How athletes use caffeine: Boosting performance or risking health?

Editor’s note: Yesterday, Deseret News looked at potential benefits and harms of caffeine in a caffeine-saturated world. Today, we look at how athletes use the drug to enhance performance.

It’s 5:30 a.m. on a Tuesday morning.

Alex Gilson pulls a green TriUtah swim cap over his head, adjusts his dark goggles and dives into the Provo Recreation Center swimming pool. He covers the 25-yard-long lane with a few powerful strokes, makes a flip turn and torpedoes through the water. The 25-year-old triathlete goes back and forth 37 times over the next 40 minutes — a distance of just over a mile — occasionally using a kickboard and stopping to rest.

Gilson then heads upstairs for strength training — lateral band walks, pull ups, planks. He’ll do one of several weekly training runs later in the day as well as ride his bike during the week. It’s a lot to squeeze in amid his senior year at BYU, working and, along with his wife, expecting his first child.

Many endurance athletes start their workouts with a jolt of caffeine in a cup of coffee or energy drink. Not Gilson. He had some water and a honey Stinger energy waffle before heading to the pool. He only takes caffeine, usually in a gel, in the closing miles of a long training ride on the bike or late in the run during a race to “take the edge off.”

Triathlons consist of swimming, biking and running in that order. Races are various distances. An Olympic triathlon has a 1.5K swim, 40K bike ride and 10K run. A full Ironman has 2.4-mile swim, 112-mile bike ride and 26.2-mile run.

Caffeine, Gilson said, doesn’t give him an energy boost. “It’s not like a magic injection or a magic pill that all of a sudden makes you perform and gives you all this immense amount of energy so you can win a race or anything,” he said.

What the drug does for him is block the signals to his brain telling him that his muscles are tired so he can push through to the finish line.

Performance enhancing

Caffeine is often called the world’s most popular psychoactive drug, consumed daily by 80% of the world’s population. It’s a stimulant found naturally in foods like coffee, tea and chocolate. It is also synthetically produced and added to sports gels, chews, energy drinks, sports drinks, chewing gum and dietary supplements. It stimulates the central nervous system by blocking adenosine receptors in the brain, reducing perceived effort, delaying fatigue, reducing pain, and improving mental focus, attention and motivation. The body absorbs synthetic caffeine faster and it takes effect faster than natural caffeine.

It’s the ergogenic effects that make it a widely used supplement across many individual and team sports, from weekend warriors to pros. Research suggests 75% to 90% of athletes consume caffeine before or during competitive events, according to the National Institutes of Health. Some NBA, NFL and MLB players are known to drink massive amounts of coffee on game day.

“It’s considered one of the most commonly used performance-enhancing drugs both for sports and for just work and life, because it reduces fatigue and improves alertness. When it comes to sports, that improved alertness is a benefit. It can improve concentration and it also helps in endurance activities and power activities, like any sort of strength-based exercise or sport; you’ll have improved performance with those activities with use of caffeine,” said Dr. Brett Toresdahl, an associate professor and director of research for the Division of Sports Medicine in the Department of Orthopedics at University of Utah Health.

There’s a line between helpful and unhelpful, he added, and it’s different for everyone based on their tolerance for the substance. Overuse can have harmful side effects. Health and nutrition experts say the best way to determine your effective dose is through repeated and careful experimentation during workouts and competition-intensity training.

Andrew Stasinos, an endurance coach and triathlete who has completed six Ironman races, gives his clients, including top Paralympic athletes, simple advice about the drug: If you consume caffeine and your body is used to it, continue. If not, don’t use it or be very careful if you do. And if you haven’t used it training, don’t use it in competition because it will probably hinder more than help your performance.

“My biggest caution for any athlete who asks me about caffeine is if you’re not used to it, don’t use it, don’t rely on it, don’t worry about it. If you’re used to it, then you can strategically use it,” he said.

