Cognitive Performance Enhancement Induced by Caffeine, Carbohydrate and Guarana Mouth Rinsing during Submaximal Exercise

Central effects of mouth rinses on endurance and strength performance

Rinsing the mouth with a carbohydrate (CHO) solution has been shown to enhance exercise performance while reducing neuromuscular fatigue. This effect is thought to be mediated through the stimulation of oral receptors, which activate brain areas associated with reward, motivation, and motor control. Consequently, corticomotor responsiveness is increased, leading to sustained levels of neuromuscular activity prior to fatigue. In the context of endurance performance, the evidence regarding the central involvement of mouth rinse (MR) in performance improvement is not conclusive. Peripheral mechanisms should not be disregarded, particularly considering factors such as low exercise volume, the participant's fasting state, and the frequency of rinsing. These factors may influence central activations. On the other hand, for strength-related activities, changes in motor evoked potential (MEP) and electromyography (EMG) have been observed, indicating increased corticospinal responsiveness and neuromuscular drive during isometric and isokinetic contractions in both fresh and fatigued muscles. However, it is important to note that in many studies, MEP data were not normalised, making it difficult to exclude peripheral contributions. Voluntary activation (VA), another central measure, often exhibits a lack of changes, mainly due to its high variability, particularly in fatigued muscles. Based on the evidence, MR can attenuate neuromuscular fatigue and improve endurance and strength performance via similar underlying mechanisms. However, the evidence supporting central contribution is weak due to the lack of neurophysiological measures, inaccurate data treatment (normalisation), limited generalisation between exercise modes, methodological biases (ignoring peripheral contribution), and high measurement variability.Trial registration: PROSPERO ID: CRD42021261714.

Food for thought: Physiological considerations for nutritional ergogenic efficacy

Top-class athletes have optimized their athletic performance largely through adequate training, nutrition, recovery, and sleep. A key component of sports nutrition is the utilization of nutritional ergogenic aids, which may provide a small but significant increase in athletic performance. Over the last decade, there has been an exponential increase in the consumption of nutritional ergogenic aids, where over 80% of young athletes report using at least one nutritional ergogenic aid for training and/or competition. Accordingly, due to their extensive use, there is a growing need for strong scientific investigations validating or invalidating the efficacy of novel nutritional ergogenic aids. Notably, an overview of the physiological considerations that play key roles in determining ergogenic efficacy is currently lacking. Therefore, in this brief review, we discuss important physiological considerations that contribute to ergogenic efficacy for nutritional ergogenic aids that are orally ingested including (1) the impact of first pass metabolism, (2) rises in systemic concentrations, and (3) interactions with the target tissue. In addition, we explore mouth rinsing as an alternate route of ergogenic efficacy that bypasses the physiological hurdles of first pass metabolism via direct stimulation of the central nervous system. Moreover, we provide real-world examples and discuss several practical factors that can alter the efficacy of nutritional ergogenic aids including human variability, dosing protocols, training status, sex differences, and the placebo effect. Taking these physiological considerations into account will strengthen the quality and impact of the literature regarding the efficacy of potential ergogenic aids for top-class athletes.

Repeated mouth rinsing of coffee improves the specific-endurance performance and jump performance of young male futsal players

BACKGROUND

Mouth-rinsing with ergogenic solutions such as carbohydrate and caffeinated drinks has been considered among athletes as a practical nutritional strategy. Therefore, this study aimed to determine the effect of repeated coffee mouth-rinsing (CMR) doses on specific performances of futsal players.

METHOD

Twenty-four male futsal players randomly participated in this randomized, double-blind, and crossover design study. During the intervention, participants were randomly placed in four different conditions including 1. low-dose CMR (LDC, n = 6, ~60 mg caffeine); 2. high-dose CMR (HDC, n = 6, ~125 mg caffeine); 3. decaffeinated CMR (PLA, n = 6, ~10 mg caffeine); and 4. no CMR (CON, n = 6). Vertical jump height was measured at baseline, baseline after CMR (baseline-CMR), immediately after the intermittent futsal endurance test (FIET) (IA-FIET), 5 min after the FIET (5"A-FIET) and 10 min after the FIET (10"A-FIET). Perceived fatigue was also measured by visual analogue scale (VAS) at baseline, IA-FIET, 5"A-FIET, and 10"A-FIET. CMR was also performed at baseline, during FIET (Repeated between levels), and 10'A-FIET. The collected data were analyzed (with SPSS software) by one- and two-way repeated measure ANOVA and Bonferroni post hoc test at P < 0.05 level.

RESULTS

The findings of the present study illustrated that the perceived fatigue in IA-FIET increased significantly compared to the baseline which was accompanied by a significant decrease in 5"A-FIET and 10"A-FIET compared to IA-FIET (P < 0.05), and no significant difference was observed between conditions in the baseline, IA-FIET, 5"A-FIET, and 10"A-FIET (P > 0.05). However, HDC and LDC rose significantly the distance covered in FIET compared to CON and PLA (P < 0.05). In addition, HDC increased the FIET performance more than LDC (P < 0.05). Although there was no difference between any of the conditions at baseline (P > 0.05), baseline-CMR increased significantly the vertical jump height (P < 0.05). At IA-FIET, vertical jump height decreased to baseline levels in CMR conditions but increased in 5"A-FIET, which remained constant until 10"A-FIET (P < 0.05). In addition, vertical jump height in HDC and LDC conditions was significantly higher than CON in IA-FIET, 5"A-FIET, and 10"A-FIET.

