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Special Article

Acute effects of dietary constituents on motor skill and

cognitive performance in athletes
Lindsay B Baker, Ryan P Nuccio, and Asker E Jeukendrup

Performance in many sports is at least partially dependent on motor control,

coordination, decision-making, and other cognitive tasks. This review summarizes

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available evidence about the ingestion of selected nutrients or isolated compounds
(dietary constituents) and potential acute effects on motor skill and/or cognitive
performance in athletes. Dietary constituents discussed include branched-chain
amino acids, caffeine, carbohydrate, cocoa flavanols, Gingko biloba, ginseng,
guarana, Rhodiola rosea, sage, L-theanine, theobromine, and tyrosine. Although
this is not an exhaustive list, these are perhaps the most researched dietary
constituents. Caffeine and carbohydrate have the greatest number of published
reports supporting their ability to enhance acute motor skill and cognitive
performance in athletes. At this time, there is insufficient published evidence to
substantiate the use of any other dietary constituents to benefit sports-related motor
skill or cognitive performance. The optimal dose and timing of caffeine and
carbohydrate intake promoting enhanced motor skill and cognitive performance
remain to be identified. Valid, reliable, and sensitive batteries of motor skills and
cognitive tests should be developed for use in future efficacy studies.
© 2014 International Life Sciences Institute

INTRODUCTION mitter systems (e.g., by increasing catecholamine release,

Nutrition plays an important role in optimal cognitive
function. There has been an abundance of research on the
effect of specific nutrients and isolated compounds (here-
after collectively referred to as dietary constituents) on
cognitive performance. Dietary constituents may influ-
ence the brain through acute effects from a single dose
and/or chronic effects of daily intake. The dietary con-
stituents and mechanisms of action purported to benefit
long-term cognitive function and/or to mitigate age- and
disease-related cognitive impairments are reviewed
elsewhere.1–8 This review will focus on the acute effects of
a dietary constituent (e.g., ingested shortly before and/or
during sports competition). Acute changes in cognition
and/or motor skill performance have been proposed to
occur via modulation of factors that stimulate the central
nervous system. Specifically, modulation of neurotrans-
inhibiting acetylcholinesterase or monoamine oxidase
activity, or inhibiting adenosine receptors) and augmen-
tation of cerebral perfusion have been suggested, espe-
cially under conditions of mental and/or physical
stress.2,9–16 Dietary constituents that have been purported
to enhance acute motor skill and/or cognitive perfor-
mance include branched-chain amino acids, caffeine, car-
bohydrate, cocoa flavanols, Gingko biloba, ginseng,
guarana, Rhodiola rosea, sage, L-theanine, theobromine,
and tyrosine. Although this list is not exhaustive, these are
perhaps the most researched dietary constituents. This
discussion will be limited primarily to the independent
effects of a dietary constituent as opposed to the combi-
nation of two or more ingredients.
Cognitive function is important to athletes, such as
skill and team sport athletes, because performance in
many sports is at least partially dependent on motor

Affiliations: LB Baker, RP Nuccio, and AE Jeukendrup are with the Gatorade Sports Science Institute, Barrington, Illinois, USA. AE Jeukendrup
is with Loughborough University, Leicestershire, UK.
Correspondence: LB Baker, Gatorade Sports Science Institute, 617 W. Main St., Barrington, IL 60010, USA. E-mail: lindsay.baker@pepsico.com,
Phone: +1-847-304-2142.
Key words: caffeine, carbohydrate, team sports

doi:10.1111/nure.12157
790 Nutrition Reviews® Vol. 72(12):790–802
control, coordination, decision-making, timing, and other
cognitive tasks. However, the literature on cognition-
enhancing dietary constituents specific to an exercise/
sport setting is relatively sparse, and there are no
comprehensive published reviews on this topic. Thus, the
objective here is to review the available evidence to deter-
mine which of these dietary constituents have scientific
support to improve motor skill and/or cognitive perfor-
mance in young healthy adults, especially athletes, to help
guide the direction of future research.
OVERVIEW OF MOTOR SKILL AND COGNITIVE TESTS
This review of the literature includes studies that tested
accuracy, alertness, attention, decision-making, memory,
visual acuity, visuomotor function, balance, agility, reac-
tion time, and sport-specific skills, as these are perhaps
the measures of motor skill and cognition most relevant
to sport performance. One of the challenges in interpret-
ing this area of the literature is the different methodology
across studies. Many tests can be used to measure the
attributes of skill and cognitive function. The definitions
and tests used to measure various aspects of motor skill
and cognitive performance are summarized below.
Motor skill is the ability to perform complex muscle-
to-nerve interaction that produces movement; it can be
classified as fine motor skill (small movements such as
dexterity or hand-steadiness tests) or gross motor skill
(large movements such as running or kicking). Some
studies have employed sport-specific motor skills such as
passing and dribbling accuracy during a simulated soccer
game.17 Agility is “rapid whole-body movement with
change of velocity or direction in response to a stimu-
lus.”18 For example, while playing defense in the game of
basketball, players need to make quick lateral movements
(i.e., defensive slides) in reaction to an opponent’s move-
ments. Visuomotor function is the coordination of move-
ment and visual perception and is measured with various
visual information-processing tests. Attention or con-
centration is the ability to selectively process certain
information while simultaneously inhibiting other infor-
mation.19 Both the accuracy and the speed of attention
can be measured; common tests include the Serial Threes
and the Serial Sevens subtraction tests and the Stroop
Color-Word Test. Vigilance is attention that is sustained
over a prolonged period of time and is often measured
with Continuous Performance Tests (such as Tests of
Variables of Attention).20 Alertness is a component
process of attention/arousal and is often measured sub-
jectively using visual analog scales.21 Memory is a filing
system in the brain that allows for the storage, encoding,
and retrieval of information. Memory is often subcatego-
rized into working (short-term) and secondary (long-
term) memory.19 Various tests, including recall, can be
Nutrition Reviews® Vol. 72(12):790–802
used to measure the quality and/or speed of memory.
