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J Appl Physiol 111: 1372–1379, 2011.

First published August 11, 2011; doi:10.1152/japplphysiol.01028.2010.

Caffeine intake improves intense intermittent exercise performance


and reduces muscle interstitial potassium accumulation
Magni Mohr,1,2 Jens Jung Nielsen,1 and Jens Bangsbo1
1
Copenhagen Muscle Research Centre, Department of Exercise and Sport Sciences, University of Copenhagen, Denmark;
and 2Sport and Health Sciences, College of Life and Environmental Sciences, St. Lukes Campus, University of Exeter, Exeter,
United Kingdom
Submitted 31 August 2010; accepted in final form 8 August 2011

Mohr M, Nielsen JJ, Bangsbo J. Caffeine intake improves intense effects of caffeine administration appear to be specific to the
intermittent exercise performance and reduces muscle interstitial po- type of exercise performed, but the effect on repeated intense
tassium accumulation. J Appl Physiol 111: 1372–1379, 2011. First exercise has not been determined. The Yo-Yo intermittent
published August 11, 2011; doi:10.1152/japplphysiol.01028.2010.— recovery test, level 2 (Yo-Yo-IR2), is well-described (7, 31,
The effect of oral caffeine ingestion on intense intermittent exercise 37) and has been shown to have a highly anaerobic nature, and
performance and muscle interstitial ion concentrations was examined.
test performance correlates with the amount of intense exercise
The study consists of two studies (S1 and S2). In S1, 12 subjects
completed the Yo-Yo intermittent recovery level 2 (Yo-Yo IR2) test performed in team sports (7). Thus, to examine the effect of

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with prior caffeine (6 mg/kg body wt; CAF) or placebo (PLA) intake. caffeine intake on intense intermittent exercise as observed in
In S2, 6 subjects performed one low-intensity (20 W) and three team sport, the Yo-Yo IR2 test can be applied.
intense (50 W) 3-min (separated by 5 min) one-legged knee-extension Caffeine has a number of physiological effects. It been
exercise bouts with (CAF) and without (CON) prior caffeine supple- shown to elevate the catecholamine levels (22, 24, 32, 44), the
mentation for determination of muscle interstitial K⫹ and Na⫹ with systemic FFA (21), NH3 concentrations, sarcoplasmatic retic-
microdialysis. In S1 Yo-Yo IR2 performance was 16% better (P ⬍ ulum Ca2⫹ handling (1, 17) as well as lower the respiratory
0.05) in CAF compared with PLA. In CAF, plasma K⫹ at the end of exchange ratio (RER) values (5). Caffeine may also increase
the Yo-Yo IR2 test was 5.2 ⫾ 0.1 mmol/l with no difference between the muscle Na⫹-K⫹-ATPase activity directly or indirectly
the trials. Plasma free fatty acids (FFA) were higher (P ⬍ 0.05) in through an elevated catecholamine response, which may delay
CAF than PLA at rest and remained higher (P ⬍ 0.05) during fatigue if accumulation of potassium in the muscle interstitium
exercise. Peak blood glucose (8.0 ⫾ 0.6 vs. 6.2 ⫾ 0.4 mmol/l) and
is involved in fatigue (27, 36, 38, 39, 42). Indeed, Lindinger et
plasma NH3 (137.2 ⫾ 10.8 vs. 113.4 ⫾ 13.3 ␮mol/l) were also higher
(P ⬍ 0.05) in CAF compared with PLA. In S2 interstitial K⫹ was
al. (32) and Graham and colleagues (23) demonstrated that
5.5 ⫾ 0.3, 5.7 ⫾ 0.3, 5.8 ⫾ 0.5, and 5.5 ⫾ 0.3 mmol/l at the end of high doses (6 and 9 mg/kg body wt) of caffeine administration
the 20-W and three 50-W periods, respectively, in CAF, which were decreased plasma K⫹ concentration during prolonged exercise,
lower (P ⬍ 0.001) than in CON (7.0 ⫾ 0.6, 7.5 ⫾ 0.7, 7.5 ⫾ 0.4, and but not during repeated 30-s maximal exercise bouts (24).
7.0 ⫾ 0.6 mmol/l, respectively). No differences in interstitial Na⫹ However, the effect of caffeine on plasma potassium is con-
were observed between CAF and CON. In conclusion, caffeine intake troversial, and no data exist about the effect of caffeine on
enhances fatigue resistance and reduces muscle interstitial K⫹ during muscle interstitial potassium and sodium.
intense intermittent exercise. Thus the aim of the present study was to examine the impact
fatigue; potassium; free fatty acids; repeated exercise; muscle ion of caffeine intake on performance and physiological response,
kinetics including changes in muscle interstitial ion concentrations,
during repeated intense exercise.

