Effects of a dietary supplement on golf drive distance and functional indices of golf performance
膳食补充剂对高尔夫开球距离和高尔夫表现功能指数的影响

Introduction 介绍

The sport of golf requires an intricate mix of physical, emotional and cognitive factors to achieve optimal performance [Citation1]. The swing itself is a complex pattern of coordinated biomechanical movements that impact both the accuracy and distance with which the ball is struck. In its purest sense, the golf swing is a movement centered mostly upon the production of power; consequently, swings are considered to be largely anaerobic in nature [Citation1].
高尔夫运动需要身体、情感和认知因素的复杂结合才能达到最佳表现[引文1 ]。挥杆本身是一种协调生物力学运动的复杂模式，会影响击球的准确性和距离。从最纯粹的意义上来说，高尔夫挥杆是一种主要以产生力量为中心的运动。因此，秋千被认为本质上是无氧的[引文1 ]。

As the popularity of golf rises, the development of ergogenic approaches have produced a seemingly endless array of clubs and other pieces of equipment intended to help improve performance. In light of the physical and cognitive challenges brought forth by golf, nutritional approaches may impact performance, but minimal effort, to date, has been made in this area.
随着高尔夫运动的普及，增效方法的发展已经产生了一系列看似无穷无尽的球杆和其他旨在帮助提高表现的设备。鉴于高尔夫带来的身体和认知挑战，营养方法可能会影响表现，但迄今为止，在这方面所做的努力很少。

The lack of nutritional considerations within the sport of golf is somewhat surprising. Currently, nutritional guidelines center upon prudent management of fluid and carbohydrate levels, but other demands found in golf present the need for additional nutritional concerns. For example, under certain environmental conditions the extended duration to complete a round of golf (~3 – 4 hours) can promote dehydration, reduced energy levels and mental fatigue [Citation1]. When these factors are considered collectively, it makes intuitive sense that a nutritional formulation that can improve anaerobic performance and increase a golfer’s focus and attention may impact performance. In this respect, one of the only published studies to examine the impact of a nutritional agent on golfing performance utilized phosphatidylserine supplementation to lower the stress hormone cortisol and improve shot-making during simulated golf swings [Citation2]. SuperDrive™ (Purity Products, Plainview, NY) is a commercially available dietary supplement that combines creatine monohydrate, coffee arabica fruit extract, calcium fructoborate and vitamin D and is marketed to the golfing community to aid in performance and recovery from musculoskeletal complications associated with participation in golf [Citation1].
高尔夫运动中缺乏营养考虑有点令人惊讶。目前，营养指南的重点是谨慎管理液体和碳水化合物水平，但高尔夫中发现的其他要求提出了额外营养问题的需要。例如，在某些环境条件下，延长打完一轮高尔夫球的时间（约 3 – 4 小时）会导致脱水、能量水平降低和精神疲劳 [引文1 ]。当综合考虑这些因素时，可以直观地看出，可以改善无氧表现并增加高尔夫球手的注意力和注意力的营养配方可能会影响表现。在这方面，仅有的一项已发表的研究研究了营养剂对高尔夫表现的影响，利用磷脂酰丝氨酸补充剂来降低应激激素皮质醇并改善模拟高尔夫挥杆过程中的击球效果[引文2 ]。 SuperDrive™（Purity Products，纽约州普莱恩维尤）是一种市售膳食补充剂，结合了一水肌酸、阿拉比卡咖啡果提取物、果糖硼酸​​钙和维生素 D，面向高尔夫界销售，以帮助提高运动表现和从与参与相关的肌肉骨骼并发症中恢复在高尔夫领域[引文1 ]。

Creatine monohydrate is one of the most popular and effective dietary supplements due to its ability to improve strength, power, lean mass and explosive performance. Creatine supplementation protocols are well established to significantly increase intramuscular levels of phosphocreatine and total creatine which, in the vast majority of studies, result in measureable improvements in a wide variety of high-intensity activities [Citation3–Citation8]. However, to our knowledge, no research is available that has examined the impact of creatine supplementation on golfing performance. In light of the fact that the golf swing is an anaerobic event [Citation1], it is logical that creatine supplementation may have the potential to improve golf swing power.
一水肌酸是最受欢迎和最有效的膳食补充剂之一，因为它能够提高力量、爆发力、瘦体重和爆发力。肌酸补充方案已得到完善，可以显着提高肌内磷酸肌酸和总肌酸的水平，在绝大多数研究中，这可以显着改善各种高强度活动[引文3 -引文8 ]。然而，据我们所知，还没有研究检验肌酸补充剂对高尔夫表现的影响。鉴于高尔夫挥杆是一项无氧活动[引文1 ]，因此补充肌酸可能具有提高高尔夫挥杆力量的潜力是合乎逻辑的。

