Secondary Logo

Practical Recommendations for Coaches and Athletes: A Meta-Analysis of Sodium Bicarbonate Use for Athletic Performance

Peart, Daniel J.1; Siegler, Jason C.2; Vince, Rebecca V.1

Journal of Strength and Conditioning Research: July 2012 - Volume 26 - Issue 7 - p 1975–1983
doi: 10.1519/JSC.0b013e3182576f3d
Brief Review
Free

Peart, DJ, Siegler, JC, and Vince, RV. Practical recommendations for coaches and athletes: A meta-analysis of sodium bicarbonate use for athletic performance. J Strength Cond Res 26(7): 1975–1983, 2012—Sodium bicarbonate (NaHCO3) is a buffering agent that is suggested to improve performance by promoting the efflux of hydrogen ions from working cells and tissues. Research surrounding its efficacy as an ergogenic aid is conflicting, making it difficult to draw conclusions as to its effectiveness for training and competition. This study performed a meta-analysis of relevant research articles to allow the development of concise practical recommendations for coaches and athletes. The overall effect size for the influence of NaHCO3 on performance was moderate, and was significantly lower for specifically trained as opposed to recreationally trained participants.

1Department of Sport, Health, and Exercise Science, University of Hull, Hull, United Kingdom

2School of Science and Health, University of Western Sydney, Penrith, Australia

Address correspondence to Daniel J. Peart, d.peart@hull.ac.uk.

Back to Top | Article Outline

Introduction

The use of ergogenic aids to improve performance is widespread (10,54,69), though their use is only recommended after a careful cost-benefit analysis (45). Alkalizing substances have been researched extensively for their potential to improve performance by minimizing the extent of metabolic acidosis, a contributor to fatigue during high-intensity exercise. One such agent that has attracted a wealth of attention is sodium bicarbonate (NaHCO3), which has been featured in the literature since as early as the 1930s (17) and regularly since the 1970s. The ingestion of NaHCO3 increases the level of bicarbonate (

) in the blood, a natural buffer that works by accepting a proton to form carbonic acid:

The additional

promotes a greater extracellular efflux of H+ and lactate, as demonstrated by a commonly reported higher blood lactate after exercise with NaHCO3 ingestion (74,86,95). Although there is a large body of evidence to support the use of NaHCO3 for sports performance, its use has been associated with possible gastrointestinal side effects (11). There is also conflicting research challenging its efficacy as an ergogenic aid, as highlighted in a number of review articles (9,52,65,71). Such reviews are essential because they summarize existing research and allow recommendations for evidence-based practice. However, the conclusions from review articles are susceptible to the opinions of the authors, because no statistical methods are used to support the arguments presented. A meta-analysis from almost 2 decades ago (43) reported only a moderate overall effect size (ES) for the effect of NaHCO3 on anaerobic performance. The analytical methods of this review allow a greater insight into the efficacy of NaHCO3 for sport performance; however, it was limited to the research of the time because there were few studies using trained subjects and no studies implementing prolonged protocols. There has since been a wealth of research articles on this topic, and therefore, a more up-to-date meta-analysis is needed to inform coaches, nutritionists, and athletes alike. The purpose of this study is to perform a meta-analysis to include more contemporary research. This will assist in the quantification of the efficacy of NaHCO3 ingestion for sports performance and provide practitioners a tool for the implementation of an effective cost-benefit analysis, that is, ergogenic potential vs. possible gastrointestinal distress.

Back to Top | Article Outline

Methods

Data Sources

A computer search for relevant peer-reviewed articles (excluding abstracts and unpublished theses and dissertations) was performed in January 2012 by entering various combinations of the following key words into PubMed, SPORTDiscus and Google Scholar; ‘sodium bicarbonate,’ ‘bicarbonate ingestion,’ ‘preexercise alkalosis,’ ‘ergogenic aids,’ ‘induced alkalosis,’ ‘acid-base balance,’ ‘sport nutrition,’ ‘sport performance,’ ‘sport,’ and ‘exercise.’ A manual cross-reference of relevant articles and review articles was also performed (9,52,65,71).

