IOC consensus statement: dietary supplements and the high-performance athlete

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm

With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.

Effect of high-dose β-Alanine supplementation on uphill cycling performance in World Tour cyclists: A randomised controlled trial

Scientists and coaches seek effective ergogenic aids for performance improvement. Cyclists commonly use β-Alanine, which may enhance post-exercise recovery and physical performance. High-dose β-Alanine supplementation's impact on World Tour cyclists during a 7-day camp remains unstudied. This study aimed to analyse the effect of a high dose of β-alanine in World Tour cyclist during a 7-day camp. A double-blinded, randomised controlled trial was conducted. 11 cyclists were included in the final analysis: β-alanine supplementation (n = 5; VO2max: 67.6±1.6 ml/kg/min) and a placebo group (n = 6; VO2max: 68.0±2.4 ml/kg/min). The duration of the supplementation protocol was seven days with four daily intakes. The subjects commenced supplementation after the physical tests (immediately following the snack) and consumed the final intake after breakfast on the day of the final test (a total of 7 days and 3 additional doses, 31 servings in total; 5g per dosage; 155g the total cumulative amount). Before and after seven days of supplementation, the cyclists performed an uphill time trial. Blood lactate, heart rate and rating of perceived exertion were measured during test. β-alanine supplementation improved the relative mean power attained during the time-trial compared with the control group (Z = -2.008; p = 0.045; Δ = 0.060), as well as the time needed to complete this trial (Z = -2.373; p = 0.018). As for physiological and metabolic variables, no significant change was found. In conclusion, the present study supports the effectiveness of one-week high dose of β-alanine during a cycling training in World Tour cyclists to improve their uphill time-trial performance. In addition, it is important to highlight the potential role of β-alanine in improving recovery power. This aspect is particularly relevant in the context of a training camp, where fatigue levels can increase alongside training intensity. Trial registration: This study was registered in ClinicalTrials.gov: (identifier: NCT04427319).

Analysis of combinatory effects of free weight resistance training and a high-protein diet on body composition and strength capacity in postmenopausal women - A 12-week randomized controlled trial

BACKGROUND

Menopause has a significant impact on the endocrine system of middle-aged women, resulting in a loss of skeletal muscle mass (SMM), changes in fat mass (FM) and a reduction in strength capacity. Resistance training (RT) and a high-protein diet (HPD) are effective methods for maintaining or increasing SMM. This study aims to determine the effects of HPD and RT on body composition, muscle thickness and strength capacity in postmenopausal women.

METHODS

In total 55 healthy postmenopausal women (age: 58.2 ± 5.6 years, weight 69.1 ± 9.6 kg, height 166.5 ± 6.5 cm) successfully participated in the study. The women were randomly assigned to either group: training + protein (2.5 g/kg fat-free mass (FFM)) (n = 15; TP); only training (n = 12; T); only protein (2.5 g/kg FFM) (n = 14; CP) or control (n = 14; C). TP and T performed RT for 12 weeks with three training sessions and five exercises each. CP and C were prohibited from training during the period. The main parameters analysed for body composition were FFM, SMM, FM, muscle thickness of the M. rectus femoris, M. biceps femoris, M. triceps brachii and M. biceps brachii muscles. Strength was tested using a dynamometer for grip strength and 1-RM in the squat (BBS) and deadlift (DL).

RESULTS

The SMM significantly increased by RT (TP: (Δ+1.4 ± 0.9 kg; p < 0.05; d = 0.4; T: Δ+1.2 ± 1.3kg; p < 0.05; d = 0.3) and FM could be reduced only in T: (Δ-2.4 ± 2.9 kg; p < 0.05; d = 0.3). In muscle thickness a significant increase in the M. biceps brachii in both training groups (TP: (Δ+0.4 ± 0.3 cm; p < 0.05; d = 1.6; T: (Δ+0.3 ± 0.3 cm; p < 0.05; d = 0.9) and in M. biceps femoris only in TP (Δ+0.3 ± 0.4 cm; p < 0.05; d = 0.9) were observed. HPD without training does not affect body composition, A significant increase in grip strength (TP: Δ+4.7 ± 2.4 kg; (p < 0.05; d = 1.5; T: (Δ+3.6 ± 3.0 kg; p < 0.05; d = 0.8), in BBS (TP: (Δ+30.0 ± 14.2 kg; p < 0.05; d = 1.5; T: (Δ+34.0 ± 12.0 kg; p < 0.05; d = 2.4) and in DL (TP: (Δ+20.8 ± 10.3 kg; p < 0.05; d = 1.6; T: (Δ+22.1 ± 7.6 kg; p < 0.05; d = 2.0) was observed in both training groups. The CP also recorded a significant increase in the BBS (Δ+7.5 ± 5.4 kg; p < 0.05; d = 0.4) and in DL (Δ+5.5 ± 7.7 kg; p < 0.05; d = 0.5). No significant differences were detected for TP and T for any of the parameters.

CONCLUSION

The results indicate that RT enhances body composition and strength capacity in postmenopausal women and is a preventive strategy against muscle atrophy. Besides HPD without training has a trivial significant effect on BBS and DL. HPD with RT has no clear additive effect on body composition and strength capacity. Further studies are needed to confirm these observations.

6'-Sialyllactose Alleviates Muscle Fatigue through Reduced Blood Lactate Level after Treadmill Exercise in Mice

6'-Sialyllactose (6'-SL), found in human breast milk, exhibits anti-inflammatory, immune function-enhancing, brain development-promoting, and gut health-improving effects. However, its effects on muscle fatigue remain unknown. Here, we aimed to investigate the effects of 6'-SL on blood lactate level, muscle fiber type, and oxidative phosphorylation protein complexes (OXPHOS) in muscle after exercise using C57BL/6J male mice. C57BL/6J mice were randomly assigned to control or 100 mg/kg 6'-SL. After 12 weeks of 6'-SL administration, the mice were made to perform treadmill exercise; their blood lactate and glucose levels were measured at the basal level (rest) and 0, 5, and 10 min after treadmill exercise. Results showed that 6'-SL treatment in C57BL/6J mice significantly reduced blood lactate level and improved blood glucose level. Moreover, 6'-SL increased the expression of slow-myosin heavy chain (MHC) and OXPHOS in gastrocnemius muscle. In addition, 6'-SL treatment for 12 weeks did not affect food intake, serum biomarkers of tissue injury, and lipid profiles compared with those of the controls. These findings indicate that non-toxic 6'-SL suppressed muscle fatigue during exercise by promoting protein expression of muscle fibers, especially slow-twitch muscle fibers characterized by abundant OXPHOS complexes and decreased blood lactate level. This study suggests that 6'-SL holds promise as a nutritional supplement in exercise and clinical settings, subject to further validation.

Nitrate: "the source makes the poison"

Interest in the role of dietary nitrate in human health and disease has grown exponentially in recent years. However, consensus is yet to be reached as to whether consuming nitrate from various food sources is beneficial or harmful to health. Global authorities continue to recommend an acceptable daily intake (ADI) of nitrate of 3.7 mg/kg-bw/day due to concerns over its carcinogenicity. This is despite evidence showing that nitrate consumption from vegetable sources, exceeding the ADI, is associated with decreased cancer prevalence and improvements in cardiovascular, oral, metabolic and neurocognitive health. This review examines the paradox between dietary nitrate and health and disease and highlights the key role of the dietary source and food matrix in moderating this interaction. We present mechanistic and epidemiological evidence to support the notion that consuming vegetable-derived nitrate promotes a beneficial increase in nitric oxide generation and limits toxic N-nitroso compound formation seen with high intakes of nitrate added during food processing or present in contaminated water. We demonstrate the need for a more pragmatic approach to nitrate-related nutritional research and guidelines. Ultimately, we provide an overview of our knowledge in this field to facilitate the various therapeutic applications of dietary nitrate, whilst maintaining population safety.