CONCLUSION

This study showed that repeated CMR with low and high doses is a useful strategy to improve specific futsal performance. However, higher dose CMR appears to have more profound effects on performance improvement than lower doses.

International society of sports nutrition position stand: energy drinks and energy shots

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of energy drink (ED) or energy shot (ES) consumption on acute exercise performance, metabolism, and cognition, along with synergistic exercise-related performance outcomes and training adaptations. The following 13 points constitute the consensus of the Society and have been approved by the Research Committee of the Society: Energy drinks (ED) commonly contain caffeine, taurine, ginseng, guarana, carnitine, choline, B vitamins (vitamins B1, B2, B3, B5, B6, B9, and B12), vitamin C, vitamin A (beta carotene), vitamin D, electrolytes (sodium, potassium, magnesium, and calcium), sugars (nutritive and non-nutritive sweeteners), tyrosine, and L-theanine, with prevalence for each ingredient ranging from 1.3 to 100%. Energy drinks can enhance acute aerobic exercise performance, largely influenced by the amount of caffeine (> 200 mg or >3 mg∙kg bodyweight [BW-1]) in the beverage. Although ED and ES contain several nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES based on scientific evidence appear to be caffeine and/or the carbohydrate provision. The ergogenic value of caffeine on mental and physical performance has been well-established, but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. Consuming ED and ES 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance with doses >3 mg∙kg BW-1. Consuming ED and ES containing at least 3 mg∙kg BW-1 caffeine is most likely to benefit maximal lower-body power production. Consuming ED and ES can improve endurance, repeat sprint performance, and sport-specific tasks in the context of team sports. Many ED and ES contain numerous ingredients that either have not been studied or evaluated in combination with other nutrients contained in the ED or ES. For this reason, these products need to be studied to demonstrate efficacy of single- and multi-nutrient formulations for physical and cognitive performance as well as for safety. Limited evidence is available to suggest that consumption of low-calorie ED and ES during training and/or weight loss trials may provide ergogenic benefit and/or promote additional weight control, potentially through enhanced training capacity. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. Individuals should consider the impact of regular coingestion of high glycemic index carbohydrates from ED and ES on metabolic health, blood glucose, and insulin levels. Adolescents (aged 12 through 18) should exercise caution and seek parental guidance when considering the consumption of ED and ES, particularly in excessive amounts (e.g. > 400 mg), as limited evidence is available regarding the safety of these products among this population. Additionally, ED and ES are not recommended for children (aged 2-12), those who are pregnant, trying to become pregnant, or breastfeeding and those who are sensitive to caffeine. Diabetics and individuals with preexisting cardiovascular, metabolic, hepatorenal, and/or neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should exercise caution and consult with their physician prior to consuming ED. The decision to consume ED or ES should be based upon the beverage's content of carbohydrate, caffeine, and other nutrients and a thorough understanding of the potential side effects. Indiscriminate use of ED or ES, especially if multiple servings per day are consumed or when consumed with other caffeinated beverages and/or foods, may lead to adverse effects. The purpose of this review is to provide an update to the position stand of the International Society of Sports Nutrition (ISSN) integrating current literature on ED and ES in exercise, sport, and medicine. The effects of consuming these beverages on acute exercise performance, metabolism, markers of clinical health, and cognition are addressed, as well as more chronic effects when evaluating ED/ES use with exercise-related training adaptions.

The impact of nutrition on visual cognitive performance in the nutrition, vision, and cognition in sport study

Introduction

The purpose of this study was to examine the influence of nutritional intake on visual perceptual-cognitive performance (VCP) in young healthy adults.

Methods

Ninety-eight healthy men (n = 38) and women (n = 60) aged 18-33 years participated and maintained their usual dietary intake throughout the study. VCP was measured using the NeuroTracker^™ CORE (NT) 3-Dimensional (3-D) software program (15 training sessions) over a 15-day period. Food logs and extensive lifestyle measures including body composition, cardiovascular health, sleep and exercise patterns, and general readiness to perform were collected. Mean intake from 10 food logs collected over the 15 days were analyzed using Nutribase software. Statistical analyses were performed in SPSS using repeated measures ANOVA including significant covariates when appropriate.

Results

Males consumed significantly more calories, macronutrients, cholesterol, choline, and zinc and performed significantly better on VCP than the females. Participants who consumed more than 40% of kcals from carbohydrates (p = 0.038), less than 24% of kcals from protein (p = 0.009), more than 2,000 μg/day lutein/zeaxanthin or more than 1.8 mg/ day vitamin B2 performed significantly better on VCP than those who consumed less than those amounts, respectively.

Discussion

VCP is an important dimension of cognitive function and in the present study is influenced by higher carbohydrate, lutein/ zeaxanthin, and vitamin B2 dietary intake while high protein consumption and the female sex negatively impacted VCP.

Comment on Hack et al. Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis. Nutrients 2023, 15, 434

We have read the recent systematic review and meta-analysis by Hack et al. [...].

Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis

The plant extract guarana is known for its caffeine content and other bioactive ingredients, which purportedly may improve cognitive performance. Recent reviews have examined the effects of chronic supplementation of guarana in clinical populations; however, the acute effects of guarana on cognitive tasks, while of interest, have produced mixed results. Whether acute guarana ingestion improves human cognitive performance was assessed by performing a systematic review coupled with a meta-analysis. Eight placebo-controlled studies were identified and met the inclusion criteria providing data on 328 participants. The dose of guarana (37.5 to 500 mg) with reported caffeine content (4.3 to 100 mg) varied. Effect sizes (ESs) were calculated as the standardized mean difference and meta-analyses were completed using a random-effects model. The ESs for guarana averaged across a variety of cognitive measures and outcome variables were less than trivial (Hedge’s g = 0.076, p = 0.14). Using a subgroup meta-analysis (Q = 12.9, p < 0.001), ESs indicating a faster response time for guarana vs. a placebo (g = 0.202, p = 0.005) differed from the accuracy measures (g = −0.077, p = 0.4) which were non-significant. For response time, guarana ingested in a capsule (g = 0.111) tended to differ (Q = 2.96, p = 0.085) compared to guarana when dissolved in liquid (g = 0.281). Meta-regression of the study ESs of overall cognitive task performance was not related to the guarana dose (R2 < 0.001) or to the time allowed prior to cognitive testing (R2 < 0.001). Acute guarana ingestion had a small effect on the response time (faster performance) during a variety of cognitive tasks without affecting the accuracy. Whether the changes were linked to the caffeine content or other bioavailable substances in guarana is unknown. Additional studies that directly compare matched doses of caffeine versus guarana are needed to understand its effects on cognitive performance.

Not Another Caffeine Effect on Sports Performance Study-Nothing New or More to Do?

The performance-enhancing potential of acute caffeine consumption is firmly established with benefits for many aspects of physical performance and cognitive function summarised in a number of meta-analyses. Despite this, there remains near exponential growth in research articles examining the ergogenic effects of caffeine. Many such studies are confirmatory of well-established ideas, and with a wealth of convincing evidence available, the value of further investigation may be questioned. However, several important knowledge gaps remain. As such, the purpose of this review is to summarise key knowledge gaps regarding the current understanding of the performance-enhancing effect of caffeine and justify their value for future investigation. The review will provide a particular focus on ten research priorities that will aid in the translation of caffeine's ergogenic potential to real-world sporting scenarios. The discussion presented here is therefore essential in guiding the design of future work that will aid in progressing the current understanding of the effects of caffeine as a performance enhancer.

Acute Effect of Caffeine-Based Multi-Ingredient Supplement on Reactive Agility and Jump Height in Recreational Handball Players

Pre-exercise caffeine and guarana-based multi-ingredient supplement (MS) consumption may be more effective for physical performance improvement than caffeine and guarana alone due to the synergistic effect of biologically active ingredients in multi-ingredient supplements. This study aimed to examine the acute effect of MS on the reactive agility and jump performance in recreational handball male players. A randomized, double-blind, crossover study involved twenty-four male handball players (body mass 74.6 ± 8.8 kg; body height 179 ± 7 cm; age 23.8 ± 1.4 years). Participants were tested under three conditions: placebo, caffeine + guarana (CAF + GUA), or MS ingestion 45 min before exercise tests. Participants performed a reactive agility test (Y-shaped test) and countermovement jump (CMJ). None of the supplements improved countermovement jump height (p = 0.06). The time needed to complete the agility test was significantly (p = 0.02) shorter in the MS condition than in the placebo. The differences in agility between PL vs. CAF + GUA and MS vs. CAF + GUA conditions were not statistically significant (p = 0.88 and p = 0.07, respectively). The results of this study indicate that the caffeine-based multi-ingredient performance was effective in improvement in reactive agility but not in jump height in recreational handball male players. A similar effect was not observed with CAF + GUA ingestion alone.

The effect of mouth rinsing with different concentrations of caffeine solutions on reaction time

Caffeine mouth rinsing (CAF-MR) has been shown to improve reaction time (RT). CAF-MR studies have generally used 1.2% CAF concentrations, but the effect of using different concentrations is unknown. Therefore, we compared the effect of different concentrations of CAF-MR on RT. Forty-five trained male athletes (age: 18 ± 3 y) volunteered to participate in this double-blind, randomized controlled crossover study. Participants completed five testing sessions (Control, Placebo (water)-MR, and 1.2%, 1.8%, and 2.4% CAF-MR), with hand and foot RTs assessed immediately after MR. All CAF-MR conditions resulted in significantly faster hand and foot RT compared to Control and Placebo (all p < 0.001, except for foot RT with 1.8% CAF-MR vs. Placebo: NS). For both hand and foot RT, 1.2% and 1.8% CAF-MR did not significantly differ, but RT for 2.4% CAF-MR was significantly faster than both (p < 0.001). Improvements in RT for 2.4% CAF-MR vs. Placebo were 22% for hand RT and 21% for foot RT. In conclusion, these findings demonstrate that higher CAF-MR concentrations than those typically used can result in greater improvements in RT. This has implications for the practical use of CAF-MR to enhance performance in sports in which optimal RT is a factor of success.

