Effects of beetroot juice supplementation on intermittent high-intensity exercise efforts

Sports Supplement Consumption in 316 Federated Female Road Cyclists

Although the extensive use of sports supplements (SSs) is prevalent among cyclists, this area has been poorly explored; in fact, no studies have been conducted on this topic regarding women cyclists to date. This descriptive, cross-sectional study, which included 316 federated female road cyclists, aimed to analyze SS consumption patterns in relation to scientific evidence and various categories. SSs were categorized according to the groups and subgroups established by the Australian Sport Institute (AIS, 2023) based on the level of evidence supporting their use. The analysis found that 85.1% of the female road cyclists surveyed used SSs, with an average consumption of 7 ± 6 supplements per individual. Pharmacies (60.8%), dietitian-nutritionists (58.9%), and health status (60.1%) were the primary purchase location, source of information, and reason for use, respectively. The most frequently consumed supplements were sports bars (77.5%), sports gels (61.4%), and caffeine (49.1%). Significantly, 80% of the ten most commonly used supplements were from the group with the highest evidence level, as classified by the AIS, with an average intake of 5 ± 3 supplements per cyclist. In summary, the use of SSs is prevalent among female road cyclists, with reliable sources for both purchasing and obtaining advice on supplements.

Consuming Beetroot Juice Improves Slalom Performance and Reduces Muscle Soreness in Alpine Skiers under Hypoxic Conditions

Background

Beetroot juice (BRJ) supplementation has been shown to increase sports performance under hypoxic conditions and to improve athletes' recovery.

Objectives

In the present study, we aimed to investigate the effect of acute BRJ supplementation on slalom (SL) run performance and muscle soreness (MS) in Alpine skiers at moderate to high altitudes.

Methods

Ten male Alpine skiers received 220 mL of BRJ (8.9 mmol/L nitrate) or placebo (PLA) in 2 sessions with a 7-d wash out interval in a randomized, crossover, PLA-controlled, double-blind study. The 90-s box jump (BJ90), agility hexagonal obstacle jump (Hex Jump), and wall-sit tests were measured before on-hill SL runs in both sessions. After the functional tests, SL run performance was measured by time to complete 2 runs on the SL course; immediately after each SL run, the rating of perceived exertion (RPE) was recorded. In addition, perceived MS was recorded using the visual analog scale at 12, 24, and 48 h after the SL runs.

Results

The data were meticulously analyzed using 2-way repeated measures analysis of variance and paired t tests with significance set at P < 0.05. The findings were significant, indicating that compared with PLA, BRJ notably improved wall-sit and BJ90 performances (P < 0.05), while a substantial reduction was observed in RPE, Hex Jump, and MS (P < 0.05). A 1.74% shorter time to complete SL runs was observed in the BRJ group compared with the PLA group; however, there were no significant differences between the PLA and BRJ groups (P > 0.05).

Conclusions

These results underscore the potential of BRJ supplementation to enhance sports performance and reduce MS in Alpine skiers under hypoxic conditions.

Optimization of ultrasonic-assisted osmotic dehydration as a pretreatment for microwave drying of beetroot (Beta vulgaris)

The aim of this study was to optimize drying conditions during ultrasonic-assisted osmotic dehydration and subsequent microwave drying of red beetroot using the Box-Behnken design. For this purpose, ultrasonic-assisted osmotic dehydration was performed at different ultrasonic powers (50, 75, and 100 W), sonication times (20, 40, and 60 min), and salt concentrations (0%, 15%, and 30%). The subsequent drying procedures were conducted with 231, 518, and 805 W microwave power. The best condition was selected as 5.15% salt concentration, 20 min sonication time, 50 W ultrasonic power, and 716.45 W microwave power. The responses obtained under optimum conditions were determined as 68.06%, 9.54 mg GAE/g dm, 28.23, 42.66, and 3.08 for DPPH• % inhibition, total phenolic content, L*, a*, and b* values, respectively. While favorable impacts on color were detected for the applied pretreatments, the DPPH• scavenging activities of the dried beetroot were determined to be more significant after ultrasonic-assisted osmotic dehydration. Furthermore, the drying kinetics of beetroot were evaluated according to the Midilli et al. model. When the fit to the model was investigated, it was compatible at R2 > 0.90 level. As a result, the ultrasonic-assisted osmotic dehydration pretreatment performed before the microwave drying method preserved the quality characteristics of beetroot samples and was successfully applied.

Current Aspects of Selected Factors to Modulate Brain Health and Sports Performance in Athletes

This review offers a comprehensive evaluation of current aspects related to nutritional strategies, brain modulation, and muscle recovery, focusing on their applications and the underlying mechanisms of physiological adaptation for promoting a healthy brain, not only in athletes but also for recreationally active and inactive individuals. We propose that applying the rule, among others, of good sleep, regular exercise, and a properly balanced diet, defined as "SPARKS", will have a beneficial effect on the function and regeneration processes of the gut-brain-muscle axis. However, adopting the formula, among others, of poor sleep, stress, overtraining, and dysbiosis, defined as "SMOULDER", will have a detrimental impact on the function of this axis and consequently on human health as well as on athletes. Understanding these dynamics is crucial for optimizing brain health and cognitive function. This review highlights the significance of these factors for overall well-being, suggesting that adopting the "SPARKS" approach may benefit not only athletes but also older adults and individuals with health conditions.

Impact of a short-term nitrate and citrulline co-supplementation on sport performance in elite rowers: a randomized, double-blind, placebo-controlled crossover trial

PURPOSE

Citrulline (CIT) and beetroot extract (BR) have separately shown benefits in rowing performance-related outcomes. However, effects of combined supplementation remain to be elucidated. The main purpose of this research was to study the effects of 1 week of daily co-supplementation of 3.5 g BR (500 mg NO3-) plus 6 g CIT on aerobic performance, maximal strength, and high-intensity power and peak stroke in elite male rowers compared to a placebo and to a BR supplementation.

METHODS

20 elite rowers participated in this randomized, double-blind, placebo-controlled crossover trial completing 1 week of supplementation in each group of study: Placebo group (PLAG); BR group (BRG); and BR + CIT group (BR-CITG). 3 main physical tests were performed: aerobic performance, Wingate test and CMJ jump, and metabolic biomarkers and physiological outcomes were collected.

RESULTS

The Wingate all-out test showed no between-condition differences in peak power, mean power, relative power, or fatigue index (P > 0.05), but clearance of lactate was better in BR-CITG (P < 0.05). In the performance test, peak power differed only between PLAG and BR-CITG (P = 0.036), while VO2peak and maximum heart rate remained similar. CMJ jumping test results showed no between-condition differences, and blood samples were consistent (P > 0.200).

CONCLUSION

Supplementation with 3.5 g of BR extract plus 6 g of CIT for 7 days improved lactate clearance after Wingate test and peak power in a performance test. No further improvements were found, suggesting longer period of supplementation might be needed to show greater benefits.

Changes in Body Composition and Nutritional Periodization during the Training Macrocycle in Football-A Narrative Review

Nutrition periodization in football training is an important determinant of adaptation to cyclic training loads. Personalizing an athlete's diet is crucial to ensure optimal performance and body composition, depending on the phase of training. The purpose of this review is to answer the question of how the body composition of football players changes over the training macrocycle and how dietary recommendations should be tailored to specific training periods. The review of scientific evidence was conducted based on the available literature, typing in phrases related to training and nutrition periodization using the PubMed and Google Scholar database methodology tools. A literature search resulted in the selection of 346 sources directly related to the topic of the study, and then those with the highest scientific value were selected. There is a need to adjust energy and nutrient intake according to the different training phases in a football player's preparation cycle. During the preparatory phase, it is recommended to increase protein and energy intake to support anabolic processes and muscle mass development. During the competitive period, due to the intensity of matches and training, the importance of carbohydrates for glycogen replenishment and recovery is emphasized. The transition phase requires the regulation of caloric intake to prevent adverse changes in body composition. Hydration has been identified as a key element in each phase of training. Cooperation between coaches, nutritionists, and players is essential to optimize sports performance and rapid recovery, and the authors recommend continuous adaptation and nutritional optimization as an integral part of football training.

