Infographics
Infographic. The road to the ergogenic effect of caffeine on
exercise performance
Joao Gabriel Baltazar-Martins,1 Diego Brito de Souza,1 Millán Aguilar,1 Jozo Grgic,‍ ‍ 2 Juan Del Coso‍ ‍ 1
The high prevalence of caffeine intake
by athletes has prompted researchers to
explore its effects on sport and exercise
performance, with a particular focus on
optimal guidelines for caffeine supplemen-
tation.1 The 2018 International Olympic
Committee consensus statement on dietary
supplements has identified caffeine as one
of the few supplements that have good
evidence of benefits for performance.2
A recent umbrella review examined
caffeine’s effect on exercise performance
and highlighted that caffeine ingestion
has a small—but significant—ergogenic
effect on muscle strength and anaerobic
power, along with moderate effect sizes
for aerobic and muscle endurance.3 These
data explain why caffeine is similarly
Baltazar-Martins JG, et al. Br J Sports Med Month 2019 Vol 0 No 0
consumed in sports with very different
physiological demands4 and support the
notion that caffeine is ergogenic across a
broad range of exercise tasks.
The purpose of this infographic is
to provide a visual explanation of the
guidelines for caffeine supplementation.
Specifically, we focus on the optimal dose,
mechanisms of action, interindividual
variation in responses, tolerance and
possible drawbacks of caffeine supplemen-
tation. While caffeine ingestion provides
an ergogenic effect across a wide range of
doses, it seems that the greatest benefits
are attained with doses from 3 to 6 mg/
kg of body mass. Lower doses (ie, <3 mg/
kg) might also be ergogenic,5 although
the magnitude of the effect with such
Br J Sports Med: first published as 10.1136/bjsports-2019-101018 on 5 July 2019. Downloaded from http://bjsm.bmj.com/ on 21 July 2019 by guest. Protected by copyright.
doses is possibly lower. Higher doses of
caffeine (ie, >6 mg/kg) might provide a
similar ergogenic effect to doses of 3–6
mg/kg; however, higher doses also seem
to increase the incidence and magnitude
of side-effects. Caffeine should be gener-
ally ingested 45–60 min before exer-
cise. Optimal timing may depend on the
form of caffeine (eg, caffeine absorption
is faster with caffeine chewing gums vs
capsules) and might vary based on the
sport. For example, athletes competing in
sports with longer duration events (ie, >3
hours) and in those with repeated compet-
itive bouts within the same day might
benefit from repeated (ie, intracompeti-
tion) dosing with caffeine.
The main mechanism behind caffeine’s
ergogenic effect lies in its tendency to
bind to adenosine A1 and A2A receptors.
By binding to these receptors, caffeine
inhibits the fatiguing effects of adenosine
and subsequently enhances perfor-
mance.6 While caffeine is ergogenic for
performance, it has become apparent
that there is high interindividual vari-
ability in responses to caffeine ingestion.
Recent data suggest that the existence of
‘non-responders’ to the ergogenic effects
of caffeine might have been exaggerated
if we consider that all athletes appear to
positively respond to caffeine when using
multiple, repeated testing sessions.7 None-
theless, given the interindividual vari-
ability to the ergogenic effect of caffeine,
athletes should experiment with different
caffeine doses and protocols of admin-
istration during training or simulated
competitions to establish individual guide-
lines for caffeine supplementation.
Although there is a lack of a consensus
about the habituation to caffeine, recent
analyses indicated that caffeine might be
still ergogenic even after 20 days of consec-
utive intake.8 The magnitude of caffeine’s
ergogenic effect was the highest on the
first day of supplementation and this
ergogenic effect was progressively atten-
uated with subsequent ingestion. Finally,
athletes need to consider the side-effects
associated with caffeine ingestion. Acute
caffeine intake may increase side-effects
such as anxiety, insomnia and high blood
pressure.9 The incidence of these side-ef-
fects increases with dose, and, therefore,
athletes need to be aware of these negative
   1
 Infographics
effects and should apply prudence with
the dose of caffeine.
1
Exercise Physiology Laboratory, Universidad Camilo
Jose Cela, Villanueva de la Cañada, Spain
2 bjsports-2018-100278
Institute of Sport, Exercise and Active Living (ISEAL),
Victoria University, Melbourne, Victoria, Australia
Correspondence to Dr Juan Del Coso, Exercise
Physiology Laboratory, Universidad Camilo Jose Cela,
Villanueva de la Cañada 28692, Spain;
​jdelcoso@​ucjc.​edu
Contributors All authors participated in the
conception of the infographic. JGB-M, DBdS and MA
designed the infographic. JGB-M and JDC wrote the
manuscript. All authors revised and approved the final
versions of both the figure and the manuscript.
Funding The authors have not declared a specific
grant for this research from any funding agency in the
public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned;
externally peer reviewed.
2 Baltazar-Martins JG, et al. Br J Sports Med Month 2019 Vol 0 No 0
© Author(s) (or their employer(s)) 2019. No commercial
re-use. See rights and permissions. Published by BMJ.
To cite Baltazar-Martins JG, Brito de Souza D,
Aguilar M, et al. Br J Sports Med Epub ahead of
print: [please include Day Month Year]. doi:10.1136/
bjsports-2019-101018
Accepted 18 June 2019
Br J Sports Med 2019;0:1–2.
doi:10.1136/bjsports-2019-101018
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