Independent and combined effects of carbohydrate and caffeine ingestion on aerobic cycling performance in the fed state

Effect of caffeine ingestion on time trial performance in cyclists: a systematic review and meta-analysis

BACKGROUND

Caffeine, widely recognized as an ergogenic aid, has undergone extensive research, demonstrating its effectiveness to enhance endurance performance. However, there remains a significant gap in systematically evaluating its effects on time trial (TT) performance in cyclists.

PURPOSE

This meta-analysis aimed to determine the efficacy of caffeine ingestion to increase cycling TT performance in cyclists and to evaluate the optimal dosage range for maximum effect.

METHODS

A search of four databases was completed on 1 December 2023. The selected studies comprised crossover, placebo-controlled investigations into the effects of caffeine ingestion on cycling TT performance. Completion time (Time) and mean power output (MPO) were used as performance measures for TT. Meta-analyses were performed using a random-effects model to assess the standardized mean differences (SMD) in individual studies.

RESULTS

Fifteen studies met the inclusion criteria for the meta-analyses. Subgroup analysis showed that moderate doses of caffeine intake (4-6 mg/kg) significantly improved cycling performance (SMD Time = -0.55, 95% confidence interval (CI) = -0.84 ~ -0.26, p < 0.01, I2 = 35%; SMD MPO = 0.44, 95% CI = 0.09 ~ 0.79, p < 0.05, I2 = 39%), while the effects of low doses (1-3 mg/kg) of caffeine were not significant (SMD Time = -0.34, 95% CI = -0.84 ~ 0.17, p = 0.19, I2 = 0%; SMD MPO = 0.31, 95% CI = -0.02 ~ 0.65, p = 0.07, I2 = 0%).

CONCLUSION

A moderate dosage (4-6 mg/kg) of caffeine, identified as the optimal dose range, can significantly improve the time trial performance of cyclists, while a low dose (1-3 mg/kg) does not yield improvement. In addition, the improvements in completion time and mean power output resulting from a moderate dose of caffeine are essentially the same in cycling time trails.

Does ergogenic effect of caffeine supplementation depend on CYP1A2 genotypes? A systematic review with meta-analysis

BACKGROUND

The ergogenic effects of caffeine intake on exercise performance are well-established, even if differences exist among individuals in response to caffeine intake. The genetic variation of a specific gene, human cytochrome P450 enzyme 1A2 (CYP1A2) (rs762551), may be one reason for this difference. This systematic review and meta-analysis aimed to comprehensively evaluate the influence of CYP1A2 gene types on athletes' exercise performance after caffeine intake.

METHODS

A literature search through 4 databases (Web of Science, PubMed, Scopus, and China National Knowledge Infrastructure) was conducted until March 2023. The effect size was expressed as the weighted mean difference (WMD) by calculating fixed effects meta-analysis if heterogeneity was not significant (I2 ≤ 50% and p ≥ 0.1). Subgroup analyses were performed based on AA and AC/CC genotype of CYP1A2.

RESULTS

The final number of studies meeting the inclusion criteria was 12 (n = 666 participants). The overall analysis showed that the cycling time trial significantly improved after caffeine intake (WMD = -0.48, 95% confidence interval (95%CI): -0.83 to -0.13, p = 0.007). In subgroup analyses, acute caffeine intake improved cycling time trial only in individuals with the A allele (WMD = -0.90, 95%CI: -1.48 to -0.33, p = 0.002), but not the C allele (WMD = -0.08, 95%CI: -0.32 to 0.17, p = 0.53). Caffeine supplementation did not influence the Wingate (WMD = 8.07, 95%CI: -22.04 to 38.18, p = 0.60) or countermovement jump test (CMJ) performance (WMD = 1.17, 95%CI: -0.02 to 2.36, p = 0.05), and these outcomes were not influenced by CYP1A2 genotype.

CONCLUSION

Participants with the CYP1A2 genotype with A allele improved their cycling time trials after caffeine supplementation. However, compared to placebo, acute caffeine supplementation failed to increase the Wingate or CMJ performance, regardless of CYP1A2 genotype.

