Effect of caffeine on mitochondrial biogenesis in the skeletal muscle - A narrative review.

Caffeine is one of the most widely used substances as recreational drug for performance-enhancement in sport, underpinned by a strong evidence base. Although the effects of caffeine are widely investigated within the scope of performance physiology, the molecular effects of caffeine within skeletal muscle remain unclear. Evidence from in vitro and in vivo models suggest that caffeine regulates the glucose metabolism in the skeletal muscle. Moreover, caffeine seems to stimulate CaMKII, PPARδ/ß, AMPK and PGC1α, classical markers of exercise-adaptations, including mitochondrial biogenesis and mitochondrial content. This review summarizes evidence to suggest caffeine-effects within skeletal muscle fibers, focusing on the putative role of caffeine on mitochondrial biogenesis to explore whether caffeine supplementation might be a strategy to enhance mitochondrial biogenesis.

Association of gene polymorphisms with body weight changes in prediabetic patients.

BACKGROUND: Recent research has demonstrated that Type 2 Diabetes (T2D) risk is influenced by a number of common polymorphisms, including MC4R rs17782313, PPARG rs1801282, and TCF7L2 rs7903146. Knowledge of the association between these single nucleotide polymorphisms (SNPs) and body weight changes in different forms of prediabetes treatment is still limited. The aim of this study was to investigate the association of polymorphisms within the MC4R, PPARG, and TCF7L2 genes on the risk of carbohydrate metabolism disorders and body composition changes in overweight or obese patients with early carbohydrate metabolism disorders. METHODS AND RESULTS: From 327 patients, a subgroup of 81 prediabetic female patients (48.7 ± 14.8 years) of Eastern European descent participated in a 3-month study comprised of diet therapy or diet therapy accompanied with metformin treatment. Bioelectrical impedance analysis and genotyping of MC4R rs17782313, PPARG rs1801282, and TCF7L2 rs7903146 polymorphisms were performed. The MC4R CC and TCF7L2 TT genotypes were associated with increased risk of T2D (OR = 1.46, p = 0.05 and OR = 2.47, p = 0.006, respectively). PPARG CC homozygotes experienced increased weight loss; however, no additional improvements were experienced with the addition of metformin. MC4R TT homozygotes who took metformin alongside dietary intervention experienced increased weight loss and reductions in fat mass (p < 0.05). CONCLUSIONS: We have shown that the obesity-protective alleles (MC4R T and PPARG C) were positively associated with weight loss efficiency. Furthermore, we confirmed the previous association of the MC4R C and TCF7L2 T alleles with T2D risk.

FABP2 Ala54Thr Polymorphism and Post-Training Changes of Body Composition and Biochemical Parameters in Caucasian Women.

The functional FABP2 Ala54Thr polymorphism (rs1799883) is strongly associated with lipid and carbohydrate metabolism, although the function of its potential modifying effect on training-induced changes in obesity-related parameters is still unknown. The aim of the present study was to investigate the influence of the Ala54Thr polymorphism on post-training changes of selected body mass and body composition measurements, as well as with biochemical parameters of energy metabolism. Accordingly, alleles and genotypes distribution in a group of 168 young, nonobese Caucasian women measured for chosen body composition parameters, lipid profile, and glucose levels before and after the completion of a 12-week aerobic training program were studied. Although the obtained results showed changes in body mass, BMI, FM, %FM, FFM, TBW, HDL-C, and glucose levels during the training program, none of the examined parameters changed significantly across the FABP2 genotypes. Instead, we found a main effect of genotype on BMI (p = 0.033), with carriers of the Thr54 allele having a higher BMI during the whole study period compared with the Ala54 carriers. We confirm that the FABP2 Ala54Thr polymorphism may help identify women at risk for overweight and obesity. However, we did not notice evidence of an interaction between physical activity and the Ala54Thr polymorphism on the examined parameters.

Why Are Masters Sprinters Slower Than Their Younger Counterparts? Physiological, Biomechanical, and Motor Control Related Implications for Training Program Design.

