This review examines the current status of sodium bicarbonate as an ergogenic aid. It builds on previous reviews in the area. Current research would suggest that as an ergogenic aid, a 300 mg·kg⁻¹ dose of NaHCO₃ can improve high-intensity exercise, within a range of exercise modalities, such as a single bout of supramaximal exercise, high-intensity intermittent activity, and skill-based sports. In particular, these benefits seem to be present to a greater extent within trained individuals. Despite this, there appears to exist a high intraindividual variability in response to NaHCO₃, and therefore, the ergogenic benefits may not be induced during every exercise bout. Current thinking also suggests that athletes need to individualize their ingestion timings to maximize peak pH or blood bicarbonate to effectively maximize the performance effect, and this may allow individuals to attain the ergogenic benefits of NaHCO₃ more consistently.

Objective: To quantify the effects of acute hypoxic exposure on exercise capacity and performance, which includes continuous and intermittent forms of exercise. Design: A systematic review was conducted with a three‐level mixed effects meta‐regression. The ratio of means method was used to evaluate main effects and moderators providing practical interpretations with percentage change. Data sources: A systemic search was performed using three databases (Google scholar, PubMed and SPORTDiscus). Eligibility criteria for selecting studies: Inclusion was restricted to investigations that assessed exercise performance (time trials (TTs), sprint and intermittent exercise tests) and capacity (time to exhaustion test, TTE) with acute hypoxic (<24 h) exposure and a normoxic comparator. Results: Eighty‐two outcomes from 53 studies (N = 798) were included in this review. The results show an overall reduction in exercise performance/capacity −17.8 ± 3.9% (95% CI −22.8% to −11.0%), which was significantly moderated by −6.5 ± 0.9% per 1000 m altitude elevation (95% CI −8.2% to −4.8%) and oxygen saturation (−2.0 ± 0.4%; 95% CI −2.9% to −1.2%). TT (−16.2 ± 4.3%; 95% CI −22.9% to −9%) and TTE (−44.5 ± 6.9%; 95% CI −51.3% to −36.7%) elicited a negative effect, whilst indicating a quadratic relationship between hypoxic magnitude and both TTE and TT performance. Furthermore, exercise less than 2 min exhibited no ergolytic effect from acute hypoxia.Summary/Conclusion: This review highlights the ergolytic effect of acute hypoxic exposure, which is curvilinear for TTE and TT performance with increasing hypoxic levels, but short duration intermittent and sprint exercise seem to be unaffected.

The aim of this study was to investigate the effects of sodium bicarbonate (NaHCO₃) on 4 km cycling time trial (TT) performance when individualised to a predetermined time to peak blood bicarbonate (HCO₃⁻). Eleven male trained cyclists volunteered for this study (height 1.82 ± 0.80 m, body mass (BM) 86.4 ± 12.9 kg, age 32 ± 9 years, peak power output (PPO) 382 ± 22 W). Two trials were initially conducted to identify time to peak HCO₃⁻ following both 0.2 g^.kg⁻¹ BM (SBC2) and 0.3 g^.kg⁻¹ BM (SBC3) NaHCO₃. Thereafter, on three separate occasions using a randomised, double-blind, crossover design, participants completed a 4 km TT following ingestion of either SBC2, SBC3, or a taste-matched placebo (PLA) containing 0.07 g^.kg⁻¹ BM sodium chloride (NaCl) at the predetermined individual time to peak HCO₃⁻. Both SBC2 (−8.3 ± 3.5 s; p < 0.001, d = 0.64) and SBC3 (−8.6 ± 5.4 s; p = 0.003, d = 0.66) reduced the time to complete the 4 km TT, with no difference between SBC conditions (mean difference = 0.2 ± 0.2 s; p = 0.87, d = 0.02). These findings suggest trained cyclists may benefit from individualising NaHCO₃ ingestion to time to peak HCO₃⁻ to enhance 4 km TT performance.

Current evidence suggests sodium bicarbonate (NaHCO₃) should be ingested based upon the individualised alkalotic peak of either blood pH or bicarbonate (HCO₃⁻) because of large inter-individual variations (10–180 min). If such a strategy is to be practical, the blood analyte response needs to be reproducible.