No independent or synergistic effects of carbohydrate-caffeine mouth rinse on repeated sprint performance during simulated soccer match play in male recreational soccer players

The study examined the synergistic and independent effects of carbohydrate-caffeine mouth rinse on repeated sprint performance during simulated soccer match play. Nine male soccer players (21 ± 3 years, 1.75 ± 0.05 m, 68.0 ± 9.0 kg) completed four trials with either 6 mg·kg^-1 caffeine + 10% maltodextrin (CHO+CAFMR), 6 mg·kg^-1 caffeine (CAFMR), 10% maltodextrin (CHOMR), water (PLA) in a block randomised, double-blinded, counterbalanced and crossover manner separated by minimum 96 h. All solutions were taste-matched and a carbohydrate-rich meal (2 g·kg^-1body mass) was provided 2 h before each trial. Each trial consisted of a 90-min soccer-specific aerobic field test (SAFT⁹⁰) and two bouts of repeated sprint ability tests (RSAT; 6 × 6 s sprints with 24 s recovery) completed at 0 min and 75^th min of SAFT⁹⁰. A 25 ml solution of either CHO+CAFMR, CAFMR, CHOMR or PLA was rinsed immediately before the second RSAT (75 min). Mean power output, peak power output (PPO) or fatigue index (FI) was not impacted by any treatment during the 75^th min RAST (p > 0.05). These results suggest that carbohydrate and/or caffeine mouth rinses do not have an ergogenic effect during simulated soccer exercise after a high carbohydrate meal.

Acute caffeine mouth rinse does not affect attention and hand-eye coordination in recreationally active adults

Study aim: The purpose of this study was to evaluate the acute effect of different four caffeine mouth rinse intervention (caffeinated coffee, decaffeinated coffee, placebo, control) on attention and hand-eye coordination.

Material and methods: Sixty-five healthy, recreationally active female (n = 41) (age 22.89 ± 3.94 years; body mass index 20.87 ± 2.63 kg/m2) and male (n = 24) (age 29.91 ± 12.06 years; body mass index 22.56 ± 2.21 kg/m2) volunteered to participate in this randomized, single-blind, placebo-controlled, crossover study. The Stroop Color-Word Test (SCWT) and Mirror-Tracing Test (MTT) was used. Participants first completed a SCWT or MTT, then rinsed and expectorated 25 ml of caffeinated coffee (containing 0.13% caffeine) or decaffeinated coffee or placebo (water) or control that did not rinse for 10 s, followed by SCWT or MTT again. Data were analyzed using a 4 (mouth rinse interventions) × 2 (pre-test and post-test) repeated measures ANOVA.

Results: SCWT time, MTT draw time and MTT number of error measures were not significantly different between four mouth rinse interventions (p > 0.05).

Conclusions: Caffeinated coffee or decaffeinated coffee mouth rinse for 10 s provided immediately prior to SCWT or MTT did not affect attention and hand-eye coordination.

Effects of the consumption of guarana on human health: A narrative review

Guarana (Paullinia cupana) is a plant from the Amazon region with cultural importance. Despite its early ancestral use by indigenous tribes, the first reports regarding the benefits of guarana consumption for human health were published in the 19th century. Since then, the use of guarana seed in powder and extract forms has been studied for its diverse effects on human health, such as stimulating, anti-inflammatory, antioxidant, anticancer, hypocholesterolemic, and anti-obesity effects. These effects are attributed to the high content of bioactive compounds found in guarana seeds, especially methylxanthines and flavonoids. In fact, the Brazilian Food Supplement Law has officially acknowledged guarana as a source of bioactive compounds. The number and diversity of studies focused on guarana and human health are increasing; thus, organizing and describing the available evidence on guarana and its applications is necessary to provide a framework for future studies. In this narrative review, we have organized the available information regarding guarana and its potential effects on human health. Guarana produces unique fruits with great potential for human health applications. However, the available evidence lacks human studies and mechanistic investigations. Future studies should be designed considering its applicability to human health, including intake levels and toxicity studies.

Effects of carbohydrate and caffeine mouth rinsing on strength, muscular endurance and cognitive performance

Background

Carbohydrate (CHO) and caffeine (CAF) mouth rinsing have been shown to enhance endurance and sprint performance. However, the effects of CHO and CAF mouth rinsing on muscular and cognitive performance in comparison between male and female athletes are less well-established. The aim of this study was to examine the effect of CHO and CAF rinsing on squat and bench press 1 repetition maximum (1-RM) strength, 3 sets of 40% of 1-RM muscular endurance and cognitive performance in both male and female athletes.

Methods

Thirteen male and fourteen female resistance-trained participants completed four testing sessions following the rinsing of 25 ml of i) 6% of CHO (1.5 g); ii) 2% CAF (500 mg), iii) combined CHO and CAF (CHOCAF) solutions or iv) water (PLA) for 10 s. Heart rate (HR), felt arousal (FA), ratings of perceived exertion (RPE) and glucose (GLU) were recorded throughout the test protocol.

Results

There were no significant differences in squat and bench press 1-RM, HR, RPE and GLU (p > 0.05) for males and females, respectively. FA was significantly increased with CAF (p = 0.04, p = 0.01) and CHOCAF (p = 0.03, p = 0.01) condition in both males and females, respectively. Squat endurance performance in the first set was significantly increased with CHOCAF condition compared to PLA in both males (p = 0.01) and females (p = 0.02). Bench press endurance was similar for all conditions in both genders (p > 0.05). Cognitive performance was significantly increased with CHOCAF compared to PLA in males (p = 0.03) and females (p = 0.02).

Conclusion

Combined CHO and CAF mouth rinsing significantly improved lower body muscular endurance and cognitive performance in both males and females.

