Placebo in sports nutrition: a proof-of-principle study involving caffeine supplementation

The Effects of Caffeine Ingestion on Measures of Rowing Performance: A Systematic Review and Meta-Analysis

The purpose of this paper was to conduct a systematic review and a meta-analysis of studies examining the acute effects of caffeine ingestion on measures of rowing performance. Crossover and placebo-controlled experiments that investigated the effects of caffeine ingestion on measures of rowing performance were included. The PEDro checklist was used to assess the methodological quality of the included studies. Seven studies of good and excellent methodological quality were included. None of the included studies examined on-water rowing. The majority of studies that were included in the meta-analysis used a 2000m rowing distance with only one using 1000m distance. Results of the main meta-analysis indicated that caffeine enhances performance on a rowing ergometer compared to placebo with a mean difference of -4.1 s (95% confidence interval (CI): -6.4, -1.8 s). These values remained consistent in the analysis in which the study that used a 1000m distance was excluded (mean difference: -4.3 s; 95% CI: -6.9, -1.8 s). We also found a significant increase in mean power (mean difference: 5.7 W; 95% CI: 2.1, 9.3 W) and minute ventilation (mean difference: 3.4 L/min; 95% CI: 1.7, 5.1 L/min) following caffeine ingestion. No significant differences between caffeine and placebo were found for the rating of perceived exertion, oxygen consumption, respiratory exchange ratio, and heart rate. This meta-analysis found that acute caffeine ingestion improves 2000m rowing ergometer performance by ~4 s. Our results support the use of caffeine pre-exercise as an ergogenic aid for rowing performance.

Coffee Ingestion Improves 5 km Cycling Performance in Men and Women by a Similar Magnitude

Caffeine is a well-established ergogenic aid, although research to date has predominantly focused on anhydrous caffeine, and in men. The primary aim of the present study was to investigate the effect of coffee ingestion on 5 km cycling time trial performance, and to establish whether sex differences exist. A total of 38 participants (19 men and 19 women) completed a 5 km time trial following the ingestion of 0.09 g·kg^-1 coffee providing 3 mg·kg^-1 of caffeine (COF), a placebo (PLA), in 300 mL of water, or control (CON). Coffee ingestion significantly increased salivary caffeine levels (p < 0.001; ηP2 = 0.75) and, overall, resulted in improved 5 km time trial performance (p < 0.001; ηP2 = 0.23). Performance following COF (482 ± 51 s) was faster than PLA (491 ± 53 s; p = 0.002; d = 0.17) and CON (487 ± 52 s; p =0.002; d = 0.10) trials, with men and women both improving by approximately 9 seconds and 6 seconds following coffee ingestion compared with placebo and control, respectively. However, no differences were observed between CON and PLA (p = 0.321; d = 0.08). In conclusion, ingesting coffee providing 3 mg·kg^-1 of caffeine increased salivary caffeine levels and improved 5 km cycling time trial performance in men and women by a similar magnitude.

Caffeine Increased Muscle Endurance Performance Despite Reduced Cortical Activation and Unchanged Neuromuscular Efficiency and Corticomuscular Coherence

The central and peripheral effects of caffeine remain debatable. We verified whether increases in endurance performance after caffeine ingestion occurred together with changes in primary motor cortex (MC) and prefrontal cortex (PFC) activation, neuromuscular efficiency (NME), and electroencephalography–electromyography coherence (EEG–EMG coherence). Twelve participants performed a time-to-task failure isometric contraction at 70% of the maximal voluntary contraction after ingesting 5 mg/kg of caffeine (CAF) or placebo (PLA), in a crossover and counterbalanced design. MC (Cz) and PFC (Fp1) EEG alpha wave and vastus lateralis (VL) muscle EMG were recorded throughout the exercise. EEG–EMG coherence was calculated through the magnitude squared coherence analysis in MC EEG gamma-wave (CI > 0.0058). Moreover, NME was obtained as the force–VL EMG ratio. When compared to PLA, CAF improved the time to task failure (p = 0.003, d = 0.75), but reduced activation in MC and PFC throughout the exercise (p = 0.027, d = 1.01 and p = 0.045, d = 0.95, respectively). Neither NME (p = 0.802, d = 0.34) nor EEG–EMG coherence (p = 0.628, d = 0.21) was different between CAF and PLA. The results suggest that CAF improved muscular performance through a modified central nervous system (CNS) response rather than through alterations in peripheral muscle or central–peripheral coupling.

Acute Enhancement of Jump Performance, Muscle Strength, and Power in Resistance-Trained Men After Consumption of Caffeinated Chewing Gum

PURPOSE

To explore the acute effects of caffeinated chewing gum on vertical-jump performance, isokinetic knee-extension/flexion strength and power, barbell velocity in resistance exercise, and whole-body power.

METHODS

Nineteen resistance-trained men consumed, in randomized counterbalanced order, either caffeinated chewing gum (300 mg of caffeine) or placebo and completed exercise testing that included squat jump; countermovement jump; isokinetic knee extension and knee flexion at angular velocities of 60 and 180°·s-1; bench-press exercise with loads corresponding to 50%, 75%, and 90% of 1-repetition maximum (1RM); and an "all-out" rowing-ergometer test.