Coffea arabica is a fruit extract (CoffeeBerry®) that is derived from the same plant as traditional coffee, thus making caffeine the primary active ingredient found within the extract. For years, scientific research has supported the use of caffeine as an ergogenic aid, primarily known for its positive impact on executive functions such as focus, attention and concentration, stimulation of fatty acid mobilization, improvements in endurance performance [Citation9], and various direct effects on muscle function [Citation10,Citation11]. From a physical perspective, caffeine is known to antagonize adenosine receptors, thereby inhibiting the negative impact of adenosine on neurotransmission, arousal, and pain perception [Citation12] in addition to reducing ratings of perceived exertion [Citation13]. Beyond physical benefits, caffeine can also operate to enhance a number of cognitive aspects. Caffeine is commonly used and accepted for its ability to promote wakefulness as well as enhance focus and concentration, all attributes that would be of particular benefit to a golfer, while also preventing both peripheral and central manifestations of fatigue [Citation10]. An excellent review by Glade summarized available literature on caffeine’s impact of cognitive functioning and reported that caffeine in doses in modest amounts (30 – 50 mg) are able to favorably impact mental energy, but typical doses of 100 – 150 mg are needed to positively impact assessments of cognitive functioning [Citation10]. Similarly, Einother and investigators expertly summarized the literature and concluded that caffeine favorably impacts both simple and complex tasks through both attention enhancement and optimized executive function [Citation14].
阿拉比卡咖啡是一种水果提取物 (CoffeeBerry®)，与传统咖啡源自同一植物，因此咖啡因成为提取物中的主要活性成分。多年来，科学研究支持使用咖啡因作为一种增强剂，主要因其对执行功能（如注意力、注意力和集中力、刺激脂肪酸动员、提高耐力表现）的积极影响而闻名[引文9 ]，以及各种对肌肉功能的直接影响[引文10 、引文11 ]。从物理角度来看，已知咖啡因可以拮抗腺苷受体，从而抑制腺苷对神经传递、唤醒和疼痛感知的负面影响 [引文12 ] 除了降低感知用力评级 [引文13 ]。除了对身体的好处外，咖啡因还可以增强许多认知能力。咖啡因因其能够促进清醒以及增强注意力和集中力而被广泛使用和接受，所有这些特性对高尔夫球手都特别有益，同时还可以防止外周和中枢疲劳的表现[引文10 ]。 Glade 的一篇精彩评论总结了关于咖啡因对认知功能影响的现有文献，并报告说，适量（30 – 50 毫克）的咖啡因能够对精神能量产生有利影响，但需要 100 – 150 毫克的典型剂量才能产生积极影响认知功能评估[引文10 ]。同样，Einother 和研究人员熟练地总结了文献，并得出结论，咖啡因通过增强注意力和优化执行功能，对简单和复杂的任务都有有利的影响[引文14 ]。

A myriad of musculoskeletal problems can negatively impact golfing performance and strategies to minimize pain and joint discomfort while also promoting favorable bone and muscle health are important concerns for active golfers. The trace mineral boron is closely linked to improved rates of calcium retention and bone health. Although no recommended daily allowance for boron has been established, doses ranging from 1–4 mg have been shown to safely promote improvements in bone density [Citation15,Citation16]. Recent technology has produced calcium fructoborate (FruiteX-B®), a patented compound that results in calcium being bound to boron, forming a natural chelation and effective stabilization of the available boron. While relatively new, calcium fructoborate has been shown to exert strong anti-inflammatory functions [Citation17] and pronounced antioxidant activity [Citation18]. Interestingly, the compound can favorably impact hormonal regulation and vitamin D metabolism leading to its interest as a pain and bone/joint health aid. Specifically, unpublished research in mild and severe osteoporotic patients using an open-label approach indicated that eight weeks of supplementation with calcium fructoborate reduced pain and stiffness during walking and climbing stairs and improved joint mobility [Citation19]. More recent published literature utilized a two-week double-blind, placebo-controlled supplementation approach on 116 osteoporotic patients and concluded that calcium fructoborate supplementation improved inflammatory markers for all groups [Citation20].
无数的肌肉骨骼问题会对高尔夫表现产生负面影响，而减少疼痛和关节不适同时促进骨骼和肌肉健康的策略是活跃高尔夫球手的重要关注点。微量矿物质硼与钙保留率和骨骼健康的改善密切相关。尽管尚未确定推荐的硼每日摄入量，但 1-4 毫克的剂量已被证明可以安全地促进骨密度的改善 [引文15 、引文16 ]。最近的技术已生产出果硼酸钙 (FruiteX-B®)，这是一种专利化合物，可导致钙与硼结合，形成天然螯合并有效稳定可用硼。虽然相对较新，但果硼酸钙已被证明具有强大的抗炎功能 [引文17 ] 和显着的抗氧化活性 [引文18 ]。有趣的是，该化合物可以有利地影响荷尔蒙调节和维生素 D 代谢，从而使其成为疼痛和骨/关节健康辅助剂。具体来说，未发表的针对轻度和重度骨质疏松症患者使用开放标签方法的研究表明，补充果硼酸钙八周可减轻步行和爬楼梯时的疼痛和僵硬，并改善关节活动度[引文19 ]。 最近发表的文献对 116 名骨质疏松症患者采用了为期两周的双盲、安慰剂对照补充剂方法，并得出结论：果糖硼酸钙补充剂可改善所有组的炎症标志物 [引文20 ]。

Another ingredient that continues to get attention regarding its ability to favorably impact bone health [Citation21] and healthy muscle metabolism [Citation22–Citation24] is vitamin D. The average adult American diet contains only 150–300 IU of vitamin D per day while recommended levels are 600–800 IU, despite multiple studies indicating that higher daily amounts may be optimal [Citation21,Citation25]. Currently, the Endocrine Society recommends 1,500 – 2,000 IU/day, with other reports recommending between 400 – 1,000 IU/day. To date, the impact of supplementation with vitamin D (either in isolation or as part of a multi-ingredient formula) on golf performance is unknown.
另一种因其对骨骼健康 [引文21 ] 和健康肌肉代谢 [引文22 -引文24 ] 产生有利影响的能力而持续受到关注的成分是维生素 D。美国成人平均饮食每天仅含有 150–300 IU 的维生素 D尽管多项研究表明较高的每日摄入量可能是最佳的，但推荐水平为 600-800 IU [引文21 、引文25 ]。目前，内分泌学会建议每天 1,500 – 2,000 IU，其他报告建议每天 400 – 1,000 IU。迄今为止，补充维生素 D（无论是单独的还是作为多成分配方的一部分）对高尔夫表现的影响尚不清楚。

The primary purpose of this preliminary, proof-of-concept investigation was to examine the impact of a nutritional formulation containing creatine, coffea arabica fruit extract (CoffeeBerry®), calcium fructoborate (FruiteX-B®) and vitamin D on functional indices of golf swing performance, and upper-body strength/power. Secondary purposes were to assess changes in indices of quality of life, pain and standard blood-based markers of clinical safety and health.
这项初步概念验证研究的主要目的是检查含有肌酸、阿拉比卡咖啡果提取物 (CoffeeBerry®)、果硼酸钙 (FruiteX-B®) 和维生素 D 的营养配方对高尔夫功能指数的影响挥杆表现和上半身力量/爆发力。次要目的是评估生活质量、疼痛和临床安全和健康的标准血液标志物的变化。