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

Pre-exercise intake of caffeine (from ~3 to 9 mg/kg) has been demonstrated as an effective supplementation strategy to increase fat oxidation during fasted exercise. However, a pre-exercise meal can alter the potential effect of caffeine on fat oxidation during exercise as caffeine modifies postprandial glycaemic and insulinemic responses. Hypothetically, the effect of caffeine on fat oxidation may be reduced or even withdrawn during fed-state exercise. The present systematic review aimed to meta-analyse investigations on the effect of acute caffeine intake on the rate of fat oxidation during submaximal aerobic exercise performed in the fed state (last meal < 5 h before exercise). A total of 18 crossover trials with randomised and placebo-controlled protocols and published between 1982 and 2021 were included, with a total of 228 participants (185 males and 43 females). Data were extracted to compare rates of fat oxidation during exercise with placebo and caffeine at the same exercise intensity, which reported 20 placebo-caffeine pairwise comparisons. A meta-analysis of the studies was performed, using the standardised mean difference (SMD) estimated from Hedges' g, with 95% confidence intervals (CI). In comparison with the placebo, caffeine increased the rate of fat oxidation during fed-state exercise (number of comparisons (n) = 20; p = 0.020, SMD = 0.65, 95% CI = 0.20 to 1.20). Only studies with a dose < 6 mg/kg of caffeine (n = 13) increased the rate of fat oxidation during fed-state exercise (p = 0.004, SMD = 0.86, 95% CI = 0.27 to 1.45), while no such effect was observed in studies with doses ≥6 mg/kg (n = 7; p = 0.97, SMD = -0.03, 95% CI = -1.40 to 1.35). The effect of caffeine on fat oxidation during fed-state exercise was observed in active untrained individuals (n = 13; p < 0.001, SMD = 0.84, 95% CI = 0.39 to 1.30) but not in aerobically trained participants (n = 7; p = 0.27, SMD = 0.50, 95% CI = -0.39 to 1.39). Likewise, the effect of caffeine on fat oxidation was observed in caffeine-naïve participants (n = 9; p < 0.001, SMD = 0.82, 95% CI = 0.45 to 1.19) but not in caffeine consumers (n = 3; p = 0.54, SMD = 0.57, 95% CI = -1.23 to 2.37). In conclusion, acute caffeine intake in combination with a meal ingested within 5 h before the onset of exercise increased the rate of fat oxidation during submaximal aerobic exercise. The magnitude of the effect of caffeine on fat oxidation during fed-state exercise may be modulated by the dose of caffeine administered (higher with <6 mg/kg than with ≥6 mg/kg), participants' aerobic fitness level (higher in active than in aerobically trained individuals), and habituation to caffeine (higher in caffeine-naïve than in caffeine consumers).

The ergogenic effects of acute carbohydrate feeding on endurance performance: a systematic review, meta-analysis and meta-regression

A systematic review with meta-analysis was conducted to analyze the effect of carbohydrate (CHO) intake during exercise and some variables that could moderate this effect on endurance performance. We included 136 studies examining the effect of CHO ingestion during endurance exercise in the meta-analysis. The overall effect on performance showed a significant increase after CHO intake compared to the placebo/control groups. A larger effect of CHO consumption is observed in time to exhaustion than in time trials performance test. Moreover, the effectiveness of CHO supplementation was greater the longer the duration of the events. Also, there seems to be a higher effect of CHO intake in lower trained than in higher trained participants. In contrast, the magnitude of performance change of CHO intake is not affected by the dosage, ergometer used, the type of intake of the CHO ingestion and the type of CHO. In addition, a lower rate of perceived exertion and higher power and heart rate are significantly associated with the ingestion of CHO during endurance exercise. These results reinforce that acute CHO feeding is an effective strategy for improving endurance performance, especially, in less trained subjects participating in time to exhaustion tests of longer durations.

Caffeine Augments the Lactate and Interleukin-6 Response to Moderate-Intensity Exercise

INTRODUCTION

The release of interleukin (IL)-6 from contracting skeletal muscle is thought to contribute to some of the health benefits bestowed by exercise. This IL-6 response seems proportional to exercise volume and to lactate production. Unfortunately, high volumes of exercise are not feasible for all people. Caffeine augments the magnitude of increase in circulating IL-6 in response to high-intensity and long-duration exercise. Caffeine also increases circulating concentrations of lactate during exercise. We hypothesized that caffeine, ingested before short-duration, moderate-intensity exercise, would lead to greater circulating concentrations of lactate and IL-6 in a study population comprising both male and female individuals.

METHODS

Twenty healthy adults (10 men and 10 women age 25 ± 7 yr (mean ± SD)) completed 30 min of moderate-intensity cycle ergometer exercise, at an intensity corresponding to 60% peak oxygen uptake, after ingesting either caffeine (6 mg·kg -1 ) or placebo. Arterialized-venous blood was collected throughout each of the exercise sessions.