Recall is the retrieval of information or events residing in
memory.19 Reaction time is the interval of time between
application of a stimulus and detection of a response.
Both the simple reaction time test and the choice reaction
time test are commonly employed.22 Further details on
cognitive function tests and definitions are available from
various resources on neuropsychological assessment.21,23
Another issue specific to cognitive assessment in ath-
letes is that many measurements of cognitive perfor-
mance may not be relevant to sports practice.
Furthermore, many of the tests used to measure skill have
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inherently high variability (day-to-day, learning effects,
etc.), and this low signal-to-noise ratio may make it dif-
ficult to detect significant differences in performance.
Thus, it is important that valid, sensitive, and sport-
specific tests applicable to realistic sporting situations or
environments be developed.
LITERATURE REVIEW OF DIETARY CONSTITUENTS
Branched-chain amino acids
Branched-chain amino acids (leucine, isoleucine, and
valine) are large neutral amino acids and have been impli-
cated as a potential nutritional countermeasure to central
fatigue during prolonged exercise, possibly mediated by
their proposed impact on serotonin synthesis in the
brain.15 Mood, arousal, and sleepiness are known to be
affected by changes in brain serotonin. For example,
administration of paroxetine24 or fluoxetine15 (serotonin
re-uptake inhibitors) have been shown to reduce exercise
time to fatigue and increase ratings of perceived exertion
in runners and cyclists. An increase in the ratio of plasma
free tryptophan (precursor of serotonin) to branched-
chain amino acids results in a rise in serotonin synthesis
in the brain. It has therefore been hypothesized that inges-
tion of branched-chain amino acids can reduce brain
serotonin concentrations and mitigate central fatigue.
The effects of branched-chain amino acid intake on
cognitive performance during exercise have been tested
in only a few studies.25–29 In 2 studies of runners, ingestion
of a carbohydrate solution with branched-chain amino
acids (total intake of 5.3 g27 or 7.5 g26 during exercise)
improved cognitive performance after a 30-km competi-
tive run compared with a carbohydrate solution without
branched-chain amino acids. In 1 of these studies,
branched-chain amino acids improved performance
during the more complex cognitive tasks (attention) but
had no impact on less-demanding tasks (mathematical
ability, short-term memory).27 In another study,
Blomstrand et al.25 reported that ingestion of 90 mg/kg of
branched-chain amino acids improved attention perfor-
791
mance compared with placebo after a bout of prolonged
cycling. By contrast, Cheuvront et al.29 recently observed
no benefits of a solution with 10 g/L branched-chain
amino acids on performance during a battery of basic and
complex cognitive computerized tests after heat-
acclimated men cycled in the heat for 90 minutes while
hypohydrated. Despite the potential mechanism behind
the hypothesis that branched-chain amino acid intake
would benefit athletes, the available experimental evi-
dence in endurance athletes is currently mixed, and no
studies have been conducted in skill-sport athletes. There-
fore, branched-chain amino acids cannot currently be
recommended to enhance motor skills or cognition for
sports performance.
Caffeine
Caffeine, a trimethylxanthine, is a naturally occurring
substance in coffee, chocolate, guarana, and other plants
such as cassina, kola nut, and yerba mate. It is probably
the dietary constituent most extensively researched
for effects on exercise and sport performance. It is
beyond the scope of this review to discuss all topics
in detail; however, other reviews and controlled trials
of the effects of caffeine on endurance exercise
performance,30–32 short-term high-intensity exercise,
and repeated sprint ability33–37 are available. This section
will focus on the effects of caffeine on motor skill and
cognitive performance.
The effect of caffeine on sports-related measures of
motor skill performance during simulated sport activity
has been tested in several studies.34,36,38–43 In 1 study,41 the
passing accuracy of soccer players was significantly better
after ingestion of 6 mg of caffeine per kilogram of body
mass (mg/kg) versus placebo 1 hour before simulated
soccer activity (consisting of 90 min of soccer-specific
intermittent running interspersed with skill tests).
