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Cited by 139Sports Performance and TrainingMuscle metabolism and nutritionExercise and Physiological Responses

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International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance

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Grgic, Jozo, Pedisic, Zeljko, Saunders, Bryan, Artioli, Guilherme G., Schoenfeld, Brad J., McKenna, Michael J., Bishop, David J., Kreider, Richard B., Stout, Jeffrey R., Kalman, Douglas S., Arent, Shawn M., VanDusseldorp, Trisha A., Lopez, Hector L., Ziegenfuss, Tim N., Burke, Louise M., Antonio, Jose, Campbell, Bill I.·2021·Journal of the International Society of Sports Nutrition
DOI 10.1186/s12970-021-00458-wPMC PMC8427947
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Abstract

Based on a comprehensive review and critical analysis of the literature regarding the effects of sodium bicarbonate supplementation on exercise performance, conducted by experts in the field and selected members of the International Society of Sports Nutrition (ISSN), the following conclusions represent the official Position of the Society: 1. Supplementation with sodium bicarbonate (doses from 0.2 to 0.5 g/kg) improves performance in muscular endurance activities, various combat sports, including boxing, judo, karate, taekwondo, and wrestling, and in high-intensity cycling, running, swimming, and rowing. The ergogenic effects of sodium bicarbonate are mostly established for exercise tasks of high-intensity that last between 30 s and 12 min. 2. Sodium bicarbonate improves performance in single- and multiple-bout exercise. 3. Sodium bicarbonate improves exercise performance in both men and women. 4. For single-dose supplementation protocols, 0.2 g/kg of sodium bicarbonate seems to be the minimum dose required to experience improvements in exercise performance. The optimal dose of sodium bicarbonate dose for ergogenic effects seems to be 0.3 g/kg. Higher doses (e.g., 0.4 or 0.5 g/kg) may not be required in single-dose supplementation protocols, because they do not provide additional benefits (compared with 0.3 g/kg) and are associated with a higher incidence and severity of adverse side-effects. 5. For single-dose supplementation protocols, the recommended timing of sodium bicarbonate ingestion is between 60 and 180 min before exercise or competition. 6. Multiple-day protocols of sodium bicarbonate supplementation can be effective in improving exercise performance. The duration of these protocols is generally between 3 and 7 days before the exercise test, and a total sodium bicarbonate dose of 0.4 or 0.5 g/kg per day produces ergogenic effects. The total daily dose is commonly divided into smaller doses, ingested at multiple points throughout the day (e.g., 0.1 to 0.2 g/kg of sodium bicarbonate consumed at breakfast, lunch, and dinner). The benefit of multiple-day protocols is that they could help reduce the risk of sodium bicarbonate-induced side-effects on the day of competition. 7. Long-term use of sodium bicarbonate (e.g., before every exercise training session) may enhance training adaptations, such as increased time to fatigue and power output. 8. The most common side-effects of sodium bicarbonate supplementation are bloating, nausea, vomiting, and abdominal pain. The incidence and severity of side-effects vary between and within individuals, but it is generally low. Nonetheless, these side-effects following sodium bicarbonate supplementation may negatively impact exercise performance. Ingesting sodium bicarbonate (i) in smaller doses (e.g., 0.2 g/kg or 0.3 g/kg), (ii) around 180 min before exercise or adjusting the timing according to individual responses to side-effects, (iii) alongside a high-carbohydrate meal, and (iv) in enteric-coated capsules are possible strategies to minimize the likelihood and severity of these side-effects. 9. Combining sodium bicarbonate with creatine or beta-alanine may produce additive effects on exercise performance. It is unclear whether combining sodium bicarbonate with caffeine or nitrates produces additive benefits. 10. Sodium bicarbonate improves exercise performance primarily due to a range of its physiological effects. Still, a portion of the ergogenic effect of sodium bicarbonate seems to be placebo-driven.

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Figures

Fig. 1 Schematic representation of the mechanism of HCO3- absorption in the stomach and the impact of sodium bicarbonate ingestion on muscle metabolism and selected blood parameters. Sodium bicarbonate ingestion increases the concentration of HCO3- in the stomach lumen, some of which neutralizes HCl to form CO2 and increases luminal pH. The rise in pH stimulates the Cl-/HCO3- antiporter in the parietal cells, which transports HCO3- into the extracellular fluid. This transport is coupled with the H-K-ATPase pump that secretes H+ into the stomach lumen to restore the pH. This results in increased pH and HCO3- concentration, which increases the activity of monocarboxylate transporters (MCT1 and MCT4, represented in light blue), thereby enhancing the transport of H+ out of muscle cells and improving intramuscular acid-base balance. Improved pH control in the muscle cells allows higher glycolytic rates, resulting in higher rates of ATP production and higher muscle and blood lactate concentrations. Solid lines indicate reactions. Dashed lines indicate transport across membranes or movement within the cell compartment. Created using BioRender.com
Fig. 1 Schematic representation of the mechanism of HCO3- absorption in the stomach and the impact of sodium bicarbonate ingestion on muscle metabolism and selected blood parameters. Sodium bicarbonate ingestion increases the concentration of HCO3- in the stomach lumen, some of which neutralizes HCl to form CO2 and increases luminal pH. The rise in pH stimulates the Cl-/HCO3- antiporter in the parietal cells, which transports HCO3- into the extracellular fluid. This transport is coupled with the H-K-ATPase pump that secretes H+ into the stomach lumen to restore the pH. This results in increased pH and HCO3- concentration, which increases the activity of monocarboxylate transporters (MCT1 and MCT4, represented in light blue), thereby enhancing the transport of H+ out of muscle cells and improving intramuscular acid-base balance. Improved pH control in the muscle cells allows higher glycolytic rates, resulting in higher rates of ATP production and higher muscle and blood lactate concentrations. Solid lines indicate reactions. Dashed lines indicate transport across membranes or movement within the cell compartment. Created using BioRender.comCC BY · PubMed Central
Fig. 2 Illustration of the contribution of different energy systems to the production of ATP to sustain maximal or near-maximal exercise over a given amount of time. The horizontal gradient-filled bars indicate exercise intensity/duration zones that are more (filled) or less (shaded) likely to result in acidosis and thus benefit from sodium bicarbonate supplementation
Fig. 2 Illustration of the contribution of different energy systems to the production of ATP to sustain maximal or near-maximal exercise over a given amount of time. The horizontal gradient-filled bars indicate exercise intensity/duration zones that are more (filled) or less (shaded) likely to result in acidosis and thus benefit from sodium bicarbonate supplementationCC BY · PubMed Central

