International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance

Enhancing exercise performance and recovery through sodium bicarbonate supplementation: introducing the ingestion recovery framework

Sodium bicarbonate (SB) supplementation is an ergogenic strategy for athletes competing in high-intensity exercise, but the efficacy of SB for accelerating recovery from exercise and thus improving performance during repeated bouts of exercise is not fully understood. In a similar fashion to using SB as a pre-exercise buffer, it is possible accelerated restoration of blood pH and bicarbonate following an exercise bout mechanistically underpins the use of SB as a recovery aid. Physiological mechanisms contributing to beneficial effects for SB during repeated bout exercise could be more far-reaching however, as alterations in strong ion difference (SID) and attenuated cellular stress response might also contribute to accelerated recovery from exercise. From inspection of existing literature, ingestion of 0.3 g kg-1 body mass SB ~60-90 min pre-exercise seems to be the most common dosage strategy, but there is evidence emerging for the potential application of post-exercise supplementation timing, gradual SB doses throughout a competition day, or even ingestion during exercise. Based on this review of literature, an SB ingestion recovery framework is proposed to guide athletes and practitioners on the use of SB to enhance performance for multiple bouts of exercise.

Sodium bicarbonate improved CrossFit® Benchmark Fran, but not subsequent 500 m rowing performance

The aim of this study was to evaluate the influence of sodium bicarbonate (SB) supplementation on physical performance, neuromuscular and metabolic responses during CrossFit® exercise. Seventeen Advanced CrossFit®-trained athletes completed the randomized, double-blind, placebo-controlled crossover protocol consisting of four visits, including two familiarization sessions and two experimental trials separated by a 7-day washout period. Participants supplemented 0.3 g/kg body mass (BM) of SB or placebo 120-min prior to performing the CrossFit® benchmark Fran followed by 500 m of rowing. SB improved time to complete Fran compared to PLA (291.2 ± 71.1 vs. 303.3 ± 77.8 s, p = 0.047), but not 500 m rowing (112.1 s ± 7.9 vs. 113.2 s ± 8.9 s, p = 0.26). No substantial side-effects were reported during the trials. This study showed that SB improved CrossFit® benchmark Fran performance, but not subsequent 500-m rowing. These data suggest that SB might be an interesting supplementation strategy for CrossFit® athletes.

Oral sodium lactate ingestion does not increase blood lactate concentrations and is accompanied by moderate-to-severe gastrointestinal side effects

Lactate has diverse roles in biology and has been implicated in the control of energy intake. A variety of methods (i.e., exercise, ingestion, and infusion) have been used to study its effects on different metabolic outcomes and the original intent of this project was to explore the effect of oral sodium lactate (Na-Lactate) ingestion on appetite regulation. During piloting, we were unable to show that Na-Lactate could increase blood lactate concentrations; thus, the purpose of this brief report is to highlight that oral Na-Lactate ingestion is not an effective method to study lactate metabolism. Five male participants (26 ± 3 yr, 82.4 ± 3.8 kg, 25.4 ± 1.6 kg·m-2) completed 15 experimental sessions where Na-Lactate solutions were consumed with the assessment of blood lactate preingestion, 30-min, 45-min, and 60-min postingestion. Oral Na-Lactate ingestion did not increase blood lactate concentrations (Pre: 0.9 ± 0.2; 30 min: 1.2 ± 0.7; 45 min: 1.0 ± 0.5; 60 min: 0.9 ± 0.4 mmol·L-1). In addition, there were moderate-to-severe gastrointestinal (GI) side effects (e.g., vomiting and diarrhea) following ingestion. Altogether, our data suggest that oral ingestion of Na-Lactate is not an effective method for studying lactate's role in metabolism as it did not increase blood lactate concentrations and was accompanied by problematic GI side effects.NEW & NOTEWORTHY Lactate has diverse roles in physiology, and a variety of methods have been used to explore its effects on metabolism. Here, we explored whether oral sodium lactate (Na-Lactate) ingestion could increase blood lactate concentrations. Oral Na-Lactate ingestion using a variety of dosing protocols did not increase blood lactate concentrations and was coupled with gastrointestinal issues. These results demonstrate that oral ingestion of Na-Lactate is not an effective method for studying lactate's role in metabolism.

Sodium bicarbonate use in the treatment of idiopathic intracranial hypertension

PURPOSE

This retrospective case-control study from 2008 to 2022 aimed to determine the effect of adjunctive sodium bicarbonate (NaHCO3) on treatment outcomes of and side effects of acetazolamide (ACZ) for the treatment of idiopathic intracranial hypertension (IIH).

SUBJECTS/METHODS

Retrospective data was collected via chart review. 288 eyes of 144 patients with IIH, including those taking ACZ alone (control group, n = 89) vs. ACZ and NaHCO3 (treatment group, n = 56). The primary outcome measure was time to IIH resolution. Secondary outcomes included retinal nerve fibre layer thickness (RNFL), visual field mean deviation (VFMD), visual acuity (VA), discontinuation ACZ, and patient-reported side effects of ACZ.

RESULTS

Cox proportional hazards model for the primary outcome yielded a hazard ratio of 0.800, which was statistically insignificant (95% CI, 0.57-1.13; p = 0.200). There was no significant difference between groups when comparing RNFL, VFMD, VA, surgical intervention, or discontinuation of ACZ. The treatment group was more likely to experience side effects from ACZ prior to starting sodium bicarbonate therapy (p < 0.001). Among the treatment group, 92.7% remained on NaHCO3 until IIH resolution, and 9 of 12 (75%) subjects reported significant improvement in ACZ-related side effects.

CONCLUSION

Sodium bicarbonate does not appear to impact treatment outcomes in patients taking acetazolamide for IIH. Sodium bicarbonate may represent a reasonable adjunctive medication to help mitigate acetazolamide-related side effects in this group of patients.

Global hotspots and trends of nutritional supplements in sport and exercise from 2000 to 2024: a bibliometric analysis

BACKGROUND

Nutritional supplements for sports and exercise (NSSE) can facilitate the exogenous replenishment of the body. This study provides the first extensive overview of NSSE research through bibliometric and visual analyses.

METHODS

We searched the Web of Science Core Collection database for literature related to "NSSE" from 1st January 2000 to 8th March 2024. A total of 1744 articles were included. CiteSpace, VOSviewer, and Bibliometrix R package software were used to analyze the data.

RESULTS

Research in the NSSE can be divided into steady growth, exponential growth, fluctuating stage, and surge stages. The United States is the most active country in this field. In recent years, the leading countries have been Croatia, Colombia, Slovenia, Chile, Egypt, China, and Thailand. The Australian Institute of Sports is the top research institution in terms of number of publications. Burke, LM from Australia published the most articles. Research in this area has primarily been published in Nutrients in Switzerland. The study population mainly consisted of men, and postmenopausal women were the main focus of the female group. Coronary heart and cardiovascular diseases continue to dominate research.

CONCLUSION

Research on the NSSE is developing rapidly, with an annual growth trend. Insulin resistance, sports nutrition, inflammation, alpha-linolenic acid, limb strength performance, female sex, and gut microbiota are the focus of the current research and trends for future research. Future research should focus on improving the scientific training system for athletes and quality of training and life for the general public.

Evidence-based sports supplements: A redox analysis

Despite the overwhelming number of sports supplements on the market, only seven are currently recognized as effective. Biological functions are largely regulated through redox reactions, yet no comprehensive analysis of the redox properties of these supplements has been compiled. Here, we analyze the redox characteristics of these seven supplements: bicarbonates, beta-alanine, caffeine, creatine, nitrates, carbohydrates, and proteins. Our findings suggest that all sports supplements exhibit some degree of redox activity. However, the precise physiological implications of these redox properties remain unclear. Future research, employing unconventional perspectives and methodologies, will reveal new redox pixels of the exercise physiology and sports nutrition picture.

Taste and Appetite at Altitude: A Comprehensive Review of Sensory and Hunger Modulation in High-Altitude Environments

Introduction: Individuals living or working at high altitudes typically experience altered taste perceptions and reduced appetite. These changes can lead to nutritional deficiencies, affecting the energy balance and body composition. Methods: We conducted a nonsystematic review of PubMed to explore these phenomena and expound on their findings to offer additional insights. Results: Changes in taste and perception are common and typically lead to loss of mass. There are limited practical solutions to mitigate these challenges. Discussion: Gradual acclimatization and tailored nutritional strategies are required to enhance health and performance in high-altitude environments. This review provides critical insights into the intersection of altitude, nutrition, and health.