RESULTS

Compared with placebo, caffeine increased circulating concentrations of lactate at the end of exercise (5.12 ± 3.67 vs 6.45 ± 4.40 mmol·L -1 , P < 0.001) and after 30 min of inactive recovery (1.83 ± 1.59 vs 2.32 ± 2.09 mmol·L -1 , P = 0.006). Circulating IL-6 concentrations were greatest after 30 min of inactive recovery ( P < 0.001) and higher with caffeine (2.88 ± 2.05 vs 4.18 ± 2.97, pg·mL -1 , P < 0.001). Secondary analysis indicated sex differences; caffeine increased the IL-6 response to exercise in men ( P = 0.035) but not in women ( P = 0.358).

CONCLUSIONS

In response to moderate-intensity exercise, caffeine evoked greater circulating lactate concentrations in men and women but only increased the IL-6 response to exercise in men. These novel findings suggest that for men unwilling or unable to perform high-intensity and/or long-duration exercise, caffeine may augment the health benefits of relatively short, moderate-intensity exercise.

Caffeine Enhances 10-km Cycling Performance in Habitual Users Only When Preceded by Caffeine Abstinence

PURPOSE

The primary objective was to assess the performance benefits of caffeine (CAF) supplementation in habitual users. Importantly, this investigation was designed to account for the potential confounding effects of CAF withdrawal (CAFW), which are inherent and common in previous work.

METHODS

Ten CAF-consuming (394 [146] mg·d-1) recreational cyclists (age 39.1 [14.9] y; maximum oxygen consumption 54.2 [6.2] mL·kg-1·min-1) completed four 10-km time trials (TTs) on a cycle ergometer. On each trial day, 8 hours before reporting to the laboratory, subjects consumed 1.5 mg·kg-1 CAF to prevent withdrawal (no withdrawal [N]) or a placebo (PLA; withdrawal [W]). Then, 1 hour prior to exercise, they received either 6 mg·kg-1 CAF or PLA. These protocols were repeated 4 times, employing all combinations of N/W and CAF/PLA.

RESULTS

CAFW did not impair TT power output (PLAW vs PLAN P = .13). However, preexercise CAF only improved TT performance when compared to PLA in the W condition (CAFN vs PLAW P = .008, CAFW vs PLAW P = .04), not when W was mitigated (PLAN vs CAFN P = .33).

CONCLUSIONS

These data indicate that preexercise CAF only improves recreational cycling performance when compared to bouts preceded by CAF abstinence, suggesting that habitual users may not benefit from 6 mg·kg-1 of CAF and that previous work may have overstated the value of CAF supplementation for habitual users. Future work should examine higher doses of CAF for habitual users.

Synergy of carbohydrate and caffeine ingestion on physical performance and metabolic responses to exercise: A systematic review with meta-analysis

Carbohydrates (CHO) and caffeine (CAF) are two ergogenic aids commonly used among athletes to enhance performance. However, there is some controversy as to whether the concurrent intake of both supplements might result in an additive and synergistic improvement in exercise performance. The aim of this systematic review and meta-analysis was to determine the effect of adding CAF to a protocol of CHO ingestion, compared with the intake of each ergogenic aid alone and with placebo, on exercise performance and metabolic responses in healthy young physically active adults. This study was conducted according to PRISMA 2020 guidelines. The PubMed, Web of Science, Medline Complete, CINAHL, SPORTDiscus and CENTRAL databases were searched including randomized controlled trials (RCT) that were at least single blind. The risk of bias assessment was performed using the Cochrane Risk-of-Bias tool 2. Meta-analysis were performed on performance variables and rating of perceived exertion (RPE) using the random-effects model. Thirteen RCT with 128 participants (117 men and 11 women) were included in this study. The ingestion of CAF and CHO reduced sprint time during repeated sprint protocols in comparison with CHO isolated ingestion (SMD: -0.45; 95% CI: -0.85, -0.05) while there was a tendency for a reduction in the time employed during time trials (SMD: -0.36; 95% CI: -0.77, 0.05). The RPE tended to be lower with CAF and CHO compared with CHO isolated ingestion during steady-state exercise (SMD: -0.43; 95% CI: -0.91, 0.05) with no differences between conditions in performance trials (SMD: -0.05, 95% CI: -0.39, 0.29). Although most of the studies showed higher values of blood glucose when CHO was co-ingested with CAF compared with PLA, only two studies observed higher values with CHO and CAF co-ingestion with respect to the isolated intake of CHO. One study observed greater fat oxidation and lower glycogen use when CAF was added to CHO. In terms of cortisol levels, one study showed an increase in cortisol levels when CAF was co-ingested with CHO compared with PLA. In summary, concurrent CHO and CAF intake may produce an additive ergogenic effect respect of the isolated ingestion of CHO. This additive effect was present when CHO was provided by a 6-9% of CHO solution (maltodextrin/dextrin + fructose) and CAF is administered in a dose of 4-6.5 mg/kg.

