Impact of Genetic Variability on Physiological Responses to Caffeine in Humans: A Systematic Review

The dose-dependent effect of caffeine supplementation on performance, reaction time and postural stability in CrossFit - a randomized placebo-controlled crossover trial

BACKGROUND

Caffeine (CAF) ingestion improves performance in a broad range of exercise tasks. Nevertheless, the CAF-induced, dose-dependent effect on discipline-specific performance and cognitive functions in CrossFit/High-Intensity Functional Training (HIFT) has not been sufficiently investigated. The aim of this study was to evaluate the effect of acute supplementation of three different doses of CAF and placebo (PLA) on specific performance, reaction time (RTime), postural stability (PStab), heart rate (HR) and perceived exertion (RPE).

METHODS

In a randomized double-blind placebo-controlled crossover design, acute pre-exercise supplementation with CAF (3, 6, or 9 mg/kg body mass (BM)) and PLA in 26 moderately trained CrossFit practitioners was examined. The study protocol involved five separate testing sessions using the Fight Gone Bad test (FGB) as the exercise performance evaluation and biochemical analyses, HR and RPE monitoring, as well as the assessment of RTime and PStab, with regard to CYP1A2 (rs762551) and ADORA2A (rs5751876) single nucleotide polymorphism (SNP).

RESULTS

Supplementation of 6 mgCAF/kgBM induced clinically noticeable improvements in FGBTotal results, RTime and pre-exercise motor time. Nevertheless, there were no significant differences between any CAF doses and PLA in FGBTotal, HRmax, HRmean, RPE, pre/post-exercise RTime, PStab variables or pyruvate concentrations. Lactate concentration was higher (p < 0.05) before and after exercise in all CAF doses than in PLA. There was no effect of CYP1A2 or ADORA2A SNPs on performance.

CONCLUSIONS

The dose-dependent effect of CAF supplementation appears to be limited to statistically nonsignificant but clinically considered changes on specific performance, RTime, PStab, RPE or HR. However, regarding practical CAF-induced performance implications in CrossFit/HIFT, 6 mgCAF/kgBM may be supposed as the most rational supplementation strategy.

Genetic susceptibility to caffeine intake and metabolism: a systematic review

BACKGROUND

Coffee and tea consumption account for most caffeine intake and 2-3 billion cups are taken daily around the world. Caffeine dependence is a widespread but under recognized problem.

OBJECTIVES

To conduct a systematic review on the genetic susceptibility factors affecting caffeine metabolism and caffeine reward and their association with caffeine intake.

METHODOLOGY

We conducted PubMed and Embase searches using the terms "caffeine", "reward", "gene", "polymorphism", "addiction", "dependence" and "habit" from inception till 2024. The demographics, genetic and clinical data from included studies were extracted and analyzed. Only case-control studies on habitual caffeine drinkers with at least 100 in each arm were included.

RESULTS

A total of 2552 studies were screened and 26 studies involving 1,851,428 individuals were included. Several genes that were involved with caffeine metabolism such as CYP1A2, ADORA2A, AHR, POR, ABCG2, CYP2A6, PDSS2 and HECTD4 rs2074356 (A allele specific to East Asians and monomorphic in Europeans, Africans and Americans) were associated with habitual caffeine consumption with effect size difference of 3% to 32% in number of cups of caffeinated drink per day per effect allele. In addition, ALDH2 was linked to the Japanese population. Genes associated with caffeine reward included BDNF, SLC6A4, GCKR, MLXIPL and dopaminergic genes such as DRD2 and DAT1 which had around 2-5% effect size difference in number of cups of caffeinated drink for each allele per day.

CONCLUSION

Several genes that were involved in caffeine metabolism and reward were associated with up to 30% effect size difference in number of cups of caffeinated drink per day, and some associations were specific to certain ethnicities. Identification of at-risk caffeine dependence individuals can lead to early diagnosis and stratification of at-risk vulnerable individuals such as pregnant women and children, and can potentially lead to development of drug targets for dependence to caffeine.

Enjoy or quit: impact of coffee on cardiac and metabolic health

Coffee is one of the most consumed beverages worldwide. The effects of coffee on the body are primarily attributed to its key active ingredient, caffeine, a methylxanthine derivative with stimulant effects. However, coffee contains over one hundred bioactive compounds apart from caffeine, such as phenolic compounds, chlorogenic acids, tannin, thiamin, spermidine, quinides, trigonelline, lignins, and minerals like potassium and magnesium, all of which may contribute to its effects on the body. Each of these compounds may have beneficial effects. A common misconception is that coffee consumption should be avoided, especially by those with cardiovascular problems. However, recent data support the safety of moderate habitual consumption of two to three cups of coffee per day. Furthermore, this moderate regular consumption is associated with reduced cardiovascular mortality, lower blood pressure, and improved metabolic state. Many recent studies report additional medical benefits associated with coffee consumption. In this article, we review recent literature on the cardiometabolic effects of regular coffee drinking, including its impact on cardiac arrhythmia, blood pressure, and glucose and lipid metabolism. To sum up the medical evidence in the literature, individuals who drink modest amounts of coffee should feel comfortable continuing to enjoy it, provided they do not experience adverse effects.

Food for thought: dietary nootropics for the optimisation of military operators' cognitive performance

Nootropics are compounds that enhance cognitive performance and have been highlighted as a medium-term human augmentation technology that could support soldier performance. Given the differing ethical, safety and legal considerations associated with the pharmaceutical subset of nootropics, this analysis focuses on dietary supplementation which may enhance cognition during training and operations. Numerous supplements have been investigated as possible nootropics; however, research is often not context specific or of high quality, leading to questions regarding efficacy. There are many other complex cofactors that may affect the efficacy of any dietary nootropic supplement which is designed to improve cognition, such as external stressors (eg, sleep deprivation, high physical workloads), task specifics (eg, cognitive processes required) and other psychological constructs (eg, placebo/nocebo effect). Moreover, military population considerations, such as prior nutritional knowledge and current supplement consumption (eg, caffeine), along with other issues such as supplement contamination, should be evaluated when considering dietary nootropic use within military populations. However, given the increasing requirement for cognitive capabilities by military personnel to complete role-related tasks, dietary nootropics could be highly beneficial in specific contexts. While current evidence is broadly weak, nutritional nootropic supplements may be of most use to the military end user during periods of high military specific stress. Currently, caffeine and L-tyrosine are the leading nootropic supplement candidates within the military context. Future military-specific research on nootropics should be of high quality and use externally valid methodologies to maximise the translation of research to practice.