Elite sprint performances typically peak during an athlete's 20s and decline thereafter with age. The mechanisms underpinning this sprint performance decline are often reported to be strength-based in nature with reductions in strength capacities driving increases in ground contact time and decreases in stride lengths and frequency. However, an as-of-yet underexplored aspect of Masters sprint performance is that of age-related degradation in neuromuscular infrastructure, which manifests as a decline in both strength and movement coordination. Here, the authors explore reductions in sprint performance in Masters athletes in a holistic fashion, blending discussion of strength and power changes with neuromuscular alterations along with mechanical and technical age-related alterations. In doing so, the authors provide recommendations to Masters sprinters-and the aging population, in general-as to how best to support sprint ability and general function with age, identifying nutritional interventions that support performance and function and suggesting useful programming strategies and injury-reduction techniques.

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.

Can Genetic Testing Predict Talent? A Case Study of 5 Elite Athletes.

PURPOSE: The genetic influence on the attainment of elite athlete status is well established, with a number of polymorphisms found to be more common in elite athletes than in the general population. As such, there is considerable interest in understanding whether this information can be utilized to identify future elite athletes. Accordingly, the aim of this study was to compare the total genotype scores of 5 elite athletes to those of nonathletic controls, to subsequently determine whether genetic information could discriminate between these groups, and, finally, to suggest how these findings may inform debates relating to the potential for genotyping to be used as a talent-identification tool. METHODS: The authors compared the total genotype scores for both endurance (68 genetic variants) and speed-power (48 genetic variants) elite athlete status of 5 elite track-and-field athletes, including an Olympic champion, to those of 503 White European nonathletic controls. RESULTS: Using the speed-power total genotype score, the elite speed-power athletes scored higher than the elite endurance athletes; however, using this speed-power score, 68 nonathletic controls registered higher scores than the elite power athletes. Surprisingly, using the endurance total genotype score, the elite speed-power athletes again scored higher than the elite endurance athletes. CONCLUSIONS: These results suggest that genetic information is not capable of accurately discriminating between elite athletes and nonathletic controls, illustrating that the use of such information as a talent-identification tool is currently unwarranted and ineffective.

A time and a place: A framework for caffeine periodization throughout the sporting year.

Caffeine is a well-established ergogenic aid, with its performance-enhancing effects demonstrated across a variety of sports and exercise types. As a result of these ergogenic properties, caffeine is widely used by athletes at all levels around both competition and training. Caffeine exerts its performance benefits through a variety of mechanisms, each of which may be of increased importance at a given stage of training or competition. Additionally, regular caffeine use may diminish the performance-enhancing effects of a subsequent dose of caffeine. Recently, interest in the concept of nutritional periodization has grown. Here we propose a framework for the periodization of caffeine through the sporting year, balancing its training and competition performance-enhancing effects, along with the need to mitigate any negative effects of habituation. Furthermore, the regular use of caffeine within training may support the development of positive beliefs toward caffeine by athletes-potentially serving to enhance future performance through placebo and expectancy mechanisms-as well as allowing for the optimization of individual athlete caffeine strategies. Although future work is required to validate some of the suggestions made, the framework proposed here represents a starting point for athletes to maximize caffeine's performance benefits across the sporting year.

CYP1A2 genotype and acute ergogenic effects of caffeine intake on exercise performance: a systematic review.

PURPOSE: To systematically review studies that examined the influence of the CYP1A2 -163C>A polymorphism on the ergogenic effects of caffeine and to discuss some of the reasons for the discrepancies in findings between the studies. METHODS: This review was performed in accordance with the PRISMA guidelines. The search for studies was performed through nine databases. RESULTS: Seventeen studies were included in the review. Based on the included studies, it seems that individuals with the AA or AC/CC genotype may experience an increase in performance following caffeine ingestion. Significant differences between genotypes were found in four studies, and all four reported a more favorable response in the AA vs. AC/CC genotype. These results suggest that if there is an actual genotype-related effect of acute caffeine supplementation, it might be in that direction. In the studies that reported such data for aerobic endurance, the findings are specific to male participants performing cycling time trials (distances of ≥ 10 km) and ingesting caffeine 60 min before exercise. For high-intensity exercise, two studies reported that genotype variations determined the response to caffeine ingestion, even though the differences were either small (~ 1 additional repetition in high-load resistance exercise set performed to muscular failure) or inconsistent (i.e., observed only in one out of eight performance tests). CONCLUSIONS: CYP1A2 genotype variations may modulate caffeine's ergogenic effects, but the differences between genotypes were small, inconsistent, or limited to specific exercise scenarios. Future studies with larger sample sizes are needed to fully elucidate this research area.

