine and Caffeinated Beverages in Children, Adolescents and Young Adults: Short Review

The prevalence of ED consumption has increased over the past 10–15 years. Studies describing the effects of caffeine and caffeinated beverages show confusing results, so it seems important to regularly summarize the available facts, and in more detail. By a thorough analysis of more than 156 scientific papers, the authors describe the molecular background of absorption, as well as the positive and negative effects of different dosages of caffeine, just like its effects in physical activity and performance. ED and EDwA consumption is a regular habit of not only adults, but nowadays even of children and adolescents. There are no safe dosages described of caffeine or ED consumption for children. There are no positive short- or long-term effects of these compounds/products concerning developing brain functions, psycho-motor functions, or social development. Instead, there are many unpleasant side effects, and symptoms of regular or higher-dose ED consumption, especially at younger ages. This mini review describes many details of these unpleasant side effects, their severity, and motivations for consuming these compounds/products. In a quantitative research in Hungary (10–26 years, mean age: 15.6 ± 3.8 y, 1459 subjects, randomly chosen population), a survey based on a questionnaire asking people about their ED consumption habits was conducted. According to the data, 81.8% of the participants consumed EDs at least once, and 63.3% tried several products of the kind. A positive correlation was found between age and consumption (p < 0.001). The results show that a high proportion of this group often consumed EDwA, in many cases leading to harmful side-effects of caffeine overdose. In a sample of Hungarian high school and college students (17–26 years), ED consumption matched the international data, and only 19.7% of respondents did not use EDs at all (had never tasted an ED in their life).

The Effect of Dietary Supplements on Endurance Exercise Performance and Core Temperature in Hot Environments: A Meta-analysis and Meta-regression

BACKGROUND

The ergogenic effects of dietary supplements on endurance exercise performance are well-established; however, their efficacy in hot environmental conditions has not been systematically evaluated.

OBJECTIVES

(1) To meta-analyse studies investigating the effects of selected dietary supplements on endurance performance and core temperature responses in the heat. Supplements were included if they were deemed to: (a) have a strong evidence base for 'directly' improving thermoneutral endurance performance, based on current position statements, or (b) have a proposed mechanism of action that related to modifiable factors associated with thermal balance. (2) To conduct meta-regressions to evaluate the moderating effect of selected variables on endurance performance and core temperature responses in the heat following dietary supplementation.

METHODS

A search was performed using various databases in May 2020. After screening, 25 peer-reviewed articles were identified for inclusion, across three separate meta-analyses: (1) exercise performance; (2) end core temperature; (3) submaximal core temperature. The moderating effect of several variables were assessed via sub-analysis and meta-regression.

RESULTS

Overall, dietary supplementation had a trivial significant positive effect on exercise performance (Hedges' g = 0.18, 95% CI 0.007-0.352, P = 0.042), a trivial non-significant positive effect on submaximal core temperature (Hedges' g = 0.18, 95% CI - 0.021 to 0.379, P = 0.080) and a small non-significant positive effect on end core temperature (Hedges' g = 0.20, 95% CI - 0.041 to 0.439, P = 0.104) in the heat. There was a non-significant effect of individual supplements on exercise performance (P = 0.973) and submaximal core temperature (P = 0.599). However, end core temperature was significantly affected by supplement type (P = 0.003), which was attributable to caffeine's large significant positive effect (n = 8; Hedges' g = 0.82, 95% CI 0.433-1.202, P < 0.001) and taurine's medium significant negative effect (n = 1; Hedges' g = - 0.96, 95% CI - 1.855 to - 0.069, P = 0.035).

CONCLUSION

Supplements such as caffeine and nitrates do not enhance endurance performance in the heat, with caffeine also increasing core temperature responses. Some amino acids might offer the greatest performance benefits in the heat. Exercising in the heat negatively affected the efficacy of many dietary supplements, indicating that further research is needed and current guidelines for performance in hot environments likely require revision.

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.

Caffeine and Exercise: What Next?

Caffeine is a widely utilized performance-enhancing supplement used by athletes and non-athletes alike. In recent years, a number of meta-analyses have demonstrated that caffeine's ergogenic effects on exercise performance are well-established and well-replicated, appearing consistent across a broad range of exercise modalities. As such, it is clear that caffeine is an ergogenic aid-but can we further explore the context of this ergogenic aid in order to better inform practice? We propose that future research should aim to better understand the nuances of caffeine use within sport and exercise. Here, we propose a number of areas for exploration within future caffeine research. These include an understanding of the effects of training status, habitual caffeine use, time of day, age, and sex on caffeine ergogenicity, as well as further insight into the modifying effects of genotype. We also propose that a better understanding of the wider, non-direct effects of caffeine on exercise, such as how it modifies sleep, anxiety, and post-exercise recovery, will ensure athletes can maximize the performance benefits of caffeine supplementation during both training and competition. Whilst not exhaustive, we hope that the questions provided within this manuscript will prompt researchers to explore areas with the potential to have a large impact on caffeine use in the future.