Impact of Viloxazine Extended-Release Capsules (Qelbree®) on Select Cytochrome P450 Enzyme Activity and Evaluation of CYP2D6 Genetic Polymorphisms on Viloxazine Pharmacokinetics

BACKGROUND AND OBJECTIVE

Viloxazine extended-release (ER) [Qelbree®] is a nonstimulant attention-deficit/hyperactivity disorder (ADHD) treatment. In vitro studies suggested potential for viloxazine to inhibit cytochrome 450 (CYP) enzymes 1A2, 2B6, 2D6 and 3A4. This clinical study therefore evaluated viloxazine ER effects on index substrates for CYP1A2, 2D6, and 3A4, and secondarily evaluated the impact of CYP2D6 polymorphisms on viloxazine pharmacokinetics.

METHODS

Thirty-seven healthy subjects received a modified Cooperstown cocktail (MCC; caffeine 200 mg, dextromethorphan 30 mg, midazolam 0.025 mg/kg) on Day 1, viloxazine ER 900 mg/day on Days 3-5, and a combination of viloxazine ER 900 mg and MCC on Day 6. Viloxazine ER effects on MCC substrates were evaluated using analysis of variance. The impact of CYP2D6 genetic polymorphisms on steady-state viloxazine plasma concentrations was evaluated using Student's t test assessing pharmacokinetic parameter differences between poor versus extensive metabolizers.

RESULTS

The least squares geometric mean ratio [GMR%] (90% CI) of MCC substrate + viloxazine ER/MCC substrate alone for caffeine maximum concentration (Cmax), area under the plasma concentration-time curve from time 0 to the last quantifiable concentration (AUCt), and area under the plasma concentration-time curve from time 0 extrapolated to infinity (AUC∞) was 99.11 (95.84-102.49), 436.15 (398.87-476.92), and 583.35 (262.41-1296.80), respectively; 150.76 (126.03-180.35), 185.76 (155.01-222.61), and 189.71 (160.37-224.42) for dextromethorphan Cmax, AUCt, and AUC∞, respectively; and 112.81 (104.71-121.54), 167.56 (153.05-183.45), and 168.91 (154.38-184.80) for midazolam Cmax, AUCt, and AUC∞, respectively. At steady state, viloxazine least squares GMR (90% CI) for poor/extensive CYP2D6 metabolizers were Cmax 120.70 (102.33-142.37) and area under the plasme concentration-time curve from time 0 to 24 hours (AUC0-24 125.66 (105.36-149.87)).

CONCLUSION

Viloxazine ER is a strong CYP1A2 inhibitor and a weak CYP2D6 and CYP3A4 inhibitor. CYP2D6 polymorphisms did not meaningfully alter the viloxazine ER pharmacokinetic profile.

Caffeine Does Not Alter Performance, Perceptual Responses, and Oxidative Stress After Short Sprint Interval Training

Despite the abundance of research investigating the efficacy of caffeine supplementation on exercise performance, the physiological and biochemical responses to caffeine supplementation during intermittent activities are less evident. This study investigated the acute effects of caffeine supplementation on measures of exercise performance, ratings of perceived exertion, and biomarkers of oxidative stress induced by an acute bout of sprint interval training. In a randomized crossover design, 12 healthy males (age: 26 ± 4 years, height: 177.5 ± 6 cm, body mass: 80.7 ± 7.6 kg) ingested 6 mg/kg of caffeine or placebo 60 min prior to performing sprint interval training (12 × 6 s "all-out sprints" interspersed by 60 s of rest). Performance scores and ratings of perceived exertion were assessed after every sprint. Blood samples were collected before supplementation, prior to and following each sprint, and 5 and 60 min after the last sprint. Caffeine had no effect on any performance measures, ratings of perceived exertion, or biomarkers of oxidative stress (p > .05). In conclusion, caffeine supplementation does not improve performance or decrease oxidative stress after an acute bout of sprint interval training.

Precision Nutrition Unveiled: Gene-Nutrient Interactions, Microbiota Dynamics, and Lifestyle Factors in Obesity Management

BACKGROUND

Obesity is a complex metabolic disorder that is associated with several diseases. Recently, precision nutrition (PN) has emerged as a tailored approach to provide individualised dietary recommendations.

AIM

This review discusses the major intrinsic and extrinsic components considered when applying PN during the management of obesity and common associated chronic conditions.

RESULTS

The review identified three main PN components: gene-nutrient interactions, intestinal microbiota, and lifestyle factors. Genetic makeup significantly contributes to inter-individual variations in dietary behaviours, with advanced genome sequencing and population genetics aiding in detecting gene variants associated with obesity. Additionally, PN-based host-microbiota evaluation emerges as an advanced therapeutic tool, impacting disease control and prevention. The gut microbiome's composition regulates diverse responses to nutritional recommendations. Several studies highlight PN's effectiveness in improving diet quality and enhancing adherence to physical activity among obese patients. PN is a key strategy for addressing obesity-related risk factors, encompassing dietary patterns, body weight, fat, blood lipids, glucose levels, and insulin resistance.

CONCLUSION

PN stands out as a feasible tool for effectively managing obesity, considering its ability to integrate genetic and lifestyle factors. The application of PN-based approaches not only improves current obesity conditions but also holds promise for preventing obesity and its associated complications in the long term.

Caffeine Drug Interactions and its Clinical Implication After Acute Coronary Syndrome: A Literature Review

The hemodynamic and cardiovascular impacts of coffee and caffeine have long been controversial. However, due to the worldwide popularity of coffee and caffeinated beverages, it is essential to understand how they affect the cardiovascular system, specifically in patients with a history of acute coronary syndrome. This literature review was conducted to explore the cardiovascular effects of coffee and caffeine and their interactions with common drugs after acute coronary syndrome and percutaneous coronary intervention. The evidence suggests that moderate coffee and caffeine consumption is not associated with cardiovascular disease in healthy individuals and patients with a history of acute coronary syndrome. The interactions of coffee or caffeine with common medications after acute coronary syndrome or percutaneous coronary intervention are less studied. However, based on the current human studies in this field, the only interaction is with the protective effect of statins on cardiac ischemia.

Coffee Intake, Caffeine Metabolism Genotype, and Survival Among Men with Prostate Cancer

BACKGROUND

Coffee intake may lower prostate cancer risk and progression, but postdiagnosis outcomes by caffeine metabolism genotype are not well characterized.

OBJECTIVE

To evaluate associations between coffee intake, caffeine metabolism genotype, and survival in a large, multicenter study of men with prostate cancer.

DESIGN, SETTING, AND PARTICIPANTS

Data from The PRACTICAL Consortium database for 5727 men with prostate cancer from seven US, Australian, and European studies were included. The cases included had data available for the CYP1A2 -163C>A rs762551 single-nucleotide variant associated with caffeine metabolism, coffee intake, and >6 mo of follow-up.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Multivariable-adjusted Cox proportional hazards models across pooled patient-level data were used to compare the effect of coffee intake (categorized as low [reference], high, or none/very low) in relation to overall survival (OS) and prostate cancer-specific survival (PCSS), with stratified analyses conducted by clinical disease risk and genotype.