Exogenous Lactate Treatment Immediately after Exercise Promotes Glycogen Recovery in Type-II Muscle in Mice

Recent studies suggest that lactate intake has a positive effect on glycogen recovery after exercise. However, it is important to verify the effect of lactate supplementation alone and the timing of glycogen recovery. Therefore, in this study, we aimed to examine the effect of lactate supplementation immediately after exercise on glycogen recovery in mice liver and skeletal muscle at 1, 3, and 5 h after exercise. Mice were randomly divided into the sedentary, exercise-only, lactate, and saline-treated groups. mRNA expression and activation of glycogen synthesis and lactate transport-related factors in the liver and skeletal muscle were assessed using real-time polymerase chain reaction. Skeletal muscle glycogen concentration showed an increasing trend in the lactate group compared with that in the control group at 3 and 5 h after post-supplementation. Additionally, exogenous lactate supplementation significantly increased the expression of core glycogen synthesis enzymes, lactate transporters, and pyruvate dehydrogenase E1 alpha 1 in the skeletal muscles. Conversely, glycogen synthesis, lactate transport, and glycogen oxidation to acetyl-CoA were not significantly affected in the liver by exogenous lactate supplementation. Overall, these results suggest that post-exercise lactate supplement enables glycogen synthesis and recovery in skeletal muscles.

Nutrition for Children and Adolescents Who Practice Sport: A Narrative Review

At a developmental age, adequate physical activity is fundamental to overall health and well-being and preventing obesity. Moreover, establishing active behavior can help children and adolescents meet their growth and neurodevelopmental goals. Nutritional requirements vary according to intensity, frequency, and practiced physical activity or sport; therefore, pediatricians should give children and adolescents and their families adequate counseling, avoiding both nutrient deficiencies and excessive or inadequate supplement intake. The focus should be not only on sports performance but also on the child's well-being, growth, and neurodevelopment. Our narrative review aims to discuss the nutritional needs of children and adolescents who practice physical activity, non-competitive sports activity, and elite sports activity while also analyzing the role of food supplements and the risk of eating disorders within this category of subjects.

Dietary Supplementation on Physical Performance and Recovery in Active-Duty Military Personnel: A Systematic Review of Randomized and Quasi-Experimental Controlled Trials

BACKGROUND

Warfighters, often called tactical athletes, seek dietary supplementation to enhance training and recovery. Roughly 69% of active-duty US military personnel have reported consuming dietary supplements. The objective of this systematic review was to examine the impact of dietary supplements on muscle-related physical performance and recovery in active-duty military personnel.

METHODS

Randomized controlled trials and quasi-experimental controlled trials of oral dietary supplementation in active-duty military members were examined. A protocol was registered (PROSPERO CRD42023401472), and a systematic search of MEDLINE and CINAHL was undertaken. Inclusion criteria consisted of studies published between 1990-2023 with outcomes of muscle performance and recovery among active-duty military populations. The risk of bias was assessed with the McMaster University Guidelines and Critical Review Form for Quantitative Studies.

RESULTS

Sixteen studies were included. Four were conducted on protein or carbohydrate; four on beta-alanine alone, creatine alone, or in combination; two on mixed nutritional supplements; two on probiotics alone or in combination with beta hydroxy-beta methylbutyrate calcium; and four on phytonutrient extracts including oregano, beetroot juice, quercetin, and resveratrol. Ten examined outcomes related to physical performance, and six on outcomes of injury or recovery. Overall, protein, carbohydrate, beta-alanine, creatine, and beetroot juice modestly improved performance, while quercetin did not. Protein, carbohydrates, beta-alanine, probiotics, and oregano reduced markers of inflammation, while resveratrol did not.

CONCLUSIONS

Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters. However, there are significant limitations in interpretation due to the largely inconsistent evidence of ingredients and comparable outcomes. Thus, there is inadequate practical evidence to suggest how dietary supplementation may affect field performance.

The effect of caffeine supplementation on muscular strength and endurance: A meta-analysis of meta-analyses

Background

Caffeine is commonly used as an ergogenic aid to increase strength and endurance in athletes. The results of meta-analyses in this regard are still conflicting. Therefore, the current umbrella meta -analysis was conducted to determine the effects of caffeine supplementation on muscle strength and endurance as a clear and final conclusion.

Methods

Relevant studies were searched in international databases including PubMed, Scopus, and Web of Science until August 15, 2022. Meta-analysis studies examining the effects of caffeine supplementation on muscle strength and endurance were included in this study. Random effects model was used to perform meta-analysis. Additional analyses including subgroup and sensitivity analyzes were performed.

Findings

In general, 9 meta-analyses were included in the study. The results showed that caffeine supplementation led to a significant increase in muscle strength (SMD = 0.18, 95 % CI: 0.14, 0.21; p < 0.001) and muscle endurance (SMD = 0.30, 95 % CI 0.21, 0.38; p < 0.001).

Conclusion

Meta -analysis showed the significant effects of caffeine consumption on muscle strength and muscle endurance. Due to the lack of evidence, further studies are needed in the women's population.

Evidence-based sports supplements: A redox analysis

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

Assessment of Nutritional Practices of Mountain Runners before and during Competitions

Mountain running, distinct from traditional road running, involves natural trails with significant elevation changes. This study aims to analyze dietary and supplementation practices among advanced and elite Polish mountain runners. Conducted from May to October 2023, this study included 36 participants (13 women, 23 men) aged 21-43 years. A custom questionnaire assessed nutrition two days before and during a competition, focusing on macronutrient intake, hydration, and supplementation. Statistical analyses were performed to compare advanced and elite athletes. Participants consumed an average of 3164.14 kcal two days before and 3176.97 kcal the day before the competition. Carbohydrate intake averaged 7.69 g/kg two days before and 7.64 g/kg the day before the race, potentially insufficient for optimal glycogen stores. Protein intake was adequate, averaging 1.63 g/kg two days before and 1.73 g/kg the day before the race. Fluid intake averaged 2811.25 mL two days before and 2891.80 mL the day before the race. During races, carbohydrate intake averaged 58.56 g/h, with variations based on race duration. Most participants used isotonic drinks and water for hydration. Mountain runners generally adhere to proper nutrition guidelines, with adequate protein and fluid intake. However, their carbohydrate intake may be insufficient for longer races. Higher carbohydrate intake during exercise could provide additional benefits.

Sports Supplement Consumption in 316 Federated Female Road Cyclists

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

Association of Genetic Profile with Muscle Mass Gain and Muscle Injury Prevention in Professional Football Players after Creatine Supplementation

BACKGROUND

In recent years, the study of creatine supplementation in professional athletes has been of great interest. However, the genetics involved in response to supplementation is unknown. The aim of this study was to analyse, for the first time, the relationship between muscle performance-related genes and the risk of an increased body mass index (BMI) and muscle mass and a decrease in fat mass in professional football players after creatine supplementation.

METHODS

For this longitudinal study, one hundred and sixty-one men's professional football players were recruited. The polymorphisms ACE I/D, ACTN3 c.1729C>T, AMPD1 c.34C>T, CKM c.*800A>G, and MLCK (c.49C>T and c.37885C>A) were genotyped using Single-Nucleotide Primer Extension (SNPE). To assess the combined impact of these six polymorphisms, a total genotype score (TGS) was calculated. The creatine supplementation protocol consisted of 20 g/day of creatine monohydrate for 5 days (loading dose) and 3-5 g/day for 7 weeks (maintenance dose). Anthropometric characteristics (body mass index (BMI), fat, and muscle mass) were recorded before and after the creatine supplementation protocol. Characteristics of non-contact muscle injuries during the 2022/2023 season were classified according to a consensus statement for injury recording. The results showed that the allelic frequencies of ACE and AMPD1 differed between responders and non-responders in muscle mass increase (all p < 0.05). Players with a TGS exceeding 54.16 a.u. had an odds ratio (OR) of 2.985 (95%CI: 1.560-5.711; p = 0.001) for muscle mass increase. By contrast, those with a TGS below 54.16 a.u. had an OR of 9.385 (95%CI: 4.535-19.425; p < 0.001) for suffering non-contact muscle injuries during the season.

