Nutritional Ergogenic

Aids in Tennis: A
Brief Review
Alvaro Lopez-Samanes, MSc,1 Juan F. Ortega Fonseca, PhD,1 Valentin E. Fernandez Elas, PhD,1
Sebastien Borreani, PhD,2 Jose L. Mate-Munoz, PhD,3 and Mark S. Kovacs, PhD4
1
Exercise Physiology Lab, University of Castilla La Mancha, Madrid, Spain; 2Laboratory of Physical Activity and Health,
University of Valencia, Valencia, Spain; 3Department of Physical Activity and Sports Sciences, Alfonso X el Sabio
University, Madrid, Spain; and 4International Tennis Performance Association, Life Sport Science Institute, Life
University, Marietta, Georgia

ABSTRACT
IN RECENT YEARS, THE INTEREST
OF ERGOGENIC AIDS HAS
GROWN IN THE COMPETITIVE
SPORTS ARENA. AS A RESULT,
SUPPLEMENTATION COMPANIES
HAVE FOUND A NEW MARKET AND
HAVE CREATED AN ARRAY OF
PRODUCTS TARGETING COMPETITIVE ATHLETES. HOWEVER, ONLY
A FEW LEGAL SUPPLEMENTS
HAVE BEEN RECOGNIZED BY
SCIENTIFIC LITERATURE AS BEING
ABLE TO ENHANCE PERFORMANCE. THESE COMPOUNDS ARE
CAFFEINE, CREATINE, AND BICARBONATE. MORE RECENTLY,
OTHER SUBSTANCES SUCH AS
b-ALANINE AND NITRIC OXIDE
PRECURSORS HAVE SHOWN ERGOGENIC EFFECTS, BUT MORE
RESEARCH IS NEEDED. THE
OBJECTIVE OF THIS REVIEW IS TO
PROVIDE TENNIS COACHES AND
SPORTS SCIENCE RESEARCHERS
THE LATEST INFORMATION.

INTRODUCTION

he use of nutritional ergogenic

aids has become more popular
for professional and recreational
athletes to enhance their performance
and to accelerate their recovery process
(14). In sports sciences, a nutritional

ergogenic aid can be defined as substances or procedures used for the purpose of
enhancing performance. Although the
term nutritional ergogenic aids is the
most common name in scientific literature referring to anything that enhances
performance, these products are also
commonly known as nutritional supplements, dietary supplements, or sports
supplements (89,90). Nutritional ergogenic aids marketed in the form of dietary
supplements accounted for approximately $660 million in US sales in 2013
(Internacional E. Vitamins and Dietary
Supplements in the US. 2014. http://
www.euromonitor.com/vitamins-anddietary-supplements-in-the-us/report).
In addition, 80% of German athletes
(17), 89% of American university athletes (43), 98.6% of Canadian university athletes (80), and 88.57% of Irish
athletes confirmed taking at least 1
supplement (105).
Tennis is an intermittent sport with
match duration from 1 hour to more
than 5 hours characterized by short
bouts of high intensity intermittent
exercise (410 seconds), a short break
between points (1020 seconds), and
moderate rest between games and sets
(90120 seconds) (38,75). Because of
intermittent activity during tennis play,
tennis players could enhance their performance on court with use of several
ergogenic aids; caffeine (CAFF) may
delay fatigue in long matches, creatine

Copyright National Strength and Conditioning Association

(Cr) may enhance the resynthesis of

phosphocreatine, b-alanine (BA) and
sodium bicarbonate (SB) may buffer lactic acid, and nitric oxide precursors may
promote cardiovascular responses.
Another aspect is thermoregulation in
tennis players. A few tournaments during the year are played in extreme
weather conditions (.408C) (i.e.,
Australian Open). Recent published
studies in tennis (46,102) simulating
these conditions in the extreme conditions mentioned above (the trials were
realized at 36.8 and 39.38C) found that
physical performance deteriorated
after 2 hours. Tournaments in heat conditions could lead to heat-related illnesses such as heat exhaustion and
heat stroke. Also, it was reported that
tennis players need at least 24 hours
after matches to recover. See the
review by Kovacs (77) for more information. Some recovery strategies could
speed recovery such as cold treatments, compressive clothing, and fluid
replacement. Regarding hydration
techniques, ranges of sweat losses
could vary between 1 and 2.5 L/h,
and tennis players should avoid 2%
dehydration during tennis matches.
Some researchers have reported
KEY WORDS:

ergogenic aid; tennis;

physical performance

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Ergogenic Aids, Tennis, and Performance

hydration strategies such as to drink

.200400 mL of a fluid replacement
beverage per changeover (76).
The aim of this review is to clarify
which ergogenic aids can improve performance in a sport as complex as
tennis, which requires a mixture of
short-distance speed between 0 and
20 m (47) agility (111) and power
(107), combined with medium to high
aerobic and anaerobic demands (38).
This review looks specifically at 3 ingredients with an abundance of scientific support (i.e., CAFF, Cr, and SB)
and 2 others that show promise in the
scientific literature (i.e., nitric oxide
modulators (NO) and BA).
CAFFEINE

CAFF (1,3,7 trimethylxanthine) is

metabolized by the liver and, through
enzymatic actions, and results in 3
metabolites: paraxanthine, theophylline, and theobromine (51,53,57).
The most common administration
method for CAFF is oral consumption.
It is interesting to note that 74% of
Spanish athletes in national and international events consume CAFF at different doses (31) and 27% of American
and Canadian youths (1119 years)
also take CAFF before competitions
(127). This supplement has global effects on the central nervous system
(affecting cognitive performance and
mood states), including hormonal (catecholamine excretions), metabolic (glycogen sparing), muscular (enhancing
endurance and strength and power values), cardiovascular (increasing heart
rate), pulmonary (higher values of ventilation), and renal functions (more blood
flow) during rest and exercise (117). Since
2004, when the World Anti-Doping
Agency eliminated CAFF from the list
of banned substances, its consumption
by athletes has increased (31,35).
The recommended CAFF dose to
obtain significant improvement in performance is 36 mg/kg bw (body
weight) (14,26,30). Therefore, the use
of lower doses (i.e., less than 2 mg/kg
bw) has shown inconsistent results from
a performance perspective (10,68).

VOLUME 37 | NUMBER 3 | JUNE 2015

CAFF is rapidly absorbed by the

body and appears in the blood within
515 minutes (52), reaching a peak
between 45 and 60 minutes after ingestion, without showing statistical differences when it is administered as
capsules or in beverages (80). However,
CAFF chewing gum has demonstrated
faster absorption when compared with
CAFF capsules (71). The half-life of
CAFF is between 2.5 and 10 hours (84).
In endurance sports, CAFF intake has
demonstrated a strong performance
enhancing effect with low to medium
doses (i.e., 36 mg/kg bw) (51
53,83,92); however, similar results are
not obtained with doses higher than 9
mg/kg bw (50,100). The same results
have been observed in activities that
require short efforts such as multiple
sprints (i.e., tennis rallies) (48,115). Until
recently, there has been much debate
about the usefulness of CAFF in sports
that are highly dependent on strength
levels. Recent research has demonstrated that small to moderate CAFF
doses (36 mg/kg bw) increase strength
and power output (32,49,96,131). However, maximum strength is only
enhanced with high doses (9 mg/kg
bw), and the secondary effects associated with CAFF ingestion should be
considered (98). CAFF ingestion could
also repair the detrimental effects on
neuromuscular performance associated
with the circadian rhythms when training early in the morning (96), the effects
being more evident in the lower-body
musculature (97).
Research on the effects of CAFF on tennis performance has been less extensive
than in endurance sports. There is little
evidence showing CAFFs effect on tennis performance (Table). As mentioned
before, tennis is an intermittent sport
because performance is the product of
the interaction of different qualities
(speed, power, endurance, etc.) (38,75).
CAFF has demonstrated performance
enhancement in prolonged exercise,
such as multiple sprints, strength, and
muscle power, all of which are qualities
required for success in tennis. To our
knowledge, all research that has assessed
tennis performance related to CAFF

