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Sleep Medicine Reviews Jun 2023The consumption of caffeine in response to insufficient sleep may impair the onset and maintenance of subsequent sleep. This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis Review
The consumption of caffeine in response to insufficient sleep may impair the onset and maintenance of subsequent sleep. This systematic review and meta-analysis investigated the effect of caffeine on the characteristics of night-time sleep, with the intent to identify the time after which caffeine should not be consumed prior to bedtime. A systematic search of the literature was undertaken with 24 studies included in the analysis. Caffeine consumption reduced total sleep time by 45 min and sleep efficiency by 7%, with an increase in sleep onset latency of 9 min and wake after sleep onset of 12 min. Duration (+6.1 min) and proportion (+1.7%) of light sleep (N1) increased with caffeine intake and the duration (-11.4 min) and proportion (-1.4%) of deep sleep (N3 and N4) decreased with caffeine intake. To avoid reductions in total sleep time, coffee (107 mg per 250 mL) should be consumed at least 8.8 h prior to bedtime and a standard serve of pre-workout supplement (217.5 mg) should be consumed at least 13.2 h prior to bedtime. The results of the present study provide evidence-based guidance for the appropriate consumption of caffeine to mitigate the deleterious effects on sleep.
Topics: Humans; Caffeine; Sleep; Polysomnography; Coffee; Sleep Deprivation
PubMed: 36870101
DOI: 10.1016/j.smrv.2023.101764 -
Nutrients Dec 2022Caffeine (1,3,7-trimethylxanthine) is one of the most widely consumed performance-enhancing substances in sport due to its well-established ergogenic effects. The use of... (Meta-Analysis)
Meta-Analysis Review
Caffeine (1,3,7-trimethylxanthine) is one of the most widely consumed performance-enhancing substances in sport due to its well-established ergogenic effects. The use of caffeine is more common in aerobic-based sports due to the ample evidence endorsing the benefits of caffeine supplementation on endurance exercise. However, most of this evidence was established with cycling trials in the laboratory, while the effects of the acute intake of caffeine on endurance running performance have not been properly reviewed and meta-analyzed. The purpose of this study was to perform a systematic review and meta-analysis of the existing literature on the effects of caffeine intake on endurance running performance. A systematic review of published studies was performed in four different scientific databases (Medline, Scopus, Web of Science, and SportDiscus) up until 5 October 2022 (with no year restriction applied to the search strategy). The selected studies were crossover experimental trials in which the ingestion of caffeine was compared to a placebo situation in a single- or double-blind randomized manner. The effect of caffeine on endurance running was measured by time to exhaustion or time trials. We assessed the methodological quality of each study using Cochrane’s risk-of-bias (RoB 2) tool. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean difference (SMD) estimated by Hedges’ g and 95% confidence intervals (CI). Results: A total of 21 randomized controlled trials were included in the analysis, with caffeine doses ranging between 3 and 9 mg/kg. A total of 21 studies were included in the systematic review, with a total sample of 254 participants (220 men, 19 women and 15 participants with no information about gender; 167 were categorized as recreational and 87 were categorized as trained runners.). The overall methodological quality of studies was rated as unclear-to-low risk of bias. The meta-analysis revealed that the time to exhaustion in running tests was improved with caffeine (g = 0.392; 95% CI = 0.214 to 0.571; p < 0.001, magnitude = medium). Subgroup analysis revealed that caffeine was ergogenic for time to exhaustion trials in both recreational runners (g = 0.469; 95% CI = 0.185 to 0.754; p = 0.001, magnitude = medium) and trained runners (g = 0.344; 95% CI = 0.122 to 0.566; p = 0.002, magnitude = medium). The meta-analysis also showed that the time to complete endurance running time trials was reduced with caffeine in comparison to placebo (g = −0.101; 95% CI = −0.190 to −0.012, p = 0.026, magnitude = small). In summary, caffeine intake showed a meaningful ergogenic effect in increasing the time to exhaustion in running trials and improving performance in running time trials. Hence, caffeine may have utility as an ergogenic aid for endurance running events. More evidence is needed to establish the ergogenic effect of caffeine on endurance running in women or the best dose to maximize the ergogenic benefits of caffeine supplementation.
Topics: Male; Humans; Female; Caffeine; Physical Endurance; Performance-Enhancing Substances; Running; Bicycling; Athletic Performance; Randomized Controlled Trials as Topic
PubMed: 36615805
DOI: 10.3390/nu15010148 -
Sports Health 2021Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use. (Meta-Analysis)
Meta-Analysis
CONTEXT
Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use.
OBJECTIVE
To evaluate the reported adverse effects of energy drink consumption.