Methods 方法

Procedures 程序

Testing protocol 测试协议

All study participants were first familiarized to all experimental procedures prior to completing their first testing session. Prior to arriving for all testing sessions, study participants were instructed to refrain from physically taxing exercise for 48 hours and to observe a 12 hour fast. Upon arrival for the initial testing session, physical activity and health history were determined using standardized questionnaires. Subjects then had their resting heart rate and blood pressure determined using an automated sphygmomanometer, standing height determined using a wall-mounted stadiometer, and body mass determined using a calibrated scale (Seca Medical Scale, Hanover, MD). On separate days thereafter, study participants completed a 1-RM test on the bench press, an upper-body power test (bench press throws) and an assessment of their golf swing performance.
在完成第一次测试之前，所有研究参与者首先熟悉所有实验程序。在参加所有测试之前，研究参与者被要求在 48 小时内避免进行体力消耗性锻炼，并禁食 12 小时。到达初始测试阶段后，使用标准化问卷确定身体活动和健康史。然后使用自动血压计测定受试者的静息心率和血压，使用壁挂式测距仪测定站立高度，并使用校准秤（Seca Medical Scale，汉诺威，马里兰州）测定体重。此后的不同日子，研究参与者完成了卧推 1-RM 测试、上半身力量测试（卧推投掷）以及高尔夫挥杆表现评估。

Supplementation protocol 补充方案

In a double-blind, placebo-controlled fashion, study participants were instructed to ingest either a powdered dietary supplement containing creatine, coffea arabica fruit extract (CoffeeBerry®), calcium fructoborate (FruiteX-B®) and vitamin D (Strong Drive™, SD, n = 14) or an isocaloric placebo (PLA, n = 13). A representative Supplement Facts label of the investigational product is shown in Figure 
以双盲、安慰剂对照的方式，研究参与者被指示摄入含有肌酸、阿拉比卡咖啡果提取物 (CoffeeBerry®)、果硼酸钙 (FruiteX-B®) 和维生素 D (Strong Drive™、 SD，n = 14）或等热量安慰剂（PLA，n = 13）。研究产品的代表性补充事实标签如图所示1. Irrespective of group assignment, all study participants were instructed to take each serving of their assigned supplement with eight ounces of cold water. For the first two weeks of the study, one serving was consumed twice per day (with breakfast and lunch). During the final two weeks of the study, study participants consumed only one serving per day of their assigned supplement (with breakfast). This protocol was employed to match manufacturer guidelines; the protocol also corresponded with previous creatine supplementation literature showing effective increases in intramuscular creatine and phosphocreatine levels [Citation3,Citation6]. To ensure complete blinding, all study supplements were in powder form of similar color, texture and flavor while also being packaged in coded generic containers. Compliance to the supplementation protocol was monitored by having study participants complete a supplementation log. In addition, study participants were required to return their empty supplement containers and were reminded of details associated with the study protocols with weekly text messages and/or emails. Participants were instructed to refrain from using other supplemental courses of caffeine or creatine.
。无论小组分配如何，所有研究参与者都被要求用八盎司冷水服用每份指定的补充剂。在研究的前两周，每天食用两次一份（早餐和午餐）。在研究的最后两周，研究参与者每天仅食用一份指定的补充剂（含早餐）。该协议用于匹配制造商指南；该方案还与之前的肌酸补充文献一致，显示肌酸和磷酸肌酸水平可以有效增加[引文3 、引文6 ]。为了确保完全盲法，所有研究补充剂均采用颜色、质地和风味相似的粉末形式，同时也包装在编码的通用容器中。通过让研究参与者填写补充日志来监测对补充方案的遵守情况。此外，研究参与者被要求归还空的补充剂容器，并通过每周短信和/或电子邮件提醒与研究方案相关的细节。参与者被指示不要使用其他咖啡因或肌酸的补充课程。

Figure 1 Supplement Facts for Strong Drive™.
图 1 Strong Drive™ 的补充事实。

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Blood collection and analysis
血液采集和分析

Whole blood and serum samples were collected using standard phlebotomy techniques on day 0 and day 30 of the study protocol. Whole blood samples were collected into K2-EDTA treated vacutainer tubes and upon collection were slowly inverted ten consecutive times prior to immediate refrigeration. Serum samples were collected in non-treated tubes and allowed to clot for 30 minutes at room temperature prior to being centrifuged (Horizon mini E Centrifuge, Drucker Diagnostics, Port Matilda, PA) for 15 minutes at 3200 rpm. Serum was extracted from all samples and aliquots were pipetted into cryovial storage tubes. All blood samples were analyzed for clinical chemistry analysis (plasma glucose, blood urea nitrogen [BUN], creatinine, aspartate aminotransaminase [AST], alanine aminotransaminase [ALT], creatine kinase, lactate dehydrogenase, total bilirubin, alkaline phosphatase [ALP], triacylglycerol [TG], total cholesterol [TC], LDL, HDL, uric acid, sodium, potassium, total protein, albumin, globulin, iron, complete blood cells, and platelet count) using automated clinical chemistry analyzers (LabCorp, Dublin, OH branch). All samples from the same day were batch analyzed with test-retest reliabilities commonly reported using internal quality control data from clinical laboratories and associated automated analyzers within a range of 3 – 5% [Citation26].
在研究方案的第 0 天和第 30 天，使用标准静脉切开术技术收集全血和血清样本。将全血样品收集到经K2-EDTA处理的真空采血管中，收集后连续缓慢翻转十次，然后立即冷藏。将血清样品收集在未经处理的试管中，并在室温下凝结 30 分钟，然后以 3200 rpm 离心（Horizo​​n mini E Centrifuge，Drucker Diagnostics，Port Matilda，PA）15 分钟。从所有样品中提取血清，并将等分试样移入冷冻储存管中。所有血液样本均进行临床化学分析（血浆葡萄糖、血尿素氮 [BUN]、肌酐、天冬氨酸转氨酶 [AST]、丙氨酸转氨酶 [ALT]、肌酸激酶、乳酸脱氢酶、总胆红素、碱性磷酸酶 [ALP]、三酰甘油[TG]、总胆固醇 [TC]、LDL、HDL、尿酸、钠、钾、总蛋白、白蛋白、球蛋白、铁、全血细胞和血小板计数），使用自动化临床化学分析仪（LabCorp，都柏林，俄亥俄州分公司） ）。对同一天的所有样本进行批量分析，重测可靠性通常使用来自临床实验室和相关自动分析仪的内部质量控制数据报告，误差范围在 3 – 5% 之间[引文26 ]。

