Wake up and smell the coffee: caffeine supplementation and exercise performance—an umbrella review of 21 published meta-analyses
TL;DR: It is suggested that caffeine ingestion improves exercise performance in a broad range of exercise tasks and the magnitude of the effect of caffeine is generally greater for aerobic as compared with anaerobic exercise.
Abstract: Objective To systematically review, summarise and appraise findings of published meta-analyses that examined the effects of caffeine on exercise performance. Design Umbrella review. Data sources Twelve databases. Eligibility criteria for selecting studies Meta-analyses that examined the effects of caffeine ingestion on exercise performance. Results Eleven reviews (with a total of 21 meta-analyses) were included, all being of moderate or high methodological quality (assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist). In the meta-analyses, caffeine was ergogenic for aerobic endurance, muscle strength, muscle endurance, power, jumping performance and exercise speed. However, not all analyses provided a definite direction for the effect of caffeine when considering the 95% prediction interval. Using the Grading of Recommendations Assessment, Development and Evaluation criteria the quality of evidence was generally categorised as moderate (with some low to very low quality of evidence). Most individual studies included in the published meta-analyses were conducted among young men. Summary/conclusion Synthesis of the currently available meta-analyses suggest that caffeine ingestion improves exercise performance in a broad range of exercise tasks. Ergogenic effects of caffeine on muscle endurance, muscle strength, anaerobic power and aerobic endurance were substantiated by moderate quality of evidence coming from moderate-to-high quality systematic reviews. For other outcomes, we found moderate quality reviews that presented evidence of very low or low quality. It seems that the magnitude of the effect of caffeine is generally greater for aerobic as compared with anaerobic exercise. More primary studies should be conducted among women, middle-aged and older adults to improve the generalisability of these findings.
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TL;DR: It is proposed that a better understanding of the wider, non-direct effects of caffeine on exercise, such as how it modifies sleep, anxiety, and post-exercise recovery, will ensure athletes can maximize the performance benefits of caffeine supplementation during both training and competition.
Abstract: Caffeine is a widely utilized performance-enhancing supplement used by athletes and non-athletes alike. In recent years, a number of meta-analyses have demonstrated that caffeine’s ergogenic effects on exercise performance are well-established and well-replicated, appearing consistent across a broad range of exercise modalities. As such, it is clear that caffeine is an ergogenic aid—but can we further explore the context of this ergogenic aid in order to better inform practice? We propose that future research should aim to better understand the nuances of caffeine use within sport and exercise. Here, we propose a number of areas for exploration within future caffeine research. These include an understanding of the effects of training status, habitual caffeine use, time of day, age, and sex on caffeine ergogenicity, as well as further insight into the modifying effects of genotype. We also propose that a better understanding of the wider, non-direct effects of caffeine on exercise, such as how it modifies sleep, anxiety, and post-exercise recovery, will ensure athletes can maximize the performance benefits of caffeine supplementation during both training and competition. Whilst not exhaustive, we hope that the questions provided within this manuscript will prompt researchers to explore areas with the potential to have a large impact on caffeine use in the future.
97 citations
Sheffield Hallam University1, Los Angeles Biomedical Research Institute2, Anglia Ruskin University3, Leeds Trinity University4, Edge Hill University5, Leeds Beckett University6, Nova Southeastern University7, Baylor University8, East Carolina University9, University of North Carolina at Chapel Hill10, University of KwaZulu-Natal11, Florida State University12, California State University San Marcos13, Texas A&M University14, University of Nevada, Las Vegas15, University of Central Florida16, Mississippi State University17, University of South Carolina18, University of South Florida19
TL;DR: Evidence supports the strategic use of caffeine to sustain performance in the latter stages of racing, particularly when sleep deprivation may compromise athlete safety, and evidence in support of ketogenic diets and/or ketone esters to improve ultra-marathon performance is lacking.