A Single Dose of Beetroot Juice not Enhance Performance during Intervallic Swimming Efforts

Despite the numerous scientific evidence on the topic, there is no clear and consistent answer that clarifies the true effects of beetroot juice (BJ) supplementation on different types of physical performance. This study examined whether an acute intake of BJ improves swimming performance, physiological variables of anaerobic metabolism, or subjective measures during high-intensity interval exercise with incomplete rest in competitive swimmers. Eighteen competitive swimmers (nine females and nine males) participated in this cross-over randomized, placebo-controlled, double-blind and counterbalanced study. In two trials, swimmers ingested BJ (70 mL, 6.4 mmol/400 mg NO3-) or placebo (PLA) (70 mL, 0.04 mmol/3 mg NO3-) three hours before a 2×6×100 m maximal effort with 40 seconds rest between repetitions and three minutes between blocks. The 100 m times showed no differences between groups (p > 0.05), but there was an interaction between block×repetition×condition (F5 = 3.10; p = 0.046; ηp2 = 0.54), indicating that the BJ group decreased the time of the sixth repetition of block2 compared to block1 (p = 0.01). Lactate concentration showed no differences between conditions (p > 0.05), but there was a main effect of block (ηp2 = 0.60) and a block×repetition interaction (ηp2 = 0.70), indicating higher values in block2 and increasing values between repetitions in block1. The subjective scales, perception of exertion (RPE) and Total Quality Recovery (TQR), showed no effects of condition (p > 0.05), but BJ swimmers had a greater TQR in the last repetitions of each block. In conclusion, a single dose of BJ did not enhance intermittent swimming performance or modified the physiological (lactate and heart rate) or subjective (RPE and TQR) variables; although there was a possible positive effect on the exercise tolerance at the end of effort.

Is There a Role of Beetroot Consumption on the Recovery of Oxidative Status and Muscle Damage in Ultra-Endurance Runners?

(1) Background: Ultra-endurance exercise involves a high physical impact, resulting in muscle damage, inflammatory response and production of free radicals that alter the body's oxidative state. Supplementation with antioxidants, such as beetroot, may improve recovery in ultra-endurance runners. The aim of this study was to determine whether there is a correlation between beetroot intake and recovery of serum oxidative status, inflammatory response and muscle damage parameters after an ultra-endurance race. (2) Methods: An observational and longitudinal study was conducted by means of surveys and blood samples collected from 32 runners during the IX Penyagolosa Trails CSP®® race and the two following days. The variables C-reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), the activity of the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GR) as well as the oxidative damage markers malondialdehyde (MDA), carbonyl groups (CG) and loss of muscle strength using the squat jump (SJ) test were analyzed to discriminate whether beetroot consumption can modulate the recovery of ultra-trail runners. (3) Results: Significant differences were observed between runners who ingested beetroot and those who did not, in terms of oxidative status, specifically in serum GPx activity at 24 and 48 h, muscle damage variables CK and LDH and regarding the SJ test results at the finish line. Therefore, the intake of supplements containing beetroot positively influences the recovery of serum oxidative status and muscle damage after ultra-endurance running.

Does Co-Supplementation with Beetroot Juice and Other Nutritional Supplements Positively Impact Sports Performance?: A Systematic Review

In the pursuit of enhanced athletic prowess in different disciplines, athletes constantly look for strategies to increase their physical performance, encompassing technical skills and dietary components, which inevitably, in most cases, include the incorporation of sports supplements. In recent years, there has been an increase in the number of athletes using ergogenic aids. In this context, scientific evidence must play a prominent role in either endorsing or warning against the use of these products, ensuring the preservation of health while promoting the theoretically established positive benefits. In this vein, beetroot juice (BJ) stands out as a key supplement as an ergogenic aid to improve sports performance, given its demonstrated influence on both aerobic and anaerobic exercise. However, despite widespread global demand, there remains a lack of understanding regarding the potential synergistic effects of combining BJ with other supplements. Consequently, our study aims to determine whether the combination of BJ with another nutritional supplement can enhance its beneficial effects and, therefore, optimize physical performance in humans. A comprehensive literature search was conducted in two major databases-Web of Science and PubMed-from 1 January 2018 to 29 January 2023, using specific keywords. After the exclusion criteria, six articles were selected for analysis. Therefore, our study shows that the effectiveness of combining BJ with another supplement mainly depends on the duration of the chronic intervention, which is where the greatest benefits have been observed.

The effects of beetroot and nitrate supplementation on body composition: a GRADE-assessed systematic review and meta-analysis

This systematic review and meta-analysis aimed to investigate the effects of beetroot (BR) or nitrate supplements on body composition indices. A systematic search was conducted for randomised controlled trials (RCT) published up to August 2022 among online databases including Scopus, PubMed/Medline, Web of Science and Embase. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCT. A total of twelve RCT met the inclusion criteria for this meta-analysis. The pooled effect size of included studies indicated that BR or nitrate supplementation did not change body weight (weighted mean differences (WMD): -0·14 kg, 95 % CI -1·22, 1·51; P = 0·836; I2 = 0 %), BMI (WMD: -0·07 kg/m2, 95 % CI -0·19,0·03; P = 0·174, I2 = 0 %), fat mass (WMD: -0·26 kg, 95 % CI -1·51, 0·98; P = 0·677, I2 = 0 %), waist circumference (WMD: -0·28 cm, 95 % CI -2·30, 1·74; P = 0·786, I2 = 0 %), body fat percentage (WMD: 0·18 %, 95 % CI -0·62, 0·99; P = 0·651, I2 = 0 %), fat-free mass (WMD: 0·31 kg, 95 % CI -0·31, 1·94; P = 0·703, I2 = 0 %) and waist-to-hip ratio (WMD: 0, 95 % CI -0·01, 0·02; P = 0·676, I2 = 0 %). Subgroup analyses based on trial duration, BR or nitrate dose, study design, baseline BMI and athletic status (athlete v. non-athlete) demonstrated similar results. Certainty of evidence across outcomes ranged from low to moderate. This meta-analysis study suggests that BR or nitrate supplements cannot efficiently ameliorate body composition indices regardless of supplement dosage, trial duration and athletic status.

Beetroot juice ingestion does not improve neuromuscular performance and match-play demands in elite female hockey players: a randomized, double-blind, placebo-controlled study

PURPOSE

Beetroot juice is a dietary supplement that contains high levels of inorganic nitrate (NO_3-) and that its intake has proven effective at increasing blood nitric oxide (NO) concentrations improving endurance performance. However, the effect of this supplement in team sport performance, especially in female athletes, has been barely studied. This study aimed to compare the acute effects of beetroot juice supplementation on neuromuscular performance and match-play demands in elite female field hockey players.

METHODS

Eleven elite female hockey players (22.8 ± 5.1 years) belonging to a bronze team medal in Eurohockey Club Champions Cup participated in this study. Participants were randomly divided into two groups undergoing a test battery with beetroot juice (70 mL, 6.4 mmol NO₃^-) or placebo (70 mL, 0.04 mmol NO₃^-) in two different days with one week between protocols. The neuromuscular test battery consisted of a countermovement jump, isometric handgrip strength (i.e., dominant hand), 20 m-sprint and repeated sprint ability test (RSA). Afterward, a simulated hockey match play (2 × 12.5 min) was performed and recorded by Global Positioning System (GPS).

RESULTS

No statistically significant improvements were observed in any physical parameters analysed comparing beetroot juice compared to placebo ingestion, countermovement jump (p = 0.776, ES = 0.16), isometric handgrip strength (p = 0.829; ES = - 0.08), 20 m sprint test (p = 0.227; ES = - 0.23), mean repeated sprint ability (p = 0.955, ES = 0.03) and in any physical match demands measured by GPS (p = 0.243-1.000; ES = 0.02-0.47).

CONCLUSION

Acute beetroot juice supplementation did not produce any statistically significant improvement in neuromuscular performance or match-play demands in elite female field hockey players.

TRIAL REGISTRATION

The study was registered in ClinicalTrials.gov with the following ID: NCT05209139. The study was retrospectively registered by 26 January 2022.