CONCLUSIONS

The increase in BMI and muscle mass in response to creatine supplementation in professional football players was influenced by a TGS derived from the combination of favourable genotypes linked to muscle performance. The CC genotype and C allele of AMPD1 were particularly associated with a higher likelihood of muscle mass increase under creatine supplementation in this group of professional football players.

Analysis of Sports Supplement Consumption of Elite Referees of the Spanish Professional Fotball League

BACKGROUND

Sports supplements (SSs) are widely used among team sport athletes; however, evidence supporting the use of SSs among football referees at the elite level is scarce. The aim of the present study was to analyze the consumption of SSs among referees with respect to their level of competition and referee type (main referees (MRs) vs. assistant referees (ARs)).

METHODS

A total of 106 football referees participated in this study, with 46.2% from the First Spanish Division and 53.8% from the Second Spanish Division, representing 84.13% of the total number of referees. Each participant completed a validated questionnaire about SS consumption, with the SSs classified according to the Australian Institute of Sport (AIS) ABCD system: Group A has strong evidence for enhancing athlete health and performance, Group B shows potential benefits but needs more evidence, Group C has inconclusive evidence against use, and Group D includes prohibited substances.

RESULTS

A total of 84.0% of the MRs and ARs reported the consumption of at least one SS. Differences were found only in the consumption of medical supplements between division (p = 0.016) and type of referee (p = 0.041), though no significant differences were found among the remaining AIS SS categories (p > 0.05). Sport performance (49.6%), Internet (41.0%), and dietitian-nutritionists (31.7%) were the primary reason for SS consumption, purchase location, and source of information, respectively. The most frequently consumed SS were whey protein (45.3%), followed by creatine (33.0%), sport bars and sports drinks (28.3%), and caffeine (19.8%).

CONCLUSIONS

MRs and ARs reported a high prevalence of dietary supplement (SS) consumption, with significant differences between division and referee type observed only in medical supplement consumption.

Effects of acute creatine supplementation on cardiac and vascular responses in older men; a randomized controlled trial

BACKGROUND AND AIMS

In the recent years creatine has been shown promising results in patients with neurodegenerative diseases, myopathies and dystrophies. Cardiovascular diseases could be another pathology that can benefit from creatine supplementation, considering the influence on the risk factors associated with the development of cardiovascular diseases including reduction in chronic inflammation, and improved control of hyperglycemia and dyslipidemia The aim of the present study was to investigate the impact of short-term creatine supplementation on cardiac and vascular health in older adults.

METHODS

Males between the ages of 55-80 were randomly assigned to three groups: creatine, placebo and control. Creatine or placebo was provided for 7-day supplementation, at a dose of 20 g/day. Testing was performed at the same time of the day at baseline and on the eighth day. Vascular responses were assessed using an arterial pulse wave velocity equipment, while cardiac assessment was performed using an impedance cardiography device.

RESULTS

The placebo group was older (71.1 ± 8.2 yr) compared to creatine (61.4 ± 5.2 yr) and control (62.5 ± 7.1 yr). Cardio-ankle vascular index improved just in the creatine group (8.7 ± 0.5 to 8.2 ± 0.5, p = 0.03). While the upstroke time of the placebo and control groups did not change after 7 days, the creatine group had a nonsignificant reduction, 178.9 ± 26.5 ms to 158.4 ± 28.6 ms, p = 0.07. Similar tendency was seen with the systolic blood pressures, while the placebo and control did not change, the creatine group showed nonsignificant improvement, especially on the right, 144.0 ± 12.7 mmHg to 136.1 ± 13.4 mmHg, p = 0.08. All three groups had similar responses in stroke volume (p = 0.61), contractility index (p = 0.64) and ejection fraction (p = 0.72).

CONCLUSIONS

In older adults, acute creatine supplementation can positively affect vascular parameters of arterial stiffness and atherosclerosis. Creatine supplementation has the potential to serve as a potent adjuvant in the management of CVD for older adults.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov; ID: NCT05329480.

Nutrition as a military capability to deliver human advantage: more people, more ready, more of the time

Soldiers must achieve high-level mission-preparedness to endure extended periods of physical and cognitive activity, with unpredictable recovery, in all environments. Nutrition provides the foundation for health and performance. Militaries have not maximised the strategic and financial value that considering nutrition as a military capability could deliver. A whole system approach to military nutrition, based on the prepare-perform-recover human capability cycle phases, is presented. Trainee nutrition requirements, through to very-high-readiness forces undertaking arduous roles at reach, must be specifically addressed. Promoting military performance diets in the prepare phase, through practitioner-supported nutrition education and food provision, will ensure mission readiness and mitigate ill health. Delivering nutrition in field settings in the perform phase-through smaller/lighter, nutritionally optimised rations and smart packaging technologies-will improve utility and minimise waste. Strategic dietary supplement use can provide a mission performance-enhancing adjunct to a food-first philosophy. Impact value chain analysis of military nutrition capability investments could support cost-benefit measurement.

Health Claims for Sports Drinks-Analytical Assessmentaccording to European Food Safety Authority's Scientific Opinion

In Europe, sports food supplements (SSFs) are subject to specific laws and regulations. Up to 70% of athletes are highly influenced by the information on the label or the advertisement of the SSF, which often does not correspond to the scientific evidence, such as health claims. The aim is to analyze such claims relating to sports drinks (SDs) in commercial messages. To this end, an observational and cross-sectional study was conducted based on the analysis of the content and degree of adequacy of the health claims indicated on the labelling or technical data sheet of the SDs with those established by the European legislation in force according to the European Food Safety Authority (EFSA). The SSFs were searched for via Amazon and Google Shopping. A total of 114 health claims were evaluated. No claim fully conformed with the recommendations. A total of 14 claims (n = 13 products) almost conformed to the recommendations; they were "Maintain endurance level in exercises requiring prolonged endurance", "Improve water absorption during physical exercise", and "Improved physical performance during high intensity, high duration physical exercise in trained adults", representing 12.3% of the total (n = 114). The vast majority of the claims identified indicated an unproven cause-effect and should be modified or eliminated, which amounts to food fraud towards the consumer.

Future development trend of food-borne delivery systems of functional substances for precision nutrition

BACKGROUND

Precision nutrition, a personalized nutritional supplementation model, is widely acknowledged for its significant impact on human health. Nevertheless, challenges persist in the advancement of precision nutrition, including consumer dietary behaviors, nutrient absorption, and utilization. Thus, the exploration of effective strategies to enhance the efficacy of precision nutrition and maximize its potential benefits in dietary interventions and disease management is imperative.

SCOPE AND APPROACH

The primary objective of this comprehensive review is to synthesize and assess the latest technical approaches and future prospects for achieving precision nutrition, while also addressing the existing constraints in this field. The role of delivery systems is pivotal in the realization of precision nutrition goals. This paper outlines the potential applications of delivery systems in precision nutrition and highlights key considerations for their design and implementation. Additionally, the review offers insights into the evolving trends in delivery systems for precision nutrition, particularly in the realms of nutritional fortification, specialized diets, and disease prevention.

KEY FINDINGS AND CONCLUSIONS

By leveraging computer data collection, omics, and metabolomics analyses, this review scrutinizes the lifestyles, dietary patterns, and health statuses of diverse organisms. Subsequently, tailored nutrient supplementation programs are devised based on individual organism profiles. The utilization of delivery systems enhances the bioavailability of functional compounds and enables targeted delivery to specific body regions, thereby catering to the distinct nutritional requirements and disease prevention needs of consumers, with a particular emphasis on special populations and dietary preferences.