Duncan et al.38 reported that sprint-dribble times and
ball-handling scores after a bout of total-body fatiguing
exercise (squat thrusts at 90% maximal capacity for
1 min) by competitive field hockey players was signifi-
cantly better after caffeine ingestion (5 mg/kg) compared
with placebo.38 In another study,36 6 mg/kg caffeine
improved passing accuracy by 10% compared with
placebo in high-level male rugby players during a simu-
lated 80-minute rugby game. The effect of caffeine on
performance was most apparent in the second half of the
simulated game. In the placebo trial, the passing accuracy
of subjects declined (by 18%) with fatigue in the second
half, whereas performance was maintained in the caffeine
trial.36 Similarly, Hornery et al.44 found that, in compari-
son with placebo, caffeine ingestion increased serve veloc-
ity by highly trained tennis players in the final set of a
simulated tennis match. In another study,39 trained ath-
792
letes of amateur and semiprofessional team sports
ingested caffeine (6 mg/kg) or placebo 1 hour before a
simulated team game involving intermittent running and
skill tests. According to a qualitative analysis of results,
there was a “likely” ergogenic effect of caffeine ingestion
on decision-making accuracy and reactive agility time
compared with placebo.39
It is important to note that a few of the exercise/
sport-related studies have reported no benefit of caffeine
on motor skill performance.34,40,42 For instance, caffeine
(364 mg for men, 260 mg for women) intake during a
tennis match did not improve the hitting accuracy of
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players in a ball-machine test performed after a simulated
match.40 Pontifex et al.34 reported that 6 mg/kg caffeine
improved repeated sprint performance in 10 moderately
trained male team-sport athletes but had no effect on
their reactive agility performance. In another study,42
intake of 6 mg/kg caffeine by college-aged active but
untrained men had no effect on agility or Wingate Test
performance. The difference in results between these
studies34,40,42 and others that found a benefit of caffeine on
athletic agility and skill36,38,39,41 is unclear. The caffeine
doses were similar across studies (5–6 mg/kg), so the
effect of other methodological differences (e.g., exercise
protocol, type of skill tests, skill level of subjects) is most
likely contributory. As mentioned previously, it is difficult
to compare results across studies because many different
tests have been used to measure motor skill and cognitive
function. However, it is interesting to note that all of the
studies reporting a performance-enhancing effect of caf-
feine on sports-related motor skill performance inter-
spersed tests within or after a period of exercise to induce
fatigue and/or simulate game play.36,38,39,41 Perhaps this
provides support to the notion that caffeine is more likely
to benefit motor skill performance of athletes in situa-
tions where physical/mental fatigue is prominent, com-
monly toward the end of practice or a game. Additionally,
most of the studies reporting enhanced performance with
caffeine used sport-specific skill tests relevant to actual
game play,36,38,41,44 which is another important aspect to
consider when assessing the potential impact of a dietary
constituent on sport performance.
To date there are no dose-response studies on the
acute effects of caffeine intake on sport-specific skill and
cognition. Dose-related effects on cognitive performance
have been tested in the general population. A recent
review of double-blind placebo-controlled studies that
assessed acute effects of caffeine on attention tasks
in healthy adults concluded that caffeine improves
performance in simple and complex attention tasks,
but there is inconclusive evidence of dose-related
(ranging from 12.5 mg to 500 mg across studies) effects
on performance.45 In only a few of the more than 15
studies included in the review were the improvements in
Nutrition Reviews® Vol. 72(12):790–802
attention clearly related to caffeine dose.45 The other
studies indicated no relation to dose, a partial relation to
dose (e.g., attention performance reached an asymptote at
the middle dose), or a dose-response effect that varied
within studies, depending on the test administered.45 A
review by Einöther and Giesbrecht45 provides more details
on the inconclusive dose-response effects of caffeine
intake on attention performance in healthy adults (non-
athletes). It is interesting to note that similar findings on
the dose response of endurance performance to caffeine
intake have been reported; that is, lower doses (∼3 mg/kg)
were just as effective at improving endurance capacity as
moderate to higher doses (∼6 to 13 mg/kg).14,46,47
For certain aspects of motor skill function or cogni-
tion, it is noteworthy that some studies have found no
effect34,40,42,48–52 and even a negative effect53–57 of caffeine
ingestion. While it appears that caffeine ingestion has a
consistent beneficial effect on alertness and attention, it
seems to have little effect on memory performance.49,50
Additionally, Loke et al.57 found that caffeine ingestion (3
or 6 mg/kg) increased anxiety and tenseness and
impaired fine motor coordination in young healthy sub-
jects. Bovim et al.53 compared the effects of oral caffeine
(300 mg as coffee) versus placebo (decaffeinated coffee)
on motor steadiness and coordination using a crossover
study design in healthy young women. Caffeine ingestion
resulted in poorer performance than exposure to placebo.
However, these relatively isolated reports of caffeine-
induced anxiety and impaired fine motor performance
seem to have occurred mostly in non-users of caf-
feine55,56,58,59 or when the caffeine dose was approximately
300 mg or higher.60,61 Studies have shown that genetics
also play a role in the individual variability in the acute
response (e.g., anxiety) to caffeine ingestion.62 At any rate,
it is important to remember that these same levels of
caffeine ingestion (≥300 mg) have also demonstrated
performance-enhancing effects on motor skills (as dis-
cussed above).
It is likely that the effect of caffeine on motor skill and
cognitive performance is at least partially related to com-
petitive inhibition of adenosine receptors. Caffeine is a
relatively nonspecific adenosine antagonist but seems to
have the highest affinity for the A1 receptor subtype.63,64
Adenosine inhibition can result in central effects that can
affect the perception of pain, fatigue, and exertion as well
as cognition, alertness, and mood during exercise.65
There is some debate as to whether the beneficial
cognitive effects of caffeine reported in the literature are
due directly to caffeine or simply to the reversal of caffeine
withdrawal.66,67 In most studies, research subjects are
regular caffeine users, and the effects of caffeine ingestion
on their cognitive performance are tested after a period of
caffeine deprivation (usually overnight). There is some
evidence that caffeine withdrawal impairs cognitive per-
Nutrition Reviews® Vol. 72(12):790–802
formance (reaction time, memory),68,69 thus leading some
to adopt the view that the alleviation of these “withdrawal
symptoms” is a major component of the ergogenic effect of
caffeine on mood and cognition. However, the weight of
evidence and opinion is against the caffeine withdrawal-
alleviation model.45,58,61,70–74 The main argument against
withdrawal alleviation is that beneficial effects of caffeine
on mood and cognitive performance are experienced by
nonconsumers (who do not experience caffeine with-
drawal) as well as regular consumers.73–75
Finally, it is important to note that, contrary to
popular belief, caffeine ingestion (<∼450 mg) before exer-
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cise and/or exposure to environmental heat stress does
not have a negative impact on hydration or body tem-
perature regulation.76–78 In conclusion, the available evi-
dence in sport-specific studies suggests that 5–6 mg/kg of
caffeine consumed before and/or during training or com-
petition can improve motor skill and cognitive perfor-
mance. It is noteworthy that lower doses (up to ∼3 mg/kg)
have been efficacious for endurance capacity in athletes46
as well as for cognition in civilian and military popula-
tions.9,79 More research, using standardized and validated
protocols, is needed to determine the optimal dose and
timing of caffeine intake for improving motor skill and
cognitive performance in athletes.