CAFFEINE is classified as part of the methylxanthine family of MATERIALS AND METHODS


drugs and is commonly consumed by athletes as an ergogenic
Subjects
aid (45), since it was removed from the World Anti-Doping
Agency list of prohibited substances (46). A caffeine ingestion The study consists of two studies (S1 and S2). The participants in
of 3– 6 mg/kg body mass has been shown to improve fatigue S1 were eight males and four females with an age of 23.1 ⫾ 0.6 yr,
resistance during various types of exercise such as time trial height of 179.0 ⫾ 3.0 cm, and body mass of 72.6 ⫾ 3.7 kg. They were
cycling (35), sprint running (20, 44), and repeated sprint all active in team sports at a subelite level and were familiar with
running (11). In trained athletes caffeine improved 1 km intense intermittent exercise. In S2 six habitually active male subjects
(age: 25.9 ⫾ 1.0 yr; height: 183.0 ⫾ 2.8 cm; body mass: 83.8 ⫾ 3.8
cycling performance (47) whereas caffeine had no effect on kg) participated. The subjects in S2 had a maximal oxygen uptake of
either muscle strength and power (4, 47) or 200-m swimming 54.0 ⫾ 1.7 ml O2·kg⫺1·min⫺1. All subjects were informed of risks
(40) in trained athletes. In addition, no effect of caffeine intake associated with the experiment before giving their written consent to
was seen in power output during intense cycling exercise (24). participate. The study conforms to the code of Ethics of World
In a study by Stuart et al. (44) caffeine administration 1 h Medical Association (Declaration of Helsinki) and was approved by
before a simulated rugby union game improved passing accu- the Ethics Committee of Copenhagen and Frederiksberg communities.
racy and 30-m sprint speed. Thus the performance-enhancing
Experimental Design

Address for reprint requests and other correspondence: J. Bangsbo, The In S1 the subjects performed the Yo-Yo intermittent recovery test,
August Krogh Bldg., IFI, Universitetsparken 13, DK-2100 Copenhagen Ø, level 2 (Yo-Yo IR2), until exhaustion (31) on two separate occasions
Denmark (e-mail: jbangsbo@ifi.ku.dk). separated by 6 days. The tests were carried out at the same time of the

1372 8750-7587/11 Copyright © 2011 the American Physiological Society http://www.jap.org


CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM 1373
day. Fluid and food intake as well as activity level was noted the day antecubital vein ⬃30 min before the exercise protocol was initiated
before the first experimental day and mimicked before the second day. for frequent blood sampling before, during, and after the test. The first
Seventy minutes before the test either caffeine (CAF; MERCK, 5 min of the Yo-Yo intermittent recovery test, level 1 (Yo-Yo IR1),
Darmstadt, Germany) or placebo (PLA; dextrose) was taken orally in was used as warm-up before the Yo-Yo IR2 test. This procedure has
a gelatin capsule (6 mg/kg body wt; 436 ⫾ 22 mg in total). The blood been shown to markedly elevate the muscle temperature (30, 31). The
glucose concentration was unaffected by the placebo intake. The Yo-Yo IR2 test was initiated 2 min after the warm-up. A blood sample
experiment was randomized, double-blinded, and counterbalanced. was taken at rest, after the warm-up period, after 160, 280, 440, 600,
In S2 the subjects performed a control (CON) and a caffeine (CAF) and 760 s, and at exhaustion in the Yo-Yo IR2 test, as well as 1, 2 and
trial separated by 80 min. For each trial the subjects performed a 5 min into recovery.
one-legged knee-extensor exercise protocol consisting of two 20-W S2. One-legged knee-extensor exercise was carried out on a mod-
exercise periods separated by 10 min of passive recovery, then after ified Krogh ergometer permitting the exercise to be confined to the
10 min of recovery the subjects completed three 3-min exercise bouts quadriceps muscle (3). The exercise is performed as knee extensions
(EX1, EX2, and EX3) at an intensity of 50 W interspersed by 5 min from an angle of 90° to ⬃170° while flywheel momentum repositions
of passive recovery (Fig. 1). The first 20-W period was carried out to the relaxed leg during the flexion. EMG recordings have demonstrated
obtain a higher reliability of the interstitial K⫹ measurements (39) and that the hamstring muscles are passive, while the quadriceps muscles
only the second 20-W period was included. The CON trial was are active in the extension phase (3). To familiarize the subjects with
completed first, and after 10 min of recovery caffeine was adminis- the exercise ergometer the subjects completed 3– 4 preexperimental
trated orally in a gelatin capsule at a concentration of 6 mg/kg body sessions. The subjects were trained to keep a constant kicking fre-
wt corresponding to 516 ⫾ 21 mg in total. Then the subject rested for quency of 60 kicks/min (by visual feedback from a display showing
70 min before starting the CAF-trial, which is sufficient for the muscle the frequency), and to confine the exercise to the quadriceps femoris
to recover from the exercise performed in CON. The CON and the muscle (by verbal and visual feedback based on online force record-