With sports, one concern is caffeine contributing to dehydration, especially when exercising in heat, as well as jitteriness and anxiousness, “which is not always a good thing when it comes to sports, especially if there’s any sort of precise component to that sport,” Toresdahl said.

And it can disrupt sleep, especially if used late in the day.

Gilson experienced that when he took 400 milligrams — the oft-cited maximum amount a person should consume in a day — during a short race. That’s roughly the amount of caffeine in four cups of brewed coffee, 10 cans of cola or two energy drinks.

“For me, I have noticed the more caffeine I take, the longer it takes me to get a good night’s rest after the race. I’m very restless that first night, can’t sleep at all. By the second day after being super exhausted, I finally get to the point where I can sleep,” he said.

Toresdahl estimated caffeine gives an athlete a 1% or 2% endurance boost.

“So for the most part, the folks who would benefit from it would be the competitive athletes who are looking for every percentage of competitive advantage. For everyone else, it may not necessarily be worth the benefit if it’s affecting sleep, if it’s affecting their heart rate or blood pressure, things like that,” he said.

Banned, not banned

Caffeine hasn’t always been an acceptable substance in sports.

The World Anti-Doping Agency, or WADA, banned high concentrations of caffeine from all Olympic events for 20 years. But in 2004, the organization determined that the drug no longer met at least two of its three criteria for inclusion on the prohibited list: has the potential to enhance sport performance; represents a health risk to the athletes; and violates the spirit of sport. Caffeine is currently on the WADA monitoring list, which means it is not banned but that the organization is watching it in case it becomes an anti-doping issue in the future.

“A large proportion of athletes in Paris will use caffeine in some form,” Wendy Martinson, the lead nutritionist for Great Britain’s Olympic team, told The Times ahead of the 2024 Summer Games. British athletes even brought their own barista to Paris to satisfy their coffee fix.

The story notes that caffeine gum is increasingly popular, with research by pharmacologists showing it is absorbed quickly for faster results. “In February, exercise scientists from Sheffield Hallam University found that recreational runners who chewed gum supplying 300 mg of caffeine 30 minutes before a Saturday morning Parkrun ran an average 17.28 seconds faster than those who were given a placebo,” according to The Times.

The National Collegiate Athletic Association restricts the amount of caffeine in an athlete’s system by limiting acceptable urine concentrations to 15 milliliters, which equates to 500 milligrams of caffeine or six to eight cups of coffee two to three hours before an event. While the NCAA agrees that there are benefits to caffeine, its fact sheet on the subject stresses that it’s addictive and has adverse health effects if not consumed in moderation and while hydrated.

“The NCAA is interesting. It is listed as a stimulant, and stimulants are a class of medications or drugs that are banned by the NCAA,” Toresdahl said, noting how much an athlete would have to ingest before reaching a detectable level in urine. “So that’s going to be hard for most athletes to reach that level that would trigger an issue.”

Caffeine free

At least one sports group, the National Interscholastic Cycling Association, bans caffeine in any amount. Its affiliate in Utah, the Utah High School Cycling League , adopted the rule for the mountain bike races it puts on for more than 7,400 students across the state.

The rule states: “Caffeine is an addictive substance that enhances performance. The League deems caffeinated products as inappropriate for young student-athletes. Caffeinated sport products such as bars, gels and sport drinks are banned before or during League races, practices and other activities. The consumption of soda and coffee products containing caffeine by student-athletes before or during NICA and League races and camps is banned.”

The American Academy of Pediatrics does not recommend caffeine for children under age 12 and advises against energy drinks for all children and teens. Johns Hopkins Medicine says children ages 12 to 18 should not consume more than 100 milligrams of caffeine a day.

“Why would you go against the best judgment out there? For us to ignore that kind of implicitly says it’s OK,” said Chris Best, Utah High School Cycling League director.

”We’re not in the athlete development business. We’re in the youth development business. We’re tasked with mentoring kids to make good choices. We just use mountain bike riding and racing as a mechanism for that.”