Back to Top | Article Outline

Inclusion Criteria and Excluded Studies

The retrieved articles were then selected for the meta-analysis according to the following inclusion criteria: (a) An acute dosage employed of 0.2–0.4 g·kg−1·body weight−1 60–120 minutes before exercise. This was chosen to take into account recommendations from recent research examining ingestion protocols (13,64,76). (b) Placebo-controlled, randomized, blinded, and repeated measures design. (c) Relevant raw data provided, that is, performance means and SDs. If the required raw data were not available in the article, then an attempt was made to contact the authors. (d) Human participants. (e) The main aim of the research was to examine the influence of NaHCO3 on performance. This was to assist clarity and allow recommendations to be made for performance. (f) Substance not combined with any other nutritional product and ergogenic aid.

All the studies that met these criteria are summarized in Table 1. The following studies were consequently excluded: (3,7,14,16–18,20,21,23–27,29,33–35,40,41,44,46,48,51,53,56,59,70,77,79,80,84,85,87,88,91,93,96) because they did not meet the inclusion criteria.

Table 1

Table 1

Back to Top | Article Outline

Coding and Classification of Variables

The articles selected that met the inclusion criteria were coded so as to categorize into the following characteristics: (a) Exercise type: Defined as either a single bout of exercise or a repeated bout exercise (e.g., repeated-sprints and sport-specific simulations). (b) Performance measure: Time to exhaustion, average and peak power, performance time, total work and distance completed and frequency of events. (c) Approximate exercise time: In studies employing a period of submaximal exercise before performance trial, only the performance aspect was counted. Recovery periods in repeated-sprint protocols were not included, and if a grand mean was calculated for repeated sprints, then the duration of 1 sprint and repetition was counted (see statistical analysis). (d) Training status of the participants: A trained participant refers to an athlete whose training plan is relevant for the respective exercise task, for example, Wilkes et al. (92) observing runners perform/compete in an 800-m race and Zabala et al. (94) observing BMX cyclists. Those participants described as healthy, active, and recreationally trained were classified as untrained. No sedentary participants were included. (e) Induced alkalosis: Calculated as the change in blood pH preingestion-postingestion in the experimental trial. To ensure consistency, only capillary blood results were analyzed because these were most common. (f) Induced acidosis: Calculated as the change in blood pH preexercise-postexercise in the placebo trial. To ensure consistency, only capillary blood results were analyzed because these were most common.

Back to Top | Article Outline

Statistical Analyses

The effectiveness of the NaHCO3 supplementation was quantified by determining the ES for each variable, which can be categorized as small (0.2), moderate (0.5), or high (0.8). This was calculated using the following equation:

This equation was reversed in the case of those studies employing performance time as the performance measure, as a lower number would be considered beneficial. An ES for studies using repeated-sprint protocols was calculated from the total work/distance completed in all of the sprints. When these data were not available, a grand mean and pooled SD from the sprints was calculated. A weighted ES was then calculated to account for changes in individual sample sizes as described in Matson and Tran (43):

The effect of training status, ingestion type, and exercise type on the ES were analyzed using a Mann-Whitney U test, and exercise duration using the Kruskal-Wallis test as the analysis of Z-scores demonstrated an absence of normal distribution. Differences between performance measures were analyzed using a 1-way analysis of variance. Pearson correlation coefficients were used to analyze the nature and magnitude of relationships between variables. No statistics were employed when observing the differences between trained and untrained subjects in each performance measure and exercise duration category because of the varied data sets available.

Back to Top | Article Outline

Results

There were 40 research articles that met the inclusion criteria for the meta-analysis, allowing the analysis of 58 ESs from 395 participants (348 men and 47 women). Of the articles included, 15 (38%) reported an ergogenic benefit. A tracking of positive and no effect publications by year is presented in Figure 1, with only those studies selected for inclusion in the meta-analysis shown to allow comparison within similar ingestion protocols. The summary of all the ESs is available in Table 2. The overall ES for the influence of NaHCO3 on performance regardless of performance measure, duration, and training status was 0.41 (weighted mean = 0.36). The overall ES was significantly higher in untrained participants compared with trained participants (p = 0.007), and higher in single bout as opposed to repeated bout exercises (p = 0.013). The ES was higher in studies administering NaHCO3 as a liquid solution as opposed to capsules but not significantly so (p = 0.457).

Table 2

Table 2

Figure 1

Figure 1

Exercise protocols employing a time to exhaustion or total work performance measure resulted in a much higher ES than the overall ES (0.60 and 0.63, respectively). The time to exhaustion ES however was lowered when the weighted mean is observed (0.50). In contrast, those studies using performance time or power as a performance measure resulted in much lower ESs of 0.17 and 0.27, respectively, with performance time reducing to 0.09 after weighting. Despite this, there were no significant differences in ESs between performance measures (F = 2.03, p = 0.12). None of the differences between exercise duration were significant (p = 0.501).