ingestion used small to moderate CAFF

doses (between 3 and 6 mg/kg bw). In
one study, Klein et al. (74) found that
CAFF administration of 6 mg/kg bw
had positive impacts on enhancing tennis performance during a tennis skill test
when compared with placebo (PLAC).
However, the effect of CYP1A2 (a liver
enzyme that contributes to CAFF
metabolism) increasing has no apparent
influence on tennis performance (74). In
another study, 4.5 and 4 mg/kg bw of
CAFF was administered to men and
women tennis players respectively. The
study evaluated different parameters during a 4-h tennis match (i.e, sprint performance, hitting accuracy and games won)
(41). Only women reported improvements in the number of games won with
respect to PLAC conditions, with no
changes observed in men between the
different protocols. The researchers
claim that the differences found could
be due to the normally lower CAFF
consumption among females versus
males (70 versus 110 mg/d) although
relative CAFF dose across genders
might be similar. However, another
study performed with the same group
and with the same CAFF doses for
men and women (4.48 mg/kg bw) did
not report any benefits in any of the
physical
parameters
that
were
measured (124).
Hornery et al. (65) compared the consumption of CAFF (3 mg/kg bw), a 6%
carbohydrate (CHO) solution, cooling
use, and PLAC during 4 simulated tennis matches; only the CAFF protocol
was able to reduce the effects of fatigue
during tennis matches and increase
serve velocity in the final set of the
matches. Strecker et al. performed 2
studies to determine the influence of
CAFF ingestion on tennis skills performance. In the first study (122), the subjects received a CAFF dose of 3 mg/kg
bw combined with a CHO solution or
PLAC before 90-minute trials of simulated tennis against a ball machine. For
every 30 minutes of the match, the subjects performed a tennis skill test consisting of 15 groundstrokes (forehand/
backhand) in all 4 directions: crosscourt and down-the-line to a specific

Table
Caffeine effects on tennis performance
Studies

Subjects

Dose

8M

4.5 mg/kg

4Performance in males

8F

4 mg/kg

[Number of game winners during simulated matches in females

Vergauwen (128)

13 M

5 mg/kg

4Performance

Struder (124)

8M

4.48 mg/kg

4Performance

Ferrauti (41)

Effects on performance

[Forehand performance

Strecker (122)
10 M

3 mg/kg

4Backhand performance

Hornery (65)

12 M

3 mg/kg

[Serve velocity

Strecker (123)

10 M

3 mg/kg

[Performance in tennis skill in the later stages of match

Klein C (74)

9M

6 mg/kg

[Performance in tennis-specific test

80 mg

4Serving accuracy tennis test

3 mg/kg

[Handgrip force, [ points with the serve

9F
Reyner and Horne (110)

6M
6F

Gallo-Salazar (44)

10 M

4Ball velocity

4F
F 5 female; M 5 male; 4 5 no effects; [ 5 increase.

target on the court. Although forehand

performance was enhanced in CAFF
protocols, backhand performance did
not reach statistical differences between
CAFF versus PLAC. The second study
(123) used the same CAFF doses as in
the previous study (3 mg/kg bw) but in
a liquid form, and the subjects of the
study played 90 minutes of simulated
matches. The CAFF protocol showed
an increase in tennis performance at latter stages of the matches. The CAFF
dose administered did not have a negative effect on hydration status before or
during matches when compared with
PLAC conditions.
Reyner and Horne (110) studied
whether CAFF ingested in small
amounts (80 mg) could counteract the
detrimental effects associated with a 33%
reduction in sleep (5 hours) compared
with normal sleep (8 hours) in a serving
accuracy test. The researchers concluded that CAFF ingestion is no substitute for lost sleep. However, the
weakness of the study, in our opinion,
was that the dose of CAFF administered

did not reach the ergogenic threshold of

36 mg/kg bw. Future studies should
consider enhancing the CAFF doses
administered to know whether CAFF
ingestion could really counteract the effects associated with sleep loss. In a classic study, Vergauwen et al. (128)
compared the consumption of CHO
(0.7 mg/kg bw), CHO + CAFF
(5 mg/kg bw), and PLAC and examined
the effects on 2 different performance
protocols; the Leuven Tennis Performance Test (LTPT) and shuttle run
(for protocols details see (129)). On each
occasion, they performed each test
before and after 2 hours of strenuous
training sessions. These protocols
showed that CHO + CAFF ingestion
did not produce any benefits compared
with CHO conditions.
Finally, a recent study by Gallo-Salazar
et al. (44) showed that 3 mg/kg bw
CAFF in liquid form increased handgrip
force in both hands, running pace at high
intensity, and the number of sprints compared with the PLAC protocol, whereas
other aspects such as ball velocity during

the service test remained unchanged

during simulated tennis matches.
Side effects associated with CAFF are
mixed. Historically, it has been reported
that ingestion of CAFF affected fluid
balance causing an increase in the urination rate and, consequently, increased
dehydration. However, a recent study
by Killer et al. (73) has shown that
ingestion of moderate doses of CAFF
did not affect the rate of fluid reduction
and, hence, the rate of dehydration. If
CAFF ingestion is high (.9 mg/kg bw)
(100), these negative hydration effects
do occur. Therefore, CAFF is a useful
and safe substance that has been shown
to benefit performance in low and moderate doses (36 mg/kg bw). Only the
use of high doses (.9 mg/kg bw) seems
to cause undesirable effects such as
increased urine flow, gastrointestinal
problems, heart palpitations, etc. CAFF
ingestion before matches/training sessions may be a useful ergogenic aid to
increase tennis performance, although
future studies should determine the
optimum dose.

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Ergogenic Aids, Tennis, and Performance

CREATINE

Cr or a-methylguanidinoacetic acid is
a nitrogenous compound that naturally
exists in the skeletal muscle in equilibrium with phosphocreatine (70). The
first studies of Cr supplementation
began in the 1900s; and in the last century, the studies on this ergogenic aid
have increased substantially. Cr is produced endogenously, mainly in the liver,
at a rate of 12 g/d and an additional
12 g/d of Cr is obtained from dietary
intake (27,95). This substance has been
proven to be an important stimulant aid
for neuromuscular (130) and cardiovascular diseases (91), and in the near
future, it appears that this substance
may have even more therapeutic effects
(i.e., cancer, type 2 diabetes, etc.) (54).
Cr is currently considered to be an effective ergogenic supplement by different
nutritional and sports medicine organizations (18,126).
The most common use of Cr administration starts with a loading phase, consisting of 4 repeated doses of 5 g
separated by 57 hours during 35 days
and a maintenance dose of 35 g/d,
which show a 1720% increase in intramuscular Cr levels (95). Other protocols
have proven to have the same success
or even better results, such as doses of
0.25 g Cr/kg fat-free mass/d (19), 3 g of
Cr per day during 30 days (69), or 20
doses of 1 g of Cr during the day (114).
Furthermore, Cr bioavailability is better
when it is consumed in conjunction
with carbohydrates (CHO). Ideally,
the CHO loading should be ingested
30 minutes after Cr ingestion to produce
peak Cr and insulin concentrations (95).
Oral administration of low-medium
doses of Cr in humans (15g) reaches
its maximum plasma Cr concentrations
in less than 2 hours, whereas doses
above 10 gr reach maximal plasma concentrations of Cr over 3 hours (114).
Therefore, the clearance rate of Cr from
the blood is highly variable and dependent on intramuscular Cr levels, hormone levels, muscle mass, and kidney
function (103).
In general, the studies with Cr supplementation have been based on sports
highly dependent on strength and

