{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:30:36Z","timestamp":1787646636734,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Caffeine is widely used in sport and exercise because of its established ergogenic effects, yet problematic use, dependence, and withdrawal in athletic populations remain poorly characterized. This structured narrative review used a systematic database search and prespecified selection process to identify studies directly addressing problematic caffeine use, dependence, use disorder, withdrawal, tolerance, habituation, or misuse in sport- and exercise-related populations. PubMed, Web of Science Core Collection, and Scopus were searched from inception to 15 June 2026. Four studies met the eligibility criteria: one cross-sectional study of caffeine dependence in university sport students, two experimental withdrawal studies, and one historical analysis of caffeine use and misuse in competitive cyclists. The evidence suggests that questionnaire-assessed dependence-related features, anxiety, self-reported withdrawal symptoms, withdrawal status, habitual intake, and performance may be interconnected; however, the studies were heterogeneous and generally did not use diagnostic assessments of caffeine use disorder. Athlete-specific prevalence and risk factors therefore remain unknown. Current evidence is insufficient for firm clinical or epidemiological conclusions, but it identifies an important gap between widespread ergogenic caffeine use and limited research on loss of control, continued use despite harm, withdrawal-driven use, and functional impairment. Standardized, athlete-specific research is urgently needed.<\/jats:p>","DOI":"10.3390\/nu18172770","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:00:48Z","timestamp":1787644848000},"page":"2770","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Ergogenic Effects: Limited Evidence on Caffeine-Related Problematic Use, Dependence, and Withdrawal in Athletic Populations\u2014A Structured Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6706-5373","authenticated-orcid":false,"given":"Haowei","family":"Liu","sequence":"first","affiliation":[{"name":"School of Sports Training, Chengdu Sport University, Chengdu 641418, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-9153","authenticated-orcid":false,"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University, 70182 Orebro, Sweden"},{"name":"Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-9123","authenticated-orcid":false,"given":"Guodong","family":"Zhang","sequence":"additional","affiliation":[{"name":"International College, Krirk University, Bangkok 10220, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Physical Education, Sichuan Agricultural University, Ya\u2019an 625014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/0265203021000007840","article-title":"Effects of caffeine on human health","volume":"20","author":"Nawrot","year":"2003","journal-title":"Food Addit. Contam."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"R77","DOI":"10.1111\/j.1750-3841.2010.01561.x","article-title":"Caffeine (1,3,7-trimethylxanthine) in Foods: A Comprehensive Review on Consumption, Functionality, Safety, and Regulatory Matters","volume":"75","author":"Heckman","year":"2010","journal-title":"J. Food Sci."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Rodak, K., Kokot, I., and Kratz, E.M. (2021). Caffeine as a Factor Influencing the Functioning of the Human Body\u2014Friend or Foe?. Nutrients, 13.","DOI":"10.3390\/nu13093088"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bevilacqua, E., Cruzat, V., Singh, I., Rose\u2019Meyer, R.B., Panchal, S.K., and Brown, L. (2023). The Potential of Spent Coffee Grounds in Functional Food Development. Nutrients, 15.","DOI":"10.3390\/nu15040994"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Contreras-Barraza, N., Madrid-Casaca, H., Salazar-Sep\u00falveda, G., Garcia-Gordillo, M.\u00c1., Adsuar, J.C., and Vega-Mu\u00f1oz, A. (2021). Bibliometric Analysis of Studies on Coffee\/Caffeine and Sport. Nutrients, 13.","DOI":"10.3390\/nu13093234"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0031-6997(24)01396-6","article-title":"Actions of caffeine in the brain with special reference to factors that contribute to its widespread use","volume":"51","author":"Fredholm","year":"1999","journal-title":"Pharmacol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.neubiorev.2016.09.001","article-title":"A review of caffeine\u2019s effects on cognitive, physical and occupational performance","volume":"71","author":"McLellan","year":"2016","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1519\/JSC.0b013e3181660cec","article-title":"Caffeine use in sports: Considerations for the athlete","volume":"22","author":"Armstrong","year":"2008","journal-title":"J. Strength Cond. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1139\/H08-130","article-title":"Caffeine and sports performance","volume":"33","author":"Burke","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1519\/JSC.0b013e31818b979a","article-title":"Effect of caffeine on sport-specific endurance performance: A systematic review","volume":"23","author":"Ganio","year":"2009","journal-title":"J. Strength Cond. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1139\/h11-052","article-title":"Prevalence of caffeine use in elite athletes following its removal from the World Anti-Doping Agency list of banned substances","volume":"36","year":"2011","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Banach, M., and Surma, S. (2025). Coffee Addiction: Is it Real?. The Link Between Coffee and Health, Springer Nature Switzerland.","DOI":"10.1007\/978-3-031-93459-9"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s40429-014-0024-9","article-title":"Caffeine Use Disorder: A Review of the Evidence and Future Implications","volume":"1","author":"Addicott","year":"2014","journal-title":"Curr. Addctn. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugalcdep.2008.08.001","article-title":"Caffeinated energy drinks\u2014A growing problem","volume":"99","author":"Reissig","year":"2009","journal-title":"Drug Alcohol Depend."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing. [5th ed.]. Text Revision.","DOI":"10.1176\/appi.books.9780890425787"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1089\/jcr.2013.0016","article-title":"Caffeine use disorder: A comprehensive review and research agenda","volume":"3","author":"Meredith","year":"2013","journal-title":"J. Caffeine Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1089\/caff.2019.0020","article-title":"Prevalence and correlates of caffeine use disorder symptoms among a United States sample","volume":"10","author":"Sweeney","year":"2020","journal-title":"J. Caffeine Adenosine Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"EFSA Panel on Dietetic Products, and Allergies, N. (2015). Scientific opinion on the safety of caffeine. EFSA J., 13, 4102.","DOI":"10.2903\/j.efsa.2015.4102"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.01.006","article-title":"Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials","volume":"31","author":"Clark","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Temple, J.L., Bernard, C., Lipshultz, S.E., Czachor, J.D., Westphal, J.A., and Mestre, M.A. (2017). The Safety of Ingested Caffeine: A Comprehensive Review. Front. Psychiatry, 8.","DOI":"10.3389\/fpsyt.2017.00080"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.fct.2017.04.002","article-title":"Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children","volume":"109","author":"Wikoff","year":"2017","journal-title":"Food Chem. Toxicol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"A5","DOI":"10.1016\/j.jclinepi.2021.04.008","article-title":"PRISMA 2020","volume":"134","author":"Tugwell","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_23","first-page":"emermed-2020-209567","article-title":"Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews","volume":"37","author":"Janati","year":"2020","journal-title":"Emerg. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.envint.2018.07.015","article-title":"Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes","volume":"121","author":"Morgan","year":"2018","journal-title":"Env. Int."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Li, H., Yang, Y., Liu, Q., Liu, L., Zhang, G., Zhang, X., Yin, M., and Cao, Y. (2024). The Effects of Caffeine on Exercise in Hot Environments: A Bibliometric Study. Nutrients, 16.","DOI":"10.3390\/nu16213692"},{"key":"ref_26","unstructured":"Singh, A., Singh, A., Kaur, S., Kaur, J., Kant, S., Singh, K., Singh, J., Singh, K., and Kaur, P. (2026). Anxiety as a mediator between caffeine dependence and simple reaction time in college sport students. J. Drug Alcohol Res., 15."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1080\/02640414.2010.541480","article-title":"Caffeine withdrawal and high-intensity endurance cycling performance","volume":"29","author":"Irwin","year":"2011","journal-title":"J. Sports Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1152\/jappl.1998.85.3.883","article-title":"Effect of caffeine on metabolism, exercise endurance, and catecholamine responses after withdrawal","volume":"85","author":"Graham","year":"1998","journal-title":"J. Appl. Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1055\/s-2008-1025901","article-title":"Caffeine: Use and abuse in sports","volume":"5","author":"Delbeke","year":"1984","journal-title":"Int. J. Sports Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1123\/ijsnem.2018-0020","article-title":"IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete","volume":"28","author":"Maughan","year":"2018","journal-title":"Int. J. Sport Nutr. Exerc Metab."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Committee on Nutrition and the Council on Sports Medicine and Fitness (2011). Sports drinks and energy drinks for children and adolescents: Are they appropriate?. Pediatrics, 127, 1182\u20131189.","DOI":"10.1542\/peds.2011-0965"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/1941738120949181","article-title":"Energy Drinks and Their Adverse Health Effects: A Systematic Review and Meta-analysis","volume":"13","author":"Nadeem","year":"2021","journal-title":"Sports Health"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2770\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:06:13Z","timestamp":1787645173000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":32,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18172770"],"URL":"https:\/\/doi.org\/10.3390\/nu18172770","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]}}}