DATA SOURCES
The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to November 2019, and pertinent data were abstracted.
STUDY SELECTION
Only clinical studies reporting adverse events after energy drink consumption were included.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 4.
DATA EXTRACTION
Data regarding sample size characteristics, energy drink characteristics, comparators, and all adverse events were extracted in duplicate and recorded.
RESULTS
A total of 32 studies and 96,549 individuals were included. Frequently reported adverse events in the pediatric population were insomnia (35.4%), stress (35.4%), and depressive mood (23.1%). Frequently reported adverse events in the adult population were insomnia (24.7%), jitteriness/restlessness/shaking hands (29.8%), and gastrointestinal upset (21.6%). Alcohol mixed with energy drinks significantly reduced the likelihood of sedation effects but increased the likelihood of stimulatory effects. Energy drink consumption significantly increased the odds of insomnia (OR, 5.02; 95% CI, 1.72-14.63) and jitteriness/activeness (OR, 3.52; 95% CI, 1.28-9.67) compared with the control group.
CONCLUSION
The authors recommend that individuals avoid frequent energy drink consumption (5-7 energy drinks/week) and avoid co-consumption with alcohol; increased regulatory standards should be placed in the sale of energy drinks, particularly with regard to the pediatric population.
Topics: Alcohol Drinking; Caffeine; Depression; Energy Drinks; Gastrointestinal Diseases; Humans; Sleep Initiation and Maintenance Disorders; Stress, Psychological
PubMed: 33211984
DOI: 10.1177/1941738120949181 -
General Hospital Psychiatry 2022Caffeine has been purported to have anxiogenic and panicogenic properties, specifically salient in patients with panic disorder (PD). However, compilations of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Caffeine has been purported to have anxiogenic and panicogenic properties, specifically salient in patients with panic disorder (PD). However, compilations of the magnitude of the effect of caffeine on anxiety and panic attacks are lacking and potential dose-response relationships have not been examined.
OBJECTIVES
In the present systematic review and meta-analysis, we aimed to examine the acute effects of placebo-controlled caffeine challenge on occurrence of panic attacks and subjective anxiety in patients with PD and healthy controls (HC), including dose-response relationships.
METHODS
Systematic searches were performed in six databases. We included blinded placebo-controlled studies of acute caffeine challenge on panic attacks and/or subjective anxiety in adult patients with PD.
RESULTS
Of the 1893 identified articles, ten met our inclusion criteria. The 9 studies investigating panic attacks included 237 patients, of which 51.1% had a panic attack following caffeine, but none after placebo. Six of these studies compared 128 patients with 115 healthy controls (HC), finding that patients (53.9%) were more vulnerable than HC (1.7%) for panic attacks following caffeine (log RR: 3.47; 95% CI 2.06-4.87). Six studies investigated subjective anxiety in 121 patients and 111 HC following caffeine, with an overall effect indicating increased sensitivity to the anxiogenic effects of caffeine in the patient group (Hedges' g = 1.02 [95% CI: 0.09-1.96]). The restricted range of caffeine employed [400-750 mg] and few studies (3) not using 480 mg prevented any meaningful analysis of a dose-response relationship.
LIMITATIONS
Of the ten studies included, only 2 reported anxiety data for the placebo condition, precluding a proper meta-analysis comparing anxiogenic effects of caffeine and placebo. The restricted dose range used prevented assessment of dose-response relationships.
CONCLUSIONS
The results confirm that caffeine at doses roughly equivalent to 5 cups of coffee induces panic attacks in a large proportion of PD patients and highly discriminates this population from healthy adults. Caffeine also increases anxiety in PD patients as well as among healthy adults at these doses although the exact relationship between caffeine-induced anxiety and panic attacks remains uncertain. The results suggest that caffeine targets important mechanisms related to the pathophysiology of PD.
IMPLICATIONS
Future studies should employ a wider range of caffeine doses and investigate contributions of biological and psychological mechanisms underlying the anxiogenic and panicogenic effects of caffeine. In the clinic, patients with PD should be informed about the panicogenic and anxiogenic effects of caffeine, with the caveat that little is known regarding smaller doses than 480 mg. Registration. PROSPERO (www.crd.york.ac.uk/prospero) registration number CRD42019120220.
Topics: Adult; Anxiety; Anxiety Disorders; Caffeine; Humans; Panic Disorder
PubMed: 34871964
DOI: 10.1016/j.genhosppsych.2021.11.005 -
Journal of the American Academy of... Jul 2023New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014...
BACKGROUND
New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies.
OBJECTIVE
To provide evidence-based recommendations related to management of AD in adults using topical treatments.
METHODS
A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations.