Is caffeine mouth rinsing an effective strategy to improve physical and cognitive performance? A systematic review

The aim of this study was to perform a systematic review on the effects of caffeine mouth rinsing on physical and cognitive performance. Following a search through 4 databases, 18 studies were found meeting the inclusion criteria (15 for physical performance and 3 for cognitive performance). All selected studies found an improvement in cognitive performance with caffeine mouth rinse. Four studies found positive effects of caffeine mouthwash on physical performance when repeated during exercise, while one study detected a positive effect with a single mouthwash before exercise, but only in a fasted state. Among these studies that showed positive effects, however, three (2 for physical performance and 1 for cognitive performance) presented fair methodological quality. There was also a variety of methodological approaches in the studies that showed no improvement in physical performance with caffeine mouth rinse, which may have influenced the potential to detect the ergogenic effect of caffeine mouth rinse. Thus, the effects of caffeine mouth rinse on physical performance are mixed, but a potential ergogenic effect might be present in a fasted state and when mouthwash is repeated during exercise. Concerning cognitive performance, caffeine mouth rinse seems to be a beneficial strategy.

Carbohydrate mouth rinsing does not affect 6-min walk test performance and blood glucose responses in older adults

PURPOSE

Carbohydrate (CHO) mouth rinsing (MR) prior to exercise has been shown to elicit enhanced performance and energy availability in some studies. Previous literature has concentrated on examining CHO MR strategies for improving aerobic endurance performance in younger athletic adults. Knowledge of the impact of CHO MR on functional performance in older adults is scarce. The purpose of this investigation was to determine if CHO MR would improve 6-min walk test (6MWT) performance, perceived exertion, and blood glucose responses in older adults.

METHOD

Thirty-three individuals (16 males, 17 females), age ≥ 70 years performed two 6MWT trials, one of which utilized a 6.4% maltodextrin CHO MR and one of which utilized a placebo MR. Participants held the MR in their mouth for 20 s prior to the 6MWT, and trials occurred in a counterbalanced fashion. Total distance walked and rating of perceived exertion (RPE) were recorded upon completion of each 6MWT. Heart rate (HR), peripheral blood oxygen saturation (SpO₂), systolic and diastolic blood pressures (BP), blood glucose, and blood lactate were measured before and after each 6MWT.

RESULT

CHO MR did not alter the response of any study parameter compared to the placebo MR (p = 0.13-0.94). HR, systolic BP, and blood lactate increased and SpO₂ decreased across time (p < 0.01).

CONCLUSION

A 6.4% maltodextrin CHO MR did not alter total distance walked, perceived exertion, or other physiological responses elicited by the 6MWT in older adults.

[Improvement of the impulsive control in adolescents with attention deficit hyperactivity disorder (ADHD) after a cognitive behavioral therapy]

AIM

MPH is the more often prescribed stimulant for Attention Deficit Hyperactivity Disorder (ADHD), but it has been estimated that 30% of patients do not adequately respond or cannot tolerate it. Therefore, some other therapies are needed, such as cognitive behavioral therapy. Cognitive behavioral therapy is an intervention proposed over several sessions and aimed at modifying behavior by teaching different techniques that participants can re-use to control their symptoms. In our Institute, we used a program centered on attentional and metacognitive functions. It consists of a series of workshops performed in group at the rate of one workshop of 90minutes per week for 12 weeks. Positive effects on the behavior of adolescents with ADHD have been reported by parents and educators, but the effects of the program on specific cognitive processes have never been precisely investigated.

METHOD

In the present study, we evaluated the impact of the program on impulsive control in adolescents with ADHD who are known to present impaired impulsive control. Impulsive control is required each time there is a conflict between an inappropriate prepotent action and a goal-directed action. At an experimental level, impulsive control can be studied with conflict tasks, such as the Simon reaction time task. Interpreted within the theoretical framework of the so-called « Dual-process activation suppression » (DPAS) model, this task is a powerful conceptual and experimental tool to separately investigate the activation and inhibition of impulsive actions, which is almost never done in studies about impulsive control. Twenty adolescents followed the program and were tested before and at the end of the program by using dynamic analyses of performance associated with DPAS model.

RESULTS

The results have shown an improvement of the impulsive control after three months of cognitive behavioral therapy, and this improvement was due to both a decrease of the propensity to trigger impulsive actions and an improvement of inhibitory processes efficiency.

CONCLUSION

This program could be a relevant alternative to the stimulant medication, more particularly when parents are reluctant with medication or when the adolescent suffers from important side effects.

Caffeine and Cognitive Functions in Sports: A Systematic Review and Meta-Analysis

Cognitive functions are essential in any form of exercise. Recently, interest has mounted in addressing the relationship between caffeine intake and cognitive performance during sports practice. This review examines this relationship through a structured search of the databases Medline/PubMed and Web of Science for relevant articles published in English from August 1999 to March 2020. The study followed PRISMA guidelines. Inclusion criteria were defined according to the PICOS model. The identified records reported on randomized cross-over studies in which caffeine intake (as drinks, capsules, energy bars, or gum) was compared to an identical placebo situation. There were no filters on participants’ training level, gender, or age. For the systematic review, 13 studies examining the impacts of caffeine on objective measures of cognitive performance or self-reported cognitive performance were selected. Five of these studies were also subjected to meta-analysis. After pooling data in the meta-analysis, the significant impacts of caffeine only emerged on attention, accuracy, and speed. The results of the 13 studies, nevertheless, suggest that the intake of a low/moderate dose of caffeine before and/or during exercise can improve self-reported energy, mood, and cognitive functions, such as attention; it may also improve simple reaction time, choice reaction time, memory, or fatigue, however, this may depend on the research protocols.

