Efficacy of sodium bicarbonate ingestion strategies for protecting blinding.

Sodium bicarbonate (NaHCO3) is a widely researched ergogenic aid, but the optimal blinding strategy during randomised placebo-controlled trials is unknown. In this multi-study project, we aimed to determine the most efficacious ingestion strategy for blinding NaHCO3 research. During study one, 16 physically active adults tasted 0.3 g kg-1 body mass NaHCO3 or 0.03 g kg-1 body mass sodium chloride placebo treatments given in different flavour (orange, blackcurrant) and temperature (chilled, room temperature) solutions. They were required to guess which treatment they had received. During study two, 12 recreational athletes performed time-to-exhaustion (TTE) cycling trials (familiarisation, four experimental). Using a randomised, double-blind design, participants consumed 0.3 g kg-1 body mass NaHCO3 or a placebo in 5 mL kg-1 body mass chilled orange squash/water solutions or capsules and indicated what they believed they had received immediately after consumption, pre-TTE and post-TTE. In study one, NaHCO3 prepared in chilled orange squash resulted in the most unsure ratings (44%). In study two, giving NaHCO3 in capsules resulted in more unsure ratings than in solution after consumption (92 vs 33%), pre-TTE (67 vs. 17%) and post-TTE (50 vs. 17%). Administering NaHCO3 in capsules was the most efficacious blinding strategy which provides important implications for researchers conducting randomised placebo-controlled trials.

Evening Caffeine Did Not Improve 100-m Swimming Time Trials Performed 60 Min Post-Ingestion or the Next Morning After Sleep.

The potential ergogenic benefits of caffeine (CAF) are well known within the athletic community, often leading to its use in adolescent swimming cohorts to enhance their performance. However, it has previously been reported that CAF has sleep-disturbing effects, which could be detrimental to performance over consecutive days in multiday competitions. Moreover, the effects that evening CAF ingestion has on sleep, side effects, and next-day performances are yet to be researched in trained adolescents. In a double-blind, randomized, crossover design, eight national-level swimmers (age: 18 ± 1 years, height: 1.76 ± 0.06 cm, body mass [BM]: 69.4 ± 6.4 kg) ingested a capsule containing 3 mg/kg BM CAF or a placebo 60 min before an evening 100-m swimming time trial. The next morning, sleep was analyzed (Core Consensus Sleep Diary) and 100-m time trials were repeated. Side effects were analyzed via visual analog scales throughout the study. No differences were found for swimming performance (p = .911) in the evening (CAF: 59.5 ± 7.8 s, placebo: 59.9 ± 7.9 s, g = 0.06) or morning (CAF: 59.7 ± 7.7 s, placebo: 60.2 ± 7.9 s, g = 0.07). In addition, no group differences were found for any subjective side effects (e.g., anxiety: p = .468, tachycardia: p = .859, alertness: p = .959) or sleep parameters (e.g., sleep latency: p = .395, total sleep time: p = .574). These results question the use of a standardized 3 mg/kg BM CAF ingestion strategy for 100-m swimming time trials in trained adolescents, although objective measures may be needed to confirm that CAF does not affect sleep within this cohort.

A critical review of citrulline malate supplementation and exercise performance.

As a nitric oxide (NO) enhancer, citrulline malate (CM) has recently been touted as a potential ergogenic aid to both resistance and high-intensity exercise performance, as well as the recovery of muscular performance. The mechanism has been associated with enhanced blood flow to active musculature, however, it might be more far-reaching as either ammonia homeostasis could be improved, or ATP production could be increased via greater availability of malate. Moreover, CM might improve muscle recovery via increased nutrient delivery and/or removal of waste products. To date, a single acute 8 g dose of CM on either resistance exercise performance or cycling has been the most common approach, which has produced equivocal results. This makes the effectiveness of CM to improve exercise performance difficult to determine. Reasons for the disparity in conclusions seem to be due to methodological discrepancies such as the testing protocols and the associated test-retest reliability, dosing strategy (i.e., amount and timing), and the recent discovery of quality control issues with some manufacturers stated (i.e., citrulline:malate ratios). Further exploration of the optimal dose is therefore required including quantification of the bioavailability of NO, citrulline, and malate following ingestion of a range of CM doses. Similarly, further well-controlled studies using highly repeatable exercise protocols with a large aerobic component are required to assess the mechanisms associated with this supplement appropriately. Until such studies are completed, the efficacy of CM supplementation to improve exercise performance remains ambiguous.