RESULTS AND LIMITATIONS

High coffee intake appeared to be associated with longer PCSS (hazard ratio [HR] 0.85, 95% confidence interval [CI] 0.68-1.08; p = 0.18) and OS (HR 0.90, 95% CI 0.77-1.07; p = 0.24), although results were not statistically significant. In the group with clinically localized disease, high coffee intake was associated with longer PCSS (HR 0.66, 95% CI 0.44-0.98; p = 0.040), with comparable results for the group with advanced disease (HR 0.92, 95% CI 0.69-1.23; p = 0.6). High coffee intake was associated with longer PCSS among men with the CYP1A2 AA (HR 0.67, 95% CI 0.49-0.93; p = 0.017) but not the AC/CC genotype (p = 0.8); an interaction was detected (p = 0.042). No associations with OS were observed in subgroup analyses (p > 0.05). Limitations include the nominal statistical significance and residual confounding.

CONCLUSIONS

Coffee intake was associated with longer PCSS among men with a CYP1A2 -163AA (*1F/*1F) genotype, a finding that will require further replication.

PATIENT SUMMARY

It is likely that coffee intake is associated with longer prostate cancer-specific survival in certain groups, but more research is needed to fully understand which men may benefit and why.

The impact of genetic variability on the relationship between caffeine and cardiometabolic outcomes: A systematic review

The relationship between caffeine consumption and cardiometabolic health has been reported, however with heterogenous results. Discrepancies in study results may be due to inter-individual variability between study participants. This systematic review aimed to identify the impact of genetics on the relationship between caffeine consumption and cardiometabolic outcomes. Electronic databases (PubMed and EMBASE) were searched for studies published until July 2021. Selected studies were of both intervention and observational design and included (1) analysis of at least one of the selected cardiometabolic outcome (type 2 diabetes, glucose/insulin levels, cardiovascular disease [CVD], blood pressure [BP] or hypertension, and blood lipid and catecholamine levels), (2) adults aged 18-65 years, and (3) genetic analysis of individuals consuming caffeine. Seventeen studies were included: four randomised controlled trials and an interventional and quasi-experimental study, six population-based prospective cohort studies, three cross-sectional studies, and three case-control studies. CYP1A2 rs762551 and ADORA rs5751876 were associated with glucose response when caffeine was consumed with carbohydrates. CYP1A2 rs762551 moderated the association between coffee intake and hypertension. Moreover, ADORA2A rs5751876 and the ADRA2B I variants moderated the associations between caffeine and BP. Studies that investigated the effects of genetic variations on CVD and caffeine consumption reported equivocal findings (CYP1A2) or warrant replication (COMT, ADORA and TRIB1). Elucidating the extent to which these genes moderate the association between caffeine and cardiometabolic outcomes will enable caffeine consumption advice to be tailored to specific individuals to optimise health.

Preventive Medicine via Lifestyle Medicine Implementation Practices Should Consider Individuals' Complex Psychosocial Profile

Noncommunicable chronic diseases are associated with lifestyle behaviors. Psychological and social factors may influence the adoption of such behaviors. Being mentally and physically energized or fatigued may influence the intention-behavior gap of healthy lifestyle adoption accordingly. We investigated the associations of age, sex, lifestyle behaviors, mood, and mental and physical energy and fatigue at both the trait and state levels. The participants (N = 670) completed questionnaires assessing their sleep, mood, mental and physical state energy and fatigue, physical activity, mental workload, and diet. The ordinary least squares regression models revealed an overlap between the mental state and trait energy levels for males who consume polyphenols, have a high mental workload, and sleep well. Being younger, having a high stress level, bad sleep habits, and being confused and depressed were associated with high mental fatigue. Physical energy and fatigue shared the same commonalities with the previous results, with greater discrepancies observed between the state and trait indicators compared to that between mental energy and fatigue. Diet and stress management seem to be predictors of high physical energy, and females report higher physical fatigue levels. Health care professionals should consider this psychosocial complex profiling in their differential diagnosis and when one is implementing lifestyle behavioral changes to address the facets of preventive medicine, wellness, and health promotion.

Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients

The plant defence compound caffeine is widely consumed as a performance enhancer in a sporting context, with potential benefits expected in both physiological and psychological terms. However, although caffeine modestly but consistently improves alertness and fatigue, its effects on mental performance are largely restricted to improved attention or concentration. It has no consistent effect within other cognitive domains that are important to sporting performance, including working memory, executive function and long-term memory. Although caffeine's central nervous system effects are often attributed to blockade of the receptors for the inhibitory neuromodulator adenosine, it also inhibits a number of enzymes involved both in neurotransmission and in cellular homeostasis and signal propagation. Furthermore, it modulates the pharmacokinetics of other endogenous and exogenous bioactive molecules, in part via interactions with shared cytochrome P450 enzymes. Caffeine therefore enjoys interactive relationships with a wide range of bioactive medicinal and dietary compounds, potentially broadening, increasing, decreasing, or modulating the time course of their functional effects, or vice versa. This narrative review explores the mechanisms of action and efficacy of caffeine and the potential for combinations of caffeine and other dietary compounds to exert psychological effects in excess of those expected following caffeine alone. The review focusses on, and indeed restricted its untargeted search to, the most commonly consumed sources of caffeine: products derived from caffeine-synthesising plants that give us tea (Camellia sinensis), coffee (Coffea genus), cocoa (Theabroma cacao) and guaraná (Paullinia cupana), plus multi-component energy drinks and shots. This literature suggests relevant benefits to mental performance that exceed those associated with caffeine for multi-ingredient energy drinks/shots and several low-caffeine extracts, including high-flavanol cocoa and guarana. However, there is a general lack of research conducted in such a way as to disentangle the relative contributions of the component parts of these products.