An Updated View of the Effect of Probiotic Supplement on Sports Performance: A Detailed Review

PURPOSE OF REVIEW

Modulation of the host microbiota through probiotics has been shown to have beneficial effects on health in the growing body of research. Exercise increases the amount and diversity of beneficial microorganisms in the host microbiome. Although low- and moderate-intensity exercise has been shown to reduce physiological stress and improve immune function, high-intensity prolonged exercise can suppress immune function and reduce microbial diversity due to intestinal hypoperfusion. The effect of probiotic supplementation on sports performance is still being studied; however, questions remain regarding the mechanisms of action, strain used, and dose. In this review, the aim was to investigate the effects of probiotic supplements on exercise performance through modulation of gut microbiota and alleviation of GI symptoms, promotion of the immune system, bioavailability of nutrients, and aerobic metabolism.

RECENT FINDINGS

Probiotic supplementation may improve sports performance by reducing the adverse effects of prolonged high-intensity exercise. Although probiotics have been reported to have positive effects on sports performance, information about the microbiome and nutrition of athletes has not been considered in most current studies. This may have limited the evaluation of the effects of probiotic supplementation on sports performance.

Nootropic supplements for esports

Background: esports, or organized video game competitions, have been expanding quickly. The use of dietary supplements by esports players appears vulgarized but lacks supporting evidence. Objectives: To outline studies that tested the effects of dietary supplements on video gaming, summarize their findings, highlight knowledge gaps, and recommend future research. Eligibility criteria: Clinical trials published in English between 1990 and 2023 that assessed the effects of dietary supplements on the cognitive performance of video gamers. Sources of evidence: The Web of Science, PubMed, Scopus, and Google Scholar databases. Charting methods: PRISMA's (2020) flow diagram was used to create the data chart. Results: Sixteen studies were outlined. Thirteen were randomized, thirteen applied acute interventions, ten applied a crossover design and only three weren't placebo-controlled. Of the 10 studies that included caffeine (40-200 mg), four reported significant positive effects on cognition (attention, processing speed, working memory), two on first-person shooter video gaming performance (reaction time, hit accuracy, time to hit 60 targets), and one on Tetris game score. All 3 studies that included arginine silicate (1500 mg) reported significant improvements in one or more aspects of cognition (reaction time, attention, visual representation, and spatial planning). Two studies that tested sucrose (21 and 26.8 g) didn't report significant improvements, while one study that tested 26.1 g of glucose registered significant positive effects on processing speed and sustained attention. Conclusions: The published literature has focused on the effects of caffeine, which may exert both positive and negative effects on esports players. Additional, high-quality research is needed.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Acute dose-response effect of photobiomodulation therapy on 5-km running performance in trained runners: a randomized, double-blind, placebo-controlled, crossover study

Photobiomodulation therapy (PBMT) has been advocated as a potential intervention to improve muscle performance and recovery in the health and sports context. However, the short- and long-term effects of PBMT on endurance running performance remain under-researched and controversial. The purpose of this study was to investigate the acute dose-response effect of PBMT with light-emitting diodes (LEDs) on endurance performance and rating of perceived exertion (RPE; 6-20 Borg) during a 5-km running trial in recreational runners. In a crossover design, eighteen young adult runners (28.7 ± 7.8 years) were randomized to receive 1 of 4 PBMT conditions (placebo, 300, 900, and 1260 Joules [J]) 60 min before the 5-km running trial on four occasions, separated by a 2-wk washout period. The treatments were applied to the quadriceps, hamstrings, and gastrocnemius muscles of both legs using a device containing 200 LEDs (100 red and 100 infrared). The following variables were assessed: endurance performance (i.e. total time, mean velocity, and velocity in the split distances at the initial 200 m and every 400 m lap) and RPE in the split distances at the initial 200 m and every 400 m lap. Data normality and homogeneity were tested using Shapiro-Wilk's and Levene's tests, respectively. Differences between treatment conditions were assessed using the analysis of variance tests (one- or two-way ANOVA, depending on the comparisons), complemented by the Bonferroni post hoc test. There were significant time effects for the running velocity and RPE in the split distances (p < 0.0001), with no significant treatment-by-time interaction (running velocity, p = 0.59; RPE, p = 0.95). The mean velocity (p = 0.997), total time (p = 0.998), and total mean of the RPE (p = 0.91) were similar between treatment conditions. In conclusion, acute PBMT with LEDs at doses of 300, 900, and 1260 J is not recommended for improving endurance performance and RPE in the 5-km running trial in recreational runners.

2024 HRS expert consensus statement on arrhythmias in the athlete: Evaluation, treatment, and return to play

Youth and adult participation in sports continues to increase, and athletes may be diagnosed with potentially arrhythmogenic cardiac conditions. This international multidisciplinary document is intended to guide electrophysiologists, sports cardiologists, and associated health care team members in the diagnosis, treatment, and management of arrhythmic conditions in the athlete with the goal of facilitating return to sport and avoiding the harm caused by restriction. Expert, disease-specific risk assessment in the context of athlete symptoms and diagnoses is emphasized throughout the document. After appropriate risk assessment, management of arrhythmias geared toward return to play when possible is addressed. Other topics include shared decision-making and emergency action planning. The goal of this document is to provide evidence-based recommendations impacting all areas in the care of athletes with arrhythmic conditions. Areas in need of further study are also discussed.

Development of a screener to assess athlete risk behavior of not using third-party tested nutritional supplements

Introduction

The aim of this cross-sectional study was to develop an algorithm to predict athletes use of third-party tested (TPT) supplements. Therefore, a nutritional supplement questionnaire was used with a section about self-reported TPT supplement use.

Methods

Outcomes were randomly assigned to a training dataset to identify predictors using logistic regression models, or a cross-validation dataset. Training data were used to develop an algorithm with a score from 0 to 100 predicting use or non-use of TPT nutritional supplements.

Results

A total of n = 410 NCAA Division I student-athletes (age: 21.4 ± 1.6 years, 53% female, from >20 sports) were included. Then n = 320 were randomly selected, of which 34% (n = 109) of users consistently reported that all supplements they used were TPT. Analyses resulted in a 10-item algorithm associated with use or non-use of TPT. Risk quadrants provided the best fit for classifying low vs. high risk toward inconsistent TPT-use resulting in a cut-off ≥60% (χ2(4) = 61.26, P < 0.001), with reasonable AUC 0.78. There was a significant association for TPT use (yes/no) and risk behavior (low vs. high) defined from the algorithm (χ2(1)=58.6, P < 0.001). The algorithm had a high sensitivity, classifying 89% of non-TPT users correctly, while having a low specificity, classifying 49% of TPT-users correctly. This was confirmed by cross-validation (n = 34), reporting a high sensitivity (83%), despite a lower AUC (0.61).

Discussion

The algorithm classifies high-risk inconsistent TPT-users with reasonable accuracy, but lacks the specificity to classify consistent users at low risk. This approach should be useful in identifying athletes that would benefit from additional counseling.

Short term creatine loading improves strength endurance even without changing maximal strength, RPE, fatigue index, blood lactate, and mode state

Creatine is consumed by athletes to increase strength and gain muscle. The aim of this study was to evaluate the effects of creatine supplementation on maximal strength and strength endurance. Twelve strength-trained men (25.2 ± 3.4 years) supplemented with 20 g Creatina + 10g maltodextrin or placebo (20g starch + 10g maltodextrin) for five days in randomized order. Maximal strength and strength endurance (4 sets 70% 1RM until concentric failure) were determined in the bench press. In addition, blood lactate, rate of perceived effort, fatigue index, and mood state were evaluated. All measurements were performed before and after the supplementation period. There were no significant changing in maximal strength, blood lactate, RPE, fatigue index, and mood state in either treatment. However, the creatine group performed more repetitions after the supplementation (Cr: Δ = +3.4 reps, p = 0.036, g = 0.53; PLA: Δ = +0.3reps, p = 0.414, g = 0.06), and higher total work (Cr: Δ = +199.5au, p = 0.038, g = 0.52; PLA: Δ = +26.7au, p = 0.402, g = 0.07). Creatine loading for five days allowed the subjects to perform more repetitions, resulting in greater total work, but failed to change the maximum strength.