RESULTS

Compared with placebo, caffeinated chewing gum enhanced (all Ps < .05) (1) vertical-jump height in the squat jump (effect size [ES] = 0.21; +3.7%) and countermovement jump (ES = 0.27; +4.6%); (2) knee-extension peak torque (ES = 0.21; +3.6%) and average power (ES = 0.25; +4.5%) at 60°·s-1 and knee-extension average power (ES = 0.30; +5.2%) at 180°·s-1, and knee-flexion peak torque at 60°·s-1 (ES = 0.22; +4.1%) and 180°·s-1 (ES = 0.31; +5.9%); (3) barbell velocity at 50% of 1RM (ES = 0.30; +3.2%), 75% of 1RM (ES = 0.44; +5.7%), and 90% of 1RM (ES = 0.43; +9.1%); and (4) whole-body peak power on the rowing-ergometer test (ES = 0.41; +5.0%). Average power of the knee flexors did not change at either angular velocity with caffeine consumption.

CONCLUSIONS

Caffeinated chewing gum with a dose of caffeine of 300 mg consumed 10 min preexercise may acutely enhance vertical-jump height, isokinetic strength and power of the lower-body musculature, barbell velocity in the bench-press exercise with moderate to high loads, and whole-body power.

The Effects of 3 Different Doses of Caffeine on Jumping and Throwing Performance: A Randomized, Double-Blind, Crossover Study

PURPOSE

To examine the acute effects of 3 doses of caffeine on upper- and lower-body ballistic exercise performance and to explore if habitual caffeine intake affects the acute effects of caffeine ingestion on ballistic exercise performance.

METHODS

Twenty recreationally active male participants completed medicine-ball-throw and vertical-jump tests under 4 experimental conditions (placebo and 2, 4, and 6 mg·kg-1 of caffeine).

RESULTS

One-way repeated-measures analysis of variance (ANOVA) with subsequent post hoc analyses indicated that performance in the medicine-ball-throw test improved, compared with placebo, only with a 6 mg·kg-1 dose of caffeine (P = .032). Effect size, calculated as the mean difference between the 2 measurements divided by the pooled SD, amounted to 0.29 (+3.7%). For the vertical-jump test, all 3 caffeine doses were effective (compared with placebo) for acute increases in performance (P values .022-.044, effect sizes 0.35-0.42, percentage changes +3.7% to +4.1%). A 2-way repeated-measures ANOVA indicated that there was no significant group × condition interaction effect, suggesting comparable responses between low (≤100 mg·d-1) and moderate to high (>100 mg·d-1) caffeine users to the experimental conditions.

CONCLUSION

Caffeine doses of 2, 4, and 6 mg·kg-1 seem to be effective for acute enhancements in lower-body ballistic exercise performance in recreationally trained male individuals. For the upper-body ballistic exercise performance, only a caffeine dose of 6 mg·kg-1 seems to be effective. The acute effects of caffeine ingestion do not seem to be affected by habitual caffeine intake; however, this requires further exploration.

The Influence of Caffeine Expectancies on Simulated Soccer Performance in Recreational Individuals

Caffeine (CAF) has been reported to improve various facets associated with successful soccer play, including gross motor skill performance, endurance capacity and cognition. These benefits are primarily attributed to pharmacological mechanisms. However, evidence assessing CAF's overall effects on soccer performance are sparse with no studies accounting for CAF's potential psychological impact. Therefore, the aim of this study was to assess CAF's psychological vs. pharmacological influence on various facets of simulated soccer performance. Utilising a double-dissociation design, eight male recreational soccer players (age: 22 ± 5 years, body mass: 78 ± 16 kg, height: 178 ± 6 cm) consumed CAF (3 mg/kg/body mass) or placebo (PLA) capsules, 60 minutes prior to performing the Loughborough Intermittent Shuttle Test (LIST) interspersed with a collection of ratings of perceived exertion (RPE), blood glucose and lactate, heart rate and performing the Loughborough Soccer Passing Test (LSPT). Whole-body dynamic reaction time (DRT) was assessed pre- and post- LIST, and endurance capacity (T_LIM) post, time-matched LIST. Statistical analysis was performed using IBM SPSS (v24) whilst subjective perceptions were explored using template analysis. Mean T_LIM was greatest (p < 0.001) for synergism (given CAF/told CAF) (672 ± 132 s) vs. placebo (given PLA/told PLA) (533 ± 79 s). However, when isolated, T_LIM was greater (p = 0.012) for CAF psychology (given PLA/told CAF) (623 ± 117 s) vs. pharmacology (given CAF/told PLA) (578 ± 99 s), potentially, via reduced RPE. Although DRT performance was greater (p = 0.024) post-ingestion (+5 hits) and post-exercise (+7 hits) for pharmacology vs. placebo, psychology and synergism appeared to improve LSPT performance vs. pharmacology. Interestingly, positive perceptions during psychology inhibited LSPT and DRT performance via potential CAF over-reliance, with the opposite occurring following negative perceptions. The benefits associated with CAF expectancies may better suit tasks that entail lesser cognitive-/skill-specific attributes but greater gross motor function and this is likely due to reduced RPE. In isolation, these effects appear greater vs. CAF pharmacology. However, an additive benefit may be observed after combining expectancy with CAF pharmacology (i.e. synergism).