Pre-Exercise Caffeine and Sodium Bicarbonate: Their Effects on Isometric Mid-Thigh Pull Performance in a Crossover, Double-Blind, Placebo-Controlled Study

Caffeine and sodium bicarbonate are extensively researched ergogenic aids known for their potential to enhance exercise performance. The stimulant properties of caffeine on the central nervous system, coupled with the buffering capacity of sodium bicarbonate, have been associated with improved athletic performance. This has led to investigations of their combined effects on strength. The aim of the present study is to investigate the effect of isolated and combined caffeine and sodium bicarbonate consumption on strength using the isometric mid-thigh pull test (IMTP). Nineteen male college students (age 23.6 ± 1.6 years) participated in this crossover, double-blind, placebo-controlled study. They were exposed to the following conditions: control (no supplement), placebo (20 g maltodextrin), caffeine (6 mg/kg), sodium bicarbonate (0.3 g/kg), and a combination of caffeine and sodium bicarbonate. Supplements and placebo were diluted in water and consumed 60 min prior to the IMTP tests. Two 5 s IMTP trials were performed at 40-60% and 60-80% of One Repetition of Maximum (1RM) with a 60 s rest between. Consumption of caffeine or Caf + NaHCO3 did not significantly change peak IMTP strength values at any intensity (p = 0.110). The peak IMTP values did not show significant differences between conditions or from control condition values (1091 ± 100 N) to Caf (1224 ± 92 N), NaHCO3 (1222 ± 74 N), and Caf ± NaHCO3 (1152 ± 109 N). However, the test of the results of the ANOVA analysis of repeated measures of effect within the caffeine condition was significant for the increase in IMTP relative strength compared to control (p < 0.05). Thus, the IMTP force values increased significantly from control to Caf (p = 0.016) and from Pla to Caf (p = 0.008), but not for other comparisons (p > 0.05). In summary, caffeine supplementation alone, taken 60 min before exercise, positively affects submaximal strength performance. In contrast, sodium bicarbonate, whether taken alone or in combination with caffeine, does not enhance submaximal strength in the IMTP tests.

Effects of acute and multi-day low-dose sodium bicarbonate intake on high-intensity endurance exercise performance in male recreational cyclists

PURPOSE

This study aimed to compare the effects of acute and multi-day low-dose sodium bicarbonate (SB) intake on high-intensity endurance exercise performance.

METHODS

In a randomized, double-blind, cross-over design, twelve recreational male cyclists (age: 31.17 ± 4.91 years; V ˙ O2peak: 47.98 ± 7.68 ml·kg-1·min-1) completed three endurance performance tests following acute SB (ASB, 0.2 g·kg-1 SB), multi-day SB (MSB, 0.2 g·kg-1·day-1 SB for four days), and placebo (PLA) intake. The high-intensity endurance performance was assessed with a cycling exercise test, wherein participants cycled on a bicycle ergometer at 95% of the predetermined anaerobic threshold for 30 min, followed by a time-to-exhaustion test at 110% of the anaerobic threshold. Data were analyzed using one-way and two-way repeated-measures ANOVA.

RESULTS

Significant main effects of supplementation protocol were evident in pre-exercise bicarbonate concentrations (F = 27.93; p < 0.01; partial eta squared (η2) = 0.72; false discovery rate (FDR)-adjusted p value = 0.001). Prior to performance test, blood bicarbonate concentrations were significantly higher in MSB (25.78 ± 1.63 mmol·L-1 [95% CI 26.55-28.44] (p < 0.001; FDR-adjusted p value = 0.001)) and ASB (27.49 ± 1.49 mmol·L-1 [95% CI 24.75-26.81] (p < 0.001; FDR-adjusted p value = 0.007)) compared to PLA (23.75 ± 1.40 mmol·L-1 [95% CI 22.86 to 24.64]). Time-to-exhaustion increased in MSB (54.27 ± 9.20 min [95% CI 48.43-60.12]) compared to PLA (49.75 ± 10.80 min [95% CI 42.89-56.62]) (p = 0.048); however, this increase in MSB did not reach the significance threshold of 1% FDR (FDR-adjusted p value = 0.040). No significant difference was noted in exhaustion times between ASB (51.15 ± 8.39 min [95% CI 45.82-56.48]) and PLA (p > 0.05).

CONCLUSION

Both acute and multi-day administration of low-dose SB improves buffering system in cyclists; nevertheless, neither intervention demonstrates sufficient efficacy in enhancing high-intensity endurance performance.

Sodium bicarbonate and beta-alanine supplementation: Is combining both better than either alone? A systematic review and meta-analysis

This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and performance. Four databases (PubMed, SPORTDiscus, Web Of Science and MEDLINE) were searched using relevant terms for studies involving healthy (e.g. no chronic diseases or conditions) male or female adults of any training status (athletes, physically active and non-athletes) and that investigated BA and SB in isolation and combination at any dose on an exercise outcome. Ten studies, totalling 243 individuals, met the criteria with 12 outcomes for each nutritional supplement. No ergogenic effect was detected in this meta-analysis for BA (SMD = 0.18, 95% CI: -0.06; 0.43, p = 0.13, tau2 = 0, tau = 0, I2 = 0.0%) or SB (SMD = 0.17, 95% CI: -0.08; 0.41, p = 0.16, tau2 = 0, tau = 0, I2 = 0.0%) in isolation. However, there was a beneficial effect for the combination of BA and SB (SMD = 0.32, 95% CI: 0.07; 0.57, p = 0.02, tau2 = 0, tau = 0, I2 = 0.0%). Meta-regression identified no differences between supplementing with BA or SB separately (F = 0.58; p = 0.57). Combining BA and SB improved exercise performance, however, there was no benefit in taking these supplements individually.

Exploring the Influence of Acid-Base Status on Athletic Performance during Simulated Three-Day 400 m Race

This study aimed to investigate the ability of highly trained athletes to consistently perform at their highest level during a simulated three-day 400 m race and to examine the impact of an alkaline diet associated with chronic consumption of bicarbonate-rich water or placebo on their blood metabolic responses before and after the three races. Twenty-two highly trained athletes, divided into two groups-one with an alkalizing diet and placebo water (PLA) and the other with an alkalizing diet and bicarbonate-rich water (BIC)-performed a 400 m race for three consecutive days. Performance metrics, urine and blood samples assessing acid-base balance, and indirect markers of neuro-muscular fatigue were measured before and after each 400 m race. The evolution of the Potential Renal Acid Load (PRAL) index and urinary pH highlights the combination of an alkalizing diet and bicarbonate-rich hydration, modifying the acid-base state (p < 0.05). Athletes in the PLA group replicated the same level of performance during three consecutive daily races without an increase in fatigue-associated markers. Athletes experienced similar levels of metabolic perturbations during the three 400 m races, with improved lactate clearance 20 min after the third race compared to the first two (p < 0.05). This optimization of the buffering capacity through ecological alkaline nutrition and hydration allowed athletes in the BIC group to improve their performance during the third 400 m race (p < 0.01). This study highlights athletes' ability to replicate high-level performances over three consecutive days with the same extreme level of metabolic disturbances, and an alkaline diet combined with bicarbonate-rich water consumption appears to enhance performance in a 400 m race.

Biodegradable hafnium-doped CaCO3 nanoparticles as a dual-modality radiosensitizer for cancer radiotherapy

Aim: Radiotherapy employs high-energy ionizing radiation to inflict DNA damage on cancer cells, thereby causing their demise. However, this procedure can inadvertently harm healthy tissue. Thus, this study aimed to develop biodegradable radiosensitizers that counteract these adverse effects by enhancing the radiation sensitivity of tumor cells and safeguarding normal cells.Materials & methods: A biodegradable radiosensitizer was engineered by incorporating hafnium ions (Hf) into calcium carbonate (CaCO3) nanoparticles via a chemical precipitation technique, resulting in the formation of Hf:CaCO3 nanoparticles.Results & conclusion: Our findings demonstrate that Hf:CaCO3 nanoparticles exhibit pH-dependent solubility and can augment the efficacy of radiotherapy in treating cancer cells. This research underscores the potential of Hf:CaCO3 nanoparticles as a dual-modality radiosensitizer in radiotherapy.