Meta-Analysis of Carbohydrate Solution Intake during Prolonged Exercise in Adults: From the Last 45+ Years' Perspective

Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes' cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group-mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects' CRF level increased, with a 6-8% CHO solution composed of GL:FRU improving performance (exercise: 1-4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6-8% single-source CHO solution increasing performance in intermittent and 'stop and start' sports and an ~6% CHO solution appearing beneficial for 45-60 min exercises, but there were no significant differences between subjects' gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject's CRF.

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.

Carbohydrate supplementation: a critical review of recent innovations

PURPOSE

To critically examine the research on novel supplements and strategies designed to enhance carbohydrate delivery and/or availability.

METHODS

Narrative review.

RESULTS

Available data would suggest that there are varying levels of effectiveness based on the supplement/supplementation strategy in question and mechanism of action. Novel carbohydrate supplements including multiple transportable carbohydrate (MTC), modified carbohydrate (MC), and hydrogels (HGEL) have been generally effective at modifying gastric emptying and/or intestinal absorption. Moreover, these effects often correlate with altered fuel utilization patterns and/or glycogen storage. Nevertheless, performance effects differ widely based on supplement and study design. MTC consistently enhances performance, but the magnitude of the effect is yet to be fully elucidated. MC and HGEL seem unlikely to be beneficial when compared to supplementation strategies that align with current sport nutrition recommendations. Combining carbohydrate with other ergogenic substances may, in some cases, result in additive or synergistic effects on metabolism and/or performance; however, data are often lacking and results vary based on the quantity, timing, and inter-individual responses to different treatments. Altering dietary carbohydrate intake likely influences absorption, oxidation, and and/or storage of acutely ingested carbohydrate, but how this affects the ergogenicity of carbohydrate is still mostly unknown.

CONCLUSIONS

In conclusion, novel carbohydrate supplements and strategies alter carbohydrate delivery through various mechanisms. However, more research is needed to determine if/when interventions are ergogenic based on different contexts, populations, and applications.

Addition of Caffeine to a Carbohydrate Feeding Strategy Prior to Intermittent Exercise

The ergogenic effect of caffeine is well established, although no investigations providing a high carbohydrate feeding strategy (pre-exercise meal=2 g/kg BM) co-ingested with caffeine exist for soccer. This investigation examines the effect of caffeine in addition to a pre-exercise carbohydrate meal and drink mid-way through a soccer simulation. Eight recreational soccer players completed an 85-minute soccer simulation followed by an exercise capacity test (Yo-yo Intermittent Endurance test level 2) on two occasions. Prior to exercise participants consumed a high carbohydrate meal, with placebo or 5 mg/kg BM_-1 caffeine. No significant performance effect was identified (p=0.099) despite a 12.8% (109 m) improvement in exercise capacity following caffeine. Rates of carbohydrate and fat oxidation did not differ between conditions and nor were differences apparent for plasma glucose, fatty acids, glycerol, β-hydroxybutyrate (p>0.05). However, an increase in lactate was observed for caffeine (p=0.039). A significant condition effect on rating of perceived exertion was identified (p<0.001), with the overall mean for the protocol lowered to 11.7±0.9 au for caffeine compared to 12.8±1.3 au. Caffeine supplementation with a carbohydrate feeding strategy failed to affect metabolic and metabolite responses, although reductions in perception of exercise were observed. While a 12.8% increase in exercise capacity was noted the findings were not significant, possibly due to the small sample size.

The Effect of Acute Caffeine Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis

BACKGROUND

Caffeine is a widely used ergogenic aid with most research suggesting it confers the greatest effects during endurance activities. Despite the growing body of literature around the use of caffeine as an ergogenic aid, there are few recent meta-analyses that quantitatively assess the effect of caffeine on endurance exercise.

