The effects of beta-alanine supplementation on performance: a systematic review of the literature.

PURPOSE: To critically review the methodological quality and synthesize information from systematic reviews and high quality studies on the effects of beta alanine (BA) on exercise and athletic performance. METHODS: A search strategy was developed in accordance with the standards for the reporting of scientific literature via systematic reviews. Five databases were thoroughly searched from inception to November 2012. Inclusion criteria were English language, human studies, used BA to increase exercise or athletic performance, systematic reviews or randomized controlled trials and were published in a peer-reviewed journal. Included studies were systematically graded for their methodological quality by rotating pairs of reviewers and the results were qualitatively synthesized. RESULTS: One systematic review and 19 randomized trials were included in this review. There is one systematic review with several methodological weaknesses that limit the confidence in its results. There are moderate to high quality studies that appear to support that BA may increase power output and working capacity, decrease the feeling of fatigue and exhaustion, and have of positive effect on body composition and carnosine content. The reporting of side effects from BA supplementation in the athletic population was generally under-reported. CONCLUSIONS: There appears to be some evidence from this review that supplementation with BA may increase athletic performance. However, there is insufficient evidence examining the safety of BA supplementation and its side effects. It is therefore recommended to err on the side of caution in using BA as an ergogenic aid until there is sufficient evidence confirming its safety.

Changes in vertebral artery blood flow following various head positions and cervical spine manipulation.

OBJECTIVE: The objective of the study was to investigate the cerebrovascular hemodynamic response of cervical spine positions including rotation and cervical spine manipulation in vivo using magnetic resonance imaging technology on the vertebral artery (VA). METHODS: This pilot study was conducted as a blinded examiner cohort with 4 randomized clinical tasks. Ten healthy male participants aged 24 to 30 years (mean, 26.8 years) volunteered to participate in the study. None of the participants had a history of disabling neck, arm, or headache pain within the last 6 months. They did not have any current or history of neurologic symptoms. In a neutral head position, physiologic measures of VA blood flow and velocity at the C1-2 spinal level were obtained using phase-contrast magnetic resonance imaging after 3 different head positions and a chiropractic upper cervical spinal manipulation. A total of 30 flow-encoded phase-contrast images were collected over the cardiac cycle, in each of the 4 conditions, and were used to provide a blood flow profile for one complete cardiac cycle. Differences between flow (in milliliters per second) and velocity (in centimeters per second) variables were evaluated using repeated-measures analysis of variance. RESULTS: The side-to-side difference between ipsilateral and contralateral VA velocities was not significant for either velocities (P = .14) or flows (P = .19) throughout the conditions. There were no other interactions or trends toward a difference for any of the other blood flow or velocity variables. CONCLUSIONS: There were no significant changes in blood flow or velocity in the vertebral arteries of healthy young male adults after various head positions and cervical spine manipulations.