The Effects of a Soccer-Specific Fitness Test on Eccentric Knee Flexor Strength.

CONTEXT: Physiological fitness testing, such as the Yo-Yo Intermittent Recovery Test (YYIR) is a key requirement of the Elite Player Performance Plan, introduced by the English Premier League. Eccentric hamstring strength has been identified as a risk factor for hamstring injuries in soccer players, with fatigue highlighted to further exasperate this issue. OBJECTIVE: The aim of the current study was to examine the effect of the YYIR level 1 (YYIR1) on eccentric knee flexor strength assessed using the NordBord in youth soccer players. DESIGN: Experimental design. SETTING: Soccer club academy. PARTICIPANTS: A total of 67 male academy soccer players (age = 16.58 [0.57] y; height = 175.45 [5.85] cm; mass = 66.30 [8.21] kg) volunteered to participate in the current study during the English competitive soccer season. MAIN OUTCOME MEASURES: Participants conducted eccentric hamstring strength assessments using the NordBord prior to and immediately postcompletion of the YYIR1, with outcome measures of peak force and peak force relative to body mass recorded. RESULTS: Paired t tests highlighted increased absolute eccentric knee flexor strength values (P < .001) immediately post-YYIR1 for both the dominant and nondominant limbs, with the same trend (P < .001) observed for eccentric strength relative to body mass. CONCLUSIONS: The results of this study indicate that the YYIR1 does not induce eccentric knee flexor fatigue and as such is not a valid assessment method to assess the effects of fatigue on hamstring function. However, results do suggest that the NordBord may be considered a viable and more accessible alternative to detect pre-post fitness test/fatigue protocol differences in eccentric knee flexor peak strength while working in the field.

The effects of sodium bicarbonate ingestion on cycling performance and acid base balance recovery in acute normobaric hypoxia.

This study investigated the effects of two separate doses of sodium bicarbonate (NaHCO3) on 4 km time trial (TT) cycling performance and post-exercise acid base balance recovery in hypoxia. Fourteen club-level cyclists completed four cycling TT's, followed by a 40 min passive recovery in normobaric hypoxic conditions (FiO2 = 14.5%) following one of either: two doses of NaHCO3 (0.2 g.kg-1 BM; SBC2, or 0.3 g.kg-1 BM; SBC3), a taste-matched placebo (0.07 g.kg-1 BM sodium chloride; PLA), or a control trial in a double-blind, randomized, repeated-measures and crossover design study. Compared to PLA, TT performance was improved following SBC2 (p = 0.04, g = 0.16, very likely beneficial), but was improved to a greater extent following SBC3 (p = 0.01, g = 0.24, very likely beneficial). Furthermore, a likely benefit of ingesting SBC3 over SBC2 was observed (p = 0.13, g = 0.10), although there was a large inter-individual variation. Both SBC treatments achieved full recovery within 40 min, which was not observed in either PLA or CON following the TT. In conclusion, NaHCO3 improves 4 km TT performance and acid base balance recovery in acute moderate hypoxic conditions, however the optimal dose warrants an individual approach.

The influence of alkalosis on repeated high-intensity exercise performance and acid-base balance recovery in acute moderate hypoxic conditions.

