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Effects of beta-alanine supplementation on performance and muscle fatigue in athletes and non-athletes of different sports: A systematic review

Authors:

Abstract

Background: Beta-alanine (BA) is a non-essential amino acid that can be synthesized in the liver and obtained from diet, particularly from white and red meat. Increased availability of BA via dietary supplement, may improve performance of athletes. The aim of this study was to conduct a review of the use of BA supplementation as an ergogenic aid to improve performance and fatigue resistance in athletes and non-athletes. Methods: In this systematic review, a search in PubMed and Bireme databases was performed for the terms "beta-alanine", "beta-alanine and exercise", "carnosine" or "carnosine and exercise" in the titles or abstracts. We included randomized, clinical trials published between 2005 and 2015. Results: Twenty-three studies were selected. Most of them included physically active individuals. The mean intervention period was 5.2 ± 1.8 weeks, and mean BA dose was 4.8 ± 1.3g / day. The main outcome measures were blood lactate, pH, perceived exertion, power and physical working capacity at fatigue threshold. After BA supplementation, no statistically significant difference was observed in total work, exercise performance time, oxygen consumption and time to exhaustion. Conclusion: BA supplementation seems to improve perceived exertion and biochemical parameters related to muscle fatigue and less evidence was found for improvement in performance.
Effects of beta-alanine supplementation on performance and muscle fatigue in
athletes and non-athletes of different sports: a systematic review
Priscila Berti Zanella
1
, Fernanda Donner Alves
2
, Carolina Guerini de Souza
1,3*
1
Center for Studies in Food and Nutrition (CESAN) Porto Alegre General Hospital
(HCPA)
2
Grêmio Náutico União de Porto Alegre (GNU)
3
Nutrition undergraduate program, Rio Grande do Sul Federal University (UFRGS)
* Corresponding address:
Carolina Guerini de Souza
Faculdade de Medicina – Departamento de Nutrição
Universidade Federal do Rio Grande do Sul
Rua Ramiro Barcelos 2400 - 4º andar, Santa Cecília
CEP: 90035-003
Porto Alegre - Rio Grande do Sul
Fone: 55 51 3308-5122
E-mail: carolina.guerini@ufrgs.br
Abstract
Background: Beta-alanine (BA) is a non-essential amino acid that can be synthesized
in the liver and obtained from diet, particularly from white and red meat. Increased
availability of BA via dietary supplement, may improve performance of athletes. The
aim of this study was to conduct a review of the use of BA supplementation as an
ergogenic aid to improve performance and fatigue resistance in athletes and non-
athletes. Methods: In this systematic review, a search in PubMed and Bireme
databases was performed for the terms “beta-alanine”, “beta-alanine and exercise”,
“carnosine” or “carnosine and exercise” in the titles or abstracts. We included
randomized, clinical trials published between 2005 and 2015. Results: Twenty-three
studies were selected. Most of them included physically active individuals. The mean
intervention period was 5.2 ± 1.8 weeks, and mean BA dose was 4.8 ± 1.3g / day. The
main outcome measures were blood lactate, pH, perceived exertion, power and physical
working capacity at fatigue threshold. After BA supplementation, no statistically
significant difference was observed in total work, exercise performance time, oxygen
consumption and time to exhaustion. Conclusion: BA supplementation seems to
improve perceived exertion and biochemical parameters related to muscle fatigue and
less evidence was found for improvement in performance.
Keywords: beta-alanine; carnosine; muscle fatigue; athletic performance; oxygen
consumption.
Introduction
Dietary supplements have been used as ergogenic aid in an attempt to increase
energy, enhance recovery and modulate body composition
1
, aiming at meeting energy
needs and improving performance
2,3
.
Beta-alanine (BA) is a non-essential amino acid that can be synthesized in the
liver and obtained from diet, particularly from white meat (poultry and fish) and red
meat
4
. Endogenous synthesis of BA derives from degradation of the pyrimidines
thymine, cytosine and uracil and its transport to skeletal muscle is sodium- and
chloride- dependent
5
. The entry of BA to the cells may be affected by similar structure
compounds (glycine, taurine, gamma-aminobutyric acid) that compete for the same
transporter
6
. It is in the skeletal muscle that BA plays its most important role, as an
intermediate and limiting factor for carnosine synthesis. Carnosine is a dipeptide,
responsible for reducing fatigue and buffering muscle acidosis
7,8,9
.
The synthesis of carnosine in the skeletal muscle using histidine and BA is ATP-
dependent and is catalyzed by carnosine synthase
9
. This process depends on the
availability of BA, from the transport of the amino acid into muscle fibers, BA dietary
intake, hepatic synthesis and carnosine synthase activity
10
. Carnosine may also be
obtained directly from diet, particularly from meat and fish, although its bioavailability
is affected by cooking
11
. In the digestive process, carnosine is mostly converted into
BA and L-histidine by the enzyme carnosinase found in jejunal mucosa. For this reason,
circulating blood levels of carnosine are relatively insignificant
12
. The content of
carnosine in the muscle is also influenced by muscle contraction, and increases with
muscle tension
13
.
Physiologically, increased availability of BA via dietary supplement, combined
with training, may improve performance of athletes who perform high-intensity
exercises, by increasing muscle buffering capacity
14-17
. Several doses and evaluation
protocols of BA have been tested in different sports, and the timing of supplementation
seems to range usually between 4 to 10 weeks and doses are distributed throughout the
day, making the effect of BA supplementation on exercise still controversial
9,15,18
. The
use of BA as an efficient ergogenic aid cannot be thoroughly recommended due to
differences in studied populations, study protocols and BA dosages. Therefore, the aim
of this study was to conduct a review of the use of BA supplementation as an ergogenic
aid to improve performance and fatigue resistance in athletes and non-athletes.
Methods
This systematic review was performed using a predetermined protocol, which
had been stablished according to the Cochrane Handbook recommendations
19
. The
results are presented following the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA Statement) criteria.