Best said kids will get more miles out of healthy nutrition than they ever will from caffeine. Though they live in a culture that “promotes shortcuts,” he said, relying on energy drinks isn’t the best way forward.

“It’s everywhere. It’s hard to get away from it. Our goal is to get kids into the mindset of what they’re putting into their body. Is it healthy? Is it necessary? Is it legal or appropriate?” he said.

There’s no drug testing in high school mountain biking. Best said the kids mostly police themselves.

How the pros do it

Caffeine use among professional athletes varies greatly.

Take the Los Angeles Dodgers. Earlier this season, a popular duo calling themselves Bat Boys on TikTok and Instagram asked Dodger players about their daily caffeine habits.

“Zero. I don’t drink caffeine at all,” All-Star outfielder Mookie Betts said. “I will say out of 365 days, 363 of them are no caffeine.”

Pitcher Landon Knack is on the other end of the spectrum. He told Bat Boys he consumes about 400 milligrams a day but bumps that to 600 milligrams on the days he pitches. “I’m an addict at this point,” he said.

Outfielder Teoscar Hernandez said he drinks a little coffee in the morning. “I’m not a big caffeine guy. Every time I drink a lot that has caffeine in it, I start shaking,” he said.

A few years back, the Portland Trailblazers’ sports performance specialist brewed coffee for players precisely 35 minutes before tipoff as a pre-game pick-me-up. Former NBA player Boris Diaw had an espresso machine in his locker when he was with the San Antonio Spurs. After being traded to the Utah Jazz, he formed a coffee group with several players, coaches and executives who sipped espresso before practices and home games.

Know before you go

While science has shown caffeine enhances performance, determining what it will do and when in individual athletes can be tricky. Each person metabolizes caffeine at their own rate, with some fully metabolizing caffeine in two hours and others taking 16 to 24 hours. Also, while coffee contains natural caffeine, the body might react differently to the synthesized caffeine in energy drinks.

Stasinos said anyone, whether an elite athlete who might face drug testing or a recreational runner or cyclist in it for fun, should beware of what’s in sports drinks, noting some were found to have trace amounts of meth or other stimulants not listed on the label. It’s a health concern regardless of your ability level.

“When I use any kind of pre-workout drink, I will make sure that it is certified safe for sports because I don’t want to do things that are technically illegal. I also don’t want to put things in my body that are not really safe,” he said. “I would say knowing what’s in the product, especially with supplements that are not regulated by the FDA, having a third party that looks at it and makes sure that what it claims to have in it is actually in it, I think is smart for any of us.”

Lucy Sorenson, a registered dietitian nutritionist with Intermountain Health, said that not all caffeine-containing products, including energy drinks, specify everything in them on the label. Athletes just looking for a caffeine boost may get more than they bargained for. “So athletes can sometimes test positive for different drug tests because of what’s in there that they don’t know is in there,” she said.

Collin Swensen, has competed in more than 100 triathlons of various lengths, including four Ironman races, over the past 21 years. He doesn’t drink coffee but said a lot of triathletes swear by coffee and espresso.

“I do think caffeine is a useful tool,” he said.

A typical week for Swensen consists of three to four bike rides, including one long one, and two to three runs, including a couple right off the bike, which is known as a “brick.” He also swims 30 to 45 minutes three times a week. It’s a demanding schedule and he tries to be consistent. He usually starts a training session with a water enhancer that contains 60 milligrams of caffeine.

“For me, caffeine is largely a placebo,” said Swensen, who runs a website called UtahTriBuzz.com. “I have some caffeine in my system. I’m ready to go.”

During races, he consumes gels and high-calorie drinks that contain caffeine, especially in an Ironman. He often grabs a Coke or Red Bull in the latter stages of a race. But he’s careful not to overdo it.

“It definitely plays a role in race day nutrition for me with the gels and with the drinks,” he said. “It can be a perk when you’re running, especially if you’re hurting.”

Contributing: Lois M. Collins