There was a moderate but significant overall relationship between ES and the state of induced alkalosis (n = 27, r = 0.45, p = 0.02), and this relationship was stronger in trained than in untrained participants (n = 15, r = 0.56, p = 0.03 and n = 12, r = 0.50, p = 0.10, respectively). The overall relationship between ES and the state of induced acidosis was weak and insignificant (n = 24, r = 0.25, p = 0.237).

Back to Top | Article Outline

Discussion

A moderate overall weighted ES for the impact of NaHCO3 on performance was calculated (0.36), lower than that reported by Matson and Tran in 1993 (0.44). This is possibly because of the increased number of publications challenging its efficacy as an ergogenic aid in recent years (Figure 1). Another explanation for this may be the greater number of trained participants in this review as a significantly lower ES was observed for this group. This finding is in contrast to previous opinion, with Webster et al. (89) claiming that the use of trained subjects was a factor consistently associated with improved performance with NaHCO3. Requena et al. (65) supported this suggestion claiming that more highly trained subjects have a higher maximal rate of anaerobic glycolysis, allowing alkaline treatment to have a more significant effect. It may instead be the case that training adaptations such as increased density of monocarboxylate transporter proteins (31) and improved muscle buffering capacity (19,90) are more effective than NaHCO3 administration for trained athletes, whereas their lesser trained counterparts are more reliant on the extra buffering capacity afforded by the NaHCO3. This is supported by the relationship observed between induced alkalosis and ES, as the correlation was statistically significant in trained but not untrained participants, suggesting that only greater inductions of alkalosis has the potential to influence performance in trained individuals as Zabala et al. suggested recently (94). It must be considered that these relationships are limited to the studies included in the meta-analysis and of capillary blood and also that a significant correlation does not represent causation.

A number of research articles have reported ergogenic effects for NaHCO3 when using repeated-sprint exercises, however, not until after the first (37) or second repetition (1,6,88). These studies suggest that a single bout exercise is unlikely to benefit from NaHCO3 administration, because its benefit arises from the improvement in acid-base recovery allowed between bouts (74). However, this study found a statistically higher performance ES in single bout as opposed to repeated bout exercises. It must be considered though that there are different proportions of trained to untrained participants in these categories, and ESs are similar when only taking into account trained participants.

The overall ES was higher in studies employing time to exhaustion or total work completed as a performance measure rather than performance time or power. However, the time to exhaustion and total work groups had a high proportion of untrained subjects, whereas the performance time group had a high proportion of trained subjects (only 1 untrained ES in group), therefore influencing the overall ESs. It is interesting that trained subjects in the performance time group had one of the lowest ESs, because it could be argued that this combination would be most applicable to elite sporting performance. Despite the differences between performance measures, there were no statistically significant differences in overall ESs. The absence of statistical differences between performance measures could be because of the differences in the size of the data sets between groups, coupled with the large confidence intervals, which often resulted in negative values at the lower 95% limit.

The most common duration of exercise protocols used to investigate the use of NaHCO3 was up to approximately 120 seconds (Table 2). This is presumable because high-intensity efforts of this duration are predominantly associated with anaerobic glycolysis. However, the overall ES for this duration of exercise was no different to medium (2–10 minutes) and long (>10-minute) duration protocols. Within the short duration category, the ES is much higher in untrained than in trained subjects, again suggesting that untrained subjects are more reliant on the extra buffering potential afforded by NaHCO3. However, once more, the confidence intervals must be taken into consideration. The similar overall ESs across exercise durations may suggest that the extra buffering capacity is not the sole mechanism behind its potential effect on performance. There has been some work to suggest that NaHCO3 may improve perceptual responses to exercise, which could account for the similarly moderate ES for longer exercise protocols (67,81,82). However, as with most research regarding NaHCO3, there is also a wealth of evidence on the contrary (1,60,78,93,95).