"I put it in my head that the supplement would help me": Open-placebo improves exercise performance in female cyclists

This study investigated the effect of open-placebo on cycling time-trial (TT) performance. Twenty-eight trained female cyclists completed a 1-km cycling TT following a control session or an open-placebo intervention. The intervention consisted of an individual presentation, provided by a medic, in which the concept of open-placebo was explained to the participant, before she ingested two red and white capsules containing flour; 15 min later, they performed the TT. In the control session, the participant sat quietly for 20 min. Heart rate and ratings of perceived exertion (RPE) were monitored throughout exercise, while blood lactate was determined pre- and post-exercise. Post-exercise questionnaires were employed to gain insight into the perceived influence of the supplement on performance. Open-placebo improved time-to-completion (P = 0.039, 103.6±5.0 vs. 104.4±5.1 s, -0.7±1.8 s, -0.7±1.7%) and mean power output (P = 0.01, 244.8±34.7 vs. 239.7±33.2, +5.1±9.5 W) during the TT. Individual data analysis showed that 11 individuals improved, 13 remained unchanged and 4 worsened their performance with open-placebo. Heart rate, RPE and blood lactate were not different between sessions (all P>0.05). Positive expectation did not appear necessary to induce performance improvements, suggesting unconscious processes occurred, although a lack of an improvement appeared to be associated with a lack of belief. Open-placebo improved 1-km cycling TT performance in trained female cyclists. Although the intervention was successful for some individuals, individual variation was high, and some athletes did not respond or even performed worse. Thus, open-placebo interventions should be carefully considered by coaches and practitioners, while further studies are warranted.

Acute Caffeine and Coconut Oil Intake, Isolated or Combined, Does Not Improve Running Times of Recreational Runners: A Randomized, Placebo-Controlled and Crossover Study

The aim was to evaluate the effect of caffeine (CAF) and extra virgin coconut oil (CO), isolated or combined, on running performance in runners. Methods: A randomized, placebo-controlled, and crossover study was conducted with thirteen recreational runners aged 18-40. All volunteers performed a 1600 m time trial at a 400 m track, each ingesting four different substances: (1) placebo (water), (2) decaffeinated coffee plus isolated CAF (DECAF + CAF), (3) decaffeinated coffee plus isolated CAF plus soy oil (DECAF + CAF + SO), and (4) decaffeinated coffee plus isolated CAF plus extra virgin coconut oil (DECAF + CAF + CO). The substances were ingested 60 min before the trials, the order of the situations was randomized, and there were one-week intervals between them. At the end of the trials, the Borg scale was applied to evaluate the rating of perceived exertion (RPE) and the time was measured. Results: Our data did not show differences in running time among the trials (placebo: 7.64 ± 0.80, DECAF + CAF: 7.61 ± 1.02, DECAF + CAF + SO: 7.66 ± 0.89, and DECAF + CAF + CO: 7.58 ± 0.74 min; p = 0.93), nor RPE (placebo: 6.15 ± 2.03, DECAF + CAF: 6.00 ± 2.27, DECAF + CAF + SO: 6.54 ± 2.73, and DECAF + CAF + CO: 6.00 ± 2.45 score; p = 0.99). Lactate concentrations (placebo: 6.23 ± 2.72, DECAF + CAF: 4.43 ± 3.77, DECAF + CAF + SO: 5.29 ± 3.77, and DECAF + CAF + CO: 6.17 ± 4.18 mmol/L; p = 0.55) also was not modified. Conclusion: Our study shows that ingestion of decaffeinated coffee with the addition of isolated CAF and extra virgin CO, either isolated or combined, does not improve 1600 m running times, nor influence RPE and lactate concentrations in recreational runners. Thus, combination of coffee with CO as a pre-workout supplement seems to be unsubstantiated for a short-distance race.

Are low doses of caffeine as ergogenic as higher doses? A critical review highlighting the need for comparison with current best practice in caffeine research

Caffeine is a popular and widely consumed sporting ergogenic aid. Over the years, the effects of different caffeine doses have been researched, with the general consensus being that 3 to 6 mg/kg of caffeine represents the optimal dose for most people. Recently, there has been increased attention placed on lower (≤3 mg/kg) caffeine doses, with some research suggesting these doses are also ergogenic. However, a critical consideration for athletes is not merely whether caffeine is ergogenic at a given dose, but whether the consumed dose provides an optimized performance benefit. Following this logic, the aim of this review was to identify a potential oversight in the current research relating to the efficacy of lower caffeine doses. Although low caffeine doses do appear to bestow ergogenic effects, these effects have not been adequately compared with the currently accepted best practice dose of 3 to 6 mg/kg. This methodological oversight limits the practical conclusions we can extract from the research into the efficacy of lower doses of caffeine, as the relative ergogenic benefits between low and recommended doses remains unclear. Here, we examine existing research with a critical eye, and provide recommendations both for those looking to use caffeine to enhance their performance, and those conducting research into caffeine and sport.

Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: a double-blind randomized trial