How Repeatable Is the Ergogenic Effect of Caffeine? Limited Reproducibility of Acute Caffeine (3 mg.kg-1) Ingestion on Muscular Strength, Power, and Muscular Endurance

This study aimed to determine the effect of 3 mg.kg−1 acute caffeine ingestion on muscular strength, power and strength endurance and the repeatability of potential ergogenic effects across multiple trials. Twenty-two university standard male rugby union players (20 ± 2 years) completed the study. Using a double-blind, randomized, and counterbalanced within-subject experimental design. Participants completed six experimental trials (three caffeine and three placebo) where force time characteristic of the Isometric Mid-Thigh Pull (IMTP), Countermovement Jump (CMJ) and Drop Jumps (DJ) were assessed followed by assessments of Chest Press (CP), Shoulder Press (SP), Squats (SQ), and Deadlifts (DL) Repetitions Until Failure (RTF at 70% 1 RM). ANOVA indicated that caffeine improved both the CMJ and DJ (p < 0.044) and increased RTF in all RTF assessments (p < 0.002). When individual caffeine trials were compared to corresponding placebo trials, effect sizes ranged from trivial-large favoring caffeine irrespective of a main effect of treatment being identified in the ANOVA. These results demonstrate for the first time that the performance enhancing effects of caffeine may not be repeatable between days, where our data uniquely indicates that this is in part attributable to between sessions variation in caffeine’s ergogenic potential.

Population pharmacokinetic modeling of caffeine in preterm infants with apnea of prematurity: New findings from concomitant erythromycin and AHR genetic polymorphisms

Current standard-dose caffeine therapy results in significant intersubject variability. The aims of this study were to develop and evaluate population pharmacokinetic (PPK) models of caffeine in preterm infants through comprehensive screening of covariates and then to propose model-informed precision dosing of caffeine for this population. A total of 129 caffeine concentrations from 96 premature neonates were incorporated into this study. Comprehensive medical record and genotype data of these neonates were collected for analysis. PPK modeling was performed by a nonlinear mixed effects modeling program (NONMEM). Final models based on the current weight (CW) or body surface area (BSA) were evaluated via multiple graphic and statistical methods. The model-informed dosing regimen was performed through Monte Carlo simulations. In addition to CW or BSA, postnatal age, coadministration with erythromycin (ERY), and aryl hydrocarbon receptor coding gene (AHR) variant (rs2158041) were incorporated into the final PPK models. Multiple evaluation results showed satisfactory prediction performance and stability of the CW- and BSA-based models. Monte Carlo simulations demonstrated that trough concentrations of caffeine in preterm infants would be affected by concomitant ERY therapy and rs2158041 under varying dose regimens. For the first time, ERY and rs2158041 were found to be associated with the clearance of caffeine in premature infants. Similar predictive performance and stability were obtained for both CW- and BSA-based PPK models. These findings provide novel insights into caffeine precision therapy for preterm infants.

Can the Brazilian Caffeine Expectancy Questionnaires Differentiate the CYP1A2 and ADORA2A Gene Polymorphisms?-An Exploratory Study with Brazilian Athletes

This study investigated the ability of the Brazilian Caffeine Expectancy Questionnaire (CaffEQ-BR), full and brief versions, to differentiate genetic profiles regarding the polymorphisms of the CYP1A2 (rs 762551) and ADORA2A (rs 5751876) genes in a cohort of Brazilian athletes. One-hundred and fifty participants were genotyped for CYP1A2 and ADORA2A. After the recruitment and selection phase, 71 (90% male and 10% female, regular caffeine consumers) completed the CaffEQ-BR questionnaires and a self-report online questionnaire concerning sociodemographic data, general health status, and frequency of caffeine consumption. The order of completion of the CaffEQ-BR questionnaires was counterbalanced. The concordance between the full and brief versions of the CaffEQ-BR was analyzed using the intraclass correlation coefficient (ICC). To determine the discriminatory capacity of the questionnaires for genotype, the receiver operating characteristic (ROC) curve was applied for sensitivity and specificity (significance level of 5%). Mean caffeine intake was 244 ± 161 mg·day−1. The frequency of AA genotypes for CYP1A2 was 47.9% (n = 34) and 52.1% (n = 37) for C-allele carriers (AC and CC). The frequencies of TT genotypes for ADORA2A were 22.7% (n = 15) and 77.3% (n = 51) for C-allele carriers (TC and CC). All CaffEQ-BR factors, for the full and brief versions, were ICCs > 0.75, except for factor 6 (anxiety/negative effects; ICC = 0.60), and presented ROC curve values from 0.464 to 0.624 and 0.443 to 0.575 for CYP1A2 and ADORA2A. Overall, the CaffEQ-BR (full and brief versions) did not show discriminatory capacity for CYP1A2 and ADORA2A gene polymorphisms. In conclusion, the CaffEQ-BR was not able to differentiate genotypes for the CYP1A2 or ADORA2A genes in this group of Brazilian athletes.

[Recent research on gene polymorphisms related to caffeine therapy in preterm infants with apnea of prematurity]

Apnea of prematurity (AOP) is one of the common diseases in preterm infants. The main cause of AOP is immature development of the respiratory control center. If AOP is not treated timely and effectively, it will lead to respiratory failure, hypoxic brain injury, and even death in severe cases. Caffeine is the first choice for the treatment of AOP, but its effectiveness varies in preterm infants. With the deepening of AOP research, more and more genetic factors have been confirmed to play important roles in the pathogenesis and treatment of AOP; in particular, the influence of single nucleotide polymorphism on the efficacy of caffeine has become a research hotspot in recent years. This article reviews the gene polymorphisms that affect the efficacy of caffeine, in order to provide a reference for individualized caffeine therapy. Citation.

Caffeine and rheumatoid arthritis: A complicated relationship

The current ideal goal of rheumatoid arthritis (RA) management is to resolve joint and systemic inflammation by using pharmacological interventions, assuming this will correspondingly lead to overall well-being. Nonetheless, it has emerged that a substantial number of RA patients do not reach optimal disease control. Thus suggesting the holistic management of subjective symptoms might be overlooked. This poses significant medical challenges; hence the proposal of incorporating lifestyle interventions as part of a multidimensional approach. Among these aspects, both patients and physicians perceive the important role of nutrition. This review shall examine how caffeine, one of the most studied bioactive components of the most widely consumed beverages, may potentially interfere with RA management. In particular, the mechanism by which caffeine affects RA pathogenesis, as a trigger for RA onset or flare, including its influence on rheumatic drug metabolism and the most common RA comorbidities and constitutional symptoms are outlined, highlighting important knowledge gaps and unmet research needs.