It should be considered when interpreting our findings that although the NaHCO3 dosages were similar in the observed studies, the method of administration differed. The majority of the studies administered the buffer in liquid solutions including water, flavored water, fruit juice and soup, whereas the other method used capsules. We have anecdotal evidence from our laboratory and others (94) that some side effects are induced by the taste of NaHCO3 in a liquid solution and that it is easier to tell the difference between placebo and NaHCO3 when ingested in a liquid solution as opposed to capsules. This is problematic for research design because there is a strong placebo effect associated with this particular buffer (47). The mean ES reported in this study is higher in those studies administering NaHCO3 in solution compare to capsules (0.46 and 0.32, respectively), particularly when observing the weighted mean (0.41 and 0.25, respectively) (Table 2). However, it must be added that there were no significant differences between said ESs. Future work should not only compare the incidence and severity of side effects between ingesting NaHCO3 in solution and capsules (as recently done by Carr et al. [13]) but also any potential differences in athletic performance.

Back to Top | Article Outline

Practical Applications

The ergogenic potential of NaHCO3 had an overall moderate ES and appeared to be more effective in recreationally as opposed to specifically trained participants. This ES however was highly variable when considering the 95% confidence intervals. Coaches and athletes can take the following practical applications from the results of this review: (a) The use of NaHCO3 should be made on an individual basis as although negative ESs were in the minority (Table 1), a number of the ESs had negative lower confidence intervals (Table 2), meaning a potentially adverse performance effect in some athletes. (b) Care should be taken when evaluating results from studies using performance measures and participants unrelated to their field. (c) The combination of trained participants and performance time resulted in a very weak weighted ES (0.05). (d) Potential performance improvements may not be limited to short exercise protocols. (e) Although it appears that only minor benefits are afforded to trained individuals, such small margins may be significant at the elite level. If NaHCO3 is to be used then it is suggested to experiment with loading protocols to develop an individual specific routine to achieve a peak alkalosis and minimize the risk of potential side effects (13). A recommended starting dosage is 0.2–0.4 g·kg−1·body weight−1 and 60–120 minutes preexercise in flavored water or capsules.

Future research should focus where possible on trained subjects performing sport-specific tasks, such as those studies on boxing (73), water polo (83), rugby (11), judo (1), and BMX cycling (94,95). Such research would avoid inflating the efficacy of NaHCO3 with untrained subjects who are unlikely to use it and so allow coaches, nutritionists, and athletes to make more informed decisions about their respective sport.

Back to Top | Article Outline

Acknowledgments

The authors wish to thank all those authors who provided us with missing data not available in their published articles.

