Use of Buffers in Specific Contexts: Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents-A Narrative Review

This narrative review evaluated the evidence for buffering agents (sodium bicarbonate, sodium citrate and beta-alanine), with specific consideration of three discrete scenarios: female athletes, extreme environments and combined buffering agents. Studies were screened according to exclusion and inclusion criteria and were analysed on three levels: (1) moderating variables (supplement dose and timing, and exercise test duration and intensity), (2) design factors (e.g., use of crossover or matched group study design, familiarisation trials) and (3) athlete-specific factors (recruitment of highly trained participants, buffering capacity and reported performance improvements). Only 19% of the included studies for the three buffering agents reported a performance benefit, and only 10% recruited highly trained athletes. This low transferability of research findings to athletes' real-world practices may be due to factors including the small number of sodium citrate studies in females (n = 2), no studies controlling for the menstrual cycle (MC) or menstrual status using methods described in recently established frameworks, and the limited number of beta-alanine studies using performance tests replicating real-world performance efforts (n = 3). We recommend further research into buffering agents in highly trained female athletes that control or account for the MC, studies that replicate the demands of athletes' heat and altitude camps, and investigations of highly trained athletes' use of combined buffering agents. In a practical context, we recommend developing evidence-based buffering protocols for individual athletes which feature co-supplementation with other evidence-based products, reduce the likelihood of side-effects, and optimise key moderating factors: supplement dose and timing, and exercise duration and intensity.

Effect of a sustained-release formulation of β-alanine on laboratory parameters and paresthesia in recreational trained men: a randomized double-blind placebo-controlled study

Introduction

Beta-alanine is a non-essential amino acid that has been a focus of increasing research by its role as ergogenic aid to improve muscle performance.

Methods

A randomized, double-blind and controlled trial was conducted to determine the effect of a nutritional supplement of a sustained-release formulation of β-alanine in recreational trained men. The active product was an innovative sustained-release β-alanine microgranules powder blend, administered at high doses (15 g/day) divided into 3 intakes during 30 days. There were 10 participants in the experimental group and 9 in the placebo group, with a mean age of 22.5 ± 3.3 years. Participants were testing at baseline and at the end of study.

Results

In the β-alanine group, there were statistically increases in serum triglycerides, LDL-cholesterol, and urea nitrogen at the end of the study as compared with baseline, although there were no differences with the control group. The occurrence of paresthesia, described above all as tickling, was the majority but presented VAS score less than 3/10 in almost all subjects.

Discussion

More studies are required to evaluate the changes in blood parameters that can be caused by high intake of β-alanine during a long period of time.

Clinical trial registration

ClinicalTrials.gov, identifier (NCT05334121).

β-Alanine Supplementation in Combat Sports: Evaluation of Sports Performance, Perception, and Anthropometric Parameters and Biochemical Markers-A Systematic Review of Clinical Trials

β-alanine does not have an ergogenic effect by itself, but it does as a precursor for the synthesis of carnosine in human skeletal muscle. β-alanine and carnosine together help improve the muscles' functionality, especially in high-intensity exercises such as combat sports. Therefore, β-alanine could be considered a nutritional ergogenic aid to improve sports performance in combat athletes. We aimed to critically review clinical trial evidence on the impact of β-alanine supplementation on sports performance, perception, and anthropometric parameters, as well as circulating biochemical markers in combat athletes. This systematic review was conducted following the specific methodological guidelines of the Preferred Report Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), the PICOS question model, the Critical Review Form of McMaster, and the PEDro scale. Furthermore, the Cochrane risk-of-bias assessment tool was used. The search was carried out in the SCOPUS, Web of Science (WOS), and Medline (PubMed) databases for studies published from the beginning of the database until July 31, 2023. Of the 41 registers identified, only 7 met the established criteria and were included in this systematic review. Overall, performance parameters related to strength, power, total exercise work capacity, and combat-specific parameters were significantly improved (p < 0.05). Perception parameters increased non-significantly (p > 0.05). Regarding biochemical parameters, carnosine increased significantly (p < 0.05), pH decreased non-significantly (p > 0.05), and the results for blood bicarbonate and blood lactate were heterogeneous. Finally, there was a non-significant (p > 0.05) improvement in the anthropometric parameters of lean mass and fat mass. β-alanine supplementation appears to be safe and could be a suitable nutritional ergogenic aid for combat athletes.

High-intensity interval training ameliorates endothelial dysfunction through adropin, nitric oxide, MR-proADM, and copeptin changes in overweight subjects

PURPOSE

The purpose of this study was to determine adropin, NO, MR-proADM, and copeptin changes following four different types of high-intensity interval training (HIIT) in men with overweight.

METHODS

In the current study, 45 overweight participants were included in the pre-intervention assessments and randomly assigned to the following groups: (1) control, (2) HIIT bike, (3) HIIT short-treadmill, and (4) HIIT long-treadmill groups. The participants were given 10-min sessions of HIIT intervention between 85 and 95% of VO_2peak, followed by 1-min inactive recovery at three sessions/week for 8 weeks. Body composition, VO_2peak, ultrasound imaging, diabesity-related risk factors, adropin, NO, MR-proADM, and copeptin were also assessed before and following the HIIT interventions.

RESULTS

There was a statistically significant elevation in adropin and NO levels (p < 0.05), while MR-proADM and copeptin were notably more decreased than those of the control group following the 8 weeks of HIIT interventions (p < 0.01). However, no statistically significant decrease was observed in carotid/femoral intima-media thickness (c/f-IMT) values following the 8-week HIIT interventions, while statistically significant reductions were demonstrated in participants who had no atherosclerotic plaque or IMT < 0.9 mm (p < 0.05).

CONCLUSIONS

In conclusion, HIIT had a greater effect on IMT remodeling of the femoral artery than of the carotid artery. Decreased MR-proADM and copeptin and increased adropin levels might act as a physiological surrogate of endothelial dysfunction through increased NO-related signaling pathways in participants with overweight following high-intensity interval training.

Effect of high-intensity interval training and high-intensity resistance training on Irisin and fibroblast growth factor 21 in men with overweight and obesity

Adipose tissue browning is a physiological process that increases energy expenditure and may combat against obesity and its related risk factors. Fibroblast growth factor 21 and Irisin, hormones affected by exercise that also affect adipose tissue browning, have not been widely studied with regards to exercise type and duration. This study compared the effect of high-intensity interval training (HIIT) and high-intensity resistance training (HIRT) on Irisin and fibroblast growth factor 21 (FGF21) in men living with overweight and obesity. After completing a training program three times weekly for eight weeks, participants' serum levels of Irisin and FGF21 were significantly increased in the HIIT and HIRT groups compared to the control group (p<0.05). Additionally, body fat percentage and body weight in both training groups were significantly reduced in comparison with the control group (p<0.05). Thus, HIIT and HIRT programs may be used as a feasible modality to promote favourable changes in body composition and Irisin and FGF21, factors critical for browning white adipose tissue in men living with overweight and obesity.