Carbohydrate
It is well established that carbohydrate intake can improve
endurance exercise performance.80 The literature suggests
there is also some potential for carbohydrate ingestion to
enhance performance in tests that simulate the skills and
cognitive demand of various team/skill sports.81–88
However, documentation of these enhanced effects in
team/skill sports is less consistent when compared with
findings on endurance outcomes. Clearly, some studies
have suggested that carbohydrate ingestion (via a 5.5–
7.5% carbohydrate solution) before and throughout exer-
cise can improve the performance of athletes during
sport-specific skill tests.81–85,89–91 Several studies in semi-
professional and professional soccer players have found
improvements with carbohydrate intake versus placebo
in soccer-specific skills such as shot speed90 and shooting,
passing, and dribbling precision.81–83,89 For example,
Currell et al.83 found significant 2–3% improvements in
agility, dribbling, and kicking drills when players ingested
a 7.5% carbohydrate-electrolyte solution before and at
halftime of a 90-minute simulated soccer game. Perfor-
mance enhancements after carbohydrate ingestion have
also been reported for other sport-specific skills, includ-
ing match-serve performance,91 stroke quality,84 and
agility40 in tennis players and shooting accuracy in boy
basketball players.85 In addition, compared with placebo,
a 6% carbohydrate-electrolyte solution significantly
793
improved performance in a whole-body motor skills test
(requiring a combination of speed and agility) during an
intermittent high-intensity exercise protocol simulating a
team game.86,87 Some studies have also reported improve-
ments in the cognitive performance of athletes when car-
bohydrate was ingested during exercise.88,92 Collardeau
et al.88 found that consumption of a 5.5% carbohydrate-
electrolyte solution before and during a 100-minute run
improved the reaction time of triathletes during a
complex cognitive test at the end of that run. Addition-
ally, Bottoms et al.92 reported that ingestion of a 6.4%
carbohydrate drink was associated with improved choice
visual reaction time during simulated squash play.
Conversely, carbohydrate has been reported to have
no effect on skill or cognitive performance in several
other studies.40,44,82,86,87,90,92–99 Compared with placebo, a
6–9% carbohydrate drink had no effect on hitting accu-
racy in various racquet sports,40,44,92,99 on skill perfor-
mance,90,96,97 agility,98 or coordination82 in soccer, on
motor skills in rugby union,93 or on shooting accuracy in
basketball players.95 Moreover, some studies have found
no benefit of an approximately 6% carbohydrate-
electrolyte solution on cognitive performance, including
attention in athletes of various team sports,86,87 perceptual
skill in tennis players,44 choice reaction time in badmin-
ton players,99 and vigilance in basketball players.94
Although the reasons for the mixed results between
studies are not entirely clear, it may be that some of the
tests used to measure motor skills and cognition in ath-
letes are not sensitive enough to detect possible changes
conferred by carbohydrate intake. Therefore, in future
studies, it would be helpful to employ assessment tools
and study protocols that are not only valid (sport-specific
and relevant to actual performance) but are also highly
reliable and sensitive (high signal-to-noise ratio). Future
research should also aim to determine whether a dose-
response relation exists between carbohydrate and skill or
cognitive performance in athletes. One study has tested
the effect of various carbohydrate doses in the perfor-
mance of military operations. Lieberman et al.100 found
that vigilance during sustained physical activity designed
to simulate a typical infantry combat operation in soldiers
improved with carbohydrate (maltodextrin) intake in a
dose-related manner. Performance was best with 12%
carbohydrate, intermediate with 6% carbohydrate, and
lowest with placebo.
Factors such as fed/fasting status and level of difficulty
or stress associated with the cognitive test seem to affect
the efficacy of glucose ingestion. For example, Martin and
Benton101 found that ingestion of a glucose drink (50 g)
improved performance during a demanding working
memory task in fasted women but not in women who had
eaten breakfast. In another study, Markus102 fed young
healthy adults either a glucose (40 g) or a placebo drink
794
and then exposed them to cold pressor stress 2 hours later.
Cold pressor stress significantly reduced cognitive perfor-
mance (reaction time during a complex task) with placebo,
whereas carbohydrate consumption prevented the nega-
tive effects of cold stress on performance.
Researchers have hypothesized that supplying
glucose to the brain affects performance more so under
conditions of high cognitive demand,103 and a few studies
seem to support this. Kennedy and Scholey104 tested the
effect of a glucose drink on word recall and attention
(Serial Threes and Serial Sevens) performance. In this
study, the subjects were also asked to rate their perceived
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mental demand of each task. Glucose ingestion signifi-
cantly improved performance on the Serial Sevens, which
was rated as the most mentally demanding task, but not
on the Serial Threes or word recall task. Similarly, Scholey
et al.105 found that glucose (25 g) consumption improved
performance on the Serial Sevens but not on a word recall
task. In a separate study, Scholey et al.106 found that a
glucose (25 g) drink significantly improved tracking per-
formance during a difficult dual-attention test compared
with placebo.106 Furthermore, Scholey et al.105 measured
the peripheral blood glucose concentrations of subjects
during different cognitive tests and found that the test
requiring the most intense cognitive processing (Serial
Sevens) led to a significant decrease (by ∼0.4–0.8 mM) in
blood glucose concentration compared with a control
(key-pressing) task. The researchers speculated that this
change was linked to increased neural energy expenditure
with increased cognitive demand.