Back to Top | Article Outline

References

1. Artioli GG, Gualano B, Coelho DF, Benatti FB, Galley AW, Lancha AH. Does sodium-bicarbonate ingestion improve simulated judo performance? Int J Sport Nutr Exerc Metab 17:206–217, 2007.
2. Aschenbach W, Ocel J, Craft L, Ward C, Spangenburg E, Williams J. Effect of oral sodium loading on high-intensity arm ergometry in college wrestlers. Med Sci Sports Exerc 32:669–675, 2000.
3. Balberman SE, Roby FB. The effects of induced alkalosis and acidosis on the work capacity of the quadriceps and hamstrings muscle groups. Int J Sports Med 4:143, 1983.
4. Bird SR, Wiles J, Robbins J. The effect of sodium bicarbonate ingestion on 1500-m racing time. J Sports Sci 13:399–403, 1995.
5. Bishop D, Claudius B. Effects of induced metabolic alkalosis on prolonged intermittent-sprint performance. Med Sci Sports Exerc 37:759–767, 2005.
6. Bishop D, Edge J, Davis C, Goodman C. Induced metabolic alkalosis affects muscle metabolism and repeated-sprint ability. Med Sci Sports Exerc 36:807–813, 2004.
7. Bouissou P, Defer G, Guezennec CY, Estrade PY, Serrurier B. Metabolic and blood catecholamine responses to exercise during alkalosis. Med Sci Sports Exerc 20:228–232, 1988.
8. Brien D, McKenzie D. The effect of induced alkalosis and acidosis on plasma lactate and work output in elite oarsmen. Eur J Appl Phsiol Occup Physiol 58:797–802, 1989.
    9. Burke LM, Pyne DB. Bicarbonate loading to enhance training and competitive performance. Int J Sport Physiol Perform 2:93–97, 2007.
    10. Calfee R, Fadale P. Popular ergogenic drugs and supplements in young athletes. Pediatrics 117:e577–e589, 2006.
    11. Cameron SL, McLay-Cooke RT, Brown RC, Gray AR, Fairbairn KA. Increased blood pH but not performance with sodium bicarbonate supplementation in elite rugby union players. Int J Sport Nutr Exerc Metab 20:307–321, 2010.
    12. Carr AJ, Gore CJ, Dawson B. Induced alkalosis and caffeine supplementation: Effects on 2,000-m rowing performance. Int J Sport Nutr Exerc Metab 21:357–364, 2011.
    13. Carr AJ, Slater GJ, Gore CG, Dawson B, Burke LM. Effect of sodium bicarbonate on [HCO3 ], pH, and gastrointestinal symptoms. Int J Sport Nutr Exerc Metab 21:189–194, 2011.
    14. Cho S, Chung D, Park S, Choi I. The effect of induced metabolic alkalosis with sodium bicarbonate on racing time, maximal oxygen uptake and anaerobic lactate threshold in competitive cyclists. Korean J Sports Sci 2:71–84, 1990.
    15. Coombes J, McNaughton LR. Effects of bicarbonate ingestion on leg strength and power during isokinetic knee flexion and extension. J Strength Cond Res 7:241–249, 1993.
    16. Costill DL, Verstappen F, Kuipers H, Janssen E, Fink W. Acid-base balance during repeated bouts of exercise: Influence of HCO3. Int J Sports Med 5:228–231, 1984.
    17. Dennig H, Talbott JH, Edwards HT, Dill DB. Effect of acidosis and alkalosis upon capacity for work. J Clin Invest 9:601–613, 1931.
    18. Dill DB, Edwards HT, Talbott JH. Alkalosis and the capacity for work. J Biol Chem 97:58–59, 1932.
    19. Edge J, Bishop D, Goodman C. The effects of training intensity on muscle buffer capacity in females. Eur J Appl Physiol 96:97–105, 2006.
    20. Gaitanos GC, Nevill ME, Brooks S, Williams C. Repeated bouts of sprint running after induced alkalosis. J Sports Sci 9:355–370, 1991.
    21. Gao J, Costill D, Horswill C, Park S. Sodium bicarbonate ingestion improves performance in interval swimming. Eur J Appl Physiol Occup Physiol 58:171–174, 1988.
    22. Goldfinch J, McNaughton L, Davies P. Induced metabolic alkalosis and its effects on 400-m racing time. Eur J Appl Physiol Occup 57:45–48, 1988.
      23. Hooker S, Morgan C, Wells C. Effect of sodium bicarbonate ingestion on time to exhaustion and blood lactate of 10k runners. Med Sci Sports Exerc 19:S68, 1987.
      24. Horswill CA, Costill DL, Fink WJ, Flynn MG, Kirwan JP, Mitchell JB, Houmard JA. Influence of sodium bicarbonate on sprint performance: Relationship to dosage. Med Sci Sports Exerc 20:566–569, 1988.
      25. Housh T, deVries H, Johnson G, Evans S, McDowell S. The effect of ammonium chloride and sodium bicarbonate ingestion on the physical working capacity at the fatigue threshold. Eur J Appl Phsiol Occup Physiol 62:189–192, 1991.