OBJECTIVES

To summarise studies that have investigated the ergogenic effects of caffeine on endurance time-trial performance and to quantitatively analyse the results of these studies to gain a better understanding of the magnitude of the ergogenic effect of caffeine on endurance time-trial performance.

METHODS

A systematic review was carried out on randomised placebo-controlled studies investigating the effects of caffeine on endurance performance and a meta-analysis was conducted to determine the ergogenic effect of caffeine on endurance time-trial performance.

RESULTS

Forty-six studies met the inclusion criteria and were included in the meta-analysis. Caffeine has a small but evident effect on endurance performance when taken in moderate doses (3-6 mg/kg) as well as an overall improvement following caffeine compared to placebo in mean power output (3.03 ± 3.07%; effect size = 0.23 ± 0.15) and time-trial completion time (2.22 ± 2.59%; effect size = 0.41 ± 0.2). However, differences in responses to caffeine ingestion have been shown, with two studies reporting slower time-trial performance, while five studies reported lower mean power output during the time-trial.

CONCLUSION

Caffeine can be used effectively as an ergogenic aid when taken in moderate doses, such as during sports when a small increase in endurance performance can lead to significant differences in placements as athletes are often separated by small margins.

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

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

Establishing a relationship between the effect of caffeine and duration of endurance athletic time trial events: A systematic review and meta-analysis

OBJECTIVES

Caffeine has well-documented benefits on endurance athletic performance. Because of caffeine's ergogenic effects of reducing perceived fatigue, it is hypothesized that as duration of athletic event increases, so will the effect size of caffeine upon performance. This study aims to examine the relationship between duration of endurance athletic event and the effect size of caffeine compared to placebo for athletic performance.

DESIGN

A systematic review and meta-analysis of placebo-controlled trials assessing the effects of caffeine in adults performing endurance athletic events.

METHODS

We searched MedLine, Web of Science, and review article references published through March 2016. We performed meta-analyses on placebo-controlled trials to determine the effect of the duration of an endurance athletic event on the standardized mean difference (Cohen's d) between the caffeine and placebo groups for athletic performance.

RESULTS

Forty articles including 56 unique comparison groups were included. Pooled results showed a Cohen's d of 0.33 (95% CI=0.21, 0.45; p=1.00; I²=0%). The effect of the duration of athletic event was significantly associated with Cohen's d (Relative Risk: 0.005; 95% CI=0.001, 0.009; p=0.024). For a 30min increase in duration of the athletic event, Cohen's d will increase by 0.150.

CONCLUSIONS

This study is the first to report on the statistical finding that the effect size of caffeine increases along with the increasing duration of the time trial event. Endurance athletes may especially benefit from caffeine for performance enhancement.

Caffeine and Physiological Responses to Submaximal Exercise: A Meta-Analysis

The aim of this study was to carry out a systematic review and meta-analysis of the effects of caffeine supplementation on physiological responses to submaximal exercise. A total of 26 studies met the inclusion criteria of adopting double-blind, randomized crossover designs that included a sustained (5-30 min) fixed-intensity bout of submaximal exercise (constrained to 60-85% maximal rate of oxygen consumption) using a standard caffeine dose of 3-6 mg·kg^-1 administered 30-90 min prior to exercise. Meta-analyses were completed using a random-effects model, and data are presented as raw mean difference (D) with associated 95% confidence limits (CLs). Relative to placebo, caffeine led to significant increases in submaximal measures of minute ventilation (D = 3.36 L·min^-1; 95% CL, 1.63-5.08; P = .0001; n = 73), blood lactate (D = 0.69 mmol·L^-1; 95% CL, 0.46-0.93; P < .00001; n = 208), and blood glucose (D = 0.42 mmol·L^-1; 95% CL, 0.29-0.55; P < .00001; n = 129). In contrast, caffeine had a suppressive effect on ratings of perceived exertion (D = -0.8; 95% CL, -1.1 to -0.6; P < .00001; n = 147). Caffeine had no effect on measures of heart rate (P = .99; n = 207), respiratory exchange ratio (P = .18; n = 181), or oxygen consumption (P = .92; n = 203). The positive effects of caffeine supplementation on sustained high-intensity exercise performance are widely accepted, although the mechanisms to explain that response are currently unresolved. This meta-analysis has revealed clear effects of caffeine on various physiological responses during submaximal exercise, which may help explain its ergogenic action.

