Sparc Final Report: Enhancing the Buffering Capacity in Rugby Union Players: Tolerability and Performance.

Sonya Cameron.1, R Cooke1, R Brown1, K Fairbairn2. 1Department of Human Nutrition, University of Otago, 2Otago Rugby Football Union

Background: Current literature indicates that the onset of fatigue can be delayed by ingestion of exogenous buffering agents. Furthermore elevated muscle buffering capacity has been associated with enhanced performance (Burke and Deakin 2000). Positive effects of NaHCO3 ingestion on performance have been observed in a number of high intensity activities including cycling, rowing, soccer, and running (Gao, Costill et al. 1988; Goldfinch, McNaughton et al. 1988; Bird, Wiles et al. 1995; McNaughton, Backx et al. 1999; McNaughton, Dalton et al. 1999; Price, Moss et al. 2003; Van Montfoort, Van Dieren et al. 2004). These periods of high intensity exercise place considerable demands on anaerobic metabolism (Deutsch, 1998). An important fitness component of team sport athletes is their ability to repeatedly perform high intensity exercise (Bishop et al, 2003). Rugby union is an intermittent sport where athletes perform low intensity exercise interspersed with repeated bursts of high intensity exercise such as sprinting, lifting, tackling and scrummaging (Deutsch, Maw et al. 1998; Duthie, Pyne et al. 2003). Therefore strategies that increase a players ability to perform repeated bouts of high intensity exercise could significantly enhance performance during rugby union game play.

Anecdotally sodium bicarbonate ingestion has been associated with infrequent mild gastrointestinal (GI) discomfort in some individuals. Reported symptoms include belching, stomach cramping, bowel urgency, flatulence, diarrhoea, bloating, stomach ache and vomiting (Van Montfoort, Van Dieren et al. 2004). Two studies have attempted to assess the side effects of sodium bicarbonate ingestion and observed a relationship between the dose and the potential incidences of GI discomfort (Price, Moss et al. 2003; Van Montfoort, Van Dieren et al. 2004). However, the methods of

assessment failed to fully quantify the type and duration of symptoms. To date reports on tolerability of sodium bicarbonate have been from athletes of low to medium body mass (75-80kg). Rugby players have a larger body mass and because supplementation is based on body weight, these athletes would need to ingest greater absolute amounts of sodium bicarbonate. No studies have investigated tolerability of the recommended dose of sodium bicarbonate in larger athletes (85130kg). The aims of this research were to: 1. Investigate physiological responses to 0.3 g.kg-1BW of NaHCO3 in well-trained rugby players. 2. Investigate the GI tolerability of 0.3 g.kg-1BW of NaHCO3 in well trained rugby players. 3. Investigate the ergogenic effect of ingestion of 0.3 g.kg-1BW of NaHCO3 on repeated sprint ability (RSA) in well-trained rugby players.

How we did this research? This study was a randomised, double-blind, placebo controlled, crossover trial. Male rugby players (n=25) were recruited from the Otago Sevens, Otago Focus Squad and the Otago Rugby Academy in Dunedin, New Zealand. The study was approved by the Otago University Ethics Committee. Players provided informed consent for their participation. Participants were randomly allocated to consume either 0.3 g.kg-1 BW of NaHCO3 or 0.045 g.kg-1 BW of NaCl (placebo) in 500 ml of isotonic sports drink. Participants replicated the experimental testing protocol after a 7 day wash-out period under the opposite condition. A crossover design was used to allow participants to act as their own controls.

