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Risk or benefit? Side effects of caffeine supplementation in sport: a systematic review

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Abstract

Purpose

The aim of this study was to systematically review evidence on the prevalence and magnitude of side effects associated with caffeine supplementation in athletes.

Methods

Systematic searches through the PubMed, VHL, Scopus, and Web of Science databases were conducted according to the PRISMA guidelines. Peer-reviewed articles written in English that reported the prevalence/percentage or magnitude/effect size of side effects after caffeine supplementation in athletes in a sports context were included. Studies were grouped by the dose of caffeine administered as follows: low =  ≤ 3.0 mg/kg; moderate = from 3.1 to 6.0 mg/kg; high =  ≥ 6.1 mg/kg. The magnitude of the side effects was calculated with effect sizes.

Results

The search retrieved 25 studies that met the inclusion/exclusion criteria with a pooled sample of 421 participants. The supplementation with caffeine produced a higher prevalence or magnitude of all side effects under investigation when compared to placebo/control situations. The prevalence (magnitude) was between 6 and 34% (ES between 0.13 and 1.11) for low doses of caffeine, between 0 and 34% (ES between −0.13 and 1.20) for moderate doses of caffeine, and between 8 and 83% (ES between 0.04 and 1.52) with high doses of caffeine. The presence of tachycardia/heart palpitations and the negative effects on sleep onset had the highest prevalence and magnitude, in athletes using supplementation with caffeine.

Conclusion

In summary, caffeine supplementation in the doses habitually used to enhance physical performance produces several side effects, both after exercise and at least 24 h after the ingestion. However, the prevalence and magnitude of side effects with high doses of caffeine were habitually higher than with low doses of caffeine. From a practical perspective, using ~3.0 mg/kg of caffeine may be the dose of choice to obtain the ergogenic benefits of caffeine with the lowest prevalence and magnitude of side effects.

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Acknowledgements

We would like to thank the authors of cited articles who collaborated to obtain the data.

Funding

No sources of funding were used to assist in the design, collection, analysis, and interpretation of data, or in writing of this manuscript.

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Authors and Affiliations

  1. Laboratory of Nutrition and Sports Training, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

    Jefferson Gomes de Souza

  2. Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain

    Juan Del Coso

  3. Physical Education Department – Laboratory of Sports Science, Federal Rural University of Pernambuco, Recife, Pernambuco, Brazil

    Fabiano de Souza Fonseca

  4. Faculty of Physical Education, University of Itaúna, Itaúna, Minas Gerais, Brazil

    Bruno Victor Corrêa Silva & João Gustavo Claudino

  5. Physical Education College, University Center of Belo Horizonte –Uni BH, Belo Horizonte, Minas Gerais, Brazil

    Bruno Victor Corrêa Silva

  6. Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain

    Diego Brito de Souza

  7. Research and Development Department, LOAD CONTROL, Contagem, Minas Gerais, Brazil

    Rodrigo Luiz da Silva Gianoni & João Gustavo Claudino

  8. Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland

    Aleksandra Filip-Stachnik

  9. Laboratory of Biomechanics – School of Physical Education and Sport, Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Julio Cerca Serrão & João Gustavo Claudino

  10. Department of Physical Education – Center for Health Sciences, Federal University of Piauí, Teresina, Piauí, Brazil

    João Gustavo Claudino

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  1. Jefferson Gomes de Souza
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  2. Juan Del Coso
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  7. Aleksandra Filip-Stachnik
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  9. João Gustavo Claudino
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Contributions

JGS: design, collection, analysis, interpretation of data, and writing up the paper. JDC: design, analysis, interpretation of data, and writing up the paper. FSF: design, collection, analysis, interpretation of data, and writing up the paper. BVCS: design, collection, analysis, interpretation of data, and writing up the paper. DBS: analysis, interpretation of data, and writing up the paper. RLSG: collection, analysis, interpretation of data. AFS: analysis, interpretation of data, and writing up the paper. JCS: design, analysis, interpretation of data, and writing up the paper. JGC: design, collection, analysis, interpretation of data, and writing up the paper.

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Correspondence to Aleksandra Filip-Stachnik.

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de Souza, J.G., Del Coso, J., Fonseca, F.d. et al. Risk or benefit? Side effects of caffeine supplementation in sport: a systematic review. Eur J Nutr 61, 3823–3834 (2022). https://doi.org/10.1007/s00394-022-02874-3

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