PURPOSE: Exacerbated hydrogen cation (H+) production is suggested to be a key determinant of fatigue in acute hypoxic conditions. This study, therefore, investigated the effects of NaHCO3 ingestion on repeated 4 km TT cycling performance and post-exercise acid-base balance recovery in acute moderate hypoxic conditions. METHODS: Ten male trained cyclists completed four repeats of 2 × 4 km cycling time trials (TT1 and TT2) with 40 min passive recovery, each on different days. Each TT series was preceded by supplementation of one of the 0.2 g kg-1 BM NaHCO3 (SBC2), 0.3 g kg-1 BM NaHCO3 (SBC3), or a taste-matched placebo (0.07 g kg-1 BM sodium chloride; PLA), administered in a randomized order. Supplements were administered at a pre-determined individual time to peak capillary blood bicarbonate concentration ([HCO3-]). Each TT series was also completed in a normobaric hypoxic chamber set at 14.5% FiO2 (~ 3000 m). RESULTS: Performance was improved following SBC3 in both TT1 (400.2 ± 24.1 vs. 405.9 ± 26.0 s; p = 0.03) and TT2 (407.2 ± 29.2 vs. 413.2 ± 30.8 s; p = 0.01) compared to PLA, displaying a very likely benefit in each bout. Compared to SBC2, a likely and possible benefit was also observed following SBC3 in TT1 (402.3 ± 26.5 s; p = 0.15) and TT2 (410.3 ± 30.8 s; p = 0.44), respectively. One participant displayed an ergolytic effect following SBC3, likely because of severe gastrointestinal discomfort, as SBC2 still provided ergogenic effects. CONCLUSION: NaHCO3 ingestion improves repeated exercise performance in acute hypoxic conditions, although the optimal dose is likely to be 0.3 g kg-1 BM.

Sodium bicarbonate supplementation improves severe-intensity intermittent exercise under moderate acute hypoxic conditions.

Acute moderate hypoxic exposure can substantially impair exercise performance, which occurs with a concurrent exacerbated rise in hydrogen cation (H+) production. The purpose of this study was therefore, to alleviate this acidic stress through sodium bicarbonate (NaHCO3) supplementation and determine the corresponding effects on severe-intensity intermittent exercise performance. Eleven recreationally active individuals participated in this randomised, double-blind, crossover study performed under acute normobaric hypoxic conditions (FiO2% = 14.5%). Pre-experimental trials involved the determination of time to attain peak bicarbonate anion concentrations ([HCO3-]) following NaHCO3 ingestion. The intermittent exercise tests involved repeated 60-s work in their severe-intensity domain and 30-s recovery at 20 W to exhaustion. Participants ingested either 0.3 g kg bm-1 of NaHCO3 or a matched placebo of 0.21 g kg bm-1 of sodium chloride prior to exercise. Exercise tolerance (+ 110.9 ± 100.6 s; 95% CI 43.3-178 s; g = 1.0) and work performed in the severe-intensity domain (+ 5.8 ± 6.6 kJ; 95% CI 1.3-9.9 kJ; g = 0.8) were enhanced with NaHCO3 supplementation. Furthermore, a larger post-exercise blood lactate concentration was reported in the experimental group (+ 4 ± 2.4 mmol l-1; 95% CI 2.2-5.9; g = 1.8), while blood [HCO3-] and pH remained elevated in the NaHCO3 condition throughout experimentation. In conclusion, this study reported a positive effect of NaHCO3 under acute moderate hypoxic conditions during intermittent exercise and therefore, may offer an ergogenic strategy to mitigate hypoxic induced declines in exercise performance.

Sodium bicarbonate improves 4 km time trial cycling performance when individualised to time to peak blood bicarbonate in trained male cyclists.

The aim of this study was to investigate the effects of sodium bicarbonate (NaHCO3) on 4 km cycling time trial (TT) performance when individualised to a predetermined time to peak blood bicarbonate (HCO3-). Eleven male trained cyclists volunteered for this study (height 1.82 ± 0.80 m, body mass (BM) 86.4 ± 12.9 kg, age 32 ± 9 years, peak power output (PPO) 382 ± 22 W). Two trials were initially conducted to identify time to peak HCO3- following both 0.2 g.kg-1 BM (SBC2) and 0.3 g.kg-1 BM (SBC3) NaHCO3. Thereafter, on three separate occasions using a randomised, double-blind, crossover design, participants completed a 4 km TT following ingestion of either SBC2, SBC3, or a taste-matched placebo (PLA) containing 0.07 g.kg-1 BM sodium chloride (NaCl) at the predetermined individual time to peak HCO3-. Both SBC2 (-8.3 ± 3.5 s; p < 0.001, d = 0.64) and SBC3 (-8.6 ± 5.4 s; p = 0.003, d = 0.66) reduced the time to complete the 4 km TT, with no difference between SBC conditions (mean difference = 0.2 ± 0.2 s; p = 0.87, d = 0.02). These findings suggest trained cyclists may benefit from individualising NaHCO3 ingestion to time to peak HCO3- to enhance 4 km TT performance.