Dietary Nitrate Ingestion Does Not Improve Neuromuscular Performance in Male Sport Climbers

Beetroot juice (BJ) is commonly used as an ergogenic aid in endurance and team sports, however, the effect of this supplement on climbing performance is barely studied. The purpose of the current study was to investigate the effect of acute BJ ingestion on neuromuscular and biochemical variables in amateur male sport climbers. Ten physically active sport climbers (28.8 ± 3.7 years) underwent a battery of neuromuscular tests consisting of the half crimp test, the pull-up to failure test, the isometric handgrip strength test, the countermovement jump (CMJ) and the squat jump (SJ). Participants performed the neuromuscular test battery twice in a cross-over design separated by 10 days, 150 min after having consumed either 70-mL of BJ (6.4 mmol NO_3-) or a 70-mL placebo (0.0034 mmol NO_3-). In addition, nitrate (NO_3-) and nitrite (NO_2-) saliva concentrations were analysed, and a side effect questionnaire related to ingestion was administrated. No differences were reported in particular neuromuscular variables measured such as the CMJ (p = 0.960; ES = 0.03), the SJ (p = 0.581; ES = -0.25), isometric handgrip strength (dominant/non dominant) (p = 0.459-0.447; ES = 0.34-0.35), the pull-up failure test (p = 0.272; ES = 0.51) or the maximal isometric half crimp test (p = 0.521-0.824; ES = 0.10-0.28). Salivary NO_3- and NO_2- increased significantly post BJ supplementation compared to the placebo (p < 0.001), while no side effects associated to ingestion were reported (p = 0.330-1.000) between conditions (BJ/placebo ingestion). Acute dietary nitrate supplementation (70-mL) did not produce any statistically significant improvement in neuromuscular performance or side effects in amateur sport climbers.

Dietary Arginine and Citrulline Supplements for Cardiovascular Health and Athletic Performance: A Narrative Review

The global market for nutritional supplements (NS) is growing rapidly, and the use of L-arginine (Arg), L-citrulline (Cit), and citrulline malate (CitMal) supplements has been shown to enhance cardiovascular health and athletic performance. Over the past decade, Arg, Cit, and CitMal supplements have received considerable attention from researchers in the field of exercise nutrition, who have investigated their potential effects on hemodynamic function, endothelial function, aerobic and anaerobic capacity, strength, power, and endurance. Previous studies were reviewed to determine the potential impact of Arg, Cit, and CitMal supplements on cardiovascular health and exercise performance. By synthesizing the existing literature, the study aimed to provide insight into the possible uses and limitations of these supplements for these purposes. The results showed that both recreational and trained athletes did not see improved physical performance or increased nitric oxide (NO) synthesis with 0.075 g or 6 g doses of Arg supplement per body weight. However, 2.4 to 6 g of Cit per day for 7 to 16 days of various NSs had a positive impact, increasing NO synthesis, enhancing athletic performance indicators, and reducing feelings of exertion. The effects of an 8 g acute dose of CitMal supplement were inconsistent, and more research is needed to determine its impact on muscle endurance performance. Based on the positive effects reported in previous studies, further testing is warranted in various populations that may benefit from nutritional supplements, including aerobic and anaerobic athletes, resistance-trained individuals, elderly people, and clinical populations, to determine the impact of different doses, timing of ingestion, and long-term and acute effects of Arg, Cit, and CitMal supplements on cardiovascular health and athletic performance.

Does Beetroot Supplementation Improve Performance in Combat Sports Athletes? A Systematic Review of Randomized Controlled Trials

While studies on dietary nitrate (NO₃^-) supplementation and its impact on combat sports performance are increasing, finite conclusions from currently available investigations remain unclear. Thus, the present systematic review examined the acute and chronic ergogenic effect(s) of dietary nitrate intake from beetroot on different aspects of combat sports performance. A systematic search for randomized placebo-controlled studies investigating the effects of beetroot supplementation on combat sports outcomes was performed through Scopus, PubMed/MEDLINE, Web of Science, Scielo, Sport Discus, and Cochrane Library databases up to 2 January 2023. The different terms related to beetroot and to combat sports were connected in the search strategies using the Boolean operators 'AND' and 'OR'. A total of nine studies with good methodological quality (based on the Cochrane risk of bias tool) fulfilled the inclusion criteria. Seven studies used an acute supplementation strategy, while the other two studies utilized chronic supplementation. Findings showed beetroot intake may be an effective tool to improve oxidative metabolism and muscle force production (i.e., isokinetic and isometric) in combat sports athletes. However, these effects may depend on the population, intake duration, muscle group activated, and exercise type. Future studies are required to (1) understand the effects on female athletes and (2) elucidate the impacts of dosing protocols and specific exercise modalities for enhancing combat sports performance.

Effects of beetroot juice intake on repeated performance of competitive swimmers

Background: Beetroot juice is a sport supplement with a high level of evidence on the physical performance enhancement. However, in swimming, there is no clear data about the effects of beetroot juice on performance. Objective: To investigate whether an acute intake of beetroot juice (BJ) improves the performance of competitive swimmers in a repeated maximum swimming effort. Method: Thirteen national-level swimmers (six females and seven males), participated in this randomized, double-blind crossover study. In two different trials, swimmers ingested a 70-mL placebo shot (.04 mmol NO₃ ^-; PLA) or a 70-mL Beet-It shot (6.4 mmol of NO₃ ^-beet juice [BJ]) 3 h before undergoing a 6 × 100-m front-crawl maximal effort test with 7 min rest between each 100 m. Results: Overall, 100-m times showed no difference between the BJ and PLA groups (p = .364), although a possibly shorter time was observed for BJ in the last repetition (p = .104; mean difference [MD] = -.99 s, mean-based inference [MBI] = 49/51/0). Participants in the BJ condition showed a possibly lower rate of perceived exertion in the first (p = .242, MD = -.85, MBI = 70/28/2) and second repetitions (p = .165, MD = 1.15, MBI = 83/16/1), whereas Total Quality Recovery scale scores were likely higher in the first (p = .110, MD = 1.15, MBI = 83/16/1) and third (p = .082, MD = -.77, MBI = 70/29/1) repetitions compared with those in the PLA group. Blood lactate concentration [La⁺] levels showed no differences between groups in any of the repetitions (p > .05, unclear), and we observed an increase in 100-m times for both BJ and PLA (BJ: p = .014, MD = -1.51 s; PLA: p = .029, MD = -1.57 s) after the fifth repetition. Conclusion: No clear differences in performance were observed in a 6 × 100-m repeated sprint test by competitive swimmers when supplementing (or not) with BJ. However, there was a trend toward a better recovery between efforts and a better tolerance of fatigue when swimmers ingested BJ.

Influence of Beetroot Juice Ingestion on Neuromuscular Performance on Semi-Professional Female Rugby Players: A Randomized, Double-Blind, Placebo-Controlled Study

PURPOSE

Beetroot juice (BRJ) is considered an ergogenic aid with good to strong evidence for improving human performance in sport modalities with similar demands to rugby. However, most of the studies were realized in male athletes with limited evidence in female athletes. Thus, the aim of this study was to explore the acute ingestion of BRJ in female rugby players.

METHODS

Fourteen semi-professional female rugby players (25.0 ± 3.7 years) belonging to a team from the First Spanish Female Rugby Division participated in this study. Participants were randomly divided into two groups that realized a neuromuscular battery after BRJ (140mL, 12.8 mmol NO₃^-) or placebo (PLAC, 140 mL, 0.08 mmol NO₃^-) ingestion on two different days separated by one week between protocols. The neuromuscular test battery consisted of a countermovement jump (CMJ), isometric handgrip strength (i.e., dominant), 10-m and 30-m sprint, agility t-test and Bronco test. Afterwards, participants reported a rate of perception scale (6-20 points) and side effects questionnaire associated with BRJ or PLAC ingestion.

RESULTS

Statistically significant improvements were observed in CMJ (7.7%; p = 0.029; ES = 0.62), while no differences were reported in dominant isometric handgrip strength (-1.7%; p = 0.274; ES = -0.20); 10-m and 30-m sprint (0.5-0.8%; p = 0.441-0.588; ES = 0.03-0.18); modified agility t-test (-0.6%; p = 0.503; ES = -0.12) and Bronco test (1.94%; p = 0.459; ES = 0.16).

CONCLUSIONS

BRJ ingestion could improve neuromuscular performance in the CMJ test, while no differences in sprint (10-m and 30-m sprint test), agility, isometric handgrip strength and endurance performance (i.e., Bronco test) were reported.