The present study aims to investigate effects of caffeine ingestion and sex difference on muscle performance, delayed-onset muscle soreness (DOMS), and various biomarkers under exercise-induced muscle damage (EIMD). Twenty (10 male and 10 female) healthy elite college athletes were recruited. Participants ingested either caffeine (6 mg/kg) or a placebo in a randomized, double-blind, and counterbalanced fashion at 24 and 48 h following EIMD. Muscle performance, DOMS, and blood samples were taken an hour before and an hour after supplementation. Caffeine ingestion restored impaired maximal voluntary isometric contractions (MVIC: 10.2%; MVIC_post: 7.2%, both P < 0.05) during EIMD across both sexes. Following caffeine ingestion during MVIC, while affected by EIMD, an interaction was found in DOMS and serum K⁺ (both P < 0.05), with males showing greater attenuation (21.5 and 16.9%, respectively) compared with females (4.6 and 1.3%, respectively). DOMS demonstrated an inverse correlation with MVIC after caffeine ingestion both overall and among male athletes (r = -0.34 and -0.54, respectively; P < 0.05) but not among female athletes (r = -0.11; P > 0.05) under EIMD. In addition, caffeine ingestion increased postexercise serum glucose and lactate concentrations across both sexes (both P < 0.05). This is the first study to show that male athletes, compared with female athletes, experience a greater reduction in DOMS during enhanced MVIC when caffeine was consumed, suggesting men might receive greater ergogenic effects from caffeine when affected by EIMD. Furthermore, caffeine ingestion was able to restore impaired muscle power among elite collegiate athletes across both sexes.NEW & NOTEWORTHY Exercise-induced muscle damage (EIMD) reduces anaerobic/aerobic performance and increases delayed-onset muscle soreness (DOMS) during exercise. We show that acute caffeine supplementation at a dosage of 6 mg/kg seems to facilitate recovery of anaerobic muscle power and attenuate DOMS after EIMD across both sexes. Furthermore, male athletes, compared with female athletes, when caffeine was prescribed, experience a greater reduction in DOMS with better restoration of impaired maximal voluntary isometric contractions. This suggests that male athletes might benefit from the ergogenic effect of acute caffeine supplementation after the onset of EIMD.

Acute Effects of an "Energy Drink" on Short-Term Maximal Performance, Reaction Times, Psychological and Physiological Parameters: Insights from a Randomized Double-Blind, Placebo-Controlled, Counterbalanced Crossover Trial

The current study examined the relationships between the effects of consuming a caffeine-containing "energy drink" upon (i) short-term maximal performance, (ii) reaction times, and (iii) psychological factors (i.e., mood state, ratings of perceived exertion (RPE), and affective load) and on physiological parameters (i.e., blood pressure and blood glucose). A randomized, double-blind, placebo-controlled, counterbalanced crossover design was implemented in this study. Nineteen male physical-education students (age: 21.2 ± 1.2 years; height: 1.76 ± 0.08 m; body-mass: 76.6 ± 12.6 kg) performed two test sessions: after drinking the "Red Bull' beverage (RB) and after drinking a placebo (PL). One hour after ingestion of each drink, resting blood glucose and blood pressure were measured and the participants completed the Profile of Mood States questionnaire. Then, after a 5-min warm-up, simple visual reaction time and handgrip force were measured, and the 30-s Wingate test was performed. Immediately after these tests, the RPE, blood glucose, and blood pressure were measured, and the affective load was calculated. Differences between treatments were assessed using two-way repeated measures analyses of variance and paired t-tests, as appropriate. Relationships between the test variables were assessed using Bland-Altman correlations. Significant (i) improvements in peak and mean power output, handgrip force, pre- and post-exercise blood glucose, blood pressure, and vigor and (ii) reductions in reaction times, depression, confusion, fatigue, anger, anxiety, RPE, and affective load scores were observed after RB compared to PL. There were significant correlations of (i) physical performances and reaction times with (ii) RPE, affective load, and pre- and post-exercise blood glucose levels. Gains in peak and mean power were significantly correlated with reductions in fatigue, anxiety (peak power only), and anger (mean power only). The reduction of reaction times was significantly correlated with decreases in confusion and anger and with increases in vigor. Handgrip force and reaction times were significantly correlated with pre- and post-exercise blood pressures. We conclude that RB ingestion has a positive effect on physical performance and reaction times. This effect is related to ergogenic responses in both psychological (i.e., RPE, affective load, and mood state) and physiological (i.e., blood glucose and blood pressure) domains.

Caffeinated Gel Ingestion Enhances Jump Performance, Muscle Strength, and Power in Trained Men

We aimed to explore the effects of caffeinated gel ingestion on neuromuscular performance in resistance-trained men. The participants (n = 17; mean ± standard deviation (SD): age 23 ± 2 years, height 183 ± 5 cm, body mass 83 ± 11 kg) completed two testing conditions that involved ingesting a caffeinated gel (300 mg of caffeine) or placebo. The testing outcomes included: (1) vertical jump height in the squat jump (SJ) and countermovement jump (CMJ); (2) knee extension and flexion peak torque and average power at angular velocities of 60°·s^-1 and 180°·s^-1; (3) barbell velocity in the bench press with loads corresponding to 50%, 75%, and 90% of one-repetition maximum (1RM); and (4) peak power output in a test on a rowing ergometer. Compared to the placebo, caffeine improved: (1) SJ (p = 0.039; Cohen's d effect size (d) = 0.18; +2.9%) and CMJ height (p = 0.011; d = 0.18; +3.3%); (2) peak torque and average power in the knee extensors at both angular velocities (d ranged from 0.21 to 0.37; percent change from +3.5% to +6.9%), peak torque (p = 0.034; d = 0.24; +4.6%), and average power (p = 0.015; d = 0.32; +6.7%) at 60°·s^-1 in the knee flexors; (3) barbell velocity at 50% 1RM (p = 0.021; d = 0.33; +3.5%), 75% 1RM (p < 0.001; d = 0.42; +5.4%), and 90% 1RM (p < 0.001; d = 0.59, +12.0%). We conclude that the ingestion of caffeinated gels may acutely improve vertical jump performance, strength, and power in resistance-trained men.