Determinants of curvature constant (W') of the power duration relationship under normoxia and hypoxia: the effect of pre-exercise alkalosis.

PURPOSE: This study investigated the effect of induced alkalosis on the curvature constant (W') of the power-duration relationship under normoxic and hypoxic conditions. METHODS: Eleven trained cyclists (mean ± SD) Age: 32 ± 7.2 years; body mass (bm): 77.0 ± 9.2 kg; VO2peak: 59.2 ± 6.8 ml·kg-1·min-1 completed seven laboratory visits which involved the determination of individual time to peak alkalosis following sodium bicarbonate (NaHCO3) ingestion, an environment specific ramp test (e.g. normoxia and hypoxia) and four x 3 min critical power (CP) tests under different experimental conditions. Participants completed four trials: alkalosis normoxia (ALN); placebo normoxia (PLN); alkalosis hypoxia (ALH); and placebo hypoxia (PLH). Pre-exercise administration of 0.3 g.kg-1 BM of NaHCO3 was used to induce alkalosis. Environmental conditions were set at either normobaric hypoxia (FiO2: 14.5%) or normoxia (FiO2: 20.93%). RESULTS: An increase in W' was observed with pre-exercise alkalosis under both normoxic (PLN: 15.1 ± 6.2 kJ vs. ALN: 17.4 ± 5.1 kJ; P = 0.006) and hypoxic conditions (ALN: 15.2 ± 4.9 kJ vs. ALN: 17.9 ± 5.2 kJ; P < 0.001). Pre-exercise alkalosis resulted in a larger reduction in bicarbonate ion (HCO3-) concentrations during exercise in both environmental conditions (p < 0.001) and a greater blood lactate accumulation under hypoxia (P = 0.012). CONCLUSION: Pre-exercise alkalosis substantially increased W' and, therefore, may determine tolerance to exercise above CP under normoxic and hypoxic conditions. This may be due to NaHCO3 increasing HCO3- buffering capacity to delay exercise-induced acidosis, which may, therefore, enhance anaerobic energy contribution.

Ingestion of Sodium Bicarbonate (NaHCO3) Following a Fatiguing Bout of Exercise Accelerates Postexercise Acid-Base Balance Recovery and Improves Subsequent High-Intensity Cycling Time to Exhaustion.

This study evaluated the ingestion of sodium bicarbonate (NaHCO3) on postexercise acid-base balance recovery kinetics and subsequent high-intensity cycling time to exhaustion. In a counterbalanced, crossover design, nine healthy and active males (age: 23 ± 2 years, height: 179 ± 5 cm, body mass: 74 ± 9 kg, peak mean minute power (Wpeak) 256 ± 45 W, peak oxygen uptake (V̇O2peak) 46 ± 8 ml.kg-1.min-1) performed a graded incremental exercise test, two familiarization and two experimental trials. Experimental trials consisted of cycling to volitional exhaustion (TLIM1) at 100% WPEAK on two occasions (TLIM1 and TLIM2) interspersed by a 90 min passive recovery period. Using a double-blind approach, 30 min into a 90 min recovery period participants ingested either 0.3 g.kg-1 body mass sodium bicarbonate (NaHCO3) or a placebo (PLA) containing 0.1 g.kg-1 body mass sodium chloride (NaCl) mixed with 4 ml.kg-1 tap water and 1 ml.kg-1 orange squash. The mean differences between TLIM2 and TLIM1 was larger for PLA compared with NaHCO3 (-53 ± 53 vs. -20 ± 48 s; p = .008, d = 0.7, CI =-0.3, 1.6), indicating superior subsequent exercise time to exhaustion following NaHCO3. Blood lactate [Bla-] was similar between treatments post TLIM1, but greater for NaHCO3 post TLIM2 and 5 min post TLIM2. Ingestion of NaHCO3 induced marked increases (p < .01) in both blood pH (+0.07 ± 0.02, d = 2.6, CI = 1.2, 3.7) and bicarbonate ion concentration [HCO3-] (+6.8 ± 1.6 mmo.l-1, d = 3.4, CI = 1.8, 4.7) compared with the PLA treatment, before TLIM2. It is likely both the acceleration of recovery, and the marked increases of acid-base after TLIM1 contributed to greater TLIM2 performance compared with the PLA condition.