It is thought that carbohydrate intake may affect cog-
nition by modulating the synthesis of certain neurotrans-
mitters. For example, acetylcholine is dependent upon
glucose for its synthesis, and thus carbohydrate feedings
may improve cognition by increasing acetylcholine pro-
duction.107 Carbohydrate feedings also affect brain sero-
tonin, a neurotransmitter associated with lethargy and
sleepiness at rest as well as with central nervous system
fatigue during prolonged exercise.15,108,109 However, the
factors that control brain serotonin synthesis respond to
carbohydrate intake differently between rest and exercise
conditions.15 As discussed above, an increase in the ratio of
plasma free tryptophan to other large neutral amino acids
results in increased entry of tryptophan (the precursor of
serotonin) into the central nervous system, thereby
increasing brain serotonin synthesis. At rest, a high-
carbohydrate meal increases this ratio because of an
insulin-induced decrease in the plasma concentration of
competing large neutral amino acids and fatty acids.110–112
As a result, ingestion of a high-carbohydrate meal at rest
increases the uptake of tryptophan by the brain,increasing
serotonin synthesis.110–112 During prolonged cycling to
fatigue, free tryptophan and the ratio of free tryptophan to
branched-chain amino acids increase progressively, but
Nutrition Reviews® Vol. 72(12):790–802
this response has been shown to be attenuated by carbo-
hydrate ingestion during exercise.113 This is because the
large increase in plasma fatty acids that normally occurs
during prolonged exercise (e.g., with placebo intake) can
be attenuated by carbohydrate ingestion.113 In addition,the
insulin response is blunted during exercise, resulting in
little or no decrease in plasma branched-chain amino
acids.113 Thus, carbohydrate intake during exercise would
decrease the synthesis of serotonin in the brain and limit
central fatigue.15 However, more research is needed to
understand the mechanisms related to the role of sero-
tonin in central fatigue during exercise.114 In addition,
while carbohydrate feeding has been shown to delay
fatigue during exercise,it is difficult to distinguish between
the potential effects of carbohydrate on central fatigue
mechanisms and the well-established effects of carbohy-
drate on skeletal muscle.15
Another potential mechanism behind the ergogenic
effect of carbohydrate on skill performance may be medi-
ated by carbohydrate-sensitive receptors in the mouth,
which affect the central nervous system and improve
central command.115 Emerging research has indicated
that rinsing the mouth with a carbohydrate beverage is
associated with improvements in performance when the
exercise is of high intensity (>75%VO2max) and of rela-
tively short duration (∼1 hour).116 Functional magnetic
resonance imaging studies have shown that the oral expo-
sure to a 6.4% glucose or maltodextrin solution activates
regions of the brain associated with reward and motor
control during exercise.117 Recently, Turner et al.118 dem-
onstrated that a carbohydrate mouth rinse can increase
activation within the primary sensorimotor cortex during
physical activity (hand-grip motor task) and enhance
activation of neural networks involved in sensory
(including visual) perception. However, the receptors in
the oral cavity have not yet been identified and the exact
role of various brain areas is not clearly understood, and
thus further research is warranted. Additionally, the effect
of carbohydrate mouth rinse on cognitive and motor skill
performance has not yet been studied.
The overall body of evidence suggests that consump-
tion of carbohydrate (e.g., in an ∼5–8% carbohydrate
drink) before and/or during practice or competition may
improve skill performance in athletes. However, future
investigations with standardized, reliable, and highly sen-
sitive sport-specific protocols are needed for corrobora-
tion and to determine the optimal dose and timing of
carbohydrate intake.
Cocoa flavanols
Cocoa beans contain a high concentration of flavanols.
The main flavanol in unprocessed cocoa is (−)-
epicatechin,119–122 but other flavanols such as (+)-catechin,
Nutrition Reviews® Vol. 72(12):790–802
epigallocatechin, and epigallocatechin gallate are also
present.121 The literature on the acute cognitive effects
after cocoa flavanol intake is sparse. Two human studies
suggested that cocoa flavanols can have beneficial effects
on cognition and visual function. Scholey et al.123 fed
healthy adults 520 mg of cocoa flavanol, 994 mg of cocoa
flavanol, or placebo in a crossover study. Compared with
the placebo condition, both 520 mg and 994 mg of cocoa
flavanol significantly improved attention. Similarly, Field
et al.124 reported that visual function (contrast sensitivity
and reaction time) and cognitive performance (memory
and reaction time) were improved after ingestion of dark
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chocolate (720 mg of cocoa flavanol) versus white choco-
late (trace amount of cocoa flavanol).
The biological mechanism by which cocoa flavanol
improved memory, learning, reaction time, and visual
function may be related to increased brain
perfusion.122,125,126 In a functional magnetic resonance
imaging study, Francis et al.125 fed healthy young adults
150 mg of cocoa flavanols for 5 days and observed an
increase in the blood-oxygenation-level-dependent signal
intensity of the subjects during performance of a cogni-
tive task. In addition, Sorond et al.,126 using transcranial
Doppler ultrasound, tested the effects of 2 weeks’ inges-
tion of flavanol-rich cocoa versus flavanol-poor cocoa on
cerebral blood flow in healthy elderly humans. They
found that mean blood flow velocity in the middle cere-
bral artery increased significantly more in the flavanol-
rich cocoa group compared with the flavanol-poor cocoa
group. The increased cerebral blood flow with repeated
days (1–2 weeks) of cocoa flavanol intake may be medi-
ated by stimulation of nitric-oxide-dependent
vasodilation.119,127–129 It has been speculated that acute
effects of a single dose of cocoa flavanol occur via a
similar mechanism.122 There is limited direct evidence
that cocoa flavanol ingestion results in acutely increased
cerebral blood flow.125 However, it is worth noting that
Vlachopoulos et al.130 found ingestion of 100 g of dark
chocolate (containing 2.62 mg of procyanidin flavanols)
improved acute endothelial function (increased flow-
mediated dilation in the brachial artery 1 h postingestion)
compared with the control condition in young healthy
adults. In summary, more work is needed to determine
the acute effects of cocoa flavanol intake on cerebral
blood flow as well as on motor skill and cognition. There
is currently no evidence of a benefit on skill or cognitive
performance in athletes.