Trait Energy and Fatigue Modify Acute Ingestion of an Adaptogenic-Rich Beverage on Neurocognitive Performance

Background: Psychological research considers traits as a long-standing pre-disposition to an individual’s mood, whereas short-term feelings are categorized as states. We previously reported similar overall acute mental performance benefits between an adaptogen-rich, caffeine-containing energy shot (e+Energy Shot–e+Shot; Isagenix International, LLC) and a caffeine-matched placebo Since the publication of that study, multiple studies have reported that trait mental and physical energy (TME/TPE), and trait mental and physical fatigue (TMF/TPF) status modify the effect of various interventions on neurocognitive performance. Therefore, we reevaluated our previously published work and accounted for the four traits. Methods: Participants (n = 30) completed a series of questionnaires to determine baseline trait energy and fatigue measures. Then, participants performed a 27 min battery of neurocognitive tasks before and three times after consuming the study beverages with 10 min breaks between each post-consumption battery of tests. Data from the previous study were re-analyzed using linear mixed-effects models. Results: We now report that the adaptogen product significantly improved mood and cognitive test responses in individuals stratified by initial TME, TPE, TMF, and TPF status. Moreover, this reevaluation also indicated that the caffeine placebo significantly increased heart rate and blood pressure in those subjects initially characterized by low physical and mental energy. Conclusions: In summary, a post-hoc re-analysis of our initial study suggests that consumption of the adaptogen-rich, caffeine-containing product preferentially benefited individuals with initial low TME/TPE and high TMF status when compared to caffeine alone. These findings also support our previous study suggesting that adaptogens may promote mental and physical performance benefits while modulating potentially negatively associated responses to caffeine.

The Inverted U-Shaped Association of Caffeine Intake with Serum Uric Acid in U.S. Adults

BACKGROUND AND AIMS

Caffeine is a worldwide popularly consumed constituent in foods that can exert physiological effects. However, previous researches about the relationship between caffeine intake and serum uric acid (SUA) were limited and controversial. Therefore, we sought to investigate that relationship in U.S. adults.

METHODS

In this cross-sectional study, the total sample of 7888 selected participants (3838 males and 4050 females) were identified from the National Health and Nutritional Examination Surveys (NHANES) 2015-2018. All subjects were tested for serum uric acid levels (μmmol/L), and their daily caffeine intakes (mg/d) were obtained by an average of two 24-hour dietary recalls. Multivariate linear regression models were used to evaluate the association between two variables in total subjects and subgroup analyses. Generalized additive models with smooth curve fittings were also performed.

RESULTS

Multivariate regression analyses showed caffeine intake was negatively correlated with SUA after adjustment of other confounders. The subgroup analyses stratified by gender showed the negative correlation of caffeine intake with SUA was statistically significant in males but not in females. Furthermore, we observed a nonlinear inverse association of caffeine intake with SUA (P nonlinear <0.001) in the generalized additive model, followed by an inverted U-shaped curve (inflection point: 60.5mg/d) for all participants. This inverted U-shaped relationship between them could also be found in both genders, individuals aged below 60 years old, overweight (BMI of 25 to 30), and Non-Hispanic White individuals.

CONCLUSIONS

This study indicated that caffeine intake exhibited an inverse correlation with SUA, especially in males. In addition, this inverse relationship was nonlinear, which followed an inverted U-shaped curve.

Effects of Low Dose Caffeine on Post-Exercise Heart Rate Variability: A Double-Blind Placebo-Controlled Trial

Caffeine may impact post-exercise heart rate variability (HRV); although, studies have yielded inconsistent findings. We examined the effects of low dose caffeine on post-exercise HRV. Healthy, college-aged adults [n = 18; age: 22.1 ± 2.6 years; BMI: 26.9 ± 4.3 kg/m²; estimated maximal oxygen consumption (VO₂max): 45.1 ± 8.3 ml·kg^-1·min^-1] participated in a repeated-measures, double-blind, placebo-controlled trial. During the experimental trials, participants were fitted with a heart rate monitor and a mouthpiece with a one-way nonrebreathing valve and then rested for 10 min during baseline HRV and expired gas assessments. Participants chewed either caffeine (~170mg) or placebo gum for 5 min. Following expectoration and a 5 min warmup, participants walked on a treadmill for 20 min at 60% of estimated VO₂max and then rested for 30 min. HRV indices were calculated from 10 min measurements during baseline and post-exercise (post 1, 2, and 3). A main effect of treatment was found for standard deviation of RR intervals (SDNN), absolute power of low frequency band (LF), absolute power of high frequency band (HF), and the standard deviation perpendicular to the line-of-identity in Poincaré plot (SD1) (p < 0.05). Further, a trend for higher root mean square of successive RR interval differences (RMSSD) with caffeine was observed (p = 0.066). Post hoc t-tests revealed that post-exercise SDNN, LF, HF, and SD1 were higher with caffeine compared to placebo (p ≤ 0.012). Results demonstrated that low dose caffeine did not delay the recovery of HRV indices reflective of parasympathetic nervous system activity following an acute bout of moderate exercise.

Caffeine increases performance and leads to a cardioprotective effect during intense exercise in cyclists

The present study was designed to investigate the effects of different caffeine dietary strategies to compare the impact on athletic performance and cardiac autonomic response. The order of the supplementation was randomly assigned: placebo(4-day)-placebo(acute)/PP, placebo(4-day)-caffeine(acute)/PC and caffeine(4-day)-caffeine(acute)/CC. Fourteen male recreationally-trained cyclists ingested capsules containing either placebo or caffeine (6 mg kg-1) for 4 days. On day 5 (acute), capsules containing placebo or caffeine (6 mg kg-1) were ingested 60 min before completing a 16 km time-trial (simulated cycling). CC and PC showed improvements in time (CC vs PP, Δ - 39.3 s and PC vs PP, Δ - 43.4 s; P = 0.00; ƞ2 = 0.33) and in output power (CC vs PP, Δ 5.55 w and PC vs PP, Δ 6.17 w; P = 0.00; ƞ2 = 0.30). At the final of the time-trial, CC and PC exhibited greater parasympathetic modulation (vagal tone) when compared to the PP condition (P < 0.00; ƞ2 = 0.92). Our study provided evidence that acute caffeine intake (6 mg∙kg-1) increased performance (time-trial) and demonstrated a relevant cardioprotective effect, through increased vagal tone.

Analysis of the effects of caffeine and dioxidine on biochemical indicators of blood in mouse

