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Effects of Sodium Bicarbonate Supplementation on Muscular Strength and Endurance: A Systematic Review and Meta-analysis

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Abstract

Background

The effects of sodium bicarbonate on muscular strength and muscular endurance are commonly acknowledged as unclear due to the contrasting evidence on the topic.

Objective

To conduct a systematic review and meta-analysis of studies exploring the acute effects of sodium bicarbonate supplementation on muscular strength and endurance.

Methods

A search for studies was performed using five databases. Meta-analyses of standardized mean differences (SMDs) were performed using a random-effects model to determine the effects of sodium bicarbonate supplementation on muscular strength (assessed by changes in peak force [N], peak torque [N m], or maximum load lifted [kg]) and muscular endurance (assessed by changes in the number of repetitions performed, isokinetic total work, or time to maintain isometric force production). Subgroup meta-analyses were conducted for the muscular endurance of small vs. large muscle groups and muscular strength tested in a rested vs. fatigued state. A random-effects meta-regression analysis was used to explore possible trends in the effects of: (a) timing of sodium bicarbonate ingestion; and (b) acute increase in blood bicarbonate concentration (from baseline to pre-exercise), on muscular endurance and muscular strength.

Results

Thirteen studies explored the effects of sodium bicarbonate on muscular endurance and 11 on muscular strength. Sodium bicarbonate supplementation was found to be ergogenic for muscular endurance (SMD = 0.37; 95% confidence interval [CI]: 0.15, 0.59; p = 0.001). The performance-enhancing effects of sodium bicarbonate were significant for both small (SMD = 0.31; 95% CI: 0.04, 0.59; p = 0.025) and large muscle groups (SMD = 0.40; 95% CI: 0.13, 0.66; p = 0.003). Sodium bicarbonate ingestion was not found to enhance muscular strength (SMD = − 0.03; 95% CI: − 0.18, 0.12; p = 0.725). No significant effects were found regardless of whether the testing was carried out in a rested (SMD = 0.02; 95% CI: − 0.09, 0.13; p = 0.694) or fatigued (SMD = − 0.16; 95% CI: − 0.59, 0.28; p = 0.483) state. No significant linear trends in the effects of timing of sodium bicarbonate ingestion or acute increase in blood bicarbonate concentrations on muscular endurance or muscular strength were found.

Conclusions

Overall, sodium bicarbonate supplementation acutely improves muscular endurance of small and large muscle groups, but no significant ergogenic effect on muscular strength was found.

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Data Availability Statement

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Authors and Affiliations

  1. Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia

    Jozo Grgic, Ramon F. Rodriguez, Alessandro Garofolini, David J. Bishop & Zeljko Pedisic

  2. Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil

    Bryan Saunders

  3. Faculty of Medicine FMUSP, Institute of Orthopaedics and Traumatology, University of São Paulo, São Paulo, Brazil

    Bryan Saunders

  4. School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia

    David J. Bishop

  5. Department of Health Sciences, Lehman College, Bronx, NY, USA

    Brad J. Schoenfeld

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  1. Jozo Grgic
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  2. Ramon F. Rodriguez
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Correspondence to Jozo Grgic.

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Funding

No sources of funding were used to assist in the preparation of this article. Bryan Saunders (2016/50438-0 and 2017/04973-4) has been financially supported by Fundação de Amparo à Pesquisa do Estado de São Paulo.

Conflict of Interest

Jozo Grgic, Ramon F. Rodriguez, Alessandro Garofolini, Bryan Saunders, David J. Bishop, Brad J. Schoenfeld and Zeljko Pedisic have no conflicts of interest that are directly relevant to the content of this article.

Author Contributions

JG conceived the idea for the review. JG and RFR conducted the study selection and data extraction. JG and AG conducted the quality assessment. JG conducted the statistical analyses. JG drafted the initial manuscript. RFR, AG, BS, DJB, BJS, and ZP contributed to writing the manuscript. All authors approved the final version of the manuscript.

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Grgic, J., Rodriguez, R.F., Garofolini, A. et al. Effects of Sodium Bicarbonate Supplementation on Muscular Strength and Endurance: A Systematic Review and Meta-analysis. Sports Med 50, 1361–1375 (2020). https://doi.org/10.1007/s40279-020-01275-y

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