We included clinical trials and randomized clinical trials (RCTs) in English,
published in the last 10 years, about the possible effects of BA and carnosine on fatigue
and physical performance in humans. The search was conducted using the PubMed and
Bireme databases for the terms “beta-alanine”, “beta-alanine and exercise”, “carnosine”
or carnosine and exercise” in the title or abstract from January to May 2015. The
outcomes of interest were decrease in muscle fatigue and/or increase in performance;
muscle carnosine content was not considered as outcome of interest. Unpublished
studies, scientific abstracts (either published or unpublished), dissertations and thesis
were not included. We considered, as intervention, the exclusive use of BA or carnosine
in at least one of the groups, in order to evaluate their isolated effects. The articles were
analyzed in an independent, blinded fashion, by two of the authors of this manuscript
(PBZ and FDA), and disagreements were resolved by a third reviewer (CGS).
Results
In the initial search for the selected terms, 241 articles were identified, and 23
were included in the final review (Figure 1). The results of these articles are
summarized in Table I.
The impact factor of the journals in which the articles were published varied
from 2.075 to 3.983, 61% of them was higher than 2.4. The articles were published
between 2006 and 2014, most of them between 2012 and 2013. The mean sample size
was 28.9 ±13.96 individuals, and the mean period of intervention was 5.2 ± 1.8 weeks.
The main intervention was BA (mean dose 4.8±1.3g), followed by maltodextrin (12
studies), dextrose (8 studies), rice flour (2 studies) and glucose (1 study). Fifty-two
percent of the studies were conducted with athletes, especially cyclists, rowers and
football players, and 48% with non-athletes (mostly physically active persons).
For a better understanding of the results, they will be presented by outcome of
interest.
Decrease in muscle fatigue
The variables were subdivided into biochemical and subjective variables, as
follows:
Blood lactate concentration (HLa) and pH
Sixteen studies investigated blood lactate concentration (HLa) and/or pH
20-35
.
Mean age of participants was 23.9±3.4 years, and sample size varied between 14 and 41
subjects. Intervention period varied from 28 days to 10 weeks, and a wide variety of
doses were administered, from fixed doses of 2-6.7 g/day to individual doses of 65
mg/kg of body weight. Glucose
30
, rice flour
24,28
, dextrose
20,27,34
and maltodextrin
21-
23,25,26,29,31-33,35
were used as placebo (PL). In three studies
20,25,34
, the authors also
investigated the effect of BA combined with sodium bicarbonate in comparison with
PL.
Among all these studies, significant differences between BA and PL were
reported in only 2 studies
29,32
, with a decrease in pH and increase in HLa in the group
receiving BA. In the first study
29
elevated acidosis (pH around 7.2) was detected at the
sixth minute of cycling exercise at an intensity of 50%. Although there was no
significant interaction effect between pH absolute values, a significant difference in
exercise-induced acidosis was found between BA and PL groups (p=0.031). In the BA
group, pH decreased 0.015 units as compared with baseline values, whereas in the PL
group, a 0.012 unit decrease was observed in the same period. In the other study
32
the
authors reported an increase in the lactate/proton concentration ratio following BA
supplementation in comparison with placebo.
Subjective assessments of exertion and fatigue
Only three articles conducted subjective assessments of perceived exertion and
muscle fatigue
20,21,36
. The number of participants varied from 26 to 40, with mean age
of 24.0 ± 2.8 years. The intervention period varied from 3 to 4 weeks; the BA doses
from 4.5 to 6.4 g, and the placebos used in these studies were dextrose
20
or
maltodextrin
21,36
.
In two studies
20,36
BA supplementation achieved significant differences in the
outcomes between the study groups. In one of the studies
20
the combination of sodium
bicarbonate and BA resulted in lower ratings of perceived exertion after exercise
(p=0.05), and this effect was not achieved either by BA or sodium bicarbonate alone. In
the second study
36
subjective feeling of fatigue, expressed as mean daily rate, was
significantly lower in the BA (3.96 ± 0.80) than PL (4.55 ± 0.83) group. In the third
study
21
subjective fatigue was not different between BA and maltodextrin group.
Improvement in performance
Due to their wide variety, the variables used for assessing performance
improvement were divided into the following subsections:
Total work done
Five studies calculated the total work done
20,25,34,36,40
. Sample size varied from
14 to 40, with mean age of 26 ± 1.7 years. Intervention period varied between 3 and 4
weeks, and BA doses between 4.5 and 6.4 g. BA effects were compared with those of
PL – maltodextrin
25,36
or dextrose
20,34,40
. In none of the studies was there a significantly
difference in total work done between the group receiving BA and the group receiving
PL.
Power
Eleven studies evaluated the effect of BA supplementation on power
20,24,27,30,33-
37,40,41
. The sample size varied from 14 to 55 individuals, with mean age of 24.6 ± 3.5
years. Intervention period varied from 3 to 8 weeks, and the dose of BA from 1.5 to
6.7g. The placebos used in these studies were rice flour
24
, glucose
30
, maltodextrin
33,35,36
or dextrose
20,27,34,37,40,41
. In one study
41
the authors also investigated the combination of
BA and creatinine on power.
BA supplementation resulted in significantly different effects, compared with
placebo, in only one study
35
. The authors reported increased peak power output by
11.4% (95% confidence interval of 7.8 – 14.9%, p=0.0001) and mean power output by
5.0% during the final sprint (95% confidence interval of 7.8 14.9%, p=0.0001) after
the intervention.
In the study by de Salles Painelli et al. (2014)
40
peak power output was
significantly higher in the non-trained, BA-supplemented group (p=0.004), and a
tendency for increased values in the trained, BA-supplemented group (p=0.08)
compared with before supplementation. In this study, BA supplementation also
increased mean power output in bout 4 for the non-trained, BA-supplemented group
(p=0.004), and in bouts 1, 2 and 4 for the trained, BA-supplemented group (p0.05),
compared with before supplementation.
In another study
41
power output associated with lactate threshold (Watts) was
significantly greater in the BA group after supplementation (130.0 ± 43.1W) compared
with before supplementation (142.5 ± 42.7W), and in the BA-CR group (136.9 ± 37.9
and 125.6 ± 36.7W in the post- and pre-supplementation conditions, respectively). The
effects of BA supplementation in these studies, although not statistically significant,
were considered effective by the authors.
Performance time
Seven studies evaluated the effect of BA supplementation on exercise (running,
cycling, rowing, swimming) performance time
21,22,26,30-32,34
. The number of participants
varied from 14 to 41, with mean age of 24.3 ± 3.6 years. The period of intervention
varied from 28 days to 10 weeks, and the BA dose ranged from 6.7 g to 3.8 g. The
effects of BA were compared with those of glucose
30
, dextrose
34
or
maltodextrin
21,22,26,31,32
with no significant difference between the amino acid and PL.