Effect of Acute Sodium Bicarbonate and Caffeine Coingestion on Repeated-Sprint Performance in Recreationally Trained Individuals: A Randomized Controlled Trial

INTRODUCTION

The acute and isolated ingestion of sodium bicarbonate (NaHCO3) and caffeine (CAF) improves performance and delays fatigue in high-intensity tasks. However, it remains to be elucidated if the coingestion of both dietary supplements stimulates a summative ergogenic effect. This study aimed to examine the effect of the acute coingestion of NaHCO3 and CAF on repeated-sprint performance.

METHODS

Twenty-five trained participants (age: 23.3 [4.0] y; sex [female/male]: 12/13; body mass: 69.6 [12.5] kg) participated in a randomized, double-blind, placebo (PLA) -controlled, crossover study. Participants were assigned to 4 conditions: (1) NaHCO3 + CAF, (2) NaHCO3, (3) CAF, or (4) PLA. Thus, they ingested 0.3 g/kg of NaHCO3, 3 mg/kg of CAF, or PLA. Then, participants performed 4 Wingate tests (Wt), consisting of a 30-second all-out sprint against an individualized resisted load, interspersed by a 1.5-minute rest period between sprints.

RESULTS

Peak (Wpeak) and mean (Wmean) power output revealed a supplement and sprint interaction effect (P = .009 and P = .049, respectively). Compared with PLA, NaHCO3 + CAF and NaHCO3 increased Wpeak performance in Wt 3 (3%, P = .021) and Wt 4 (4.5%, P = .047), while NaHCO3 supplementation increased mean power performance in Wt 3 (4.2%, P = .001). In Wt 1, CAF increased Wpeak (3.2%, P = .054) and reduced time to Wpeak (-8.5%; P = .008). Plasma lactate showed a supplement plus sprint interaction (P < .001) when NaHCO3 was compared with CAF (13%, P = .031) and PLA (23%, P = .021).

CONCLUSION

To summarize, although the isolated ingestion of CAF and NaHCO3 improved repeated-sprint performance, the coingestion of both supplements did not stimulate a synergic ergogenic effect.

Sodium bicarbonate induces alkalosis, but improves high-intensity cycling performance only when participants expect a beneficial effect: a placebo and nocebo study

The study aimed to investigate the effects of sodium bicarbonate (NaHCO3) intake with divergent verbal and visual information on constant load cycling time-to-task failure, conducted within the severe intensity domain. Fifteen recreational cyclists participated in a randomized double-blind, crossover study, ingesting NaHCO3 or placebo (i.e., dextrose), but with divergent information about its likely influence (i.e., likely to induce ergogenic, inert, or harmful effects). Performance was evaluated using constant load cycling time to task failure trial at 115% of peak power output estimated during a ramp incremental exercise test. Data on blood lactate, blood acid-base balance, muscle electrical activity (EMG) through electromyography signal, and the twitch interpolation technique to assess neuromuscular indices were collected. Despite reduced peak force in the isometric maximal voluntary contraction and post-effort peripheral fatigue in all conditions (P < 0.001), neither time to task failure, EMG nor, blood acid-base balance differed between conditions (P > 0.05). Evaluation of effect sizes of all conditions suggested that informing participants that the supplement would be likely to have a positive effect (NaHCO3/Ergogenic: 0.46; 0.15-0.74; Dextrose/Ergogenic: 0.45; 0.04-0.88) resulted in improved performance compared to control. Thus, NaHCO3 ingestion consistently induced alkalosis, indicating that the physiological conditions to improve performance were present. Despite this, NaHCO3 ingestion did not influence performance or indicators of neuromuscular fatigue. In contrast, effect size estimates indicate that participants performed better when informed that they were ingesting an ergogenic supplement. These findings suggest that the apparently ergogenic effect of NaHCO3 may be due, at least in part, to a placebo effect.

Effects of CurraNZ, a New Zealand Blackcurrant Extract during 1 Hour of Treadmill Running in Female and Male Marathon des Sables Athletes in Hot Conditions: Two Case Studies

Four weeks before competition in the 2023 Marathon des Sables, a 6-stage, ~250 km running event in the Sahara Desert, we examined the effects of a 7-day intake of New Zealand blackcurrant extract (210 mg anthocyanins per day) on 1 h treadmill running-induced physiological and metabolic responses in the heat (~34 °C, relative humidity: ~30%) in non-acclimatized amateur female and male athletes (age: 23, 38 yrs, BMI: 24.2, 28.4 kg·m-2, body fat%: 29.2, 18.8%, V˙O2max: 50.1, 52.1 mL·kg-1·min-1). During the 1 h run at 50%V˙O2max (speed female: 7.3, male: 7.5 km·h-1), indirect calorimetry was used, and heart rate was recorded at 15 min intervals with core temperature monitoring (0.05 Hz). The 1 h runs took place 3 h after a light breakfast and 2 h after intake of the final dose of New Zealand blackcurrant extract with water allowed ad libitum during the run. The New Zealand blackcurrant extract had no effects on the female athlete. The respiratory exchange ratio (RER) of the female athlete in the non-supplement control condition was 0.77 ± 0.01, indicating an existing ~77% contribution of fat oxidation to the energy requirements. In the male athlete, during 1 h of running, fat oxidation was higher by 21% (p < 0.01), carbohydrate oxidation was 31% lower (p = 0.05), RER was 0.03 units lower (p = 0.04), and core temperature was 0.4 °C lower (p < 0.01) with no differences for heart rate, minute ventilation, oxygen uptake, and carbon dioxide production for the New Zealand blackcurrant condition compared to the non-supplement control condition. Seven-day intake of New Zealand blackcurrant extract (210 mg anthocyanins per day) provided beneficial physiological and metabolic responses during exertional heat stress by 1 h of indoor (~34 °C) treadmill running in a male Marathon des Sables athlete 4 weeks before competition. Future work is required to address whether New Zealand blackcurrant provides a nutritional ergogenic effect for Marathon des Sables athletes during long-duration running in the heat combined with personalized nutrition.

No additive effect of creatine, caffeine, and sodium bicarbonate on intense exercise performance in endurance-trained individuals

BACKGROUND

Athletes commonly use creatine, caffeine, and sodium bicarbonate for performance enhancement. While their isolated effects are well-described, less is known about their potential additive effects.

METHODS

Following a baseline trial, we randomized 12 endurance-trained males (age: 25 ± 5 years, VO2max: 56.7 ± 4.6 mL kg-1 min-1; mean ± SD) and 11 females (age: 25 ± 3 years, VO2max: 50.2 ± 3.4 mL kg-1 min-1) to 5 days of creatine monohydrate (0.3 g kg-1 per day) or placebo loading, followed by a daily maintenance dose (0.04 g kg-1) throughout the study. After the loading period, subjects completed four trials in randomized order where they ingested caffeine (3 mg kg-1), sodium bicarbonate (0.3 g kg-1), placebo, or both caffeine and sodium bicarbonate before a maximal voluntary contraction (MVC), 15-s sprint, and 6-min time trial.

RESULTS

Compared to placebo, mean power output during 15-s sprint was higher following loading with creatine than placebo (+34 W, 95% CI: 10 to 58, p = 0.008), but with no additional effect of caffeine (+10 W, 95% CI: -7 to 24, p = 0.156) or sodium bicarbonate (+5 W, 95% CI: -4 to 13, p = 0.397). Mean power output during 6-min time trial was higher with caffeine (+12 W, 95% CI: 5 to 18, p = 0.001) and caffeine + sodium bicarbonate (+8 W, 95% CI: 0 to 15, p = 0.038), whereas sodium bicarbonate (-1 W, 95% CI: -7 to 6, p = 0.851) and creatine (-6 W, 95% CI: -15 to 4, p = 0.250) had no effects.

CONCLUSION

While creatine and caffeine can enhance sprint- and time trial performance, respectively, these effects do not seem additive. Therefore, supplementing with either creatine or caffeine appears sufficient to enhance sprint or short intense exercise performance.

Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort

Sodium bicarbonate is used as an ergogenic supplement to enhance people's performances in various exercises. This study aimed to evaluate the effects of intestinal delivery of sodium bicarbonate on bicarbonate absorption and associated side effects in an experimental human trial. After preparing and assessing enteric-coated and uncoated sodium bicarbonate tablet formulations, pharmacokinetic analysis and gastrointestinal symptom tests were performed after oral administration in the human body. The dose required to increase blood bicarbonate concentration over 5 mmol∙L-1 for the purpose of improving performance during high-intensity exercise was also determined. Enteric-coated tablet formulation protects sodium bicarbonate under acidic conditions and releases bicarbonate in the intestine. Enteric-coated tablet formulation also reduced the oral dose required to achieve a blood bicarbonate concentration over 5 mmol∙L-1 from 300 mg∙kg-1 of uncoated tablet formulation to 225 mg∙kg-1. Gastrointestinal discomfort was significantly decreased for the group given 225 mg∙kg-1 enteric-coated tablets compared to that given 300 mg∙kg-1 uncoated tablets. These results suggest that enteric-coated tablet formulation could reduce the oral dose required in order to achieve a blood bicarbonate concentration over 5 mmol∙L-1 by 25%, from 300 mg∙kg-1 to 225 mg∙kg-1, along with its ability to reduce gastrointestinal discomfort associated with the dosage.

A century of exercise physiology: effects of muscle contraction and exercise on skeletal muscle Na+,K+-ATPase, Na+ and K+ ions, and on plasma K+ concentration-historical developments

This historical review traces key discoveries regarding K+ and Na+ ions in skeletal muscle at rest and with exercise, including contents and concentrations, Na+,K+-ATPase (NKA) and exercise effects on plasma [K+] in humans. Following initial measures in 1896 of muscle contents in various species, including humans, electrical stimulation of animal muscle showed K+ loss and gains in Na+, Cl- and H20, then subsequently bidirectional muscle K+ and Na+ fluxes. After NKA discovery in 1957, methods were developed to quantify muscle NKA activity via rates of ATP hydrolysis, Na+/K+ radioisotope fluxes, [3H]-ouabain binding and phosphatase activity. Since then, it became clear that NKA plays a central role in Na+/K+ homeostasis and that NKA content and activity are regulated by muscle contractions and numerous hormones. During intense exercise in humans, muscle intracellular [K+] falls by 21 mM (range - 13 to - 39 mM), interstitial [K+] increases to 12-13 mM, and plasma [K+] rises to 6-8 mM, whilst post-exercise plasma [K+] falls rapidly, reflecting increased muscle NKA activity. Contractions were shown to increase NKA activity in proportion to activation frequency in animal intact muscle preparations. In human muscle, [3H]-ouabain-binding content fully quantifies NKA content, whilst the method mainly detects α2 isoforms in rats. Acute or chronic exercise affects human muscle K+, NKA content, activity, isoforms and phospholemman (FXYD1). Numerous hormones, pharmacological and dietary interventions, altered acid-base or redox states, exercise training and physical inactivity modulate plasma [K+] during exercise. Finally, historical research approaches largely excluded female participants and typically used very small sample sizes.

Differences in Consumption Behaviour of Dietary Supplements in Competitive Athletes Depends on Sports Discipline

BACKGROUND

The consumption of dietary supplements (DS) is widespread among the general population and competitive athletes. However, only a few competitive athletes seek information from experts about the effects and use of DS. Furthermore, it is currently unknown whether certain sports have a higher affinity for DS than others.

METHODS

This study aimed to identify differences between different sports categories and subgroups that may have a very high affinity for DS. For this purpose, competitive athletes were surveyed. The survey included the type of sport, the training frequency, the number of competitions, the consumption behaviour of five DS categories (general health, regeneration promotion, performance enhancement, booster, and weight loss) as well as personal data such as biological sex and age. Subsequently, correlations, configural frequencies (CFA), and multiple correspondence analyses (MCA) were used to identify subgroups with a high affinity of consumption behaviour.

RESULTS

A total of 409 questionnaires could be evaluated. It was found that all DS categories except weight loss were related. In addition, it was observed that in sports from the power category and from the endurance category, there was even higher consumption behaviour than in other sports categories. Male power athletes in particular have a higher affinity for consuming DS than other subgroups.

CONCLUSIONS

This study shows that there is a clear different consumption behaviour depending on the type of sport. Male power athletes in particular are the subgroup with the greatest consumption behaviour and therefore require special education on the effects and use of DS. This subgroup in particular should receive increased attention in counselling on DS to minimise the possible risks of DS use.

The effect of diminished metabolic acidosis on thermoregulatory response during exercise

It was reported that metabolic acidosis inhibits the activity of warm-sensitive hypothalamic neurons. The present study was designed to test the hypothesis that metabolic alkalosis may improve heat loss during intensive exercise in men. Fifteen male subjects aged 22-24 years were submitted to incremental exercise on two randomized occasions one week apart. During the bicarbonate trial exercise was preceded by ingestion of NaHCO3 at a dose 250 mg/kg whilst during the placebo trial lactose was administered. Exercise load was increased every 3 min by 30 W until volitional exhaustion. Ambient temperature was kept at 23-24°C and humidity 50-60%. Tympanic and skin temperatures were recorded and the rate of sweating was assayed by humidity measurement of nitrogen flowing through a capsule attached to the mid posterior chest. Total sweat loss was determined by the changes in body mass. Venous blood samples were taken before exercise and at the end of each workload for determination of acid-base parameters. The subjects attained similar maximal workload in the two tests (260 ± 6 W) with heart rate 185 ± 6 beats/min. Blood concentration of hydrogen ions was lower (p < 0.001) in the bicarbonate than in the placebo trial throughout the whole exercise period. There were no significant differences between these tests in tympanic and mean skin temperatures, sweating rate and total sweat loss. The present data showed that in men attenuation of metabolic acidosis by bicarbonate ingestion did not influence thermoregulation during incremental exercise performed until volitional exhaustion, possibly due to too short duration of exertional uncompensated metabolic acidosis.

Does sodium bicarbonate based extra-cellular buffering support reduce high intensity exercise-induced fatigue and enhance short-term recovery assessed by selected blood biochemical indices?

Exercise-induced metabolic processes induce muscle acidification which contributes to a reduction in the ability to perform repeated efforts. Alkalizing agents such as sodium bicarbonate (NaHCO3) prevent large blood pH changes, however, there is no evidence on whether regulation of acid-base balance may also support whole body homeostasis monitored through heamatological and biochemical blood markers in a dose-dependent manner. Thirty Cross-Fit-trained participants were studied in a randomized, multi cross-over, placebo (PLA)-controlled double-blind manner in which they performed a control session (CTRL, without supplementation), three NaHCO3 visits (three different doses) and PLA (sodium chloride in an equimolar amount of sodium as NaHCO3). Each visit consisted of two 30-s Wingate tests separated by CrossFit-specific benchmarks (Wall Balls and Burpees - both performed for 3 min). Blood samples were collected at rest, immediately post-exercise and after 45 min recovery. Significant differences between visits appeared for blood pH, percentage of lymphocytes and granulocytes, red blood cells count and haemoglobin concentration at post-exercise and 45-min recovery, and for white blood cells count, percentage of monocytes, concentration of magnesium and creatinine at 45-min recovery. Most of the observed differences for heamatological and biochemical markers were significant compared to CTRL, but not different after PLA. NaHCO3 supplementation compared to PLA did not significantly affect exercise or recovery shifts in studied blood indicators. However, the changes in these markers after NaHCO3 and PLA in relation to CTRL indicate a possible role of sodium.

Naturally Bicarbonated Water Supplementation Does Not Improve Anaerobic Cycling Performance or Blood Gas Parameters in Active Men and Women

The completion of high-intensity exercise results in robust perturbations to physiologic homeostasis, challenging the body's natural buffering systems to mitigate the accumulation of metabolic by-products. Supplementation with bicarbonate has previously been used to offset metabolic acidosis, leading to improvements in anaerobic exercise performance.

PURPOSE

The purpose of this study was to investigate the presence of ergogenic properties in naturally occurring low-dose bicarbonated water and their effects on anaerobic cycling performance and blood gas kinetics in recreationally active men and women.