VOLUME 37 | NUMBER 3 | JUNE 2015

hypertrophy levels (9,118). However,

the increase in muscle mass and strength
values associated with Cr ingestion have
drawn the attention of intermittent sports
(e.g., soccer, handball) because of the fact
that different physical capacities such as
repeated sprints, agility performance,
jumping ability, and maximum lowerbody strength are necessary for success
in intermittent sports. However, other
studies did not find improvement in performance in repeated sprints and other
variables associated with performance in
intermittent sports (28). Regarding tennis
performance, Cr ingestion has been less
reported; only 2 studies have used Cr
ingestion to observe the effects on performance. Eijnde et al. (37) used a Cr
dose of 20 g/d during 5 days (divided
into 4 doses per day) with 8 well-trained
tennis players and evaluated performance on the LTPTand the 70-m shuttle
run on 2 different occasions (Cr protocol
versus PLAC protocol). No significant
differences were reported between treatments in any of the variables, and they
concluded that short-term high dose Cr
ingestion does not benefit tennis
performance.
Pluim et al. (104) observed the effects
of both Cr supplementation over short
(6 days) and medium terms (4 weeks)
compared with PLAC condition
period in tennis players. A Cr intervention with a loading phase of 0.3 mg/kg
bw during 6 days and a maintenance
phase of 0.03 mg/kg bw during 28 days
was used. No gains in body weight
were reported in the short-term intervention, but gains were reported in the
medium term between Cr versus
PLAC (+1.4 versus 20.2 kg). Some aspects related to tennis performance
were evaluated (i.e., sprint velocity over
5, 10, and 20 m, upper and lower-body
strength values, and groundstrokes performance drills). No differences were
found for the short or medium term
in any variable. As a result, it was concluded that Cr should not be recommended to tennis players.
The controversial secondary effects of
Cr ingestion lack supportive scientific
evidence. According to the literature, it
seems that Cr ingestion may be related

to an increase of 12% in body weight

(79) possibly associated with water
retention. Other secondary effects
linked to Cr consumption, such as gastrointestinal, renal, and liver damage,
have only been anecdotally reported.
Future investigations should clarify
the issue (18). Currently, Cr is a safe
ergogenic aid regarding athletes health
(116) possibly with the ability to positively impact tennis recovery.
SODIUM BICARBONATE

SB (NaHCO3) is an extracellular buffer

with an important role in maintaining
a stable electrolyte gradient between
intracellular and extracellular environments (20). SB has been extensively
studied in recent years mainly for its
properties as a buffering agent. In normal human conditions, arterial blood
pH is 7.4 and human muscle pH is
normally 7.0. After exhaustive exercise,
arterial pH tends to fall to 7.1 and muscle pH to 6.8 resulting in fatigue (94).
The acid-base balance has been studied since the 1930s. In those years,
some scientists postulated that the
ingestion of alkaloid agents might
reduce the decline of muscle pH (33).
Studies on SB and athletic performance have been published since the
1980s. The best time for NaHCO3
ingestion is 60120 minutes before
the event, and it must be diluted preferably in about 400 mL of water
(101,108); peak blood alkalosis can be
expected ;120150 minutes after
ingestion (24).
The optimum dose of SB ingestion has
been a cause of debate. Costill et al. reported several studies demonstrating
the efficacy of SB in enhancing performance in several sports (i.e., swimming
and cycling) (29,45). In a well-designed
experiment (93) with different doses
(0.1, 0.2, 0.3, 0.4, and 0.5 g/kg bw),
McNaughton et al. were the first to
establish that 0.3 g/kg bw was
the minimum dose with which changes
were noticeable in the variables measured in the study: total work performed
and peak power output. Men and
women responded the same way to
the ingestion of SB, showing the same,

or nearly the same, improvements with

this ergogenic aid (24). A different published meta-analysis that described SB
as a useful ergogenic aid to improve
athletic performance reported a small
to moderate effect size (0.44 versus
0.36, respectively) (87,101). Training status seems to impact the effect seen from
SB use (i.e., untrained people benefit
more from SB intake when compared
with high-performance athletes, particularly in repeated bouts protocols, time
exhaustion test, and short [,2 minutes],
medium [210 minutes], and long protocols [.10 minutes]) (103). However,
although the effects are less pronounced
in highly trained athletes, there seems to
be evidence that in events characterized
by high-intensity protocols and those
that recruit large muscle groups, athletes
can benefit from SB intake (109). Effects
on neuromuscular performance are not
clear; although some studies reported
positive results (25,36), others have
not (133).
Regarding tennis, Wu et al. (134) developed the only study with SB ingestion.
Nine male college tennis players in
a randomized crossover, PLACcontrolled, and double-blind study
investigated the intake of SB (0.3 g/kg
bw) or PLAC (0.209 g/kg bw NaCl);
the researchers investigated the effect
on a skilled tennis performance test
(Loughborough Tennis Skill Test)
before and after a simulated game of
tennis (a duration of approximately
50 minutes). This study suggested that
SB supplementation could prevent the
decline in skilled tennis performance
after a simulated match. Others suggest
that SB could be useful for tennis performance (13) through improvement in
RSA performance, a quality that has
been demonstrated to be important
in intermittent sports (e.g., tennis,
soccer) (39,106).
SB is associated with a wide spectrum
of secondary effects: gastrointestinal
upset, diarrhea, and cramps (23). Several strategies have been suggested
to minimize the secondary effects, such
as familiarization trials and intravenous
administration (109). The consumption of food alongside SB reduces

gastrointestinal side effects relative to

the same dose taken on an empty
stomach, and serum increases of bicarbonate seem to be highest when ingested with food (24).
Because of the lack of research regarding
the intake of SB on tennis performance,
more studies need to be developed
regarding this topic. Likewise, because
of the minor effect reported in highly
trained athletes, interventions would
need to examine the effectiveness, or
otherwise, of SB in highly trained tennis
players. Additionally, studies that combine extracellular buffers (such as SB)
and intracellular buffers (BA) need to
be conducted to determine whether this
substance should be considered an ergogenic aid to tennis performance.
b-ALANINE

BA is found in muscles in combination

with L -histidine forming the dipeptide
carnosine. This is found in high concentration in the mammalian skeletal
muscle. It is synthesized by the enzyme
carnosine synthase from the amino
acids L -histidine and BA (34).
Although it was discovered more than
100 years ago, the use of this substance
to enhance athletic performance is still
a new topic (56). It shows a good muscle buffering capacity (MBC) of H+ at
a higher rate during intense exercise
and is perhaps the most important
intracellular buffer (1). The majority
of the bodys carnosine, over 99%, is
present in muscles, whereas other places in the body have small quantities
(e.g., brain) (34), with more pronounced quantities in fast twitch fibers
at the end compared with those in slow
twitch fibers. Furthermore, studies
have demonstrated that men have
approximately 2025% more carnosine
content than do women (86). However, BA is a nonessential amino acid
synthesized by the liver (88), which can
be ingested through a diet containing
animal sources (meat) or through dietary supplements (6). The study of BA
has attracted interest because of its
direct relation to the synthesis of carnosine. The body is unable to absorb carnosine directly from the bloodstream

(88), and concentrations of BA in the

muscle are relatively small compaired
with histadine and carnosine synthetase
(61). Endogenous synthesis of BA is
limited to a small amount produced in
the liver (88). The synthesis of carnosine
in skeletal muscle may be limited by the
availability of BA in the diet (113).
The most commonly used dosing regimen to enhance performance provides
a total dose of 46.4 g/d over several
weeks. This total dose is typically
achieved by ingesting multiple doses
per day (i.e., 46 doses) (72,121) in individual dosing amounts of 410 g that
have shown to cause a 4080% increase
in intramuscular carnosine (57,72). The
washout period may take .9 weeks to
return to baseline levels (7,119) with
a decline rate of 24% per week on average, which is a longer (7) and slower process if compared with other substances
such as CAFF. A recent meta-analysis
showed that the median effect of BA supplementation is 2.85%, being especially
effective in events of between 60240 seconds and .240 seconds but not reaching
statistical differences in events whose durations are ,60 seconds (58).
Highly trained anaerobic athletes have
greater buffering capacity and intramuscular carnosine than untrained people or
endurance athletes (99), but BA supplementation improves the carnosine deposits in all of the cases mentioned
before. Regarding neuromuscular performance, the ingestion of BA does not
seem to improve maximum strength
(60,72). These finding are not surprising
considering that the improvement in
buffering capacity and maximum neuromuscular performance is not limited by
acidosis (6). In the tennis field, no studies
have been conducted yet, but in complex
intermittent sports such as tennis in
which the bouts of exercise require that
players have a good buffering capacity,
BA could be an interesting ergogenic aid.
In fact, other alkalinizing agents such as
SB have shown good results against the
decline in performance during simulated
tennis matches (134). Although the main
buffering of H+ is generated by bicarbonate, the pH of carnosine (6.83) is closer
to the physiological system than the pH