Effects of caffeine on endurance capacity and psychological state in young females and males exercising in the heat

Acute caffeine ingestion is considered effective in improving endurance capacity and psychological state. However, current knowledge is based on the findings of studies that have been conducted on male subjects mainly in temperate environmental conditions, but some physiological and psychological effects of caffeine differ between the sexes. The purpose of this study was to compare the physical performance and psychological effects of caffeine in young women and men exercising in the heat. Thirteen male and 10 female students completed 2 constant-load walks (60% of thermoneutral peak oxygen consumption on a treadmill until volitional exhaustion) in a hot-dry environment (air temperature, 42 °C; relative humidity, 20%) after caffeine (6 mg·kg–1) and placebo (wheat flour) ingestion in a double-blind, randomly assigned, crossover manner. Caffeine, compared with placebo, induced greater increases (p < 0.05) in heart rate (HR) and blood lactate concentrations in both males and females but had no impact on rectal or skin temperatures or on walking time to exhaustion in subjects of either gender. Caffeine decreased (p < 0.05) ratings of perceived exertion and fatigue in males, but not in females. In females, but not in males, a stronger belief that they had been administered caffeine was associated with a shorter time to exhaustion. In conclusion, acute caffeine ingestion increases HR and blood lactate levels during exercise in the heat, but it has no impact on thermoregulation or endurance capacity in either gender. Under exercise-heat stress, caffeine reduces ratings of perceived exertion and fatigue in males but not in females.

The Effects of Caffeine Supplementation on Physiological Responses to Submaximal Exercise in Endurance-Trained Men

OBJECTIVES

The aim of this study was to evaluate the effects of caffeine on physiological responses to submaximal exercise, with a focus on blood lactate concentration ([BLa]).

METHODS

Using a randomised, single-blind, crossover design; 16 endurance-trained, male cyclists (age: 38 ± 8 years; height: 1.80 ± 0.05 m; body mass: 76.6 ± 7.8 kg; [Formula: see text]: 4.3 ± 0.6 L∙min-1) completed four trials on an electromagnetically-braked cycle ergometer. Each trial consisted of a six-stage incremental test (3 minute stages) followed by 30 minutes of passive recovery. One hour before trials 2-4, participants ingested a capsule containing 5 mg∙kg-1 of either caffeine or placebo (maltodextrin). Trials 2 and 3 were designed to evaluate the effects of caffeine on various physiological responses during exercise and recovery. In contrast, Trial 4 was designed to evaluate the effects of caffeine on [BLa] during passive recovery from an end-exercise concentration of 4 mmol∙L-1.

RESULTS

Relative to placebo, caffeine increased [BLa] during exercise, independent of exercise intensity (mean difference: 0.33 ± 0.41 mmol∙L-1; 95% likely range: 0.11 to 0.55 mmol∙L-1), but did not affect the time-course of [BLa] during recovery (p = 0.604). Caffeine reduced ratings of perceived exertion (mean difference: 0.5 ± 0.7; 95% likely range: 0.1 to 0.9) and heart rate (mean difference: 3.6 ± 4.2 b∙min-1; 95% likely range: 1.3 to 5.8 b∙min-1) during exercise, with the effect on the latter dissipating as exercise intensity increased. Supplement × exercise intensity interactions were observed for respiratory exchange ratio (p = 0.004) and minute ventilation (p = 0.034).

CONCLUSIONS

The results of the present study illustrate the clear, though often subtle, effects of caffeine on physiological responses to submaximal exercise. Researchers should be aware of these responses, particularly when evaluating the physiological effects of various experimental interventions.

A systematic review and meta-analysis of carbohydrate benefits associated with randomized controlled competition-based performance trials

Background

Carbohydrate supplements are widely used by athletes as an ergogenic aid before and during sports events. The present systematic review and meta-analysis aimed at synthesizing all available data from randomized controlled trials performed under real-life conditions.

Methods

MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched systematically up to February 2015. Study groups were categorized according to test mode and type of performance measurement. Subgroup analyses were done with reference to exercise duration and range of carbohydrate concentration. Random effects and fixed effect meta-analyses were performed using the Software package by the Cochrane Collaboration Review Manager 5.3.