Effects of beta-alanine supplementation on body composition: a GRADE-assessed systematic review and meta-analysis

Purpose

Previous studies have suggested that beta-alanine supplementation may benefit exercise performance, but current evidence regarding its effects on body composition remains unclear. This systematic review and meta-analysis aimed to investigate the effects of beta-alanine supplementation on body composition indices.

Methods

Online databases, including PubMed/Medline, Scopus, Web of Science, and Embase, were searched up to April 2021 to retrieve randomized controlled trials (RCTs), which examined the effect of beta-alanine supplementation on body composition indices. Meta-analyses were carried out using a random-effects model. The I² index was used to assess the heterogeneity of RCTs.

Results

Among the initial 1413 studies that were identified from electronic databases search, 20 studies involving 492 participants were eligible. Pooled effect size from 20 studies indicated that beta-alanine supplementation has no effect on body mass (WMD: −0.15 kg; 95% CI: −0.78 to 0.47; p = 0.631, I² = 0.0%, p = 0.998), fat mass (FM) (WMD: −0.24 kg; 95% CI: −1.16 to 0.68; p = 0.612, I² = 0.0%, p = 0.969), body fat percentage (BFP) (WMD: −0.06%; 95% CI: −0.53 to 0.40; p = 0.782, I² = 0.0%, p = 0.936), and fat-free mass (FFM) (WMD: 0.05 kg; 95% CI: −0.71 to 0.82; p = 0.889, I² = 0.0%, p = 0.912). Subgroup analyses based on exercise type (resistance training [RT], endurance training [ET], and combined training [CT]), study duration (<8 and ≥8 weeks), and beta-alanine dosage (<6 and ≥6 g/d) demonstrated similar results. Certainty of evidence across outcomes ranged from low to moderate.

Conclusions

This meta-analysis study suggests that beta-alanine supplementation is unlikely to improve body composition indices regardless of supplementation dosage and its combination with exercise training. No studies have examined the effect of beta-alanine combined with both diet and exercise on body composition changes as the primary variable. Therefore, future studies examining the effect of the combination of beta-alanine supplementation with a hypocaloric diet and exercise programs are warranted.

Dietary Supplements for Athletic Performance in Women: Beta-Alanine, Caffeine, and Nitrate

Beta-alanine, caffeine, and nitrate are dietary supplements generally recognized by the sport and exercise science community as evidence-based ergogenic performance aids. Evidence supporting the efficacy of these supplements, however, is greatly skewed due to research being conducted primarily in men. The physiological differences between men and women, most notably in sex hormones and menstrual cycle fluctuations, make generalizing male data to the female athlete inappropriate, and potentially harmful to women. This narrative review outlines the studies conducted in women regarding the efficacy of beta-alanine, caffeine, and nitrate supplementation for performance enhancement. Only nine studies on beta-alanine, 15 on caffeine, and 10 on nitrate in healthy women under the age of 40 years conducted in normoxia conditions were identified as relevant to this research question. Evidence suggests that beta-alanine may lower the rate of perceived exertion and extend training bouts in women, leading to greater functional adaptations. Studies of caffeine in women suggest the physiological responder status and caffeine habituation may contribute to caffeine's efficacy, with a potential plateau in the dose-response relationship of performance enhancement. Nitrate appears to vary in influence based on activity type and primary muscle group examined. However, the results summarized in the limited literature for each of these three supplements provide no consensus on dosage, timing, or efficacy for women. Furthermore, the literature lacks considerations for hormonal status and its role in metabolism. This gap in sex-based knowledge necessitates further research on these ergogenic supplements in women with greater considerations for the effects of hormonal status.

Physiological Responses to Low-Volume Interval Training in Women

Interval training is a form of exercise that involves intermittent bouts of relatively intense effort interspersed with periods of rest or lower-intensity exercise for recovery. Low-volume high-intensity interval training (HIIT) and sprint interval training (SIT) induce physiological and health-related adaptations comparable to traditional moderate-intensity continuous training (MICT) in healthy adults and those with chronic disease despite a lower time commitment. However, most studies within the field have been conducted in men, with a relatively limited number of studies conducted in women cohorts across the lifespan. This review summarizes our understanding of physiological responses to low-volume interval training in women, including those with overweight/obesity or type 2 diabetes, with a focus on cardiorespiratory fitness, glycemic control, and skeletal muscle mitochondrial content. We also describe emerging evidence demonstrating similarities and differences in the adaptive response between women and men. Collectively, HIIT and SIT have consistently been demonstrated to improve cardiorespiratory fitness in women, and most sex-based comparisons demonstrate similar improvements in men and women. However, research examining insulin sensitivity and skeletal muscle mitochondrial responses to HIIT and SIT in women is limited and conflicting, with some evidence of blunted improvements in women relative to men. There is a need for additional research that examines physiological adaptations to low-volume interval training in women across the lifespan, including studies that directly compare responses to MICT, evaluate potential mechanisms, and/or assess the influence of sex on the adaptive response. Future work in this area will strengthen the evidence-base for physical activity recommendations in women.

Evaluation of High-Intensity Interval Training and Beta-Alanine Supplementation on Efficiency of Electrical Activity and Electromyographic Fatigue Threshold

ABSTRACT

Herda, AA, Smith-Ryan, AE, Kendall, KL, Cramer, JT, and Stout, JR. Evaluation of high-intensity interval training and beta-alanine supplementation on efficiency of electrical activity and electromyographic fatigue threshold. J Strength Cond Res 35(6): 1535-1541, 2021-The purpose of this study was to determine the effects of high-intensity interval training (HIIT) with or without β-alanine (BA) supplementation on the electromyographic fatigue threshold (EMGFT) and efficiency of electrical activity (EEA) in young women. Forty-four women (mean ± SD; age [yrs]: 21.7 ± 3.7; height [cm]: 166.3 ± 6.4; body mass [kg]: 66.1 ± 10.3) were randomly assigned to one of 3 treatment groups. The supplement groups performed HIIT on the cycle ergometer 3 times·wk-1 for 6 weeks. Electromyographic fatigue threshold and EEA were assessed at baseline (PRE), after 3 weeks of training (MID), and after 6 weeks of HIIT (POST). Two 2-way mixed factorial analyses of variance (time [PRE vs. MID vs. POST] × treatment (BA vs. PL vs. CON)] were used to analyze EMGFT and EEA with a predetermined level of significance α of 0.05. For EMGFT, there was no interaction (p = 0.26) and no main effect for time (p = 0.28) nor treatment (p = 0.86); thus, there were no changes in EMGFT regardless of training or supplementation status. For EEA, there was no interaction (p = 0.70) nor treatment (p = 0.79); however, there was a main effect for time (p < 0.01). Our findings indicated that neither training nor supplementation was effective in improving EMGFT in women. Efficiency of electrical activity was altered, potentially because of a learning effect. Coaches and practitioners may not use these tests to monitor training status; however, they may find EEA as a useful tool to track cycling efficiency.