METHODS

Thirty-nine healthy, recreationally active men and women (28.1 ± 8.0 years, 169.8 ± 11.7 cm, 68.9 ± 10.8 kg, 20.1 ± 7.9% fat, V˙O2peak: 42.8 ± 7.6 mL/kg/min) completed two separate testing sessions consisting of 15 cycling sprints (10 s sprint, 20 s active rest) against 7.5% of their body mass. Using a randomized, double-blind, placebo-controlled, parallel group study design, study participants consumed a 10 mL/kg dose of either spring water (SW) or bicarbonated mineral water (BMW) (delivering ~3 g/day of bicarbonate) for 7 days. Venous blood was collected before, immediately after, and 5 and 10 min after the sprint protocol and was analyzed for lactate and a series of blood gas components. After the completion of 15 cycling sprints, averages of peak and mean power for bouts 1-5, 6-10, and 11-15, along with total work for the entire cycling protocol, were calculated. All performance and blood gas parameters were analyzed using a mixed-factorial ANOVA.

RESULTS

pH was found to be significantly higher in the BMW group immediately after (7.17 ± 0.09 vs. 7.20 ± 0.11; p = 0.05) and 10 min post exercise (7.21 ± 0.11 vs. 7.24 ± 0.09; p = 0.04). A similar pattern of change was observed 5 min post exercise wherein pH levels in the SW group were lower than those observed in the BMW group; however, this difference did not achieve statistical significance (p = 0.09). A statistical trend (p = 0.06) was observed wherein lactate in the BMW group tended to be lower than in the SW group 5 min post exercise. No significant main effect for time (p > 0.05) or group × time interactions (p > 0.05) for the total work, average values of peak power, or average values of mean power were observed, indicating performance was unchanged.

CONCLUSION

One week of consuming water with increased bicarbonate (10 mL/kg; ~3 g/day bicarbonate) showed no effect on anaerobic cycling performance. BMW decreased blood lactate concentrations 5 min after exercise and increased blood pH immediately and 10 min after exercise.

Effects of dietary supplements on athletic performance in elite soccer players: a systematic review

Dietary supplements are widely used among athletes, and soccer players are no exception. Nevertheless, evidence supporting the use of dietary supplements aiming to enhance performance in soccer is somewhat contradictory, scarce, or even nonexistent. Thus, the present study aimed to systematically review and synthesize the effects of dietary supplements on athletic performance (e.g. distance covered, sprinting, jump performance) in elite soccer players. Studies enrolling highly trained, elite, and world-class soccer players using dietary supplements were searched in MEDLINE/PubMed, Web of Science, Scopus, and EBSCO databases in June 2022. In total, 1043 studies were identified, and 18 met the eligibility criteria. The studies evaluated the impacts on athletic performance of several dietary supplements, including caffeine, creatine, protein, beverages with carbohydrates and electrolytes, tart cherry juice, nitrate-rich beetroot juice, sodium bicarbonate with minerals, yohimbine, and a proprietary nutraceutical blend. Caffeine supplementation in doses between 3 and 6 mg/kg of body mass may improve jump height and sprint ability, particularly in female players, but individual response to caffeine must be considered. Creatine may improve sprint, agility, and in female players, jump performance. Protein supplementation can improve sprint and jump performance between matches, especially if protein ingested from food is not up to recommendations. Beverages containing carbohydrates and electrolytes can be used as part of the strategies to achieve carbohydrate intake during training and match-days but used alone do not benefit athletic performance. Tart cherry juice might be useful for maintaining athletic performance after matches that produce higher force loss and exercise-induced muscle damage, although polyphenols from the diet might attenuate the effects of tart cherry supplementation. Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches. Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances. Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players. Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.

Sodium Bicarbonate Ingestion in a Fasted State Improves 16.1-km Cycling Time-Trial Performance

PURPOSE

The use of sodium bicarbonate (SB) as a preexercise ergogenic aid has been extensively studied in short-duration high-intensity exercise. Very few studies have considered the effects of SB ingestion before prolonged high-intensity exercise. The aim of the present study was to determine the effects of a 0.3 g·kg -1 body mass dose of SB ingested before the start of a 16.1-km cycling time trial in cyclists.

METHOD

Ten trained male cyclists (age, 31.1 ± 9 yr; height, 1.84 ± 0.05 m; body mass, 82.8 ± 8.5 kg; and V̇O 2peak , 60.4 ± 3.1 mL·kg -1 ·min -1 ) completed this study. Participants ingested 0.3 g·kg -1 in gelatine (SB-G) and enteric capsules (SB-E) 1 wk apart to determine individualized time-to-peak alkalosis for each ingestion form. Using a randomized crossover design, participants then performed simulated 16.1-km time trials after ingestion of SB-G, SB-E, or a placebo.

RESULTS

There were significant differences in performance between the SB and placebo ingestion strategies ( f = 5.50, P = 0.014, p η2 = 0.38). Performance time was significantly improved by SB ingestion (mean improvement: 34.4 ± 42.6 s ( P = 0.031) and 40.4 ± 45.5 s ( P = 0.020) for SB-G and SB-E, respectively) compared with the placebo. Gastrointestinal symptoms were lower after SB-E compared with SB-G (36.3 ± 4.5 vs 5.6 ± 3.1 AU, P < 0.001, g = 7.09).

CONCLUSIONS

This study demonstrates that increased buffering capacity after acute preexercise SB ingestion can improve endurance cycling time-trial performances. The use of SB could be considered for use in 16.1-km cycling time trials, but further work is required to establish these effects after a preexercise meal.

Evidence-based nutritional approaches to enhance exercise adaptations

PURPOSE OF REVIEW

The purpose of this opinion paper is to provide current-day and evidence-based information regarding dietary supplements that support resistance training adaptations or acutely enhance strength-power or endurance performance.

RECENT FINDINGS

Several independent lines of evidence support that higher protein diets, which can be readily achieved through animal-based protein supplements, optimize muscle mass during periods of resistance training, and this likely facilitates strength increases. Creatine monohydrate supplementation and peri-exercise caffeine consumption also enhance strength and power through distinct mechanisms. Supplements that favorably affect aspects of endurance performance include peri-exercise caffeine, nitrate-containing supplements (e.g., beet root juice), and sodium bicarbonate consumption. Further, beta-alanine supplementation can enhance high-intensity endurance exercise efforts.

SUMMARY

Select dietary supplements can enhance strength and endurance outcomes, and take-home recommendations will be provided for athletes and practitioners aiming to adopt these strategies.

Caffeine, lactic acid, or nothing: What effect does expectation have on men's performance and perceived exertion during an upper body muscular endurance task?

Objective

We tested the impact of subjects' belief in an ingested substance's ergogenic or ergolytic properties on muscular endurance performance and perceived exertion.

Methods

Trained men (n = 15, age = 41 ± 4 y; body mass = 82.1 ± 15.8 kg; height = 173 ± 8 cm; experience = 7.4 ± 2.3 y) completed one set to failure at 80% repetition maximum of the bench press under three conditions. In all conditions, subjects ingested capsules of an identical, inert substance (300 mg cellulose), but, in a randomized order, subjects were told that they were either ingesting caffeine (Placebo), lactic acid (Nocebo), or cellulose (Control) and received information on the respective alleged ergogenic/ergolytic/neutral effects of each. Repetitions completed and rating of perceived exertion (RPE) were recorded. The data were analyzed among conditions using a Friedman test with post hoc analyses accomplished through Durbin-Conover tests. Spearman correlations were used to compare repetitions performed and RPE between Nocebo and Placebo conditions. Statistical significance was set at P ≤ 0.05.

Results

Subjects lifted more (P < 0.001) repetitions in the Placebo condition (14.1 ± 3.0) versus Control (10.3 ± 2.9) or Nocebo (7.5 ± 2.6), while Control and Nocebo performances were similar (P = 0.192). Lower RPE was noted in Placebo versus Control (P = 0.003) and Nocebo (P < 0.001) and lower in Control versus Nocebo (P = 0.025). Subjects who performed more repetitions with Placebo tended to perform fewer repetitions under the Nocebo condition (Spearman's Rho =-0.578).

Conclusion

This study believes that the ergogenic or ergolytic properties of a substance can measurably impact upper-body muscular endurance performance and RPE in trained men.

