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Lit review

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Lit review

  1. 1. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 1Sodium Bicarbonate: A Role in Collegiate SwimmingAllison KliewerUniversity of the Incarnate WordNovember 20, 2012
  2. 2. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 2IntroductionCompetitive athletes compete and train to the best of their abilities. They have to beable to perform in any condition and at their best in order to excel in a sport. Athletes trying toachieve at the highest level of competition often use ergogenic aids such as creatine, caffeine,and ephedrine to enhance sport performance. An ergogenic aid is defined as “any means ofenhancing energy utilization, including energy production, control, and efficiency” (Silver,2001). Albeit limited, the use of ergogenic aids has been increasing in the collegiate athletepopulation (Dascombe et al, 2010).Athletes have been using special foods to enhance physical performance for manyyears. In 500 BC athletes would eat the liver of a deer or the heart of a lion in beliefs that thefoods would provide speed and courage needed for victory in sport or battle (Rosenbloom andRosbruck, 2008). Today many dietary supplements are available for athletes but the factremains that very few improve performance, however, sport nutrition and weight losssupplements are over the $18 billion dollar mark in sales (Rosenbloom and Rosbruck, 2008).Health claims of dietary supplements are regulated by the Dietary Supplements and HealthEducation Act of 1994 (DSHEA). The DSHEA prohibits claims that diagnose, mitigate, treat, cureor prevent specific disease or medical conditions, but allows drug manufactures to make healthclaims related to body structure and function (ADA, 2009). Claims for enhanced performancecan be made, whether valid or not, without demonstrated safety and efficacy of a product(ADA, 2009).
  3. 3. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 3To understand the full nature of ergogenic use by collegiate athletes, knowledge ofnutrition, supplements and performance, motivation for use, environmental influences,attitude and efficacy need to be determined.Use of Ergogenic AidsThe use of performance enhancing substance unfortunately begins at an early age, asseen the Goulet et study, 2010, that showed one out of four young athletes use performanceenhancing supplements. A retrospective survey of self-reported use of performance enhancingsubstances in young athletes found that 25% of the 3527 athletes took one or more of 15prohibited or restricted substances banned by the International Olympic Committee (IOC). Thesurvey was sent to civic and school sport programs across Quebec. The mean age was 15 years.Goulet et at found a significant relationship associated with use of supplement behavior,athletic level, and subjective norms (2010). If the athlete believed supplementation wouldincrease the chances to compete on a level playing field with opponents or make an elite team,the use of supplementation increased. Cost and effectiveness had a moderate influence on theathlete’s intention to use supplements. Coaches, physicians, teammates and friends can have asignificant influence of intention to use or abstain from using supplements. Moral obligationwas the most significant influence for athletes not to take supplements. Athletic attitude wasfound not to be the sole factor, rather the athletes psychosocial environment measured byfactors such as subjective norms and facilitating factors have significant impact on the decisionto use supplements (Goulet et al, 2010).Nutritional knowledge of Collegiate Athletes
  4. 4. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 4Although athletes are familiar with the use of supplements, many lack basic nutritionknowledge. Based on a true or false nutrition questionnaire, Ozdogan, Y. and Ozcelik, A. (2011),found of the 343 participants receiving sports education at a university level, neither athletesnor coaches were found to have sufficient nutrition knowledge. The results are similar to thefindings of Torres-McGhee et al, who conducted a cross-sectional study on division I, II, and IIIinstitutions across the United States surveying nutritional knowledge of athletes, coaches,athletic trainers, and strength and conditioning specialists (2012). A questionnaire of 20 itemsbased on nutritional resources, basic nutrition, supplements and performance, weightmanagement, and hydration was sent to various institutions via email. Adequate sportsnutrition knowledge was defined as an overall score of 75% out of a possible 100% in alldomains. Total response rate was 38% of the 100 National Collegiate Athletic Association(NCAA) institutions recruited; subjects consisted of 185 athletes, 131 coaches, 192 athletictrainers, and 71 strength and conditioning specialists. The average score of basic nutritionknowledge was 68.5%. Only 35.9% of coaches and 9% of athletes received an adequate score.Therefore, it is shown that both coaches and athletes have an inadequate base knowledge ofnutrition. Athletes and coaches also had the lowest scores in the knowledge for supplementsand performance domain.Athlete’s Attitude/Beliefs/Influences on Use of Ergogenic AidsA study of use and perceptions of nutrition and supplements was conducted byKarabudak and Ercumen on elite water sport athletes who competed at national, internationaland Olympic levels within Europe (2011). Results show that 72% of athletes take supplements,