Recent Developments in the Use of Sodium Bicarbonate as an Ergogenic Aid.

This review examines the current status of sodium bicarbonate as an ergogenic aid. It builds on previous reviews in the area. Current research would suggest that as an ergogenic aid, a 300 mg·kg dose of NaHCO3 can improve high-intensity exercise, within a range of exercise modalities, such as a single bout of supramaximal exercise, high-intensity intermittent activity, and skill-based sports. In particular, these benefits seem to be present to a greater extent within trained individuals. Despite this, there appears to exist a high intraindividual variability in response to NaHCO3, and therefore, the ergogenic benefits may not be induced during every exercise bout. Current thinking also suggests that athletes need to individualize their ingestion timings to maximize peak pH or blood bicarbonate to effectively maximize the performance effect, and this may allow individuals to attain the ergogenic benefits of NaHCO3 more consistently.

The Effects of a Carbohydrate Hydrogel System for the Delivery of Bicarbonate Mini-Tablets on Acid-Base Buffering and Gastrointestinal Symptoms in Resting Well-trained Male Cyclists.

BACKGROUND: A new commercially available sodium bicarbonate (SB) supplement claims to limit gastrointestinal (GI) discomfort and increase extracellular buffering capacity. To date, no available data exists to substantiate such claims. Therefore, the aim of this study was to measure blood acid-base balance and GI discomfort responses following the ingestion of SB using the novel "Bicarb System" (M-SB). Twelve well-trained male cyclists completed this randomised crossover designed study. Maximal oxygen consumption was determined in visit one, whilst during visits two and three participants ingested 0.3 g∙kg-1 BM SB using M-SB (Maurten, Sweden) or vegetarian capsules (C-SB) in a randomised order. Finger prick capillary blood samples were measured every 30 min for pH, bicarbonate (HCO3-), and electrolytes (potassium, chloride, calcium, and sodium), for 300 min. Visual analogue scales (VAS) were used to assess GI symptoms using the same time intervals. RESULTS: Peak HCO3- was 0.95 mmol∙L-1 greater following M-SB (p = 0.023, g = 0.61), with time to peak HCO3- achieved 38.2 min earlier (117 ± 37 vs. 156 ± 36 min; p = 0.026, r = 0.67) and remained elevated for longer (p = 0.043, g = 0.51). No differences were observed for any electrolytes between the conditions. Aggregated GI discomfort was reduced by 79 AU following M-SB (p < 0.001, g = 1.11), with M-SB reducing stomach cramps, bowel urgency, diarrhoea, belching, and stomach-ache compared to C-SB. CONCLUSIONS: This is the first study to report that M-SB can increase buffering capacity and reduce GI discomfort. This presents a major potential benefit for athletes considering SB as an ergogenic supplement as GI discomfort is almost eliminated. Future research should determine if M-SB is performance enhancing.

The novel 'Bicarb System' (M-SB) reduced, and almost eliminated the gastrointestinal (GI) discomfort compared to vegetarian capsules (C-SB). The changes in acid-base balance following ingestion of M-SB were significantly greater compared to C-SB. It is unkown if this would translate to increased performance benefits, however, and the next step therefore is to determine the performance responses from M-SB. The increase in HCO₃⁻ was sustained >5 mmol L⁻¹ HCO₃⁻ for longer with M-SB ingestion versus C-SB. This might suggest there is an "ergogenic window", and ingestion timing could therefore be flexible prior to exercise.

Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment.