Muscular strength and power determination
肌肉力量和力量决定

On day 0 and day 30, maximal upper body muscle strength was estimated by 1-RM bench press testing using protocols adapted from the National Strength and Conditioning Association [Citation27]. Only upper-body strength was assessed in this study due to previous experience in our lab and others indicating greater reliability of upper-body vs. lower-body testing [Citation28]. It is recognized that the bench press exercise acts primarily in the sagittal plane whereby the golf swing occurs through multiple planes at a wide range of accelerations and decelerations. In this respect, Marta and colleagues published a review of EMG studies involving the golf swing and they reported that the pectoralis muscle group experienced a great deal of activity during the golf swing movement [Citation29]. Thus, our analytical approach in this styd was to combine a standardized, well-accepted measure of upper-body strength and power (1RM bench press and bench throws) along with a three-dimensional analysis of golf swing performance (described below) to assess the potential impact of nutritional supplementation. After a general warm-up of three to five minutes of light activity consisting of upper body ergometry and static stretching of the involved musculature, the subject performed a warm-up set of ten repetitions with only the bar, followed by eight repetitions at approximately 50% of their estimated 1-RM, followed by one set of three repetitions at 70% of their perceived 1-RM. Thereafter, study participants performed single repetition lifts at progressively increasing loads until 1-RM was determined. No more than five maximal attempts were completed in one testing session.
在第 0 天和第 30 天，使用美国体能协会改编的方案，通过 1-RM 卧推测试估算最大上身肌肉力量 [引文27 ]。由于我们实验室和其他实验室之前的经验表明上半身与下半身测试的可靠性更高，因此本研究中仅评估了上半身力量 [引文28 ]。人们认识到，卧推练习主要作用于矢状面，由此高尔夫挥杆以大范围的加速度和减速度通过多个平面发生。在这方面，Marta 和同事发表了一篇涉及高尔夫挥杆的肌电图研究综述，他们报告说，在高尔夫挥杆运动期间，胸肌群经历了大量的活动[引文29 ]。因此，我们在该研究中的分析方法是将标准化的、广为接受的上身力量和力量测量（1RM 卧推和卧推）与高尔夫挥杆表现的三维分析（如下所述）结合起来，以评估营养补充的潜在影响。经过三到五分钟的轻度活动（包括上身测力和相关肌肉组织的静态拉伸）的一般热身后，受试者只用杠铃进行十次重复的热身，然后以大约 50 米的速度重复八次。他们估计的 1-RM 的 %，然后以他们感知的 1-RM 的 70% 进行一组 3 次重复。 此后，研究参与者以逐渐增加的负荷进行单次重复举重，直到确定 1-RM。在一次测试中完成的最大尝试次数不超过五次。

Upper body power production (average power [AP], average velocity [AV], peak power [PP], peak velocity [PV]) was assessed using the bench press exercise using a Tendo unit interfaced to a standard Smith machine rack. Previous studies have successfully incorporated the use of a Tendo into their study design [Citation30] and Stock and colleagues [Citation31] recently published data to indicate it is a reliable means of assessment. The unit consists of a position transducer that measures the rate of linear displacement providing velocity and acceleration in addition to power production. After 1RM determination, subjects rested for five minutes and completed three sets of three explosive repetitions (i.e. bench throws) with a load equal to 40% of their actual 1-RM on the bench press. Interset rest periods were strictly standardized at 90 seconds each. The reliability of our procedures using these procedures is similar to that previously reported [Citation28,Citation31].
使用连接到标准 Smith 机架的 Tendo 装置进行卧推练习来评估上身力量产生（平均功率 [AP]、平均速度 [AV]、峰值功率 [PP]、峰值速度 [PV]）。先前的研究已成功地将 Tendo 的使用纳入他们的研究设计中 [引文30 ]，Stock 及其同事 [引文31 ] 最近发表的数据表明它是一种可靠的评估手段。该装置由一个位置传感器组成，用于测量线性位移速率，除了发电之外还提供速度和加速度。确定 1RM 后，受试者休息 5 分钟，并完成三组，每组 3 次爆发性重复（即卧推投掷），负载等于其卧推上实际 1-RM 的 40%。场间休息时间严格标准化为每次 90 秒。我们使用这些程序的可靠性与之前报道的相似[引文28 、引文31 ]。