Development and validation of a high-performance thin-layer chromatography method for detection of sibutramine in dietary supplements

INTRODUCTION

In the period between 1997 and 2010, sibutramine-containing drugs were widely prescribed for obesity and over-weight management. Due to safety concerns, in 2010 all medicines containing sibutramine were urgently withdrawn from the USA and European pharmaceutical market. Although sibutramine is no longer available in pharmaceutical products, there have been numerous reports of mislabeled weight-loss dietary supplements containing sibutramine.

The effects of coenzyme Q10 supplementation on biomarkers of exercise-induced muscle damage, physical performance, and oxidative stress: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials

PURPOSE

This study aims to elucidate the dose-dependent effect of coenzyme Q10 supplementation (CoQ10) on exercise-induced muscle damage (EIMD), physical performance, and oxidative stress in adults.

METHODS

A systematic search was conducted through PubMed, Scopus, and ISI Web of Science databases up to August 2023, focusing on randomized control trials (RCTs) that investigated the effects of CoQ10 supplementation on EIMD recovery, physical performance and oxidative stress mitigation in adults. The weighted mean difference (WMD) and 95 % confidence interval (95 %CI) were estimated using the random-effects model.

RESULTS

The meta-analysis incorporated 28 RCTs, encompassing 830 subjects. CoQ10 supplementation significantly decreased creatine kinase (CK) (WMD: -50.64 IU/L; 95 %CI: -74.75, -26.53, P < 0.001), lactate dehydrogenase (LDH) (WMD: -52.10 IU/L; 95 %CI: -74.01, -30.19, P < 0.001), myoglobin (Mb) (WMD: -21.77 ng/ml; 95 %CI: -32.59, -10.94, P < 0.001), and Malondialdehyde (MDA) (WMD: -0.73 μmol/l; 95 %CI: -1.26, -0.20, P = 0.007) levels. No significant alteration in total antioxidant capacity was observed post-CoQ10 treatment. Each 100 mg/day increase in CoQ10 supplementation was correlated with a significant reduction in CK (MD: -23.07 IU/L, 95 %CI: -34.27, -11.86), LDH (WMD: -27.21 IU/L, 95 %CI: -28.23, -14.32), Mb (MD: -7.09 ng/ml; 95 %CI: -11.35, -2.83) and MDA (WMD: -0.17 μmol/l, 95 %CI: -0.29, -0.05) serum levels. Using SMD analysis, "very large" effects on LDH and "moderate" effects on CK and MDA were noted, albeit nonsignificant for other outcomes.

CONCLUSION

CoQ10 supplementation may be effective in reducing biomarkers of EIMD and oxidative stress in adults. Nevertheless, given the preponderance of studies conducted in Asia, the generalizability of these findings warrants caution. Further RCTs, particularly in non-Asian populations with large sample sizes and extended supplementation durations, are essential to substantiate these observations.

Supplementation with Lactiplantibacillus brevis GKEX Combined with Resistance Exercise Training Improves Muscle Mass, Strength Performance, and Body Fat Condition in Healthy Humans

In addition to maintaining good exercise and dietary habits, recent studies have shown that probiotics may have potential benefits for muscle mass and strength. It is worth noting that the effects may vary depending on the specific strains used. To date, no studies have analyzed the effects of Lactiplantibacillus brevis in this context. Here, we combine the L. brevis strain GKEX with resistance training to further understand its effects on muscle mass, thickness, performance, and fat loss. In a six-week intervention for a double-blind randomized trial, 52 healthy subjects were divided into two groups (10 male and 16 female participants in each group): a placebo group (two capsules/day, containing 0 CFU of GKEX per capsule) and a GKEX group (two capsules/day, containing 1 × 1010 CFU of GKEX per capsule). Before the intervention, no differences were observed between the two groups in any of the tests (body composition, muscle thickness, exercise performance, and blood parameters). However, supplementation with GKEX significantly improved muscle mass and thickness, as well as grip strength, muscle strength, and explosive performance, when compared to the associated parameters before the intervention. Additionally, GKEX supplementation promoted a reduction in the body fat percentage (p < 0.05). Through analysis of the change amount, we observed that GKEX supplementation yielded significantly improved benefits when compared to the placebo group (p < 0.05). In summary, our findings support the notion that a six-week resistance exercise training program combined with L. brevis GKEX supplementation has superior additive effects that enhance muscle mass and strength performance, while also reducing body fat percentage. This intervention can promote muscle gain and fat loss.

Biological assessment of the omega-3 status after omega-3 enriched dietary during an active seasonal performance on soccer players

BACKGROUND

To assess the physiological change of blood fatty acid composite during the seasonal performance of soccer players with omega-6/omega-3 polyunsaturated fatty acid balanced dietary supplementation.

METHODS

This study included 20 healthy and trained male soccer players. During the study, data collection was performed three times (pre-, mid-, post-season). Anthropometric data collection and blood sampling for the assessment of the omega index were performed. The mid- and post-seasonal data were compared with baseline data collected before the starting season (pre-seasonal data).

RESULTS

Elevated levels of omega-3, HS-omega, and trans fatty acid were observed in both the mid- and post-seasonal data. During the season, the levels of omega-6/omega-3 and saturated fatty acid decreased, whereas there were no differences in total cholesterol, cholesterol LDL, HDL, BUN/Cr, HbA1c (NGSP), and cystatin C.

CONCLUSIONS

n-3 PUFA-enriched dietary supplementation might alter blood omega-3 indices in soccer players during the season.

Dietary supplementation habits in international natural bodybuilders during pre-competition

Bodybuilding is characterized by high-rates of sport supplementation. This is the first study to compare the supplementation patterns of winners (WB) and non-winners (NWB) among international natural bodybuilders during contest preparation. Fifty-six natural bodybuilders (5 women) (age = 28.85 ± 8.03 years; final body mass = 71.50 ± 10.28 kg), 19 WB (athletes who had achieved victory in an official natural bodybuilding championship at least once) and 37 NWB (athletes who never achieved victory), from 18 countries (55.36% from Spain) responded to this cross-sectional online survey related to their nutritional habits, strategies and supplementation practices. WB were significantly older (p = 0.024), completed more competitive seasons (p = 0.027) and participated in more competitions in the last contest year (p = 0.011). There were no significant differences between WB and NWB for years training for bodybuilding (p = 0.055), weeks of dieting for competition (p = 0.392), and body weight at the start (p = 0.553) and end (p = 0.330) of the season. Beverage and supplement consumption, purchasing patterns, and information sources did not differ between groups (p > 0.05). In conclusion, natural bodybuilding WB tended to be older and had more competitive experience, but shared similar supplementation protocols to NWB. Athletes' supplementation patterns were influenced by different sources of information. However, these natural bodybuilders mainly purchased their supplements through the internet without guidance from a coach or dietitian.

Not Only Protein: Dietary Supplements to Optimize the Skeletal Muscle Growth Response to Resistance Training: The Current State of Knowledge

Regarding skeletal muscle hypertrophy, resistance training and nutrition, the most often discussed and proposed supplements include proteins. Although, the correct amount, quality, and daily distribution of proteins is of paramount importance for skeletal muscle hypertrophy, there are many other nutritional supplements that can help and support the physiological response of skeletal muscle to resistance training in terms of muscle hypertrophy. A healthy muscle environment and a correct whole muscle metabolism response to the stress of training is a prerequisite for the increase in muscle protein synthesis and, therefore, muscle hypertrophy. In this review, we discuss the role of different nutritional supplements such as carbohydrates, vitamins, minerals, creatine, omega-3, polyphenols, and probiotics as a support and complementary factors to the main supplement i.e., protein. The different mechanisms are discussed in the light of recent evidence.