The Influence of Transcranial Alternating Current Stimulation on Fatigue Resistance

Previous research has shown that some forms of non-invasive brain stimulation can increase fatigue resistance. The purpose of this study is to determine the influence of transcranial alternating current stimulation (tACS) on the time to task failure (TTF) of a precision grip task. The study utilized a randomized, double-blind, SHAM-controlled, within-subjects design. Twenty-six young adults completed two experimental sessions (tACS and SHAM) with a 7-day washout period between sessions. Each session involved a fatiguing isometric contraction of the right hand with a precision grip with either a tACS or SHAM stimulation applied to the primary motor cortex (M1) simultaneously. For the fatiguing contraction, the participants matched an isometric target force of 20% of the maximum voluntary contraction (MVC) force until task failure. Pre- and post-MVCs were performed to quantify the force decline due to fatigue. Accordingly, the dependent variables were the TTF and MVC force decline as well as the average EMG activity, force error, and standard deviation (SD) of force during the fatiguing contractions. The results indicate that there were no significant differences in any of the dependent variables between the tACS and SHAM conditions (p value range: 0.256-0.820). These findings suggest that tACS does not increase the TTF during fatiguing contractions in young adults.

A Determination of the Caffeine Content in Dietary Supplements According to Green Chemistry Principles

Caffeine is a natural psychoactive substance that belongs to a group of chemical compounds called purine alkaloids. Caffeine is found in various plants such as coffee, tea, cocoa, guarana, and yerba mate. It is often added to dietary supplements for its ability to increase metabolism and aid in weight loss. To determine the caffeine content in dietary supplements, a novel UHPLC method was developed, compatible with the rules of green analytical chemistry. The developed method used only water and ethanol for sample preparation and chromatographic separation on a short C18 column. The obtained method confirmed that caffeine may be analyzed using only environmentally friendly solvents, ethanol, and water. The developed method is characterized by its low limit of quantitation, equal to 0.047 µg/mL, and good reproducibility (a relative standard deviation lower than 1.1%). The obtained results show that the caffeine content in tested dietary supplements is 4-35% higher than the declared amount in most cases. In comparison, the caffeine content of the drug determined using this method was performed with an accuracy of 0.4% RSD.

Effects of Nutrition Interventions on Athletic Performance in Soccer Players: A Systematic Review

BACKGROUND

More than 270 million participants and 128,893 professional players play soccer. Although UEFA recommendations for nutrition in elite football exist, implementing these guidelines among professional and semiprofessional soccer players remains suboptimal, emphasizing the need for targeted and individualized nutritional strategies to improve adherence to established recommendations.

METHODS

We conducted a comprehensive search in PubMed, Scopus, Web of Science, and clinical trial registers. Inclusion criteria focused on professional or semiprofessional soccer players, nutrition or diet interventions, performance improvement outcomes, and randomized clinical trial study types. We assessed quality using the Risk of Bias 2 (RoB 2) tool. We identified 16 eligible articles involving 310 participants. No nutritional interventions during the recovery period effectively improved recovery. However, several performance-based interventions showed positive effects, such as tart cherry supplementation, raw pistachio nut kernels, bicarbonate and mineral ingestion, creatine supplementation, betaine consumption, symbiotic supplements, and a high-carbohydrate diet. These interventions influenced various aspects of soccer performance, including endurance, speed, agility, strength, power, explosiveness, and anaerobic capacity.

CONCLUSIONS

Specific strategies, such as solutions with bicarbonate and minerals, high carbohydrate diets, and supplements like creatine, betaine, and tart cherry, can enhance the performance of professional soccer players. These targeted nutritional interventions may help optimize performance and provide the competitive edge required in professional soccer. We did not find any dietary interventions that could enhance recovery.

The interplay between bicarbonate kinetics and gastrointestinal upset on ergogenic potential after sodium bicarbonate intake: a randomized double-blind placebo-controlled trial

This double-blind placebo-controlled cross-over study utilized comprehensive monitoring of blood bicarbonate (HCO₃^¯) kinetics and evaluation of gastrointestinal (GI) upset to determine their impact on an ergogenic potential of sodium bicarbonate (SB) co-ingested with carbohydrate (CHO). Nineteen CrossFit athletes performed 6 bouts of 15 s Wingate Anaerobic Test (WAnT) 90 min post-ingestion of 0.4 g·kg^-1 body mass (BM) of SB (SB + CHO treatment) or PLA (PLA + CHO treatment) with 15 g CHO. Blood HCO₃^¯ concentration was evaluated at baseline, 30-, 60-, 75- and 90 min post-ingestion, in between WAnT bouts, and 3 and 45 min post-exercise, while GI upset at 120 min after protocol started. Control (no supplementation; CTRL) procedures were also performed. An effective elevation of extra-cellular buffering capacity was observed 60-90 min post-ingestion of SB + CHO. At mean peak blood HCO₃^¯, or at start of exercise an increase > 6 mmol·L^-1 in HCO₃^¯ was noted in 84% and 52.6% participants, respectively. SB + CHO did not prevent performance decrements in WAnT bouts. There were no significant relationships between changes in blood HCO₃^¯ and WAnTs' performance. Total GI was significantly higher in SB + CHO compared to CTRL, and stomach problems in SB + CHO compared to CTRL and PLA + CHO. There were inverse associations between peak- (p = 0.031; r = - 0.495), average- (p = 0.002; r = - 0.674) and minimum power (p = 0.008; r = - 0.585) and total GI upset, as well as average power and severe GI distress (p = 0.042; r = - 0.471) at SB + CHO. The implemented dose of SB + CHO was effective in improving buffering capacity, but did not prevent decrements in WAnTs' performance. GI side effects were crucial in affecting the ergogenic potential of SB and thus must be insightfully monitored in future studies.

Can a basic solution activate the inflammatory reflex? A review of potential mechanisms, opportunities, and challenges

Stimulation of the inflammatory reflex (IR) is a promising strategy to treat systemic inflammatory disorders. However, this strategy is hindered by the cost and side effects of traditional IR activators. Recently, oral intake of sodium bicarbonate (NaHCO3) has been suggested to activate the IR, providing a safe and inexpensive alternative. Critically, the mechanisms whereby NaHCO3 might achieve this effect and more broadly the pathways underlying the IR remain poorly understood. Here, we argue that the recognition of NaHCO3 as a potential IR activator presents exciting clinical and research opportunities. To aid this quest, we provide an integrative review of our current knowledge of the neural and cellular pathways mediating the IR and discuss the status of physiological models of IR activation. From this vantage point, we derive testable hypotheses on potential mechanisms whereby NaHCO3 might stimulate the IR and compare NaHCO3 with classic IR activators. Elucidation of these mechanisms will help determine the therapeutic value of NaHCO3 as an IR activator and provide new insights into the IR circuitry.

Effects of Capsaicin and Capsiate on Endurance Performance: A Meta-Analysis

Several studies have explored the effects of capsaicin and capsiate on endurance performance, with conflicting findings. This systematic review aimed to perform a meta-analysis examining the effects of capsaicin and capsiate vs. placebo on endurance performance in humans. Seven databases were searched to find eligible studies. The effects of capsaicin and capsiate on aerobic endurance (e.g., time-trials or time-to-exhaustion tests), muscular endurance (e.g., repetitions performed to muscular failure), and rating of perceived exertion (RPE) were examined in a random-effects meta-analysis. Fourteen studies (n = 183) were included in the review. Most studies provided capsaicin or capsiate in the dose of 12 mg, 45 min before exercise. In the meta-analysis for aerobic endurance, there was no significant difference between the placebo and capsaicin/capsiate conditions (Cohen’s d: 0.04; 95% confidence interval: −0.16, 0.25; p = 0.69). In subgroup meta-analyses, there were no significant differences between the placebo and capsaicin/capsiate conditions when analyzing only studies that used time-trials (p = 0.20) or time-to-exhaustion tests (p = 0.80). In the meta-analysis for muscular endurance, a significant ergogenic effect of capsaicin/capsiate was found (Cohen’s d: 0.27; 95% confidence interval: 0.10, 0.43; p = 0.002). When analyzing set-specific effects, an ergogenic effect of capsaicin/capsiate was found in set 1, set 2, and set 3 (Cohen’s d: 0.21–29). Capsaicin/capsiate ingestion reduced RPE following muscular endurance (p = 0.03) but not aerobic endurance tests (p = 0.58). In summary, capsaicin/capsiate supplementation acutely enhances muscular endurance, while the effects on aerobic endurance are less clear.