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Ergogenic Aids, Tennis, and Performance

of bicarbonate (6.37), which means that

it may be used primarily in highintensity exercise (66). Therefore BA
supplementation could contribute to
the ability of muscle carnosine to buffer
between 7 and 25% of the acid produced
(6,56,86). The contribution of carnosine
for these purposes may differ depending
on the fiber type involvement with
greater contributions coming from type
II fibers (86).
Secondary effects reported with BA
ingestion are symptoms of paresthesia
(an unpleasant sensation characterized
by the irritation of the skin and prickly
sensation) and are reduced or eliminated when the quantity is less than
800 mg per day. To avoid these symptoms, BA should be administered in several doses during the day (58) because
of the fact that symptoms of paresthesia
are associated with peak blood values of
BA serum (120). However, these symptoms of paresthesia were not observed
when BA was ingested in conjunction
with carbohydrates. (61) This suggests
that administering BA with food reduces
the maximum concentration in serum
by up to 50% because of delayed gastric
emptying (56).
In tennis, no studies have been conducted regarding the use of BA, but in
complex intermittent sports such as tennis, in which the bouts of exercise require
that players have a good buffer capacity,
BA could be an interesting ergogenic aid
that should be studied. Furthermore, coingestion with other buffering agents
such as SB could be another area to
explore in future publications.
NITRIC OXIDE

Nitric oxide (NO) is a labile lipidsoluble gas synthesized at several locations in the body with antioxidant and
vasodilator properties that also regulate
the use of glucose and oxygen (3). The
production of nitric oxide occurs in 2
different ways: NO synthase (NOS)
dependent and NOS independent (12).
Importantly, it is the first gaseous chemical that has been shown to be produced
by living cells to send intracellular signals. The different properties (i.e., vasodilator mechanism) have caught the

VOLUME 37 | NUMBER 3 | JUNE 2015

attention of the exercise physiology field

because of the potential beneficial effects
of this substance as an ergogenic aid.
NOS-dependent pathway L-arginine
(L-Arg) is a semiessential amino acid
and also a precursor to nitric oxide
(NO), which can be synthesized by
the kidneys where L-Arg is formed from
L-citrulline. The dietary intake of L-Arg
is close to 45 g/d (125). Scientific findings have reported that L-Arg supplementation varied between 1.5 and 20
g/d in different studies, with durations
of between 1 and 180 days (22,42). The
half-life L-Arg after oral ingestion of 6 g
is between 50 and 120 minutes (15), and
its excretion varies according to the food
consumption and renal function of
individuals.
The ingestion of nitrate and nitrite can
also be reduced to nitric oxide (NO).
Nitric oxide deposits can be obtained
exogenously through diet, knowing
that some kinds of vegetables contain
large amounts of nitrates (i.e., beets,
spinach, or lettuce). The most common supplementation reported is
between 300 and 600 mg of nitrate
per day for 115 days, eliciting favorable physiological effects (65,71). After
bolus nitrate ingestion, plasma nitrate
ingestion (nitrate) peaks after 12
hours and plasma nitrite peaks after
23 hours (71). Finally, baseline values
return to normal 24 hours after
ingestion.
Over the last several years, consumption of L-Arg has increased considerably
among athletes because it increases the
bloods acute vasodilatation and has
been associated with a neuromuscular and cardiovascular performance
enhancement (4). A study on NCAA
athletes showed that 8% of males and
5% of females regularly used L-Arg as an
ergogenic aid (85). However, the scientific evidence is not so clear. The acute
effects of L-Arg administration showed
that the majority of the studies have
been developed using aerobic protocols,
with different results. Although some
studies showed an improvement in
some parameters with L-Arg ingestion,
such as reduced oxygen consumption

(V O2), cost of moderate-intensity cycle

exercise, and time to exhaustion (8,135),
other studies did not find the same results (81). The scientific literature
regarding chronic ingestion of L-Arg is
more extensive compared with the literature regarding acute ingestion of this
ergogenic aid. However, the results are
inconclusive as well. Although some
studies showed L-Arg use to have positive effects on cardiovascular and neuromuscular performance (21,22), other
studies did not find any differences
(2,132). Bescos et al.(11) have developed the only study pertaining to tennis,
which included 9 highly trained male
tennis players. They followed 3 different
diets during 3 days (with 5.5, 9, and 20
g/d of L-Arg) with washout periods of 4
days between trials. Participants performed a submaximal treadmill test until
8590% V O2max in which oxygen
uptake, heart rate, and blood lactate
were measured. No differences were
noted between the various protocols
with various doses of L-Arg.
The most common method of NOSindependent pathway intake reported
is through beetroot juice. A recent
meta-analysis by Hoon et al. (63)
showed that untrained or recreational
athletes showed better improvements
with nitrate intake, reported modest
improvement with protocols until
exhaustion, and showed small improvements in time trial protocols that,
though not statistically significant,
might be useful for elite athletes. However, the controversy over the usefulness of nitrate ingestion in elite athletes
continues because although some studies reported benefits in highly trained
rowing athletes (64), other studies did
not find improvement in time trial performances (62) or at 1,500 m (16).
Regarding tennis, the only study to have
been developed is by Aksit et al. (3). The
objective of this study was to establish
a relationship between tennis performance test results and NOx levels (the
sum of nitrate + nitrite). Twenty welltrained tennis players performed three
4-minute bouts and 2 minutes of continuous groundstrokes with balls shot
from a tennis ball machine at speeds

of 50, 55, 62, and 70 km/h. After this

exercise, the participants had 20 minutes
of passive rest. After each period and
during the recovery phase, NOx levels,
glucose, lactate levels, and lactate elimination speed were measured. The study
suggested that no significant correlation
was found between NOx levels and tennis performance. However, it was suggested that the addition of loads in the
third period of tennis training may be
beneficial and that the relationship
between performance on court and
NOx levels and glucose should be studied in real game situations (i.e., official
tennis matches).
Secondary effects associated with L-Arg
and NO are not well reported in the
literature. Basically, the most common
side effect reported with L-Arg is diarrhea. An excellent review that has been
lvares et al. (5)
published recently by A
showed that low oral doses of L-Arg
(#20 g) could obtain the same results
as those of higher doses (2130 g) without secondary effects such as nausea,
diarrhea, etc., which are associated with
doses above 20 g. Regarding nitrate
ingestion, it has been reported that supplementation through vegetable sources
(mainly beetroot juice) is unlikely to be
harmful or have side effects for the
organism, even at higher doses. However, nitrite in higher doses may cause
hypotension, especially if combined with
other vasodilatory drugs (82).
Because of the limited evidence available from studies using L-Arg or NOx
in the scientific literature on tennis performance, we should be cautious and
wait for further studies to clarify
whether this ergogenic aid could be
useful in sports as complex as tennis.
PRACTICAL APPLICATIONS

Despite the limited evidence we have

about ergogenic aids on the tennis court
(except for CAFF), a series of recommendations are presented to coaches,
strength and conditioning coaches,
and tennis-related medical personnel.
CAFF, in small doses (3 mg/kg bw)
may improve tennis performance (i.e.,
more points won with the serve),
although further studies should be

performed with different doses to determine whether there is an optimum dose.

