RESEARCH: Studies from 29 Jun to 5 Jul 2026

1. Perceptions of elite athletes and support staff on altitude training

2. Sodium bicarbonate improves sprint performance in endurance cycling

3. Cramping and injury incidence are reduced by creatine supplementation

4. The influence of resistance exercise training prescription variables

5. Evidence that daily resting and activity energy expenditures are independent

Study date: Jun 2018

Altitude training is used by endurance runners to stimulate physiological adaptations that improve sea-level performance. Despite growing scientific evidence supporting its use, less is known about how elite athletes and coaches actually applied these methods in practice. In this study, the authors set out to “establish perceptions of elite endurance athletes on the role and worth of altitude training”.

STUDY DETAILS

1. In the lead-up to the 2012 Olympic Games, 39 elite British endurance runners and 20 support staff completed an internet-based survey.

2. The survey examined which altitude and hypoxic training methods were being used, reasons for their use, and situational, cultural, and behavioural factors influencing these choices.

3. Responses were compared against accepted research-based best-practice recommendations.

KEY RESULTS

1. Altitude and hypoxic training were almost universally adopted with 98% of athletes and 95% of support staff having used or recommended these methods.

2. 75% of athletes rated altitude and hypoxia as “very important” to their training regime, compared to 50% of support staff.

3. Athletes and support staff broadly agreed on approach, with camps of three to four weeks at 1,500–2,500m being most popular.

AUTHORS’ CONCLUSION

• Elite British endurance runners and their support staff are applying altitude training in a manner that broadly aligns with research-based recommendations.

• The survey highlighted specific challenges and priorities that could inform future optimisation of altitude training for elite endurance performance.

RESULT CONFIDENCE

• Data relied entirely on self-report, which is susceptible to social desirability bias. The respondents may have reported practices aligned with what they believed was scientifically endorsed.

• Several authors were affiliated with the English Institute of Sport, which has an institutional interest in altitude training being viewed positively.

PRACTICAL TAKEAWAY

This study showed that elite British endurance runners and their coaches are applying altitude training in line with scientific guidance, favouring camps of three to four weeks at 1,500–2,500m.

My recommendation for athletes aiming to use altitude is to follow the guidelines that have proven to be effective: ensure adequate iron levels prior to an altitude camp, aim for 3-4 weeks at ~2000m, and account for individual adaptation in designing training sessions and managing training load. To see all the research I’ve shared on altitude, follow the link to the altitude archives below.

RELATED RESEARCH

• Study archive: Altitude

• Hemoglobin mass and performance responses during 4 weeks of normobaric “live high–train low and high”

• Haemoglobin mass responses and performance outcomes among high-performance swimmers following a 3-week live-high, train-high camp at 2320m

Study date: Mar 2021

Sodium bicarbonate (NaHCO₃) is a well-established ergogenic aid in short, high-intensity exercise, where it buffers the acid build-up that impairs muscle function. Its potential benefit over longer endurance efforts had remained unexplored, as the buffering agent is typically depleted well before a race concludes. In this study, the authors set out to “investigate the effect of stacked sodium bicarbonate loading on sprint performance following a 3h simulated cycling race”.

STUDY INTERVENTION

1. 11 trained male cyclists (VO2 Max: 63.7ml/kg/min) completed a double-blind, randomised, placebo-controlled crossover study, ingesting either 300mg/kg body weight of NaHCO₃ or a sodium chloride placebo, split into two doses: one before and one during the ride.

2. Participants completed a 3-hour simulated cycling race at intensities varying between 60–90% of lactate threshold, followed immediately by a 90-second all-out sprint.

3. Blood samples were taken to track pH, lactate, and bicarbonate concentrations throughout.

KEY RESULTS

1. NaHCO₃ increased mean power output during the 90-second sprint by approximately 3% (541W vs 524W) compared to placebo.

2. Blood bicarbonate and pH were meaningfully elevated prior to the final sprint in the NaHCO₃ condition, confirming the stacked dosing strategy successfully preserved alkalosis.