Acute enteric-coated sodium bicarbonate has negligible effect on anaerobic performance but affects metabolomics and attenuates the gastrointestinal response

Sodium bicarbonate ingestion before exercise has a performance-enhancing effect on high-intensity exercise. However, gastrointestinal symptoms can be a problematic side-effect. Enteric-coated sodium bicarbonate can attenuate gastrointestinal symptoms following acute bicarbonate loading. In addition, the subsequent effects on exercise performance and metabolomics have not been investigated. The purpose of this study was to investigate the acute effect of enteric-coated sodium bicarbonate supplementation on the anaerobic performance, physiological profile, and symptoms of gastrointestinal discomfort after severe-intensity intermittent exercise. At the same time, targeted metabolomics was used to study the changes in urine metabolism after ingestion of enteric-coated sodium bicarbonate and to explore the characteristics of biological metabolism. In a randomized crossover design, twelve male college students completed four Wingate anaerobic 30-s cycling tests (WACT) after consuming a placebo (PL) and two experimental conditions: 0.2 g/kg body mass in enteric-coated sodium bicarbonate pills (ES) or general sodium bicarbonate pills (GS). Blood lactate (BLA), heart rate (HR), ratings of perceived exertion (RPE), and gastrointestinal–symptoms assessment questionnaire (GSAQ) were measured pre-exercise and post-exercise. In contrast, mean power (MP) and peak power (PP) were recorded immediately post-exercise. Urine samples were collected before formal tests and 50 min after the third WACT. Our findings indicate the following: 1) mean power and peak power showed no significant difference among conditions (MP: F_{2.0, 33} = 0.541, p = 0.587, η² = 0.032; PP: F_{2.0, 33} = 0.526, p = 0.596, η² = 0.031). The PP decline of the ES and GS after the third WACT was lower than that of the PL; 2) There were no significant differences in physiological responses, such as BLA (F_{2.0, 33.0}= 0.191, p = 0.827, η² = 0.011) and heart rate (F_{2, 33} = 0.418, p = 0.662, η² = 0.025), between the three conditions. Although blood lactate concentration after 10 min of the third WACT was lower with ES and GS than with placebo; 3) Fewer participants experienced gastrointestinal symptoms with enteric-coated than with general sodium bicarbonate; 4) The metabolites with differences among the three conditions 50 min after exercise were 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, cis-aconitate, oxaloacetate, and citrate. ES had higher levels of 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, and cis-aconitate than GS. The 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, and cis-aconitate levels in GS were significantly lower than in PL. In contrast, the citrate level in GS was significantly higher than that in other experimental conditions. Compared to PL, the level of oxaloacetate was higher after exercise in ES. This data suggests that supplementation of enteric-coated and general sodium bicarbonate before exercise can alter energy metabolism following anaerobic exercise, involving the metabolism of 3-phospho-d-glycerate, D-Glucose 6-phosphate, pyruvate, cis-aconitate, oxaloacetate, citrate, and lactate. However, they do not affect anaerobic performance and blood lactate. The supplementation of acute enteric-coated sodium bicarbonate and general sodium bicarbonate can enhance some of the weak effects of blood lactate clearance during anaerobic exercise, which may be beneficial for glycolytic energy supply. In addition, enteric-coated sodium bicarbonate intake mitigates gastrointestinal symptoms compared to general sodium bicarbonate.

Effects of serial and acute enteric-coated sodium bicarbonate supplementation on anaerobic performance, physiological profile, and metabolomics in healthy young men

Background

Previous studies have reported that sodium bicarbonate ingestion may enhance high-intensity exercise performance and cause severe gastrointestinal distress. However, enteric-coated sodium bicarbonate may reduce gastrointestinal symptoms of sodium bicarbonate after oral administration. This remains to be confirmed. This study aimed to verify the effects of serial and acute enteric-coated sodium bicarbonate supplementation on anaerobic performance, physiological profile, and metabolomics in healthy young men.

Methods

Healthy young males (n = 12) ingested 0.2 g/kg body mass of enteric-coated sodium bicarbonate (ES) in serial enteric-coated sodium bicarbonate (SES, continuous ES supplementation for 5 days) and acute enteric-coated sodium bicarbonate (AES, acute ES supplementation before exercise) or a placebo (PL) in a randomized crossover design. After each supplement protocol, the participants completed four Wingate anaerobic tests (WAT). The first three Wingate tests (testing anaerobic capacity) were performed with a 5-min passive recovery between each. After the third Wingate test, participants were required to complete a 50-min recovery followed by a fourth WAT test (testing the recovery of anaerobic capacity after 50-min intervals). Blood lactate (BLA), heart rate (HR), and ratings of perceived exertion (RPE) were measured in all conditions during the test, as was the subjective gastrointestinal–symptoms assessment questionnaire (GSAQ). Mean power (MP) and peak power (PP) were recorded after four WATs. Urine samples were collected before the test and 50 min after the 3rd WAT.

Results

Serial enteric-coated sodium bicarbonate supplementation improved anaerobic capacity in the third bout of WATs, as observed based on an increase in mean power (SES vs. PL (613 ± 57 vs. 542 ± 64 W), P = 0.024) and peak power (SES vs. PL (1,071 ± 149 vs. 905 ± 150 W), P = 0.016). Acute ES supplementation did not affect anaerobic capacity. The occurrence of gastrointestinal symptoms after enteric-coated sodium bicarbonate supplementation was minimal and no difference compared to placebo in the current study. In particular, serial enteric-coated sodium bicarbonate supplementation had no gastrointestinal side effects before the test. The AES and SES groups had a trivial effect on blood lactate compared to the PLA group. There was no significant difference in HR and RPE among the three groups. Based on targeted metabolomics analysis, the 50 min after the third WAT, the levels of lactate (P &lt; 0.001), L-Malic acid (P &lt; 0.05), and oxaloacetate (P &lt; 0.05) were significantly higher in the SES group than in the PL group. Compared with the AES group, the levels of lactate and fumarate in the SES group were significantly increased (P &lt; 0.05).

Conclusions

Our study indicates that serial enteric-coated sodium bicarbonate supplementation positively improves anaerobic performance among healthy young men. However, acute ingestion of enteric-coated sodium bicarbonate did not improve anaerobic exercise performance. Either with serial or acute supplementation doses, enteric-coated sodium bicarbonate produced fewer gastrointestinal symptoms and no difference compared to placebo, especially with no gastrointestinal side effects after serial supplementation. Serial and acute supplementation of enteric-coated sodium bicarbonate might tend to promote lactate clearance. Furthermore, serial enteric-coated sodium bicarbonate ingestion may cause changes in the metabolism of lactate, L-Malic acid, oxaloacetate, and fumarate 50 min after exercise, which presumably may promote the tricarboxylic acid cycle and lactate clearance.

Repeated Simulated Match-Induced Changes in Finger Flexor Force and Blood Acid-Base Balance in World-Class Female Judokas

PURPOSE

The aim of this study was to investigate the time course of maximal isometric finger flexor force and blood acid-base balance during repeated simulated matches in world-class judokas.

METHODS

Seven 21- to 28-year-old world-class female judokas (including Olympic and World Championship medalists) repeated four 4-minute judo combats interspersed by 15 minutes of passive recovery. Maximal voluntary isometric finger flexor contraction (MVIC) force was measured in both hands after warm-up and immediately after each combat using a handgrip dynamometer. MVIC force was classified as MVIC hikite force (pulling hand) and MVIC tsurite force (lifting hand).

RESULTS

Blood lactate concentration, pH, bicarbonate concentration, partial pressure of oxygen, and oxygen saturation were measured between 3 and 5 minutes after each match. At completion of the fourth combat, mean MVIC hikite and tsurite force decreased by 18% and 12%, respectively (g = 0.23 and 0.29, respectively; P < .05), demonstrating that force production was substantial throughout repeated matches. Blood lactate concentration increased ∼5-fold from 2.69 (1.37) mmol·L-1 after warm-up to 13.10 (2.61) mmol·L-1 after the last match (g = 4.13, P = .018). Concurrently, blood pH decreased slightly from 7.44 (0.03) to 7.26 (0.05) (g = 2.34, P = .018), that is, by only 0.18 units. The decreased blood pH was significantly correlated with a decrease in bicarbonate concentration (R2 = .94, P < .001). Finally, partial pressure of oxygen and oxygen saturation remained unchanged during the judo contest.