Acute Effects of Beetroot Juice Supplementation on Isometric Muscle Strength, Rate of Torque Development and Isometric Endurance in Young Adult Men and Women: A Randomized, Double-Blind, Controlled Cross-Over Pilot Study

This study was conducted to investigate the effect of concentrated beetroot juice on isometric strength and knee extensor muscle endurance in healthy adults. We conducted a randomized cross-over, double-blind experiment in which participants (18 healthy, physically active adults, 9 men, 9 women) consumed either concentrated beetroot juice (140 mL) or low-nitrate control supplement 2.5 h before the measurement. Isometric maximum strength (peak torque), explosive strength (isometric rate of torque development), and strength endurance at 50% of peak torque were measured on an isometric dynamometer. The results showed that concentrated beetroot juice had no effect on the maximum voluntary isometric strength and rate of torque development of the knee extensors. The only exception was the maximum rate of torque development, for which a positive influence was demonstrated only in men. As for the endurance of the knee extensors, the supplement had a positive effect in men (endurance time increased from 86.4 ± 46.1 s to 103.4 ± 53.7 s; p = 0.022), but not in women. The absence of effect on maximal voluntary strength is consistent with previous research. One the other hand, improvements in endurance and rate of torque development in men only point to an important aspect of a previously under-researched area of sex-specific responses to nitrate supplementation.

Effects of Citrulline Supplementation on Different Aerobic Exercise Performance Outcomes: A Systematic Review and Meta-Analysis

Supplementation with Citrulline (Cit) has been shown to have a positive impact on aerobic exercise performance and related outcomes such as lactate, oxygen uptake (VO₂) kinetics, and the rate of perceived exertion (RPE), probably due to its relationship to endogenous nitric oxide production. However, current research has shown this to be controversial. The main objective of this systematic review and meta-analysis was to analyze and assess the effects of Cit supplementation on aerobic exercise performance and related outcomes, as well as to show the most suitable doses and timing of ingestion. A structured literature search was carried out by the PRISMA^® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PICOS guidelines in the following databases: Pubmed/Medline, Scopus, and Web of Science (WOS). A total of 10 studies were included in the analysis, all of which exclusively compared the effects of Cit supplementation with those of a placebo group on aerobic performance, lactate, VO₂, and the RPE. Those articles that used other supplements and measured other outcomes were excluded. The meta-analysis was carried out using Hedges’ g random effects model and pooled standardized mean differences (SMD). The results showed no positive effects of Cit supplementation on aerobic performance (pooled SMD = 0.15; 95% CI (−0.02 to 0.32); I², 0%; p = 0.08), the RPE (pooled SMD = −0.03; 95% CI (−0.43 to 0.38); I², 49%; p = 0.9), VO₂ kinetics (pooled SMD = 0.01; 95% CI (−0.16 to 0.17); I², 0%; p = 0.94), and lactate (pooled SMD = 0.25; 95% CI (−0.10 to 0.59); I², 0%; p = 0.16). In conclusion, Cit supplementation did not prove to have any benefits for aerobic exercise performance and related outcomes. Where chronic protocols seemed to show a positive tendency, more studies in the field are needed to better understand the effects.

The Effects of Consuming Amino Acids L-Arginine, L-Citrulline (and Their Combination) as a Beverage or Powder, on Athletic and Physical Performance: A Systematic Review

Consumption of amino acids L-arginine (L-Arg) and L-citrulline (L-Cit) are purported to increase nitric oxide (NO) production and improve physical performance. Clinical trials have shown relatively more favorable outcomes than not after supplementing with L-Cit and combined L-Arg and L-Cit. However, in most studies, other active ingredients such as malate were included in the supplement. Therefore, the aim of this study was to determine the efficacy of consuming standalone L-Arg, L-Cit, and their combination (in the form of powder or beverage) on blood NO level and physical performance markers. A systematic review was undertaken following PRISMA 2020 guidelines (PROSPERO: CRD42021287530). Four electronic databases (PubMed, Ebscohost, Science Direct, and Google scholar) were used. An acute dose of 0.075 g/kg of L-Arg or 6 g L-Arg had no significant increase in NO biomarkers and physical performance markers (p > 0.05). Consumption of 2.4 to 6 g/day of L-Cit over 7 to 16 days significantly increased NO level and physical performance markers (p < 0.05). Combined L-Arg and L-Cit supplementation significantly increased circulating NO, improved performance, and reduced feelings of exertion (p < 0.05). Standalone L-Cit and combined L-Arg with L-Cit consumed over several days effectively increases circulating NO and improves physical performance and feelings of exertion in recreationally active and well-trained athletes.

The Impact of Supplements on Sports Performance for the Trained Athlete: A Critical Analysis

ABSTRACT

Elite athletes often use nutritional supplements to improve performance and gain competitive advantage. The prevalence of nutrient supplementation ranges from 40% to 100% among trained athletes, yet few athletes have a trusted source of information for their supplement decisions and expected results. This critical analysis review evaluates systematic reviews, meta-analyses, randomized control trials, and crossover trials investigating commonly used supplements in sport: caffeine, creatine, beta-alanine (β-alanine), branched chain amino acids (BCAAs), and dietary nitrates. By reviewing these supplements' mechanisms, evidence relating directly to improving sports performance, and ideal dosing strategies, we provide a reference for athletes and medical staff to personalize supplementation strategies. Caffeine and creatine impact power and high-intensity athletes, β-alanine, and BCAA mitigate fatigue, and dietary nitrates improve endurance. With each athlete having different demands, goals to maximize their performance, athletes and medical staff should collaborate to personalize supplementation strategies based on scientific backing to set expectations and potentiate results.

Acute Effects of Beetroot Juice Supplements on Lower-Body Strength in Female Athletes: Double-Blind Crossover Randomized Trial

BACKGROUND

Beetroot juice (BRJ) is used as an ergogenic aid, but no previous study has analyzed the effect this supplement has on the production of explosive force and muscular endurance in physically active women.

HYPOTHESIS

BRJ improves explosive force and muscular endurance in the lower limbs of physically active women.

STUDY DESIGN

Randomized double-blind crossover study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Fourteen physically active women performed a countermovement jump (CMJ) test, a back squat test for assessing velocity and power at 50% and 75% of one-repetition maximum (1RM), and the number of repetitions on a muscular endurance test consisting of 3 sets at 75% of 1RM in a resistance training protocol comprising 3 exercises (back squat, leg press, and leg extension). The participants performed the test in 2 sessions, 150 minutes after ingesting 70 mL of either BRJ (400 mg of nitrate) or a placebo (PLA).

RESULTS

A greater maximum height was achieved in the CMJ after consuming BRJ compared with a PLA (P = 0.04; effect size (ES) = 0.34). After a BRJ supplement at 50% 1RM, a higher mean velocity [+6.7%; P = 0.03; (ES) = 0.39 (-0.40 to 1.17)], peak velocity (+6%; P = 0.04; ES = 0.39 [-0.40 to 1.17]), mean power (+7.3%; P = 0.02; ES = 0.30 [-0.48 to 1.08]) and peak power (+6%; P = 0.04; ES = 0.20 [-0.59 to 0.98]) were attained in the back squat test. In the muscular endurance test, BRJ increased performance compared with the PLA (P < 0.00; η_p² = 0.651).

CONCLUSION

BRJ supplements exert an ergogenic effect on the ability to produce explosive force and muscular endurance in the lower limbs in physically active women.

CLINICAL RELEVANCE

If physically active women took a BRJ supplement 120 minutes before resistance training their performance could be enhanced.

Effects of Multi-Ingredient Pre-Workout Supplement and Caffeine on Bench Press Performance: A Single-Blind Cross-Over Study

The problem addressed in this study is the appropriateness of using different pre-training supplementation strategies and their ability to improve training performance and psychological measures. The aim of the study is the evaluation of the effectiveness of a multi-ingredient pre-workout supplement (MIPS) containing beta-alanine, L-citrulline malate, arginine alpha-ketoglutarate, L-taurine, L-tyrosine and caffeine compared to an exact dosage of anhydrous caffeine in bench press strength endurance, feeling scale (FS), felt arousal scale (FAS) and session rating of perceived exertion (sRPE). A group of fifteen resistance-trained males, weighing 83.92 ± 8.95 kg and having an average of 5.6 ± 3.38 years of training experience, tested their bench press 10 repetition maximum (79.01 ± 12.13). In a cross-over manner, they participated in two sessions where they were blinded to the order of supplementation they were given: either a MIPS including caffeine or caffeine alone. They completed the bench press strength endurance test with pre- and post-training psychological assessments containing FS, FAS and sRPE. Bench press repetition volume was greater after anhydrous caffeine than MIPS supplementation with no difference in psychological measures. These results indicate that MIPS supplementation is less ergogenic and cost effective than caffeine alone.

