Public Health - The Effective of Caffeine on Improving Athlete’s Performance

Running head: PUBLIC HEALTH
Public health
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Part one: The effective of caffeine on improving athlete’s performance
Introduction:
For many sports athletes, use of nutritional supplements is part of their regular training.
However, many of them use these supplements without having an understanding about the
benefits and risk associated with its use (Sousa et al., 2016). Some common supplements used by
athletes include caffeine, beet root juice or alkanizing agents. Caffeine is a common supplement
used by all and having knowledge about its effect on sport performance is necessary to
understand the level of consumption needed by athletes. The main research question that will
guide the search process in relation to the above issue is as follows:
What is the effectiveness of caffeine use in improving athlete’s performance compared to
no supplements?
Search strategy:
The search for literature has been done in CINAHL and EBSCO. The key words for the
search process have been taken from the research question by differentiating the key words in the
form of tables. The example of keywords used is given in the PICO table below:
Population Intervention Comparison Outcome
Athletes Caffeine consumption
OR
Caffeine use
Or
Caffeine
No supplements Sports performance
Or
physical performance

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supplementation
The criteria for article selection included the following:
 All the articles must be published within the past five years
 Only RCT or systematic review will be included in the review
 All papers must have caffeine as the main intervention
By the use of above keywords and selection criteria, two articles that were found relevant
to the research included the systematic review by Mielgo-Ayuso et al. (2019) and the RCT
trial by Jodra et al. (2020). The main rationale for choosing these two article was both the
article fulfilled the PICO question requirement. In addition, systematic review is top quality
of evidence in hierarchy table as it uses rigorous method for article analysis. Furthermore,
RCTs use condition like blinding and allocation concealment that eliminates bias and helps
in transparent evaluation of the effect of any intervention (Spieth et al., 2016) Hence, finding
from both systematic review and RCT is likely to be reliable and the extracted data is given
in appendix 1.
Critical appraisal:
Article 1 (Systematic review):
The first article by Mielgo-Ayuso et al. (2019) had clear focused aim of evaluating the
effect of caffeine supplementation (CS) on sports performance. The study included right types of
papers for review as only RCT papers were included which is an appropriate research design for
evaluation of effectiveness of any intervention (Spieth et al., 2016). The relevance of the

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included study is evidenced by the exclusion criteria which ensured that irrelevant papers were
excluded. The rigour in the research method is seen by the quality assessment process used to
assess the quality of the papers. Methodological quality and risk of bias was measured using the
Cochrane Risk of Bias tool which helped to identify papers with high, low and severe risk of
bias. The results of many reviews were combined to demonstrated the number of studies which
demonstrated effect of caffeine on aerobic performance and anaerobic performance. Similar
results for each category was put together. The main results from the review were that CS is
associated with improved aerobic capacity in men and women and there is difference in
manifestation of muscle power and speed in males and females. The preciseness was low as
effect size was found to be small for increase in strength in men. Hence, it is a high quality
papers as important outcomes were considered and rigorous method was used to make the
research valid. However, as most studies have low sample size, the results cannot be applied in
local population until similar results with larger trials are obtained. The critical appraisal tool for
systematic review has been attached in appendix 4.
Article 2 (RCT):
The study by Jodra et al. (2020) used crossover randomized double blinding method to
recruit elite and trained recreational athletes in the study. 8 elite athletes and 10 trained
recreational athletes took part in the study. As it was a cross-over trial, the groups were not
similar. Elite athlete’s weight, body mass, height and age varied compared to other group. Apart
from the experiment, other conditions were same for both the groups. The main outcome of
interest for the study was mood state and anaerobic performance. The review of the findings
revealed that both groups have increased anaerobic performance. However, the effect of caffeine
on mood dimension differed in case of elite athletes. The preciseness of the result is understood

