Effects of Acute Caffeine Supplementation on Physical, Sport-Specific, Physiological, Perceptual, and Cognitive Outcomes in Female Team-Sport Athletes: A Three-Level Meta-Analysis.

BACKGROUND AND

objectivesEvidence on the acute effects of caffeine in female team-sport athletes is limited. This study aimed to quantify the acute effects of caffeine on female team-sport athletes across physical performance, sport-specific performance, physiological responses, perceptual responses, and cognitive performance and determine moderators.

methodsPubMed and Web of Science were systematically searched for randomized, placebo-controlled crossover trials of acute, dose-defined caffeine in female team-sport athletes. Effect sizes were expressed as Hedges' g and synthesized within each domain using a three-level CHE model with CR2 cluster-robust variance estimation and Satterthwaite degrees of freedom; 95% confidence intervals and prediction intervals were reported. Risk of bias (RoB 2), methodological quality (PEDro), and certainty of evidence (GRADE) were assessed.

resultsTwenty-six studies were included, comprising 26 randomized, blind, placebo-controlled crossover trials. As a descriptive cross-domain summary, acute caffeine intake showed a small overall effect when all available domains were pooled (Hedges' g = 0.24, 95% CI 0.13 to 0.35); however, because these domains represent different constructs, domain-specific estimates were considered the primary interpretable findings. For physical performance, caffeine showed a small favorable effect (g = 0.32, 95% CI 0.22 to 0.42), with statistical evidence for repeated sprint ability (g = 0.43), agility or change in direction (g = 0.42), sprint or speed performance (g = 0.39), anaerobic power (g = 0.30), and jumping performance (g = 0.29). For sport-specific performance, the pooled estimate indicated a small favorable effect but did not reach conventional statistical significance (g = 0.36, 95% CI: -0.01 to 0.73). Exploratory sub-indicator analyses, each based on only a few studies, suggested possible favorable directions for sport-specific locomotion or running performance (g = 0.46) and throwing or ball-speed outcomes (g = 0.19), whereas evidence was insufficient for shooting or scoring accuracy. Physiological outcomes were direction-aligned to the value conventionally regarded as favourable for each indicator (i.e., lower heart rate, lactate, and glucose), so that positive values denote the conventionally favourable direction; because the domain aggregates indicators of differing clinical desirability, its pooled value is a descriptive summary only and showed no clear domain-level direction (g = -0.05, 95% CI -0.31 to 0.21). The heart rate submetric showed a statistically detectable difference (g = -0.30), indicating that caffeine increased heart rate, the expected pharmacological response to a stimulant rather than an adverse effect; there were no clear effects on blood lactate or blood glucose. Perceptual responses improved modestly (g = 0.42), largely through reduced rating of perceived exertion (g = 0.35). Cognitive performance, based on only four studies with low degrees of freedom and wide uncertainty, showed a nonsignificant direction (g = 0.37) with no clear evidence for reaction time or cognitive accuracy, and these data should not be interpreted as showing that caffeine improves cognitive performance in female team-sport athletes. Exploratory moderator analyses did not provide statistically reliable evidence of moderation by caffeine dose, timing of intake, formulation or source, sport type, competitive level, habitual caffeine intake, or blinding status.

conclusionsAvailable evidence most consistently supports small, outcome-specific benefits of acute caffeine for physical performance and reduced perceived exertion. Evidence for sport-specific skills and cognitive outcomes remained uncertain, based on few studies per outcome and not supporting a general benefit. Current data do not support dose-, timing-, formulation-, habitual-intake-, sport-, or population-stratified recommendations. Future trials should be adequately powered, prospectively report menstrual-cycle phase, hormonal-contraceptive use, habitual caffeine intake, and adverse symptoms, and verify the integrity of blinding.