RESULTS
The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines.
LIMITATIONS
The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data.
CONCLUSIONS
Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.
Topics: Adult; Humans; Dermatitis, Atopic; Calcineurin Inhibitors; Dermatologic Agents; Administration, Topical; Glucocorticoids; Anti-Infective Agents, Local; Histamine Antagonists
PubMed: 36641009
DOI: 10.1016/j.jaad.2022.12.029 -
Nutrients Jun 2022Nutritional ergogenic aids (NEAs) are substances included within the group of sports supplements. Although they are widely consumed by athletes, evidence-based analysis... (Meta-Analysis)
Meta-Analysis Review
Nutritional ergogenic aids (NEAs) are substances included within the group of sports supplements. Although they are widely consumed by athletes, evidence-based analysis is required to support training outcomes or competitive performance in specific disciplines. Combat sports have a predominant use of anaerobic metabolism as a source of energy, reaching peak exertion or sustained effort for very short periods of time. In this context, the use of certain NEAs could help athletes to improve their performance in those specific combat skills (i.e., the number of attacks, throws and hits; jump height; and grip strength, among others) as well as in general physical aspects (time to exhaustion [TTE], power, fatigue perception, heart rate, use of anaerobic metabolism, etc.). Medline/PubMed, Scopus and EBSCO were searched from their inception to May 2022 for randomised controlled trials (RCTs). Out of 677 articles found, 55 met the predefined inclusion criteria. Among all the studied NEAs, caffeine (5-10 mg/kg) showed strong evidence for its use in combat sports to enhance the use of glycolytic pathways for energy production during high-intensity actions due to a greater production of and tolerance to blood lactate levels. In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved. Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion. Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports. Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.
Topics: Athletes; Athletic Performance; Caffeine; Dietary Supplements; Humans; Performance-Enhancing Substances; Sports Nutritional Physiological Phenomena
PubMed: 35807770
DOI: 10.3390/nu14132588 -
Pediatrics Nov 2021In this state-of-the-art review, we highlight the major advances over the last 5 years in neonatal acute kidney injury (AKI). Large multicenter studies reveal that... (Review)
Review
In this state-of-the-art review, we highlight the major advances over the last 5 years in neonatal acute kidney injury (AKI). Large multicenter studies reveal that neonatal AKI is common and independently associated with increased morbidity and mortality. The natural course of neonatal AKI, along with the risk factors, mitigation strategies, and the role of AKI on short- and long-term outcomes, is becoming clearer. Specific progress has been made in identifying potential preventive strategies for AKI, such as the use of caffeine in premature neonates, theophylline in neonates with hypoxic-ischemic encephalopathy, and nephrotoxic medication monitoring programs. New evidence highlights the importance of the kidney in "crosstalk" between other organs and how AKI likely plays a critical role in other organ development and injury, such as intraventricular hemorrhage and lung disease. New technology has resulted in advancement in prevention and improvements in the current management in neonates with severe AKI. With specific continuous renal replacement therapy machines designed for neonates, this therapy is now available and is being used with increasing frequency in NICUs. Moving forward, biomarkers, such as urinary neutrophil gelatinase-associated lipocalin, and other new technologies, such as monitoring of renal tissue oxygenation and nephron counting, will likely play an increased role in identification of AKI and those most vulnerable for chronic kidney disease. Future research needs to be focused on determining the optimal follow-up strategy for neonates with a history of AKI to detect chronic kidney disease.
Topics: Acute Kidney Injury; Biomarkers; Caffeine; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Infant, Premature; Kidney; Lipocalin-2; Multicenter Studies as Topic; Oxygen Consumption; Renal Replacement Therapy; Research; Risk Factors; Theophylline; Water-Electrolyte Balance
PubMed: 34599008
DOI: 10.1542/peds.2021-051220 -
Nutrients Jun 2020Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing... (Meta-Analysis)
Meta-Analysis
Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing competition, its significance is not sufficiently established. This review aimed to provide nutritional strategies to optimize performance and recovery in rowing athletes based on a literature review. Following the guidelines given in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we performed web searches using online databases (Pubmed, Web of Science, Wiley Online Library, ACS Publications, and SciFinder). Typically, a rowing competition involves a 6-8-min high-intensity exercise on a 2000-m course. The energy required for the exercise is supplied by muscle-stored glycogens, which are derived from carbohydrates. Therefore, rowing athletes can plan their carbohydrate consumption based on the intensity, duration, and type of training they undergo. For effective and safe performance enhancement, rowing athletes can take supplements such as β-alanine, caffeine, β-hydroxy-β-methylbutyric acid (HMB), and beetroot juice (nitrate). An athlete may consume carbohydrate-rich foods or use a carbohydrate mouth rinse. Recovery nutrition is also very important to minimize the risk of injury or unexplained underperformance syndrome (UUPS) from overuse. It must take into account refueling (carbohydrate), rehydration (fluid), and repair (protein). As lightweight rowing athletes often attempt acute weight loss by limiting food and fluid intake to qualify for a competition, they require personalized nutritional strategies and plans based on factors such as their goals and environment. Training and competition performance can be maximized by including nutritional strategies in training plans.