Effects of Dietary Supplements on Adaptations to Endurance Training

Endurance training leads to a variety of adaptations at the cellular and systemic levels that serve to minimise disruptions in whole-body homeostasis caused by exercise. These adaptations are differentially affected by training volume, training intensity, and training status, as well as by nutritional choices that can enhance or impair the response to training. A variety of supplements have been studied in the context of acute performance enhancement, but the effects of continued supplementation concurrent to endurance training programs are less well characterised. For example, supplements such as sodium bicarbonate and beta-alanine can improve endurance performance and possibly training adaptations during endurance training by affecting buffering capacity and/or allowing an increased training intensity, while antioxidants such as vitamin C and vitamin E may impair training adaptations by blunting cellular signalling but appear to have little effect on performance outcomes. Additionally, limited data suggest the potential for dietary nitrate (in the form of beetroot juice), creatine, and possibly caffeine, to further enhance endurance training adaptation. Therefore, the objective of this review is to examine the impact of dietary supplements on metabolic and physiological adaptations to endurance training.

Supplements and Nutritional Interventions to Augment High-Intensity Interval Training Physiological and Performance Adaptations-A Narrative Review

High-intensity interval training (HIIT) involves short bursts of intense activity interspersed by periods of low-intensity exercise or rest. HIIT is a viable alternative to traditional continuous moderate-intensity endurance training to enhance maximal oxygen uptake and endurance performance. Combining nutritional strategies with HIIT may result in more favorable outcomes. The purpose of this narrative review is to highlight key dietary interventions that may augment adaptations to HIIT, including creatine monohydrate, caffeine, nitrate, sodium bicarbonate, beta-alanine, protein, and essential amino acids, as well as manipulating carbohydrate availability. Nutrient timing and potential sex differences are also discussed. Overall, sodium bicarbonate and nitrates show promise for enhancing HIIT adaptations and performance. Beta-alanine has the potential to increase training volume and intensity and improve HIIT adaptations. Caffeine and creatine have potential benefits, however, longer-term studies are lacking. Presently, there is a lack of evidence supporting high protein diets to augment HIIT. Low carbohydrate training enhances the upregulation of mitochondrial enzymes, however, there does not seem to be a performance advantage, and a periodized approach may be warranted. Lastly, potential sex differences suggest the need for future research to examine sex-specific nutritional strategies in response to HIIT.

The Effect of Beta-Alanine versus Alkaline Agent Supplementation Combined with Branched-Chain Amino Acids and Creatine Malate in Highly-Trained Sprinters and Endurance Athletes: A Randomized Double-Blind Crossover Study

The study aimed to verify the effect of intra- (beta-alanine—BA) versus extra- (alkaline agents—ALK) cellular buffering agent supplementation, combined with customarily used branched-chain amino acids (BCAAs) and creatine malate (TCM) treatment in natural training conditions. Thirty-one elite athletes (11 sprinters and 20 endurance athletes) participated in the study. Eight-week randomized double-blind, crossover, combined supplementation with BA-ALKpla_BCAA&TCM and ALK-BApla_BCAA&TCM was implemented. In the course of the experiment, body composition, aerobic capacity, and selected blood markers were assayed. After BA-ALKpla_BCAA&TCM supplementation, total fat-free mass increased in sprinters (p = 0.009). No other differences were found in body composition, respiratory parameters, aerobic capacity, blood lactate concentration, and hematological indices after BA-ALKpla_BCAA&TCM/ALK-BApla_BCAA&TCM supplementation. The maximum post-exercise blood ammonia (NH₃) concentration decreased in both groups after BA-ALKpla_BCAA&TCM supplementation (endurance, p = 0.002; sprint, p < 0.0001). Also, lower NH₃ concentrations were observed in endurance athletes in the post-exercise recovery period. The results of our study indicate that combined BCAA, TCM, and BA supplementation is more effective than combined BCAA, TCM and ALK supplementation for an increase in fat-free mass and exercise adaptation, but not for aerobic capacity improvement. Besides, it seems that specific exercise stimuli and the training status are key factors affecting exercise performance, even in athletes using efficient supplementation.

Ergogenic Effects of β-Alanine Supplementation on Different Sports Modalities: Strong Evidence or Only Incipient Findings?

Brisola, GMP and Zagatto, AM. Ergogenic effects of β-alanine supplementation on different sports modalities: strong evidence or only incipient findings? J Strength Cond Res 33(1): 253-282, 2019-β-Alanine supplementation is a popular nutritional ergogenic aid among the sports community. Due to its efficacy, already proven in the literature, to increase the intramuscular carnosine content (β-alanyl-L-histidine), whose main function is intramuscular buffering, β-alanine supplementation has become a nutritional strategy to improve performance, mainly in high-intensity efforts. However, although many studies present evidence of the efficacy of β-alanine supplementation in high-intensity efforts, discrepancies in outcomes are still present and the performance enhancing effects seem to be related to the specificities of each sport discipline, making it difficult for athletes/coaches to interpret the efficacy of β-alanine supplementation. Thus, this study carried out a review of the literature on this topic and summarized, analyzed, and critically discussed the findings with the objective of clarifying the current evidence found in the literature on different types of efforts and sport modalities. The present review revealed that inconsistencies are still found in aerobic parameters determined in incremental tests, except for physical working capacity at the neuromuscular fatigue threshold. Inconsistencies are also found for strength exercises and intermittent high-intensity efforts, whereas in supramaximal continuous mode intermittent exercise, the beneficial evidence is strong. In sports modalities, the evidence should be analyzed separately for each sporting modality. Thus, sports modalities that have strong evidence of the ergogenic effects of β-alanine supplementation are: cycling race of 4 km, rowing race of 2,000 m, swimming race of 100 and 200 m, combat modalities, and water polo. Finally, there is some evidence of slight additional effects on physical performance from cosupplementation with sodium bicarbonate.