Golf swing performance
高尔夫挥杆表现

On day 1 and day 30, golf swing performance was measured using a three-dimensional (3-D) swing analysis system (TRACKMAN PRO, Brighton, MI) by a NCAA Division I golf coach. Study participants completed a series of 10 successive swings using their 7-iron and driver. Although a wide variety of data is captured with this system (e.g. club delivery, ball launch, flight data) for the purpose of this study we chose to focus on peak and average club head speed, ball speed, as well as average and best distance for each club. Reliability was determined by having five representative participants complete five swings using both the 7-iron and driver clubs. Intraclass correlation coefficient and standard error of measurement using the 7-iron were calculated for ball speed (ICC_3,1: 0.934, SEM: 10.99 miles/hour), club speed (ICC_3,1: 0.991, SEM: 2.42 miles/hour) and total distance (ICC_3,1: 0.862, SEM: 41.74 yards). Identical measurements were made using the driver for ball speed (ICC_3,1: 0.975, SEM: 3.26 miles/hour) , club speed (ICC_3,1: 0.990, SEM: 2.28 miles/hour) and total distance (ICC_3,1: 0.967, SEM: 8.46 yards). All calculations and assumptions were made according to Weir 2005 [Citation32].
在第 1 天和第 30 天，由 NCAA I 级高尔夫教练使用三维 (3-D) 挥杆分析系统（TRACKMAN PRO，布莱顿，密歇根州）测量高尔夫挥杆表现。研究参与者使用 7 号铁杆和一号木杆完成了 10 次连续挥杆。尽管出于本研究的目的，该系统捕获了各种各样的数据（例如球杆传送、球发射、飞行数据），但我们选择关注峰值和平均杆头速度、球速以及平均和最佳距离对于每个俱乐部。可靠性是通过让五名代表参与者使用 7 号铁杆和发球杆完成五次挥杆来确定的。使用 7 号铁杆计算球速（ICC _3,1 ：0.934，SEM：10.99 英里/小时）、球杆速度（ICC _3,1 ：0.991，SEM：2.42 英里/小时）的组内相关系数和标准误差）和总距离（ICC _3,1 ：0.862，SEM：41.74 码）。使用发球杆对球速（ICC _3,1 ：0.975，SEM：3.26 英里/小时）、球杆速度（ICC _3,1 ：0.990，SEM：2.28 英里/小时）和总距离（ICC _{3， 1} ：0.967，SEM：8.46 码）。所有计算和假设均根据 Weir 2005 [引文32 ] 进行。

Qualitative assessments 定性评估

Study participants were asked to maintain their normal patterns of exercise and habitual physical activity. Assessment of physical activity was completed on day 0, day 1 and day 30 using the Yale Physical Activity Survey prior to the study protocol and again on the last day of testing [Citation33]. The Brief Pain Inventory and Quality of Life (SF-12, version 2) were also administered on day 1 and day 30.
研究参与者被要求保持正常的运动模式和习惯性的身体活动。在研究方案之前和测试的最后一天，使用耶鲁体力活动调查在第 0 天、第 1 天和第 30 天完成体力活动评估 [引文33 ]。第 1 天和第 30 天还进行了简短疼痛量表和生活质量（SF-12，第 2 版）。

Dietary intake 膳食摄入量

No dietary restrictions or prescriptions were made as part of this study protocol. Subjects recorded their dietary intake over a three day period (two week days, one weekend day) according to instructions given by a research dietitian on day 0 and day 30. Each subject’s baseline diet was analyzed by NutriBase IX software (CyberSoft, Inc., Phoenix, AZ) to determine average energy and macronutrient content as well as distribution. Additional three-day dietary records were collected and analyzed in an identical fashion at the end of the supplementation protocol (day 30). Twenty-four hours prior to post-testing on day 30, study participants duplicated their dietary intake using diet records from day 0.
作为本研究方案的一部分，没有制定饮食限制或处方。受试者根据研究营养师在第 0 天和第 30 天给出的指示记录他们在三天内（两周，一个周末）的饮食摄入量。每个受试者的基线饮食均通过 NutriBase IX 软件（Cyber​​Soft, Inc.,亚利桑那州菲尼克斯）确定平均能量和常量营养素含量以及分布。在补充方案结束时（第 30 天）以相同的方式收集和分析额外的三天饮食记录。在第 30 天测试后的 24 小时前，研究参与者使用第 0 天的饮食记录复制了他们的饮食摄入量。

Results 结果

Of the 45 people screened for this study, 30 met inclusion criteria and were randomized to the study protocol. Reasons for excluding participants included not achieving an adequate golf handicap score, taking medications for blood pressure and not wanting to cease current supplement use. Of the 30 people randomized into the protocol, three participants were dropped because one did not arrive for post-testing while two others failed to show for their final golf swing performance test. Thus, 27 people completed the study. Descriptive characteristics and baseline demographics are found in Table 
在本研究筛选的 45 人中，有 30 人符合纳入标准，并被随机分配到研究方案中。排除参与者的原因包括未达到足够的高尔夫差点分数、服用血压药物以及不想停止当前的补充剂使用。在随机加入该方案的 30 名参与者中，有 3 名参与者被剔除，因为其中一名参与者没有参加后期测试，另外两名参与者未能参加最终的高尔夫挥杆表现测试。因此，27 人完成了这项研究。描述性特征和基线人口统计数据见表1. No significant differences (p > 0.05) were found at baseline between groups for age, height, body mass, systolic blood pressure, or diastolic blood pressure. Resting heart rate values at baseline tended to be greater in the PLA group (PLA: 67.5 ± 8.4 vs. SD: 61.4 ± 7.4 beats/min, p = 0.052). In response to the intervention, no significant group × time interaction (p > 0.05) effects were revealed for body mass, systolic blood pressure, diastolic blood pressure or resting heart rate.
。基线时，各组之间的年龄、身高、体重、收缩压或舒张压没有发现显着差异（p > 0.05）。 PLA 组的基线静息心率值往往更高（PLA：67.5 ± 8.4 对比 SD：61.4 ± 7.4 次/分钟，p = 0.052）。作为对干预的反应，体重、收缩压、舒张压或静息心率没有显着的组×时间交互作用 (p > 0.05)。