Effect of Caffeine Supplementation on Sports Performance Based on Differences Between Sexes: A Systematic Review

Most studies that have shown the positive effects of caffeine supplementation on sports performance have been carried out on men. However, the differences between sexes are evident in terms of body size, body composition, and hormonal functioning, which might cause different outcomes on performance for the same dosage of caffeine intake in men vs. women. The main aim of this systematic review was to analyze and compare the effects of caffeine intake between men and women on sports performance to provide a source of knowledge to sports practitioners and coaches, especially for those working with women athletes, on the use of caffeine as an ergogenic aid. A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in the Web of Science, Cochrane Library, and Scopus databases until 28 July 2019. The search included studies in which the effects of caffeine supplementation on athletic performance were compared between sexes and to an identical placebo situation (dose, duration and timing). No filters were applied for participants’ physical fitness level or age. A total of 254 articles were obtained in the initial search. When applying the inclusion and exclusion criteria, the final sample was 10 articles. The systematic review concluded that four investigations (100% of the number of investigations on this topic) had not found differences between sexes in terms of caffeine supplementation on aerobic performance and 3/3 (100%) on the fatigue index. However, four out of seven articles (57.1%) showed that the ergogenicity of caffeine for anaerobic performance was higher in men than women. In particular, it seems that men are able to produce more power, greater total weight lifted and more speed with the same dose of caffeine than women. In summary, caffeine supplementation produced a similar ergogenic benefit for aerobic performance and the fatigue index in men and women athletes. Nevertheless, the effects of caffeine to produce more power, total weight lifted and to improve sprint performance with respect to a placebo was higher in men than women athletes despite the same dose of caffeine being administered. Thus, the ergogenic effect of acute caffeine intake on anaerobic performance might be higher in men than in women.

Effect of heat exposure and physical exercise until exhaustion in normothermic and hyperthermic conditions on serum, sweat and urinary concentrations of magnesium and phosphorus

AIM

The aim of this survey was to ascertain the difference in the levels of Magnesium (Mg) and Phosphorus (P) after an exercise test in normothermia and hyperthermia before and after heat acclimation in comparison to their respective pre-test values.

METHODS

Twenty-nine male university students were divided into an Experimental Group (EG) (n = 15) and a Control Group (CG) (n = 14). All of them voluntarily participated in this investigation. Both groups performed an incremental test until exhaustion on a cycloergometer in normothermia (22 °C) and hyperthermia (42 °C). EG underwent 9 sessions of heat acclimation (100 °C) in a sauna (Harvia C105S Logix Combi Control; 3-15 W; Finland). Once the experimental period was completed, all initial measurements were carried out again under identical conditions. Urine and blood samples were obtained before and after each trial. Sweat samples were collected at the end of every test performed in hyperthermia. The samples were frozen at -80 °C until further analysis by ICP-MS.

RESULTS

Lower seric Mg levels were observed in both groups at the end of pre-acclimation tests. After acclimation, only EG experimented a decrease of Mg in serum after testing (p < .01). The urinary excretion was unaffected in the pre-acclimated period, but EG experimented an increase in Mg after trials in the post-acclimation evaluation (p < .01). Mg sweat loss decreased significantly after heat acclimation (p < .05). P did not undergo changes, except in its urinary excretion, which was elevated after the normothermia trial in the post-acclimation period (p < .05).

CONCLUSIONS

It seems that exercise in hyperthermia altered Mg status but not P homeostasis. Additionally, heat acclimation reduces Mg losses in sweat while increasing its loss in urine. Thus, Mg supplementation should be considered in unacclimated and acclimated subjects if physical exercise is going to be performed in hyperthermic conditions.

Effects of caffeine ingestion on the diurnal variation of cognitive and repeated high-intensity performances

The purpose of this study was to evaluate the effects of caffeine ingestion on the daily variation of cognitive (i.e., reaction time (RT), attention) and repeated high-intensity exercise performances. Fifteen active males (age: 20 ± 1 years, height: 174.3 ± 4.3 cm, body-mass: 70.8 ± 3.5 kg) performed cognitive and physical tasks under two different circumstances [after a placebo or caffeine ingestion (6 mg/kg of body-mass)] at six different time-of-day (07 h00, 09 h00, 11 h00, 13 h00, 15 h00 and 17 h00) in a randomized double-blind balanced crossover design. During each session, RT, attention and 5-m multiple shuttles run test' performances were recorded. During both the placebo and the caffeine conditions, a significant diurnal variation was found with improvement of cognitive performances recorded at 11 h00 (e.g., RT: 0.37 ± 0.02-s and 0.36 ± 0.02-s for placebo and caffeine respectively) and 17 h00 (e.g., RT: 0.37 ± 0.02-s and 0.35 ± 0.03-s for placebo and caffeine respectively) compared to (i.e., worst performances) 07 h00 (e.g., RT: 0.41 ± 0.02-s and 0.38 ± 0.02-s for placebo and caffeine respectively) and 13 h00 (e.g., RT: 0.41 ± 0.02-s and 0.38 ± 0.02-s for placebo and caffeine respectively) (p < 0.05). For physical performance, improved values were recorded at 17 h00 (e.g., total distance: 730.00 ± 43.92-m and 733.93 ± 43.08-m for placebo and caffeine respectively) compared to 07 h00 (e.g., total distance: 698.14 ± 45.39-m and 709.21 ± 43.78-m for placebo and caffeine respectively) (p < 0.05). Compared to placebo, cognitive (e.g., RT: by 6.4% at 07 h00, 4.1% at 09 h00, 3.4% at 11 h00, 6.0% at 13 h00, 3.8% at 15 h00 and 3.8% at 17 h00) and physical (e.g., total distance: 1.6% at 07 h00, 0.9% at 09 h00, 0.1% at 11 h00 (p > 0.05), 0.5% at 13 h00, 1.0% at 15 h00 and 0.5% at 17 h00) performances increased at all time-of-day (p < 0.05). In conclusion, cognitive and physical performances are time-of-day dependent and caffeine is an effective ergogenic aid to improves both cognitive and physical performances especially at the moment of their lowest values.