      26. Hunter AM, De Vito G, Bolger C, Mullany H, Galloway SDR. The effect of induced alkalosis and submaximal cycling on neuromuscular response during sustained isometric contraction. J Sports Sci 27:1261–1269, 2009.
      27. Inbar O, Rotstein A, Jacobs I, Kaiser P, Dlin R, Dotan R. The effects of alkaline treatment on short-term maximal exercise. J Sports Sci 1:95–104, 1983.
      28. Iwaoka K, Okagawa S, Mutih Y, Miyashita M. Effects of bicarbonate ingestion on the respiratory compensation threshold and maximal exercise performance. Jpn J Physiol 39:255–265, 1989.
      29. Jones NL, Sutton JR, Taylor R, Toews CJ. Effect of pH on cardiorespiratory and metabolic responses to exercise. J Appl Physiol 43:959–964, 1977.
      30. Joyce S, Minahan C, Anderson M, Osborne M. Acute and chronic loading of sodium bicarbonate in highly trained swimmers. Eur J Appl Physiol 112:1–9, 2011.
        31. Juel C. Regulation of pH in human skeletal muscle: Adaptations to physical activity. Acta Physiol 193:17–24, 2008.
        32. Katz A, Costill DL, King DS, Hargreaves M, Fink WJ. Maximal exercise tolerance after induced alkalosis. Int J Sports Med 5:107–110, 1984.
        33. Kindermann W, Keul J, Huber G. Physical exercise after induced alkalosis (bicarbonate or tris-buffer). Eur J Appl Phsiol Occup Physiol 37:197–204, 1977.
        34. Kowalchuk JM, Heigenhauser GJ, Jones NL. Effect of pH on metabolic and cardiorespiratory responses during progressive exercise. J Appl Physiol 57:1558–1563, 1984.
        35. Kozak-Collins K, Burke ER, Schoene RB. Sodium-bicarbonate ingestion does not improve performance in women cyclists. Med Sci Sports Exer 26:1510–1515, 1994.
        36. Kupcis PD, Slater GJ, Pruscino CL, Kemp JG. Influence of sodium bicarbonate on performance and hydration in lightweight rowing. Int J Sport Physiol Perf 7:11–18, 2012.
          37. Lavender G, Bird SR. Effect of sodium bicarbonate ingestion upon repeated sprints. Brit J Sports Med 23:41–45, 1989.
          38. Linderman J, Kirk L, Musselman J, Dolinar B, Fahey TD. The effects of sodium bicarbonate and pyridoxine-alpha-ketoglutarate on short-term maximal exercise capacity. J Sports Sci 10:243–253, 1992.
          39. Lindh AM, Peyrebrune MC, Ingham SA, Bailey DM, Folland JP. Sodium bicarbonate improves swimming performance. Int J Sports Med 29:519–523, 2008.
          40. Margaria R, Aghemo P, Sassi G. Effect of alkalosis on performance and lactate formation in supramaximal exercise. Eur J Appl Phsiol Occup Physiol 29:215–223, 1971.
          41. Marx J, Gordon S, Vos N, Nindl B, Gómez A, Volek J, Pedro J, Ratamess N, Newton R, French D, Rubin M, Häkkinen K, Kraemer W. Effect of alkalosis on plasma epinephrine responses to high intensity cycle exercise in humans. Eur J Appl Physiol 87:72–77, 2002.
          42. Materko W, Santos EL, Novaes JS. Effect of bicarbonate supplementation on muscular strength. J Exerc Physiol Online 11:25–33, 2008.
            43. Matson LG, Tran ZV. Effects of sodium bicarbonate ingestion on anaerobic performance: A meta-analytic review. Int J Sport Nutr 3:2–28, 1993.
            44. Matsuura R, Arimitsu T, Kimura T, Yunoki T, Yano T. Effect of oral administration of sodium bicarbonate on surface EMG activity during repeated cycling sprints. Eur J Appl Physiol 101:409–417, 2007.
            45. Maughan RJ. Contamination of dietary supplements and positive drug tests in sport. J Sports Sci 23:883–889, 2005.
            46. McCartney N, Heigenhauser GJ, Jones NL. Effects of pH on maximal power output and fatigue during short-term dynamic exercise. J Appl Physiol 55:225–229, 1983.
            47. McClung M, Collins D. “Because I know it will!”: Placebo effects of an ergogenic aid on athletic performance. J Sport Exerc Psychol 29:382–394, 2007.
            48. McKenzie DC. Changes in urinary pH following bicarbonate loading. Can J Sport Sci 13:254–256, 1988.
            49. McNaughton L, Dalton B, Palmer G. Sodium bicarbonate can be used as an ergogenic aid in high-intensity, competitive cycle ergometry of 1 h duration. Eur J Appl Physiol Occup Physiol 80:64–69, 1999.
            50. McNaughton LR. Bicarbonate ingestion: Effects of dosage on 60 s cycle ergometry. J Sports Sci 10:415–423, 1992.
            51. McNaughton LR. Sodium bicarbonate ingestion and its effects on anaerobic exercise of various durations. J Sports Sci 10:425–435, 1992.