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Research works printed but not linked: 10

  1. CamposEZSangaliEBNetoJGGobbiRBFreitas JuniorIFPapotiMEffects of sodium bicarbonate ingestion during an intermittent exercise on blood lactate, stroke parameters, and performance of swimmersJ Exerc Physiol Online.201215 6 84 92
  2. DrillerMWilliamsABellingerPHoweSFellJThe effects of NaHCO3 and NaCl loading on hematocrit and high-intensity cycling performanceJ Exerc Physiol Online.201215 1 47 56
  3. MaterkoWSantosELNovaesJDSEffect of bicarbonate supplementation on muscular strengthJ Exerc Physiol Online.200811 6 25 33
  4. MaughanRJLeiperJBLitchfieldPE DotsonCOHumphreyJHThe effects of induced acidosis and alkalosis on isometric endurance capacity in manExercise physiology, current selected research1986 New York AMS Press 73 82
  5. McNaughtonLRFordSNewboldCEffect of sodium bicarbonate ingestion on high intensity exercise in moderately trained womenJ Strength Cond Res.199711 2 98 102
  6. McNaughtonLStrangeNBackxKThe effects of chronic sodium bicarbonate ingestion on multiple bouts of anaerobic work and power outputJ Hum Mov Stud.200038 307 322
  7. SchaufMBallTEEffects of sodium bicarbonate ingestion on anaerobic performance of women: dosage effectJ Hum Mov Stud.199631 4 179 187
  8. TanakaSYamaguchiDIgawaSEffect of low-dose sodium bicarbonate sup-plementation on intermittent endurance performanceFood Nutr Sci.20189 1316 1326 1:CAS:528:DC%2BC1MXhtFahurnF
  9. MeroAAKeskinenKLMalvelaMTSallinenJMCombined creatine and sodium bicarbonate supplementation enhances interval swimmingJ Strength Cond Res.200418 2 306 310 15142001 15142001
  10. LindingerMIFranklinTWLandsLCPedersenPKWelshDGHeigenhauserGJRole of skeletal muscle in plasma ion and acid-base regulation after NaHCO3 and KHCO3 loading in humansAm J Physiol.1999276 1 R32 R43 1:CAS:528:DyaK1MXntlSnsg%3D%3D 9887175 9887175

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Authors
Grgic, J., Pedisic, Z., Saunders, B., Artioli, G. G., Schoenfeld, B. J., McKenna, M. J., Bishop, D. J., Kreider, R. B., Stout, J. R., Kalman, D. S., Arent, S. M., VanDusseldorp, T. A., Lopez, H. L., Ziegenfuss, T. N., Burke, L. M., Antonio, J., & Campbell, B. I.
Affiliations
  • Victoria University (AU)
  • Institute for Health and Sport, Victoria University
  • Universidade de São Paulo (BR)
  • Manchester Metropolitan University (GB)
  • Lehman College (US)
  • Texas A&M University (US)
  • University of Central Florida (US)
  • Nova Southeastern University (US)
  • University of South Carolina (US)
  • Kennesaw State University (US)
  • The Center for Applied Health Sciences
  • Australian Catholic University (AU)
  • Exercise and Sport Science
  • University of South Florida (US)
Corresponding author
Grgic, Jozo
ORCID
Venue
Journal of the International Society of Sports Nutrition
Publisher
Informa UK Limited
Published
2021-01-02
Volume
18
Issue
1
Pages
61-61
ISSN
1550-2783 (ISSN-L)
DOI
10.1186/s12970-021-00458-w
PMC
PMC8427947
OpenAlex
W3197275089
Cited by
138
References
230
Citations by year
2026: 38 · 2025: 33 · 2024: 28 · 2023: 22 · 2022: 14 · 2021: 3
FWCI
3.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the International Society of Sports Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Victoria University Research Repository (Victoria University) (submittedVersion, cc-by)
  • DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
  • Scholar Commons (University of South Carolina) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Funders
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (16/50438-0)
  • Universidade de São Paulo
  • Faculdade de Medicina da Universidade de São Paulo (2020.1.362.5.2)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
  • Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Keywords
sodium bicarbonate, ergogenic aids, exercise performance, high-intensity exercise, muscular endurance, combat sports, single bout exercise, dose-response relationship, timing of supplementation, long-term supplementation, training effects, adverse effects, bloating, gastrointestinal discomfort, acid-base balance, buffering capacity
MeSH terms
Female, Humans, Male, Exercise, Sodium Bicarbonate, Athletic Performance, Performance-Enhancing Substances, Sports Nutritional Sciences

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