The effects of a novel bicarbonate loading protocol on serum bicarbonate concentration: a randomized controlled trial

Adam Marcus, Amerigo Rossi, Andrew Cornwell, Steven A Hawkins, Nazareth Khodiguian, Adam Marcus, Amerigo Rossi, Andrew Cornwell, Steven A Hawkins, Nazareth Khodiguian

Abstract

Background: Previous studies have shown that sodium bicarbonate ingestion may enhance intense exercise performance, but may also cause severe gastrointestinal distress. The purpose of this study was to determine whether a modified sodium bicarbonate (SB) ingestion protocol would elevate serum bicarbonate concentration more than previous methods without causing gastrointestinal distress.

Methods: In randomized order, seven (5 men, 2 women) elite middle-distance runners ingested either placebo, Modified SB (600 mg·kg- 1 over 19.5 h), or Acute SB (300 mg·kg- 1) in opaque gelatin capsules. Baseline and post-ingestion blood samples were analyzed for bicarbonate, pH, sodium, hematocrit, and lactate. Repeated measures ANOVA (2 time points × 3 conditions) were analyzed to determine differences in serum bicarbonate, lactate, sodium, blood pH, and hematocrit. Gastrointestinal distress was assessed via self-report on a Likert scale of 1-10. Simple (condition) and repeated (time) within-participant contrasts were used to determine the location of any statistically significant main and interaction effects (p ≤ 0.05).

Results: Both Modified SB (7.6 mmol·L- 1, p < 0.01) and Acute SB (5.8 mmol·L- 1, p < 0.01) increased serum bicarbonate concentration compared to the placebo (p ≤ 0.05). Post-ingestion serum bicarbonate concentration was significantly higher for the Modified SB (34.7 ± 2.2 mmol·L- 1, 28.0% increase) trials than the Acute SB (33.5 ± 2.0 mmol·L- 1, 20.9% increase) trials (p = 0.05). There was no reported severe GI distress in the Modified SB trials, but two cases in the Acute SB trials.

Conclusions: Modified SB elevated serum bicarbonate concentration more than Acute SB, without any severe gastrointestinal side effects. Consequently, it is recommended that future experimentation involving SB by researchers and athletes use the novel ingestion protocol described in this study due to its potential for improved effectiveness and reduced gastrointestinal impact.

Trial registration: ClinicalTrials.gov , NCT03813329 . Registered 23 January 2019 - Retrospectively registered.

Keywords: Bicarbonate; Buffer; Elite; Ergogenic; Lactate; Nutrition; Running; Supplement.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Serum Bicarbonate Concentration at Baseline, Post-ingestion. * Significantly different from placebo. † Significantly different from Acute SB