Relevance . In connection with the widespread use of caffeine, an important issue is the study of its interaction with substances that can exhibit toxic effects. Objective. The aim of the study is to assess the degree of influence of caffeine and dioxidine on the biochemical parameters of blood in mice in the forced swimming test. Materials and methods. The studies were carried out on 6 groups of male mice: control and five experimental. During 15 days of the experiment, the animals of the control group were injected with physiological saline, and the experimental animals were injected with caffeine at a dose of 40 mg/kg or 100 mg/kg (1 and 2), dioxidine in an amount of 200 mg/kg (3), and caffeine was combined and dioxidine (4 and 5). Biochemical parameters were used to determine the content of glucose, cholesterol, urea, creatinine, the activity of aspartic and alanine aminotransferases. Results . The introduction of caffeine at a dose of 40 mg/kg led to a decrease in glucose levels below normal and an increase in cholesterol and urea concentrations. The use of caffeine at a dose of 100 mg/ kg caused a decrease in glucose levels below normal and an increase in urea concentration. With the introduction of dioxidine at a dose of 200 mg/kg, an increase in the level of glucose, cholesterol, urea, as well as the activity of AST and ALT was taken. The combined use of caffeine and dioxidine by the 15th day led to 100 % mortality in experimental animals. Conclusions . The results of the experiment indicate that the introduction of caffeine at a dose of 40 mg/kg and 100 mg/kg leads to an increase in most of the measured parameters relative to the control values, but they do not go beyond normal values, however, a decrease in glucose levels is noted. These changes in indicators are due to the predominance of catabolic processes over anabolic ones. In animals treated with dioxidine, a significant increase in the concentration of metabolites and the activity of blood enzymes was found, especially an increase in AST and ALT was noted, which indicates a predominant lesion of cardiomyocytes. The mortality rate of the experimental groups receiving caffeine and dioxidine together by the last day of the experiment is due to the action of an excessive stress factor leading to the depletion of the adaptive capabilities of the organism and the death of experimental animals.

Can 3 mg·kg-1 of Caffeine Be Used as An Effective Nutritional Supplement to Enhance the Effects of Resistance Training in Rugby Union Players?

The present study uniquely examined the effect of 3 mg·kg⁻¹ chronic caffeine consumption on training adaptations induced by 7-weeks resistance training and assessed the potential for habituation to caffeine’s ergogenicity. Thirty non-specifically resistance-trained university standard male rugby union players (age (years): 20 ± 2; height (cm): 181 ± 7; body mass (kg): 92 ± 17) completed the study), who were moderate habitual caffeine consumers (118 ± 110 mg), completed the study. Using a within-subject double-blind, placebo-controlled experimental design, the acute effects of caffeine intake on upper and lower limb maximal voluntary concentric and eccentric torque were measured using isokinetic dynamometry (IKD) prior to and immediately following a resistance training intervention. Participants were split into strength-matched groups and completed a resistance-training program for seven weeks, consuming either caffeine or a placebo before each session. Irrespective of group, acute caffeine consumption improved peak eccentric torque of the elbow extensors (p < 0.013), peak concentric torque of the elbow flexors (p < 0.005), total eccentric work of the elbow flexors (p < 0.003), total concentric work of the knee extensors (p < 0.001), and total concentric and eccentric work of the knee flexors (p < 0.046) following repeated maximal voluntary contractions. Many of these acute caffeine effects were still prevalent following chronic exposure to caffeine throughout the intervention. The training intervention resulted in significant improvements in upper and lower body one-repetition maximum strength (p < 0.001). For the most part, the effect of the training intervention was equivalent in both the caffeine and placebo groups, despite a small but significant increase (p < 0.037) in the total work performed in the participants that consumed caffeine across the course of the intervention. These results infer that caffeine may be beneficial to evoke acute improvements in muscular strength, with acute effects prevalent following chronic exposure to the experimental dose. However, individuals that consumed caffeine during the intervention did not elicit superior post-intervention training- induced adaptations in muscular strength.

The Effect of Acute Caffeine Ingestion on Cognitive Dual Task Performance during Assessment of Static and Dynamic Balance in Older Adults

The present work aimed to evaluate the effect of 3 mg·kg⁻¹ caffeine consumption on the standing and dynamic balance performance of older adults and sought to establish if caffeine ingestion can modulate the influence of a cognitive dual task on balance performance. Twelve apparently healthy participants (8 females) aged >65 years (72 ± 3.7 years) completed the study. Bipedal postural sway, four square step test, timed up and go, Y-balance (anterior reach only) and force-time characteristics of sit-to-stand performance were used to assess standing and dynamic balance. Attention and working memory were assessed using a serial 3s and 7s subtraction task during seated rest and completion of the bipedal standing assessment and Y-balance test. This battery of assessments was completed on two separate occasions, once following the consumption of a non-ergogenic placebo and again following the consumption of 3 mg·kg⁻¹ caffeine. The administration of treatments was randomised, counterbalanced and double-blind. Caffeine reduced performance in the bipedal standing balance assessments, evidenced by an increase in COP_ML, COP_Path, COP_Velocity. Performance during the dynamic balance tests was unaffected, other than rate of force development during the sit-to-stand, which was improved following caffeine ingestion. The introduction of a cognitive dual task had either limited effects, or improved facets of bipedal standing balance, whilst performance during the dynamic balance task was significantly reduced. In both balance assessments, there was evidence for a reduction in the performance of the cognitive task when both the balance and cognitive tests were performed simultaneously, with this effect not modulated by caffeine consumption. These findings refute the idea that caffeine ingestion may have positive effects on balance performance. However, despite a caffeine-induced reduction in bipedal standing balance, it is unlikely that caffeine ingestion would exacerbate fall risk given the limited effects in the dynamic balance tests. Future work should establish if these effects are generalisable to older frail participants and if caffeine can modulate the detrimental effects of an acute exercise bout on balance performance.

Caffeine, exercise physiology, and time-trial performance: no effect of ADORA2A or CYP1A2 genotypes

The aim of this study was to investigate the influence of ADORA2A and CYP1A2 genotypes on the physiological and ergogenic effects of caffeine. Sixty-six male cyclists were screened for ADORA2A and CYP1A2 genotypes; with 40 taking part subsequently in a randomised, double-blind, placebo-controlled study. Trial 1 was used to establish the oxygen uptake-power output relationship and maximal oxygen uptake. In trials 2 and 3, participants ingested 5 mg·kg^-1 of caffeine or placebo 1 h before completing a submaximal incremental cycling test, followed by a time-trial (∼30 min). Relative to placebo, caffeine led to a significant reduction in time to complete the time-trial (caffeine: 29.7 ± 1.8 min; placebo: 30.8 ± 2.3 min); but there was no effect of genotype. During submaximal exercise, caffeine reduced mean heart rate by 2.9 ± 3.7 beats·min^-1, with effects dissipating as exercise intensity increased. Caffeine also significantly reduced perceived exertion by 0.5 ± 0.8, and increased blood lactate by 0.29 ± 0.42 mmol·L^-1, respiratory exchange ratio by 0.013 ± 0.032, and minute ventilation by 3.1 ± 6.8 L·min^-1. Nonetheless, there were no supplement × genotype interactions. In conclusion, caffeine influences physiological responses to submaximal exercise and improves time-trial performance irrespective of ADORA2A or CYP1A2 genotypes. Novelty: Caffeine affects physiological responses at rest and during submaximal exercise independent of ADORA2A or CYP1A2 genotypes. Variability in the effect of caffeine on time-trial performance is not explained by ADORA2A or CYP1A2 genotypes.