  5. 5. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 5and believe they are necessary to be successful in sport. The primary purpose for takingsupplements was to provide energy, maintain strength, maintain health, and restore nutrients.The most commonly used supplements by swimmers were multivitamins, multivitamin withminerals and creatine. The lack of congruence between the reasons and supplements used,shows poor understanding of why the athletes take supplements. Fourty-one percent of theathletes claimed an explanation for not seeking further information regarding a specificsupplement was that “the product must be safe since it is a commonly advice.” Results alsoindicate that the belief of supplements as an unavoidable part of competition, and the pressureto take dietary supplements is reflected in the high prevalence of use (Karabudak and Ercumen,2011). Fifty-four percent of those who do not take supplements and 78% of those who do takesupplements felt well informed about nutrition and nutrition supplements, however, otherresults showed that 53% of athletes had minimal or no knowledge about the supplements theytook, and only 36% of those who used supplements were aware of the possible contamination.The authors conclude that athletes appear to take supplements with poor understanding ofwhy they take them (Karabudak and Ercumen, 2011).Froiland et al, 2004, conducted a survey on 207 male and female division I athletes. Thesurvey was developed to determine an athlete’s definition of supplement, use and regularity ofsupplements, source of information and recommendations regarding use and reasons forchoosing to use, supplemental frequency of use, personal explanation for use and how itenhances performance or improve health, and demographics. Only 11% reported having neverused supplements and 34% accurately defined supplements by including a positive effect onsport performance, strength, muscle, and recovery in their definition. Of those who used, 86%
  6. 6. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 6took supplements for energy. Most information on supplements was obtained from either,family, teammates, strength coach, athletic trainer, registered dietitian (RD), friend or coach.The reasons for use were for health, strength and power, increased energy, and weight andmuscle gain. Thirty-three percent did not consider fluid and calorie replacement products as adietary supplement, and only 37% correctly identified the appropriate function of vitaminswhile 30% thought vitamins provided energy. Therefore, it is evident that athletes do not havea clear or complete understanding of what qualifies as a dietary supplement. It should be notedthe athletic department provided a RD specializing in sports nutrition at no charge to theathletes. In this study advice given by staff clearly affected the choices of the athletes regardingsupplementation.Recent master’s theses papers have examined the use of supplements in collegiateathletes. Burgio, R., 2006, determined the nutritional knowledge base of student-athletesattending California State University in Northridge (CSUN). Burgio found that CSUN athletes hadinadequate nutrition knowledge and 67% asked for improved sport performance education. Ofthe CSUN athletes taking supplements, many lacked basic understanding of supplements andtheir physiological impact. Burgio found that athletes believe that a higher intake of nutritionalsupplementation is required in order to maximize recovery, improve training adaptations,intensity and performance and/or avoid illness and maintain health, in agreement withconclusions published by Froiland et al, 2004. Athlete’s reasons for use include physical demandof their respective sport, teammates, coaches and parents. Based on the findings of Burgio in2006, Rodriguez, D. developed a brochure on nutrition education to enhance athletic