            52. McNaughton LR, Siegler JC, Midgley A. The ergogenic effect of sodium bicarbonate. Curr Sport Med Rep 7:230–236, 2008.
            53. Mero AA, Keskinen KL, Malvela MT, Sallinen JM. Combined creatine and sodium bicarbonate supplementation enhances interval swimming. J Strength Cond Res 18:306–310, 2004.
            54. Nieper A. Nutritional supplement practices in UK junior national track and field athletes. Br J Sports Med 39:645–649, 2005.
            55. Parry-Billings M, MacLaren DP. The effect of sodium bicarbonate and sodium citrate ingestion on anaerobic power during intermittent exercise. Eur J Appl Physiol Occup Physiol 55:524–529, 1986.
            56. Pierce EF, Eastman NW, Hammer WH, Lynn TD. Effect of induced alkalosis on swimming time trials. J Sports Sci 10:255–259, 1992.
            57. Portington KJ, Pascoe DD, Webster MJ, Anderson LH, Rutland RR, Gladden LB. Effect of induced alkalosis on exhaustive leg press performance. Med Sci Sports Exerc 30:523–528, 1998.
            58. Potteiger JA, Webster MJ, Nickel GL, Haub MD, Palmer RJ. The effects of buffer ingestion on metabolic factors related to distance running performance. Eur J Appl Phsiol Occup Physiol 72:365–371, 1996.
              59. Poulus A, Docter H, Westra H. Acid-base balance and subjective feelings of fatigue during physical exercise. Eur J Appl Phsiol Occup Physiol 33:207–213, 1974.
              60. Price M, Moss P, Rance S. Effects of sodium bicarbonate ingestion on prolonged intermittent exercise. Med Sci Sports Exerc 35:1303–1308, 2003.
              61. Price MJ, Simons C. The effect of sodium bicarbonate ingestion on high-intensity intermittent running and subsequent performance. J Strength Cond Res 24:1834–1842, 2010.
              62. Pruscino CL, Ross MLR, Gregory JR, Savage B, Flanagan TR. Effects of sodium bicarbonate, caffeine, and their combination on repeated 200-m freestyle performance. Int J Sport Nutr Exerc Metab 18:116–130, 2008.
              63. Raymer GH, Marsh GD, Kowalchuk JM, Thompson RT. Metabolic effects of induced alkalosis during progressive forearm exercise to fatigue. J Appl Physiol 96:2050–2056, 2004.
              64. Renfree A. The time course for changes in plasma [H+] after sodium bicarbonate ingestion. Int J Sport Physiol Perform 2:323–326, 2007.
              65. Requena B, Zabala M, Padial P, Feriche B. Sodium bicarbonate and sodium citrate: Ergogenic aids? J Strength Cond Res 19:213–224, 2005.
              66. Robergs R, Hutchinson K, Hendee S, Madden S, Siegler J. Influence of pre-exercise acidosis and alkalosis on the kinetics of acid-base recovery following intense exercise. Int J Sport Nutr Exerc Metab 15:59–74, 2005.
              67. Roberston RJ, Falkel JE, Drash AL, Swank AM, Metz KF, Spungen SA, LeBoeuf JR. Effect of blood pH on peripheral and central signals of perceived exertion. Med Sci Sports Exerc 18:114–122, 1986.
              68. Robertson RJ, Falkel JE, Drash AL, Swank AM, Metz KF, Spungen SA, Leboeuf JR. Effect of induced alkalosis on physical work capacity during arm and leg exercise. Ergonomics 30:19–31, 1987.
              69. Ronsen O, Sundgot-Borgen J, Maehlum S. Supplement use and nutritional habits in Norwegian elite athletes. Scand J Med Sci Sports 9:28–35, 1999.
              70. Rupp JC, Bartels RL, Zuelzer W, Fox EL, Clark RN. Effect op sodium bicarbonate digestion on blood and muscle pH and exercise performance. Med Sci Sports Exerc 15:115, 1983.
              71. Shelton J, Praveen Kumar GV. Sodium bicarbonate—A potent ergogenic aid? Food Nutr Sci 1:1–4, 2010.
              72. Siegler JC, Gleadall-Siddall DO. Sodium bicarbonate ingestion and repeated swim sprint performance. J Strength Cond Res 24:3105–3111, 2010.
              73. Siegler JC, Hirscher K. Sodium bicarbonate ingestion and boxing performance. J Strength Cond Res 24:103–108, 2010.
              74. Siegler JC, Keatley S, Midgley AW, Nevill AM, McNaughton LR. Pre-exercise alkalosis and acid-base recovery. Int J Sports Med 29:545–551, 2008.
              75. Siegler JC, McNaughton LR, Midgley AW, Keatley S, Hillman A. Metabolic alkalosis, recovery and sprint performance. Int J Sports Med 31:797–802, 2010.