CONCLUSIONS

Female world-class judokas were able to maintain a high level of grip strength in both hands and efficiently regulate blood acid-base balance during repeated simulated high-intensity matches.

Herbs as an Active Ingredient in Sport: Availability and Information on the Internet

The use of supplements containing herbal active ingredients in sport has increased in recent years. Their consumption is explained by the benefits they may provide and because their natural origin do not involve health complications, from the point of view of the consumers. The aim of this study is to analyze the availability of four supplements (caffeine, turmeric, ginseng, cannabidiol) on the internet and understand the nature of these websites. A descriptive, observational, and cross-sectional study design was used. A detailed search was carried out with specifically developed software. The searches and data evaluation took 10 days. The websites consulted correspond to those that sell supplements, or some sport websites in the case of the Spanish ones, whereas those in English belong to pharmacies, parapharmacies, or herbalists. It is concluded that the websites do not provide adequate information to ensure proper consumption and lack advice on the choices of supplements and their administration guidelines.

What is the Effect of Paracetamol (Acetaminophen) Ingestion on Exercise Performance? Current Findings and Future Research Directions

In recent years, studies have explored the effects of paracetamol (acetaminophen) ingestion on exercise performance. However, due to the contrasting findings, there is still no consensus on this topic. This article provides an overview of the effects of paracetamol on endurance, sprinting, and resistance exercise performance. Studies have reported that paracetamol ingestion may be ergogenic for endurance performance. These effects occur when paracetamol is ingested 45-60 min before exercise and appear to be more pronounced in time-to-exhaustion versus time-trial tests. Besides endurance, paracetamol ingestion 30 min before exercise increases mean power during repeated cycling sprints in interval training involving repeated 30-s all-out bouts. Preliminary data on paracetamol ingestion also suggest: (a) improved endurance performance in the heat; (b) an improvement in single sprint performance, at least when paracetamol is ingested following exercise-induced fatigue; and (c) attenuation of the decline in muscular strength that occurs with repeated maximum contractions. An ergogenic effect of paracetamol is most commonly observed when a dose of 1500 mg is ingested 30-60 min before exercise. Despite these performance-enhancing effects, the aim of this article is not to promote paracetamol use, as side effects associated with its consumption and ethical aspects need to be considered before utilizing paracetamol as an ergogenic aid. Future research on this topic is still needed, particularly related to paracetamol dosing, timing of ingestion, and the effects of paracetamol in females and elite athletes.

“Food First but Not Always Food Only”: Recommendations for Using Dietary Supplements in Sport

The term “food first” has been widely accepted as the preferred strategy within sport nutrition, although there is no agreed definition of this and often limited consideration of the implications. We propose that food first should mean “where practically possible, nutrient provision should come from whole foods and drinks rather than from isolated food components or dietary supplements.” There are many reasons to commend a food first strategy, including the risk of supplement contamination resulting in anti-doping violations. However, a few supplements can enhance health and/or performance, and therefore a food only approach could be inappropriate. We propose six reasons why a food only approach may not always be optimal for athletes: (a) some nutrients are difficult to obtain in sufficient quantities in the diet, or may require excessive energy intake and/or consumption of other nutrients; (b) some nutrients are abundant only in foods athletes do not eat/like; (c) the nutrient content of some foods with established ergogenic benefits is highly variable; (d) concentrated doses of some nutrients are required to correct deficiencies and/or promote immune tolerance; (e) some foods may be difficult to consume immediately before, during or immediately after exercise; and (f) tested supplements could help where there are concerns about food hygiene or contamination. In these situations, it is acceptable for the athlete to consider sports supplements providing that a comprehensive risk minimization strategy is implemented. As a consequence, it is important to stress that the correct terminology should be “food first but not always food only.”

Effect of β-alanine and sodium bicarbonate co-supplementation on the body's buffering capacity and sports performance: A systematic review

Muscle acidification is one of the main factors causing fatigue during exercise, thus compromising performance. The sport supplements beta alanine (β-A) and sodium bicarbonate (SB) are thought to enhance the effects of the body's buffer systems by reducing H⁺ concentrations. The aim of this systematic review was to analyze the effects of β-A and SB co-supplementation on the organism's buffering capacity and sport performance. The databases PubMed, Web of Science, Medline, CINAHL and SPORTDiscus were searched until November 2021 following PRISMA guidelines. Randomized controlled trials, at least single-blind, performed in athletes of any age were considered. Nine studies including a total of 221 athletes were identified for review. Athletes were supplemented with β-A and SB while they performed exercise tests to assess physical performance and buffer capacity. Five of the nine studies indicated there was some additional improvement in buffering capacity and performance with co-supplementation, while one study concluded that the effect was comparable to the added effects of the individual supplements. According to the results of the studies reviewed, we would recommend β-A and SB co-supplementation during high intensity exercises lasting between 30 s and 10 min.

Sport supplements and the athlete's gut: a review

Vigorous or prolonged exercise poses a challenge to gastrointestinal system functioning and is associated with digestive symptoms. This narrative review addresses 1) the potential of dietary supplements to enhance gut function and reduce exercise-associated gastrointestinal symptoms and 2) strategies for reducing gastrointestinal-related side effects resulting from popular sports supplements. Several supplements, including probiotics, glutamine, and bovine colostrum, have been shown to reduce markers of gastrointestinal damage and permeability with exercise. Yet, the clinical ramifications of these findings are uncertain, as improvements in symptoms have not been consistently observed. Among these supplements, probiotics modestly reduced exercise-associated gastrointestinal symptoms in a few studies, suggesting they are the most evidenced-based choice for athletes looking to manage such symptoms through supplementation. Carbohydrate, caffeine, and sodium bicarbonate are evidence-based supplements that can trigger gastrointestinal symptoms. Using glucose-fructose mixtures is beneficial when carbohydrate ingestion is high (>50 g/h) during exercise, and undertaking multiple gut training sessions prior to competition may also be helpful. Approaches for preventing caffeine-induced gastrointestinal disturbances include using low-to-moderate doses (<500 mg) and avoiding/minimizing exacerbating factors (stress, anxiety, other stimulants, fasting). Adverse gastrointestinal effects of sodium bicarbonate can be avoided by using enteric-coated formulations, low doses (0.2 g/kg), or multi-day loading protocols.

Effects of sodium bicarbonate supplementation on exercise performance: an umbrella review

BACKGROUND

We aimed to perform an umbrella review of meta-analyses examining the effects of sodium bicarbonate supplementation on exercise performance.

METHODS

We systematically searched for meta-analyses that examined the effects of sodium bicarbonate supplementation on exercise performance. The methodological quality of the included reviews was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) checklist. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for downgrading the certainty in evidence was used, which included assessments of risk of bias, inconsistency, indirectness, imprecision, and publication bias.

RESULTS

Eight reviews of moderate and high methodological quality met inclusion criteria. Using the GRADE framework, evidence for the ergogenic effects of sodium bicarbonate supplementation on peak and mean power in the Wingate test and Yo-Yo test performance was classified as being of moderate quality. The evidence for these outcomes did not receive a point on the indirectness GRADE item, as "serious indirectness" was detected. Low-quality evidence was found for the ergogenic effect of sodium bicarbonate supplementation on endurance events lasting ∼45 s to 8 min, muscle endurance, and 2000-m rowing performance. Evidence for these outcomes was classified as low quality, given that risk of bias, indirectness, and publication bias were assessed as "unclear", "serious", and "strongly suspected", respectively. The ergogenic effects ranged from trivial (pooled effect size: 0.09) to large (pooled effect size: 1.26). Still, for most outcomes, sodium bicarbonate elicited comparable ergogenic effects. For example, sodium bicarbonate produced similar effects on performance in endurance events lasting ∼45 s to 8 min, muscle endurance tests, and Yo-Yo test (pooled effect size range: 0.36 to 0.40). No significant differences between the effects of sodium bicarbonate and placebo were found for general mean power, muscle strength, and repeated-sprint ability.

CONCLUSION

Based on meta-analyses of moderate to high quality, it can be concluded that sodium bicarbonate supplementation acutely enhances peak anaerobic power, anaerobic capacity, performance in endurance events lasting ∼45 s to 8 min, muscle endurance, 2000-m rowing performance, and high-intensity intermittent running. More research is needed among women to improve the generalizability of findings.