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CAF trial were performed on the same day to ensure that the ings).
microdialysis probes were placed in the same position. The CON trial On the experimental day the subjects reported to the laboratory in
was performed before the CAF trial to avoid possible effects of the morning and followed the same guidelines as described in S1. Six
caffeine in the CON trial. None of the subjects were heavy coffee microdialysis probes were inserted parallel to the muscle fibers of the
drinkers. vastus lateralis muscle in the experimental leg under local anesthesia
Experimental Protocol (lidocaine, 1 ml of 20 mg/ml) as previously described (27, 36, 39).
The probes were custom design (length of microdialysis membrane
S1. All subjects were familiar with the Yo-Yo IR2 test and had 30 – 40 mm, outer diameter 0.22 mm) as described by Hellsten et al.
performed at least two familiarization trials. On the experimental day (25). The perfusate was Ringer acetate containing (in mM) 130 Na⫹,
the subjects reported to the laboratory in the morning after consuming 2 Ca2⫹, 4 K⫹, 1 Mg2⫹, and 30 Ac⫺. The exact perfusate K⫹
a light meal. The subjects were instructed to avoid intake of caffeine concentration was determined in each experiment. In addition, the
containing food and drinks on the day of the experiment as well as perfusate contained 3 mM of glucose and 201Tl (activity ⬍ 7,000
alcohol consumption and heavy physical activity on the day before the Bq/ml). The probes were flushed and connected to a pump (CMA
experiment. Thus no caffeine was ingested in the last 12–15 h before 102). Then they were perfused at a rate of 2 ␮l/min for 1 h and 5
the experiment. A catheter (Venflon Pro, 18G) was inserted into an ␮l/min for the remaining part of the experiment. In addition, a catheter

Fig. 1. Schematic overview of the experimental protocol.