3. Peak blood lactate and heart rate at the end of the sprint were higher in the NaHCO₃ condition, indicating greater anaerobic contribution and effort.

AUTHORS’ CONCLUSION

• The authors concluded that stacked sodium bicarbonate loading before and during a simulated race can improve end-of-race sprint performance, opening up a supplementation strategy previously limited to short-duration events.

• The protocol was well tolerated, with no gastrointestinal disturbances reported, though the authors recommend keeping doses small and frequent and combining intake with a high-carbohydrate meal to further reduce GI risk.

RESULT CONFIDENCE

• The sample was small (11 male cyclists), limiting statistical power and generalisability, particularly to female athletes or recreational riders.

• The simulated race lacked the irregular surges characteristic of real competition, meaning the NaHCO₃ buffer may be more depleted in actual race conditions than this protocol suggests.

PRACTICAL TAKEAWAY

This study showed that consuming sodium bicarbonate at 300mg/kg body weight, split between a pre-race dose and a dose taken during a 3-hour ride, improved 90-second all-out sprint power by around 3% compared to placebo.

My recommendation for athletes competing in longer events is to consider additional doses of sodium bicarbonate during their races. I suggest following the protocol in the study of 300mg/kg bodyweight split into multiple doses of ~50mg/kg bodyweight in the two hours before and then each hour during the event. The protocol should be practised in training first, taken in small frequent doses, and ideally combined with a carbohydrate-rich meal to minimise the risk of gastrointestinal discomfort.

RELATED RESEARCH

• Study archive: Supplement - BICARBONATE

• International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance

• Sodium bicarbonate and high-intensity-cycling capacity

Study date: Sep 2003

Anecdotal reports have long suggested creatine supplementation might worsen cramping and injury risk during intense training, despite limited evidence supporting this claim. In this study, the authors set out to “examine the effects of creatine supplementation on the incidence of cramping and injury observed during 1 season of National Collegiate Athletic Association Division IA football training and competition”.

STUDY INTERVENTION

1. The study was an open-label, observational design with no placebo group.

2. 38 of 72 players (53%) volunteered to take creatine, ingesting 0.3g/kg/day for 5 days, then around 0.03g/kg/day after workouts, practices and games.

3. Training occurred across one season in temperatures of 15–37°C and 46–91% humidity.

KEY RESULTS

1. Cramping and injury incidence was significantly lower, or proportionally similar, in creatine users versus non-users.

2. No significant differences emerged between groups for non-contact joint injuries, contact injuries, illness, missed practices, or season-ending injuries.

3. Heat illness and dehydration rates were not higher among creatine users.

AUTHORS’ CONCLUSION

• Creatine supplementation did not increase cramping or injury risk and was associated with lower incidence in some categories.

• Findings support creatine’s safety profile during a demanding college football season.

RESULT CONFIDENCE

• This was a non-randomised, open-label design with self-selected volunteers, not a placebo-controlled trial, limiting causal conclusions.

• The single university cohort and modest sample size reduce generalisability to other athletic populations.

PRACTICAL TAKEAWAY

This study showed that creatine supplementation during a full football season did not raise cramping, injury or heat-illness rates compared with non-users, and may have lowered them.

My recommendation for athletes is that the benefits of creatine for performance are clear and there is no need to avoid it out of cramping concerns.

RELATED RESEARCH

• Study archive: Supplement - CREATINE

• SUMMARY: Creatine supplementation

Study date: Jan 2024

Resistance training (RT) is well established for improving muscle mass, strength and physical function. In this review, the authors set out to “determine the impact of resistance training (RT) and individual RT prescription variables on muscle mass, strength, and physical function in healthy adults”.

REVIEW DETAILS

1. The authors searched Ovid MEDLINE, SPORTDiscus and Web of Science up to December 2021, following PRISMA guidelines.

2. The review included 44 eligible systematic reviews, meta-analyses, meta-regressions and one umbrella review covering healthy adults over 18 years.