Although SB and BA, because of their
buffer capacities, could have a place in
a sport such as tennis in which the
ability to recover between efforts is
critical, additional studies should be
performed to determine their usefulness in the world of tennis. As for
L -Arg and NOx, studies in real game
situations could be developed to consider them for use as ergogenic aids.

Sebatien
Borreani is
a member of the
research group in
Sports and
Health in the
Departament of
Physical Education and Sports at the University of
Valencia.
Jose Luis MateMunoz is a member of the Departament of
Physical Activity
and Sports Science at Alfonso X
University.

Finally, because of the weight gain in

tennis players associated with Cr ingestion and the lack of scientific evidence
(because little has been published about
Cr on tennis performance), more
research is needed during competitive
matches and during training blocks to
determine whether it may be appropriate at certain times of competition/
training.

Mark Kovacs is
CEO of the
International Tennis Performance
Association and
member of Sports
Science Institute at
Life University.

Conflicts of Interest and Source of Funding:

The authors report no conflicts of interest
and no source of funding.

Alvaro Lopez
Samanes is
a member of the
Exercise Physiology Lab at Castilla la Mancha
University.
Juan Fernando
Ortega
Fonseca is
a member of the
Exercise Physiology Lab at Castilla la Mancha
University.

Valentin Emilio
Fernandez
Elias is a member
of the Exercise
Physiology Lab
at Castilla La
Mancha
University.

REFERENCES
1. Abe H. Role of histidine-related
compounds as intracellular proton
buffering constituents in vertebrate
muscle. Biochemistry (Mosc) 65: 757
765, 2000.
2. Abel T, Knechtle B, Perret C, Eser P, von
Arx P, and Knecht H. Influence of chronic
supplementation of arginine aspartate in
endurance athletes on performance and
substrate metabolismA randomized,
double-blind, placebo-controlled study.
Int J Sports Med 26: 344349, 2005.
3. Aksit T, Turgay F, Kutlay E, Ozkol M, and
Vural F. The relationships between
simulated tennis performance and
biomarkers for nitric oxide synthesis.
J Sports Sci Med 12: 267274, 2013.
4. Alvares TS, Conte CA, Paschoalin VM,
Silva JT, Meirelles Cde M, Bhambhani YN,
and Gomes PS. Acute l-arginine
supplementation increases muscle blood
volume but not strength performance.
Appl Physiol Nutr Metab 37: 115126,
2012.

Strength and Conditioning Journal | www.nsca-scj.com

Ergogenic Aids, Tennis, and Performance

5. Alvares TS, Meirelles CM, Bhambhani YN,

Paschoalin VM, and Gomes PS. L-Arginine
as a potential ergogenic aid in healthy
subjects. Sports Med 41: 233248, 2011.
6. Artioli GG, Gualano B, Smith A, Stout J,
and Lancha AH Jr. Role of beta-alanine
supplementation on muscle carnosine and
exercise performance. Med Sci Sports
Exerc 42: 11621173, 2010.
7. Baguet A, Reyngoudt H, Pottier A,
Everaert I, Callens S, Achten E, and
Derave W. Carnosine loading and
washout in human skeletal muscles.
J Appl Physiol (1985) 106: 837842,
2009.
8. Bailey SJ, Winyard PG, Vanhatalo A,
Blackwell JR, DiMenna FJ, Wilkerson DP,
and Jones AM. Acute L-arginine
supplementation reduces the O2 cost of
moderate-intensity exercise and enhances
high-intensity exercise tolerance. J Appl
Physiol (1985) 109: 13941403, 2010.
9. Becque MD, Lochmann JD, and
Melrose DR. Effects of oral creatine
supplementation on muscular strength
and body composition. Med Sci Sports
Exerc 32: 654658, 2000.
10. Bellar DM, Kamimori G, Judge L,
Barkley JE, Ryan EJ, Muller M, and
Glickman EL. Effects of low-dose caffeine
supplementation on early morning
performance in the standing shot put
throw. Eur J Sport Sci 12: 5761, 2012.
11. Bescos R, Gonzalez-Haro C, Pujol P,
Drobnic F, Alonso E, Santolaria ML,
Ruiz O, Esteve M, and Galilea P. Effects of
dietary L-arginine intake on
cardiorespiratory and metabolic
adaptation in athletes. Int J Sport Nutr
Exerc Metab 19: 355365, 2009.
12. Bescos R, Sureda A, Tur JA, and Pons A.
The effect of nitric-oxide-related
supplements on human performance.
Sports Med 42: 99117, 2012.
13. Bishop D. Improve lactate tolerance in
tennis players. 10th International Tennis
Simposium. Milan, Italy, November
1516, 2008.
14. Bishop D. Dietary supplements and teamsport performance. Sports Med 40: 995
1017, 2010.
15. Bode-Boger SM, Boger RH, Galland A,
Tsikas D, and Frolich JC. L-arginineinduced vasodilation in healthy humans:
Pharmacokinetic-pharmacodynamic
relationship. Br J Clin Pharmacol 46:
489497, 1998.
16. Boorsma RK, Whitfield J, and Spriet LL.
Beetroot juice supplementation does not
improve performance of elite 1500-m

VOLUME 37 | NUMBER 3 | JUNE 2015

runners. Med Sci Sports Exerc 46: 2326

2334, 2014.
17. Braun H, Koehler K, Geyer H, Kleiner J,
Mester J, and Schanzer W. Dietary
supplement use among elite young
German athletes. Int J Sport Nutr Exerc
Metab 19: 97109, 2009.
18. Buford TW, Kreider RB, Stout JR,
Greenwood M, Campbell B, Spano M,
Ziegenfuss T, Lopez H, Landis J, and
Antonio J. International society of sports
nutrition position stand: Creatine
supplementation and exercise. J Int Soc
Sports Nutr 4: 6, 2007.
19. Burke DG, Chilibeck PD, Parise G,
Candow DG, Mahoney D, and
Tarnopolsky M. Effect of creatine and
weight training on muscle creatine and
performance in vegetarians. Med Sci
Sports Exerc 35: 19461955, 2003.
20. Burke LM and Pyne DB. Bicarbonate
loading to enhance training and
competitive performance. Int J Sports
Physiol Perform 2: 9397, 2007.
21. Camic CL, Housh TJ, Zuniga JM,
Hendrix RC, Mielke M, Johnson GO, and
Schmidt RJ. Effects of arginine-based
supplements on the physical working
capacity at the fatigue threshold. J Strength
Cond Res 24: 13061312, 2010.
22. Campbell B, Roberts M, Kerksick C,
Wilborn C, Marcello B, Taylor L, Nassar E,
Leutholtz B, Bowden R, Rasmussen C,
Greenwood M, and Kreider R.
Pharmacokinetics, safety, and effects on
exercise performance of L-arginine alphaketoglutarate in trained adult men.
Nutrition 22: 872881, 2006.
23. Carr AJ, Hopkins WG, and Gore CJ.
Effects of acute alkalosis and acidosis on
performance: A meta-analysis. Sports
Med 41: 801814, 2011.
24. Carr AJ, Slater GJ, Gore CJ, Dawson B,
and Burke LM. Effect of sodium
bicarbonate on [HCO3-], pH, and
gastrointestinal symptoms. Int J Sport
Nutr Exerc Metab 21: 189194, 2011.
25. Carr BM, Webster MJ, Boyd JC,
Hudson GM, and Scheett TP. Sodium
bicarbonate supplementation improves
hypertrophy-type resistance exercise
performance. Eur J Appl Physiol 113:
743752, 2013.
26. Conway KJ, Orr R, and Stannard SR.
Effect of a divided caffeine dose on
endurance cycling performance,
postexercise urinary caffeine
concentration, and plasma paraxanthine.
J Appl Physiol (1985) 94: 15571562,
2003.