Effects of 4 weeks of β-alanine supplementation on aerobic fitness in water polo players

The purpose of the present study was to investigate the ergogenic effects of 4 weeks of β-alanine supplementation on peak oxygen uptake (V˙O2peak) and force associated with V˙O2peak (FV˙O2peak) during a tethered swimming graded exercise test, and a three-minute all-out effort (3min_ALL-OUT) in water polo players. Twenty-two male national competitive level water polo players were randomly assigned to receive either 4 weeks of β-alanine (n = 11) or a placebo (n = 11) (i.e., 4.8 g·day^-1 for 10 days, then6.4 g·day^-1 for 18 days, resulting in 163.2 g over 28 days). The participants performed the TS_GET and 3min_ALL-OUT before and after the supplementation period. There were no significant interaction effects between-groups for any variable, however, the magnitude-based inferences analyses showed a possibly beneficial effect (74%) of β-alanine supplementation on FV˙O2peak compared to placebo treatment (Δ% [post–pre] for Placebo group = -5.2%; Δ% [post–pre] for β-alanine group = +0.7%). Only the β-alanine group presented a significant reduction in V˙O2peak expressed in absolute values (PRE = 3.3±0.6L·min^-1; POST = 3.0±0.4L·min^-1; p = .021). Similarly, only the β-alanine group presented a significant increase in critical force (PRE = 51.2±10.4N; POST = 56.5±13.1N; p = .044) and a reduction in the curvature constant parameter (W'; PRE = 2998.0±1103.7N·s; POST = 2224.6±1058.9N·s; p = .049). Thus, we can conclude that 4 weeks of β-alanine supplementation presented mixed results in water polo players, indicating that this nutritional strategy may not be effective in improving parameters of the TS_GET and 3min_{ALL-OUT .}

A molecular receptor selective for zwitterionic alanine

A molecular receptor has been synthesized joining an aza-crown ether with a chiral chromane which mimics the oxyanion hole of the enzymes. With this receptor an apolar host-guest complex with zwitterionic alanine has been achieved through the formation of up to seven H-bonds. This complex allows the extraction of aqueous alanine to a chloroform phase, while other natural amino acids are poorly extracted or are not extracted at all. Due to the chiral nature of the receptor, enantioselective extraction from the aqueous alanine solution to a chloroform phase takes place. X-Ray analysis combined with anisotropic effects, NOE and CD studies revealed the absolute configuration of both strong and weak complexes. Modelling studies also support the proposed structures. The presence of an oxyanion-hole motif in this structure was corroborated by X-ray diffraction studies.

Effects of β-Alanine Supplementation on Carnosine Elevation and Physiological Performance

β-Alanine is one of the more popular sport supplements used by strength/power athletes today. The popularity of β-alanine stems from its ability to enhance intracellular muscle-buffering capacity thereby delaying fatigue during high-intensity exercise by increasing muscle carnosine content. Recent evidence also suggests that elevated carnosine levels may enhance cognitive performance and increase resiliency to stress. These benefits are thought to result from carnosine's potential role as an antioxidant. This review will discuss these new findings including recent investigations examining β-alanine supplementation and increased resiliency to posttraumatic stress and mild traumatic brain injury. This review will focus on the physiology of carnosine, the effect of β-alanine ingestion on carnosine elevations, and the potential ergogenic benefits it has for competitive and tactical athletes.

The Chronic Effect of Interval Training on Energy Intake: A Systematic Review and Meta-Analysis

Single bouts of acute exercise do not appear to increase subsequent energy intake (EI), even when energy deficit is large. However, studies have shown a compensatory effect on EI following chronic exercise, and it remains unclear whether this is affected by exercise intensity. We investigated the chronic effect of high-intensity interval training (HIIT) and sprint interval training (SIT) on EI when compared with moderate-intensity continuous training (MICT) or no exercise (CON). Databases were searched until 13 March 2017 for studies measuring EI in response to chronic exercise (≥4 weeks of duration) of a high-intensity interval nature. Meta-analysis was conducted for between-group comparisons on EI (kilojoules) and bodyweight (kg). Results showed large heterogeneity, and therefore, metaregression analyses were conducted. There were no significant differences in EI between HIIT/SIT versus MICT (P=0.282), HIIT/SIT versus CON (P=0.398), or MICT versus CON (P=0.329). Although bodyweight was significantly reduced after HIIT/SIT versus CON but not HIIT/SIT versus MICT (in studies measuring EI), this was not clinically meaningful (<2% mean difference). In conclusion, there is no compensatory increase in EI following a period of HIIT/SIT compared to MICT or no exercise. However, this review highlights important methodological considerations for future studies.

Effects of acute ingestion of a pre-workout dietary supplement with and without p-synephrine on resting energy expenditure, cognitive function and exercise performance

BACKGROUND

The purpose of this study was to examine the effects of acute ingestion of a pre-workout dietary supplement (PWS) with and without p-synephrine (S) on perceptions of readiness to perform, cognitive function, exercise performance, and markers of safety.

METHODS

In a randomized, double-blind, and counterbalanced manner; 25 healthy and recreationally active male and female participants ingested a flavored maltodextrin placebo (PLA), a PWS containing beta-alanine (3 g), creatine nitrate as a salt (2 g), arginine alpha-ketoglutarate (2 g), N-Acetyl-L-Tyrosine (300 mg), caffeine (284 mg), Mucuna pruiriens extract standardized for 15% L-Dopa (15 mg), Vitamin C as Ascorbic Acid (500 mg), niacin (60 mg), folate as folic acid (50 mg), and Vitamin B12 as Methylcobalamin (70 mg) with 2 g of maltodextrin and flavoring; or, the PWS with Citrus aurantium (PWS + S) extract standardized for 30% p-synephrine (20 mg). Participants had heart rate (HR), blood pressure, resting energy expenditure (REE), 12-lead electrocardiograms (ECG), perceptions about readiness to perform, cognitive function (Stroop Color-Word test), bench and leg press performance (2 sets of 10 repetitions at 70% of 1RM and 1 set to failure), and Wingate anaerobic capacity (WAC) sprint performance determined as well as donated blood samples prior to and/or following exercise/supplementation. Data were analyzed by MANOVA with repeated measures as well as mean changes from baseline with 95% confidence intervals (CI).

RESULTS

No clinically significant differences were observed among treatments in HR, blood pressure, ECG, or general clinical blood panels. There was evidence that PWS and PWS + S ingestion promoted greater changes in REE responses. Participants reported higher perception of optimism about performance and vigor and energy with PWS and PWS + S ingestion and there was evidence that PWS and PWS + S improved changes in cognitive function scores from baseline to a greater degree than PLA after 1 or 2 h. However, the scores in the PWS + S treatment did not exceed PLA or PWS responses at any data point. No statistically significant differences were observed among treatments in total bench press lifting volume, leg press lifting volume or WAC sprint performance.

CONCLUSIONS

Within the confines of this study, ingestion of PWS and/or PWS + S prior to exercise appears to be well-tolerated when consumed by young, healthy individuals. The primary effects appear to be to increase REE responses and improve perceptions about readiness to perform and cognitive function with limited to no effects on muscular endurance and WAC. The addition of 20 mg of p-synephrine to the PWS provided limited to no additive benefits.

TRIAL REGISTRATION

This trial (NCT02952014) was retrospectively registered on September 13th 2016.