Caffeine: Well-known as psychotropic substance, but little as immunomodulator

To date, numerable reviews are found in the literature prominent to the effect of caffeine on the immune system, with the latest review published in 2006. Database screening reveals around three thousand articles that have been published during the last decade. Interestingly, less than hundred articles involved humans and rodents as tested models, out of which 20% is of interest to this paper excluding studies done on the nervous and cardiac systems, and in pregnant and cancer cases. In this review, information pertaining to the experimental setup of various studies, namely, the tested model, the study type (in vivo or in vitro), and caffeine dose is covered to discern the behaviour of major cellular and molecular immune components in light of caffeine exposure. Although it is hard to extrapolate results done in rodents to humans and to relay conclusions from in vitro to in vivo studies, most of the collected data favor the suppressive effects of caffeine on the proliferation of stimulated lymphocytes. Macrophages and natural killer cells also exhibited a reduced activity in the presence of high caffeine doses compared to increased activity at low doses. Immunosuppression is also supported by reduced levels of major anti-inflammatory cytokines, IL-2, IL-6, TNF-α. Moreover, certain innate and adaptive immune receptors, such as TLR1, TLR2, TLR4, and MHC class I-related chain B (MICB) molecules, exhibited decreased expression levels. Thus, we support the use of caffeine to alleviate various inflammatory conditions and autoimmune diseases.

Cortical neural arousal is differentially affected by type of physical exercise performed

Critical flicker frequency (CFF) threshold is a visual discrimination task designed to assess cortical neural arousal, where higher values are associated with increased information processing and improved cognitive function. Previous studies using CFF assessments before and after exercise have only used one type of exercise (e.g., short, fatiguing, steady state, time to exhaustion, etc.). Therefore, the purpose of this study was to determine the effect of exercise type and intensity on neural arousal. 22 recreational runners (10 men, 12 women; age 25 ± 6 years) volunteered to participate in the study. They completed a VO_2max test (short, fatiguing trial), and three 30-min treadmill runs (longer, steady-state trials) at rating of perceived exertion (RPE) levels of 13, 15, and 17. Before and after each exercise test, subjects were asked to complete the CFF test; M_tot and M_di were calculated, which are the average and difference of the ascending/descending frequency trials, respectively. There were no main effects found for either intensity (p = 0.641) or time (p = 0.283); there was, however, a significant interaction found (intensity*time; p = 0.001). In the VO_2max test and in the longer, steady-state runs at RPE13 and 15, there was no change in M_tot. There was a significant increase in M_tot after the run at RPE17 (p = 0.019). For M_di, the VO_2max test elicited a significant decrease (p = 0.005), but there was no change after the steady-state runs. The results suggest that short, fatiguing and longer, steady-state exercise affect cortical neural arousal differently. Increases in arousal, and perhaps the related domain of information processing, are more likely to come from steady-state exercise at a vigorous intensity.

Distinct sensitivity to caffeine-induced insomnia related to age

Caffeine acts by antagonizing the effect of the endogenous homeostatic sleep factor adenosine. In the current study we aimed to evaluate the pattern of caffeine-induced insomnia and its relation to age and sex in a general population sample derived from a web survey. The sample included 75,534 participants (28.1% men) from 18 to 75 years who answered self-report questionnaires by accessing a website in Brazilian Portuguese (BRAINSTEP project). In our sample, 3620 (17.0%) men and 9920 (18.3%) women reported insomnia due to caffeine intake. Caffeine-induced insomnia increased with aging in both men and women. This difference remained after adjusting for sociodemographic, psychiatric and sleep related variables as well as caffeine intake. Women showed higher proportion of caffeine-induced insomnia than men, but this difference did not remain after controlling for covariates. Also, individuals with caffeine-induced insomnia reported poorer sleep quality, higher latency to fall asleep and a higher proportion of psychiatric diagnoses and daily use of hypnotic drugs. In conclusion, our results show an age-associated increase in caffeine-induced insomnia and poorer mental health indicators among people with caffeine-induced insomnia complaints.