J Appl Physiol • VOL 111 • NOVEMBER 2011 • www.jap.org


1374 CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM

(Venflon Pro, 18G) was placed in an antecubital vein for blood Physiological Response During the Yo-Yo IR2 Test
sampling.
After insertion of the microdialysis probes the subjects rested for at Plasma K⫹ was 3.6 ⫾ 0.1 and 3.9 ⫾ 0.1 mmol/l at rest in
least 60 min followed by the control trial (CON). Before, during, and CAF and PLA, respectively, and rose (P ⬍ 0.05) during the
10 min after the second 20-W period dialysate was sampled. During Yo-Yo IR2 test to 5.2 ⫾ 0.2 and 5.9 ⫾ 0.4 mmol/l at
exercise samples were collected at 0.5–2.5, 2.5– 4.5, 4.5– 6.5, and exhaustion, respectively, with no differences between the two
6.5–10 min taking into account the delay in collecting the sample from trials (Fig. 2A). Also peak plasma potassium in CAF and PLA
muscle interstitium (⬃30 s) due to the space in the outlet tubing. In was not different (5.3 ⫾ 0.2 and 5.9 ⫾ 0.3 mmol/l, respec-
recovery dialysate was collected after 0.5–2.5, 2.5– 4.5, 4.5– 6.5, and
6.5–10 min. During EX1, EX2, and EX3 dialysate was collected in
tively). In CAF blood lactate increased (P ⬍ 0.05) from 1.0 ⫾
1.5-min intervals starting at 0.5 min of exercise. In recovery dialysate 0.1 to 8.6 ⫾ 0.7 mmol/l during the test with no differences
was collected after 0.5–2, 2–3.5, and 3.5–5 min. Blood samples were between the two trials (Fig. 2B). The peak blood lactate
drawn at rest, after the second 20-W period, and after all three 50-W concentration was 11.2 ⫾ 0.6 and 10.8 ⫾ 0.8 mmol/l in CAF
periods (Fig. 1). After CON caffeine was administrated and the and PLA, respectively.
procedures in CAF were the same as in CON. No placebo was given Blood glucose was 5.8 ⫾ 0.6 mmol/l before the test in CAF,
before CON. which tended to be higher (P ⫽ 0.06) than in PLA (4.5 ⫾ 0.5
Analysis of Dialysate
mmol/l; Fig. 2C). The blood glucose levels at exhaustion were
6.4 ⫾ 0.5 mmol/l in CAF, which was not significantly different
The perfusion rate of the individual microdialysis probes was from PLA (4.9 ⫾ 0.3 mmol/l). Peak blood glucose level during
determined throughout the experiment by weighing the sample tube the test was 8.1 ⫾ 0.6 mmol/l in CAF and higher (P ⬍ 0.01)
before and after collection. Samples were excluded if the perfusion than in PLA (6.2 ⫾ 0.5 mmol/l). Plasma NH3 was 32.7 ⫾ 5.5

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rate deviated by ⬎30% from the target perfusion rate, or if there was and 30.0 ⫾ 3.1 ␮mol/l at rest in CAF and PLA, respectively,
any sign of hemoglobin in the dialysate. Interstitial K⫹ ([K⫹]int) and increased (P ⬍ 0.05) during the Yo-Yo IR2 test to 76.7 ⫾
(interstitial K⫹) was measured by flame photometry (FLM3, Radiom-
9.8 and 94.0 ⫾ 18.4 ␮mol/l, respectively, with no differences
eter, Denmark) using lithium as internal standard. Thallium loss was
determined as previously described (27). between trials (Fig. 2D). However, 5 min into recovery the
plasma NH3 was 137.2 ⫾ 10.8 ␮mol/l in CAF, which was
Calculations higher (P ⬍ 0.05) than in PLA (105.1 ⫾ 10.7 ␮mol/l). At rest
plasma FFA was 490 ⫾ 77 ␮mol/l in CAF, which was higher
The relative loss (RL) of 201Tl was calculated as RLTl ⫽ (perfusate
activity - dialysate activity)/perfusate activity. [K⫹]int was calculated (P ⬍ 0.05) than in PLA (167 ⫾ 31 ␮mol/l; Fig. 2E), and
from the dialysate potassium concentrations, assuming that fractional remained higher (P ⬍ 0.05) in CAF than in PLA during the
201
TI loss from the perfusate was equal to the fractional gain of K⫹ to entire experiment (Fig. 2E).
the perfusate : [K⫹]int ⫽ K⫹perfusate ⫹ [(K⫹dialysate ⫺ K⫹perfusate)/
RLTl] (27). Muscle Interstitial Potassium and Sodium
Blood Analyses At rest [K⫹]int was 4.3 ⫾ 0.2 and 4.2 ⫾ 0.5 mmol/l in CAF
Blood samples were obtained in 2-ml syringes with heparin. Im-
and CON, respectively. During the 20-W knee-extensor exer-
mediately after sampling, 100 ␮l of heparinized blood was hemolyzed cise [K⫹]int was lower (P ⬍ 0.05) in CAF than CON and
in an ice-cold 100 ␮l Triton X-100 buffer solution and stored on ice remained lower (P ⬍ 0.05) during the 10-min recovery period
for ⬃30 min until analyzed for lactate and glucose (YSI 2300, Yellow (Fig. 3A). At rest [Na⫹]int was 134 ⫾ 6 and 134 ⫾ 3 mmol/l in
Spring Instruments, OH). Plasma was collected from centrifuged CAF and CON, respectively. No changes in [Na⫹]int were
samples and stored at ⫺80°C until further analysis. Plasma FFA, observed with exercise during the 20-W period and no statis-
NH3, potassium, and sodium were analyzed using Hitachi 912 auto- tical differences were found between CAF and CON (Fig. 3B).
matic analyzer (Roche Diagnostics, Germany). FFA was determined Before EX1 [K⫹]int was not significantly different in CAF
fluorometrically after an enzymatic reaction using a kit (WAKO and CON, but during EX1 the levels were lower (P ⬍ 0.05) in
NEFA C ACS-ACOD Method, Trichem), and NH3 was determined CAF than CON with peak values being 5.7 ⫾ 0.3 and 7.5 ⫾ 0.7
fluorometrically after an enzymatic reaction using a kit (Roche Diag-
nostics, Germany). Potassium and sodium were determined by the use
mmol/l, respectively (Fig. 4A). In the recovery period after
of ion selective electrodes (Roche Diagnostics). EX1 [K⫹]int remained lower (P ⬍ 0.05) in CAF than CON .
During and after EX2 [K⫹]int was lower (P ⬍ 0.05) in CAF
Statistics than CON (Fig. 4A). Also during EX3 [K⫹]int was lower (P ⬍
Values are means ⫾ SE. For each subject in S2 an average [K⫹]int
0.05) in CAF than CON with peak values being 5.5 ⫾ 0.3 vs.
and [Na⫹]int was calculated from the measurements of each probe. 7.3 ⫾ 0.3 mmol/l, respectively (Fig. 4A).
Mean [K⫹]int and SE were determined from these individual means. [Na⫹]int did not change during the 50-W exercise periods
Possible differences in muscle interstitial and blood variables between and no differences were found between CAF and CON, al-
CON and CAF as well as between PLA and CAF were tested using a though [Na⫹]int in CAF tended to be higher than in CON (P ⫽
two-way ANOVA for repeated measurements. In case of significant 0.07; Figs. 3B and 4B).
main effects a Student-Newman-Keuls post hoc test was used to
identify the points of difference. Significance was set at the 0.05 level. Plasma Potassium and Metabolites During Knee-Extensor
RESULTS
Exercise