Functional in vitro characterization of small extracellular vesicles isolated from menstrual blood-derived mesenchymal stem/stromal cells

Menstrual blood is a rich source of mesenchymal stem/stromal cells (MenSCs) with a diverse potential to differentiate into various cell types. Similar to other cells, MenSCs produce extracellular vesicles from which, small extracellular vesicles have attracted much interest due to their therapeutic and regenerative capacities. Here using in vitro approaches, several properties of MenSC-derived small extracellular vesicles (MEX) have been investigated. HUVEC angiogenesis assay was used to evaluate the proangiogenic function of MEX. The immune regulatory property of MEX was assessed using a T cell proliferation assay. Proliferation, migration, and gene expression of primary fibroblasts were selected to determine the scar-related activity of MEX. Finally, the anti-cancer effect of MEX on the proliferation of cancerous cell lines was tested. Our results demonstrated that the small extracellular vesicles isolated from MenSCs have proangiogenic and immune-suppressive abilities. Moreover, these vesicles performed as an anti-proliferative agent for cancerous cell lines. MEX was also able to reduce the migration of primary fibroblasts. In summary, MEX has shown promising in vitro characteristics for regenerative applications. They may offer a great cell-free strategy with therapeutic potential for a diverse range of diseases. For future therapeutic applications and further clinical translation, more studies are needed to elucidate the involved mechanisms. This article is protected by copyright. All rights reserved.

The Effects of Dietary Nitrate Supplementation on Explosive Exercise Performance: A Systematic Review

Dietary nitrate supplementation is evidenced to induce physiological effects on skeletal muscle function in fast-twitch muscle fibers and may enhance high-intensity exercise performance. An important component of sport-specific skills is the ability to perform explosive movements; however, it is unclear if nitrate supplementation can impact explosive efforts. We examined the existing evidence to determine whether nitrate supplementation improves explosive efforts lasting ≤ 6 s. PubMed, Scopus and Directory of Open Access Journals (DOAJ) were searched for articles using the following search strategy: (nitrate OR nitrite OR beetroot) AND (supplement OR supplementation) AND (explosive OR power OR high intensity OR high-intensity OR sprint* OR “athletic performance”). Out of 810 studies, 18 were eligible according to inclusion criteria. Results showed that 4 of the 10 sprint-type studies observed improved sprint time, power output, and total work in cycling or running, whereas 4 of the 10 resistance-based exercise studies observed improvements to power and velocity of free-weight bench press as well as isokinetic knee extension and flexion at certain angular velocities. These results suggest that nitrate potentially improves explosive exercise performance, but further work is required to clarify the factors influencing the efficacy of nitrate in different exercise modalities.

Green Medicine: A Novel Preparation Method for Green Synthesizing of Iron Nanoparticles Derived from Beta Vulgaris Extract

This study aimed to synthesize new iron nanoparticles (FeNPs) using Beta Vulgaris (beet) extract as a reducing agent and test its bioactivity against Pseudomonas aeruginosa. In total, five grams of beet were ground and dissolved in 50 ml of distilled water and filtered with filter paper. The filtrate was then isolated. Different concentrations, including 25%, 50%, 100%, and 150% of the isolated filtrated substances were prepared from the stock solution. FeNPs were prepared from 0.5 moles of iron nitrate salt (Fe(NO₃)3.9H₂O which was mixed with the aqueous solution of beet extract. Moreover, two aqueous solutions were mixed thoroughly with continuous stirring at 60°C. The FeNPs were isolated, separated, identified, and characterized using different physicochemical techniques (i.e., X-Ray Diffraction, Ultraviolet-visible Spectroscopy, and Atomic Force Microscope). Subsequently, the bioactivity of the NPs against P. aeruginosa was tested. The Vitek antibiotic test for P. aeruginosa showed resistant activity against Piperacillin/Tazobactam, Cefazolin, Ceftazidime, Cefepime, Imipenem, Cefepime, Ceftazidime, Cefazolin, and Piperacillin/Tazobactam; in addition, it revealed high sensitivity toward Tobramycin, Levofloxacin, Trimethoprim, Gentamicin, Nitrofurantoin, and Ciprofloxacin. The FeNPs at 50% concentration showed the best inhibition activity against P. aeruginosa. In the current study, novel FeNPs were synthesized which showed activity toward P. aeruginosa that could be used to replace certain antibiotics as a green medicine.

The Effect of Beetroot Ingestion on High-Intensity Interval Training: A Systematic Review and Meta-Analysis

Dietary nitrate supplementation has shown promising ergogenic effects on endurance exercise. However, at present there is no systematic analysis evaluating the effects of acute or chronic nitrate supplementation on performance measures during high-intensity interval training (HIIT) and sprint interval training (SIT). The main aim of this systematic review and meta-analysis was to evaluate the evidence for supplementation of dietary beetroot-a common source of nitrate-to improve peak and mean power output during HIIT and SIT. A systematic literature search was carried out following PRISMA guidelines and the PICOS framework within the following databases: PubMed, ProQuest, ScienceDirect, and SPORTDiscus. Search terms used were: ((nitrate OR nitrite OR beetroot) AND (HIIT or high intensity or sprint interval or SIT) AND (performance)). A total of 17 studies were included and reviewed independently. Seven studies applied an acute supplementation strategy and ten studies applied chronic supplementation. The standardised mean difference for mean power output showed an overall trivial, non-significant effect in favour of placebo (Hedges' g = -0.05, 95% CI -0.32 to 0.21, Z = 0.39, p = 0.69). The standardised mean difference for peak power output showed a trivial, non-significant effect in favour of the beetroot juice intervention (Hedges' g = 0.08, 95% CI -0.14 to 0.30, Z = 0.72, p = 0.47). The present meta-analysis showed trivial statistical heterogeneity in power output, but the variation in the exercise protocols, nitrate dosage, type of beetroot products, supplementation strategy, and duration among studies restricted a firm conclusion of the effect of beetroot supplementation on HIIT performance. Our findings suggest that beetroot supplementation offers no significant improvement to peak or mean power output during HIIT or SIT. Future research could further examine the ergogenic potential by optimising the beetroot supplementation strategy in terms of dosage, timing, and type of beetroot product. The potential combined effect of other ingredients in the beetroot products should not be undermined. Finally, a chronic supplementation protocol with a higher beetroot dosage (>12.9 mmol/day for 6 days) is recommended for future HIIT and SIT study.

Effects of Beetroot Juice Supplementation on Cognitive Function, Aerobic and Anaerobic Performances of Trained Male Taekwondo Athletes: A Pilot Study

Studies have shown that nitrate (NO₃⁻)-rich beetroot juice (BJ) supplementation improves endurance and high-intensity intermittent exercise. The dose–response effects on taekwondo following BJ supplementation are yet to be determined. This study aimed to investigate two acute doses of 400 mg of NO₃⁻ (BJ-400) and 800 mg of NO₃⁻ (BJ-800) on taekwondo-specific performance and cognitive function tests compared with a placebo (PL) and control (CON) conditions. Eight trained male taekwondo athletes (age: 20 ± 4 years, height: 180 ± 2 cm, body mass: 64.8 ± 4.0 kg) completed four experimental trials using a randomized, double-blind placebo-controlled design: BJ-400, BJ-800, PL, and CON. Participants consumed two doses of BJ-400 and BJ-800 or nitrate-depleted PL at 2.5 h prior to performing the Multiple Frequency Speed of Kick Test (FSKT). Countermovement jump (CMJ) was performed before the (FSKT) and PSTT, whereas cognitive function was assessed (via the Stroop test) before and after supplementation and 10 min following PSTT. Blood lactate was collected before the CMJ tests immediately and 3 min after the FSKT and PSST; rating of perceived exertion (RPE) was recorded during and after both specific taekwondo tests. No significant differences (p > 0.05), with moderate and large effect sizes, between conditions were observed for PSTT and FSKT performances. In addition, blood lactate, RPE, heart rate, and CMJ height were not significantly different among conditions (p > 0.05). However, after the PSTT test, cognitive function was higher in BJ-400 compared to other treatments (p < 0.05). It was concluded that acute intake of 400 and 800 mg of NO₃⁻ rich BJ reported a moderate to large effect size in anaerobic and aerobic; however, no statistical differences were found in taekwondo-specific performance.

Portuguese Football Federation consensus statement 2020: nutrition and performance in football

Nutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.