References

    1. Heibel AB, Perim PHL, Oliveira LF, McNaughton LR, Saunders B. Time to optimize supplementation: modifying factors influencing the individual responses to extracellular buffering agents. Front Nutr. 2018;5:35. doi: 10.3389/fnut.2018.00035.
    1. Mueller SM, Gehrig SM, Frese S, Wagner CA, Boutellier U, Toigo M. Multiday acute sodium bicarbonate intake improves endurance capacity and reduces acidosis in men. J Int Soc Sports Nutr. 2013;10(1):16. doi: 10.1186/1550-2783-10-16.
    1. Krustrup P, Ermidis G, Mohr M. Sodium bicarbonate intake improves high-intensity intermittent exercise performance in trained young men. J Int Soc Sports Nutr. 2015;12:25. doi: 10.1186/s12970-015-0087-6.
    1. Carr AJ, Hopkins WG, Gore CJ. Effects of acute alkalosis and acidosis on performance: a meta-analysis. Sports Med. 2011;41(10):801–814. doi: 10.2165/11591440-000000000-00000.
    1. Schubert MM, Astorino TA. A systematic review of the efficacy of ergogenic aids for improving running performance. J Strength Cond Res. 2013;27(6):1699–1707. doi: 10.1519/JSC.0b013e31826cad24.
    1. Hadzic M, Eckstein ML, Schugardt M. The impact of sodium bicarbonate on performance in response to exercise duration in athletes: a systematic review. J Sports Sci Med. 2019;18(2):271–281.
    1. Van Montfoort MC, Van Dieren L, Hopkins WG, Shearman JP. Effects of ingestion of bicarbonate, citrate, lactate, and chloride on sprint running. Med Sci Sports Exerc. 2004;36(7):1239–1243. doi: 10.1249/01.MSS.0000132378.73975.25.
    1. Kozak-Collins K, Burke ER, Schoene RB. Sodium bicarbonate ingestion does not improve performance in women cyclists. Med Sci Sports Exerc. 1994;26(12):1510–1515. doi: 10.1249/00005768-199412000-00015.
    1. 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. 2002;34(4):614–621.
    1. Carr AJ, Slater GJ, Gore CJ, Dawson B, Burke LM. Effect of sodium bicarbonate on [HCO3-], pH, and gastrointestinal symptoms. Int J Sport Nutr Exerc Metab. 2011;21(3):189–194. doi: 10.1123/ijsnem.21.3.189.
    1. McNaughton LR. Bicarbonate ingestion: effects of dosage on 60 s cycle ergometry. J Sports Sci. 1992;10(5):415–423. doi: 10.1080/02640419208729940.
    1. Saunders B, Sale C, Harris RC, Sunderland C. Sodium bicarbonate and high-intensity-cycling capacity: variability in responses. Int J Sports Physiol Perform. 2014;9(4):627–632. doi: 10.1123/ijspp.2013-0295.
    1. Douroudos II, Fatouros IG, Gourgoulis V, Jamurtas AZ, Tsitsios T, Hatzinikolaou A, et al. Dose-related effects of prolonged NaHCO3 ingestion during high-intensity exercise. Med Sci Sports Exerc. 2006;38(10):1746–1753. doi: 10.1249/01.mss.0000230210.60957.67.
    1. Siegler JC, Midgley AW, Polman RC, Lever R. Effects of various sodium bicarbonate loading protocols on the time-dependent extracellular buffering profile. J Strength Cond Res. 2010;24(9):2551–2557. doi: 10.1519/JSC.0b013e3181aeb154.
    1. Durkalec-Michalski K, Zawieja EE, Podgórski T, Zawieja BE, Michałowska P, Łoniewski I, et al. The effect of a new sodium bicarbonate loading regimen on anaerobic capacity and wrestling performance. Nutrients. 2018;10(6):E697. doi: 10.3390/nu10060697.
    1. Joyce S, Minahan C, Anderson M, Osborne M. Acute and chronic loading of sodium bicarbonate in highly trained swimmers. Eur J Appl Physiol. 2012;112(2):461–469. doi: 10.1007/s00421-011-1995-z.
    1. Oliveira LF, de Salles Painelli V, Nemezio K, Gonçalves LS, Yamaguchi G, Saunders B, et al. Chronic lactate supplementation does not improve blood buffering capacity and repeated high-intensity exercise. Scand J Med Sci Sports. 2017;27(11):1231–1239. doi: 10.1111/sms.12792.
    1. 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. 1998;30(4):523–528. doi: 10.1097/00005768-199804000-00009.
    1. McNaughton LR. Sodium bicarbonate ingestion and its effects on anaerobic exercise of various durations. J Sports Sci. 1992;10(5):425–435. doi: 10.1080/02640419208729941.
    1. Bentzur KM, Kravitz L, Lockner DW. Evaluation of the BOD POD for estimating percent body fat in collegiate track and field female athletes: a comparison of four methods. J Strength Cond Res. 2008;22(6):1985–1991. doi: 10.1519/JSC.0b013e318185f196.
    1. Wilmore JH, Vodak PA, Parr RB, Girandola RN, Billing JE. Further simplification of a method for determination of residual lung volume. Med Sci Sports Exerc. 1980;12(3):216–218. doi: 10.1249/00005768-198023000-00016.
    1. Carr AJ, Slater GJ, Gore CJ, Dawson B, Burke LM. Reliability and effect of sodium bicarbonate: buffering and 2000-m rowing performance. Int J Sports Physiol Perform. 2012;7(2):152–160. doi: 10.1123/ijspp.7.2.152.
    1. Boning D, Schweigart U, Kunze M. Diurnal variations of protein and electrolyte concentrations and of acid-base status in plasma and red cells of normal man. Eur J Appl Physiol Occup Physiol. 1974;32(3):239–250. doi: 10.1007/BF00423219.
    1. Kobos RK, Abbott SD, Levin HW, Kilkson H, Peterson DR, Dickinson JW. Electrochemical determination of hemoglobin, hematocrit, and hemolysis. Clin Chem. 1987;33(1):153–158.
    1. Silva JF, Pannall PR. Hydrogen ion homeostasis: blood gas levels. Clinical chemistry in diagnosis and treatment. London: Lloyd-Luke; 1979. pp. 78–113.
    1. Department of Health and Human Services . 510k Substantial Equivalance Determination Decision Summary (k093611) 2007.
    1. McNaughton LR, Gough L, Deb S, Bentley D, Sparks SA. Recent developments in the use of sodium bicarbonate as an ergogenic aid. Curr Sports Med Rep. 2016;15(4):233–244.
    1. Rotstein A, Bar-Or O, Dlin R. Hemoglobin, hematocrit, and calculated plasma volume changes induced by a short, supramaximal task. Int J Sports Med. 1982;3(4):230–233. doi: 10.1055/s-2008-1026093.
    1. Sims ST, van Vliet L, Cotter JD, Rehrer NJ. Sodium loading aids fluid balance and reduces physiological strain of trained men exercising in the heat. Med Sci Sports Exerc. 2007;39(1):123–130. doi: 10.1249/01.mss.0000241639.97972.4a.
    1. Sims ST, Rehrer NJ, Bell ML, Cotter JD. Preexercise sodium loading aids fluid balance and endurance for women exercising in the heat. J Appl Physiol. 2007;103(2):534–541. doi: 10.1152/japplphysiol.01203.2006.

Source: PubMed

3
Tilaa