The Post Covid-19 Condition (commonly known as Long Covid) has been defined by the World Health Organisation as occurring in individuals with a history of probable or confirmed SARS CoV 2 infection, usually within 3 months from the onset of acute Covid-19 infection with symptoms that last for at least two months which cannot be explained by an alternative diagnosis. Long Covid is associated with over two hundred recognised symptoms and affects tens of millions of people worldwide. Widely reported reductions in quality of life(QoL) and functional status are caused by extremely sensitive and cyclical symptom profiles that are augmented following exposure to physical, emotional, orthostatic, and cognitive stimuli. This manifestation prevents millions of people from engaging in routine activities of daily living (ADLs) and has important health and well-being, social and economic impacts. Post-exertional symptom exacerbation (PESE) (also known as post-exertional malaise) is an exacerbation in the severity of fatigue and other symptoms following physical, emotional, orthostatic and cognitive tasks. Typically, this will occur 24-72 h after "over-exertion" and can persist for several days and even weeks. It is a hallmark symptom of Long Covid with a reported prevalence of 86%. The debilitating nature of PESE prevents patients from engaging in physical activity which impacts functional status and QoL. In this review, the authors present an update to the literature relating to PESE in Long Covid and make the case for evidence-based guidelines that support the design and implementation of safe rehabilitation approaches for people with Long Covid. This review also considers the role of objective monitoring to quantify a patient's response to external stimuli which can be used to support the safe management of Long Covid and inform decisions relating to engagement with any stimuli that could prompt an exacerbation of symptoms.

Nutritional Supplement Use in a UK High-Performance Swimming Club.

The aim of this study was to observe the nutritional supplement practices of highly trained swimmers on a national talent pathway, since it is often reported that swimmers engage in widespread supplement use at the elite level. Thus, this study employed a validated supplement intake questionnaire with forty-four swimmers from a high-performance swimming club, which had three distinct talent stages: development (aged 11-14 years, n = 20), age-group (aged 13-17 years, n = 13), and national level (aged ≥ 16 years, n = 11). Ninety-eight percent of the interviewed swimmers reported using at least one supplement, with performance (34%) and recovery (19%) cited as the primary reasons. National swimmers used more total supplements (8.1 ± 3.4 supplements) compared to age-group (4.8 ± 2.0 supplements, p = 0.003, g = 1.17) and development (3.9 ± 1.7 supplements, p < 0.001, g = 1.69) swimmers, mostly because of a greater intake of ergogenic aids (2.4 ± 1.4 supplements vs. age-group: 0.5 ± 0.5 supplements, p < 0.001, g = 1.12; vs. development: 0.1 ± 0.2 supplements, p < 0.001, g = 1.81). Parents/guardians were the primary supplement informants of development swimmers (74%, p < 0.001, V = 0.50), whereas performance nutritionists informed ~50% of supplements used by age-group and national swimmers (p < 0.001, V = 0.51). Based on these results, supplement education and greater focus on basic sport nutrition practices may be required for parents/guardians at the development level. Moreover, further research is needed to support the high number of ergogenic aids used by national swimmers, with the efficacy of these supplements currently equivocal in the applied setting.

Beneficial effects of oral and topical sodium bicarbonate during a battery of team sport-specific exercise tests in recreationally trained male athletes.