Dietary Supplementation for Para-Athletes: A Systematic Review

The use of dietary supplements is high among athletes and non-athletes alike, as well as able-bodied individuals and those with impairments. However, evidence is lacking in the use of dietary supplements for sport performance in a para-athlete population (e.g., those training for the Paralympics or similar competition). Our objective was to examine the literature regarding evidence for various sport supplements in a para-athlete population. A comprehensive literature search was conducted using PubMed, SPORTDiscus, MedLine, and Rehabilitation and Sports Medicine Source. Fifteen studies met our inclusion criteria and were included in our review. Seven varieties of supplements were investigated in the studies reviewed, including caffeine, creatine, buffering agents, fish oil, leucine, and vitamin D. The evidence for each of these supplements remains inconclusive, with varying results between studies. Limitations of research in this area include the heterogeneity of the subjects within the population regarding functionality and impairment. Very few studies included individuals with impairments other than spinal cord injury. Overall, more research is needed to strengthen the evidence for or against supplement use in para-athletes. Future research is also recommended on performance in para-athlete populations with classifiable impairments other than spinal cord injuries.

Dietary and Ergogenic Supplementation to Improve Elite Soccer Players' Performance

BACKGROUND

Soccer is an extremely competitive sport, where the most match important moments can be defined in detail. Use of ergogenic supplements can be crucial to improve the performance of a high-performance athlete. Therefore, knowing which ergogenic supplements are important for soccer players can be an interesting strategy to maintain high level in this sport until final and decisive moments of the match. In addition, other supplements, such as dietary supplements, have been studied and increasingly referenced in the scientific literature. But, what if ergogenic supplements were combined with dietary supplements? This review brings some recommendations to improve performance of soccer athletes on the field through dietary and/or ergogenic supplements that can be used simultaneously.

SUMMARY

Soccer is a competitive sport, where the match important moments can be defined in detail. Thus, use of ergogenic supplements covered in this review can improve performance of elite soccer players maintaining high level in the match until final moments, such as creatine 3-5 g day-1, caffeine 3-6 mg kg-1 BW around 60 min before the match, sodium bicarbonate 0.1-0.4 g kg-1 BW starting from 30 to 180 min before the match, β-alanine 3.2 and 6.4 g day-1 provided in the sustained-release tablets divided into 4 times a day, and nitrate-rich beetroot juice 60 g in 200 mL of water (6 mmol of NO3- L) around 120 min before match or training, including a combination possible with taurine 50 mg kg-1 BW day-1, citrulline 1.2-3.4 g day-1, and arginine 1.2-6 g day-1. Key Messages: Soccer athletes can combine ergogenic and dietary supplements to improve their performance on the field. The ergogenic and dietary supplements used in a scientifically recommended dose did not demonstrate relevant side effects. The use of various evidence-based supplements can add up to further improvement in the performance of the elite soccer players.

Effect of hypoxia and nitrate supplementation on different high-intensity interval-training sessions

PURPOSE

To test the hypothesis that interval-training (IHT) would be impaired by hypoxia to a larger extent than repeated-sprint training (RSH) and that dietary nitrate (NO₃^-) would mitigate the detrimental effect of hypoxia to a larger extent during IHT than RSH.

METHODS

Thirty endurance-trained male participants performed IHT (6 × 1 min at 90%∆ with 1 min active recovery) and RSH (2 sets of 6 × 10 s "all-out" efforts with 20 s active recovery) on a cycle ergometer, allocated in one of three groups: normobaric hypoxia (~ 13% F_iO₂) + NO₃^- - HNO, n = 10; normobaric hypoxia + placebo - HPL, n = 10; normoxia (20.9% F_iO₂) + placebo - CON, n = 10. Submaximal oxygen uptake ([Formula: see text]O₂), time spent above 90% of maximal [Formula: see text]O₂ (≥ 90 [Formula: see text]O₂max) and heart rate (≥ 90 HRmax) were compared between IHT and RSH sessions and groups. Additionally, mean power output (MPO), decrement score and % of power associated with [Formula: see text]O_2max (%p[Formula: see text]O₂max) in RSH sessions were analyzed.

RESULTS

[Formula: see text]O₂ at sub-maximal intensities did not differ between training protocols and groups (~ 27 ml kg^-1 min^-1).  ≥ 90 HRmax was significantly higher in IHT compared to RSH session (39 ± 8 vs. 30 ± 8%, p = 0.03) but only in HNO group. MPO (range 360-490 W) and decrement score (10-13%) were similar between groups although %p[Formula: see text]O₂max was significantly higher (p = 0.04) in CON (166 ± 16 W) compared with both HPL (147 ± 15 W) and HNO (144 ± 10 W) groups.

CONCLUSION

IHT responses were neither more impaired by hypoxia than RSH ones. Moreover, dietary NO₃^- supplementation impacted equally IHT and RSH training responses' differences between hypoxia and normoxia.

A Survey on Dietary Supplement Consumption in Amateur and Professional Rugby Players

Purpose: the aim of the present study was to analyse the pattern of dietary supplements (DS) consumption on federated rugby players, including the analysis of differences based on the sex and competitive level (professional vs. amateurs). Material and methods: 144 rugby players (83 male and 61 female), of whom 69 were professionals and 75 amateurs, were recruited for the study. All the participants filled out a specific questionnaire about DS consumption including questions related to the consumption of DS and their effects on sport performance and health status. Results: 65.3% of participants declared consuming at least one DS, with a higher prevalence in males than females (77.1% vs. 49.2%) and in professionals thanin amateur players (79.7% vs. 52.0%). The main reason for consumption was to enhance sport performance (62.3%) with differences only based on sex (74.3% males vs. 43.2% females). The most common purchase sites were the Internet (45.6%) and specialised stores (39.8%). As to the moment of ingestion, professionals did this most frequently during competition and training (56.4% vs. 28.2%), whereas amateur players did so only during competition (20.5% vs. 3.6%). Moreover, professional player intake most frequently in post-exercise (65.5% vs. 35.9%), whereas amateur during pre-exercise (30.8% vs. 5.5%). The DS most consumed included whey protein (44%), caffeine (42%), sports drinks (38%), energy bars (34%) and creatine monohydrate (31%), with a higher prevalence in male and professional players of whey protein and creatine monohydrate. Conclusions: The main reason for DS consumption is for enhancing sports performance). Professional players more frequently purchase them on the Internet and consume DS during training and competition period and in the post-exercise, whereas amateur players consume during competition and pre-exercise. Related to the main form of DS consumption, it is observed that a moderate consumption of DS could be considered ergogenic, such as whey protein, sport bar and creatine, while an absence of other DS could be considered ergogenic.

Understanding the effects of beetroot juice intake on CrossFit performance by assessing hormonal, metabolic and mechanical response: a randomized, double-blind, crossover design

BACKGROUND

Acute beetroot juice (BJ) intake has shown to enhance aerobic and anaerobic performance. However, no studies have evaluated the effects of BJ intake on CrossFit (CF) performance by linking hormonal, metabolic, and mechanical responses. The purpose of this study was to determine the causal physiological association between hormonal, metabolic and mechanical responses, and CF workouts performance after acute BJ intake.

METHODS

Twelve well-trained male practitioners undertook a CF workout after drinking 140 mL of BJ (~ 12.8 mmol NO3-) or placebo. The two experimental conditions (BJ or placebo) were administered using a randomized, double-blind, crossover design. The CF workout consisted of repeating the same exercise routine twice: Wall ball (WB) shots plus full back squat (FBS) with 3-min rest (1st routine) or without rest (2nd routine) between the two exercises. A 3-min rest was established between the two exercise routines.

RESULTS

An interaction effect was observed in the number of repetitions performed (p = 0.04). The Bonferroni test determined a higher number of repetitions after BJ than placebo intake when a 3-min rest between WB and FBS (1st routine) was established (p = 0.007). An interaction effect was detected in cortisol response (p = 0.04). Cortisol showed a higher increase after BJ compared to placebo intake (76% vs. 36%, respectively). No interaction effect was observed in the testosterone and testosterone/cortisol ratio (p > 0.05). A significant interaction effect was found in oxygen saturation (p = 0.01). A greater oxygen saturation drop was observed in BJ compared to placebo (p <  0.05). An interaction effect was verified in muscular fatigue (p = 0.03) with a higher muscular fatigue being observed with BJ than placebo (p = 0.02).

CONCLUSIONS

BJ intake improved anaerobic performance only after the recovery time between exercises. This increase in performance in the first routine probably generated greater hypoxia in the muscle mass involved, possibly conditioning post-exercise performance. This was observed with a fall in oxygen saturation and in muscle fatigue measured at the end of the CF workout. The greatest perceived changes in cortisol levels after BJ intake could be attributed to the nitrate-nitrite-nitric oxide pathway.

