Placebo in sports nutrition: a proof-of-principle study involving caffeine supplementation

Scand J Med Sci Sports. 2017 Nov;27(11):1240-1247. doi: 10.1111/sms.12793. Epub 2016 Nov 23.

Abstract

We investigated the effects of supplement identification on exercise performance with caffeine supplementation. Forty-two trained cyclists (age 37 ± 8 years, body mass [BM] 74.3 ± 8.4 kg, height 1.76 ± 0.06 m, maximum oxygen uptake 50.0 ± 6.8 mL/kg/min) performed a ~30 min cycling time-trial 1 h following either 6 mg/kgBM caffeine (CAF) or placebo (PLA) supplementation and one control (CON) session without supplementation. Participants identified which supplement they believed they had ingested ("caffeine", "placebo", "don't know") pre- and post-exercise. Subsequently, participants were allocated to subgroups for analysis according to their identifications. Overall and subgroup analyses were performed using mixed-model and magnitude-based inference analyses. Caffeine improved performance vs PLA and CON (P ≤ 0.001). Correct pre- and post-exercise identification of caffeine in CAF improved exercise performance (+4.8 and +6.5%) vs CON, with slightly greater relative increases than the overall effect of caffeine (+4.1%). Performance was not different between PLA and CON within subgroups (all P > 0.05), although there was a tendency toward improved performance when participants believed they had ingested caffeine post-exercise (P = 0.06; 87% likely beneficial). Participants who correctly identified placebo in PLA showed possible harmful effects on performance compared to CON. Supplement identification appeared to influence exercise outcome and may be a source of bias in sports nutrition.

Keywords: Placebo effect; caffeine supplementation; cycling time-trial; exercise performance; expectancy; nocebo effect; supplement identification.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Athletic Performance
  • Bicycling / physiology*
  • Caffeine / administration & dosage
  • Caffeine / pharmacology*
  • Dietary Supplements*
  • Double-Blind Method
  • Exercise Test
  • Humans
  • Male
  • Oxygen Consumption
  • Performance-Enhancing Substances / administration & dosage
  • Performance-Enhancing Substances / pharmacology*
  • Proof of Concept Study
  • Sports Nutritional Physiological Phenomena

Substances

  • Performance-Enhancing Substances
  • Caffeine