Effects of Different Dietary Supplements on Swimming Performance: A Systematic Review and Network Meta-Analysis

Background: Nutritional supplements are widely used by swimmers, but the effectiveness of various supplements and the identification of the most effective intervention require further investigation. Purpose: This paper evaluated and compared the effectiveness of various nutrition-based interventions on swimming performance through both direct and indirect comparisons. Methods: PubMed, Embase, Web of Science, Cochrane Library, and SPORTDiscus databases were thoroughly searched up to 4 April 2024. The risk of bias was judged using the Cochrane risk of bias tool. A random-effect model was adopted to compute standardized mean differences (SMD) and 95% confidence intervals (CI). Results: L-arginine (Arg) demonstrated superior performance to the placebo (SMD = -1.66, 95% CI [-2.92, -0.44]), emerging as the most effective intervention for reducing 100 swimming time (SUCRA = 89.5%). Beta-alanine (BA) was the best intervention for improving blood lactate (SUCRA = 80%). Creatine combined with sodium bicarbonate (Creatine_NaHCO3) significantly increased blood pH compared to the placebo (SMD = 3.79, 95% CI [1.85, 5.80]), with a SUCRA score of 99.9%, suggesting it is the most effective intervention for this parameter. No prominent differences were noted among the interventions in 50 m time, 200 m time, heart rate, and body mass. Conclusions: Dietary supplements might provide benefits for improving swimming performance. Arg emerged as the most efficacious modality for reducing 100 m time. BA proved to be the preeminent strategy for decreasing blood lactate. Creatine_NaHCO3 was distinguished as the optimal approach for improving blood pH.