Abstract: Background In this Position Statement, the International Society of Sports Nutrition (ISSN) provides an objective and critical review of the literature pertinent to nutritional considerations for training and racing in single-stage ultra-marathon. Recommendations for Training. i) Ultra-marathon runners should aim to meet the caloric demands of training by following an individualized and periodized strategy, comprising a varied, food-first approach; ii) Athletes should plan and implement their nutrition strategy with sufficient time to permit adaptations that enhance fat oxidative capacity; iii) The evidence overwhelmingly supports the inclusion of a moderate-to-high carbohydrate diet (i.e., ~ 60% of energy intake, 5–8 g·kg− 1·d− 1) to mitigate the negative effects of chronic, training-induced glycogen depletion; iv) Limiting carbohydrate intake before selected low-intensity sessions, and/or moderating daily carbohydrate intake, may enhance mitochondrial function and fat oxidative capacity. Nevertheless, this approach may compromise performance during high-intensity efforts; v) Protein intakes of ~ 1.6 g·kg− 1·d− 1 are necessary to maintain lean mass and support recovery from training, but amounts up to 2.5 g.kg− 1·d− 1 may be warranted during demanding training when calorie requirements are greater; Recommendations for Racing. vi) To attenuate caloric deficits, runners should aim to consume 150–400 Kcal·h− 1 (carbohydrate, 30–50 g·h− 1; protein, 5–10 g·h− 1) from a variety of calorie-dense foods. Consideration must be given to food palatability, individual tolerance, and the increased preference for savory foods in longer races; vii) Fluid volumes of 450–750 mL·h− 1 (~ 150–250 mL every 20 min) are recommended during racing. To minimize the likelihood of hyponatraemia, electrolytes (mainly sodium) may be needed in concentrations greater than that provided by most commercial products (i.e., > 575 mg·L− 1 sodium). Fluid and electrolyte requirements will be elevated when running in hot and/or humid conditions; viii) Evidence supports progressive gut-training and/or low-FODMAP diets (fermentable oligosaccharide, disaccharide, monosaccharide and polyol) to alleviate symptoms of gastrointestinal distress during racing; ix) The evidence in support of ketogenic diets and/or ketone esters to improve ultra-marathon performance is lacking, with further research warranted; x) Evidence supports the strategic use of caffeine to sustain performance in the latter stages of racing, particularly when sleep deprivation may compromise athlete safety.
76 citations
TL;DR: Caffeine supplementation produced a similar ergogenic benefit for aerobic performance and the fatigue index in men and women athletes, Nevertheless, the effects of caffeine to produce more power, total weight lifted and to improve sprint performance with respect to a placebo was higher in men than women athletes despite the same dose of caffeine being administered.
Abstract: Most studies that have shown the positive effects of caffeine supplementation on sports performance have been carried out on men. However, the differences between sexes are evident in terms of body size, body composition, and hormonal functioning, which might cause different outcomes on performance for the same dosage of caffeine intake in men vs. women. The main aim of this systematic review was to analyze and compare the effects of caffeine intake between men and women on sports performance to provide a source of knowledge to sports practitioners and coaches, especially for those working with women athletes, on the use of caffeine as an ergogenic aid. A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in the Web of Science, Cochrane Library, and Scopus databases until 28 July 2019. The search included studies in which the effects of caffeine supplementation on athletic performance were compared between sexes and to an identical placebo situation (dose, duration and timing). No filters were applied for participants’ physical fitness level or age. A total of 254 articles were obtained in the initial search. When applying the inclusion and exclusion criteria, the final sample was 10 articles. The systematic review concluded that four investigations (100% of the number of investigations on this topic) had not found differences between sexes in terms of caffeine supplementation on aerobic performance and 3/3 (100%) on the fatigue index. However, four out of seven articles (57.1%) showed that the ergogenicity of caffeine for anaerobic performance was higher in men than women. In particular, it seems that men are able to produce more power, greater total weight lifted and more speed with the same dose of caffeine than women. In summary, caffeine supplementation produced a similar ergogenic benefit for aerobic performance and the fatigue index in men and women athletes. Nevertheless, the effects of caffeine to produce more power, total weight lifted and to improve sprint performance with respect to a placebo was higher in men than women athletes despite the same dose of caffeine being administered. Thus, the ergogenic effect of acute caffeine intake on anaerobic performance might be higher in men than in women.
59 citations
Cites background from "Wake up and smell the coffee: caffe..."
...In this respect, while there is a position and recommendations about the use of caffeine supplements in athletes [18,19], there is not enough comparative information on the effects of caffeine on athletic performance between men and women athletes [20]....
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TL;DR: A classification of athletes that habitually consume caffeine by using dietary questionnaires is proposed to reduce the likelihood of discrepancies caused by the improper qualification of daily caffeine intake in studies directed at the assessment of acute caffeine consumption in habitual caffeine consumers.