Oxygen (O
2
) consumption
Eight studies evaluated O
2
consumption
21,28,29,33,35,37,39,41
. The sample size varied
from 14 to 55 individuals, with mean age of 24 ± 3.7 years. Intervention period varied
between 28 days and 8 weeks, and the BA dose between 1.4 and 6.4 g. The PL used in
these studies were rice flour
28
, dextrose
37,41
or maltodextrin
21,29,33,35,39
. No difference
was found between BA and PL groups.
In the study by Gross et al. (2014)
33
, BA supplementation increased maximal
oxygen consumption (VO2 max) compared with pre-supplementation period. In another
study
41
VO2 (L/min) associated with ventilatory and lactate threshold (1.74 ± 0.4 and
2.02 ± 0.50 L/min, respectively) and peak VO2 associated with ventilatory threshold
(64.7 ± 10.5 %) were significantly higher in the group supplemented with BA and
creatinine as compared with pre-supplementation period (1.84 ± 0.44 L/min, 2.18 ± 0.42
L/min and 69.8 ± 11.4%, respectively). In these studies, although not statistically
significant, the effect of BA supplementation was considered effective by the authors.
Time to exhaustion (TTE)
Five studies evaluated the time to exhaustion (TTE)
25,28,35,39,41
. These studies
involved 20-55 participants, aged 24.3 ±2.6 years. The intervention protocol varied
from 28 days to 8 weeks. The BA dose ranged from 3.25 to 6.4g, and the placebos used
were rice flour
28
, dextrose
41
or maltodextrin
25,35,39
. No statistically significant difference
in the TTE was observed between BA and PL groups.
In the study by Sale et. al., (2011)
25
, TTE significantly increased by 12.1% after
BA supplementation, and by 16.2% after BA combined with sodium bicarbonate
supplementation, compared with before supplementation. Stout et. al., (2007)
39
also
reported a significant increase in TTE (seconds) in the group supplemented with BA
(1117.55 ± 118.98) compared to baseline (1146.73±110.27). In these studies, although
not statistically significant, the effect of BA supplementation was considered effective
by the authors.
Physical working capacity at fatigue threshold
Two studies
38,39
involving 22 and 55 volunteers, respectively, with mean age of
25.9 ± 2 years examined the effects of BA supplementation on the fatigue using the
physical working capacity at fatigue threshold. The intervention period was 4 weeks in
both studies, the dose of BA ranged from 3.9 to 5.6 g, and the placebos were dextrose
38
and maltodextrin
39
.
In the first study
38
the authors also evaluated the effects of BA and creatine
supplementation in comparison with PL. There was a significant effect of BA
supplementation on physical working capacity at fatigue threshold. When adjusted for
pre-test values, post-test values (in Watts) were higher in the BA group (170.0 ± 15.9 vs
198.8 ± 19.9) compared with PL group (215.8 ± 19.0 vs 211.2 ± 23.7). The group
supplemented with BA and creatinine also showed higher values compared with the PL
group (190.7 ± 18.6 vs 214.3 ± 17.1). In the other study
39
a statistically significant
difference was observed after BA supplementation (113.64 ± 12.45 Watts) compared
with pre-supplementation values (130.00 ± 12.99 Watts). Similarly to the previous
outcomes, although the difference between BA and PL groups was not statistically
significant, the effect of BA supplementation compared to pre-supplementation
conditions was considered as effective by the authors.
Discussion
This review aimed to describe the result of clinical trials using BA
supplementation as an ergogenic aid to improve performance and fatigue resistance in
athletes and non-athletes. Few of the outcomes studied showed a significant difference
between the intervention (BA supplementation) and the PL groups. There was,
however, an important effect of BA supplementation in the intra-group comparison, i.e.
post-supplementation vs pre-supplementation condition.
A higher number of the variables studied in the articles were more related to
improvement of performance than to decrease of muscle fatigue. In addition, the studies
were heterogeneous in terms of the dose of BA, period of intervention, and protocol of
exercise, which makes the comparison of results difficult.
Controversial findings have been found with respect to blood HLa and pH.
While some studies using either BA or BA plus sodium bicarbonate supplementation
showed significantly increased values post-exercise, others showed a decrease in HLa
concentrations and pH. The increase in HLa concentrations after sodium bicarbonate
ingestion in the post-exercise period has been reported
43
. The mechanisms proposed for
this response include higher lactate production caused by inhibition of glycolytic
enzymes involved in the conversion of this intermediate into acetyl coenzyme
20
. On the
other hand, the decrease in acidosis reported by some of the studies included in this
systematic review may be explained by the increase in muscle carnosine, which acts as
a physiological buffer, in response to BA supplementation
44
.
Regarding the decrease in muscle fatigue, indicated by a reduction in subjective
fatigue in response to the intervention, the supplementation of BA, either alone or
combined with sodium bicarbonate, seems to decrease perceived exertion due to the
buffering role of both compounds. In addition, the training status may affect the
response to BA supplementation. For example, high-intensity, long-term training, per
se, may increase muscle carnosine concentrations and hence, in this condition, the effect
of BA supplementation on this dipeptide levels may be blunted
45
.
According to a recent review of BA supplementation by the International
Society of Sports Nutrition (ISSN), the intervention improves high-intensity, short-
duration (60-240 seconds) exercise performance
46,47
and appears to be safe. Besides, the
physiological role of carnosine on the regulation of calcium sensitivity of the contractile
apparatus and calcium sarcoplasmic reticulum release is well known
48
. Therefore, the
effect of BA supplementation in improving high-intensity exercise performance may be
associated with an increase in muscle carnosine levels, and consequently, higher
calcium sensitivity of the contractile apparatus and strength production, in addition to a
reduction in muscle fatigue
44,49
. Also, we identified in this review that the positive
effects of BA supplementation were mainly related to single doses of BA (4.5g or
6.4g/day), with the intervention period varied between 3 and 6 weeks, and all studies
with significant results were conducted exclusively on men, practitioners of judo, jiu-
jitsu, football, and cycling.