Milk or Kefir, in Comparison to Water, Do Not Enhance Running Time-Trial Performance in Endurance Master Athletes

This study compared flavored kefir (KFR) and flavored milk (MLK) as a recovery drink in endurance master athletes. Using a randomized, placebo-controlled, non-blinded crossover design, 11 males and females completed three testing visits whilst acutely ingesting either KFR, MLK, or water as a placebo (PLA). KFR supplementation occurred for 14 days before the KFR-testing day, followed by a 3-week washout period. Testing visits consisted of an exhausting-exercise (EE) bout, a 4-h rest period where additional carbohydrate feeding was provided, and a treadmill 5 km time trial (TT). The Gastrointestinal Symptom Rating Scale (GSRS) survey was assessed at four timepoints. Blood was collected at baseline and after the TT and was analyzed for I-FABP levels. No significant difference (PLA: 33:39.1 ± 6:29.0 min, KFR: 33:41.1 ± 5:44.4 min, and MLK: 33:36.2 ± 6:40.5 min, p = 0.99) was found between the groups in TT performance. The KFR GSRS total score was significantly lower than the PLA after EE (p = 0.005). No differences in I-FABP were observed between conditions. In conclusion, acute KFR supplementation did not impact TT performance or I-FABP levels but may have reduced subjective GI symptoms surrounding exercise when compared to MLK or PLA.

Functional nutrition for the health of exercising individuals and elite sportspersons

INTRODUCTION

Elite sportspersons who are involved in high-intensity physical sports indulge in severe training and competition schedules, which exposes them to high levels of inflammatory and oxidative stress, hence it may hamper their health sometimes. Disturbance in the health of sportspersons also induces compromised performances.

THE PREMISE FOR FUNCTIONAL NUTRITION

Functional nutrition is essential for elite sportspersons training for securing both rest and recovery to have proper health and anticipated performance. Apart from serving the energy needs of the sportspersons, the nutrition strategies should provide them with certain metabolic advantages, which provide greater health and immunity, to ensure proper training and competition. The diet of the sportspersons needs to contain appropriate anti-inflammatory and antioxidative nutrients, to ensure to reduction and control of the physiological stress of tissues during high-intensity physical sports, especially during marathon running. Preserving anabolic valence among sportspersons for muscle myokine optimization is an essential aspect of sports nutrition, which secures health and provides excellent performance potential. Preservation and optimization of gut microbiome among sportspersons enhance immune health and performance, through proper gut integrity and enhanced metabolic cascades. As the genes are to be properly expressed for excellent manifestation in protein synthesis and other metabolic signaling, achieving genetic valance through proper nutrition ensures the health of the sportspersons.

CONCLUSION

Functional nutrition seems a very necessary and potent factor in the training and competition aspects of elite sportspersons since nutrition not only provides recovery but also ensures proper health for elite sportspersons.

Supplementation for Performance and Health in Patients with Phenylketonuria: An Exercise-Based Approach to Improving Dietary Adherence

Supplementation is crucial for improving performance and health in phenylketonuria (PKU) patients, who face dietary challenges. Proteins are vital for athletes, supporting muscle growth, minimizing catabolism, and aiding muscle repair and glycogen replenishment post-exercise. However, PKU individuals must limit phenylalanine (Phe) intake, requiring supplementation with Phe-free amino acids or glycomacropeptides. Tailored to meet nutritional needs, these substitutes lack Phe but fulfill protein requirements. Due to limited supplement availability, athletes with PKU may need higher protein intake. Various factors affect tolerated Phe levels, including supplement quantity and age. Adhering to supplement regimens optimizes performance and addresses PKU challenges. Strategically-timed protein substitutes can safely enhance muscle synthesis and sports performance. Individualized intake is essential for optimal outcomes, recognizing proteins' multifaceted role. Here, we explore protein substitute supplementation in PKU patients within the context of physical activity, considering limited evidence.

How Cool is That? The Effects of Menthol Mouth Rinsing on Exercise Capacity and Performance: A Systematic Review and Meta-analysis

BACKGROUND

Menthol (MEN) mouth rinsing (MR) has gained considerable interest in the athletic population for exercise performance; however, the overall magnitude of effect is unknown.

OBJECTIVE

The aim of this systematic review and meta-analysis was to determine the efficacy of menthol MEN MR and the impact it has on exercise capacity and performance.

METHODS

Three databases were searched with articles screened according to the inclusion/exclusion criteria. Three-level meta-analyses were used to investigate the overall efficacy of MEN MR and the impact it has on exercise capacity and performance. Meta-regressions were then performed with 1) mean VO2peak, 2) MEN swilling duration; 3) the MEN concentration of MR solution, 4) the number of executed swills throughout a single experiment, 5) the use of flavoured sweetened, non-caloric, or non-flavoured neutral solutions as controls, 6) mean environmental temperature at the time of exercise tests, and 7) exercise type as fixed factors to evaluate their influence on the effects of MEN MR.

RESULTS

Ten MEN MR studies included sufficient information pertaining to MEN MR and exercise performance and capacity. MR with MEN resulted in no significant change in capacity and performance (SMD = 0.12; 95% CI - 0.08, 0.31; p = 0.23, n = 1, tau21 < 0.0001, tau22 =  < 0.0001, I2 = 0%). No significant influence was detected in meta-regressions for VO2peak, (estimate: 0.03; df = 8; 95% CI - 0.03, 0.09; p = 0.27), swilling duration (5 vs. 10 s: 0.00; df = 16; 95% CI - 0.41, 0.41; p = 1.0), MEN concentration (low [0.01%] vs. high [0.1%]: - 0.08; df = 15; 95% CI - 0.49, 0.32; p = 0.67), number of swills (estimate: 0.02; df = 13; 95% CI - 0.05, 0.09; p = 0.56), the use of flavoured sweetener or non-caloric as control (non-flavoured vs. flavoured: 0.12; df = 16; 95% CI - 0.30, 0.55; p = 0.55) or mean room temperature during exercise tests (estimate: 0.01; df = 16; 95% CI - 0.02, 0.04; p = 0.62).

CONCLUSION

MEN MR did not significantly improve overall exercise capacity and performance, though those involved in endurance exercise may see benefits.

Supplement usage and doping attitudes in elite youth sports: The mediating role of dietary supplement acceptance

This study investigated whether dietary supplement acceptance mediated the relationship between supplement use and doping attitudes in youth sports. To this end, we employed a two-wave half-longitudinal design during a sports season (time point one [T1] to time point two [T2]). The sample consisted of 217 elite youth athletes (47% male; mean age = 16.98 years, standard deviation = 0.88) who competed in team sports (43%; N = 93; basketball, floorball, handball, and ice hockey) and individual sports (57%; N = 124; alpine skiing, biathlon, cross-country skiing, swimming, and tennis). The participants were recruited from eight Norwegian sports academy high schools that provide extracurricular, higher-level training and specialization for youth athletes. Results from structural equation modeling analysis indicated that dietary supplement acceptance (T2) mediated the positive relationship between supplement use (T1) and doping attitudes (T2) when accounting for prior levels of the mediator and the outcome variable. These findings suggest that when young athletes used dietary supplements at the start of the season to improve their performance, they were more likely to view the use of supplements as acceptable and to report more favorable attitudes toward doping at the end of the season six months later. For those seeking to prevent doping in youth sports, targeting athletes' views on the acceptable use of dietary supplements may be important.

Prevalence of sports supplements consumption and its association with food choices among female elite football players

OBJECTIVES

The present study aimed to 1) investigate the consumption of Sports Supplements (SSs) among female elite football players, 2) evaluate the influence of age on SS consumption, and 3) determine the relationship between the consumption of SSs and dietary choices among elite football players.