Effects of ingesting a pre-workout dietary supplement with and without synephrine for 8 weeks on training adaptations in resistance-trained males

BACKGROUND

The purpose of this study was to examine whether ingesting a pre-workout dietary supplement (PWS) with and without synephrine (S) during training affects training responses in resistance-trained males.

METHODS

Resistance-trained males (N = 80) were randomly assigned to supplement their diet in a double-blind manner with either a flavored placebo (PLA); a PWS containing beta-alanine (3 g), creatine nitrate as a salt (2 g), arginine alpha-ketoglutarate (2 g), N-Acetyl-L-Tyrosine (300 mg), caffeine (284 mg), Mucuna pruiriens extract standardized for 15% L-Dopa (15 mg), Vitamin C as Ascorbic Acid (500 mg), niacin (60 mg), folate as folic acid (50 mg), and Vitamin B12 as Methylcobalamin (70 mg); or, the PWS supplement with Citrus aurantium extract containing 20 mg of synephrine (PWS + S) once per day for 8-weeks during training. Participants donated a fasting blood sample and had body composition (DXA), resting heart rate and blood pressure, cognitive function (Stroop Test), readiness to perform, bench and leg press 1 RM, and Wingate anaerobic capacity assessments determined a 0, 4, and 8-weeks of standardized training. Data were analyzed by MANOVA with repeated measures. Performance and cognitive function data were analyzed using baseline values as covariates as well as mean changes from baseline with 95% confidence intervals (CI). Blood chemistry data were also analyzed using Chi-square analysis.

RESULTS

Although significant time effects were seen, no statistically significant overall MANOVA Wilks' Lambda interactions were observed among groups for body composition, resting heart and blood pressure, readiness to perform questions, 1RM strength, anaerobic sprint capacity, or blood chemistry panels. MANOVA univariate analysis and analysis of changes from baseline with 95% CI revealed some evidence that cognitive function and 1RM strength were increased to a greater degree in the PWS and/or PWS + S groups after 4- and/or 8-weeks compared to PLA responses. However, there was no evidence that PWS + S promoted greater overall training adaptations compared to the PWS group. Dietary supplementation of PWS and PWS + S did not increase the incidence of reported side effects or significantly affect the number of blood values above clinical norms compared to PLA.

CONCLUSION

Results provide some evidence that 4-weeks of PWS and/or PWS + S supplementation can improve some indices of cognitive function and exercise performance during resistance-training without significant side effects in apparently health males. However, these effects were similar to PLA responses after 8-weeks of supplementation and inclusion of synephrine did not promote additive benefits.

TRIAL REGISTRATION

This trial (NCT02999581) was retrospectively registered on December 16th 2016.

Interval Running Training Improves Cognitive Flexibility and Aerobic Power of Young Healthy Adults

Venckunas, T, Snieckus, A, Trinkunas, E, Baranauskiene, N, Solianik, R, Juodsnukis, A, Streckis, V, and Kamandulis, S. Interval running training improves cognitive flexibility and aerobic power of young healthy adults. J Strength Cond Res 30(8): 2114-2121, 2016-The benefits of regular physical exercise may well extend beyond the reduction of chronic diseases risk and augmentation of working capacity, to many other aspects of human well-being, including improved cognitive functioning. Although the effects of moderate intensity continuous training on cognitive performance are relatively well studied, the benefits of interval training have not been investigated in this respect so far. The aim of the current study was to assess whether 7 weeks of interval running training is effective at improving both aerobic fitness and cognitive performance. For this purpose, 8 young dinghy sailors (6 boys and 2 girls) completed the interval running program with 200 m and 2,000 m running performance, cycling maximal oxygen uptake, and cognitive function was measured before and after the intervention. The control group consisted of healthy age-matched subjects (8 boys and 2 girls) who continued their active lifestyle and were tested in the same way as the experimental group, but did not complete any regular training. In the experimental group, 200 m and 2,000 m running performance and cycling maximal oxygen uptake increased together with improved results on cognitive flexibility tasks. No changes in the results of short-term and working memory tasks were observed in the experimental group, and no changes in any of the measured indices were evident in the controls. In conclusion, 7 weeks of interval running training improved running performance and cycling aerobic power, and were sufficient to improve the ability to adjust behavior to changing demands in young active individuals.

Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies

The current review clarifies the cardiometabolic health effects of high-intensity interval training (HIIT) in adults. A systematic search (PubMed) examining HIIT and cardiometabolic health markers was completed on 15 October 2015. Sixty-five intervention studies were included for review and the methodological quality of included studies was assessed using the Downs and Black score. Studies were classified by intervention duration and body mass index classification. Outcomes with at least 5 effect sizes were synthesised using a random-effects meta-analysis of the standardised mean difference (SMD) in cardiometabolic health markers (baseline to postintervention) using Review Manager 5.3. Short-term (ST) HIIT (<12 weeks) significantly improved maximal oxygen uptake (VO₂ max; SMD 0.74, 95% CI 0.36 to 1.12; p<0.001), diastolic blood pressure (DBP; SMD -0.52, 95% CI -0.89 to -0.16; p<0.01) and fasting glucose (SMD -0.35, 95% CI -0.62 to -0.09; p<0.01) in overweight/obese populations. Long-term (LT) HIIT (≥12 weeks) significantly improved waist circumference (SMD -0.20, 95% CI -0.38 to -0.01; p<0.05), % body fat (SMD -0.40, 95% CI -0.74 to -0.06; p<0.05), VO₂ max (SMD 1.20, 95% CI 0.57 to 1.83; p<0.001), resting heart rate (SMD -0.33, 95% CI -0.56 to -0.09; p<0.01), systolic blood pressure (SMD -0.35, 95% CI -0.60 to -0.09; p<0.01) and DBP (SMD -0.38, 95% CI -0.65 to -0.10; p<0.01) in overweight/obese populations. HIIT demonstrated no effect on insulin, lipid profile, C reactive protein or interleukin 6 in overweight/obese populations. In normal weight populations, ST-HIIT and LT-HIIT significantly improved VO₂ max, but no other significant effects were observed. Current evidence suggests that ST-HIIT and LT-HIIT can increase VO₂ max and improve some cardiometabolic risk factors in overweight/obese populations.

β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis of the evidence on the effects of β-alanine supplementation on exercise capacity and performance.

DESIGN

This study was designed in accordance with PRISMA guidelines. A 3-level mixed effects model was employed to model effect sizes and account for dependencies within data.

DATA SOURCES

3 databases (PubMed, Google Scholar, Web of Science) were searched using a number of terms ('β-alanine' and 'Beta-alanine' combined with 'supplementation', 'exercise', 'training', 'athlete', 'performance' and 'carnosine').

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Inclusion/exclusion criteria limited articles to double-blinded, placebo-controlled studies investigating the effects of β-alanine supplementation on an exercise measure. All healthy participant populations were considered, while supplementation protocols were restricted to chronic ingestion. Cross-over designs were excluded due to the long washout period for skeletal muscle carnosine following supplementation. A single outcome measure was extracted for each exercise protocol and converted to effect sizes for meta-analyses.