The results of BA supplementation are controversial, with some studies finding
significant effects while others reporting no effects. This may be explained by evidence
on the capacity of BA absorption and utilization by the skeletal muscle, which varies
individually. It is speculated that the response to BA supplementation would be similar
to that of creatine supplementation, whose response depends on pre-existing levels of
muscular creatine levels, and approximately 20% of individuals are non-responsive
50
.
This would explain, in part, the controversial results on the ergogenic effects of BA
supplementation.
Also despite of the absence of significant difference in muscle fatigue and
performance in some of the studies evaluated in our review, it should be remembered
the low sample size combined with the discrete magnitude of supplementation effects
on performance, could result in low statistical power in many studies
51
. Therefore,
although the performance improvement was not statistically significant in these studies,
the relevance of this effect in a competitive situation should not be neglected.
In studies that showed an improvement in performance, the period of
intervention varied between 4 and 8 weeks, and a mean BA dose of 4.4g (3.2 – 6.4g) per
day was used, lower than those used in the studies evaluating the effect of BA on
muscle fatigue. The mostly used methods for BA supplementation were dose increment
or dose decrease. Only one study was carried out with women. The sport studied was
cycling, and the other studies were conducted with physically active volunteers.
The inconsistent findings around the studies in this review may be related to (a)
supplementation period, (b) dosage, (c) type of exercise training, (d) participants’
training status, (e) sample size, (f) methodological problems of the RCTs. In light of
this, the most prominent effects of BA were modulation of muscle acid-base balance
and decrease in perceived exertion.
Conclusion
Current evidence indicates that BA supplementation leads to improvements in
perceived exertion and biochemical parameters related to muscle fatigue, particularly in
protocols using 4.5 - 6.4g per day of BA for 4 weeks. In addition, BA seems to improve
exercise performance, especially in non-athletes. The heterogeneity of protocols and
scarcity of data on women suggest the need for further studies.
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Legends of figures and tables
Figure 1. Flowchart of the literature search.
Table I. Effects of beta-alanine supplementation on performance and muscle
fatigue.
Table I. Effects of beta-alanine supplementation on performance and muscle fatigue.
Authors and
year
Study type and
sample Intervention Follow-up period Outcome measures Results
Tobias, et al.,
2013 (20)
RCT with judo (n=19)
and jiu-jitsu (n=21)
male competitors
BA supplementation (6.4g/day)
or PL (dextrose 6.4g/day) for 4
weeks. In the last week of
supplementation, the athletes
also received SB (500 mg/kg of
body mass) or PL (calcium
carbonate, 500 mg/kg of body
mass). Hence, 4 study groups
were formed: PL-PL, BA-PL,
PL-SB and BA-SB
4 weeks HLa, rate of perceived exertion, total
work done, peak and mean power.
HLA: significantly higher after BA-PL, PL-
SB and BA-SB supplementation
Rate of perceived exertion: significantly
lower in BA-SB group
Total work done, peak and mean power:
significantly higher after BA-PL, PL-SB
and BA-BS supplementation
Saunders et
al., 2012
(21)
Double-blind, RCT
with male elite (n=20)
and non-elite (n=20)
game players.
BA supplementation (6.4g/day)
or PL
(maltodextrin 6.4g/day)
4 weeks HLa, perceived exertion, sprint
performance (time) and VO
2
max
There was no statistically significant
difference between groups
Chung et al.,
2012 (22)
Double blind, RCT
with swimmers of
both sexes (n = 41)
BA supplementation (4.8g/day
for 4 weeks, 3.2g/day for 6
weeks) or PL (maltodextrin
4.8g/day for 4 weeks and 3.2
g/day for 6 weeks)
10 weeks HLa, pH, SB concentrations and training
performance (time).
There was no statistically significant
difference between groups
Smith-Ryan
et al., 2012
(23)
Double blind, RCT
with physically active
individuals (n= 15) of
both sexes
BA supplementation (4.8g/day)
or PL (maltodextrin 4.8g/day)
28 days HLa, time to exhaustion and velocity HLa and velocity: no statistically
significant difference
Time to exhaustion: significantly greater
after supplementation (compared with pre-
supplementation value) in men
Sweeney et
al., 2010 (24)
Double blind, RCT
with college men
(n=19)
BA or PL (rice flour)
supplementation (4g/day in the
first week, and 6 g per day over
the next 4 weeks)
5 weeks HLa, horizontal power (peak and mean),
percentage of fatigue
HLa, horizontal power (peak), percentage
of fatigue: no statistically significant
difference.
HLa, horizontal power (mean): significantly
lower in BA and PL groups (compared with
pre-supplementation values)
Sale et al.,
2011 (25)
Randomized, cross-
over clinical trial with
physically active men
BA supplementation (6.4g/day)
or PL (maltodextrin 6.4g/day),
using a crossover design with 2
4 weeks
HLa, PH, BS concentration, work done
and TTE.
HLa: significantly higher in all groups (pre-
supplementation vs. post-supplementation)
(n=20) days of rest between trials,
creating four study groups: PL-
PL, BA-PL, PL-SB, BA-SB.
pH: significantly higher in the PL-SB and
BA-SB groups (compared with pre-
supplementation period)
BS concentration: significantly lower in all
groups (post-supplementation vs. pre-
supplementation)
Work done and TTE: significantly higher in
the BA-PL and BA-SB groups (post-
supplementation vs. pre-supplementation)
Baguet et al.,
2010 (26)
RCT with rowers
(n=18) of both sexes
BA supplementation (5g/day) or
PL (maltodextrin 5g/day)
7 weeks HLa and performance (time) There was no statistically significant
difference between the groups
Kern &
Robinson,
2011 (27)
Double blind, RCT
with football players
(n=15) and physically
active individuals
(n=22)
BA supplementation (4g/day) or
PL (dextrose 4g/day)
8 weeks HLa and anaerobic power There was no statistically significant
difference between the groups
Jagim et al.,
2013 (28)
Double blind, RCT
with physically active
men (n=21)
BA supplementation or PL (rice
flour) (4g/day in the first week
and 6g/day in the following
weeks)
5 weeks HLa, TTE and VO
2
max There was no statistically significant
difference between the groups
Baguet et al.,
2009 (29)
Double blind, RCT
with male physical
education students
(n=14)
BA or PL (maltodextrin)
supplementation (2.4g/day in
the first 2 days, 3.6g/day in the
next 2 days, and 4.8g/day until
the end of the study)
4 weeks HLa, pH, SB concentration, kinetics of
pulmonary oxygen consumption
pH: different between BA and PL groups
HLa, SB concentration, kinetics of
pulmonary oxygen consumption: no
statistically significant difference
Ducker,
Dawson &
Wallman,
2013
(30)
RCT with male
rowers (n=16)
BA supplementation (6.7g/day)
or PL (glucose, 10g/day)
28 days HLa, pH, mean power, split power and
race time
HLa and mean power: no statistically
significant difference
pH, split power and race time: significantly
higher in the BA group (post-
supplementation vs. pre-supplementation
values)
Derave et al.,
2007
(31)
Double blind, RCT
with male athletics
athletes (n=15)
BA supplementation or PL
(maltodextrin) (2.4g/day in the
first 4 days, 3.6g/day in the
following 4 days, and 4.8g/day
until the end of the study)
4-5 weeks HLa and running time HLa: significantly higher in both groups
(post-supplementation vs. pre-
supplementation value)
Running time: significantly lower in both
groups (post-supplementation vs. pre-
supplementation value).