The effect of acute caffeine ingestion on upper and lower body anaerobic exercise performance

The current study examined the effect of acute caffeine ingestion on mean and peak power production, fatigue index and rating of perceived exertion (RPE) during upper body and lower body Wingate anaerobic test (WANT) performance. Using a double-blind design, 22 males undertook one upper body and one lower body WANT, 60 min following ingestion of caffeine (5 mg*kg^-1) and one upper body and one lower body WANT following ingestion of placebo (5 mg*kg^-1 Dextrose). Peak power was significantly higher (P = .001) following caffeine ingestion in both upper and lower body WANT. Peak power and mean power was also significantly higher during lower body, compared to upper body WANTs irrespective of substance ingested. However, caffeine ingestion did not enhance mean power neither in upper nor lower-body WANT. There were no significant differences in mean fatigue index as a consequence of substance ingested or mode of exercise (all P > 0.05). For RPE there was also a significant substance ingested X mode interaction (P = .001) where there were no differences in RPE between caffeine and placebo conditions in lower body WANTs but significantly lower RPE during upper body WANT in the presence of caffeine compared to placebo (P = .014). This is the first study to compare the effects of caffeine ingestion on upper and lower body 30-second WANT performance and suggests that caffeine ingestion in the dose of 5 mg*kg^-1 ingested 60 min prior to exercise significantly enhances peak power when data from upper and lower body WANTs are combined.

Caffeine and resistance exercise: the effects of two caffeine doses and the influence of individual perception of caffeine

Although caffeine is a widely used ergogenic resource, some information regarding its effects on resistance exercises is still lacking. The objective of the present study was to verify the acute effect of the ingestion of two different doses of caffeine on performance during a session of resistance exercises and to analyze the perception of the subjects in relation to the intake of caffeine. Following a double-blind, randomised, cross-over, controlled, and non-placebo design, 14 trained and healthy men (24.7 ± 6.8 years; 79.8 ± 9.8 kg; 177.3 ± 8.5 cm) performed a training session in chest-press, shoulder-press, and biceps curl exercises (3 sets until exhaustion; 70% 1RM; 3 min rest interval; 2 s for each concentric and eccentric phase) on three non-consecutive days after ingestion of 3 mg.kg^-1 caffeine (CAF3), 6 mg.kg^-1 caffeine (CAF6), or no substance (CON). Subjects were informed that one of the caffeine doses would be placebo. The total number of repetitions performed in CON (93.6 ± 22.4) was significantly lower than in CAF3 (108.0 ± 19.9, P = 0.02) and in CAF6 (109.3 ± 19.8, P = 0.03) and there were no differences between caffeine doses. Eight subjects noticed that caffeine was in CAF3 and six in CAF6 and there were no differences in the number of repetitions between sessions in which the subjects perceived and did not perceive caffeine. In conclusion, caffeine doses of 3 or 6 mg.kg^-1 similarly increased performance in resistance upper limb exercises, independent of the subject's perception of substance ingestion.

Cardiovascular prevention and at-risk behaviours in a large population of amateur rugby players

BACKGROUND AND AIM

We aimed to investigate cardiovascular risk factors and health behaviours prospectively in a large population of French amateur rugby players.

METHODS

An anonymous questionnaire was displayed to rugby players aged over 12 years enrolled in the 2014-2015 French amateur rugby championship from the Burgundy region (n = 5140). Questions addressed awareness on: (a) cardiovascular prevention; (b) tobacco, alcohol and highly caffeinated beverages consumption; and (c) adherence to prevention guidelines (ECG checks, training in basic life support, avoidance of sports practice during fever/infectious episodes).

RESULTS

Among the 640 participants who completed the questionnaires, most were male (90%) and were aged under 35 years (80%). Almost half had basic life support training (42%), but only a minority attended an ECG check-up before licensing (37%), and only a few were aware of the cardiovascular prevention information campaign (17%), similarly across the age groups. Surprisingly, playing rugby with fever was commonly reported (44%) and was even more frequent in young women (55%). A high number of respondents were current smokers (35%), of whom most reported consumption less than 2 hours before/after a rugby session. Alcohol drinkers were frequent (69%), of whom most (79%) drank alcohol less than 2 hours before/after a match. Highly caffeinated beverages consumption (34%) was high, particularly in younger players (39%). Half highly caffeinated beverages consumption was in the setting of a rugby session, even greater in women and mainly motivated by performance enhancement (34%).

CONCLUSION

Our findings from a representative regional cohort may help to identify targets for cardiovascular prevention through the development of educational programmes aiming to improve the knowledge and behaviour of amateur rugby players.

Effects of placebo on bench throw performance of Paralympic weightlifting athletes: a pilot study

BACKGROUND

The aim of the present study was to analyse the effects of placebo on bench throw performance in Paralympic weightlifting athletes.

METHODS

The study involved four Paralympic weightlifting male athletes (age: 40.25 ± 9.91 years, weight: 60.5 ± 8.29 kg, height: 1.60 ± 0.15 m) that visited the laboratory in three occasions, separated by 72 h. In the first session, the athletes were tested for bench press one repetition maximum (1RM). The other two sessions were performed in a randomized counter-balanced order and involved bench throw tests performed either after taking placebo while being informed that the capsule contained caffeine or without taking any substance (control). The bench throw tests were performed with loads corresponding to 50, 60, 70 and 80% of the bench press 1RM.

RESULTS

According to the results, mean velocity (∆: 0.08 m/s, ES 0.36, p < 0.05) and mean propulsive velocity (∆: 0.11 m/s, ES 0.49, p < 0.05) at 50% of 1RM were significantly higher during placebo than control (p < 0.05). However, there were no difference between control and placebo for 60, 70 and 80% of 1RM (p > 0.05).

CONCLUSION

Our results suggest that placebo intake, when the athletes were informed they were taking caffeine, might be an efficient strategy to improve the performance of explosive movements in Paralympic weightlifting athletes when using low-loads. This brings the possibility of using placebo in order to increase performance, which might reduce the risks associated with ergogenic aids, such as side-effects and positive doping testing.

