Effect of Pre-Exercise Caffeine Intake on Endurance Performance and Core Temperature Regulation During Exercise in the Heat: A Systematic Review with Meta-Analysis.

Background: Heat is associated with physiological strain and endurance performance (EP) impairments. Studies have investigated the impact of caffeine intake upon EP and core temperature (C_T) in the heat, but results are conflicting. There is a need to systematically determine the impact of pre-exercise caffeine intake in the heat. Objective: To use a meta-analytical approach to determine the effect of pre-exercise caffeine intake on EP and C_T in the heat. Design: Systematic review with meta-analysis. Data Sources: Four databases and cross-referencing. Data Analysis: Weighted mean effect summaries using robust variance random-effects models for EP and C_T, as well as robust variance meta-regressions to explore confounders. Study Selection: Placebo-controlled, randomized studies in adults (≥ 18 years old) with caffeine intake at least 30 min before endurance exercise ≥ 30 min, performed in ambient conditions ≥ 27 °C. Results: Respectively six and 12 studies examined caffeine's impact on EP and C_T, representing 52 and 205 endurance-trained individuals. On average, 6 mg/kg body mass of caffeine were taken 1 h before exercises of ~ 70 min conducted at 34 °C and 47% relative humidity. Caffeine supplementation non-significantly improved EP by 2.1 ± 0.8% (95% CI − 0.7 to 4.8) and significantly increased the rate of change in C_T by 0.10 ± 0.03 °C/h (95% CI 0.02 to 0.19), compared with the ingestion of a placebo. Conclusion: Caffeine ingestion of 6 mg/kg body mass ~ 1 h before exercise in the heat may provide a worthwhile improvement in EP, is unlikely to be deleterious to EP, and trivially increases the rate of change in C_T. [ABSTRACT FROM AUTHOR]