Chung et al.,
2013 (32)
RCT with male
cyclists (n=28)
BA supplementation or PL
(maltodextrin) (6.4g/day)
6 weeks HLa, pH, SB concentrations and time trial
performance
HLa: significantly higher in the BA group
pH, SB concentrations, time trial
performance: there was no statistically
significant difference
Gross et al.,
2014 (33)
Double blind, RCT
with physically active
men (n=17)
BA supplementation or PL
(maltodextrin) (3.2g/day in the
first 38 days)
38 days HLa, pH, peak power, power at
ventilatory threshold and VO
2
max
HLa and VO
2
max: significantly higher in
the BA group (post- supplementation vs.
pre-supplementation values).
pH, peak power, and power at ventilatory
threshold: there was no statistically
significant difference
Bellinger et
al., 2012 (34)
Double blind, RCT
with male cyclists
(n=14)
BA supplementation (65 mg/kg
of body mass, PL (dextrose 65
mg/kg of body mass), BA+PL,
PL+BS (0.3 mg/kg of body
mass) or BA+SB
28 days pH, total work done, mean power and 4-
min cycling time trial performance
pH: significantly lower in PL-BS and BA-
SB groups (post- supplementation vs. pre-
supplementation values).
Total work done and mean power:
significantly higher in the PL-SB and BA-
SB (post- supplementation vs. pre-
supplementation values).
4-min cycling time trial performance: no
statistically significant difference
Thienen et
al., 2009
(35)
Double blind, RCT
with male cyclists
(n=21)
BA supplementation or PL
(maltodextrin) (2g/day in the
first two weeks, 3g/day in the
third and fourth week and
4g/day until the end of the
study)
8 weeks HLa, power, peak VO
2
and TTE HLA and peak VO
2
: no statistically
significant difference
Power: significantly increased during the
final sprint after the time trial after BA
supplementation
TTE: significantly higher in both groups
(post-supplementation vs. pre-
supplementation)
Hoffman et
al., 2007 (36)
RCT with football
players (n=26)
BA supplementation or PL
(maltodextrin) (4.5g/day)
3 weeks Fatigue rate, subjective sensation of
fatigue, total work done, peak and mean
power
Subjective sensation of fatigue:
significantly lower in the BA group
Fatigue rate, total work done, peak and
mean power: no statistically significant
difference
Walter et al., Double blind, RCT BA+PL supplementation (1.5g+ 8 weeks Power at the ventilatory threshold and Power at the ventilatory threshold and VO
2
2010 (37) with physically active
women (n=44)
dextrose 15g/day) or PL
(dextrose 16.5g/day)
VO
2
peak peak: significantly higher in both groups
(post-supplementation vs. pre-
supplementation values)
Stout et al.,
2006 (38)
Double blind, RCT
with male volunteers
(n=55)
BA supplementation (6.4g/day
in the first 6 days, and 3.2g/day
until the end of the study), PL
(dextrose 34g), CR (5.25g) or
BA + CR (1.6g+5.25g)
28 days Physical working capacity at fatigue
threshold
Physical working capacity at fatigue
threshold: significantly higher in the BA
and BA-CR groups
Stout et al.,
2007
(39)
Double blind, RCT
with female
volunteers (n=22)
BA supplementation or PL
(maltodextrin) (3.2g/day in the
first week and 6.4g/day in
following weeks)
4 weeks VO
2
max, ventilatory threshold, TTE and
physical working capacity at fatigue
threshold
VO
2
max: there was no statistically
significant difference
Ventilatory threshold, TTE and physical
working capacity at fatigue threshold:
significantly higher in the BA group (post-
supplementation vs. pre-supplementation)
Painelli et al.,
2014
(40)
RCT with male
trained and non-
trained cyclists
(n=40).
BA supplementation or PL
(6.4g/day) in four experimental
conditions: non-trained PL,
non-trained BA, trained BA and
trained BA
4 weeks Total work done, peak and mean power,
and performance
Total work done: significantly higher in
non-trained-BA and trained-BA groups, and
significantly lower in the non-trained-PL
and trained-PL (post-supplementation vs.
pre-supplementation values)
Peak power: significantly higher in the non-
trained-BA group (post-supplementation vs.
pre-supplementation values)
Mean power: significantly higher in the
non-trained-BA and trained-BA groups
(post-supplementation vs. pre-
supplementation)
Performance: there was no statistically
significant difference
Zoeller et al.,
2006
(41)
Double blind, RCT
with male volunteers
(n=55)
BA supplementation
(6.4g/day in the first 6 days and
3.2 g/day until the end of the
study), PL (dextrose 34g), CR
(5.25g) or BA + CR
(1.6g+5.25g)
28 days Power output, VO
2
, % peak VO
2
, and
VO
2
at ventilatory and lactate threshold,
and TTE
Power output, VO
2
, % peak VO
2
, VO
2
at
ventilatory and lactate threshold:
significantly higher in the BA-CR group
(post-supplementation vs. pre-
supplementation)
Power output at lactate threshold:
significantly higher in the BA and BA-CR
groups (post-supplementation vs. pre-
supplementation)
TTE: there was no statistically significant
difference
Smith et al..,
2008
(42)
Double blind, RCT
with male, physically
active volunteers
(n=46)
BA supplementation (6g/day in
the first two weeks and 3g/day
until the end of the study) or
PL (dextrose 16.5g)
5 weeks Efficiency of electrical activity (muscle
function) and
electromyographic fatigue
threshold
Efficiency of electrical activity (muscle
function) and
electromyographic fatigue
threshold: significantly improved in both
groups (post-supplementation vs. pre-
supplementation)
RCT – randomized clinical trial; BA – beta alanine; PL – placebo; SB – sodium bicarbonate; HLa – blood lactate concentration; CR – creatine;
VO
2
– volume of oxygen consumed; TTE – time to exhaustion.