PPARGC1A gene polymorphism is associated with exercise-induced fat loss.

Obesity is a widespread problem within modern society, serving to increase the risk of cardiovascular, metabolic, and neurodegenerative disorders. Peroxisome proliferator-activated receptor gamma (PPARγ) and PPARγ coactivator 1 α (PGC1α) play a key role in the regulation of cellular energy metabolism and is implicated in the pathology of these diseases. This study examined the association between polymorphisms of the PPARG and PPARGC1A genes and individual variability in weight loss in response to physical activity intervention. 39 obese Ukrainian women (44.4 ± 7.5 years, BMI > 30.0 kg/m2) undertook a 3-month fitness program whilst following a hypocaloric diet (~ 1500 cal). Anthropometric and biochemical measurements took place before and after the program. Single nucleotide polymorphisms within or near PPARG (n = 94) and PPARGC1A (n = 138) were identified and expression of PPARG mRNA was measured via reverse transcription and amplification. The association between DNA polymorphisms and exercise-induced weight loss, initial body mass, biochemistry and PPARG expression was determined using one-way analysis of variance (ANOVA). The present intervention induced significant fat loss in all participants (total fat: 40.3 ± 5.3 vs 36.4 ± 5.7%; P < 0.00001). Only one polymorphism (rs17650401 C/T) within the PPARGC1A gene was found to be associated with fat loss efficiency after correction for multiple testing, with T allele carriers showing the greatest reduction in body fat percentage (2.5-fold; P = 0.00013) compared to non-carriers. PPARGC1A (rs17650401) is associated with fat loss efficiency of the fitness program in obese women. Further studies are warranted to test whether this variation is associated with fat oxidation.

A comparison of a ketogenic diet with a LowGI/nutrigenetic diet over 6 months for weight loss and 18-month follow-up.

BACKGROUND: Obesity and its related metabolic disturbances represent a huge health burden on society. Many different weight loss interventions have been trialled with mixed efficacy, as demonstrated by the large number of individuals who regain weight upon completion of such interventions. There is evidence that the provision of genetic information may enhance long-term weight loss, either by increasing dietary adherence or through underlying biological mechanisms. METHODS: The investigators followed 114 overweight and obese subjects from a weight loss clinic in a 2-stage process. 1) A 24-week dietary intervention. The subjects self-selected whether to follow a standardized ketogenic diet (n = 53), or a personalised low-glycemic index (GI) nutrigenetic diet utilising information from 28 single nucleotide polymorphisms (n = 61). 2) After the 24-week diet period, the subjects were monitored for an additional 18 months using standard guidelines for the Keto group vs standard guidelines modified by nutrigenetic advice for the low-Glycaemic Index nutrigenetic diet (lowGI/NG) group. RESULTS: After 24 weeks, the keto group lost more weight: - 26.2 ± 3.1 kg vs - 23.5 ± 6.4 kg (p = 0.0061). However, at 18-month follow up, the subjects in the low-GI nutrigenetic diet had lost significantly more weight (- 27.5 ± 8.9 kg) than those in the ketogenic diet who had regained some weight (- 19.4 ± 5.0 kg) (p < 0.0001). Additionally, after the 24-week diet and 18-month follow up the low-GI nutrigenetic diet group had significantly greater (p < 0.0001) improvements in total cholesterol (ketogenic - 35.4 ± 32.2 mg/dl; low-GI nutrigenetic - 52.5 ± 24.3 mg/dl), HDL cholesterol (ketogenic + 4.7 ± 4.5 mg/dl; low-GI nutrigenetic + 11.9 ± 4.1 mg/dl), and fasting glucose (ketogenic - 13.7 ± 8.4 mg/dl; low-GI nutrigenetic - 24.7 ± 7.4 mg/dl). CONCLUSIONS: These findings demonstrate that the ketogenic group experienced enhanced weight loss during the 24-week dietary intervention. However, at 18-month follow up, the personalised nutrition group (lowGI/NG) lost significantly more weight and experienced significantly greater improvements in measures of cholesterol and blood glucose. This suggests that personalising nutrition has the potential to enhance long-term weight loss and changes in cardiometabolic parameters. TRIAL REGISTRATION: NCT04330209, Registered 01/04/2020, retrospectively registered.