Effects of diet interventions, dietary supplements, and performance-enhancing substances on the performance of CrossFit-trained individuals: A systematic review of clinical studies

CrossFit (CF) is characterized as a constantly varied, high-intensity, functional movement training program, performed with little or no rest between bouts, combining strength and endurance exercises, such as running, cycling, rowing, Olympic weightlifting, power weightlifting, and gymnastic-type exercises. Several nutritional strategies are used to improve sports performance of CF practitioners; however, most of them are empirical and lack scientific evidence. Thus, the aim of this review was to determine the effects of diet intervention, dietary supplements, and performance-enhancing substances on exercise-performance parameters of CF practitioners. MEDLINE/PubMed, Web of Science, LILACS, SciELO, and Scopus databases were searched using specific Medical Subject Headings and keywords for clinical studies that enrolled CF athletes in an intervention using diet, dietary supplements, or performance-enhancing substances. Athletic performance was considered as the primary outcome. No other filters were applied. Including grey literature search, 219 studies were identified; however only 14 studies met the eligibility criteria. Two studies evaluated the effects of caffeine supplementation on exercise performance; five studies evaluated high- or low-carbohydrate effects on performance and other parameters. One study verified the effects of multi-ingredient supplementation on CF-specific performance and body composition. One study compared the intake of protein supplements on performance and body composition. Two studies assessed the effect of green tea and (-)-epicatechin on performance and other parameters. One study evaluated the effects of nitrate supplementation on exercise performance. One study investigated the effect of betaine supplementation on body composition and muscle performance. Finally, one study examined the effects of sodium bicarbonate (SB) ingestion on exercise performance and aerobic capacity. Only SB supplementation improved CF performance. These outcomes may have been obtained due to methodological limitations such as small sample size, lack of control over influencing variables, short period of exercise intervention. Despite the popularity and growing evidence about CF, little is known about the relationship between performance-enhancing substances or dietary interventions and CF performance. Given the lack of scientific evidence, new studies with potential ergogenic supplements, a better methodological model, and practical application are required.

Translation and Validation of the Caffeine Expectancy Questionnaire in Brazil (CaffEQ-BR)

Caffeine is the world's most commonly used stimulant of the central nervous system. Caffeine is present in coffee and other beverages such as tea, soft drinks, and cocoa-based foods. The caffeine expectancy questionnaire was developed to investigate the effects of caffeine expectations and thus contribute to knowledge about its usage and subjective effects (response expectancies). This study aimed to evaluate caffeine expectation psychometrically in a sample of the Brazilian population. The original version of the "Caffeine Expectancy Questionnaire (CaffEQ)" was translated and validated into Brazilian-Portuguese and adapted to Brazilian culture to be used in the Brazilian adult (19-59 y) population. After the translation and back-translation processes of the original CaffEQ questionnaire, the content and semantic validation were performed by a group of experts. The Brazilian-Portuguese version of the questionnaire consists of 47 items, in seven factors, which assess subjective perceptions about the effects of caffeine. Interobserver reproducibility and internal consistency of the questionnaire were tested with a convenience sample (n = 50) of Brazilian adult consumers of caffeine sources, who completed the Brazilian CaffEQ (CaffEQ-BR) on two occasions separated by 24 h. All of the 47 questions were adequate regarding reliability, clarity, and comprehension. Psychometric properties could be replicated consistently. Appropriate internal consistency and validation were confirmed by Cronbach's alpha (α) 0.948, and an intraclass correlation coefficient of 0.976 was observed. The CaffEQ-BR was applied using a web-based platform to a convenience sample of Brazilian adults from all 27 Brazilian states (n = 4202 participants), along with measures of sociodemographic and caffeine consumption data. Factor validity was verified by confirmatory factor analysis. The seven factors presented a good fit for Root Mean Square Error of Approximation-RMSEA = 0.0332 (95% CI: 0.0290-0.0375). By confirming the validity and reliability of CaffEQ-BR, a useful tool is now available to assess caffeine expectations in the Brazilian adult population.

The Performance Effect of Scheduled Carbohydrate and Caffeine Intake during Simulated Team Sport Match-Play

The aim of the current investigation was to identify the effects of scheduled carbohydrate (CHO) and caffeine (CAF) supplementation on simulated team sport match-play performance. Ten male hurling players completed three hurling match-play simulation protocols (HSP) performed 7 days apart in a double-blind, randomized design. Supplementation included CHO, CHO + CAF, and placebo (PLA). In a randomized order, participants ingested either a 6% CHO solution, a PLA solution of similar taste, or a combined intake of 6% CHO solution + 200 mg CAF capsule. At specific time points (Pre-0 min; half time (HT)-30 min; full time (FT)-60 min), participants completed a repeated sprint protocol (RAST; 12 × 20 m). Physiological [% maximal oxygen uptake (%VO_2max), % mean oxygen uptake (%VO_2mean), % maximal heart rate (%HR_max), % mean heart rate (%HR_mean), respiratory exchange ratio (RER), and blood lactate (BLa)] and performance [(best sprint time (RSA_best), mean sprint time (RSA_mean), and rate of perceived exertion (RPE)] variables were monitored throughout each simulation. Non-significant differences were observed between supplement trials (CHO, CHO + CAF, and PLA) for BLa (η² = 0.001, small), %VO_2max (η² = 0.001, small), %VO_2mean (η² = 0.004, small), %HR_max (η² = 0.007, small), %HR_mean (η² = 0.018, small), RER (η² = 0.007, small), RPE (η² = 0.007, small), and RSA_best (η² = 0.050, small). RSA_mean performance significantly improved in CHO + CAF trials compared to PLA, with sprint times significantly improved from Pre to FT also (η² = 0.135, medium). A significant difference was observed in BLa between time points (Pre, HT, and FT) (η² = 0.884, large) in % HRmax (η² = 0.202, medium), %HR_mean (η² = 0.477, large), and RER (η² = 0.554, large) across halves and in RPE across time points (η² = 0.670, large). Our data provide novel data regarding the effects of CHO and CAF supplementation on team sport performance, with co-ingestion of CHO + CAF reducing the decrement in repeated sprint performance compared to PLA.

Caffeine and Exercise: What Next?

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

Caffeine-dependent changes of sleep-wake regulation: Evidence for adaptation after repeated intake

BACKGROUND

Circadian and sleep-homeostatic mechanisms regulate timing and quality of wakefulness. To enhance wakefulness, daily consumption of caffeine in the morning and afternoon is highly common. However, the effects of such a regular intake pattern on circadian sleep-wake regulation are unknown. Thus, we investigated if daily daytime caffeine intake and caffeine withdrawal affect circadian rhythms and wake-promotion in habitual consumers.