  7. 7. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 7performance as a master’s thesis, and found the brochure to be useful and highly valued by theCSUN athletes with recommendations for more information regarding supplements (2012).Hansen, T. (2010) and Lewis, M. (2012) conducted similar master’s theses papers as thatof Burgio in 2006. Hansen surveyed 147 division I female soccer players and found that thispopulation was most influenced by RDs and strength and conditioning coaches regardingnutrition related knowledge (2010). Lewis surveyed 152 male and female division I athletes ofvarious sports with a 14 item questionnaire. Results showed that 51% of those that usednutritional ergogenic aids, and 33% of those who did not, believed supplements are the mosteffective way to build muscle and increase energy (2012). Of the 80% who used nutritionalergogenic supplements, 90% reported an experienced benefit.Caffeine is the most widely used ergogenic aid with elite competitors (Applegate, 1999).The ergogenic dose is between 250 mg and 350 mg, or 3-13 mg per kg body weight, which cansometimes result in restlessness, nervousness and insomnia (Ghaphery, 1995 and Applegate,1999). Creatine is also a commonly used ergogenic aid. Athletes take the supplement ofapproximately 20-25 g per day, for several days, to increases creatine levels in the muscle by 20percent to delay fatigue and enhance performance (Applegate, 1999).Sodium Bicarbonate as an Ergogenic AidSodium bicarbonate (SB), more commonly known as baking soda, has been used foryears. As an ergogenic aid SB is reported to reduce the negative effects of acid build up in thecirculation. SB proponents claim that it increases endurance, shortens recovery time, and helpsincrease intensity during exercise. In addition, claims by supplement shops and drug
  8. 8. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 8manufacture’s include that taking SB will increase intensity with resistance training, help withmuscle recovery, and maximize physique and performance impact. There are no regulationsagainst the use of SB and it is not banned by the IOC or NCAA. However, there is conflictingevidence in the literature that the supplement enhances performance, as the ergogenic effectsof SB have been demonstrated in some types of exercise and not others. There is limitedresearch on competitive collegiate swimmers even though many swimmers use it and manycoaches recommend using it (personal experience). Conclusive evidence is needed todetermine the role of SB on competitive swimmers (Edge, J., Bishop, D., and Goodman, C.2006).Mechanism of Sodium BicarbonateDuring high-intensity exercise the body is supplied energy via anaerobic glycolysis. Theby-product of anaerobic glycolysis is lactic acid which builds up within the muscle cell, inhibitingenergy production, and resulting in fatigue (Ghaphery, N. A. 1995). The buildup of lactic acideventually will leak out of the muscle cell into the blood (Ghaphery, N. A. 1995). Sodiumbicarbonate is used as a buffering agent in the extracellular environment to improveperformance during continuous short-term high intensity work. Increased extracellularbuffering capacity efficiently buffers diffused hydrogen ions and lactate. This helps to indirectlymaintain intracellular pH because SB cannot diffuse directly into the muscle cells and affectintracellular pH (Ghaphery, N. A. 1995).Preventing a decrease in blood pH via increased buffering capacity has beenhypothesized to provide a delay in fatigue and enhance performance. Fatigue is attributed to
  9. 9. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING 9lower pH values which inhibit muscular contraction by: inhibiting enzyme activity in keymetabolic pathways (glycolysis, citric acid cycle and electron transport oxidativephosphorylation), inhibiting the release of calcium ions from the sarcoplasmic reticulum andthe binding of calcium ions to the protein troponin reducing the rate of cross bridge cycling. Italso impairs the rate of depolarization of the muscle membrane and propagation of the neuralimpulse initiated at the motor end plate (Requena et al, 2005).Intra and extracellular buffer systems act to reduce buildup of hydrogen ions bypreventing a large drop in pH during intense muscle contractions (Edge, J., Bishop, D., andGoodman, C. 2006). Sodium bicarbonate ingestion acts as a buffering agent and is thought toimprove performance in short term anaerobic exercise by reducing the accumulation ofhydrogen ions in skeletal muscle, interstitium, and blood (Edge, J., Bishop, D., and Goodman, C.2006). Sodium bicarbonate facilitates efflux of hydrogen ions and lactic acid from cells andreportedly increases the rate of ATP production. (Raymer, G., Marsh, G., Kowalchuk, T., andThompson, R. 2004). Edge et al. found SB ingestion leads to a greater lactate threshold, meanpower, and short term endurance (2006).Conclusions and Future ResearchBased of the articles, sodium bicarbonate does benefit sport performance in highintensity short exercises as well as longer moderate intensity exercise. The ergogenic effects aremoderate and do not dramatically improve performance, rather it helps athletes stay at a highintensity for a longer period of time due to the muscle buffering capacity.