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from the fact that statistically significant results for tension level were found. The significance of
this research is that it proved that effect of caffeine may vary based on the types of athletes
taking the supplementation. However, one factor that limits the generalizability of findings is
that the effect of caffeine on athletes taking part in different sports was not done. Future research
should focus on this area. The critical appraisal tool for RCT has been attached in appendix 5.
Application to the scenario
The scenario was related to stating the safety and efficacy of caffeine as a nutritional
supplement for sports performance. The critical analysis of the two papers revealed that caffeine
is effective in improving physical performance of athletes. However, one safety concern found
was differential effect of caffeine on mood of different types of athletes. Based on the review of
results related to difference outcomes of caffeine based on gender and types of athletes, it is
recommended to the sporting association that they prepare a chart for acceptable dose of caffeine
for male and female athletes. It is also recommended to do more research work to find out how
effectiveness of caffeine may differ on performance of athletes taking part in different sports.
Part two: The experience, beliefs and concerns of sporting professionals regarding
consumption of nutritional supplements.
Introduction
Young athletes are in need of increased energy and they seek for ergogenic aid to achieve
victory. However, many athletes fail to take decisions regarding the right nutritional supplements
to be taken because of different beliefs and concerns related to consumption of nutritional
supplements. As young athletes are joining sports each day, it is necessary to assess their
knowledge and concerns related to use of nutritional supplements. This will help to address

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issues that prevent them from meeting their energy requirement. To address this knowledge gap,
this research will aim to review experience by following research question:
What is perception or beliefs of sporting professionals regarding the use of nutritional
supplements?
Search strategy:
The article search has been done in databases like CINAHL and EBSCO. The key words
for search process has been developed using the PICO format which has been listed below:
Population Intervention Comparison Outcome
Athletes Nutritional
supplements
OR
Use of nutritional
supplements
No supplements Perception or concern
related to use of
vaccines
Apart from primary search term, the search terms has been used in combination with Boolean
operators like ‘AND’ and ‘OR. For example, Athlete perception AND use of Nutritional
supplements, Nutritional supplements AND athletes concern over risk and benefits.
After the use of above search, the articles were retrieved. The first step was to review the
title and abstract of the paper. The article selection process was confirmed by certain inclusion
criteria which are as follows:
 All articles must be qualitative research papers
 The main population group for each paper must be athletes

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 The report must report mainly about the perceptions or opinions related to nutritional
supplement use in sports
 All article must be published within 5 years
 The article must be in English language
Based on the comparison of articles based on inclusion criteria, two articles were found
appropriate to answer the research question included the study by Pajor et al. (2017) and Sceery
(2017). The main rationale for taking these two papers was that both used qualitative study
design to explore athletes perception related to dietary supplement use. Qualitative study design
is best research design as it mainly seeks to describe participant’s opinion or experience about a
phenomenon. Hence, the two papers are likely to give answers to the research question.
Critical appraisal:
The critical appraisal of the paper has been done using CASP checklist for qualitative
study which has been attached in appendix 6. The study by Pajor et al. (2017) used focus group
discussions to explore about user’s and non-user’s beliefs towards dietary supplements. Focus
group discussion is a form of qualitative inquiry where questions about experience or ideas are
asked from people with similar characteristics (Mishra, 2016). Hence, the design used in the
study was appropriate to address the research aim. The recruitment strategy was rigorous as
exclusion and inclusion criteria were developed to define users and non-users and online and
offline platforms were utilized for recruitment. The eligibility of the participants was confirmed
by screening questionnaire which further ensure that right sample group were chosen. Data
collection was done using open-ended questions and this format ensured getting descriptive
answers on the topic. The data analysis process was extensive as descriptive statistics along with

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systematic interpretative content analysis was done. The finding revealed that users were critical
about supplements use, whereas non-users were convinced that regular food is enough. Hence,
difference in perception was found suggesting the need for extended knowledge about dietary
supplements for both the participants.
The second article by Jovanov et al. (2019) explored perceptions about nutritional
supplementation among young student athletes. The study used qualitative semi-structured study
design which was appropriate to examine perception on nutrition. The samples for the study
included 10 Division II student athletes and non-random purposive selection was used to select
participants. Use of this sampling strategy is effective as this helps in recruiting samples based
on the objective of the study and key characteristics of the population. The sample size was
appropriate too and use of grounded theory approach for analysis ensured that relevant themes
were identified. All ethical procedures were followed. The results of the study revealed gap in
knowledge about nutritional impact on performance and nutritional supplements as the cause
behind disordered eating. This study gave the implication to implement facilitated sessions so
that young athletes could get necessary knowledge about risk and benefits of nutritional
supplements. However, one limitation was single centre study that affects the generalizability of
the result.
Application to the scenario:
From the analysis of two qualitative studies, it can be concluded that knowledge about
nutritional supplement benefit and risk is low both in users and non-users. The exploration of
beliefs particularly in school athletes suggest that increasing knowledge in this area is critical to
prevent disordered eating. Hence, it is recommended that the sporting association implement