RESULTS

40 individual studies employing 65 different exercise protocols and totalling 70 exercise measures in 1461 participants were included in the analyses. A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. Meta-regression demonstrated that exercise duration significantly (p=0.004) moderated effect sizes. Subgroup analyses also identified the type of exercise as a significant (p=0.013) moderator of effect sizes within an exercise time frame of 0.5-10 min with greater effect sizes for exercise capacity (0.4998 (95% CI 0.246 to 0.753)) versus performance (0.1078 (95% CI -0.201 to 0.416)). There was no moderating effect of training status (p=0.559), intermittent or continuous exercise (p=0.436) or total amount of β-alanine ingested (p=0.438). Co-supplementation with sodium bicarbonate resulted in the largest effect size when compared with placebo (0.43 (95% CI 0.22 to 0.64)).

SUMMARY/CONCLUSIONS

β-alanine had a significant overall effect while subgroup analyses revealed a number of modifying factors. These data allow individuals to make informed decisions as to the likelihood of an ergogenic effect with β-alanine supplementation based on their chosen exercise modality.

Heart-Rate Variability Threshold as an Alternative for Spiro-Ergometry Testing: A Validation Study

Mankowski, RT, Michael, S, Rozenberg, R, Stokla, S, Stam, HJ, and Praet, SFE. Heart-rate variability threshold as an alternative for spiro-ergometry testing: a validation study. J Strength Cond Res 31(2): 474-479, 2017-Although spiro-ergometry is the established "gold standard" for determination of the second ventilatory threshold (VT2), it is a costly and rather time-consuming method. Previous studies suggest that assessing the second anaerobic threshold (AT2) on the basis of heart rate variability (HRV) during exercise may be a more cost-effective and noninvasive manner. However, appropriate validation studies, are still lacking. Eleven healthy, moderately trained subjects underwent 3 incremental exercise tests. Ventilation, oxygen uptake (V[Combining Dot Above]O2), CO2 production (V[Combining Dot Above]CO2), and HRV were measured continuously. Exercise testing was performed in 3 oxygen (FiO2) conditions of inspired air (14, 21, and 35% of oxygen). Participants and assessors were blinded to the FiO2 conditions. Two research teams assessed VT2s and HRVT2s independently from each other. Mean workloads corresponding to VT2 and HRVT2 in hypoxia were, respectively, 19 ± 17% (p = 0.01) and 15 ± 15% (p = 0.1) lower in comparison with hyperoxic conditions. Bland-Altman analysis showed low estimation bias (2.2%) and acceptably precise 95% limits of agreement for workload -15.7% to 20.1% for all FiO2 conditions. Bias was the lowest under normoxic conditions (1.1%) in comparison with hypoxia (3.7%) and hyperoxia (4.7%). Heart rate variability-based AT2 assessment had a most acceptable agreement with VT2 under normoxic conditions. This simple HRVT2 assessment may have potential applications for exercise monitoring in commercial fitness settings.

β-Alanine supplementation and military performance

During sustained high-intensity military training or simulated combat exercises, significant decreases in physical performance measures are often seen. The use of dietary supplements is becoming increasingly popular among military personnel, with more than half of the US soldiers deployed or garrisoned reported to using dietary supplements. β-Alanine is a popular supplement used primarily by strength and power athletes to enhance performance, as well as training aimed at improving muscle growth, strength and power. However, there is limited research examining the efficacy of β-alanine in soldiers conducting operationally relevant tasks. The gains brought about by β-alanine use by selected competitive athletes appears to be relevant also for certain physiological demands common to military personnel during part of their training program. Medical and health personnel within the military are expected to extrapolate and implement relevant knowledge and doctrine from research performed on other population groups. The evidence supporting the use of β-alanine in competitive and recreational athletic populations suggests that similar benefits would also be observed among tactical athletes. However, recent studies in military personnel have provided direct evidence supporting the use of β-alanine supplementation for enhancing combat-specific performance. This appears to be most relevant for high-intensity activities lasting 60-300 s. Further, limited evidence has recently been presented suggesting that β-alanine supplementation may enhance cognitive function and promote resiliency during highly stressful situations.

Physiological and health-related adaptations to low-volume interval training: influences of nutrition and sex

Interval training refers to the basic concept of alternating periods of relatively intense exercise with periods of lower-intensity effort or complete rest for recovery. Low-volume interval training refers to sessions that involve a relatively small total amount of exercise (i.e. ≤10 min of intense exercise), compared with traditional moderate-intensity continuous training (MICT) protocols that are generally reflected in public health guidelines. In an effort to standardize terminology, a classification scheme was recently proposed in which the term 'high-intensity interval training' (HIIT) be used to describe protocols in which the training stimulus is 'near maximal' or the target intensity is between 80 and 100 % of maximal heart rate, and 'sprint interval training' (SIT) be used for protocols that involve 'all out' or 'supramaximal' efforts, in which target intensities correspond to workloads greater than what is required to elicit 100 % of maximal oxygen uptake (VO2max). Both low-volume SIT and HIIT constitute relatively time-efficient training strategies to rapidly enhance the capacity for aerobic energy metabolism and elicit physiological remodeling that resembles changes normally associated with high-volume MICT. Short-term SIT and HIIT protocols have also been shown to improve health-related indices, including cardiorespiratory fitness and markers of glycemic control in both healthy individuals and those at risk for, or afflicted by, cardiometabolic diseases. Recent evidence from a limited number of studies has highlighted potential sex-based differences in the adaptive response to SIT in particular. It has also been suggested that specific nutritional interventions, in particular those that can augment muscle buffering capacity, such as sodium bicarbonate, may enhance the adaptive response to low-volume interval training.

β-Alanine supplementation for athletic performance: an update

β-alanine supplementation has become a common practice among competitive athletes participating in a range of different sports. Although the mechanism by which chronic β-alanine supplementation could have an ergogenic effect is widely debated, the popular view is that β-alanine supplementation augments intramuscular carnosine content, leading to an increase in muscle buffer capacity, a delay in the onset of muscular fatigue, and a facilitated recovery during repeated bouts of high-intensity exercise. β-alanine supplementation appears to be most effective for exercise tasks that rely heavily on ATP synthesis from anaerobic glycolysis. However, research investigating its efficacy as an ergogenic aid remains equivocal, making it difficult to draw conclusions as to its effectiveness for training and competition. The aim of this review was to update, summarize, and critically evaluate the findings associated with β-alanine supplementation and exercise performance with the most recent research available to allow the development of practical recommendations for coaches and athletes. A critical review of the literature reveals that when significant ergogenic effects have been found, they have been generally shown in untrained individuals performing exercise bouts under laboratory conditions. The body of scientific data available concerning highly trained athletes performing single competition-like exercise tasks indicates that this type of population receives modest but potentially worthwhile performance benefits from β-alanine supplementation. Recent data indicate that athletes may not only be using β-alanine supplementation to enhance sports performance but also as a training aid to augment bouts of high-intensity training. β-alanine supplementation has also been shown to increase resistance training performance and training volume in team-sport athletes, which may allow for greater overload and superior adaptations compared with training alone. The ergogenic potential of β-alanine supplementation for elite athletes performing repeated high-intensity exercise bouts, either during training or during competition in sports which require repeated maximal efforts (e.g., rugby and soccer), needs scientific confirmation.