Ginkgo biloba
Ginkgo biloba is an herbal extract from the leaves of the
maidenhair tree native to China.2 The active compounds
in Ginkgo biloba include flavonoids, terpenoids, and
terpene lactones (i.e., ginkgolides and bilobalide).131,132
795
These have been suggested to increase cerebral blood
flow, reduce blood viscosity, scavenge free radicals, and
modify neurotransmitter systems.2 Very few studies have
looked at the acute effects of Ginkgo biloba ingestion on
brain function in healthy participants. One study133 has
reported that Ginkgo biloba (360 mg) ingestion can
acutely modulate cerebroelectrical activity in healthy
young adults. In general, studies report conflicting results
about the acute effects of Ginkgo biloba intake (120–
600 mg) on cognitive performance.2 Confirming this
statement, a recent meta-analysis concluded that Ginkgo
biloba had no significant positive effects on memory or
attention in healthy individuals.134 It is also important to
note that the effects of Ginkgo biloba intake have not been
tested during sports/exercise. Thus, there is currently a
lack of evidence to show a cognitive-enhancing effect of
Ginkgo biloba for athletes.
Ginseng
There are several ginseng species, including Panax
ginseng (Korean ginseng), Panax quinquefolius (Ameri-
can ginseng), Panax notoginseng (Sanchi ginseng), Panax
japonicus (Satsuma-ninjin), and Eleutherococcus
senticosus Maxim (Siberian ginseng).136 The most com-
monly researched type of ginseng is Panax ginseng.135
Ginsenosides (particularly Rb 1), which are triterpene
saponins suggested to modulate hypothalamic-pituitary-
adrenal axis activity,2 are thought to be the primary active
components of Panax ginseng.2,136,137 One electroencepha-
lography study has reported increased electrical activity
of the brain following Panax ginseng ingestion (200 mg)
in healthy young adults.133
Ginseng is commonly suggested to have
performance-enhancing effects on cognition in individu-
als who are fatigued or under stress. However, results of
studies testing the impact of Panax ginseng on cognitive
performance are equivocal.135,138 Overall, the studies con-
ducted in the general population with young healthy
adults suggest that a single dose of Panax ginseng can
improve some aspects of cognitive performance,139–142
especially memory,139–141 but not others.140,142,143 For
instance,in a series of studies,Kennedy et al.139–141 reported
that various doses (200 mg or 400 mg) of Panax ginseng
improved speed of performing a timed memory task,
quality of memory, secondary memory, and accuracy of
performing attention tasks. Others142 have reported that
400 mg of Panax ginseng improved speed of attention but
had no effect on episodic memory. Additionally, some
decrements in performance have been reported. In 1
study,140 200 mg and 600 mg doses of Panax ginseng sig-
nificantly impaired speed of attention. In another study,143
Panax ginseng improved accuracy during an attention
task, but at the expense of response time.
796
As far as is known,only 1 study has tested the effects of
ginseng on motor skill or cognition in athletes. In skiers
during a biathlon, Eleutherococcus senticosus (Siberian
ginseng) ingestion improved the number of target hits
in the shooting event for the treatment group compared
with the control group.144 However, more research regard-
ing the effect of ginseng on skill and cognition is needed.
Overall, due to the mixed effects on attention, the lack of a
clear mechanism of action, and the paucity of sport-
specific research, ginseng is not currently recommended
for motor skill or cognitive performance in athletes.
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Guarana
The guarana seed comes from plants (Paullinia cupana)
local to the Amazon,and its composition includes caffeine,
theobromine, and theophylline.139 The independent effect
of guarana on cognitive performance has been tested in
only 2 studies. Haskell et al.145 tested the acute effects of
37.5 mg, 75 mg, 150 mg, and 300 mg of guarana on cogni-
tive performance in humans. They found that all doses
improved secondary memory performance and subjective
alertness compared with placebo, with the 2 lower doses
producing more positive results than the 2 higher doses.
Kennedy et al.139 also tested the acute cognitive effects of
75 mg of guarana (containing 9 mg of caffeine) in healthy
young adults. Their results suggested that guarana
improved speed during an attention task compared with
placebo, but at the expense of reduced accuracy.
The active ingredient in guarana is thought to be
caffeine. However, some have postulated that the positive
effects of guarana on cognitive performance are not likely
attributable to caffeine because the caffeine content of
guarana is low (as little as 9 mg of caffeine or less) at the
doses of guarana found to be effective.139,145 Therefore, the
exact mechanism to explain the acute changes in cogni-
tion with a single dose of guarana remains unknown.
Furthermore, the effects of guarana ingestion on sport-
specific performance are not known. In summary, there is
currently not enough evidence to suggest a benefit of
guarana intake on motor skill or cognitive performance
in athletes.
Rhodiola rosea
Another dietary constituent thought to enhance cognitive
function in the face of fatigue and stress is Rhodiola rosea.