Results

Twenty-four randomized controlled trials met the objectives and were included in the present systematic review, 16 of which provided data for meta-analyses. Carbohydrate supplementations were associated with a significantly shorter exercise time in groups performing submaximal exercise followed by a time trial [mean difference −0.9 min (95 % confidence interval −1.7, −0.2), p = 0.02] as compared to controls. Subgroup analysis showed that improvements were specific for studies administering a concentration of carbohydrates between 6 and 8 % [mean difference −1.0 min (95 % confidence interval −1.9, −0.0), p = 0.04]. Concerning groups with submaximal exercise followed by a time trial measuring power accomplished within a fixed time or distance, mean power output was significantly higher following carbohydrate load (mean difference 20.2 W (95 % confidence interval 9.0, 31.5), p = 0.0004]. Likewise, mean power output was significantly increased following carbohydrate intervention in groups with time trial measuring power within a fixed time or distance (mean difference 8.1 W (95 % confidence interval 0.5, 15.7) p = 0.04].

Conclusion

Due to the limitations of this systematic review, results can only be applied to a subset of athletes (trained male cyclists). For those, we could observe a potential ergogenic benefit of carbohydrate supplementation especially in a concentration range between 6 and 8 % when exercising longer than 90 min.

Electronic supplementary material

The online version of this article (doi:10.1186/s12970-016-0139-6) contains supplementary material, which is available to authorized users.

The influence of commercial energy shots on response time and power output in recreational cyclists

Background

Caffeine based energy shot products accounted for $1.3 billion in sales in 2011. Caffeine has been shown to confer numerous benefits during exercise and is oftentimes combined with ingredients such as carbohydrates and taurine in the hope of further performance improvement. The purpose of this project was to compare auditory response time, power output, and physiological responses between the ingestion of a CHO, PRO, caffeine supplement (CPC), a caffeine-taurine-niacin based supplement (CTN), and a placebo (PL) in commercially formulated products that make claims as to improving performance.

Methods

Fourteen subjects cycled an interval exercise of 70% VO₂max for 13 minutes and 90% of VO₂max for two minutes for a total of 120 minutes which was then followed by a six-minute power output (PO) task. Subjects ingested a total of 45 g CHO, 7.5 g PRO, and 375 mg caffeine for CPC while 512 mg caffeine and 1200 mg taurine were ingested for CTN throughout the exercise. The treatments were administered in a double blind, randomly assigned protocol. Response time was assessed by auditory response. Significance was set at p < 0.05.

Results

Average PO was significantly greater for CPC: 309 ± 60 W than CTN: 290 ± 57 W and PL: 282 ± 63 W. Response time was significantly faster for the CPC: 0.219 ± .049 s than CTN: 0.232 ± .060 s and PL: 0.228 ± .047 s. HR was significantly greater for CTN: 143 ± 16 bpm than CPC: 139 ± 16 bpm. RPE was significantly lower for CPC: 13.0 ± 1.7 than CTN: 13.5 ± 1.2 and PL: 13.8 ± 1.9. Blood glucose was greater for CPC: 5.5 ± 0.8 mM/L than CTN: 4.9 ± 0.7 mM/L and PL: 4.6 ± 1.1 mM/L. No significant differences were observed for RER.

Conclusions

The co-ingestion of CPC improved both cycling power output and auditory response time following 2 hours of moderate and high intensity interval cycling compared to CTN and PL. It is possible that the CPC treatment conferred not only a positive peripheral effect, but also a central effect. Even with a large caffeine dose, the combination of caffeine, taurine, niacin led to an inhibitory pattern which did not improve power output or response time performances over a PL.

Global metabolomic analysis of human saliva and plasma from healthy and diabetic subjects, with and without periodontal disease