Sport Nutrigenomics: Personalized Nutrition for Athletic Performance

An individual's dietary and supplement strategies can influence markedly their physical performance. Personalized nutrition in athletic populations aims to optimize health, body composition, and exercise performance by targeting dietary recommendations to an individual's genetic profile. Sport dietitians and nutritionists have long been adept at placing additional scrutiny on the one-size-fits-all general population dietary guidelines to accommodate various sporting populations. However, generic "one-size-fits-all" recommendations still remain. Genetic differences are known to impact absorption, metabolism, uptake, utilization and excretion of nutrients and food bioactives, which ultimately affects a number of metabolic pathways. Nutrigenomics and nutrigenetics are experimental approaches that use genomic information and genetic testing technologies to examine the role of individual genetic differences in modifying an athlete's response to nutrients and other food components. Although there have been few randomized, controlled trials examining the effects of genetic variation on performance in response to an ergogenic aid, there is a growing foundation of research linking gene-diet interactions on biomarkers of nutritional status, which impact exercise and sport performance. This foundation forms the basis from which the field of sport nutrigenomics continues to develop. We review the science of genetic modifiers of various dietary factors that impact an athlete's nutritional status, body composition and, ultimately athletic performance.

Effects of Caffeine Supplementation on Power Performance in a Flywheel Device: A Randomised, Double-Blind Cross-Over Study

Despite the demonstrated evidence of the importance of eccentric contractions in sports performance, no research has evaluated the ergogenic effects of caffeine on this type of contraction means during flywheel exercises. Therefore, the aims of the present study were to compare the power outcomes, using different inertial loads, between caffeine and placebo conditions. Twenty-four young, healthy, and active men (age: 22.5 ± 4.8 years) took part in the study. A crossed, randomised double-blind design was used to analyse the effects of caffeine on lower limb power outcomes during a flywheel half-squat exercise. Participants completed four sets of eight all-out repetitions with a fixed three-minutes rest interval, and each set was performed using different inertial loads (i.e., 0.025, 0.050, 0.075 and 0.100 kg·m⁻²). Both the mean power (MP) and peak power (PP) in concentric (CON) and eccentric (ECC) movement phases at each inertial load were recorded after participants were administered either a caffeine supplement (6 mg·kg⁻¹) or placebo (sucrose). Participants receiving a caffeine supplementation demonstrated improvements versus the placebo in total MP (MP_total), as well as MP in CON phase (MP_con) and in ECC phase (MP_ecc) at each inertial load (22.68 to 26.53%; p < 0.01, effect size (ES) = 0.89–1.40). In addition, greater improvements with caffeine ingestion were obtained with respect to the placebo condition (18.79 to 24.98%; p < 0.01, ES = 1.03–1.40) in total PP (PP_total), as well as PP in CON phase (PP_con) and in ECC phase (PP_ecc) at each inertial load. Thus, the supplementation of 6 mg·kg⁻¹ caffeine may be considered to maximise on-field physical performance in those sports characterised by high demands of resistance.

Improvement of Lower-Body Resistance-Exercise Performance With Blood-Flow Restriction Following Acute Caffeine Intake

PURPOSE

To examine the effects of acute caffeine (CAF) intake on physical performance in 3 sets of unilateral knee extensions with blood-flow restriction.

METHODS

In a double-blind crossover design, 22 trained men ingested 6 mg·kg^-1 of CAF or a placebo (PLA), 1 h prior to performing unilateral knee-extension exercise with blood-flow restriction until exhaustion (30% of 1 maximal repetition).

RESULTS

There was a significant difference in the number of repetitions between the CAF and PLA conditions in the first set (28.3 [5.3] vs 23.7 [3.2]; P = .005), second set (11.6 [3.1] vs 8.9 [2.9]; P = .03), and total repetitions performed across the 3 sets (44.5 [9.4] vs 35.0 [6.6]; P = .001). Blood lactate was also significantly different (P = .03) after exercise between the CAF (7.8 [1.1] mmol·L^-1) and PLA (6.0 [0.9] mmol·L^-1). In regard to pain perception, there was a difference between the CAF and PLA in the second (6.9 [1.5] vs 8.4 [1.4]; P = .04) and third sets (8.7 [0.4] vs 9.5 [0.6]; P = .01). No differences were found for perceived effort.

CONCLUSION

Acute caffeine intake increases performance and blood lactate concentration and reduces perception of pain in unilateral knee-extension exercise with blood-flow restriction.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

The Influence of Caffeine Expectancies on Sport, Exercise, and Cognitive Performance

Caffeine (CAF) is widely consumed across sport and exercise for its reputed ergogenic properties, including central nervous stimulation and enhanced muscular force development. However, expectancy and the related psychological permutations that are associated with oral CAF ingestion are generally not considered in most experimental designs and these could be important in understanding if/how CAF elicits an ergogenic effect. The present paper reviews 17 intervention studies across sport, exercise, and cognitive performance. All explore CAF expectancies, in conjunction with/without CAF pharmacology. Thirteen out of 17 studies indicated expectancy effects of varying magnitudes across a range of exercise tasks and cognitive skills inclusive off but not limited to; endurance capacity, weightlifting performance, simple reaction time and memory. Factors, such as motivation, belief, and habitual CAF consumption habits influenced the response. In many instances, these effects were comparable to CAF pharmacology. Given these findings and the lack of consistency in the experimental design, future research acknowledging factors, such as habitual CAF consumption habits, habituated expectations, and the importance of subjective post-hoc analysis will help to advance knowledge within this area.