Commonly referred to as golden root or arctic root,
Rhodiola rosea is an aromatic plant found in mountain-
ous regions of the world.146 Rhodiola rosea contains a
myriad of different compounds that can be separated into
several groups. These include flavonoids (e.g., rhodiolin,
rodionin, rodiosin, acetylrodalgin, tricin), phenylpro-
panoids (e.g., rosavin, rosin, rosarin), phenylethanol
Nutrition Reviews® Vol. 72(12):790–802
derivatives (e.g., salidroside, tyrosol), phenolic acids
(e.g., chlorogenic, hydroxycinnamic, and gallic acids),
triterpenes (e.g., daucosterol, β-sitosterol), and mono-
terpenes (e.g., rosiridol, rosaridin).146
Very few studies have assessed the acute effects of
Rhodiola rosea ingestion on cognitive performance.
Aslanyan et al.147 tested healthy women aged 20–68 years
reporting to be under psychological stress and found that,
compared with placebo, a single 270-mg dose of Rhodiola
rosea (in combination with Schisandra chinensis and
Eleutherococcus senticosus Maxim) improved attention,
speed, and accuracy during stressful cognitive tasks.
Shevtsov et al.148 compared the acute effects of placebo
versus the acute effects of 370 mg and 555 mg of Rhodiola
rosea on cognitive performance in 161 male cadets
(19–21 years). Subjects completed a battery of tests
involving visual perception, information processing,
short-term memory, attention span, and attention switch-
ing. Investigators evaluated overall performance by cal-
culating a composite score. The results indicated an
improvement in overall performance with both doses of
Rhodiola rosea compared with placebo, but no significant
differences between doses. The authors also concluded
that Rhodiola rosea had a greater impact on the quality of
mental work (i.e., accuracy) than on the quantity of work
completed (i.e., reaction time).
There is a small body of literature regarding the acute
effects of Rhodiola rosea on physical performance in ath-
letes,149 but only 2 studies measured cognition.150,151
DeBock et al.151 found that 200 mg of Rhodiola rosea had
no effect on visual reaction time or the ability to sustain
attention during a cycling test to exhaustion (lasting
≈17 minutes) in physically active male and female college
students. Similarly, Noreen et al.150 reported no effect of
3 mg/kg (∼170 mg) Rhodiola rosea on attention in
recreationally active women after completion of a 10-km
cycling time trial.
Rhodiola rosea’s mechanisms of action have been
proposed to include modulation of the hypothalamic-
pituitary-adrenal axis activity and modulation of brain
neurotransmitter systems in individuals under
stress.146,152 The compounds salidroside, rosavin, and
p-tyrosol primarily are regarded as playing important
roles in conferring these effects,146 but more work is
needed to clarify potential mechanisms. Although there
have been some interesting findings, at present there is no
evidence or mechanism for a performance-enhancing
effect of Rhodiola rosea on motor skill or cognitive per-
formance in athletes.
Sage
Members of the sage family, such as Salvia officinalis
(common garden sage) and Salvia lavandulaefolia
Nutrition Reviews® Vol. 72(12):790–802
(Spanish sage), are herbs that have cholinesterase-
inhibiting properties that purportedly affect learning,
memory, and attention.153 There are a limited number of
studies on the acute effects of sage on cognitive perfor-
mance in healthy humans.154–157 Kennedy et al.154 fed
healthy young adults placebo or 300 mg or 600 mg of
dried sage (Salvia officinalis) leaf and found that both
levels of sage improved acute alertness. Similarly, in a
series of studies, Tildesley et al.156,157 found that, compared
with placebo, single doses of Spanish sage essential oil
(25 μL, 50 μL, and/or 100 μL) improved word recall,
speed of memory, secondary memory, and self-ratings of
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alertness in healthy young adults. Although these results
are interesting, more work is needed to determine the
acute effects of sage intake on motor skill and cognition.
There is currently no evidence of a benefit on skill or
cognitive performance in athletes.
L-theanine
L-theanine (γ-glutamylethylamide) is a nonprotein
amino acid that is found almost exclusively in tea, espe-
cially green tea, and has been suggested to reduce anxiety
and improve attention. Ito et al.158 has shown a graded
increase in alpha brain waves (which are often associated
with a relaxed yet alert state) with administration of
50 mg and 200 mg of theanine. Similar improvements in
alpha wave activity have been reported by Nobre et al.159
with 50 mg and by Gomez-Ramirez et al.160 with 250 mg.
These effects of L-theanine on brain function are thought
to be related to the modulation of neurotransmitter
(dopamine, serotonin, and γ-aminobutyric acid)
concentrations.161–163
Several studies have tested the effect of L-theanine on
various cognitive tasks; however, cognitive improvements
have typically only been seen when L-theanine is com-
bined with caffeine. Various doses of L-theanine (ranging
100–250 mg) have shown no improvements in
visuospatial attention,164 decrements in mathematic
tasks,165 or slowed reaction times.160,166 Conversely, when
L-theanine is combined with caffeine, improvements in
attention,164,167–169 reaction time,165,169 memory,169 and
accuracy of information processing165 have been consis-
tently reported. Only 1 study has found a cognitive
benefit from L-theanine alone. Foxe et al.170 compared the
effects of 50 mg of caffeine, 100 mg of L-theanine, and
their combination versus placebo on the maintenance of
vigilance during a sustained attention task in healthy
adults. The error rates of the subjects during the task were
significantly reduced after ingestion of caffeine alone and
L-theanine alone. No further improvements in perfor-
mance were conferred by the combined treatment. These
results suggest that perhaps only a specific type of cogni-
tive performance, namely vigilant attention, is improved
797
by L-theanine. It is important to note that the effect of
L-theanine on cognitive performance in athletes has not
been tested. Thus, there is a lack of convincing evidence at
present to show L-theanine intake improves attention or
any other aspect of cognition during sports.