  10. 10. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING10There have only been limited studies conducted with swimmer athletes, Zajac et al(2009) and Lindh et al (2008), of small subject size and lack of female athletes that limit thevalidity. Of the studies conducted on swimmers, none reported on the motivation behind takingSB such as health claims, coach recommendations, influence of other athletes, perceivedeffectiveness, perceived experienced benefit, reported gastrointestinal risk, source ofinformation about SB, knowledge of basic nutrition, knowledge of supplement use and sports,frequency of ingestion, how much money the athlete spends on SB, reasons for furtherresearch of SB or lack of by the athlete, perceived pressure to take SB, use with othersupplements, or personal explanation for reasons to take SB. As previously addressed, there is adirect relationship between an athlete’s attitude/beliefs and the decision to use ergogenic aids.Therefore, to fully understand the role SB plays on collegiate swimming, the above criteria needto be evaluated in collegiate swimmers who currently or have previously taken SB.
  11. 11. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING11ReferencesBurigo, R. (2006). Development of nutritional information for the CSUN varsity athlete.Unpublished Master’s Thesis.Dascombe, B., Karunaratna, M., Cartoon, J., Fergie, B., & Goodman, C. (2010) Nutritionalsupplementation habits and perceptions of elite athletes within a state-based sportinginstitute. Journal of Science and Medicine in Sport. 13(2): 274-280.Edge, J., Bishop, D., & Goodman, C. (2006). Effects of chronic NaHCO ingestion during intervaltraining on changes to muscle buffer capacity, metabolism, and short-term enduranceperformance. Journal of Applied Physiology, 101, 918-925.dio:10.1152/japplphysiol.01534.2005.Froiland, K., Koszewski, W., Hingst. J. & Kopecky, L. (2004). Nutritional supplement use amongcollege athletes and their sources of information. International Journal of SportNutrition and Exercise Metabolism. 14: 104-120.Ghaphery, N. A. (1995) Performance enhancing drugs. Orthopedic Clinics of North America, 26(3), 438-439.Goulet, C., Valois, P., Buist, A. & Cote, M. (2010). Predictors of the use of performance-enhancing substances by young athletes. Clinical Journal of Sports Medicine. 20(4): 243-248.Hasnsen, T. (2010). Attitude and efficacy toward nutrition-related practices in division I femalesoccer players. Master’s Theses.
  12. 12. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING12Karabudak, E. & Ercumen, S. (2011). Water sports athletes and nutritional supplements: A studyof use and perceptions. Scientific Research and Essays. 6(2): 4839-4847.Lewis, M., (2012). Evaluation of knowledge beliefs and use of nutritional ergogenic aids amongcollegiate athletes. Master’s Theses. paper 835.Lindh, A., Peyrebrune, M., Ingham, S., Bailey, D., & Folland, J. (2008). Sodium bicarbonateimproves swimming performance. International Journal of Sports Medicine. 29: 519-523.Ozdogan, Y. & Ozcelik, A. (2011). Evaluation of the nutritional knowledge of sports departmentstudents of universities. Journal of the International Society of Sports Nutrition. 8: 11.Raymer, G., Marsh, G., Kowalchuk, T., & Thompson, R. (2004). Etabolic effects of inducedalkalosis during progressive forearm exercise to fatigue. Journal of Applied Physiology,96, 2050-2056. doi:10.1152/japplphysoiol.01261.2003.Requena, B., Zabala, M., Padial, P. & Feriche, B. (2005). Sodium bicarbonate and sodium citrate:Ergogenic aids? Journal of Strength and Conditioning Research. 19; 1: 213-224.Rodriguez, D. (2012). Nutrition made easy: A brochure of nutrition education to enhanceathletic performance of the CSUN athlete. Master’s Project.Torres-McGehee, T., Pritchett, K., zippel, D., Minton, D., Cellamare, A. & Sibilia, M. (2012).Sports nutrition knowledge among collegiate athletes, coaches, athletic trainers, andstrength and conditioning specialists. Journal of Athletic Training. 47(2): 205-211.
  13. 13. SODIUM BICARBONATE: A ROLE IN COLLEGIATE SWIMMING13Zajac, A., Cholewa, J., Poprzecki, S Waskiewicz,Z., & Langfort, J. (2009). Effects of sodiumbicarbonate ingestion on swim Performance in youth athletes. Journal of Sports Scienceand Medicine, 8, 45-50.(2009). Position of the American Dietetic Association, Dietitians of Canada, and the AmericanCollege of Sports Medicine: Nutrition and athletic performance. Journal of the AmericanDietetic Association. Doi:10.1016/j.jada.2009.01.005.

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