METHODS

Twenty male young volunteers participated in a randomised, double-blind, within-subject study with three conditions: i) caffeine (150 mg 3 x daily for 10 days), ii) placebo (3 x daily for 10 days) and iii) withdrawal (150 mg caffeine 3 x daily for eight days, followed by a switch to placebo for two days). Starting on day nine of treatment, salivary melatonin and cortisol, evening nap sleep as well as sleepiness and vigilance performance throughout day and night were quantified during 43 h in an in-laboratory, light and posture-controlled protocol.

RESULTS

Neither the time course of melatonin (i.e. onset, amplitude or area under the curve) nor the time course of cortisol was significantly affected by caffeine or withdrawal. During withdrawal, however, volunteers reported increased sleepiness, showed more attentional lapses as well as polysomnography-derived markers of elevated sleep propensity in the late evening compared to both the placebo and caffeine condition.

CONCLUSIONS

The typical pattern of caffeine intake with consumption in both the morning and afternoon hours may not necessarily result in a circadian phase shift in the evening nor lead to clear-cut benefits in alertness. The time-of-day independent effects of caffeine withdrawal on evening nap sleep, sleepiness and performance suggest an adaptation to the substance, presumably in the homeostatic aspect of sleep-wake regulation.

Synergistic effects between ADORA2A and DRD2 genes on anxiety disorders in children with ADHD

The prevalence of anxiety disorders in patients with Attention Deficit/Hyperactivity Disorder (ADHD) is around 15-40%, three times higher than in the general population. The dopaminergic system, classically associated with ADHD, interacts directly with the adenosinergic system through adenosine A_2A receptors (A_2A) and dopamine D₂ receptors (D₂) forming A_2A-D₂ heterodimers. Both dopaminergic and adenosinergic systems are implicated in anxiety disorders. Therefore, the aims of this study were: a) to investigate the main effects of ADORA2A and DRD2 gene variants on anxiety disorders in an ADHD sample of children and adolescents; b) to test potential synergism between ADORA2A and DRD2 genes on the same outcome; c) to explore ADORA2A variants functionality using an in silico approach. The sample consists of 478 children and adolescents with ADHD and their parents, totalizing 1.239 individuals. An association between the ADORA2A rs2298383 TT genotype with the presence of anxiety disorders (P = .004) and an interaction between ADORA2A-DRD2 risk haplotypes with the same outcome (P = .005) was detected. The in silico analyses showed that rs2298383 has the highest score for regulatory function among all variants in the ADORA2A gene described up to date. Altogether, the present findings suggested that the ADORA2A gene and the interaction of ADORA2A and DRD2 genes may play a role in anxiety disorders in children and adolescents with ADHD.

The Development of a Personalised Training Framework: Implementation of Emerging Technologies for Performance

Over the last decade, there has been considerable interest in the individualisation of athlete training, including the use of genetic information, alongside more advanced data capture and analysis techniques. Here, we explore the evidence for, and practical use of, a number of these emerging technologies, including the measurement and quantification of epigenetic changes, microbiome analysis and the use of cell-free DNA, along with data mining and machine learning. In doing so, we develop a theoretical model for the use of these technologies in an elite sport setting, allowing the coach to better answer six key questions: (1) To what training will my athlete best respond? (2) How well is my athlete adapting to training? (3) When should I change the training stimulus (i.e., has the athlete reached their adaptive ceiling for this training modality)? (4) How long will it take for a certain adaptation to occur? (5) How well is my athlete tolerating the current training load? (6) What load can my athlete handle today? Special consideration is given to whether such an individualised training framework will outperform current methods as well as the challenges in implementing this approach.

Challenging the Myth of Non-Response to the Ergogenic Effects of Caffeine Ingestion on Exercise Performance

The ergogenicity of caffeine on several exercise and sport situations is well-established. However, the extent of the ergogenic response to acute caffeine ingestion might greatly vary among individuals despite using the same dosage and timing. The existence of one or several individuals that obtained minimal ergogenic effects or even slightly ergolytic effects after caffeine intake (i.e., non-responders) has been reported in several previous investigations. Nevertheless, the concept non-responding to caffeine, in terms of physical performance, relies on investigations based on the measurement of one performance variable obtained once. Recently it has been suggested that correct identification of the individual ergogenic effect induced by caffeine intake requires the repeated measurement of physical performance in identical caffeine–placebo comparisons. In this communication, we present data from an investigation where the ergogenic effect of acute caffeine intake (3 mg/kg) was measured eight times over a placebo in the same individuals and under the same conditions by an incremental cycling test to volitional fatigue and an adapted version of the Wingate cycling test. The ergogenic response to caffeine varied from 9% to 1% among individuals, but all participants increased both cycling power in the incremental test and Wingate mean power at least three to eight times out of eight the caffeine–placebo comparisons. These data expand the suggestion of a minimal occurrence of caffeine non-responders because it shows that all individuals responded to caffeine when caffeine is compared to a placebo on multiple and repeated testing sessions.

Urine Caffeine Concentration in Doping Control Samples from 2004 to 2015

The ergogenic effect of caffeine is well-established, but the extent of its consumption in sport is unknown at the present. The use of caffeine was considered "prohibited" until 2004, but this stimulant was moved from the List of Prohibited Substances to the Monitoring Program of the World Anti-Doping Agency to control its use by monitoring urinary caffeine concentration after competition. However, there is no updated information about the change in the use of caffeine as the result of its inclusion in the Monitoring Program. The aim of this study was to describe the changes in urine caffeine concentration from 2004 to 2015. A total of 7488 urine samples obtained in official competitions held in Spain and corresponding to athletes competing in Olympic sports (2788 in 2004, 2543 in 2008, and 2157 in 2015) were analyzed for urine caffeine concentration. The percentage of samples with detectable caffeine (i.e., >0.1 μg/mL) increased from ~70.1%, in 2004⁻2008 to 75.7% in 2015. The median urine caffeine concentration in 2015 (0.85 μg/mL) was higher when compared to the median value obtained in 2004 (0.70 μg/mL; p < 0.05) and in 2008 (0.70 μg/mL; p < 0.05). The urine caffeine concentration significantly increased from 2004 to 2015 in aquatics, athletics, boxing, judo, football, weightlifting, and rowing (p < 0.05). However, the sports with the highest urine caffeine concentration in 2015 were cycling, athletics, and rowing. In summary, the concentration of caffeine in the urine samples obtained after competition in Olympic sports in Spain increased from 2004 to 2015, particularly in some disciplines. These data indicate that the use of caffeine has slightly increased since its removal from the list of banned substances, but urine caffeine concentrations suggest that the use of caffeine is moderate in most sport specialties. Athletes of individual sports or athletes of sports with an aerobic-like nature are more prone to using caffeine in competition.