Effects of 28 days of beta-alanine and creatine supplementation on muscle carnosine, body composition and exercise performance in recreationally active females

BACKGROUND

The purpose of this study was to examine the short-term and chronic effects of β-ALA supplementation with and without creatine monohydrate on body composition, aerobic and anaerobic exercise performance, and muscle carnosine and creatine levels in college-aged recreationally active females.

METHODS

Thirty-two females were randomized in a double-blind, placebo-controlled manner into one of four supplementation groups: β-ALA only (BA, n = 8), creatine only (CRE, n = 8), β-ALA and creatine combined (BAC, n = 9) and placebo (PLA, n = 7). Participants supplemented for four weeks included a loading phase for the creatine for week 1 of 0.3 g/kg of body weight and a maintenance phase for weeks 2-4 of 0.1 g/kg of body weight, with or without a continuous dose of β-ALA of 0.1 g/kg of body weight with doses rounded to the nearest 800 mg capsule providing an average of 6.1 ± 0.7 g/day of β-ALA. Participants reported for testing at baseline, day 7 and day 28. Testing sessions consisted of obtaining a resting muscle biopsy of the vastus lateralis, body composition measurements, performing a graded exercise test on the cycle ergometer for VO2peak with lactate threshold determination, and multiple Wingate anaerobic capacity tests.

RESULTS

Although mean changes were consistent with prior studies and large effect sizes were noted, no significant differences were observed among groups in changes in muscle carnosine levels (BA 35.3 ± 45; BAC 42.5 ± 99; CRE 0.72 ± 27; PLA 13.9 ± 44%, p = 0.59). Similarly, although changes in muscle phosphagen levels after one week of supplementation were consistent with prior reports and large effect sizes were seen, no statistically significant effects were observed among groups in changes in muscle phosphagen levels and the impact of CRE supplementation appeared to diminish during the maintenance phase. Additionally, significant time × group × Wingate interactions were observed among groups for repeated sprint peak power normalized to bodyweight (p = 0.02) and rate of fatigue (p = 0.04).

CONCLUSIONS

Results of the present study did not reveal any consistent additive benefits of BA and CRE supplementation in recreationally active women.

Evidence-based evaluation of potential benefits and safety of beta-alanine supplementation for military personnel

This Department of Defense-sponsored evidence-based review evaluates the safety and putative outcomes of enhancement of athletic performance or improved recovery from exhaustion in studies involving beta-alanine alone or in combination with other ingredients. Beta-alanine intervention studies and review articles were collected from 13 databases, and safety information was collected from adverse event reporting portals. Due to the lack of systematic studies involving military populations, all the available literature was assessed with a subgroup analysis of studies on athletes to determine if beta-alanine would be suitable for the military. Available literature provided only limited evidence concerning the benefits of beta-alanine use, and a majority of the studies were not designed to address safety. Overall, the strength of evidence in terms of the potential for risk of bias in the quality of the available literature, consistency, directness, and precision did not support the use of beta-alanine by military personnel. The strength of evidence for a causal relation between beta-alanine and paresthesia was moderate.

Effects of beta-alanine supplementation and interval training on physiological determinants of severe exercise performance

INTRODUCTION

We aimed to manipulate physiological determinants of severe exercise performance. We hypothesized that (1) beta-alanine supplementation would increase intramuscular carnosine and buffering capacity and dampen acidosis during severe cycling, (2) that high-intensity interval training (HIT) would enhance aerobic energy contribution during severe cycling, and (3) that HIT preceded by beta-alanine supplementation would have greater benefits.

METHODS

Sixteen active men performed incremental cycling tests and 90-s severe (110 % peak power) cycling tests at three time points: before and after oral supplementation with either beta-alanine or placebo, and after an 11-days HIT block (9 sessions, 4 × 4 min), which followed supplementation. Carnosine was assessed via MR spectroscopy. Energy contribution during 90-s severe cycling was estimated from the O2 deficit. Biopsies from m. vastus lateralis were taken before and after the test.

RESULTS

Beta-alanine increased leg muscle carnosine (32 ± 13 %, d = 3.1). Buffering capacity and incremental cycling were unaffected, but during 90-s severe cycling, beta-alanine increased aerobic energy contribution (1.4 ± 1.3 %, d = 0.5), concurrent with reduced O2 deficit (-5.0 ± 5.0 %, d = 0.6) and muscle lactate accumulation (-23 ± 30 %, d = 0.9), while having no effect on pH. Beta-alanine also enhanced motivation and perceived state during the HIT block. There were no between-group differences in adaptations to the training block, namely increased buffering capacity (+7.9 ± 11.9 %, p = 0.04, d = 0.6, n = 14) and glycogen storage (+30 ± 47 %, p = 0.04, d = 0.5, n = 16).

CONCLUSIONS

Beta-alanine did not affect buffering considerably, but has beneficial effects on severe exercise metabolism as well as psychological parameters during intense training phases.

VO2max trainability and high intensity interval training in humans: a meta-analysis

Endurance exercise training studies frequently show modest changes in VO₂max with training and very limited responses in some subjects. By contrast, studies using interval training (IT) or combined IT and continuous training (CT) have reported mean increases in VO₂max of up to ∼1.0 L · min⁻¹. This raises questions about the role of exercise intensity and the trainability of VO₂max. To address this topic we analyzed IT and IT/CT studies published in English from 1965–2012. Inclusion criteria were: 1)≥3 healthy sedentary/recreationally active humans <45 yrs old, 2) training duration 6–13 weeks, 3) ≥3 days/week, 4) ≥10 minutes of high intensity work, 5) ≥1∶1 work/rest ratio, and 6) results reported as mean ± SD or SE, ranges of change, or individual data. Due to heterogeneity (I² value of 70), statistical synthesis of the data used a random effects model. The summary statistic of interest was the change in VO₂max. A total of 334 subjects (120 women) from 37 studies were identified. Participants were grouped into 40 distinct training groups, so the unit of analysis was 40 rather than 37. An increase in VO₂max of 0.51 L ·min⁻¹ (95% CI: 0.43 to 0.60 L · min⁻¹) was observed. A subset of 9 studies, with 72 subjects, that featured longer intervals showed even larger (∼0.8–0.9 L · min⁻¹) changes in VO₂max with evidence of a marked response in all subjects. These results suggest that ideas about trainability and VO₂max should be further evaluated with standardized IT or IT/CT training programs.