Data from maximal strength and power assessments are found in Table 
最大力量和功率评估的数据见表2. Significant baseline differences (p < 0.05) were found for maximal strength and peak power production during all sets of the bench throws. As a result, ANCOVA was used to determine statistical differences for these variables during post-testing. Both the PLA and SD groups experienced similar significant increases in body mass (data not shown) and 1RM bench press across time (p < 0.001 in both groups) with but no between-group differences were present via ANCOVA (p = 0.86). Using ANCOVA, no between group differences (p > 0.05) were found for peak power production during all sets that were completed (Table 
。在所有组的卧推投掷过程中，发现最大力量和峰值功率产生显着的基线差异（p < 0.05）。因此，ANCOVA 用于确定测试后这些变量的统计差异。 PLA 组和 SD 组的体重（数据未显示）和 1RM 卧推随着时间的推移都经历了相似的显着增加（两组均 p < 0.001），但通过 ANCOVA 未发现组间差异（p = 0.86）。使用 ANCOVA，在完成的所有组中未发现组间峰值功率产生差异 (p > 0.05)（表2). Using 2x2 mixed factorial ANOVA, no significant group × time interaction were found for peak velocity during set 2 and set 3 while the peak velocity tended (p = 0.07) to change for set 1 peak velocity (Table 
）。使用 2x2 混合因子方差分析，在第 2 组和第 3 组期间，未发现峰值速度存在显着的组 × 时间交互作用，而第 1 组峰值速度的峰值速度倾向于 (p = 0.07) 发生变化（表2). Additionally, the SD group experienced a significant within-group increase (delta: 0.079 ± 0.089 miles/hour, p = 0.005; ES = 0.62) in peak velocity during the 1^st set of bench throws. In contrast, within-group changes in the PLA group for peak velocity during set 1 of bench throws were not significant (delta: 0.015 ± 0.086, p = 0.55; ES = 0.11).
）。此外，SD 组在第一^组卧推投掷期间的峰值速度出现显着的组内增加（增量：0.079 ± 0.089 英里/小时，p = 0.005；ES = 0.62）。相比之下，PLA 组在第 1 组卧推投掷期间峰值速度的组内变化并不显着（δ：0.015 ± 0.086，p = 0.55；ES = 0.11）。

Golf performance data are shown in Table 
高尔夫表现数据见表3. Using 2×2 mixed factorial ANOVA, no significant (p > 0.05) group × time interaction effect was found for best 7-iron club speed, best 7-iron ball speed and best 7-iron distance. There was a significant difference at baseline (p < 0.05) in best driver distance, best driver club speed, and best driver ball speed, thus ANCOVA was used to compare post-test values for these variables. No between-group differences were noted for best driver club speed and best driver ball speed, but a significant difference was found for best driver distance (Table 
。使用 2×2 混合因子方差分析，没有发现最佳 7 铁杆速度、最佳 7 铁球速度和最佳 7 铁距离的显着 (p > 0.05) 组 × 时间交互效应。最佳发球距离、最佳发球杆速度和最佳发球速度在基线上存在显着差异（p < 0.05），因此使用 ANCOVA 来比较这些变量的测试后值。最佳发球杆速度和最佳发球速度没有组间差异，但最佳发球距离存在显着差异（表3 and Figure  和图2) and there was a tendency for average driver distance to be different (PLA: 2.7 ± 25.2 vs. SD: 13.6 ± 24.5 yards, p = 0.07). In the SD group, a trend (delta: 13.6 ± 29.0 yards, p = 0.10, ES = 0.75) was identified for best drive distance. No within-group changes were seen in the PLA group for any of the golf performance parameters with the exception of a tendency for an increase in best 7-iron distance (+6.9 ± 13.2 yards, p = 0.08, ES = 0.31).
）并且平均发球距离有不同的趋势（PLA：2.7 ± 25.2 vs. SD：13.6 ± 24.5 码，p = 0.07）。在 SD 组中，确定了最佳开球距离的趋势（增量：13.6 ± 29.0 码，p = 0.10，ES = 0.75）。除了最佳 7 号铁杆距离增加的趋势（+6.9 ± 13.2 码，p = 0.08，ES = 0.31）之外，PLA 组的任何高尔夫表现参数均未出现组内变化。

Figure 2 Best distance using driver for placebo = PLA (black bars) and Strong Drive = SD (white bars). § = Significant group differences using ANCOVA (p = 0.04) with respective baseline scores as the covariate due to significant differences between groups at baseline.
图 2使用驱动器的最佳距离：安慰剂 = PLA（黑条），强驱动 = SD（白条）。 § = 使用 ANCOVA (p = 0.04) 并以相应基线分数作为协变量的显着组差异，因为各组之间在基线时存在显着差异。

Display full size 显示全尺寸

No significant group × time interaction effects were revealed for the following blood variables (Table 
对于以下血液变量，未发现显着的组×时间交互效应（表4): red blood cell count, hemoglobin, hematocrit, glucose, blood urea nitrogen (BUN), creatinine, BUN: creatinine, sodium, potassium, chloride, carbon dioxide, calcium, total protein, albumin, globulin, albumin: globulin, bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, HDL cholesterol, VLDL cholesterol, LDL cholesterol, vitamin D (25-hydroxy D) and C-reactive protein. Only a small number of blood variables experienced changes or seemed to exhibit within-group changes over time. In all situations, the magnitude of change was within clinically accepted normative ranges for these variables. Specifically, in the SD group significant changes (p < 0.05) were noted in diastolic blood pressure, carbon dioxide, and total cholesterol while in the PLA group significant changes were noted in sodium, potassium, and glucose. Both groups experienced significant changes in total protein, globulin, and albumin: globulin ratio. No significant group × time interaction effects were reported for any of the pain indices, physical activity or enjoyment scales (Table 
）：红细胞计数、血红蛋白、血细胞比容、葡萄糖、血尿素氮（BUN）、肌酐、BUN：肌酐、钠、钾、氯化物、二氧化碳、钙、总蛋白、白蛋白、球蛋白、白蛋白：球蛋白、胆红素、碱性磷酸酶、丙氨酸转氨酶、天冬氨酸转氨酶、总胆固醇、甘油三酯、HDL胆固醇、VLDL胆固醇、LDL胆固醇、维生素D（25-羟基D）和C反应蛋白。随着时间的推移，只有少数血液变量经历了变化或似乎表现出组内变化。在所有情况下，这些变量的变化幅度均在临床可接受的标准范围内。具体来说，在 SD 组中，舒张压、二氧化碳和总胆固醇发生了显着变化（p < 0.05），而在 PLA 组中，钠、钾和葡萄糖发生了显着变化。两组的总蛋白、球蛋白和白蛋白：球蛋白比率均发生显着变化。对于任何疼痛指数、体力活动或享受量表，均未报告显着的组×时间交互效应（表5, p > 0.05). ，p > 0.05）。