27. Cooper R, Naclerio F, Allgrove J, and

Jimenez A. Creatine supplementation with
specific view to exercise/sports
performance: An update. J Int Soc Sports
Nutr 9: 33, 2012.
28. Cornish SM, Chilibeck PD, and
Burke DG. The effect of creatine
monohydrate supplementation on sprint
skating in ice-hockey players. J Sports
Med Phys Fitness 46: 9098, 2006.
29. Costill DL, Verstappen F, Kuipers H,
Janssen E, and Fink W. Acid-base
balance during repeated bouts of
exercise: Influence of HCO3. Int J Sports
Med 5: 228231, 1984.
30. Cox GR, Desbrow B, Montgomery PG,
Anderson ME, Bruce CR, Macrides TA,
Martin DT, Moquin A, Roberts A,
Hawley JA, and Burke LM. Effect of
different protocols of caffeine intake on
metabolism and endurance performance.
J Appl Physiol (1985) 93: 990999,
2002.
31. Del Coso J, Munoz G, and MunozGuerra J. Prevalence of caffeine use in
elite athletes following its removal from
the World Anti-Doping Agency list of
banned substances. Appl Physiol Nutr
Metab 36: 555561, 2011.
32. Del Coso J, Salinero JJ, GonzalezMillan C, Abian-Vicen J, and PerezGonzalez B. Dose response effects of
a caffeine-containing energy drink on
muscle performance: A repeated
measures design. J Int Soc Sports Nutr 9:
21, 2012.
33. Dennig H, Talbott JH, Edwards HT, and
Dill DB. Effect of acidosis and alkalosis
upon capacity for work. J Clin Invest 9:
601613, 1931.
34. Derave W, Everaert I, Beeckman S, and
Baguet A. Muscle carnosine metabolism
and beta-alanine supplementation in
relation to exercise and training. Sports
Med 40: 247263, 2010.
35. Desbrow B and Leveritt M. Well-trained
endurance athletes knowledge, insight,
and experience of caffeine use. Int J Sport
Nutr Exerc Metab 17: 328339, 2007.
36. Duncan MJ, Weldon A, and Price MJ. The
effect of sodium bicarbonate ingestion on
back squat and bench press exercise to
failure. J Strength Cond Res 28: 1358
1366, 2014.
37. Eijnde BO, Vergauwen L, and Hespel P.
Creatine loading does not impact on
stroke performance in tennis. Int J Sports
Med 22: 7680, 2001.
38. Fernandez J, Mendez-Villanueva A, and
Pluim BM. Intensity of tennis match play.

Br J Sports Med 40: 387391, 2006;

discussion 391.
39. Fernandez-Fernandez J, Zimek R,
Wiewelhove T, and Ferrauti A. Highintensity interval training vs. repeatedsprint training in tennis. J Strength Cond
Res 26: 5362, 2012.
40. Fernandez-Fernandez JS-R, Sanz-Rivas D,
and Mendez-Villanueva A. A review of the
activity profile and physiological demands
of tennis match play. Strength Cond J 31:
1526, 2009.
41. Ferrauti A, Weber K, and Struder HK.
Metabolic and ergogenic effects of
carbohydrate and caffeine beverages in
tennis. J Sports Med Phys Fitness 37:
258266, 1997.
42. Fricke O, Baecker N, Heer M, Tutlewski B,
and Schoenau E. The effect of L-arginine
administration on muscle force and power
in postmenopausal women. Clin Physiol
Funct Imaging 28: 307311, 2008.
43. Froiland K, Koszewski W, Hingst J, and
Kopecky L. Nutritional supplement use
among college athletes and their sources
of information. Int J Sport Nutr Exerc
Metab 14: 104120, 2004.
44. Gallo-Salazar C, Areces F, Abian-Vicen J,
Lara B, Salinero JJ, Gonzalez-Millan C,
Portillo J, Munoz V, Juarez D, and Del
Coso J. Caffeinated energy drinks
enhance physical performance in elite
junior tennis players. Int J Sports Physiol
Perform 10: 305310, 2015.
45. Gao JP, Costill DL, Horswill CA, and
Park SH. Sodium bicarbonate ingestion
improves performance in interval
swimming. Eur J Appl Physiol Occup
Physiol 58: 171174, 1988.
46. Girard O, Christian RJ, Racinais S, and
Periard JD. Heat stress does not
exacerbate tennis-induced alterations in
physical performance. Br J Sports Med
48(Suppl 1): i39i44, 2014.
47. Girard O and Millet GP. Physical
determinants of tennis performance in
competitive teenage players. J Strength
Cond Res 23: 18671872, 2009.
48. Glaister M, Howatson G, Abraham CS,
Lockey RA, Goodwin JE, Foley P, and
McInnes G. Caffeine supplementation and
multiple sprint running performance. Med
Sci Sports Exerc 40: 18351840, 2008.
49. Goldstein E, Jacobs PL, Whitehurst M,
Penhollow T, and Antonio J. Caffeine
enhances upper body strength in
resistance-trained women. J Int Soc
Sports Nutr 7: 18, 2010.
50. Goldstein ER, Ziegenfuss T, Kalman D,
Kreider R, Campbell B, Wilborn C,

Taylor L, Willoughby D, Stout J,

Graves BS, Wildman R, Ivy JL, Spano M,
Smith AE, and Antonio J. International
society of sports nutrition position stand:
Caffeine and performance. J Int Soc
Sports Nutr 7: 5, 2010.

62. Hoon MW, Hopkins WG, Jones AM,

Martin DT, Halson SL, West NP,
Johnson NA, and Burke LM. Nitrate
supplementation and high-intensity
performance in competitive cyclists. Appl
Physiol Nutr 39: 10431049, 2014.

51. Graham TE. Caffeine and exercise:

Metabolism, endurance and performance.
Sports Med 31: 785807, 2001.

63. Hoon MW, Johnson NA, Chapman PG,

and Burke LM. The effect of nitrate
supplementation on exercise performance
in healthy individuals: A systematic review
and meta-analysis. Int J Sport Nutr Exerc
Metabol 23: 522532, 2013.

52. Graham TE, Hibbert E, and Sathasivam P.

Metabolic and exercise endurance effects
of coffee and caffeine ingestion. J Appl
Physiol (1985) 85: 883889, 1998.
53. Graham TE and Spriet LL. Metabolic,
catecholamine, and exercise performance
responses to various doses of caffeine.
J Appl Physiol (1985) 78: 867874,
1995.
54. Gualano B, Roschel H, Lancha-Jr AH,
Brightbill CE, and Rawson ES. In sickness
and in health: The widespread application
of creatine supplementation. Amino Acids
43: 519529, 2012.
55. Harland BF. Caffeine and nutrition.
Nutrition 16: 522526, 2000.
56. Harris RC, Tallon MJ, Dunnett M,
Boobis L, Coakley J, Kim HJ,
Fallowfield JL, Hill CA, Sale C, and
Wise JA. The absorption of orally supplied
beta-alanine and its effect on muscle
carnosine synthesis in human vastus
lateralis. Amino Acids 30: 279289,
2006.
57. Hill CA, Harris RC, Kim HJ, Harris BD,
Sale C, Boobis LH, Kim CK, and Wise JA.
Influence of beta-alanine supplementation
on skeletal muscle carnosine
concentrations and high intensity cycling
capacity. Amino Acids 32: 225233,
2007.
58. Hobson RM, Saunders B, Ball G,
Harris RC, and Sale C. Effects of betaalanine supplementation on exercise
performance: A meta-analysis. Amino
Acids 43: 2537, 2012.
59. Hoffman J, Ratamess N, Kang J,
Mangine G, Faigenbaum A, and Stout J.
Effect of creatine and beta-alanine
supplementation on performance and
endocrine responses in strength/power
athletes. Int J Sport Nutr Exerc Metabol
16: 430446, 2006.
60. Hoffman J, Ratamess NA, Ross R, Kang J,
Magrelli J, Neese K, Faigenbaum AD, and
Wise JA. Beta-alanine and the hormonal
response to exercise. Int J Sports Med
29: 952958, 2008.
61. Hoffman JR, Emerson NS, and Stout JR.
Beta-Alanine supplementation. Curr
Sports Med Rep 11: 189195, 2012.