Acute Beetroot Juice Supplementation Does Not Improve Match-Play Activity in Professional Tennis Players

OBJECTIVE

Beetroot juice is a source of dietary nitrate (NO₃-) recognized as a potential ergogenic aid to enhance tolerance during endurance exercise of submaximal-to-maximal intensity. However, little is known about the effects of beetroot juice on exercise performance in intermittent sports such as tennis. The present study aimed to determine the effect of acute beetroot juice supplementation on movement patterns during a competitive tennis match in professional players.

METHODS

In a double-blind and randomized experiment, nine professional tennis players performed two experimental trials 3 h after ingesting either 70 mL of a commercially-available concentrated beetroot juice (6.4 mmol NO₃-) or placebo (0.005 mmol NO₃-). In each experimental trial, players completed a 3-set tennis match and two performance tests (i.e., serve speed and isometric handgrip strength) before and after the match. Match-play running performance was recorded using wearable GPS and accelerometer units.

RESULTS

In comparison to the placebo trial, the acute beetroot juice supplementation did not modify any match-play running performance (p = 0.178 to 0.997, d = 0.01 to 0.42). Furthermore, beetroot juice supplementation did not alter the pre-to-post match change in serve speed (p = 0.663, ηp² = 0.03) or isometric handgrip strength (p = 0.219, ηp² = 0.18).

CONCLUSIONS

The current results indicated that acute ingestion of a commercialized shot of nitrate-rich beetroot juice (70 mL containing 6.4 mmol of NO₃-) did not produce any performance benefit on tennis matchplay. Thus, acute beetroot juice supplementation seems an ergogenic aid with little value to enhance physical performance in professional tennis players.

The Effect of Dietary Nitrate Supplementation on Isokinetic Torque in Adults: A Systematic Review and Meta-Analysis

Dietary nitrate (NO3-) supplementation, which can enhance performance in exercise settings involving repeated high-intensity efforts, has been linked to improved skeletal muscle contractile function. Although muscular strength is an important component of explosive movements and sport-specific skills, few studies have quantified indices of muscular strength following NO3- supplementation, particularly isokinetic assessments at different angular velocities. We performed a systematic review and meta-analysis to determine whether dietary NO3- supplementation improves peak torque, as assessed by the gold standard method of isokinetic dynamometry, and if this effect was linked to the angular velocity imposed during the assessment. Dialnet, Directory of Open Access Journals, MEDLINE, PubMed, SciELO, Scopus, and SPORTDiscus were searched for articles using the following search strategy: (nitrate OR beet*) AND (supplement* OR nutr* OR diet*) AND (isokinetic OR strength OR "resistance exercise" OR "resistance training" OR "muscular power"). The meta-analysis of data from 5 studies with 60 participants revealed an overall effect size of -0.01 for the effect of nitrate supplementation on isokinetic peak torque, whereas trivial effect sizes ranging from -0.11 to 0.16 were observed for independent velocity-specific (90°/s, 180°/s, 270°/s, and 360°/s) isokinetic peak torque. Four of the five studies indicated that dietary NO3- supplementation is not likely to influence voluntary knee extensor isokinetic torque across a variety of angular velocities. These results suggest that NO3- supplementation does not influence isokinetic peak torque, but further work is required to elucidate the potential of NO3- supplementation to influence other indices of muscular strength, given the dearth of experimental evidence on this topic.

Effects of Dietary Nitrates on Time Trial Performance in Athletes with Different Training Status: Systematic Review

Much research has been done in sports nutrition in recent years as the demand for performance-enhancing substances increases. Higher intake of nitrates from the diet can increase the bioavailability of nitric oxide (NO) via the nitrate-nitrite-NO pathway. Nevertheless, the increased availability of NO does not always lead to improved performance in some individuals. This review aims to evaluate the relationship between the athlete's training status and the change in time trial performance after increased dietary nitrate intake. Articles indexed by Scopus and PubMed published from 2015 to 2019 were reviewed. Thirteen articles met the eligibility criteria: clinical trial studies on healthy participants with different training status (according to VO_2max), conducting time trial tests after dietary nitrate supplementation. The PRISMA guidelines were followed to process the review. We found a statistically significant relationship between VO_2max and ergogenicity in time trial performance using one-way ANOVA (p = 0.001) in less-trained athletes (VO₂ < 55 mL/kg/min). A strong positive correlation was observed in experimental situations using a chronic supplementation protocol but not in acute protocol situations. In the context of our results and recent histological observations of muscle fibres, there might be a fibre-type specific role in nitric oxide production and, therefore, supplement of ergogenicity.

The synergistic hepatoprotective potential of Beta vulgaris juice and 2,3- dimercaptosuccinic acid in lead-intoxicated rats via improving the hepatic oxidative and inflammatory stress

BACKGROUND

Lead (Pb) is observed in all areas of the environment, mainly derived from human operations such as mining, processing, and burning fossil fuels. Pb toxicity is one of the most prevalent causes of human hepatotoxicity. The available chelator drugs used now have many adverse effects and therefore the world is looking for natural and secure alternatives.

METHODS

Here, we evaluated the hepatoprotective role of the oral administration (1 g/kg b.w.) of the lyophilized Beta vulgaris juice (BVJ) against Pb-induced rat hepatotoxicity. We also examined the possible synergistic hepatoprotective impact of the combination between BVJ and 2,3- dimercaptosuccinic acid (DMSA, the currently approved drug for Pb-toxicity). The evaluation depends on the ability of BVJ, DMSA, or their combination (BVJ-DMSA) to reduce serum and hepatic Pb level and to avoid oxidative stress and inflammation caused by Pb. The level of lipid peroxidation, reduced glutathione (GSH), total antioxidant capacity, and the activity of the antioxidant enzymes were quantified. In addition, the level of interleukin (IL)-6, nitric oxide (NO), DNA fragmentation, and liver histology were studied.

RESULTS

The results showed that BVJ contained considerable amounts of betalains, vitamin C, and various types of phenolic compounds. Therefore, BVJ displayed a significant (p < 0.05) preventive influence on the elevation of Pb levels in blood and liver as well as the hepatic DNA fragmentation. In addition, it significantly (p < 0.05) improved most of the studied antioxidant and inflammatory markers in the Pb-intoxicated rats. However, the combined extract (BVJ-DMSA) revealed synergistic (combination index < 1) activities in most of the tested parameters. The histopathological results verified the biochemical findings of this research.

CONCLUSION

BVJ has a potent efficiency in the protection from Pb-induced hepatotoxicity through the reduction of its accumulation in blood and liver and the prevention of the oxidative stress and inflammation induced by Pb. Additionally, the treatment of hepatotoxicity with BVJ and DMSA in combination showed a synergistic effect and reduced the adverse effects induced by DMSA. Thus, BVJ can be a promising hepatoprotective extract against lead toxicity and its combination with DMSA potentiates this effect.

Effects of Dietary Nitrate Supplementation on Weightlifting Exercise Performance in Healthy Adults: A Systematic Review

Dietary nitrate (NO3-) supplementation has been evidenced to induce an ergogenic effect in endurance and sprint-type exercise, which may be underpinned by enhanced muscle contractility and perfusion, particularly in type II muscle fibers. However, limited data are available to evaluate the ergogenic potential of NO3- supplementation during other exercise modalities that mandate type II fiber recruitment, such as weightlifting exercise (i.e., resistance exercise). In this systematic review, we examine the existing evidence basis for NO3- supplementation to improve muscular power, velocity of contraction, and muscular endurance during weightlifting exercise in healthy adults. We also discuss the potential mechanistic bases for any positive effects of NO3- supplementation on resistance exercise performance. Dialnet, Directory of Open Access Journals, Medline, Pubmed, Scielo, Scopus and SPORT Discus databases were searched for articles using the keywords: nitrate or beetroot and supplement or nut*r or diet and strength or "resistance exercise" or "resistance training" or "muscular power". Four articles fulfilling the inclusion criteria were identified. Two of the four studies indicated that NO3- supplementation could increase aspects of upper body weightlifting exercise (i.e., bench press) performance (increases in mean power/velocity of contraction/number of repetitions to failure), whereas another study observed an increase in the number of repetitions to failure during lower limb weightlifting exercise (i.e., back squat). Although these preliminary observations are encouraging, further research is required for the ergogenic potential of NO3- supplementation on weightlifting exercise performance to be determined.

Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: a systematic review

In recent decades, the search for non-doping substances that enhance sports performance has increased. Ergogenic aids such as beetroot juice (BRJ) and BRJ rich in nitrates (NO₃^-) are widely used to cause physiological benefits that may lead to physical improvements. Therefore, the purpose of this systematic review was to explore the knowledge reported to date on the NO₃^- derived from BRJ intake effect on fatigue resistance during repeated sprints. A digital search was conducted following systematic review guidelines, and 18 studies met inclusion criteria from a total of 209 articles. In a third of the selected studies, the consumption of beet juice rich in NO₃^- contributes to an increase in nitrites in plasma that led to the rise in peak power, mean power, number of sprint repetitions, total work and time to task failure, and causes a decrease in fatigue index and sprints times. Some different dose has been proposed for both chronic and acute protocols. It seems that a chronic intake of ∼5-6 mmol of NO₃^- in 70 ml of BRJ, twice a day, for a minimum of 3-6 days could lead to a fatigue resistance improvement during repeated sprints. Besides, acute intake of NO₃^- 2.5-3 h before physical exertion or a dose of 250 ml/d to 500 ml/d of BRJ could lead to similar effective results. This systematic review presents some improvements (1.2-5.38%) in fatigue resistance during repeated sprints when consuming BRJ derived NO₃^-. The in-field practical meaning of these results should be explored.

Beetroot (Beta Vulgaris L.) Extract Acutely Improves Heart Rate Variability Recovery Following Strength Exercise: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial-Pilot Study

OBJECTIVE

We assessed the acute effect of beetroot extract intake on cardiovascular and autonomic recovery subsequent to strength exercise.

METHODS

This is a crossover, randomized, double-blind and placebo-controlled trial. We assessed 16 subjects but only 12 healthy male adults completed the two protocols in two randomized days: Beetroot extract (600 mg in capsule) and placebo (600 mg starch in capsule). Beetroot extract or placebo was ingested, the subjects endured 120 minutes seated at rest, followed by a 75% 1RM strength exercise and then remained seated for 60 minutes at rest. Cardiorespiratory parameters, heart rate (HR) variability (HRV) (SDNN, rMSSD, pNN50, SD1, SD2 HF [ms²]) were estimated before, during exercise and during recovery from exercise.

RESULTS

ingestion of beetroot extract before exercise: accelerates the recovery of SBP following physical effort; improves HR recovery to baseline resting levels (beetroot protocol: change in ∼62% vs. placebo protocol: change in ∼80%), and intensifies the return of vagal HR control during recovery after exercise.

CONCLUSIONS

Beetroot extract acutely improved cardiovascular and autonomic recovery after exercise.

Diet in neurogenic bowel management: A viewpoint on spinal cord injury

The aim of this review is to offer dietary advice for individuals with spinal cord injury (SCI) and neurogenic bowel dysfunction. With this in mind, we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy, autonomic dysreflexia and neurogenic bladder. In addition, SCI is often associated with a sedentary lifestyle, which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation, including cardiovascular and chronic kidney diseases. The Mediterranean diet, along with exercise and dietary supplements, has been suggested as an anti-inflammatory intervention in individuals with SCI. However, individuals with chronic SCI have a daily intake of whole fruit, vegetables and whole grains lower than the recommended dietary allowance for the general population. Some studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake; therefore, this finding could explain the low consumption of plant foods. Low consumption of fibre induces dysbiosis, which is associated with both endotoxemia and inflammation. Dysbiosis can be reduced by exercise and diet in individuals with SCI. Therefore, to summarize our viewpoint, we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise guidelines. Nutritional guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI, chronic kidney diseases, chronic pain and irritable bowel syndrome. We also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength, flexibility and cardiorespiratory fitness and to obtain cardiometabolic benefits. Finally, dietary advice for Paralympic athletes is suggested.

A review on bioactive compounds of beet (Beta vulgaris L. subsp. vulgaris) with special emphasis on their beneficial effects on gut microbiota and gastrointestinal health

This review discusses the available literature concerning the bioactive compounds of beet (Beta vulgaris L.) and their ability to modulate the gut microbiota and parameters indicative of gastrointestinal health. Data of published literature characterize beet as a source of a variety of bioactive compounds (e.g. diet fiber, pectic-oligosaccharides, betalains and phenolics) with proven beneficial effects on human health. Beet extracts and pectin and pectic-oligosaccharides from beet have shown able to modulate positively gut microbiota composition and activity, with noticeable bifidogenic effects, in addition to stimulate the growth and metabolism of probiotics. Beet betalains and phenolics seem to increase the production of metabolites (e.g. short chain fatty acids) by gut microbiota and probiotics, which are linked with different beneficial effects on host health. The outstanding contents of betalains and phenolics with antioxidant, anti-inflammatory and anti-carcinogenic properties have been linked to the positive effects of beet on gastrointestinal health. Beet should be a healthy choice for use in domestic meal preparations and a source of ingredients to formulate added-value functionalized food products.

Effects of Arginine Supplementation on Athletic Performance Based on Energy Metabolism: A Systematic Review and Meta-Analysis

Nitric oxide related ergogenic aids such as arginine (Arg) have shown to impact positively on sport performance through several physiological and metabolic mechanisms. However, research results have shown to be controversial. The great differences regarding required metabolic pathways and physiological demands between aerobic and anaerobic sport disciplines could be the reasons. The aim of this systematic review and meta-analysis was to evaluate the effects of Arg supplementation on aerobic (≤VO₂max) and anaerobic (>VO₂max) performance. Likewise, to show the effective dose and timing of this supplementation. A structured search was carried out in accordance with PRISMA^® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and PICOS guidelines in PubMed/MEDLINE, Web of Science (WOS), and Scopus databases from inception to January 2020. Eighteen studies were included which compare Arg supplementation with placebo in an identical situation and testing its effects on aerobic and anaerobic performance tests. Trials analyzing supplementation with other supplements were removed and there was not athlete's level, gender, ethnicity, or age filters. The performed meta-analysis included 15 studies and random effects model and pooled standardized mean differences (SMD) were used according to Hedges' g. Results revealed that Arg supplementation could improve aerobic (SMD, 0.84; 95% CI, 0.12 to 1.56; magnitude of SMD (MSMD), large; I2, 89%; p = 0.02) and anaerobic (SMD, 0.24; 95% CI, 0.05 to 0.43; MSMD, small; I2, 0%; p = 0.01) performance tests. In conclusion, acute Arg supplementation protocols to improve aerobic and anaerobic performance should be adjusted to 0.15 g/kg of body weight ingested between 60-90 min before. Moreover, chronic Arg supplementation should include 1.5-2 g/day for 4-7 weeks in order to improve aerobic performance, and 10-12 g/day for 8 weeks to enhance anaerobic performance.

Analysis of Sports Supplements Consumption in Young Spanish Elite Dinghy Sailors

The sports performance of dinghy sailors is determined by their state of nutrition and hydration. Sports supplementation plays a prominent role in elite sailors, being essential in periods of competition due to its characteristics. This study aims to analyze the consumption of sports supplements (SS) in the different categories and groups of sailors based on the level of evidence, differentiating according to sex, competitive level, and type of boat. A total of 42 sailors from national and international levels and belonging to the Laser, 420, Techno-293 and RS:X classes participated in this study. They completed a questionnaire with questions about the consumption of SS and the possible repercussions on health and/or sports performance. The results were analyzed based on the different categorizations and group organization recently established by the Australian Institute of Sport (AIS), as well as by sex, level of competition and class to which the participants belonged. The male sailors and those who competed internationally had a higher prevalence in the consumption of SS. Among the classes of vessels studied, class 420 had the lowest SS consumption. SS intake was higher during competition days, regardless of sex or level of competition. Based on the classification established by the AIS, statistically significant differences were observed in sex, level of competition, and the type of boat.

Biological effects of red beetroot and betalains: A review

Over the past few years, the use of natural substances as protective or therapeutic agents has gained much attention worldwide. Recent modern studies have shown a variety of health benefits for red beetroot and its active compounds betalains (also betanin) such as antioxidative, anti-inflammation, anticancer, blood pressure and lipid lowering, also antidiabetic and anti-obesity effects. Betanin, the main component of the red beetroot, is a betalain glycosidic pigment, which is used as a food additive. This review summarizes findings in the literature and shows the therapeutic potential of red beetroot and its active compounds (betalains) as promising alternatives for supplemental therapies in multiple diseases.