Effect of sodium bicarbonate contribution on energy metabolism during exercise: a systematic review and meta-analysis

The effects of sodium bicarbonate (NaHCO₃) on anaerobic and aerobic capacity are commonly acknowledged as unclear due to the contrasting evidence thus, the present study analyzes the contribution of NaHCO₃ to energy metabolism during exercise.

Following a search through five databases, 17 studies were found to meet the inclusion criteria. Meta-analyses of standardized mean differences (SMDs) were performed using a random-effects model to determine the effects of NaHCO₃ supplementation on energy metabolism. Subgroup meta-analyses were conducted for the anaerobic-based exercise (assessed by changes in pH, bicarbonate ion [HCO₃^-], base excess [BE] and blood lactate [BLa]) vs. aerobic-based exercise (assessed by changes in oxygen uptake [VO₂], carbon dioxide production [VCO₂], partial pressure of oxygen [PO₂] and partial pressure of carbon dioxide [PCO₂]).

The meta-analysis indicated that NaHCO₃ ingestion improves pH (SMD = 1.38, 95% CI: 0.97 to 1.79, P < 0.001; I² = 69%), HCO₃^- (SMD = 1.63, 95% CI: 1.10 to 2.17, P < 0.001; I² = 80%), BE (SMD = 1.67, 95% CI: 1.16 to 2.19, P < 0.001, I² = 77%), BLa (SMD = 0.72, 95% CI: 0.34 to 1.11, P < 0.001, I² = 68%) and PCO₂ (SMD = 0.51, 95% CI: 0.13 to 0.90, P = 0.009, I² = 0%) but there were no differences between VO₂, VCO₂ and PO₂ compared with the placebo condition.

This meta-analysis has found that the anaerobic metabolism system (AnMS), especially the glycolytic but not the oxidative system during exercise is affected by ingestion of NaHCO₃. The ideal way is to ingest it is in a gelatin capsule in the acute mode and to use a dose of 0.3 g•kg^- 1 body mass of NaHCO₃ 90 min before the exercise in which energy is supplied by the glycolytic system.