Development and validation of next generation sequencing based 35-gene hereditary cancer panel.

BACKGROUND: Understanding the genetic basis of cancer risk is a major international endeavor. The emergence of next-generation sequencing (NGS) in late 2000's has further accelerated the discovery of many cancer susceptibility genes. The use of targeted NGS-based multigene testing panels to provide comprehensive analysis of cancer susceptible genes has proven to be a viable option, with the accurate and robust detection of a wide range of clinically relevant variants in the targeted genes being crucial. METHODS: We have developed and validated a targeted NGS-based test for hereditary cancer risk assessment using Illumina's NGS platform by analyzing the protein-coding regions of 35 hereditary cancer genes with a bioinformatics pipeline that utilizes standard practices in the field. This 35-gene hereditary cancer panel is designed to identify germline cancer-causing mutations for 8 different cancers: breast, ovarian, prostate, uterine, colorectal, pancreatic, stomach cancers and melanoma. The panel was validated using well-characterized DNA specimens [NIGMS Human Genetic Cell Repository], where DNA had been extracted using blood of individuals whose genetic variants had been previously characterized by the 1000 Genome Project and the Coriell Catalog. RESULTS: The 35-gene hereditary cancer panel shows high sensitivity (99.9%) and specificity (100%) across 4820 variants including single nucleotide variants (SNVs) and small insertions and deletions (indel; up to 25 bp). The reproducibility and repeatability are 99.8 and 100%, respectively. CONCLUSIONS: The use of targeted NGS-based multigene testing panels to provide comprehensive analysis of cancer susceptible genes has been considered a viable option. In the present study, we developed and validated a 35-gene panel for testing 8 common cancers using next-generation sequencing (NGS). The performance of our hereditary cancer panel is assessed across a board range of variants in the 35 genes to support clinical use.

CYP1A2 genotype and acute effects of caffeine on resistance exercise, jumping, and sprinting performance.

BACKGROUND: It has been suggested that polymorphisms within CYP1A2 impact inter-individual variation in the response to caffeine. The purpose of this study was to explore the acute effects of caffeine on resistance exercise, jumping, and sprinting performance in a sample of resistance-trained men, and to examine the influence of genetic variation of CYP1A2 (rs762551) on the individual variation in responses to caffeine ingestion. METHODS: Twenty-two men were included as participants (AA homozygotes n = 13; C-allele carriers n = 9) and were tested after the ingestion of caffeine (3 mg/kg of body mass) and a placebo. Exercise performance was assessed with the following outcomes: (a) movement velocity and power output in the bench press exercise with loads of 25, 50, 75, and 90% of one-repetition maximum (1RM); (b) quality and quantity of performed repetitions in the bench press exercise performed to muscular failure with 85% 1RM; (c) vertical jump height in a countermovement jump test; and (d) power output in a Wingate test. RESULTS: Compared to placebo, caffeine ingestion enhanced: (a) movement velocity and power output across all loads (effect size [ES]: 0.20-0.61; p <  0.05 for all); (b) the quality and quantity of performed repetitions with 85% of 1RM (ES: 0.27-0.85; p <  0.001 for all); (c) vertical jump height (ES: 0.15; p = 0.017); and (d) power output in the Wingate test (ES: 0.33-0.44; p <  0.05 for all). We did not find a significant genotype × caffeine interaction effect (p-values ranged from 0.094 to 0.994) in any of the analyzed performance outcomes. CONCLUSIONS: Resistance-trained men may experience acute improvements in resistance exercise, jumping, and sprinting performance following the ingestion of caffeine. The comparisons of the effects of caffeine on exercise performance between individuals with the AA genotype and AC/CC genotypes found no significant differences. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry. ID: ACTRN12619000885190.

ADOR2A C Allele Carriers Exhibit Ergogenic Responses to Caffeine Supplementation.