International society of sports nutrition position stand: caffeine and exercise performance

Following critical evaluation of the available literature to date, The International Society of Sports Nutrition (ISSN) position regarding caffeine intake is as follows: 1. Supplementation with caffeine has been shown to acutely enhance various aspects of exercise performance in many but not all studies. Small to moderate benefits of caffeine use include, but are not limited to: muscular endurance, movement velocity and muscular strength, sprinting, jumping, and throwing performance, as well as a wide range of aerobic and anaerobic sport-specific actions. 2. Aerobic endurance appears to be the form of exercise with the most consistent moderate-to-large benefits from caffeine use, although the magnitude of its effects differs between individuals. 3. Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. Minimal effective doses of caffeine currently remain unclear but they may be as low as 2 mg/kg body mass. Very high doses of caffeine (e.g. 9 mg/kg) are associated with a high incidence of side-effects and do not seem to be required to elicit an ergogenic effect. 4. The most commonly used timing of caffeine supplementation is 60 min pre-exercise. Optimal timing of caffeine ingestion likely depends on the source of caffeine. For example, as compared to caffeine capsules, caffeine chewing gums may require a shorter waiting time from consumption to the start of the exercise session. 5. Caffeine appears to improve physical performance in both trained and untrained individuals. 6. Inter-individual differences in sport and exercise performance as well as adverse effects on sleep or feelings of anxiety following caffeine ingestion may be attributed to genetic variation associated with caffeine metabolism, and physical and psychological response. Other factors such as habitual caffeine intake also may play a role in between-individual response variation. 7. Caffeine has been shown to be ergogenic for cognitive function, including attention and vigilance, in most individuals. 8. Caffeine may improve cognitive and physical performance in some individuals under conditions of sleep deprivation. 9. The use of caffeine in conjunction with endurance exercise in the heat and at altitude is well supported when dosages range from 3 to 6 mg/kg and 4-6 mg/kg, respectively. 10. Alternative sources of caffeine such as caffeinated chewing gum, mouth rinses, energy gels and chews have been shown to improve performance, primarily in aerobic exercise. 11. Energy drinks and pre-workout supplements containing caffeine have been demonstrated to enhance both anaerobic and aerobic performance.

Effects of caffeine ingestion on dynamic visual acuity: a placebo-controlled, double-blind, balanced-crossover study in low caffeine consumers

BACKGROUND

Acute caffeine ingestion has been associated with improvements in cognitive performance and visual functioning. The main objective of this study was to determine the effects of caffeine intake on dynamic visual acuity (DVA).

METHODS

Twenty-one low caffeine consumers (22.5 ± 1.6 years) took part in this placebo-controlled, double-blind, and balanced crossover study. In two different days and following a random order, participants ingested either caffeine (4 mg/kg) or placebo, and DVA was measured after 60 min of ingesting the corresponding capsule. A recently developed and validated software (moV& test, V&mp Vision Suite, Waterloo, Canada) was used to assess DVA.

RESULTS

We found a greater accuracy for both the horizontal and random motion paths of DVA after caffeine ingestion (p < 0.001 and p = 0.002, respectively). In regard to the speed of the response, our data revealed that caffeine intake was associated with a faster reaction time for horizontally (p = 0.012) but not for randomly (p = 0.846) moving targets. Also, participants reported higher levels of perceived activation after consuming caffeine in comparison to placebo (p < 0.001).

CONCLUSIONS

Our data suggest that caffeine intake (i.e., a capsule containing 4 mg/kg) has an ergogenic effect on DVA, which may be of special relevance in real-word contexts that require to accurately and rapidly detect moving targets (e.g., sports, driving, or piloting).

The Effects of Caffeine Mouth Rinsing on Exercise Performance: A Systematic Review

Caffeine ingestion can improve performance across a variety of exercise modalities but can also elicit negative side effects in some individuals. Thus, there is a growing interest in the use of caffeine mouth rinse solutions to improve sport and exercise performance while minimizing caffeine’s potentially adverse effects. Mouth rinse protocols involve swilling a solution within the oral cavity for a short time (e.g., 5–10 s) before expectorating it to avoid systemic absorption. This is believed to improve performance via activation of taste receptors and stimulation of the central nervous system. Although reviews of the literature indicate that carbohydrate mouth rinsing can improve exercise performance in some situations, there has been no attempt to systematically review the available literature on caffeine mouth rinsing and its effects on exercise performance. To fill this gap, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two independent reviewers. The search resulted in 11 randomized crossover studies that were appraised and reviewed. Three studies found significant positive effects of caffeine mouth rinsing on exercise performance, whereas the remaining eight found no improvements or only suggestive benefits. The mixed results may be due to heterogeneity in the methods across studies, interindividual differences in bitter tasting, and differences in the concentrations of caffeine solutions. Future studies should evaluate how manipulating the concentration of caffeine solutions, habitual caffeine intake, and genetic modifiers of bitter taste influence the efficacy of caffeine mouth rinsing as an ergogenic strategy.

Can caffeine intake combined with aerobic exercise lead to improvement in attentional and psychomotor performance in trained individuals?

•

Supplementation effect was found, suggesting distinct interaction mechanisms between attention and SRT (simple reaction time).

•

The change in the SRT magnitude increased after 60 min from caffeine intake, and even more after exercise.

•

The decrease in the SRT magnitude after caffeine intake and exercise suggests additional effects of caffeine on exercise.