Time elapsed 0:00 min Standardised Snack Questionnaire 0 (0 min)

baseline

30 min Blood Test 1

Beverage Administration 30 min Questionnaire 1A (30 min after

beverage ingestion)

65 min

Blood Test 2
(60 min after beverage ingestion)

Questionnaire 1B (Immediately after

blood test 2)

95 min

Begin rugby specific warm-up

Questionnaire 1C (90 min after 25 min

beverage ingestion)

120 min

Begin rugby specific training

9 min 129 min Begin RSRST Blood Test 3 / RPE 5 min 134 min Distribution of chronic GI symptom Questionnaire (2A) Questionnaire 1D (120 min after
beverage ingestion)

Figure 1. Outline of the experimental testing protocol

The experimental testing protocol attempted to simulate competitive game play. The protocol is outlined in figure 1. Participants began the experimental testing session in pairs at five minute intervals, the protocol commenced with participants consuming a standardised snack. Following the consumption of the standardised snack, participants rested for 30 min. During this rest period a baseline blood sample was collected and participants completed a baseline GI discomfort symptom questionnaire. Subsequent GI discomfort symptom questionnaires were completed at 60, 90 and 120 min post ingestion of the test or placebo beverage. Following the rest period, participants consumed the test or placebo beverage within 15 min. A second blood sample was collected 60 min after consumption of the test or placebo beverage. This was immediately followed by a rugby specific warm-up for 30 min. Participants then engaged in nine min of exercise that simulated rugby game play. The warm-up and rugby game play were designed to simulate fatigue levels equivalent to those experienced in a rugby game. Following the rugby game play, participants completed a five min rugby specific repeated sprint test (RSST), which was immediately followed by collection of the third blood test. At this time,

participants rated their perceived exertion on a modified 10 point Borg scale (Borg, 1998). A chronic GI discomfort symptom questionnaire was distributed and participants were asked to complete this over the next 24 hour. Time line: 2007 Early September: Late September: Early October:

Application for ethical approval submitted Ethical approval obtained Commenced participant recruitment Begun data collection

2008 February: March: May November:

Data collection completed Data input and statistical analysis

Thesis writing and publication preparation Present findings at Sport and Exercise Science New Zealand (SESNZ) Conference

2009

Publish in a peer reviewed sports nutrition/medicine journal Submit final report to SPARC Present findings at an international sport medicine conference

What were the key findings? The physical characteristics of the 25, well-trained rugby players who participated in the study are presented in Table 1. The forwards were on average taller (7 cm) and heavier (18 kg) than the backs. Bodyweight (BW) of participants ranged from 66.8 kg to 120.3 kg, and height ranged from 1.66 to 1.93 m. The average age of participants was 21.6 yrs.

Table 1: Mean (SD) participant characteristics (n=25) Forwards (n=11) Height (m) Weight (kg) Age (yr) 1.87 (0.03) 105 (9) 20 (1.9) Backs (n=14) 1.80 (0.07) 87 (11) 22 (2.9) Total (n=25) 1.82 (0.07) 95 (13) 21.6 (2.6)

Blood pH response, along with bicarbonate (HCO3-) and lactate concentrations for the NaHCO3 condition versus the placebo condition at baseline, post ingestion and following the rugby specific repeated sprint test (RSRST) are presented in Table 4.2. Following ingestion, blood HCO3- increased for the NaHCO3 condition compared to the placebo condition (p<0.001) and remained elevated after the RSRST (p<0.001). Lactate concentrations were significantly higher for the NaHCO3 compared to the placebo group (p<0.001) following the RSRST. Following ingestion of the beverage and immediately after the RSRST pH was higher for the NaHCO3 compared to the placebo (p<0.001).

Table 2: Physiological responses on NaHCO3 and placebo conditions mean (SD) NaHCO3 pH (unit) Baseline Post ingestion Post exercise Bicarbonate (mmolL ) Baseline Post ingestion Post exercise Lactate (mmolL ) Baseline Post ingestion Post exercise
a -1 -1

