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A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance—Part 37
  1. J Pearce1,
  2. L E Norton2,
  3. D S Senchina3,
  4. L L Spriet4,
  5. L M Burke5,
  6. S J Stear6,
  7. L M Castell7
  1. 1English Institute of Sport, Bisham Abbey, Bucks, UK
  2. 2Biolayne LLC, Tampa, Florida, USA
  3. 3Biology Department, Drake University, Des Moines, Iowa, USA
  4. 4Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, Canada
  5. 5Australian Institute of Sport, Canberra, Australia
  6. 6Performance Influencers Limited, London, UK
  7. 7Green Templeton College, University of Oxford, Oxford, UK
  1. Correspondence to L M Castell, Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; lindy.castell{at}

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Introductory remarks

Finishing up letter ‘S’, and in another rare departure from our A–Z list of supplement components, we decided it was important to address the issue of ‘stacking’—strategically combining or cycling the use of different supplement products. While this originated and still resonates mostly with body builders, it is an issue that has consequences for athletes of all types and levels due to the prevalence of multiple supplement use. Moving on to ‘T’ we deal with taurine, theobromine and theophylline: all three of these can be found in sports drinks/bars, which purport to stimulate performance.


J Pearce, L E Norton

In this summary, stacking is defined as the consumption of two or more supplements at the same time in an attempt to maximise results. This practice originated from anabolic steroid regimes of body builders and other resistance training athletes where products were combined, often to address the side effects or potentiate the actions of individual products.1 A more global view of supplement stacking in sports nutrition finds that supplement combinations can be deliberate or unintentional. Deliberate stacking aims to take advantage of positive physiological responses that arise from combining nutrients, foods or compounds (eg, vitamin C enhancing iron absorption). Few studies have examined the possible benefits to stacking2–5 and have produced equivocal results despite theoretical support. Combining creatine with β-alanine had a unique effect on delaying fatigue while stacking creatine with hydroxy-B-methylbutyrate produced additive effects on lean body mass.4 ,5 The combination of β-alanine (intracellular) and bicarbonate (extracellular) buffers for events involving sustained high-intensity exercise that produces significant acidosis warrants comprehensive study.6 While stacking some supplements may provide additional benefits, some athletes may not be aware that taking multiple supplement products creates the potential for doubling up on some ingredients or co-ingesting ingredients that are best not combined. Inadvertent or unintentional …

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  • Competing interests LN has his own business, Biolayne LLC.

  • Provenance and peer review Commissioned; not externally peer reviewed.