Supplementary resource (1)

... Beta-alanine is a non-essential amino acid that can be obtained through the diet or synthesized by the body from L-alanine (6). Beta-alanine supplementation has been widely studied as a strategy to improve performance in high intensity, short duration exercise such as sprints and weightlifting exercises (6). ...
... Beta-alanine is a non-essential amino acid that can be obtained through the diet or synthesized by the body from L-alanine (6). Beta-alanine supplementation has been widely studied as a strategy to improve performance in high intensity, short duration exercise such as sprints and weightlifting exercises (6). The main physiological effect of beta-alanine is to increase the concentration of carnosine in skeletal muscles. ...
... BLC is a measure that reflects muscle overload during exercise and is used as an indicator of pain and peripheral fatigue (45). If β-alanine is a precursor of carnosine production, which in turn is considered an intramuscular buffer, it can act to reduce BLC and, consequently, attenuate metabolic acidosis and increase muscle performance (3,6). ...
Article
Full-text available
The aim of the present study was to evaluate the effects of acute β-alanine supplementation on the rate of perceived exertion, training impulse and heart rate variability during high intensity functional training. Twelve trained men (age: 22.0 ± 5.0 years old; body mass index: 23.6 ± 4.2 Kg/m2; fat mass: 9.8 ± 2.3; VO2max: 54.0 ± 4.5 mL/kg/min) participated in the present study. At the first visit to the training center, they performed a cardiopulmonary exercise test in the rowing ergometer to determine the maximum oxygen consumption. At the two subsequent visits, participants were randomized as-signed to the following conditions: a) placebo supplementation and b) 6.4g of β-alanine supple-mentation. The training protocol adopted was to execute the maximal number of repetitions of 5 pull-ups, 10 push-ups, and 15 squats per round in 20 minutes. Simultaneously, the following training load parameters were measured and then also compared during the two experimental conditions: session load (SL), training impulse (TRIMP), blood lactate concentration (BLC) and heart rate variability (HRV). β-alanine supplementation increased performance (p <0.05) and reduced BLC (p <0.05). Additionally, the internal training load parameters showed strong correlations with performance after β-alanine supplementation (SL: r=0.80, p <0.01; TRIMP: r=0.80, p <0.01; and HRV: r=0.79, p <0.01). Therefore, β-alanine supplementation may increase performance in high intensity functional fitness training.
... Four studies reported the average participant age ranged from 17.4 to 85.3 years. Five of these reviews directly examined exercise performance, 5,13,15,18,19 while the other focused on fatigue resistance 14 and body composition. 16 The BA dosage in studies ranged between 1.2 and 7.0 g/day. ...
... Three other studies included in this review reported moderate ergogenic effects which were not significant. 13,14,18 Ojeda et al. pooled 19 studies with BA supplementation for athletes and healthy individuals, with dosages and intervention durations varying from 1.2-6.4 g/d and 5-10 weeks, respectively. ...
... g/d for an intervention period of 3-8 weeks and explored the impact of BA supplementation on the body fatigue threshold. 14 The results showed that supplementation of BA improved exertion and biochemical parameters associated with muscle fatigue. However, no statistically significant change was seen in terms of total work, exercise performance time, oxygen consumption, or time to exhaustion. ...
... Systematic reviews and meta-analyses have been conducted to assess capacity and exercise performance associated with supplementation with β-alanine, all of which have demonstrated a significant overall beneficial effect but influenced by different modifying variables related to the type of exercise, training status, exercise duration, intermittent or continuous exercise, and co-supplementation with other products (e.g., sodium bicarbonate, carbohydrates) (4)(5)(6). ...
... Foot-to-foot bioimpedance analysis (BIA) was used to determine fat mass, lean mass, and muscle mass using Tanita BC-420MA BIA analyzer (Tanita Corporation, Arlington Heights, IL, United States). The conditions considered for the BIA measurement were: (1) Overnight fasting or avoidance of food and/or beverages during the 4 to 8 h prior to measurement, (2) Urinate before measurement, (3) No exercise (24 h prior), (4) No alcohol or diuretics (48 h prior), (5) No menstruation, (6) No metal objects and/or prostheses, (7) Minimal clothing should be worn, (8) The electrodeskin contact area must be clean, (9) Perform the measurement after 5 min of rest of the subject, and (10) Take the measurement at the same time as the previous measurement. Compliance with the study product as well as adverse events were evaluated at visit. ...
Article
Full-text available
Introduction Beta-alanine is a non-essential amino acid that has been a focus of increasing research by its role as ergogenic aid to improve muscle performance. Methods A randomized, double-blind and controlled trial was conducted to determine the effect of a nutritional supplement of a sustained-release formulation of β-alanine in recreational trained men. The active product was an innovative sustained-release β-alanine microgranules powder blend, administered at high doses (15 g/day) divided into 3 intakes during 30 days. There were 10 participants in the experimental group and 9 in the placebo group, with a mean age of 22.5 ± 3.3 years. Participants were testing at baseline and at the end of study. Results In the β-alanine group, there were statistically increases in serum triglycerides, LDL-cholesterol, and urea nitrogen at the end of the study as compared with baseline, although there were no differences with the control group. The occurrence of paresthesia, described above all as tickling, was the majority but presented VAS score less than 3/10 in almost all subjects. Discussion More studies are required to evaluate the changes in blood parameters that can be caused by high intake of β-alanine during a long period of time. Clinical trial registration ClinicalTrials.gov, identifier (NCT05334121).