OBJECTIVE: This study examined the effects of oral and topical (PR Lotion; Momentous) sodium bicarbonate (NaHCO3) during a battery of team sport-specific exercise tests. METHOD: In a block randomized, crossover, double-blind, placebo-controlled design, 14 recreationally trained male team sport athletes performed a familiarization visit and three experimental trials receiving: (i) 0.3 g·kg-1 body mass (BM) NaHCO3 in capsules + placebo lotion (SB-ORAL), (ii) placebo capsules +0.9036 g·kg-1 BM PR Lotion (SB-LOTION), or (iii) placebo capsules + placebo lotion (PLA). Supplements were given ~120 min prior to the team sport-specific exercise tests: countermovement jumps (CMJ), 8 × 25 m repeated sprints and Yo-Yo Intermittent Recovery Level 2 (Yo-Yo IR2). Blood acid-base balance (pH, bicarbonate) and electrolytes (sodium, potassium) were measured throughout. Rating of perceived exertion (RPE) was recorded after each sprint and post-Yo-Yo IR2. RESULTS: Distance covered during the Yo-Yo IR2 was 21% greater for SB-ORAL compared with PLA (+94 m; p = 0.009, d = 0.64) whereas performance was only 7% greater for SB-LOTION compared with PLA (480 ± 122 vs. 449 ± 110 m; p = 0.084). Total completion time for the 8 × 25 m repeated sprint test was 1.9% faster for SB-ORAL compared with PLA (-0.61 s; p = 0.020, d = 0.38) and 2.0% faster for SB-LOTION compared with PLA (-0.64 s; p = 0.036, d = 0.34). CMJ performance was similar between treatments (p > 0.05). Blood acid-base balance and electrolytes were significantly improved for SB-ORAL compared with PLA, but no differences were observed for SB-LOTION. Compared to PLA, RPE was lower for SB-LOTION after the fifth (p = 0.036), sixth (p = 0.012), and eighth (p = 0.040) sprints and for SB-ORAL after the sixth (p = 0.039) sprint. CONCLUSIONS: Oral NaHCO3 improved 8 × 25 m repeated sprint (~2%) and Yo-Yo IR2 performance (21%). Similar improvements in repeated sprint times were observed for topical NaHCO3 (~2%), but no significant benefits were reported for Yo-Yo IR2 distance or blood acid-base balance compared to PLA. These findings suggest that PR Lotion might not be an effective delivery system for transporting NaHCO3 molecules across the skin and into systematic circulation, therefore further research is needed to elucidate the physiological mechanisms responsible for the ergogenic effects of PR Lotion.

The Impact of COVID-19 on the Social Determinants of Cardiovascular Health.

Cardiovascular disease is the leading noncommunicable disease and cause of premature mortality globally. Despite well established evidence of a cause-effect relationship between modifiable lifestyle behaviours and the onset of risk of chronic disease, preventive approaches to curtail increasing prevalence have been ineffective. This has undoubtedly been exacerbated by the response to COVID-19, which saw widespread national lockdowns implemented to reduce transmission and alleviate pressure on strained health care systems. A consequence of these approaches was a well documented negative impact on population health in the context of both physical and mental well-being. Although the true extent of the impact of the COVID-19 response on global health has yet to be fully realised or understood, it seems prudent to review effective preventative and management strategies that have yielded positive outcomes across the spectrum (ie, from individual to society). There is also a clear need to heed lessons learned from the COVID-19 experience in the power of collaboration and how this can be used in the design, development, and implementation of future approaches to address the longstanding burden of cardiovascular disease.

Sodium Bicarbonate and Time-to-Exhaustion Cycling Performance: A Retrospective Analysis Exploring the Mediating Role of Expectation.

BACKGROUND: Research has shown that ingesting 0.3 g·kg-1 body mass sodium bicarbonate (NaHCO3) can improve time-to-exhaustion (TTE) cycling performance, but the influence of psychophysiological mechanisms on ergogenic effects is not yet understood. OBJECTIVE: This study retrospectively examined whether changes in TTE cycling performance are mediated by positive expectations of receiving NaHCO3 and/or the decline in blood bicarbonate during exercise. METHODS: In a randomised, crossover, counterbalanced, double-blind, placebo-controlled design, 12 recreationally trained cyclists (maximal oxygen consumption, 54.4 ± 5.7 mL·kg·min-1) performed four TTE cycling tests 90 min after consuming: (1) 0.3 g·kg-1 body mass NaHCO3 in 5 mL·kg-1 body mass solution, (2) 0.03 g·kg-1 body mass sodium chloride in solution (placebo), (3) 0.3 g·kg-1 body mass NaHCO3 in capsules and (4) cornflour in capsules (placebo). Prior to exercise, participants rated on 1-5 Likert type scales how much they expected the treatment they believe had been given would improve performance. Capillary blood samples were measured for acid-base balance at baseline, pre-exercise and post-exercise. RESULTS: Administering NaHCO3 in solution and capsules improved TTE compared with their respective placebos (solution: 27.0 ± 21.9 s, p = 0.001; capsules: 23.0 ± 28.1 s, p = 0.016). Compared to capsules, NaHCO3 administered via solution resulted in a higher expectancy about the benefits on TTE cycling performance (Median: 3.5 vs. 2.5, Z = 2.135, p = 0.033). Decline in blood bicarbonate during exercise was higher for NaHCO3 given in solution compared to capsules (2.7 ± 2.1 mmol·L-1, p = 0.001). Mediation analyses showed that improvements in TTE cycling were indirectly related to expectancy and decline in blood bicarbonate when NaHCO3 was administered in solution but not capsules. CONCLUSIONS: Participants' higher expectations when NaHCO3 is administered in solution could result in them exerting themselves harder during TTE cycling, which subsequently leads to a greater decline in blood bicarbonate and larger improvements in performance. KEY POINTS: Ingesting 0.3 g·kg-1 body mass sodium bicarbonate in solution and capsules improved time-to-exhaustion cycling performance Positive expectancy about the benefits of sodium bicarbonate and decline in blood bicarbonate were higher when sodium bicarbonate was administered in solution compared with capsules Improvements in time-to-exhaustion cycling performance for sodium bicarbonate administered in solution were related to expectancy and the enhanced extracellular buffering response.

