SynthesisJournal of the International Society of Sports Nutrition2025
Negligible benefit of oral single-dose sodium bicarbonate on continuous running performance: systematic review with meta-analysis of randomized, double-blind, placebo-controlled trials.
Synthesis in Journal of the International Society of Sports Nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundSodium bicarbonate (SB) supplementation may enhance short-term, high-intensity exercise performance through improved extracellular buffering capacity, but its effect on continuous running performance has not been systematically evaluated. We conducted a systematic review with meta-analysis of randomized, double-blind, placebo-controlled trials examining the effects of oral single-dose SB supplementation on continuous running performance.
methodsWe searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for eligible trials published through 31 December 2024. The primary outcome was performance on a continuous running test. Secondary outcomes included gastrointestinal (GI) symptoms and GI-associated study withdrawal rates. Running performance was analyzed using random-effects meta-analysis with adjustment for GI-related study withdrawals using intent-to-treat methods and publication bias using the trim-and-fill method. Treatment effects were reported using the standardized mean difference (SMD) statistic where 0.00-0.19 represents negligible benefit, 0.20-0.49 small benefit, 0.50-0.79 medium benefit, and ≥ 0.80 large benefit. We used univariable meta-regression to examine factors associated with treatment effect magnitude. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
resultsAmong 11 studies with 126 participants, all used a cross-over design. Most (84%) subjects were male, SB dose was typically 0.3 g/kg, and performance test durations ranged from 1 to 30 minutes (median: 4 minutes). GI symptoms occurred more frequently with SB than placebo (29.5% vs. 2.6%; odds ratio = 5.9;
conclusionsSB supplementation has a negligible benefit on continuous running performance in a mixed-sex population, the ergogenic effect may be more pronounced in males, GI symptoms are common, and some users may not tolerate supplementation. Athletes should carefully weigh the potential performance benefit of SB against the risk of GI symptoms and establish individual tolerance during training before considering use during competition.
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