Carnosine: from exercise performance to health

Carnosine was first discovered in skeletal muscle, where its concentration is higher than in any other tissue. This, along with an understanding of its role as an intracellular pH buffer has made it a dipeptide of interest for the athletic population with its potential to increase high-intensity exercise performance and capacity. The ability to increase muscle carnosine levels via β-alanine supplementation has spawned a new area of research into its use as an ergogenic aid. The current evidence base relating to the use of β-alanine as an ergogenic aid is reviewed here, alongside our current thoughts on the potential mechanism(s) to support any effect. There is also some emerging evidence for a potential therapeutic role for carnosine, with this potential being, at least theoretically, shown in ageing, neurological diseases, diabetes and cancer. The currently available evidence to support this potential therapeutic role is also reviewed here, as are the potential limitations of its use for these purposes, which mainly focusses on issues surrounding carnosine bioavailability.

Carnosine treatment for gulf war illness: a randomized controlled trial

About 25% of 1990-1991 Persian Gulf War veterans experience disabling fatigue, widespread pain, and cognitive dysfunction termed Gulf War illness (GWI) or Chronic Multisymptom Illness (CMI). A leading theory proposes that wartime exposures initiated prolonged production of reactive oxygen species (ROS) and central nervous system injury. The endogenous antioxidant L-carnosine (β-alanyl-L-histidine) is a potential treatment since it is a free radical scavenger in nervous tissue. To determine if nutritional supplementation with L-carnosine would significantly improve pain, cognition and fatigue in GWI, a randomized double blind placebo controlled 12 week dose escalation study involving 25 GWI subjects was employed. L-carnosine was given as 500, 1000, and 1500 mg increasing at 4 week intervals. Outcomes included subjective fatigue, pain and psychosocial questionnaires, and instantaneous fatigue and activity levels recorded by ActiWatch Score devices. Cognitive function was evaluated by WAIS-R digit symbol substitution test. Carnosine had 2 potentially beneficial effects: WAIS-R scores increased significantly, and there was a decrease in diarrhea associated with irritable bowel syndrome. No other significant incremental changes were found. Therefore, 12 weeks of carnosine (1500 mg) may have beneficial cognitive effects in GWI. Fatigue, pain, hyperalgesia, activity and other outcomes were resistant to treatment.

International Society of Sports Nutrition position stand: energy drinks

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the safety and efficacy of the use of energy drinks (ED) or energy shots (ES). The ISSN has concluded the following. 1. Although ED and ES contain a number of nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES appear to be carbohydrate and/or caffeine. 2. The ergogenic value of caffeine on mental and physical performance has been well-established but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. 3. Consuming ED 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance. 4. Many ED and ES contain numerous ingredients; these products in particular merit further study to demonstrate their safety and potential effects on physical and mental performance. 5. There is some limited evidence that consumption of low-calorie ED during training and/or weight loss trials may provide ergogenic benefit and/or promote a small amount of additional fat loss. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. 6. Athletes should consider the impact of ingesting high glycemic load carbohydrates on metabolic health, blood glucose and insulin levels, as well as the effects of caffeine and other stimulants on motor skill performance. 7. Children and adolescents should only consider use of ED or ES with parental approval after consideration of the amount of carbohydrate, caffeine, and other nutrients contained in the ED or ES and a thorough understanding of the potential side effects. 8. Indiscriminant use of ED or ES, especially if more than one serving per day is consumed, may lead to adverse events and harmful side effects. 9. Diabetics and individuals with pre-existing cardiovascular, metabolic, hepatorenal, and neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should avoid use of ED and/or ES unless approved by their physician.

Ergogenic effects of β-alanine and carnosine: proposed future research to quantify their efficacy

β-alanine is an amino acid that, when combined with histidine, forms the dipeptide carnosine within skeletal muscle. Carnosine and β-alanine each have multiple purposes within the human body; this review focuses on their roles as ergogenic aids to exercise performance and suggests how to best quantify the former’s merits as a buffer. Carnosine normally makes a small contribution to a cell’s total buffer capacity; yet β-alanine supplementation raises intracellular carnosine concentrations that in turn improve a muscle’s ability to buffer protons. Numerous studies assessed the impact of oral β-alanine intake on muscle carnosine levels and exercise performance. β-alanine may best act as an ergogenic aid when metabolic acidosis is the primary factor for compromised exercise performance. Blood lactate kinetics, whereby the concentration of the metabolite is measured as it enters and leaves the vasculature over time, affords the best opportunity to assess the merits of β-alanine supplementation’s ergogenic effect. Optimal β-alanine dosages have not been determined for persons of different ages, genders and nutritional/health conditions. Doses as high as 6.4 g day⁻¹, for ten weeks have been administered to healthy subjects. Paraesthesia is to date the only side effect from oral β-alanine ingestion. The severity and duration of paraesthesia episodes are dose-dependent. It may be unwise for persons with a history of paraesthesia to ingest β-alanine. As for any supplement, caution should be exercised with β-alanine supplementation.

Effects of β-alanine supplementation on exercise performance: a meta-analysis

Due to the well-defined role of β-alanine as a substrate of carnosine (a major contributor to H⁺ buffering during high-intensity exercise), β-alanine is fast becoming a popular ergogenic aid to sports performance. There have been several recent qualitative review articles published on the topic, and here we present a preliminary quantitative review of the literature through a meta-analysis. A comprehensive search of the literature was employed to identify all studies suitable for inclusion in the analysis; strict exclusion criteria were also applied. Fifteen published manuscripts were included in the analysis, which reported the results of 57 measures within 23 exercise tests, using 18 supplementation regimes and a total of 360 participants [174, β-alanine supplementation group (BA) and 186, placebo supplementation group (Pla)]. BA improved (P = 0.002) the outcome of exercise measures to a greater extent than Pla [median effect size (IQR): BA 0.374 (0.140–0.747), Pla 0.108 (−0.019 to 0.487)]. Some of that effect might be explained by the improvement (P = 0.013) in exercise capacity with BA compared to Pla; no improvement was seen for exercise performance (P = 0.204). In line with the purported mechanisms for an ergogenic effect of β-alanine supplementation, exercise lasting 60–240 s was improved (P = 0.001) in BA compared to Pla, as was exercise of >240 s (P = 0.046). In contrast, there was no benefit of β-alanine on exercise lasting <60 s (P = 0.312). The median effect of β-alanine supplementation is a 2.85% (−0.37 to 10.49%) improvement in the outcome of an exercise measure, when a median total of 179 g of β-alanine is supplemented.