Caffeine and Placebo Improved Maximal Exercise Performance Despite Unchanged Motor Cortex Activation and Greater Prefrontal Cortex Deoxygenation

Caffeine (CAF) is an ergogenic aid used to improve exercise performance. Independent studies have suggested that caffeine may have the ability to increase corticospinal excitability, thereby decreasing the motor cortex activation required to generate a similar motor output. However, CAF has also been suggested to induce a prefrontal cortex (PFC) deoxygenation. Others have suggested that placebo (PLA) may trigger comparable effects to CAF, as independent studies found PLA effects on motor performance, corticospinal excitability, and PFC oxygenation. Thus, we investigated if CAF and CAF-perceived PLA may improve motor performance, despite the likely unchanged MC activation and greater PFC deoxygenation. Nine participants (26.4 ± 4.8 years old, VO_2MAX of 42.2 ± 4.6 mL kg^-1 min^-1) performed three maximal incremental tests (MITs) in control (no supplementation) and ∼60 min after CAF and PLA ingestion. PFC oxygenation (near-infrared spectroscopy at Fp1 position), MC activation (EEG at Cz position) and vastus lateralis and rectus femoris muscle activity (EMG) were measured throughout the tests. Compared to control, CAF and PLA increased rectus femoris muscle EMG (P = 0.030; F = 2.88; d = 0.84) at 100% of the MIT, and enhanced the peak power output (P = 0.006; F = 12.97; d = 1.8) and time to exhaustion (P = 0.007; F = 12.97; d = 1.8). In contrast, CAF and PLA did not change MC activation, but increased the PFC deoxygenation as indicated by the lower O₂Hb (P = 0.001; F = 4.68; d = 1.08) and THb concentrations (P = 0.01; F = 1.96; d = 0.7) at 80 and 100% the MIT duration. These results showed that CAF and CAF-perceived PLA had the ability to improve motor performance, despite unchanged MC activation and greater PFC deoxygenation. The effectiveness of CAF as ergogenic aid to improve MIT performance was challenged.

Consensus statement on placebo effects in sports and exercise: The need for conceptual clarity, methodological rigour, and the elucidation of neurobiological mechanisms

In June 2017 a group of experts in anthropology, biology, kinesiology, neuroscience, physiology, and psychology convened in Canterbury, UK, to address questions relating to the placebo effect in sport and exercise. The event was supported exclusively by Quality Related (QR) funding from the Higher Education Funding Council for England (HEFCE). The funder did not influence the content or conclusions of the group. No competing interests were declared by any delegate. During the meeting and in follow-up correspondence, all delegates agreed the need to communicate the outcomes of the meeting via a brief consensus statement. The two specific aims of this statement are to encourage researchers in sport and exercise science to 1. Where possible, adopt research methods that more effectively elucidate the role of the brain in mediating the effects of treatments and interventions. 2. Where possible, adopt methods that factor for and/or quantify placebo effects that could explain a percentage of inter-individual variability in response to treatments and intervention.

The CYP1A2 -163C>A polymorphism does not alter the effects of caffeine on basketball performance

Purpose

The aim of this investigation was to analyze the influence of the genetic variations of the -163C>A polymorphism of the CYP1A2 gene on the ergogenic effects of caffeine in elite basketball players.

Methods

Nineteen elite basketball players (10 men and 9 women) ingested 3 mg⋅kg^-1 of caffeine or a placebo 60 min before performing 10 repetitions of the following series: the Abalakov jump test followed by the Change-of-Direction and Acceleration Test (CODAT). The players then competed in a 20-min simulated basketball game. Self-perceived performance and side effects were recorded by questionnaires after the trials. The effects of caffeine on basketball performance were established according to players’ CYP1A2 genotype (rs762551): AA homozygotes (n = 10) and C-allele carriers (n = 9).

Results

In the 10 repetitions, caffeine increased Abalakov jump height by a mean of 2.9±3.6% in AA homozygotes (p = 0.03) while this effect did not reach statistical significance for C-allele carriers (2.3 ± 6.8%; p = 0.33). Caffeine did not affect sprint time in the CODAT test in either genotype group but it increased the number of impacts performed during the simulated game in both AA homozygotes (4.1 ± 5.3%; p = 0.02) and C-allele carriers (3.3 ± 3.2%; p = 0.01). During the 24 h following the test, AA homozygotes tended to experience increased insomnia with caffeine while C-allele carriers did not present this effect. The remaining variables were unaffected by the genotype.

Conclusion

The CYP1A2 -163C>A polymorphism minimally altered the ergogenicity derived from the consumption of a moderate dose of caffeine in elite basketball players.

Effects of caffeine intake on muscle strength and power: a systematic review and meta-analysis

Background

Caffeine is commonly used as an ergogenic aid. Literature about the effects of caffeine ingestion on muscle strength and power is equivocal. The aim of this systematic review and meta-analysis was to summarize results from individual studies on the effects of caffeine intake on muscle strength and power.

Methods

A search through eight databases was performed to find studies on the effects of caffeine on: (i) maximal muscle strength measured using 1 repetition maximum tests; and (ii) muscle power assessed by tests of vertical jump. Meta-analyses of standardized mean differences (SMD) between placebo and caffeine trials from individual studies were conducted using the random effects model.