Sodium bicarbonate (NaHCO3) is a well-established nutritional ergogenic aid, though gastrointestinal (GI) distress is a common side-effect. Delayed-release NaHCO3 may alleviate GI symptoms and enhance bicarbonate bioavailability following oral ingestion, although this has yet to be confirmed. In a randomised crossover design, pharmacokinetic responses and acid-base status were compared following two forms of NaHCO3, as were GI symptoms. Twelve trained healthy males (mean ± SD age 25.8 ± 4.5 years, maximal oxygen uptake ( $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\max } $$ ) 58.9 ± 10.9 mL kg min−1, height 1.8 ± 0.1 m, body mass 82.3 ± 11.1 kg, fat-free mass 72.3 ± 10.0 kg) underwent a control (CON) condition and two experimental conditions: 300 mg kg−1 body mass NaHCO3 ingested as an aqueous solution (SOL) and encased in delayed-release capsules (CAP). Blood bicarbonate concentration, pH and base excess (BE) were measured in all conditions over 180 min, as were subjective GI symptom scores. Incidences of GI symptoms and overall severity were significantly lower (mean difference = 45.1%, P < 0.0005 and 47.5%, P < 0.0005 for incidences and severity, respectively) with the CAP than with the SOL. Symptoms displayed increases at 40 to 80 min post-ingestion with the SOL that were negated with CAP (P < 0.05). Time to reach peak bicarbonate concentration, pH and BE were significantly longer with CAP than with the SOL. In summary, CAP can mitigate GI symptoms induced with SOL and should be ingested earlier to induce similar acid-base changes. Furthermore, CAP may be more ergogenic in those who experience severe GI distress with SOL, although this warrants further investigation.

Background: Digital health interventions are efficacious in health-promoting behaviors (eg, healthy eating and regular physical activity) that mitigate health risks and menopausal symptoms in midlife. However, integrated evidence-based knowledge about the mechanisms of change in these interventions is unclear. Objective: This systematic review aimed to evaluate studies on behavior change techniques (BCTs) and mechanisms of change in digital health interventions aimed at promoting health-enhancing behaviors in midlife women (aged 40-65 years). Methods: A systematic literature search of the electronic databases PubMed, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials in the Cochrane Library was conducted. In total, 2 independent reviewers selected the studies for inclusion, extracted data, and completed BCT mapping of eligible studies. The mechanism of action and intervention functions of eligible studies were evaluated using the behavior change wheel framework. Reporting of psychological theory use within these interventions was explored using the Theory Coding Scheme. Mode of delivery, psychological theory, and BCTs were presented as descriptive statistics. Results: In total, 13 interventions (including 1315 women) reviewed used 13 (SD 4.30, range 6-21) BCTs per intervention on average. The “Shaping knowledge” and “Repetition and substitution” behavior change categories were used most frequently, with 92% (12/13) of the interventions implementing at least one of the BCTs from these 2 categories. Only 13.98% (169/1209) of the 93 available BCTs were used, with “Instructions on behaviour” most frequently used (12/13, 92%). The behavior change wheel mapping suggests that half of the intervention content aimed to increase “Capability” (49/98, 50% of the intervention strategies), “Motivation” (41/98, 42%), and “Opportunity” (8/98, 8%). “Behavioural Regulation” was the most frequently used mechanism of action (15/98, 15%), followed by increasing “Knowledge” (13/98, 13%) and “Cognitive and Interpersonal skills” (10/98, 10%). A total of 78% (7/9) of the intervention functions were used in the studies to change behavior, primarily through “Enablement” (60/169, 35.5%), whereas no study used “Restriction” or “Modelling” functions. Although 69% (9/13) of the interventions mentioned a psychological theory or model, most (10/13, 77%) stated or suggested rather than demonstrated the use of a theoretical base, and none reported explicit links between all BCTs within the intervention and the targeted theoretical constructs. Technological components were primarily based on web-based (9/13, 69%) modes of delivery, followed by phone or SMS text message (8/13, 62%) and wearables (7/13, 54%). Conclusions: The findings of this review indicate an overall weak use of theory, low levels of treatment fidelity, insignificant outcomes, and insufficient description of several interventions to support the assessment of how specific BCTs were activated. Thus, the identified limitations in the current literature provide an opportunity to improve the design of lifestyle health-enhancing interventions for women in midlife. Trial Registration: PROSPERO CRD42021259246; https://tinyurl.com/4ph74a9u