METHODS

A total of 126 female football players of Primera Iberdrola and Reto Iberdrola who participated in this descriptive, observational, and cross-sectional study completed a self-administered questionnaire on SSs and the Athletes' Food Choices Questionnaire.

RESULTS

Overall, 84.1% of participants consumed supplements, mainly for improved sports performance (68.3%) and health (34.1%). The main sources of purchase were the Internet (34.9%) and specialized shops (23.8%), and players were commonly advised by a dietitian-nutritionist to use SSs (56.3%). The SSs most often consumed included whey protein (30.2%), sports drinks (28.6%), creatine monohydrate (28.6%), sports bars (27.8%), and caffeine (27.8%). Older players consumed more supplements at the time of data compilation. Players predominantly acquired these supplements by using the Internet and reported benefits from their use (all P ≤ 0.036). Additionally, players who consumed SSs conveyed more concern about their food choices.

CONCLUSIONS

A high prevalence of female football players consumed SSs, particularly SSs supported by robust scientific evidence. Older players had higher supplement consumption rates. The use of SSs was related to food choices through nutritional characteristics of foods, knowledge about health and nutrition, weight control with the help of food, and the performance benefits players could acquire.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Perceptions of the importance of sports nutrition knowledge and barriers in implementing them: a qualitative study among track and field stakeholders in Sri Lanka

BACKGROUND

Integrating the core aspects of sports nutrition knowledge [SNK] into the multidisciplinary team is critical to improving an athlete's performance and well-being. Conducting in-depth interviews with members of the sports-related team is a comprehensive method of gathering information on various aspects of SNK. This qualitative study aimed to examine the opinions and beliefs of stakeholders in athletics regarding the importance of SNK.

METHODS

Fifteen professional track and field athletes and stakeholders were recruited into the study. Separate in-depth interviews were conducted to collect information within four key themes. Practical difficulties in getting an appropriate meal were included in an additional theme. Thematic analysis was performed using NVIVO v10.0.

RESULTS

All participants were mindful of the importance of proper food habits for overall athletic outcomes and reported different opinions on meal timing and composition. The opinions on supplements were heterogeneous and both positive and negative claims were reported. Beliefs regarding hydration demonstrated that the cohort was well aware of the significance of adequate hydration plus the signs and consequences of dehydration with many reporting experiences of the negative consequences of dehydration. All respondents reported that both alcohol and smoking may have an adverse impact on performance and health.

CONCLUSIONS

All respondents emphasized the importance of proper food habits for sports performance and well-being, but also identified barriers to optimizing nutrition.

Pattern of Consumption of Sports Supplements of Spanish Handball Players: Differences According to Gender and Competitive Level

(1) Background: Given the physiological characteristics of handball, players may require the use of certain sports supplements (SS). However, very few studies have investigated the consumption of SS in handball. The aims were to determine the number of handball players who consume SS, to analyze their SS consumption pattern according to gender and competitive level, and to assess whether the SS they consume are supported by scientific evidence, and to which group they belong according to the classification of the Australian Institute of Sport (AIS). (2) Methods: A descriptive-correlational study was carried out on the habitual consumption of SS in 360 federated Spanish players by using a self-administered and validated questionnaire. (3) Results: These showed 65.8% of the sample consumed SS. According to the total number of participants, the most consumed supplements were from Group A: sports drinks (30.8%) and whey protein (30.4%). When analyzing the data by gender, the men's consumption was significantly higher for whey protein (p < 0.001), caffeine (p = 0.009), and creatine monohydrate (p < 0.001). When analyzed by competitive level, the provincial category players group showed a significantly lower consumption than the rest of the groups for protein bars (p = 0.038), whey protein (p = 0.005) and creatine monohydrate (p < 0.001), while the honor division group showed a significantly higher intake of creatine monohydrate than the remaining groups (p < 0.001). (4) Conclusions: The handball players showed a moderate consumption of SS, without using substances that were not supported by scientific evidence and opting in most cases for supplements belonging to group A from the AIS classification. Men tended to consume more SS, and SS consumption increased based on competitive level.

Athletes' nutritional demands: a narrative review of nutritional requirements

Nutrition serves as the cornerstone of an athlete's life, exerting a profound impact on their performance and overall well-being. To unlock their full potential, athletes must adhere to a well-balanced diet tailored to their specific nutritional needs. This approach not only enables them to achieve optimal performance levels but also facilitates efficient recovery and reduces the risk of injuries. In addition to maintaining a balanced diet, many athletes also embrace the use of nutritional supplements to complement their dietary intake and support their training goals. These supplements cover a wide range of options, addressing nutrient deficiencies, enhancing recovery, promoting muscle synthesis, boosting energy levels, and optimizing performance in their respective sports or activities. The primary objective of this narrative review is to comprehensively explore the diverse nutritional requirements that athletes face to optimize their performance, recovery, and overall well-being. Through a thorough literature search across databases such as PubMed, Google Scholar, and Scopus, we aim to provide evidence-based recommendations and shed light on the optimal daily intakes of carbohydrates, protein, fats, micronutrients, hydration strategies, ergogenic aids, nutritional supplements, and nutrient timing. Furthermore, our aim is to dispel common misconceptions regarding sports nutrition, providing athletes with accurate information and empowering them in their nutritional choices.

Nutrition knowledge, weight loss practices, and supplement use in senior competition climbers

Introduction

Sport climbing has gained increased scientific attention, including studies investigating the dietary habits and nutritional requirements of climbers; however, significant gaps in the literature remain. An assessment of nutritional knowledge, weight loss for competition, and supplement use has not been previously reported in senior competition climbing athletes.

Methods

Fifty climbers (26 male, 24 female; BMI 21.6 ± 1.9; 23.7 ± 5.2 years) participated in the study. Participants answered a 72-item questionnaire, comprised of demographic data and three main sections to assess general and sports nutrition knowledge, weight loss strategies, and supplement use.

Results

The mean nutrition knowledge score was 'average', with considerable individual variation (53.5 ± 11.1 %). There were no significant sex differences in the general (GNK) or sport (SNK) nutrition knowledge scores, or effect of age. Significantly higher knowledge was demonstrated by national vs. international athletes for the GNK scores (11.09 ± 1.58 vs. 9.58 ± 1.75; p = 0.028). Participants scored well in questions concerning protein, carbohydrates, alcohol, and supplements, and conversely, performed poorly in hydration and micronutrient related questions. Less than one-fifth of respondents had access to a dietitian. Forty-six percent of males and 38% of female climbers reported intentional weight loss for competition on at least one occasion. Of those, ~76% reported utilizing concerning practices, including methods that conform with disordered eating and/or eating disorders, dehydration, vomiting, and misuse of laxatives. Approximately 65% of athletes reported using at least one nutritional supplement in the previous 6 months, with 44% reporting multiple supplement use. There was no significant difference in supplement use between sexes or competition level.

Discussion

Due to the established importance of nutritional intake on athlete health and performance, educational support should be employed to improve knowledge in climbers and address shortcomings. Moreover, intentional weight loss for climbing competition is common, with most athletes achieving ~3-8% body weight loss over ≥2 weeks. It is crucial that professionals working with competitive climbers are vigilant in identifying athletes at risk of concerning weight management and establish referral pathways to the appropriate specialist services. High quality intervention trials to assess the efficacy of ergogenic aids in climbing remains inadequate.