To evaluate the acute effects of ingestion of 500 mg of caffeine in addition to aerobic exercise on the optimization of cognitive attention tasks and simple reaction time. Twenty men were randomly divided into two groups, caffeine (CAF) and placebo (PLA), and underwent cardiopulmonary exercise testing and cognitive testing (D2SLK, D2GZ, D2F% and TRS). Then, both ingested 500 mg of caffeine or placebo (double blind), and after 60 min performed a 30-minute continuous exercise session at 70 % VO2Max. Cognitive tests were repeated immediately after exercise, and after 30 min. D2SLK, D2GZ, D2F% and TRS scores were compared by repeated measures ANOVA. The magnitude of the effect was established, and it was considered meaningful p = 0.05. CAF is able to alter D2SLK and also reduce D2F% (0.001 - moderate effect, 0.82) and improve the task after 30 min of exercise (p = 0.014 - moderate effect 0.95). The TRS showed significant gains for the CAF group compared to PLA (0.000 - high effect 1.76). Caffeine induces significant effects in attention and reaction time domains independent of the effect of aerobic exercise.

Can taste be ergogenic?

Taste is a homeostatic function that conveys valuable information, such as energy density, readiness to eat, or toxicity of foodstuffs. Taste is not limited to the oral cavity but affects multiple physiological systems. In this review, we outline the ergogenic potential of substances that impart bitter, sweet, hot and cold tastes administered prior to and during exercise performance and whether the ergogenic benefits of taste are attributable to the placebo effect. Carbohydrate mouth rinsing seemingly improves endurance performance, along with a potentially ergogenic effect of oral exposure to both bitter tastants and caffeine although subsequent ingestion of bitter mouth rinses is likely required to enhance performance. Hot and cold tastes may prove beneficial in circumstances where athletes' thermal state may be challenged. Efficacy is not limited to taste, but extends to the stimulation of targeted receptors in the oral cavity and throughout the digestive tract, relaying signals pertaining to energy availability and temperature to appropriate neural centres. Dose, frequency and timing of tastant application likely require personalisation to be most effective, and can be enhanced or confounded by factors that relate to the placebo effect, highlighting taste as a critical factor in designing and administering applied sports science interventions.

The Effect of Carbohydrate Mouth Rinsing on Multiple Choice Reaction Time During Amateur Boxing

PURPOSE

To examine whether the use of a carbohydrate mouth rinse (CMR) can improve multiple choice reaction time in amateur boxers during sparring.

METHODS

A total of 8 male amateur boxers (age 22 [3] y, stature 1.78 [0.07] m, mass 73.6 [14.2] kg) with at least 18 months of experience in the sport volunteered to participate in the study. All participants attended a familiarization session, followed by an experimental (CMR; 6% dextrose) and placebo trials in a randomized order. Participants undertook 3 × 2 minutes of sparring against an ability- and size-matched (stature and mass) opponent. Multiple choice reaction time and perceived exertion were measured before round 1 and then after each round. The respective mouth rinse was administered in a 25-mL solution for 10 seconds before each round. Magnitude-based inferences were used to compare the results of each round (mean difference; ±90% confidence limits).

RESULTS

The CMR was unlikely to have a beneficial effect on multiple choice reaction time compared with placebo (mean ± 90% confidence limits: 5 ± 9.5, 4 ± 3.4, -1 ± 8.5 lights for rounds 1 to 3, respectively) and had a possibly harmful effect on perceived exertion in round 1 (10 ± 20). There was an unlikely harmful effect on perceived exertion in rounds 2 (1 ± 12) and 3 (9 ± 23).

CONCLUSION

There is no evidence to support the use of CMR during sparring in amateur boxers.

Sub-Chronic Consumption of Dark Chocolate Enhances Cognitive Function and Releases Nerve Growth Factors: A Parallel-Group Randomized Trial

Previous research has shown that habitual chocolate intake is related to cognitive performance and that frequent chocolate consumption is significantly associated with improved memory. However, little is known about the effects of the subchronic consumption of dark chocolate (DC) on cognitive function and neurotrophins. Eighteen healthy young subjects (both sexes; 20-31 years old) were randomly divided into two groups: a DC intake group (n = 10) and a cacao-free white chocolate (WC) intake group (n = 8). The subjects then consumed chocolate daily for 30 days. Blood samples were taken to measure plasma levels of theobromine (a methylxanthine most often present in DC), nerve growth factor (NGF), and brain-derived neurotrophic factor, and to analyze hemodynamic parameters. Cognitive function was assessed using a modified Stroop color word test and digital cancellation test. Prefrontal cerebral blood flow was measured during the tests. DC consumption increased the NGF and theobromine levels in plasma, enhancing cognitive function performance in both tests. Interestingly, the DC-mediated enhancement of cognitive function was observed three weeks after the end of chocolate intake. WC consumption did not affect NGF and theobromine levels or cognitive performance. These results suggest that DC consumption has beneficial effects on human health by enhancing cognitive function.

The effects of Guarana (Paullinia cupana) supplementation on the cognitive performance of young healthy adults – a Systematic Review

Objectives

Guarana (Paullinia cupana) from the Sapindaceae family, native to the Amazon basin, is a natural stimulant herb that can be found in popular energy drinks, pharmaceutical shops or local herb shops. With the use of natural health products increasing, guarana has gained a fair amount of popularity in the past years. In this systematic review, we examined the effects of guarana supplementation on cognitive performance. A secondary objective was to compare guarana with caffeine on cognitive performance.

Methods

Searches were made in PubMed using the terms ‘Guarana’ or ‘Paullinia cupana’. Filters focused on Controlled Clinical trials. Inclusion criteria were met by studies using interventions with guarana, while focusing on guarana’s effects on cognition. Participants needed to be young, healthy adults. Studies not published in English or Greek were excluded. The last date of our search was March 7, 2019.