COVID-19 and elite sport: Cardiovascular implications and return-to-play.

Curtailing elite sports during the coronavirus disease 2019 (COVID-19) pandemic was necessary to prevent widespread viral transmission. Now that elite sport and international competitions have been largely restored, there is still a need to devise appropriate screening and management pathways for athletes with a history of, or current, COVID-19 infection. These approaches should support the decision-making process of coaches, sports medicine practitioners and the athlete about the suitability to return to training and competition activities. In the absence of longitudinal data sets from athlete populations, the incidence of developing prolonged and debilitating symptoms (i.e., Long COVID) that affects a return to training and competition remains a challenge to sports and exercise scientists, sports medicine practitioners and clinical groups. As the world attempts to adjust toward 'living with COVID-19' the very nature of elite and international sporting competition poses a risk to athlete welfare that must be screened for and managed with bespoke protocols that consider the cardiovascular implications for performance.

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 75th 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 75th 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.

The effects of sodium bicarbonate supplementation at individual time-to-peak blood bicarbonate on 4-km cycling time trial performance in the heat.

The purpose of this study was to explore the effect of individualised sodium bicarbonate (NaHCO3) supplementation according to a pre-established individual time-to-peak (TTP) blood bicarbonate (HCO3-) on 4-km cycling time trial (TT) performance in the heat. Eleven recreationally trained male cyclists (age: 28 ± 6 years, height: 180 ± 6 cm, body mass: 80.5 ± 8.4 kg) volunteered for this study in a randomised, crossover, triple-blind, placebo-controlled design. An initial visit was conducted to determine TTP HCO3- following 0.2 g.kg-1 body mass (BM) NaHCO3 ingestion. Subsequently, on three separate occasions, participants completed a 4-km cycling TT in the heat (30 degrees centigrade; °C) (relative humidity ∼40%) following ingestion of either NaHCO3 (0.2 g.kg-1 body mass), a sodium chloride placebo (0.2 g.kg-1 BM; PLA) at the predetermined individual TTP HCO3-, or no supplementation (control; CON) . Absolute peak [HCO3-] prior to the 4-km cycling TT's was elevated for NaHCO3 compared to PLA (+2.8 mmol.l-1; p = 0.002; g = 2.2) and CON (+2.5 mmol.l-1; p < 0.001; g = 2.1). Completion time following NaHCO3 was 5.6 ± 3.2 s faster than PLA (1.6%; CI: 2.8, 8.3; p = 0.001; g = 0.2) and 4.7 ± 2.8 s faster than CON (1.3%; CI: 2.3, 7.1; p = 0.001; g = 0.2). These results demonstrate that NaHCO3 ingestion at a pre-established individual TTP HCO3- improves 4-km cycling TT performance in the heat, likely through enhancing buffering capacity.Highlights This is the first time NaHCO3 ingestion has been shown to improve 4-km cycling TT performance in conditions of high ambient heat.A smaller dose of NaHCO3 (0.2 g.kg-1 BM) is ergogenic in the heat, which is smaller than the dose typically ingested for sports performance (0.3 g.kg-1 BM). This is important, as gastrointestinal discomfort is typically lower as the dose reduces.This study suggests that the individualised time-to-peak HCO3- ingestion strategy with lower doses of NaHCO3 is an ergogenic strategy in conditions of high ambient heat.