High School Athletes' Use and Knowledge of (Safe) Nutritional Supplement Use: An Exploratory Study

The use of nutritional supplements can lead to doping risk and no data exist on high school athletes' use of certified third-party tested supplements. A cross-sectional cohort design was developed using an anonymous survey. Descriptive data for supplement use, use of third-party tested supplements, and knowledge in high school athletes were reported. A total of 225 high school athletes, ranging from 14-19 years of age, from a private high school in the western US, were included in the analysis of the results. A total of 94% (n=211) of athletes reported nutritional supplement use within the past year with an average of six (interquartile range: 3-9) individual supplements, ranging from 0-20 supplements per person. Most frequently reported were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), caffeine (37%, as part of normal beverages, or 13% as a supplement), followed by creatine (23%). A total of 24% claimed to know for sure that all their supplements were third-party tested. In addition, the recognition of third-party testing organization icons was low (46% in supplement users vs. 14% in nonusers). Athletes also scored low in reporting how to find (22%) and how to order (25%) third-party tested supplements. In conclusion, almost all athletes in this study reported the use of multiple nutritional supplements annually. Only one-fourth of the athletes reported consistently using third-party tested supplements. Knowledge of where and how tested supplements could be purchased was limited in this high school athlete population.

Personality Determinants Related to the Use of Selective and Effective Dietary Supplements by Elite Polish Team Sport Athletes

INTRODUCTION

The purpose of this research was to analyse relationships between personality traits and the use of selected dietary supplements among Polish athletes training in team sports. This subject matter has not been explored in prior research.

MATERIAL AND METHODS

This research was carried out among a group of 213 athletes (men) in the 18-36 age range, with the implementation of a proprietary validated questionnaire for the use of dietary supplements and the NEO-PI-R inventory (Neuroticism-Extraversion-Openness Personality Inventory-Revised). Statistical analyses were performed with the Kruskal-Wallis and Mann-Whitney tests, assuming the following level of significance: α = 0.05.

RESULTS

It was shown that athletes who periodically and regularly consumed isotonic drinks, as well as energy bars and gels, were characterised by a lower level of neuroticism than those who did not consume them. Athletes who periodically took multivitamin preparations were characterised by a lower level of extraversion and openness, and those periodically using multimineral preparations were characterised by a higher level of agreeableness than those who did not use these agents. Athletes not taking creatine were characterised by the lowest level of conscientiousness among the study participants. The use of protein nutrients, probiotics and caffeine was not associated with any personality traits in the athletes.

CONCLUSIONS

Further relationships of the Big Five personality traits were demonstrated with the use of effective dietary supplements by athletes; the most unambiguous correlations were described for neuroticism and conscientiousness in such a way that the use of isotonic drinks, as well as energy bars and gels, was connected with a low level of neuroticism, while the use of creatine was connected with high conscientiousness.

Are the Dietary-Nutritional Recommendations Met? Analysis of Intake in Endurance Competitions

BACKGROUND

In recent decades the number of endurance events has increased, as well as the number of athletes participating in them. Adequate nutritional and water planning is essential to maintain optimal sports performance and to reduce the incidence of gastrointestinal problems. The main objective of this study is to determine the dietary intake and compliance with nutritional recommendations of athletes in two endurance competitions, as well as to assess the incidence of gastrointestinal complaints.

METHODS

An observational and cross-sectional study was carried out on the consumption of liquids, food, and supplements in 42 triathletes and mountain runners (MRs) participating in a Vi-Half-Gasteiz triathlon and the Ultra Sierra de Cazorla trail run. At the completion of the trials, participants completed a validated questionnaire (NIQEC).

RESULTS

The mean caloric intake during the test of the participants in this study was 192.17 kcal/h, while the mean carbohydrate intake was 43.67 g/h, the mean sodium intake was 267.43 mg/h, and the mean caffeine intake was 15.53 mg/h, with no significant differences between the two sports. The amount of liquids consumed by the participants was 421.21 mL/h, with no significant differences between the triathletes and MRs. As for gastrointestinal problems, it was observed that the participants presented gastrointestinal discomfort in 61.9% of the cases.

CONCLUSIONS

The intakes of energy, carbohydrates, water, sodium, and caffeine were lower than the current recommendations. There were no differences in the energy, carbohydrate, water, sodium, and caffeine intakes between the triathletes and mountain runners. Gastrointestinal problems showed a high prevalence in these athletes.

Direct and indirect impact of low energy availability on sports performance

Low energy availability (LEA) occurs inadvertently and purposefully in many athletes across numerous sports; and well planned, supervised periods with moderate LEA can improve body composition and power to weight ratio possibly enhancing performance in some sports. LEA however has the potential to have negative effects on a multitude of physiological and psychological systems in female and male athletes. Systems such as the endocrine, cardiovascular, metabolism, reproductive, immune, mental perception, and motivation as well as behaviors can all be impacted by severe (serious and/or prolonged or chronic) LEA. Such widely diverse effects can influence the health status, training adaptation, and performance outcomes of athletes leading to both direct changes (e.g., decreased strength and endurance) as well as indirect changes (e.g., reduced training response, increased risk of injury) in performance. To date, performance implications have not been well examined relative to LEA. Therefore, the intent of this narrative review is to characterize the effects of short-, medium-, and long-term exposure to LEA on direct and indirect sports performance outcomes. In doing so we have focused both on laboratory settings as well as descriptive athletic case-study-type experiential evidence.

Moderators of Caffeine's Effects on Jumping Performance in Females: A Systematic Review and Meta-Analysis

We aimed to perform a systematic review and meta-analysis of caffeine's effects on vertical jumping performance in females, with subgroup analyses for potential moderators, including phase of the menstrual cycle, testing time of day, caffeine dose, and test type. Fifteen studies were included in the review (n = 197). Their data were pooled in a random-effects meta-analysis of effect sizes (Hedges' g). In the main meta-analysis, we found an ergogenic effect of caffeine on jumping performance (g: 0.28). An ergogenic effect of caffeine on jumping performance was found when the testing was carried out in the luteal phase (g: 0.24), follicular phase (g: 0.52), luteal or follicular phase (g: 0.31), and when the phase was not specified (g: 0.21). The test for subgroup differences indicated that the ergogenic effects of caffeine were significantly greater in the follicular phase compared to all other conditions. An ergogenic effect of caffeine on jumping performance was found when the testing was carried out in the morning (g: 0.38), evening (g: 0.19), mixed morning or evening (g: 0.38), and when time was not specified (g: 0.32), with no subgroup differences. An ergogenic effect of caffeine on jumping performance was found when the dose was ≤3 mg/kg (g: 0.21), or >3 mg/kg (g: 0.37), with no subgroup differences. An ergogenic effect of caffeine on jumping performance was found in the countermovement jump test (g: 0.26) and squat jump test (g: 0.35), with no subgroup differences. In summary, caffeine ingestion is ergogenic for vertical jumping performance in females, and it seems that the magnitude of these effects is the largest in the follicular phase of the menstrual cycle.

Analysis of Sports Supplement Consumption in 1688 Federated Road Cyclists

The widespread use of sports supplements (SS) to enhance athletic performance extends to cyclists, although little research has been conducted on this subject within this sport. This descriptive and cross-sectional study involved 1688 federated road cyclists, aiming to analyse the pattern of SS consumption concerning the degree of scientific evidence and different categories. This study categorised SS based on the groups and subgroups established by the Australian Sport Institute (AIS, 2023) based on the level of evidence. Our results showed that 62.5% of the sample cyclists used SS, with an average of 12.2 ± 8.6 supplements consumed per participant. Health status (78.2%), pharmacies (62.5%), and medical doctors (45.7%) were the main reasons, purchase sites, and sources of information for SS consumption, respectively. The most prevalent SS consumed were Sports Gels (94%), Sports Bars (89.3%), and Sports Drinks (73.8%). Notably, 80% of the top ten most consumed SS belonged to the group with the highest level of evidence according to the AIS, with an average of 6.9 ± 3.2 supplements per participant. However, 23.3% of the total SS consumers used prohibited substances. In conclusion, while the prevalence of SS consumption among road cyclists is considerable and the primary sources for purchasing SS and obtaining advice are reliable, there is a notable prevalence of prohibited substance use within the sample.

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

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