3. The methodological quality was rated using AMSTAR and graded evidence quality, generating standardised effectiveness statements for each RT variable.

KEY RESULTS

1. Compared with non-exercising controls, RT consistently improved muscle mass, strength and physical function.

2. Training volume (number of sets) and muscle action type (eccentric favoured) influenced muscle mass gains, while volume, load, weekly frequency and exercise order affected strength gains.

3. Inter-set rest, periodisation, training to failure, contraction velocity and set configuration showed no clear effect on mass or strength; evidence on physical function was too sparse for firm conclusions.

AUTHORS’ CONCLUSION

• Resistance training reliably increases muscle mass, strength and physical function compared with no exercise, with training volume the most consistently important variable across both outcomes.

• The authors suggested that many other prescription variables (rest periods, periodisation, set configuration) can be chosen flexibly provided total volume is adequate, and called for more research into physical function outcomes.

RESULT CONFIDENCE

• The quality of underlying evidence varied widely: several included reviews scored low on methodological quality (AMSTAR) or showed high statistical heterogeneity between studies, which limits confidence in some individual findings, particularly around training load and frequency effects.

PRACTICAL TAKEAWAY

This review showed that resistance training reliably builds muscle mass, strength and physical function compared with no exercise, and that training volume (number of sets) is the most important variable to prioritise for both outcomes. Load and frequency matter mainly for strength, while factors such as rest periods, order and pace of repetitions can be chosen flexibly without compromising results.

My recommendation for athletes performing strength training is to focus on the training load and frequency of training as their priority. Follow a training plan that allows for progressive overloads and builds volume over time.

RELATED RESEARCH

• Study archive: STRENGTH

• Progressive overload affects the magnitude of muscle hypertrophy

• Effect of resistance training frequency on gains in muscular strength

Study date: Jun 2026

Total energy expenditure (TEE) is traditionally modelled as the sum of resting energy expenditure (REE), activity energy expenditure (AEE) and diet-induced thermogenesis: an additive model recently challenged by the constrained energy balance model, which proposes that rises in AEE are offset by falls in mass-adjusted REE. In this study, the authors set out to “test these competing models using two complementary approaches”.

STUDY INTERVENTION

1. 12 adults completed two 10-day periods of high and low physical activity, separated by a washout period, with TEE, AEE and REE measured throughout.

2. TEE was measured using doubly labelled water, AEE using wearable sensors, and REE using indirect calorimetry and anthropometric equations.

3. A cross-sectional sample of 268 adults from the Pennington Center Longitudinal Study had TEE and REE measured, with both datasets analysed using size-adjusted regression models.

KEY RESULTS

1. A roughly 28% rise in AEE, about 250kcal/day, increased TEE by 10%, or 272kcal/day.

2. Mass-adjusted REE did not fall as AEE rose in the longitudinal experiment.

3. In the cross-sectional sample, mass-adjusted REE and AEE were statistically independent, with no sign of compensation.

AUTHORS’ CONCLUSION

• The findings support the additive model of energy expenditure rather than the constrained model.

• Increased physical activity does not suppress REE, so exercise should genuinely add to overall energy balance rather than being offset by the body.

RESULT CONFIDENCE

• The longitudinal experiment relied on only twelve participants completing short ten-day activity periods, a small sample that limits statistical power and may reduce the generalisability of these findings to wider populations.

PRACTICAL TAKEAWAY

This study showed that increasing physical activity raises total energy expenditure without triggering a compensatory drop in resting metabolism. This suggests exercise is not undermined by the body’s own restraint mechanisms, so a more active lifestyle should not be cancelled out by reduced calorie burn at rest.

My recommendation for athletes is to calculate energy expenditure estimates using an additive model and not to account for any compensation by the body when determining their energy needs.

RELATED RESEARCH

• Study archive: Physiology - ENERGY METABOLISM / DIGESTION

• Is the response of human energy expenditure to increased physical activity additive or constrained?

• Physical activity is directly associated with total energy expenditure without evidence of constraint or compensation