64. Hoon MW, Jones AM, Johnson NA,

Blackwell JR, Broad EM, Lundy B,
Rice AJ, and Burke LM. The effect of
variable doses of inorganic nitrate-rich
beetroot juice on simulated 2,000-m
rowing performance in trained athletes. Int
J Sports Physiol Perform 9: 615620,
2014.
65. Hornery DJ, Farrow D, Mujika I, and
Young WB. Caffeine, carbohydrate, and
cooling use during prolonged simulated
tennis. Int J Sports Physiol Perform 2:
423438, 2007.
66. Hultman E and Sahlin K. Acid-base
balance during exercise. Exerc Sport Sci
Rev 8: 41128, 1980.
67. Hultman E, Soderlund K, Timmons JA,
Cederblad G, and Greenhaff PL. Muscle
creatine loading in men. J Appl Physiol
(1985) 81: 232237, 1996.
68. Jenkins NT, Trilk JL, Singhal A,
OConnor PJ, and Cureton KJ. Ergogenic
effects of low doses of caffeine on cycling
performance. Int J Sport Nutr Exerc
Metabol 18: 328342, 2008.
69. Jones AM. Dietary nitrate
supplementation and exercise
performance. Sports Med 44(Suppl 1):
S35S45, 2014.
70. Juhn M. Popular sports supplements and
ergogenic aids. Sports Med 33: 921
939, 2003.
71. Kamimori GH, Karyekar CS,
Otterstetter R, Cox DS, Balkin TJ,
Belenky GL, and Eddington ND. The rate
of absorption and relative bioavailability of
caffeine administered in chewing gum
versus capsules to normal healthy
volunteers. Int J Pharm 234: 159167,
2002.
72. Kendrick IP, Harris RC, Kim HJ, Kim CK,
Dang VH, Lam TQ, Bui TT, Smith M, and
Wise JA. The effects of 10 weeks of
resistance training combined with betaalanine supplementation on whole body
strength, force production, muscular
endurance and body composition. Amino
Acids 34: 547554, 2008.

Strength and Conditioning Journal | www.nsca-scj.com

Ergogenic Aids, Tennis, and Performance

73. Killer SC, BA, and Jeukendrup AE. No

evidence of dehydration with moderate
daily coffee intake: A counterbalanced
cross-over study in a free-living
population. PLoS One 9: e84154,
2014.
74. Klein C, Clawson A, Martin M,
Saunders MJ, Flohr JA, Bechtel MA,
Dunham W, Hancock M, and
Womack CJ. The effect of caffeine on
performance in collegiate tennis players.
J Caffeine Res 2: 111116, 2013.
75. Kovacs MS. Tennis physiology: Training
the competitive athlete. Sports Med 37:
189198, 2007.
76. Kovacs MS. A review of fluid and
hydration in competitive tennis. Int J
Sports Physiol Perform 3: 413423,
2008.
77. Kovacs MS and Baker LB. Recovery
interventions and strategies for improved
tennis performance. Br J Sports Med 48
(Suppl 1): i1821, 2014.
78. Kristiansen M, Levy-Milne R, Barr S, and
Flint A. Dietary supplement use by varsity
athletes at a Canadian university. Int J
Sport Nutr Exerc Metab 15: 195210,
2005.
79. Kutz MR and Gunter MJ. Creatine
monohydrate supplementation on body
weight and percent body fat. J Strength
Cond Res 17: 817821, 2003.
80. Liguori A, Hughes JR, and Grass JA.
Absorption and subjective effects of
caffeine from coffee, cola and capsules.
Pharmacol Biochem Behav 58: 721
726, 1997.
81. Liu TH, Wu CL, Chiang CW, Lo YW,
Tseng HF, and Chang CK. No effects of
short-term arginine supplementation on
nitric oxide production, metabolism and
performance in intermittent exercise in
athletes. J Nutr Biochem 20: 462468,
2009.
82. Lundberg JO, Larsen FJ, and Weitzberg E.
Supplementation with nitrate and nitrite
salts in exercise: A word of caution. J Appl
Physiol (1985) 111: 616617, 2011.
83. MacIntosh BR and Wright BM. Caffeine
ingestion and performance of a 1,500metre swim. Can J Appl Physiol 20: 168
177, 1995.

information among college athletes. Adv

Med Sci 52: 5054, 2007.
86. Mannion AF, Jakeman PM, Dunnett M,
Harris RC, and Willan PL. Carnosine and
anserine concentrations in the quadriceps
femoris muscle of healthy humans. Eur J
Appl Physiol Occup Physiol 64: 4750,
1992.

98. Pallares JG, Fernandez-Elias VE,

Ortega JF, Munoz G, Munoz-Guerra J, and
Mora-Rodriguez R. Neuromuscular
responses to incremental caffeine doses:
Performance and side effects. Med Sci
Sports Exerc 45: 21842192, 2013.

87. Matson LG and Tran ZV. Effects of

sodium bicarbonate ingestion on
anaerobic performance: A meta-analytic
review. Int J Sport Nutr 3: 228, 1993.

99. Parkhouse WS, McKenzie DC,

Hochachka PW, and Ovalle WK.
Buffering capacity of deproteinized
human vastus lateralis muscle. J Appl
Physiol (1985) 58: 1417, 1985.

88. Matthews MM and Traut TW. Regulation

of N-carbamoyl-beta-alanine
amidohydrolase, the terminal enzyme in
pyrimidine catabolism, by ligand-induced
change in polymerization. J Biol Chem
262: 72327237, 1987.
89. Maughan RJ, Depiesse F, and Geyer H.
The use of dietary supplements by
athletes. J Sports Sci 25(Suppl 1):
S103S113, 2007.
90. Maughan RJ, King DS, and Lea T. Dietary
supplements. J Sports Sci 22: 95113,
2004.
91. McCarty MF. Supplemental creatine may
decrease serum homocysteine and
abolish the homocysteine gender gap
by suppressing endogenous creatine
synthesis. Med Hypotheses 56: 57,
2001.
92. McLellan TM and Bell DG. The impact of
prior coffee consumption on the
subsequent ergogenic effect of
anhydrous caffeine. Int J Sport Nutr Exerc
Metab 14: 698708, 2004.
93. McNaughton LR. Sodium bicarbonate
ingestion and its effects on anaerobic
exercise of various durations. J Sports Sci
10: 425435, 1992.
94. McNaughton LR, Siegler J, and Midgley A.
Ergogenic effects of sodium bicarbonate.
Curr Sports Med Rep 7: 230236, 2008.
95. Mesa JL, Ruiz JR, Gonzalez-Gross MM,
Gutierrez Sainz A, and Castillo
Garzon MJ. Oral creatine
supplementation and skeletal muscle
metabolism in physical exercise. Sports
Med 32: 903944, 2002.

84. Magkos F and Kavouras SA. Caffeine use

in sports, pharmacokinetics in man, and
cellular mechanisms of action. Crit Rev
Food Sci Nutr 45: 535562, 2005.

96. Mora-Rodriguez R, Garcia Pallares J,

Lopez-Samanes A, Ortega JF, and
Fernandez-Elias VE. Caffeine ingestion
reverses the circadian rhythm effects on
neuromuscular performance in highly
resistance-trained men. PLoS One 7:
e33807, 2012.

85. Malinauskas BM, Overton RF,

Carraway VG, and Cash BC.
Supplements of interest for sport-related
injury and sources of supplement

97. Mora-Rodriguez R, Pallares JG, LopezGullon JM, Lopez-Samanes A, FernandezElias VE, and Ortega JF. Improvements on
neuromuscular performance with caffeine

10

VOLUME 37 | NUMBER 3 | JUNE 2015

ingestion depend on the time-of-day. J Sci

Med Sport 18: 338342, 2015.