Placebo

Difference

95% (CI)

p-value

7.39 (0.03) a 7.47 (0.04) 7.25 (0.09)

ab

7.38 (0.03) 7.39 (0.03) 7.19 (0.09)

ab

0.01 0.80 0.06

0.02 - 0.01 0.07 - 0.11 0.03 - 0.08

0.549 <0.001 <0.001

23.35 (4.23) 30.33 (6.26) 14.87 (4.41)

a ab

23.80 (1.99) 24.03 (1.69) 12.35 (3.73)

ab

0.45 6.29 2.56

2.23 - 1.34 3.47 - 9.11 1.63 - 3.43

0.611 <0.001 <0.001

2.87 (1.16) 2.83 (0.78) 19.23 (4.25)

ab

2.76 (1.19) 2.47 (0.63) 16.05 (4.43)

b ab

0.11 0.36 3.17

0.24 - 0.46 0.48 - 0.77 2.02 - 4.33

0.510 0.081 <0.001

n =25. Significantly different from baseline. Significantly different from post ingestion. CI = confidence interval. Difference = difference in means. NaHCO3 = sodium bicarbonate. SD = standard deviation. p-value for difference between NaHCO3 and placebo

There were no significant differences in performance outcomes between the NaHCO3 and placebo condition. The incidence of belching, stomach ache, diarrhoea, stomach bloating and nausea were significantly higher after ingestion of the NaHCO3 compared to placebo (p<0.05). The severity of stomach cramps, belching, stomach ache, bowel urgency, diarrhoea, vomiting, stomach bloating and flatulence were rated as significantly worse after the ingestion of NaHCO3 compared to placebo (p<0.05). Significantly different from baseline b Significantly different from post What is the practical importance of this research? ingestion This study demonstrates that NaHCO3 supplementation can increase HCO3a

concentration and maintain pH during high intensity exercise in well-trained rugby players. However, the higher incidence and greater severity of GI symptoms after the consumption of the NaHCO3 may negatively impact on the physical performance of some individuals. The lack of any performance improvement and the presence of GI

discomfort in this study after NaHCO3 ingestion suggest it is essential that rugby players, or heavier athletes, who need to ingest greater absolute amounts of NaHCO3, should trial this supplement during training before considering its use as an ergogenic aid during competitive situations.

How are we disseminating this information? Scientific Results were presented at the Sports Medicine and Exercise Science conference Nov 2008 Results will be presented to the Department of Human Nutrition in March 2009 I am currently writing a scientific paper which will be sent to the journal Medicine and Science in Sports and Exercise for peer review. Public Information was given to the Otago Rugby football Union (coaches, trainers, dietitian). Individual results were presented and discussed with each participant

References Bird, S. R., J. Wiles, et al. (1995). "The effect of sodium bicarbonate ingestion on 1500-m racing time." Journal of Sports Sciences 13(5): 399-403. Burke, L. and V. Deakin (2000). Clinical Sports Nutrition, McGraw-Hill. Deutsch, M. U., G. J. Maw, et al. (1998). "Heart rate, blood lactate and kinematic data of elite colts (under-19) rugby union players during competition." Journal of Sports Sciences 16(6): 561-570. Duthie, G., D. Pyne, et al. (2003). "Applied physiology and game analysis of rugby union." Sports Medicine 33(13): 973-991. Gao, J., D. L. Costill, et al. (1988). "Sodium bicarbonate ingestion improves performance in interval swimming." European Journal of Applied Physiology 58(1): 171-174. Goldfinch, J., L. McNaughton, et al. (1988). "Induced metabolic alkalosis and its effects on 400-m racing time." European Journal of Applied Physiology 57(1): 45-48.

McNaughton, L., K. Backx, et al. (1999). "Effects of chronic bicarbonate ingestion on the performance of high-intensity work." European Journal of Applied Physiology and Occupational Physiology 80(4): 333-336. McNaughton, L., B. Dalton, et al. (1999). "Sodium bicarbonate can be used as an ergogenic aid in high-intensity, competitive cycle ergometry of 1 h duration." European Journal of Applied Physiology and Occupational Physiology 80(1): 64-69. Price, M., P. Moss, et al. (2003). "Effects of Sodium Bicarbonate Ingestion on Prolonged Intermittent Exercise." Medicine & Science in Sports & Exercise 35(8): 1303. Van Montfoort, M. C. E., L. Van Dieren, et al. (2004). "Effects of Ingestion of Bicarbonate, Citrate, Lactate, and Chloride on Sprint Running." Med Sci Sports Exerc 36(7): 1239-43.