A Systematic Review and Meta-analysis on Sodium Bicarbonate Administration and Equine Running Performance: Is it Time to Stop Horsing Around With Baking Soda?

Sodium bicarbonate administration in the hours prior to exercise has been used as a performance-enhancing substance in horses since the late 1980s. Although sodium bicarbonate administration to racehorses 24 hours before racing is a banned practice in most racing industries, whether or not it improves running performance in racehorses is currently unclear. The aim of this systematic review and meta-analysis was to establish whether or not acute sodium bicarbonate administration improves running performance in trained Standardbred and Thoroughbred horses. Seven randomized controlled trials, including eight experimental (exercise) trials and 74 horses, were included after a comprehensive search for relevant studies that met the inclusion criteria. Results indicated that sodium bicarbonate administration at 2.5-5 hours prior to a standardized treadmill test to exhaustion or simulated race (time-trial) does not influence running performance (number of horses, the overall effect [95% CI]: 32, -0.13 [-0.64 to 0.37] and 42, 0.01 [-0.42 to 0.44], respectively, both P > .05). The included studies demonstrated minimal heterogeneity (I² = 0%-2%), low risks of bias according to the Cochrane Risk of Bias Tool and a lack of publication bias. On the basis of these findings, there is high-quality evidence to suggest that sodium bicarbonate administration does not improve running performance in trained Standardbred or Thoroughbred horses.