Caffeine's ergogenic effects on exercise performance are generally explained by its ability to bind to adenosine receptors. ADORA2A is the gene that encodes A2A subtypes of adenosine receptors. It has been suggested that ADORA2A gene polymorphisms may be responsible for the inter-individual variations in the effects of caffeine on exercise performance. In the only study that explored the influence of variation in ADORA2A-in this case, a common polymorphism (rs5751876)-on the ergogenic effects of caffeine on exercise performance, C allele carriers were identified as "non-responders" to caffeine. To explore if C allele carriers are true "non-responders" to the ergogenic effects of caffeine, in this randomized, double-blind study, we examined the acute effects of caffeine ingestion among a sample consisting exclusively of ADORA2A C allele carriers. Twenty resistance-trained men identified as ADORA2A C allele carriers (CC/CT genotype) were tested on two occasions, following the ingestion of caffeine (3 mg/kg) and a placebo. Exercise performance was evaluated with movement velocity, power output, and muscle endurance during the bench press exercise, countermovement jump height, and power output during a Wingate test. Out of the 25 analyzed variables, caffeine was ergogenic in 21 (effect size range: 0.14 to 0.96). In conclusion, ADORA2A (rs5751876) C allele carriers exhibited ergogenic responses to caffeine ingestion, with the magnitude of improvements similar to what was previously reported in the literature among samples that were not genotype-specific. Therefore, individuals with the CT/CC genotype may still consider supplementing with caffeine for acute improvements in performance.

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

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

Wake up and smell the coffee: caffeine supplementation and exercise performance-an umbrella review of 21 published meta-analyses.

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.

Isolated effects of caffeine and sodium bicarbonate ingestion on performance in the Yo-Yo test: A systematic review and meta-analysis.

OBJECTIVES: To conduct a systematic review and a meta-analysis of studies exploring the effects of caffeine and/or sodium bicarbonate on performance in the Yo-Yo test. DESIGN: Systematic review and meta-analysis. METHODS: A total of six databases were searched, and random-effects meta-analyses were performed examining the isolated effects of caffeine and sodium bicarbonate on performance in the Yo-Yo test. RESULTS: After reviewing 988 search records, 15 studies were included. For the effects of caffeine on performance in the Yo-Yo test, the meta-analysis indicated a significant favoring of caffeine as compared with the placebo conditions (p=0.022; standardized mean difference [SMD]=0.17; 95% CI: 0.08, 0.32; +7.5%). Subgroup analyses indicated that the effects of caffeine were significant for the level 2 version of the Yo-Yo test, but not level 1. Four out of the five studies that explored the effects of sodium bicarbonate used the level 2 version of the Yo-Yo test. The pooled SMD favored the sodium bicarbonate condition as compared with the placebo/control conditions (p=0.007; SMD: 0.36; 95% CI: 0.10, 0.63; +16.0%). CONCLUSIONS: This review demonstrates that isolated ingestion of caffeine and sodium bicarbonate enhances performance in the Yo-Yo test. Given these ergogenic effects, the intake of caffeine and sodium bicarbonate before the Yo-Yo test needs to be standardized (i.e., either restricted or used in the same way before each testing session). Furthermore, the results suggest that individuals competing in sports involving intermittent exercise may consider supplementing with caffeine or sodium bicarbonate for acute improvements in performance.

Is Coffee a Useful Source of Caffeine Preexercise?

Caffeine is a well-established ergogenic aid, with its performance-enhancing effects demonstrated across a wide variety of exercise modalities. Athletes tend to frequently consume caffeine as a performance enhancement method in training and competition. There are a number of methods available as a means of consuming caffeine around exercise, including caffeine anhydrous, sports drinks, caffeine carbohydrate gels, and gum. One popular method of caffeine ingestion in nonathletes is coffee, with some evidence suggesting it is also utilized by athletes. In this article, we discuss the research pertaining to the use of coffee as an ergogenic aid, exploring (a) whether caffeinated coffee is ergogenic, (b) whether dose-matched caffeinated coffee provides a performance benefit similar in magnitude to caffeine anhydrous, and (c) whether decaffeinated coffee consumption affects the ergogenic effects of a subsequent isolated caffeine dose. There is limited evidence that caffeinated coffee has the potential to offer ergogenic effects similar in magnitude to caffeine anhydrous; however, this requires further investigation. Coingestion of caffeine with decaffeinated coffee does not seem to limit the ergogenic effects of caffeine. Although caffeinated coffee is potentially ergogenic, its use as a preexercise caffeine ingestion method represents some practical hurdles to athletes, including the consumption of large volumes of liquid and difficulties in quantifying the exact caffeine dose, as differences in coffee type and brewing method may alter caffeine content. The use of caffeinated coffee around exercise has the potential to enhance performance, but athletes and coaches should be mindful of the practical limitations.