Topics: Athletes; Athletic Performance; Caffeine; Dietary Carbohydrates; Dietary Supplements; Energy Metabolism; Female; Fluid Therapy; Glycogen; Humans; Male; Muscle, Skeletal; Nitrates; Nutritional Physiological Phenomena; Nutritional Requirements; Physical Conditioning, Human; Water Sports; beta-Alanine
PubMed: 32516908
DOI: 10.3390/nu12061685 -
Effects of dietary supplements on athletic performance in elite soccer players: a systematic review.Journal of the International Society of... Dec 2023Dietary supplements are widely used among athletes, and soccer players are no exception. Nevertheless, evidence supporting the use of dietary supplements aiming to... (Review)
Review
Dietary supplements are widely used among athletes, and soccer players are no exception. Nevertheless, evidence supporting the use of dietary supplements aiming to enhance performance in soccer is somewhat contradictory, scarce, or even nonexistent. Thus, the present study aimed to systematically review and synthesize the effects of dietary supplements on athletic performance (e.g. distance covered, sprinting, jump performance) in elite soccer players. Studies enrolling highly trained, elite, and world-class soccer players using dietary supplements were searched in MEDLINE/PubMed, Web of Science, Scopus, and EBSCO databases in June 2022. In total, 1043 studies were identified, and 18 met the eligibility criteria. The studies evaluated the impacts on athletic performance of several dietary supplements, including caffeine, creatine, protein, beverages with carbohydrates and electrolytes, tart cherry juice, nitrate-rich beetroot juice, sodium bicarbonate with minerals, yohimbine, and a proprietary nutraceutical blend. Caffeine supplementation in doses between 3 and 6 mg/kg of body mass may improve jump height and sprint ability, particularly in female players, but individual response to caffeine must be considered. Creatine may improve sprint, agility, and in female players, jump performance. Protein supplementation can improve sprint and jump performance between matches, especially if protein ingested from food is not up to recommendations. Beverages containing carbohydrates and electrolytes can be used as part of the strategies to achieve carbohydrate intake during training and match-days but used alone do not benefit athletic performance. Tart cherry juice might be useful for maintaining athletic performance after matches that produce higher force loss and exercise-induced muscle damage, although polyphenols from the diet might attenuate the effects of tart cherry supplementation. Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches. Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances. Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players. Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.
Topics: Humans; Female; Soccer; Caffeine; Sodium Bicarbonate; Creatine; Nitrates; Athletic Performance; Dietary Supplements; Electrolytes; Carbohydrates
PubMed: 37462346
DOI: 10.1080/15502783.2023.2236060 -
Arab Journal of Urology 2021To analyse the current therapeutic options for patients with premature ejaculation (PE) and highlight their mechanism(s) of action, effectiveness, advantages and... (Review)
Review
To analyse the current therapeutic options for patients with premature ejaculation (PE) and highlight their mechanism(s) of action, effectiveness, advantages and limitations. A literature search was conducted using the PubMed database searching for articles exploring different PE treatment modalities. A Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) approach was used to report the results of the literature search. A total of 149 articles were included in this review. The currently available treatment methods for PE include behavioural therapy, local anaesthetics, tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective phosphodiesterase inhibitors. Most PE treatments are either experimental or used off-label. New treatments are certainly warranted to overcome this exasperating sexual dysfunction. AIPE: Arabic Index of Premature Ejaculation; CNS: central nervous system; CYP: cytochrome P450; ED: erectile dysfunction; FDA: United States Food and Drug Administration; H1: histamine receptors; 5-HT: 5-hydroxytryptamine; IELT: The intravaginal ejaculation latency time; IPE: Index of Premature Ejaculation; M1: muscarinic receptors; OCD: obsessive-compulsive disorder; PDE5: phosphodiesterase type 5; PE: premature ejaculation; PEP: Premature Ejaculation Profile; PRO: patient-reported outcome; RCT: randomised controlled trial; SS: Severance Secret (cream); SSRIs: selective serotonin reuptake inhibitors; TCAs: tricyclic antidepressants.
PubMed: 34552780
DOI: 10.1080/2090598X.2021.1943273