Abstract: Caffeine is the most popular psychoactive substance in the world, and data suggests that it is widely used by athletes before competition to enhance physical and mental performance. The high number of athletes that regularly use caffeine suggests the need to investigate the effect of acute caffeine ingestion in athletes habituated to caffeine. However, most of the studies supporting this claim have used samples of athletes who do not consume caffeine on a regular basis, and with caffeine intake withdrawal prior to the experiments. A search through 19 databases conducted on habitual caffeine users was performed. The results of the studies regarding the ergogenic effect of caffeine in naive vs. habitual caffeine consumers are contradictory. The diversity of results are likely associated with the use of different thresholds to categorize individuals as naive or high caffeine consumers. There are no valid and standardized methods to accurately estimate the amount of caffeine ingested per day in athletes. We proposed a classification of athletes that habitually consume caffeine by using dietary questionnaires, and ultimately, to reduce the likelihood of discrepancies caused by the improper qualification of daily caffeine intake in studies directed at the assessment of acute caffeine intake in habitual caffeine consumers.
50 citations
Cites background from "Wake up and smell the coffee: caffe..."
...This classification combines the most common doses of caffeine used in previous studies related to the acute effect of caffeine in elite and amateur athletes [24,25]....
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TL;DR: The results of the present study indicate that high acute doses of CAF did not improve muscle strength nor muscle endurance in athletes habituated to this substance.
Abstract: Background: The main goal of this study was to assess the acute effects of the intake of 9 and 11 mg/kg/ body mass (b.m.) of caffeine (CAF) on maximal strength and muscle endurance in athletes habituated to caffeine. Methods: The study included 16 healthy strength-trained male athletes (age = 24.2 ± 4.2 years, body mass = 79.5 ± 8.5 kg, body mass index (BMI) = 24.5 ± 1.9, bench press 1RM = 118.3 ± 14.5 kg). All participants were habitual caffeine consumers (4.9 ± 1.1 mg/kg/b.m., 411 ± 136 mg of caffeine per day). This study had a randomized, crossover, double-blind design, where each participant performed three experimental sessions after ingesting either a placebo (PLAC) or 9 mg/kg/b.m. (CAF-9) and 11 mg/kg/b.m. (CAF-11) of caffeine. In each experimental session, participants underwent a 1RM strength test and a muscle endurance test in the bench press exercise at 50% 1RM while power output and bar velocity were measured in each test. Results: A one-way repeated measures ANOVA revealed a significant difference between PLAC, CAF-9, and CAF-11 groups in peak velocity (PV) (p = 0.04). Post-hoc tests showed a significant decrease for PV (p = 0.04) in the CAF-11 compared to the PLAC group. No other changes were found in the 1RM or muscle endurance tests with the ingestion of caffeine. Conclusion: The results of the present study indicate that high acute doses of CAF (9 and 11 mg/kg/b.m.) did not improve muscle strength nor muscle endurance in athletes habituated to this substance.
42 citations
Cites background from "Wake up and smell the coffee: caffe..."
...) and ingested in the form of capsules 30 to 90 minutes before exercise [6]....
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References
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TL;DR: The GRADE process begins with asking an explicit question, including specification of all important outcomes, and provides explicit criteria for rating the quality of evidence that include study design, risk of bias, imprecision, inconsistency, indirectness, and magnitude of effect.
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TL;DR: This paper reports on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.
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TL;DR: The umbrella review methodology described here is the first to consider reviews that report other than quantitative evidence derived from randomized controlled trials, and provides a ready means for decision makers in healthcare to gain a clear understanding of a broad topic area.
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1,001 citations
TL;DR: The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty.
Abstract: Regular physical activity helps to improve physical and mental functions as well as reverse some effects of chronic disease to keep older people mobile and independent. Despite the highly publicised benefits of physical activity, the overwhelming majority of older people in the United Kingdom do not meet the minimum physical activity levels needed to maintain health. The sedentary lifestyles that predominate in older age results in premature onset of ill health, disease and frailty. Local authorities have a responsibility to promote physical activity amongst older people, but knowing how to stimulate regular activity at the population-level is challenging. The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty. The evidence shows that regular physical activity is safe for healthy and for frail older people and the risks of developing major cardiovascular and metabolic diseases, obesity, falls, cognitive impairments, osteoporosis and muscular weakness are decreased by regularly completing activities ranging from low intensity walking through to more vigorous sports and resistance exercises. Yet, participation in physical activities remains low amongst older adults, particularly those living in less affluent areas. Older people may be encouraged to increase their activities if influenced by clinicians, family or friends, keeping costs low and enjoyment high, facilitating group-based activities and raising self-efficacy for exercise.
716 citations