Yo-Yo IR2 Performance Venous plasma K⫹ was 3.7 ⫾ 0.1 and 3.9 ⫾ 0.0 mmol/l at rest in
CAF and CON, respectively. After the 20-W exercise plasma K⫹
Yo-Yo IR2 performance was 607 ⫾ 55 m in CAF, which became lower (P ⬍ 0.05) in CAF than in CON (3.8 ⫾ 0.1 and 4.2 ⫾
was 16% better (P ⬍ 0.05) than in PLA (523 ⫾ 55 m). 0.1 mmol/l, respectively). Plasma K⫹ was also lower (P ⬍ 0.05) in

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CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM 1375

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Fig. 2. Plasma K⫹ (A), blood lactate (B), blood glucose (C), plasma NH3 (D), and plasma FFA (E) at rest, during and after the Yo-Yo IR2 test with prior ingestion
of placebo (PLA; Œ) or caffeine (CAF; ). #Significant difference (P ⬍ 0.05) between CAF and PLA (n ⫽ 12 unless otherwise stated).

CAF compared with CON after EX1 (4.0 ⫾ 0.2 and 4.3 ⫾ 0.0 Plasma FFA was 437 ⫾ 103 and 124 ⫾ 41 mmol/l at rest
mmol/l, respectively) but not after EX2 and EX3. At rest plasma Na⫹ in CAF and CON, respectively (P ⫽ 0.07). After the 20-W
was 138 ⫾ 1 and 135 ⫾ 2 mmol/l in CAF and CON, and no changes exercise bout plasma FFA in CAF was higher (P ⬍ 0.05)
were observed during exercise in either CAF or CON. than in CON (726 ⫾ 179 and 200 ⫾ 64 mmol/l, respec-

J Appl Physiol • VOL 111 • NOVEMBER 2011 • www.jap.org


1376 CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM

performing better after caffeine intake. In support, Stuart et al.