Theobromine
Theobromine is a methylxanthine and, like caffeine, is an
adenosine receptor antagonist.However,theobromine has
been suggested to have only one-fifth the potency of caf-
feine.171 When compared with placebo, the combination of
caffeine (19 mg) and theobromine (250 mg) has been
reported to improve cognitive function (reaction time).172
However, when the independent and combined effects of
theobromine (700 mg) and caffeine (120 mg) were tested
in healthy young adults, the results suggested that caffeine
had a strong beneficial impact on alertness, while the
effects of theobromine were negligible.173 Other studies
have reported no effect or limited benefits on attention,
short-term memory, simple reaction time, and visual vigi-
lance with up to 500 mg of theobromine174,175 and even
some impaired performance effects on attention with
1000 mg of theobromine.174 There are no data on the
acute effects of theobromine ingestion in athletes. Thus,
theobromine cannot currently be recommended to
enhance motor skills or cognition for sports performance.
Tyrosine
Tyrosine, an amino acid found in many animal and plant
protein foods, is a dietary precursor to catecholamine
(dopamine and norepinephrine) synthesis. The ingestion
of tyrosine is thought to be an effective countermeasure
to mitigate some adverse behavioral, cognitive, and physi-
ological effects of acute stress. It has been hypothesized
that, during acutely stressful situations, central
catecholamine neurons are unable to synthesize sufficient
neurotransmitters.176 Sleep deprivation,177,178 exposure to
cold,179–183 heat,184 or altitude,179,185 and emotional/mental
stress186–188 are all associated with cognitive deficits,
and tyrosine administration has been found to reverse
these negative effects. Much of the evidence support-
ing an acute stress-mitigating effect of tyrosine ingestion
on cognitive performance has come from animal
studies.183–185,187,189,190 However, the effect of tyrosine
ingestion on acute cognitive performance has also been
explored in humans.9,191 Studies involving acute environ-
mental stress and/or sleep deprivation typical of military
operations have shown that intake of 100–300 mg/kg
tyrosine can mitigate performance decrements in
memory, logical reasoning, map/compass reading,
pattern recognition, reaction time, visual vigilance, and
psychomotor function in healthy young adults.177–182
798
However, some human studies have reported a lack of
acute cognitive benefit from tyrosine intake. Thomas
et al.188 reported improvements in working memory but
no change in arithmetic, visual, or auditory task perfor-
mance with tyrosine intake (150 mg/kg) compared with
placebo. Waters et al.192 found that tyrosine (150 mg/kg)
had no effect on alertness in healthy young men after
36 hours without sleep.
There are limited data on the acute effects of tyrosine
ingestion on cognition in an athlete population. One
study193 administered either tyrosine (150 mg/kg total) or
placebo to 8 physically active, unacclimated men before
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and every 15 minutes during cycling (70% VO2peak) to
exhaustion (∼60 min) in a hot environment. Postexercise
attention, memory, and rapid visual information process-
ing did not differ between tyrosine and placebo trials. The
effect of tyrosine intake on cognition has not been tested
in a skill/team-sport scenario. Therefore, in contrast to
the body of evidence available in the military literature,
there are no data to suggest that tyrosine improves cog-
nition or motor skill performance in athletes. It may be
that the stress experienced in the exercise studies has not
been sufficient to deplete the catecholamine supply, and,
as a result, cognitive performance is unaffected by tyro-
sine administration in a sporting context.
CONCLUSION
Foods contain many nutrients and isolated compounds,
some of which have been purported to exert a beneficial
impact on motor skill and/or cognitive performance
upon ingestion. This review has described the proposed
benefits, putative mechanisms, and level of scientific
support for the efficacy of several dietary constituents in
healthy young adults/athletes. Caffeine and carbohydrate
are the dietary constituents for which the greatest number
of reports describing improved skill and cognitive aspects
of sports performance have been published. However,
more work is needed to determine the optimal dose and
timing of caffeine and carbohydrate intake needed to
elicit maximal and consistent benefits in motor skill and
cognitive performance. In fact, dose-response studies are
needed for all dietary constituents, as the paucity of such
studies represents a significant gap in the literature.
Overall, the body of literature reviewed suggests that
study participants with impaired cognitive function states
(e.g., sleep deprivation, mental stress, or exercise-induced
fatigue) are more likely to experience acute benefits from
caffeine or carbohydrate ingestion. There is currently a
lack of evidence to substantiate the use of any other
dietary constituents to benefit sports-related motor skill
or cognitive performance. Specifically, branched-chain
amino acids, cocoa flavanols, Gingko biloba, ginseng,
guarana, Rhodiola rosea, sage, L-theanine, theobromine,
Nutrition Reviews® Vol. 72(12):790–802
and tyrosine cannot currently be recommended to
enhance motor skills or cognition for sports perfor-
mance. Carbohydrate and caffeine are the only dietary
constituents that have been tested for their efficacy as an
ergogenic aid in sport-specific skill tests. For other dietary
constituents, researchers usually used motor skill and
cognitive tests designed for the general population, and
such tests have questionable relevance to sports settings.
It is crucial that future efficacy studies develop and
employ valid, reliable, and sensitive batteries of motor
skill and cognitive tests.
Acknowledgments
Funding. No external funding was provided for this
work. All authors are employed by the Gatorade Sports
Science Institute.
Declaration of interest. Lindsay B. Baker and Ryan P.
Nuccio are employees of the Gatorade Sports Science
Institute, a division of PepsiCo, Inc. Asker E. Jeukendrup
is an employee of the Gatorade Sports Science Institute
and a visiting professor at Loughborough University,
United Kingdom. The views expressed in this article are
those of the authors and do not necessarily reflect the
position or policy of PepsiCo, Inc.
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