Recent studies suggest that periodontal disease and type 2 diabetes mellitus are bi-directionally associated. Identification of a molecular signature for periodontitis using unbiased metabolic profiling could allow identification of biomarkers to assist in the diagnosis and monitoring of both diabetes and periodontal disease. This cross-sectional study identified plasma and salivary metabolic products associated with periodontitis and/or diabetes in order to discover biomarkers that may differentiate or demonstrate an interaction of these diseases. Saliva and plasma samples were analyzed from 161 diabetic and non-diabetic human subjects with a healthy periodontium, gingivitis and periodontitis. Metabolite profiling was performed using Metabolon's platform technology. A total of 772 metabolites were found in plasma and 475 in saliva. Diabetics had significantly higher levels of glucose and α-hydroxybutyrate, the established markers of diabetes, for all periodontal groups of subjects. Comparison of healthy, gingivitis and periodontitis saliva samples within the non-diabetic group confirmed findings from previous studies that included increased levels of markers of cellular energetic stress, increased purine degradation and glutathione metabolism through increased levels of oxidized glutathione and cysteine-glutathione disulfide, markers of oxidative stress, including increased purine degradation metabolites (e.g. guanosine and inosine), increased amino acid levels suggesting protein degradation, and increased ω-3 (docosapentaenoate) and ω-6 fatty acid (linoleate and arachidonate) signatures. Differences in saliva between diabetic and non-diabetic cohorts showed altered signatures of carbohydrate, lipid and oxidative stress exist in the diabetic samples. Global untargeted metabolic profiling of human saliva in diabetics replicated the metabolite signature of periodontal disease progression in non-diabetic patients and revealed unique metabolic signatures associated with periodontal disease in diabetics. The metabolites identified in this study that discriminated the periodontal groups may be useful for developing diagnostics and therapeutics tailored to the diabetic population.

Hypertension in an Adolescent Secondary to Performance-Enhancement Supplement Use

Objective: To describe the effects of performance-enhancing supplements and caffeine on the blood pressure (BP) of an adolescent male. Case Summary: An adolescent male presented to his primary care provider for a preseason athletic physical. On physical exam, his BP was 162/90, exceeding the 99th percentile for his age. It had been elevated during the previous 2 yearly physicals. He was referred to the Pediatric Preventive Cardiology Clinic for follow-up. Illegal substance use and renal trauma were ruled out. During the evaluation, the patient acknowledged using energy drinks and performance-enhancing supplements, the majority of which were caffeine-based. His intention was to continue the use of supplements, so lisinopril was initiated. On follow-up, however, the patient reported supplement discontinuation, intermittent medication adherence, and lower home-based BP readings. He was subsequently lost to follow-up. An objective causality assessment revealed that the adverse drug event was probable. Discussion: When working with adolescent patients, it is particularly important to conduct an in-depth interview reflecting lifestyle choices. Use of performance-enhancing supplements and caffeine for adolescent athletes has been well reported in the literature. Adolescent use of supplements may be driven by misguided beliefs and lack of knowledge about potentially detrimental health effects, such as altered heart rate and elevated BP. Little evidence-based research is available to provide treatment guidance for clinicians regarding potential effects. Conclusions: A thorough patient history, including specific questions probing for any recent or chronic use of nutritional supplements, including energy drinks, will help identify substances that may contribute to BP variations. Even mild BP elevations in adolescents should lead clinicians to further investigate supplement use and include specific questions on any product use within the past 24 hours, several days, or longer. Adolescents may not consider the potential for adverse health effects when ingesting performance-enhancing supplements or energy drinks.

Strategies of dietary carbohydrate manipulation and their effects on performance in cycling time trials

The relationship between carbohydrate (CHO) availability and exercise performance has been thoroughly discussed. CHO improves performance in both prolonged, low-intensity and short, high-intensity exercises. Most studies have focused on the effects of CHO supplementation on the performance of constant-load, time-to-exhaustion exercises. Nevertheless, in the last 20 years, there has been a consistent increase in research on the effects of different forms of CHO supplementation (e.g., diet manipulation, CHO supplementation before or during exercise) on performance during closed-loop exercises, such as cycling time trials (TTs). A TT is a highly reproducible exercise and reflects a more realistic scenario of competition compared with the time-to-exhaustion test. CHO manipulation has been performed in various time periods, such as days before, minutes before, during a TT or in a matched manner (e.g. before and during a TT). The purpose of this review is to address the possible effects of these different forms of CHO manipulation on the performance during a cycling TT. Previous data suggest that when a high-CHO diet (~70% of CHO) is consumed before a TT (24-72 h before), the mean power output increases and reduces the TT time. When participants are supplemented with CHO (from 45 to 400 g) prior to a TT (from 2 min to 6 h before the TT), mean power output and time seem to improve due to an increase in CHO oxidation. Similarly, this performance also seems to increase when participants ingest CHO during a TT because such consumption maintains plasma glucose levels. A CHO mouth rinse also improves performance by activating several brain areas related to reward and motor control through CHO receptors in the oral cavity. However, some studies reported controversial results concerning the benefits of CHO on TT performance. Methodological issues such as time of supplementation, quantity, concentration and type of CHO ingested, as well as the TT duration and intensity, should be considered in future studies because small variations in any of these factors may have beneficial or adverse effects on TT performance.