(44) substantiated an elevated performance level during re-
peated sprint tests performed during a simulated rugby game in
high-level players after caffeine intake. Moreover, others have
shown improved high-intensity work during a 90-min simu-
lated soccer game (18) and simulated tennis (26). Thus caffeine
ingestion seems to elevate fatigue resistance during team sport-
relevant, high-intensity intermittent exercise. A number of
studies have used short-term all-out exercise protocols to
investigate possible performance-enhancing effects of caffeine
(8, 12, 24, 48). These studies using maximal sprinting exercise
lasting 15–30 s showed no performance-enhancing effects of
caffeine administration, indicating that the ergogenic effects of
caffeine do not appear to have an impact on performance
during these short-term, single-exercise bouts. In contrast, a
large number of observations using both laboratory and field-
based exercise protocols report an elevated fatigue resistance
during exhaustive intense exercise trials lasting from 1 to 15
min (8, 16, 17, 48). Caffeine appears to be especially ergogenic

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Fig. 3. Interstitial K⫹ (A) and Na⫹ (B) concentrations during and after a 10-min
period of one-legged knee-extension exercise at 20 W with (; CAF) and
without (Œ; CON) prior caffeine intake. #Significant difference (P ⬍ 0.05)
between CON and CAF (n ⫽ 6).

tively), and remained higher during the three 50-W exercise


bouts.
DISCUSSION

The main findings of the present study were that caffeine


ingestion improved fatigue resistance and skeletal muscle
[K⫹]int was lowered during intense intermittent exercise. Thus,
the delayed fatigue development after caffeine intake may be
associated with caffeine-induced acceleration of muscle K⫹
handling.
The present study is the first to report an effect of caffeine
intake on performance during progressive high-intensity inter-
mittent exercise. The Yo-Yo IR2 test has been shown to have
a high rate of anaerobic energy turnover (31), and performance
in the test is correlated to the work rate during the most intense
periods of a soccer game (7). Thus caffeine appears to delay
the type of fatigue that occurs in team sports during short-term
Fig. 4. Interstitial K⫹ (A) and Na⫹ (B) concentrations during three intense
intense intermittent exercise bouts with a large anaerobic 3-min one-legged knee-extension exercise periods at a power output of 50 W
component (21). The caffeine-induced performance enhance- (separated by 5 min recovery) with (; CAF) and without (Œ; CON) caffeine
ment was clear in the present study with 11 of the 12 subjects intake. #Significant difference (P ⬍ 0.05) between CON and CAF (n ⫽ 6).

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CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM 1377
for speed endurance exercise ranging 1–3 min (15). Thus the In the present study plasma FFA was markedly elevated
performance-stimulating effect of caffeine seems to occur in in CAF before and during the entire test compared with
relatively short-term intense exercise with a marked anaerobic PLA. Other studies have shown that plasma epinephrine
component indicating that caffeine stimulates physiological increases ⬃1 h after caffeine intake in similar doses as in the
mechanisms counteracting this specific type of fatigue. present study (13, 24, 44), which most likely caused the
Fatigue development during high-intensity intermittent ex- augmented lipolytic activity. Thus it may be proposed that
ercise is complex, but an altered resting membrane potential caffeine may affect performance in an intermittent test by
has been proposed as a central candidate (19, 34, 41). The main elevating fat oxidation in the recovery bouts and a concom-
contributor to the depolarized sarcolemmal potential is a itant glycogen-sparing effect (43). However, it is unlikely
marked efflux of K⫹ from the muscle cell (34) and a concom- that this has had a significant impact on the fatigue resis-
itant accumulation in the muscle interstitium (27, 36, 38, 39, tance during the exercise due to the relatively short duration
42). The Yo-Yo IR2 test has been substantiated to exert a of the test and limited muscle glycogen usage. In support, it
major stimulus on the anaerobic energy systems, and venous has been shown that the muscle glycogen concentrations are
K⫹ concentrations reach the approximate levels (31) observed still high after a Yo-Yo IR2 test of similar duration as in this
by others at the point of fatigue during intense exercise lasting study (31).
a few minutes (6, 38). In the present study no differences in The caffeine-induced elevation of catecholamine levels
plasma K⫹ between CAF and PLA were observed, but in CAF may have had multiple other physiological effects including
it tended to be lower during the entire trial (Fig. 2A). In support a proposed accelerated oxygen uptake kinetics and muscle
of this Crowe and coworkers (14) found a significant decrease glycolysis (21, 45). Greer et al. (24) showed markedly