Results

Ten studies on the strength outcome and ten studies on the power outcome met the inclusion criteria for the meta-analyses. Caffeine ingestion improved both strength (SMD = 0.20; 95% confidence interval [CI]: 0.03, 0.36; p = 0.023) and power (SMD = 0.17; 95% CI: 0.00, 0.34; p = 0.047). A subgroup analysis indicated that caffeine significantly improves upper (SMD = 0.21; 95% CI: 0.02, 0.39; p = 0.026) but not lower body strength (SMD = 0.15; 95% CI: -0.05, 0.34; p = 0.147).

Conclusion

The meta-analyses showed significant ergogenic effects of caffeine ingestion on maximal muscle strength of upper body and muscle power. Future studies should more rigorously control the effectiveness of blinding. Due to the paucity of evidence, additional findings are needed in the female population and using different forms of caffeine, such as gum and gel.

Are the Current Guidelines on Caffeine Use in Sport Optimal for Everyone? Inter-individual Variation in Caffeine Ergogenicity, and a Move Towards Personalised Sports Nutrition

Caffeine use is widespread in sport, with a strong evidence base demonstrating its ergogenic effect. Based on existing research, current guidelines recommend ingestion of 3-9 mg/kg approximately 60 min prior to exercise. However, the magnitude of performance enhancement following caffeine ingestion differs substantially between individuals, with the spectrum of responses ranging between highly ergogenic to ergolytic. These extensive inter-individual response distinctions are mediated by variation in individual genotype, environmental factors, and the legacy of prior experiences partially mediated via epigenetic mechanisms. Here, we briefly review the drivers of this inter-individual variation in caffeine response, focusing on the impact of common polymorphisms within two genes, CYP1A2 and ADORA2A. Contemporary evidence suggests current standardised guidelines are optimal for only a sub-set of the athlete population. Clearer understanding of the factors underpinning inter-individual variation potentially facilitates a more nuanced, and individually and context-specific customisation of caffeine ingestion guidelines, specific to an individual's biology, history, and competitive situation. Finally, we identify current knowledge deficits in this area, along with future associated research questions.

Understanding Personalized Training Responses: Can Genetic Assessment Help?

Background:

Traditional exercise prescription is based on the assumption that exercise adaptation is predictable and standardised across individuals. However, evidence has emerged in the past two decades demonstrating that large inter-individual variation exists regarding the magnitude and direction of adaption following exercise.

Objective:

The aim of this paper was to discuss the key factors influencing this personalized response to exercise in a narrative review format.

Findings:

Genetic variation contributes significantly to the personalized training response, with specific polymorphisms associated with differences in exercise adaptation. These polymorphisms exist in a number of pathways controlling exercise adaptation. Environmental factors such as nutrition, psycho-emotional response, individual history and training programme design also modify the inter-individual adaptation following training. Within the emerging field of epigenetics, DNA methylation, histone modifications and non-coding RNA allow environmental and lifestyle factors to impact genetic expression. These epigenetic mechanisms are themselves modified by genetic and non-genetic factors, illustrating the complex interplay between variables in determining the adaptive response. Given that genetic factors are such a fundamental modulator of the inter-individual response to exercise, genetic testing may provide a useful and affordable addition to those looking to maximise exercise adaption, including elite athletes. However, there are ethical issues regarding the use of genetic tests, and further work is needed to provide evidence based guidelines for their use.

Conclusion:

There is considerable inter-individual variation in the adaptive response to exercise. Genetic assessments may provide an additional layer of information allowing personalization of training programmes to an individual’s unique biology.

Dispelling the myth that habitual caffeine consumption influences the performance response to acute caffeine supplementation

This study investigates the influence of habitual caffeine intake on aerobic exercise-performance responses to acute caffeine supplementation. A double-blind, crossover, counterbalanced study was performed. Forty male endurance-trained cyclists were allocated into tertiles, according to their daily caffeine intake: low (58 ± 29 mg/d), moderate (143 ± 25 mg/d), and high (351 ± 139 mg/d) consumers. Participants completed three trials in which they performed simulated cycling time trials (TTs) in the fastest time possible following ingestion of the following: caffeine (CAF: 6 mg/kg body mass), placebo (PLA), and no supplement (CON). A mixed-model analysis revealed that TT performance was significantly improved in CAF compared with PLA and CON (29.92 ± 2.18 vs. 30.81 ± 2.67 and 31.14 ± 2.71 min, respectively; P = 0.0002). Analysis of covariance revealed no influence of habitual caffeine intake as a covariate on exercise performance ( P = 0.47). TT performance was not significantly different among tertiles ( P = 0.75). No correlation was observed between habitual caffeine intake and absolute changes (CAF − CON) in TT performance with caffeine ( P = 0.524). Individual analysis showed that eight, seven, and five individuals improved above the variation of the test in CAF in the low, moderate, and high tertiles, respectively. A Fisher’s exact test did not show any significant differences in the number of individuals who improved in CAF among the tertiles ( P > 0.05). Blood lactate and ratings of perceived exertion were not different between trials and tertiles ( P > 0.05). Performance effects of acute caffeine supplementation during an ~30-min cycling TT performance were not influenced by the level of habitual caffeine consumption.

NEW & NOTEWORTHY There has been a long-standing paradigm that habitual caffeine intake may influence the ergogenicity of caffeine supplementation. Low, moderate, and high caffeine consumers showed similar absolute and relative improvements in cycling time-trial performance following acute supplementation of 6 mg/kg body mass caffeine. Performance effects of acute caffeine were not influenced by the level of habitual caffeine consumption, suggesting that high habitual caffeine intake does not negate the benefits of acute caffeine supplementation.