... Among the ergogenic resources on the market, beta-alanine is one of the few that has strong scientific evidence that proves its positive effects on physical performance as its intracellular buffering action directly influences the regulation of the pH of the muscular environment, delaying fatigue and enabling an improvement in the performance of high-intensity activities that use the anaerobic lactic system to resynthesize adenosine triphosphate -ATP (Sauders et al., 2017;Zanella et al., 2017;Quesnele et al., 2014). ...
Article
This study aimed to review the effects of beta-alanine supplementation on cognitive performance in adult individuals. This review was carried out according to the PRISMA guidelines, using PubMed, Google Scholar, and Scopus databases, retrieving articles published between 2014 and 2024. Eligibility criteria followed the PICOS tool: healthy adult individuals of both sexes, isolated supplementation of beta-alanine, use of intervention and control groups, results of validated tests to assess cognitive capacity, and randomized controlled studies with parallel or crossover designs. Seven studies were included in this work, totaling 86 participants and using seven cognitive tests. The methodological quality and risk of bias were assessed using the PEDro and Cochrane Risk of Bias 2.0 scales, respectively. Most studies were considered good quality and had a low risk of bias. The analysis and interpretation of the studies demonstrated contradictory results of beta-alanine supplementation on cognitive performance regardless of the test protocols used. In four studies, this supplementation did not produce a significant effect, and in another three, an improvement was observed in cognitive tests after supplementation. It can be concluded that there is still 2 CUADERNOS DE EDUCACIÓN Y DESARROLLO, Portugal, v.16, n.10, p. 01-23, 2024 insufficient evidence to guarantee that beta-alanine supplementation can improve the cognitive performance of adult individuals. RESUMO Este estudo teve como objetivo revisar os efeitos da suplementação de beta-alanina no desempenho cognitivo em indivíduos adultos. Esta revisão foi realizada de acordo com as diretrizes PRISMA, utilizando as bases de dados PubMed, Google Scholar e Scopus, recuperando artigos publicados entre 2014 e 2024. Os critérios de elegibilidade seguiram a ferramenta PICOS: indivíduos adultos saudáveis de ambos os sexos, suplementação isolada de beta-alanina, utilização de grupos de intervenção e controle, resultados de testes validados para avaliação da capacidade cognitiva e estudos randomizados controlados com desenhos paralelos ou cruzados. Sete estudos foram incluídos neste trabalho, totalizando 86 participantes e utilizando sete testes cognitivos. A qualidade metodológica e o risco de viés foram avaliados pelas escalas PEDro e Cochrane Risk of Bias 2.0, respectivamente. A maioria dos estudos foi considerada de boa qualidade e apresentava baixo risco de viés. A análise e interpretação dos estudos demonstraram resultados contraditórios da suplementação de beta-alanina no desempenho cognitivo, independentemente dos protocolos de teste utilizados. Em quatro estudos esta suplementação não produziu efeito significativo e em outros três foi observada melhora nos testes cognitivos após a suplementação. Pode-se concluir que ainda não existem evidências suficientes para garantir que a suplementação de beta-alanina possa melhorar o desempenho cognitivo de indivíduos adultos. Palavras-chave: aminoácidos, stroop test, suplementação alimentar, testes cognitivos. RESUMEN Este estudio tuvo como objetivo revisar los efectos de la suplementación con beta-alanina sobre el rendimiento cognitivo en individuos adultos. Esta revisión se realizó según las guías PRISMA, utilizando las bases de datos PubMed, Google Scholar y Scopus, recuperando artículos publicados entre 2014 y 2024. Los criterios de elegibilidad siguieron la herramienta PICOS: individuos adultos sanos de ambos sexos, suplementación aislada de beta-alanina, uso de grupos de intervención y control, resultados de pruebas validadas para evaluar la capacidad cognitiva y estudios controlados aleatorios con diseños paralelos o cruzados. En este trabajo se incluyeron siete estudios, con un total de 86 participantes y que utilizaron siete pruebas cognitivas. La calidad metodológica y el riesgo de sesgo se evaluaron mediante las escalas PEDro y Cochrane Risk of Bias 2.0, respectivamente. La mayoría de los estudios se consideraron de buena calidad y tuvieron un riesgo bajo de sesgo. El análisis y la interpretación de los estudios demostraron resultados contradictorios de la suplementación con beta-alanina sobre el rendimiento cognitivo, independientemente de los protocolos de prueba utilizados. En cuatro estudios esta suplementación no 3 CUADERNOS DE EDUCACIÓN Y DESARROLLO, Portugal, v.16, n.10, p. 01-23, 2024 produjo un efecto significativo y en otros tres se observó una mejora en las pruebas cognitivas después de la suplementación. Se puede concluir que aún no hay evidencia suficiente para garantizar que la suplementación con beta-alanina pueda mejorar el rendimiento cognitivo de los individuos adultos. Palabras clave: aminoácidos, test de stroop, suplementación alimentaria, tests cognitivos.
... Our review's results are in agreement with previous systematic reviews (Berti Zanella et al., 2017;Quesnele et al., 2014) that also found improvements in the same parameters. Beyond that, our results indicate that beta-alanine supplementation can enhance both exercise performance and capacity, agreeing with previous research ). ...
Article
Beta-alanine is a nonessential amino acid that is commonly used to improve exercise performance. It could influence the buffering of hydrogen ions produced during intense exercise and delay fatigue, providing a substrate for increased synthesis of intramuscular carnosine. This systematic review evaluates the effects of beta-alanine supplementation on maximal intensity exercise in trained, young, male individuals. Six databases were searched on August 10, 2023, to identify randomized, double-blinded, placebo-controlled trials investigating the effect of chronic beta-alanine supplementation in trained male individuals with an age range of 18–40 years. Studies evaluating exercise performance through maximal or supramaximal intensity efforts falling within the 0.5–10 min duration were included. A total of 18 individual studies were analyzed, employing 18 exercise test protocols and 15 outcome measures in 331 participants. A significant ( p = .01) result was observed with an overall effect size of 0.39 (95% confidence interval [CI] [0.09, 0.69]), in favor of beta-alanine supplementation versus placebo. Results indicate significant effects at 4 weeks of supplementation, effect size 0.34 (95% CI [0.02, 0.67], p = .04); 4–10 min of maximal effort, effect size 0.55 (95% CI [0.07, 1.04], p = .03); and a high beta-alanine dosage of 5.6–6.4 g per day, effect size 0.35 (95% CI [0.09, 0.62], p = .009). The results provide insights into which exercise modality will benefit the most, and which dosage protocols and durations stand to provide the greatest ergogenic effects. This may be used to inform further research, and professional or recreational training design, and optimization of supplementation strategies.