100. Pasman WJ, van Baak MA,

Jeukendrup AE, and de Haan A. The
effect of different dosages of caffeine on
endurance performance time. Int J Sports
Med 16: 225230, 1995.
101. Peart DJ, Siegler JC, and Vince RV.
Practical recommendations for coaches
and athletes: A meta-analysis of sodium
bicarbonate use for athletic performance.
J Strength Cond Res 26: 19751983,
2012.
102. Periard JD, Racinais S, Knez WL,
Herrera CP, Christian RJ, and Girard O.
Thermal, physiological and perceptual
strain mediate alterations in match-play
tennis under heat stress. Br J Sports Med
48(Suppl 1): i32i38, 2014.
103. Persky AM and Brazeau GA. Clinical
pharmacology of the dietary supplement
creatine monohydrate. Pharmacol Rev
53: 161176, 2001.
104. Pluim BM, Ferrauti A, Broekhof F,
Deutekom M, Gotzmann A, Kuipers H, and
Weber K. The effects of creatine
supplementation on selected factors of
tennis specific training. Br J Sports Med
40: 507511, 2006; discussion 511502.
105. Pumpa KL, Madigan SM, Wood
Martin RE, Flanagan R, and Roche N. The
development of nutritional-supplement
fact sheets for Irish athletes: A case study.
Int J Sport Nutr Exerc Metab 22: 220
224, 2012.
106. Rampinini E, Coutts AJ, Castagna C,
Sassi R, and Impellizzeri FM. Variation in
top level soccer match performance. Int J
Sports Med 28: 10181024, 2007.
107. Reid M and Schneiker K. Strength and
conditioning in tennis: Current research
and practice. J Sci Med Sport 11: 248
256, 2008.
108. Renfree A. The time course for changes in
plasma [h+] after sodium bicarbonate
ingestion. Int J Sports Physiol Perform 2:
323326, 2007.
109. Requena B, Zabala M, Padial P, and
Feriche B. Sodium bicarbonate and

sodium citrate: Ergogenic aids?.

J Strength Cond Res 19: 213224,
2005.
110. Reyner LA and Horne JA. Sleep
restriction and serving accuracy in
performance tennis players, and effects of
caffeine. Physiol Behavior 120: 9396,
2013.
111. Roetert EG, Garrett GE, Brown SW, and
Camaione DN. Performance profiles of
nationally ranked junior tennis players.
J Strength Cond Res 6: 225231, 1992.
112. Sale C, Harris RC, Florance J, Kumps A,
Sanvura R, and Poortmans JR. Urinary
creatine and methylamine excretion
following 4 x 5 g x day(-1) or 20 x 1 g x day
(-1) of creatine monohydrate for 5 days.
J Sports Sci 27: 759766, 2009.
113. Sale C, Saunders B, and Harris RC.
Effect of beta-alanine supplementation on
muscle carnosine concentrations and
exercise performance. Amino Acids 39:
321333, 2010.
114. Schedel JM, Tanaka H, Kiyonaga A,
Shindo M, and Schutz Y. Acute creatine
ingestion in human: Consequences on
serum creatine and creatinine
concentrations. Life Sci 65: 24632470,
1999.
115. Schneiker KT, Bishop D, Dawson B, and
Hackett LP. Effects of caffeine on
prolonged intermittent-sprint ability in
team-sport athletes. Med Sci Sports
Exerc 38: 578585, 2006.
116. Schroder H, Terrados N, and Tramullas A.
Risk assessment of the potential side
effects of long-term creatine
supplementation in team sport athletes.
Eur J Nutr 44: 255261, 2005.
117. Sokmen B, Armstrong LE, Kraemer WJ,
Casa DJ, Dias JC, Judelson DA, and
Maresh CM. Caffeine use in sports:
Considerations for the athlete. J Strength
Cond Res 22: 978986, 2008.
118. Souza-Junior TP, Willardson JM,
Bloomer R, Leite RD, Fleck SJ,
Oliveira PR, and Simao R. Strength and
hypertrophy responses to constant and
decreasing rest intervals in trained men

using creatine supplementation. J Int Soc

Sports Nutr 8: 17, 2011.
119. Stellingwerff T, Anwander H, Egger A,
Buehler T, Kreis R, Decombaz J, and
Boesch C. Effect of two beta-alanine
dosing protocols on muscle carnosine
synthesis and washout. Amino Acids 42:
24612472, 2012.
120. Stellingwerff T, Decombaz J, Harris RC,
and Boesch C. Optimizing human in vivo
dosing and delivery of beta-alanine
supplements for muscle carnosine
synthesis. Amino Acids 43: 5765, 2012.
121. Stout JR, Cramer JT, Zoeller RF, Torok D,
Costa P, Hoffman JR, Harris RC, and
OKroy J. Effects of beta-alanine
supplementation on the onset of
neuromuscular fatigue and ventilatory
threshold in women. Amino Acids 32:
381386, 2007.
122. Strecker E, Foster EB, Taylor K, Bell L,
Pascoe, and David D. The effect of
caffeine ingestion on tennis skill
performance. Med Science Sports
Exercise 38: S175, 2006.
123. Strecker E, Foster EB, Taylor K, Bell L,
Pascoe D, and David D. The effect of
caffeine ingestion on tennis skill
performance and hydration status. Med
Sci Sports Exerc 2007: S43, 2007.
124. Struder H, Ferrauti A, Gotzmann A,
Webber K, and Hollman W. Effects of
carbohydrate and caffeine on plasma
amino acids, neuroendocrine reponses
and performance in tennis. Nutr Neurosci
1: 419426, 1999.
125. Sureda A and Pons A. Arginine and
citrulline supplementation in sports and
exercise: Ergogenic nutrients? Med Sport
Science 59: 1828, 2012.
126. Terjung RL, Clarkson P, Eichner ER,
Greenhaff PL, Hespel PJ, Israel RG,
Kraemer WJ, Meyer RA, Spriet LL,
Tarnopolsky MA, Wagenmakers AJ, and
Williams MH. American College of Sports
Medicine roundtable. The physiological
and health effects of oral creatine
supplementation. Med Sci Sports Exerc
32: 706717, 2000.

127. Turley K, Rivas D, Townseed J, Morton A,

Kosarek J, and Cullum M. Effects of
caffeine on anaerobic exercise in boys.
Pediatr Exerc Sci: 210219, 2012.
128. Vergauwen L, Brouns F, and Hespel P.
Carbohydrate supplementation
improves stroke performance in tennis.
Med Sci Sports Exerc 30: 1289
1295, 1998.
129. Vergauwen L, Spaepen AJ, Lefevre J, and
Hespel P. Evaluation of stroke
performance in tennis. Med Sci
Sports Exerc 30: 12811288, 1998.
130. Vorgerd M, Grehl T, Jager M, Muller K,
Freitag G, Patzold T, Bruns N, Fabian K,
Tegenthoff M, Mortier W, Luttmann A,
Zange J, and Malin JP. Creatine therapy
in myophosphorylase deficiency
(McArdle disease): A placebo-controlled
crossover trial. Arch Neurol 57: 956
963, 2000.
131. Warren GL, Park ND, Maresca RD,
McKibans KI, and Millard-Stafford ML.
Effect of caffeine ingestion on muscular
strength and endurance: A meta-analysis.
Med Sci Sports Exerc 42: 13751387,
2010.
132. Wax B, Kavazis AN, Webb HE, and
Brown SP. Acute L-arginine alpha
ketoglutarate supplementation fails to
improve muscular performance in
resistance trained and untrained men.
J Int Soc Sports Nutr 9: 17, 2012.
133. Webster MJ, Webster MN,
Crawford RE, and Gladden LB. Effect
of sodium bicarbonate ingestion on
exhaustive resistance exercise
performance. Med Sci Sports Exerc 25:
960965, 1993.
134. Wu CL, Shih MC, Yang CC, Huang MH,
and Chang CK. Sodium bicarbonate
supplementation prevents skilled tennis
performance decline after a simulated
match. J Int Soc Sports Nutr 7: 33, 2010.
135. Yavuz HU, Turnagol H, and Demirel AH.
Pre-exercise arginine supplementation
increases time to exhaustion in elite male
wrestlers. Biol Sport 31: 187191,
2014.

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