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in plasma K⫹ after caffeine intake, and others have demon- higher plasma epinephrine levels before four all-out 30-s
strated a similar pattern during prolonged exercise (24, 32). sprints, but the effect disappeared during exercise. More-
However, any fatiguing effect of elevated extracellular K⫹ is over, neither oxygen uptake nor blood lactate was different
exerted in the interstitium of the exercising muscles. Therefore, during exercise between the caffeine and control trials. In
in S2 the effect of caffeine administration on interstitial K⫹ contrast plasma epinephrine was increased during an entire
was studied, and [K⫹]int was markedly lower during and after ⬃80-min simulated rugby game after prior caffeine intake
both moderate-intensity exercise and repeated intense exercise (44). In the present study blood glucose was higher both
(Figs. 3A and 4A). Thus caffeine intake attenuates the accu- before the Yo-Yo IR2 test as well as the peak levels reached
mulation of interstitial K⫹ during repeated intense exercise, during the test, indicating increased catecholamine stimula-
which may delay fatigue as seen in S1. It should be noted that
tion. However, no difference in blood lactate concentrations
the average values of a level of 7– 8 mmol/l is not expected to
during the Yo-Yo IR2 test was observed between the trials,
cause fatigue (27, 36, 38, 39) and are lower than observed in
indicating similar glycolytic activity. On the other hand the
other studies where exhaustive intense exercise has been ex-
plasma NH3 rose to significantly higher values in CAF than
amined. In addition, in S1 plasma potassium was not different
PLA, which is in agreement with findings by Greer and
between the caffeine and placebo trial, despite that a marked
difference in [K⫹] int was found in S2, which suggests that coworkers (24) during repeated sprints. Thus the AMP
plasma K⫹ during whole body exercise is not a sensitive breakdown may be accelerated by caffeine intake, but it
measure of [K⫹] int. does not appear to have affected performance. The ergo-
There are several possible mechanisms for a caffeine-in- genic effect of caffeine ingestion has also been linked to
duced effect on [K⫹]int. First, caffeine may have stimulated the supraspinal or central fatigue, since caffeine apparently
activity in the Na⫹-K⫹ pump indirectly by an elevated cate- increases motorneuron or motor cortical excitability during
cholamine response (15, 22, 32). Caffeine could also have had exercise (28). Thus it cannot be excluded that there have
a direct effect on the muscle, since it has been shown that high been a central component to the better performance in S1.
doses of caffeine restore force in K⫹ inhibited muscle in vitro In summary, the present study demonstrates that high-inten-
(10). Furthermore, the elevated glucose concentrations in the sity intermittent exercise performance is significantly improved
caffeine trial may per se have improved performance through by oral caffeine administration. Moreover, for the first time
an effect on the Na⫹-K⫹ pump, as it has been suggested that caffeine has been shown to lower muscle interstitial potassium
high glucose concentrations are preventing the deterioration of during intense exercise. Thus the performance-enhancing ef-
electrical properties of the muscle fiber membrane (29, 33). fect of caffeine intake before intense intermittent exercise may
The fact that [Na⫹]int tended (P ⫽ 0.07) to be higher in CAF be associated with an improved interstitial potassium handling
gives added support to the notion of caffeine-stimulated in- in the exercising muscles.
crease in Na⫹-K⫹ pump activity. Moreover, the rate of [K⫹]int
accumulation was higher in the control trial than in the caffeine ACKNOWLEDGMENTS
trial in the initial phase of the 20-W exercise period (data not We thank the subjects for their participation.
shown). Thus caffeine may preactivate or accelerate the
Na⫹-K⫹ pump activity and therefore reduce the time lag in GRANTS
pump activity in the first part of an exercise bout. It has been
shown that the rate of accumulation in [K⫹]int is highest in the The study was supported by The Danish Ministry of Culture (Kulturmin-
isteriets Udvalg for Idrætsforskning).
initial part of an intense exercise bout (36, 39), and that the
accumulation rate decreases when intense exercise is repeated
(36), which may associate with an elevated Na⫹-K⫹ pump DISCLOSURES
activity. No conflicts of interest, financial or otherwise, are declared by the author(s).

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1378 CAFFEINE AFFECTS PERFORMANCE AND INTERSTITIAL POTASSIUM

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