... On the other hand, lactate concentration is correlated with H + ion accumulation, so proton gradient and pH maintenance may help to attenuate fatigue. 13,14 Therefore, a strategy to attenuate the fatigue doubles the importance of BA supplementation. So its unique features became the focus of attention and attracted our interest to evaluate its effects on recovery biomarkers. ...
Article
Full-text available
Background: Clinical studies, investigating the effect of β-Alanine (BA) supplementation on recovery biomarkers in physically active individuals, have generated inconsistent results. This systematic review and meta-analysis study aimed to clarify the clinically relevant dietary effects of BA supplementation. Methods: A comprehensive search was done in the electronic databases of Scopus, PubMed, ISI Web of Science and Embase from inception to 2020. Meta-analysis was done using the random-effects model. Pooled effect size was evaluated using standard mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity of between-study was evaluated according to Cochran’s Q test and I2. Subgroup analysis was conducted to identify the potential sources of heterogeneity. Results: Overall, 32 studies were included in the current study. The results suggested that BA supplementation increases carnosine level significantly (SMD: 0.22mmol/L, 95%CI: -0.17,0.61, P=0.27) but no effect was shown about lactate, fatigue, VO2, PH and bicarbonate (HCO3-) (P>0.05). Subgroup analysis revealed a significant association of VO2, carnosine and fatigue with supplementation dosage, gender and duration of administration respectively. Conclusion: BA supplementation emerged its beneficial effects on enhancing carnosine level which highlights its ergogenic effects. In contrast, no significant effects had been shown in term of fatigue delay and blood levels of lactate, HCO3-, PH, and VO2 value. These results warrant more investigation in a prospective design to clarify the exact mechanism in this way.
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β-alanine is an amino acid that, when combined with histidine, forms the dipeptide carnosine within skeletal muscle. Carnosine and β-alanine each have multiple purposes within the human body; this review focuses on their roles as ergogenic aids to exercise performance and suggests how to best quantify the former's merits as a buffer. Carnosine normally makes a small contribution to a cell's total buffer capacity; yet β-alanine supplementation raises intracellular carnosine concentrations that in turn improve a muscle's ability to buffer protons. Numerous studies assessed the impact of oral β-alanine intake on muscle carnosine levels and exercise performance. β-alanine may best act as an ergogenic aid when metabolic acidosis is the primary factor for compromised exercise performance. Blood lactate kinetics, whereby the concentration of the metabolite is measured as it enters and leaves the vasculature over time, affords the best opportunity to assess the merits of β-alanine supplementation's ergogenic effect. Optimal β-alanine dosages have not been determined for persons of different ages, genders and nutritional/health conditions. Doses as high as 6.4 g day(-1), for ten weeks have been administered to healthy subjects. Paraesthesia is to date the only side effect from oral β-alanine ingestion. The severity and duration of paraesthesia episodes are dose-dependent. It may be unwise for persons with a history of paraesthesia to ingest β-alanine. As for any supplement, caution should be exercised with β-alanine supplementation.
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Smith-Ryan, AE, Fukuda, DH, Stout, JR, and Kendall, KL. High-velocity intermittent running: effects of beta-alanine supplementation. J Strength Cond Res 26(10): 2798-2805, 2012-The use of β-alanine in sport is widespread. However, the effects across all sport activities are inconclusive. The purpose of this study was to evaluate the effects of β-alanine supplementation on high-intensity running performance and critical velocity (CV) and anaerobic running capacity (ARC). Fifty recreationally trained men were randomly assigned, in a double-blind fashion, to a β-alanine group (BA, 2 × 800 mg tablets, 3 times daily; CarnoSyn; n = 26) or placebo group (PL, 2 × 800 mg maltodextrin tablets, 3 times daily; n = 24). A graded exercise test (GXT) was performed to establish peak velocity (PV). Three high-speed runs to exhaustion were performed at 110, 100, and 90% of PV, with 15 minutes of rest between bouts. The distances achieved were plotted over the time to exhaustion (TTE). Linear regression was used to determine the slope (CV) and y-intercept (ARC) of these relationships to assess aerobic and anaerobic performances, respectively. There were no significant treatment effects (p > 0.05) on CV or ARC for either men or women. Additionally, no TTE effects were evident for bouts at 90-110%PV lasting 1.95-5.06 minutes. There seems to be no ergogenic effect of β-alanine supplementation on CV, ARC, or high-intensity running lasting approximately 2-5 minutes in either men or women in the current study.
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Interest into the effects of carnosine on cellular metabolism is rapidly expanding. The first study to demonstrate in humans that chronic ß-alanine (BA) supplementation (~3-6 g BA/day for ~4 weeks) can result in significantly augmented muscle carnosine concentrations (>50%) was only recently published. BA supplementation is potentially poised for application beyond the niche exercise and performance-enhancement field and into other more clinical populations. When examining all BA supplementation studies that directly measure muscle carnosine (n = 8), there is a significant linear correlation between total grams of BA consumed (of daily intake ranges of 1.6-6.4 g BA/day) versus both the relative and absolute increases in muscle carnosine. Supporting this, a recent dose-response study demonstrated a large linear dependency (R (2) = 0.921) based on the total grams of BA consumed over 8 weeks. The pre-supplementation baseline carnosine or individual subjects' body weight (from 65 to 90 kg) does not appear to impact on subsequent carnosine synthesis from BA consumption. Once muscle carnosine is augmented, the washout is very slow (~2%/week). Recently, a slow-release BA tablet supplement has been developed showing a smaller peak plasma BA concentration and delayed time to peak, with no difference in the area under the curve compared to pure BA in solution. Further, this slow-release profile resulted in a reduced urinary BA loss and improved retention, while at the same time, eliciting minimal paraesthesia symptoms. However, our complete understanding of optimizing in vivo delivery and dosing of BA is still in its infancy. Thus, this review will clarify our current knowledge of BA supplementation to augment muscle carnosine as well as highlight future research questions on the regulatory points of control for muscle carnosine synthesis.