              76. Siegler JC, Midgley AW, Polman RCJ, Lever R. Effects of various sodium bicarbonate loading protocols on the time-dependent extracellular buffering profile. J Strength Cond Res 24:2551–2557, 2010.
              77. Sostaric SM, Skinner SL, Brown MJ, Sangkabutra T, Medved I, Medley T, Selig SE, Fairweather I, Rutar D, McKenna MJ. Alkalosis increases muscle K+ release, but lowers plasma [K+] and delays fatigue during dynamic forearm exercise. J Physiol 570:185–205, 2006.
              78. Stephens TJ, McKenna MJ, Canny BJ, Snow RJ, McConell GK. Effect of sodium bicarbonate on muscle metabolism during intense endurance cycling. Med Sci Sports Exerc 34:614–621, 2002.
              79. Sutton JR, Jones NL, Toews CJ. Growth hormone secretion in acid-base alterations at rest and during exercise. Clin Sci Mol Med 50:241–247, 1976.
              80. Sutton JR, Jones NL, Toews CJ. Effect of pH on muscle glycolysis during exercise. Clin Sci (Lond) 61:331–338, 1981.
              81. Swank A, Robertson RJ. Effect of induced alkalosis on perception of exertion during intermittent exercise. J Appl Physiol 67:1862–1867, 1989.
              82. Swank AM, Roberston RJ. Effect of induced alkalosis on perception of exertion during exercise recovery. J Strength Cond Res 16:491–499, 2002.
              83. Tan F, Polglaze T, Cox G, Dawson B, Mujika I, Clark S. Effects of induced alkalosis on simulated match performance in elite female water polo players. Int J Sport Nutr Exerc Metab 20:198–205, 2010.
              84. Tiryaki GR, Atterbom HA. The effects of sodium bicarbonate and sodium citrate on 600 m running time of trained females. J Sports Med Phys Fitness 35:194–198, 1995.
              85. Van Montfoort MCE, Van Dieren L, Hopkins WG, Shearman JP. Effects of ingestion of bicarbonate, citrate, lactate, and chloride on sprint running. Med Sci Sports Exerc 36:1239–1243, 2004.
              86. Vanhatalo A, McNaughton LR, Siegler J, Jones AM. Effect of induced alkalosis on the power-duration relationship for “All-out” Exercise. Med Sci Sports Exerc 42:563–570, 2010.
              87. Verbitsky O, Mizrahi J, Levin M, Isakov E. Effect of ingested sodium bicarbonate on muscle force, fatigue, and recovery. J Appl Physiol 83:333–337, 1997.
              88. Wahl P, Zinner C, Achtzehn S, Bloch W, Mester J. Effect of high- and low-intensity exercise and metabolic acidosis on levels of GH, IGF-I, IGFBP-3 and cortisol. Growth Horm IGF Res 20:380–385, 2010.
              89. Webster MJ, Webster MN, Crawford RE, Gladden LB. Effect of sodium bicarbonate ingestion on exhaustive resistance exercise performance. Med Sci Sports Exerc 25:960–965, 1993.
              90. Weston AR, Myburgh KH, Lindsay FH, Dennis SC, Noakes TD, Hawley JA. Skeletal muscle buffering capacity and endurance performance after high-intensity interval training by well-trained cyclists. Eur J Appl Phsiol Occup Physiol 75:7–13, 1996.
              91. Wijnen S, Verstappen F, Kuippers H. The influence of intravenous sodium bicarbonate administration on interval exercise: Acid-base balance and endurance. Int J Sports Med 5:130–132, 1984.
              92. Wilkes D, Gledhill N, Smyth R. Effect of acute induced metabolic alkalosis on 800-m racing time. Med Sci Sports Exerc 15:277–280, 1983.
              93. Wu C-L, Shih M-C, Yang C-C, Huang M-H, Chang C-K. Sodium bicarbonate supplementation prevents skilled tennis performance decline after a simulated match. J Int Soc Sports Nutr 7:33, 2010.
              94. Zabala M, Peinado A, Calderón F, Sampedro J, Castillo M, Benito P. Bicarbonate ingestion has no ergogenic effect on consecutive all out sprint tests in bmx elite cyclists. Eur J Appl Physiol 111:1–8, 2011.
              95. Zabala M, Requena B, Sanchez-Munoz C, Gonzalez-Badillo JJ, Garcia I, Oopik V, Paasuke M. Effects of sodium bicarbonate ingestion on performance and perceptual responses in a laboratory-simulated BMX cycling qualification series. J Strength Cond Res 22:1645–1653, 2008.
              96. Zajac A, Cholewa J, Poprzecki S, Waskiewicz Z, Langfort J. Effects of sodium bicarbonate ingestion on swim performance in youth athletes. J Sports Sci Med 8:45–50, 2009.
              Keywords:

              buffering; alkalosis; ergogenic aid; nutrition

              © 2012 National Strength and Conditioning Association