Context: Carbohydrate (CHO) and caffeine (CAF) both improve endurance performance. Purpose: To determine by systematic literature review coupled with meta-analysis whether CAF ingested with CHO (CHO+CAF) improves endurance performance more than CHO alone. Methods: Databases were searched using the keywords caffeine, endurance, exercise, carbohydrate, and performance. Criteria for inclusion were studies that used human subjects performing an endurance-exercise performance task and included both a CHO and CHO+CAF condition. Effect sizes (ESs) were calculated as the standardized mean difference. Results: Twenty-one studies met the criteria for analysis. ESs for individual studies ranged from -0.08 (trivial effect favoring CHO) to 1.01 (large effect favoring CHO+CAF). The overall ES equaled 0.26 (95% CI 0.15-0.38, p < .001), indicating that CHO+CAF provides a small but significant performance benefit over CHO. ES was not significantly (p > .05) related to CAF dose, exercise duration, or performance-assessment method. To determine whether ES of CHO+CAF vs. CHO was different than CAF compared with water (placebo), a subgroup meta-analysis compared 36 CAF vs. placebo studies against the 21 CHO+CAF vs. CHO studies. The overall ES for the former group of studies (ES = 0.51, 95% CI 0.40-0.61) was nearly 2-fold greater than in CHO+CAF vs. CHO studies (p = .006). Conclusions: CHO+CAF ingestion provides a significant but small effect to improve endurance performance compared with CHO alone. However, the magnitude of the performance benefit that CAF provides is less when added to CHO than when added to placebo.

Collier, NB, Hardy, MA, Millard-Stafford, ML, and Warren, GL. Small beneficial effect of caffeinated energy drink ingestion on strength. J Strength Cond Res 30(7): 1862-1870, 2016-Because caffeine ingestion has been found to increase muscle strength, our aim was to determine whether caffeine when combined with other potential ergogenic ingredients, such as those in commercial energy drinks, would have a similar effect. Fifteen young healthy subjects were used in a double-blind, repeated-measures experimental design. Each subject performed 3 trials, ingesting either a caffeinated energy drink, an uncaffeinated version of the drink, or a placebo drink. The interpolated twitch procedure was used to assess maximum voluntary isometric contraction (MVIC) strength, electrically evoked strength, and percent muscle activation during MVIC of the knee extensors both before and after drink ingestion, and after a fatiguing bout of contractions; electromyographic (EMG) amplitude of the knee extensors during MVIC was also assessed. The mean (±SE) change in MVIC strength from before to after drink ingestion was significantly greater for the caffeinated energy drink compared with placebo [+5.0 (±1.7) vs. -0.5 (±1.5)%] and the difference between the drinks remained after fatigue (p = 0.015); the strength changes for the uncaffeinated energy drink were not significantly different from those of the other 2 drinks at any time. There was no significant effect of drink type on the changes in electrically evoked strength, percent muscle activation, and EMG from before to after drink ingestion. This study indicates that a caffeinated energy drink can increase MVIC strength but the effect is modest and the strength increase cannot be attributed to increased muscle activation. Whether the efficacy of energy drinks can be attributed solely to caffeine remains unclear.

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