Discussion 讨论

Golf is a unique sport that requires a challenging combination of physical, mental and emotional attributes. Nutritional formulations developed to enhance these attributes are lacking, but multiple ingredients are available that have been examined scientifically which may improve golfing performance. The primary findings from the present study were that, over a 4-week period of supplementation, a blend of ingredients found in SD (e.g. creatine monohydrate, coffea arabica fruit extract [CoffeeBerry®], calcium fructoborate [FruiteX-B®], and vitamin D) significantly increased best drive distance and tended to improve average driver distance (p = 0.07) more so than the placebo group. In addition, both groups experienced significant improvements in bench press strength while the SD also experienced significant improvements in peak power and peak velocity production after the first set of bench press throws while no such changes were observed in the placebo group. Supplementation was well tolerated and no safety concerns/side effects were noted.
高尔夫是一项独特的运动，需要身体、心理和情感属性的具有挑战性的结合。目前还缺乏为增强这些属性而开发的营养配方，但有多种经过科学检验的成分可以改善高尔夫表现。本研究的主要发现是，在 4 周的补充期间，SD 中发现的多种成分的混合物（例如一水肌酸、阿拉比卡咖啡果提取物 [CoffeeBerry®]、果硼酸钙 [FruiteX-B®] 和维生素 D）显着增加了最佳驾驶距离，并且比安慰剂组更能改善平均驾驶距离 (p = 0.07)。此外，在第一组卧推投掷后，两组的卧推力量都经历了显着改善，而 SD 组的峰值功率和峰值速度也经历了显着改善，而安慰剂组则没有观察到此类变化。补充剂的耐受性良好，没有发现安全问题/副作用。

Although this study was not designed to determine the mechanisms underpinning any observed changes with SD supplementation, one or more of the ingredients in the formula were likely responsible for the observed changes. For example, a number of previous investigations using creatine monohydrate at the dosage provided in this study (10 grams/day × first two weeks, 5 grams/day × last two weeks) have routinely reported improvements in strength, upper-body performance, power and overall exercise capacity [Citation3,Citation7]. Thus, even though we did not collect muscle phosphagen data it is likely that the observed non-significant improvements in upper-body power and velocity primarily stemmed from the creatine monohydrate contained in SD. Future studies should utilize three groups to confirm this hypothesis (i.e. placebo vs. SD formula vs. creatine control).
尽管这项研究的目的不是确定补充 SD 后观察到的任何变化的机制，但配方中的一种或多种成分可能是造成观察到的变化的原因。例如，之前的许多研究均按本研究中提供的剂量（10 克/天 × 前两周，5 克/天 × 最后两周）进行一水肌酸的研究，通常报告了力量、上半身表现、爆发力的改善。和整体运动能力[引文3 ，引文7 ]。因此，即使我们没有收集肌肉磷酸原数据，观察到的上半身力量和速度的非显着改善很可能主要源于 SD 中含有的一水肌酸。未来的研究应利用三组来证实这一假设（即安慰剂、SD 配方与肌酸对照）。

Another potential candidate for performance enhancement in the SD formula is caffeine. As a dietary supplement, caffeine has successfully been used for years at doses of 3–6 mg/kg of body mass to improve both cognitive and physical aspects of exercise performance [Citation10,Citation11]. In the present study, no assessments of focus or concentration were made to evaluate changes as a result of supplementation because of the relatively low dose of caffeine in the test product (i.e. 50 mg or ~ 0.6 mg/kg body mass for these subjects). In addition, the last dose of SD (or placebo) was taken 24-hours prior to day 30 testing. Thus, we consider it unlikely that the caffeine contained in the coffea arabica fruit extract (CoffeeBerry®) of SD played a major role in the results. It is worth mentioning we cannot completely discount the potential effects that other unique ingredients in CoffeeBerry® (e.g., various chlorogenic acids and plant phenolics), may have had on these results.
SD 配方中另一种可以提高成绩的潜在候选者是咖啡因。作为膳食补充剂，咖啡因多年来已成功地以 3-6 毫克/公斤体重的剂量使用，以改善运动表现的认知和身体方面[引文10 、引文11 ]。在本研究中，由于测试产品中咖啡因的剂量相对较低（即这些受试者的咖啡因剂量为 50 毫克或约 0.6 毫克/千克体重），因此没有对焦点或浓度进行评估来评估补充后的变化。此外，最后一剂 SD（或安慰剂）是在第 30 天测试前 24 小时服用的。因此，我们认为 SD 的阿拉比卡咖啡果提取物 (CoffeeBerry®) 中所含的咖啡因不太可能在结果中发挥主要作用。值得一提的是，我们不能完全忽视 CoffeeBerry® 中其他独特成分（例如各种绿原酸和植物酚类）可能对这些结果产生的潜在影响。

Finally, data surrounding boron and vitamin D continue to lend support towards these nutrients and their ability to mitigate pain [Citation20] as well as improve bone [Citation21] and muscle health [Citation23]. Findings from the present study did not reveal improved outcomes associated with self-reported pain, fatigue or weakness levels as assessed before and after the four week supplementation period. We speculate that the primary reason for these findings was associated with the existing joint and bone health of our study participants. For example, our study participants were otherwise healthy, middle-aged men who golfed on a regular basis and as a result were maintaining a basic level of physical activity. When compared to the study participants in other published trials showing improvements in self-reported pain [Citation19–Citation21,Citation24], participants from the present study were younger, healthier and had minimal baseline levels of pain. The lack of change found in serum levels of 25-hydroxy vitamin D as a result of supplementation was not entirely unexpected. Given the moderate dose (1,000 IU/day), the time of year the study was conducted (late Fall), and general latitude of the study location (Kent, OH = 41.15^° N), it is our contention that the majority of supplemented vitamin D was quickly absorbed by peripheral tissues.
最后，有关硼和维生素 D 的数据继续支持这些营养素及其减轻疼痛 [引文20 ] 以及改善骨骼 [引文21 ] 和肌肉健康 [引文23 ] 的能力。本研究的结果并未显示与自我报告的疼痛、疲劳或虚弱水平相关的改善结果（在四个星期的补充期之前和之后进行评估）。我们推测这些发现的主要原因与研究参与者现有的关节和骨骼健康有关。例如，我们的研究参与者都是健康的中年男性，他们经常打高尔夫球，因此保持了基本的身体活动水平。与其他已发表试验中自我报告的疼痛有所改善的研究参与者相比[引文19 -引文21 、引文24 ]，本研究的参与者更年轻、更健康，并且基线疼痛水平最低。补充后发现血清 25-羟基维生素 D 水平没有变化并不完全出乎意料。考虑到中等剂量（1,000 IU/天）、研究进行的时间（秋末）以及研究地点的一般纬度（俄亥俄州肯特郡 = 41.15 ^° N），我们认为大多数补充维生素D很快被周围组织吸收。