Results

A total of 29 studies were identified and screened. After screening, 17 studies were excluded. The remaining 12 studies were found eligible for data extraction. After reading the full text of the 12 studies, 3 studies were excluded. In the end, 9 studies were found eligible for our systematic review (n = 369 participants). In these studies, guarana showed to improve reaction time and accuracy of performance at cognitive tasks. No significant differences were found when comparing guarana with caffeine.

Conclusion

Guarana seems to improve reaction time and accuracy of performance at tasks, but no significant effects were found when compared with caffeine. High quality randomized controlled clinical trials with a low risk of bias are needed to further study the herb.

Impact of Carbohydrate Ingestion on Cognitive Flexibility and Cerebral Oxygenation during High-Intensity Intermittent Exercise: A Comparison between Maple Products and Usual Carbohydrate Solutions

BACKGROUND

The aim of this study was to compare the effects of carbohydrate (CHO) drinks (6% per volume) sweetened with maple (syrup or sap) to a commercial sports drink, glucose, and a control solution (water) on cognitive flexibility during high-intensity intermittent exercise.

METHODS

Eighty-five active men completed six 3-min bouts at 95% of their maximal aerobic power on a stationary bike, with 3 min of passive rest between efforts. Subjects were randomly allocated to an ingestion condition. Following each exercise bout, subjects ingested 166 mL of the experimental solution, drinking a total of 1 L of the same solution throughout the experimentation. Cognitive flexibility was measured using reaction time and accuracy on the Stroop task. The cognitive task was performed a total of 10 times, including 15 and 30 min post-exercise. Glycemia and cerebral oxygenation were also measured at each time point. Statistical analyses were performed using a two-way ANOVA (Condition × Time) with repeated measures.

RESULTS

The ingestion of maple products and the commercial sports drink led to a lesser increase in glycemia than glucose ingestion. CHO ingestion, when compared to water, induced a slight reduction in reaction times on the cognitive task, especially in the switching trials. CHO ingestion had no impact on cerebral oxygenation.

CONCLUSIONS

This study shows that CHO ingestion, regardless of its type, tends to improve cognitive performance throughout exercise, especially during difficult cognitive tasks.

Effects of Carbohydrate, Caffeine, and Guarana on Cognitive Performance, Perceived Exertion, and Shooting Performance in High-Level Athletes

Purpose: To investigate the effect of ingesting carbohydrate (CHO), caffeine  (CAF), and a guarana complex (GUAc) during a running exercise on cognitive performance, rating of perceived exertion (RPE), and shooting performance in high-level modern pentathlon athletes. Methods: A total of 10 athletes completed 4 counterbalanced sessions within a 2-wk period, corresponding to ingestions of CHO (30 g), GUAc (300 mg), CAF (200 mg), or placebo. The exercise involved a 40-min run on a treadmill at a steady speed, previously determined as a "somewhat hard" exercise (RPE 13). Shooting and cognitive performance (Simon task) were assessed in 3 phases: before exercise and ingestion, before exercise and after half ingestion, and after exercise and full ingestion. Drinks were consumed 40 min (250 mL) and 5 min (125 mL) prior to exercise and after 20 min of running (125 mL). RPE was assessed at 10-min intervals during exercise. Results: There was an interaction between drink and exercise on mean reaction time (P = .01, ηp2=.41 ) and a drink effect on RPE (P = .01, ηp2=.15 ). CHO, CAF, and GUAc enhanced the speed of information processing after exercise (P = .003, P = .004, and P = .04, respectively), but only CAF and GUAc decreased RPE (P = .002 and P = .02, respectively). Conclusion: The results highlight a beneficial effect of nutritional supplements on information processing and RPE. This finding is particularly interesting as decision-making processes are crucial in the performance of many sports.

Administration of Caffeine in Alternate Forms

There has been recent interest in the ergogenic effects of caffeine delivered in low doses (~ 200 mg or ~ 3 mg/kg body mass) and administered in forms other than capsules, coffee and sports drinks, including chewing gum, bars, gels, mouth rinses, energy drinks and aerosols. Caffeinated chewing gum is absorbed quicker through the buccal mucosa compared with capsule delivery and absorption in the gut, although total caffeine absorption over time is not different. Rapid absorption may be important in many sporting situations. Caffeinated chewing gum improved endurance cycling performance, and there is limited evidence that repeated sprint cycling and power production may also be improved. Mouth rinsing with caffeine may stimulate nerves with direct links to the brain, in addition to caffeine absorption in the mouth. However, caffeine mouth rinsing has not been shown to have significant effects on cognitive performance. Delivering caffeine with mouth rinsing improved short-duration, high-intensity, repeated sprinting in normal and depleted glycogen states, while the majority of the literature indicates no ergogenic effect on aerobic exercise performance, and resistance exercise has not been adequately studied. Studies with caffeinated energy drinks have generally not examined the individual effects of caffeine on performance, making conclusions about this form of caffeine delivery impossible. Caffeinated aerosol mouth and nasal sprays may stimulate nerves with direct brain connections and enter the blood via mucosal and pulmonary absorption, although little support exists for caffeine delivered in this manner. Overall, more research is needed examining alternate forms of caffeine delivery including direct measures of brain activation and entry of caffeine into the blood, as well as more studies examining trained athletes and female subjects.