From an adverse event and/or clinical safety perspective, the SD supplement was well tolerated with no significant group × time interactive changes in any of the measured clinical markers (Tables 
从不良事件和/或临床安全的角度来看，SD补充剂具有良好的耐受性，任何测量的临床标志物均未出现显着的组×时间交互变化（表4 and  和5). A few variables did experience significant within-group changes (e.g., diastolic blood pressure, glucose, sodium, potassium, carbon dioxide, albumin: globulin ratio, total protein and globulin, etc.), but in all such circumstances, both groups changes remained within clinical accepted normative values.
）。一些变量确实经历了显着的组内变化（例如，舒张压、葡萄糖、钠、钾、二氧化碳、白蛋白：球蛋白比率、总蛋白和球蛋白等），但在所有这些情况下，两组变化仍然存在在临床接受的标准值范围内。

The strengths of the present study are that it was a double-blind, placebo-controlled investigation using a “free-living” approach. Thus, the findings are applicable to many consumers who golf but do not follow a rigid diet or exercise program. To date, extremely limited research is available exploring the potential impact of various nutritional agents on golf performance, with one of the only published accounts reporting an improvement in stress hormone levels and shot-making after phosphatidylserine supplementation [Citation2]. The disadvantages of the present study primarily revolve around the pilot nature of the investigation and the lack of female subjects. The authors recognize that the relatively small number of subjects and short supplementation period (4 weeks) likely hindered the ability to uncover significant effects in some outcome measures, particularly since the participants were relatively young and healthy and were not required to follow a particular exercise training program or dietary regimen. It is also important to discuss other considerations related to our data and findings. For example, the positive outcome surrounding best drive distance is likely impacted by a number of other factors that we weren’t able to be measured in our study design including, but not limited to: club head acceleration at the point of impact with the ball, club head deceleration through the zone of impact, rotational power, improved accuracy of club head placement relative the ball, club face angle at ball strike, and musculoskeletal range of motion. Two additional factors are upper-body strength and power that were measured in the present study by determining bench press 1RM and sagittal plane power development during bench press throws. The authors recognize that performance of the bench press exercise may be viewed by some as having very little carryover to golf swing performance, but these parameters were chosen due to their high reliability of measurement and as being valid and commonly used measures of maximal strength and power in the sports science literature. Additionally, it is important to highlight that Marta and colleagues indicate that the pectoralis major, deltoid, and latissimus dosi are the most active muscle groups during the golf swing movement, particularly during the acceleration phase [Citation29]. A three-dimensional analysis of golf swing performance using two common clubs was employed as a measurement method of golfing performance. While much more practical, this measurement method only reports on final performance and thus does not allow for a clearer understanding of what aspects of performance SD may have improved according to our findings, particularly as they relate to best drive distance. In this respect, it is important for the reader to understand other factors may have impacted our observed outcomes related to best driver distance.
本研究的优点在于，这是一项采用“自由生活”方法的双盲、安慰剂对照研究。因此，这些发现适用于许多打高尔夫球但不遵循严格饮食或锻炼计划的消费者。迄今为止，探索各种营养剂对高尔夫表现的潜在影响的研究极其有限，仅有的一份已发表的报告报告称，补充磷脂酰丝氨酸后，应激激素水平和击球效果有所改善[引文2 ]。本研究的缺点主要在于调查的试点性质和缺乏女性受试者。作者认识到，受试者数量相对较少和补充周期较短（4 周）可能阻碍了发现某些结果指标的显着影响的能力，特别是因为参与者相对年轻和健康，并且不需要遵循特定的运动训练计划或饮食方案。讨论与我们的数据和发现相关的其他考虑因素也很重要。例如，围绕最佳开球距离的积极结果可能会受到我们在研究设计中无法测量的许多其他因素的影响，包括但不限于： 与球撞击时的球杆头加速度、通过冲击区域的球杆头减​​速、旋转功率、改进的球杆头相对于球的放置精度、击球时的球杆面角度以及肌肉骨骼的运动范围。 另外两个因素是上身力量和力量，在本研究中通过确定卧推 1RM 和卧推投掷过程中矢状面力量的发展来测量。作者认识到，有些人可能认为卧推练习的表现对高尔夫挥杆表现影响很小，但之所以选择这些参数，是因为它们的测量可靠性高，并且是有效且常用的最大力量和爆发力测量方法在体育科学文献中。此外，需要强调的是，Marta 和同事指出，胸大肌、三角肌和背阔肌是高尔夫挥杆运动过程中最活跃的肌肉群，特别是在加速阶段 [引文29 ]。采用使用两个普通球杆对高尔夫挥杆性能进行三维分析作为高尔夫性能的测量方法。虽然更实用，但这种测量方法仅报告最终性能，因此无法更清楚地了解根据我们的发现，SD 性能的哪些方面可能有所改进，特别是因为它们与最佳驾驶距离相关。在这方面，读者必须了解其他因素可能会影响我们观察到的与最佳驾驶距离相关的结果。

Conclusions 结论

This preliminary investigation yielded significantly greater improvements in best drive distance (~13.6 yards) and a tendency for average driver distance to improve in healthy male golfers consuming SD for four weeks. Careful interpretation of these data is encouraged due to their preliminary nature and need to be followed-up with a larger and longer investigation.
这项初步调查显示，健康男性高尔夫球手服用 SD 4 周后，最佳开球距离（约 13.6 码）有了显着改善，平均开球距离也有改善的趋势。由于这些数据的初步性质，因此鼓励对这些数据进行仔细解释，并需要进行更大规模、更长期的调查来跟进。