The Impact of Lepidium Meyenii (MACA) Supplementation on Basketball-related Performance and Anti-fatigue Ability: a Double Blind Crossover Study
Phase: NA
Conditions: Sports
Sponsor: National Taiwan Sport University

1 
 
The impact of Lepidium meyenii (MACA) supplementation on basketball-related performance 
and anti-fatigue ability: a double blind crossover study 
Document Date: January 30, 2024 
Project summary 
Supplementation with Lepidium meyenii (MACA) has been shown in animal studies to increase blood 
lactate clearance and rapid lactate removal, which may be effective in reducing fatigue during 
intermittent exercise. However, no studies have investigated the effects of MACA supplementation on 
interval exercise and basketball performance. We hypothesized that MACA supplementation could 
reduce fatigue and improve performance in elite healthy male basketball players. This study aimed to 
determine the effectiveness of MACA compared to placebo on overall basketball performance.In this 
randomized crossover study, ten elite healthy male basketball players were included. Following a 
17:00 PM training routine, participants completed a two-week supplementation with 2000 mg of 
MACA or placebo. After supplementation, participants underwent a Basketball Jump Shooting 
Accuracy Test and Repeated Sprint Ability Test.  
General information  
Protocol title: The impact of Lepidium meyenii (MACA) supplementation on basketball-related 
performance and anti-fatigue ability: a double blind crossover study (Date: 30/01/2024; ID: NA)  

2 
 
Funder: This study was not funded by any organization. 

3 
 
INTRODUCTION.  
1 
Lepidium meyenii (MACA) is a Peruvian cruciferous vegetable growing more than 4000 m and 
2 
cultivated for over 2000 years (1). Traditionally, the Andean people used MACA as food or medicine 
3 
(2). They believed consumption of MACA improves stamina and strength (1). In the 13th century, Inca 
4 
consumed MACA prior to entering battle to increase their energy (3). Now the MACA has attracted 
5 
interest as a dietary supplement because of its potential positive effects on physical and sexual activity 
6 
(4).  
7 
Several studies have been conducted to examine its biological activity, and have shown increased 
8 
endurance capacity and protection against exercise-induced oxidative stress (5-7). In animal 
9 
experiments, supplementation with MACA was found to improve endurance exercise capacity and 
10 
enhance clearance of metabolites such as blood lactate in mice (8-11). However, we found that most 
11 
scientific research on the biological activity of MACA in humans has focused on improving sexual 
12 
performance or fertility (12). To date, one study has demonstrated that 14 days of MACA 
13 
supplementation improved 40km time trial performance and libido in trained male cyclists (7). 
14 
Therefore, more well-designed, randomized, placebo-controlled studies are needed to assess the effect 
15 
of MACA supplementation on the clearance of blood lactate and specific exercise performance.  
16 
Basketball players perform a range of technical skills during the game, including speed, agility, 
17 
anaerobic capacity, vertical jumping ability, and game-specific skills. This high-intensity interval 
18 
exercise has been found to increase the accumulation of lactic acid in the blood and lead to induced 
19 

4 
 
fatigue (13-15). In animal studies, MACA supplementation has been demonstrated to increase the 
20 
clearance of blood lactate (10, 16). However, no studies have examined the effects of MACA on 
21 
basketball-related performance and lactate clearance in basketball players. We hypothesized that 
22 
MACA supplementation could reduce fatigue and improve performance in trained healthy male 
23 
basketball players, and aimed to determine the effectiveness of MACA compared to placebo in overall 
24 
basketball performance. 
25 
 
26 
METHODS 
27 
Study Design 
28 
   The study used a double blind, randomized controlled, crossover, repeated measures, placebo 
29 
(control) trial design. Participants were randomized on a 1:1 basis to supplement daily with MACA 
30 
(MC)or placebo (PL) for two weeks before sport performance tests, and separated by 14 days. 
31 
Randomization was performed using a permuted block design with a computer random number 
32 
generator by a research assistant not involved in any other aspect of the study. All researchers and those 
33 
involved in outcome assessments (i.e. basic data collection, individuals performing sport performance 
34 
tests, data entry, and analyses) were blinded to group assignments. The study was approved by the 
35 
Institutional Review Board of Jen-Ai Hospital - Dali Branch (JCH-IRB 111-24). Participants were 
36 
informed of the risks and purposes of the study before written consent was obtained. The study 
37 

5 
 
complied with the World Medical Association Declaration of Helsinki–Ethical Principles for Medical 
38 
Research Involving Human Participants. We adhered to the Consolidated Standards of Reporting Trials 
39 
(CONSORT) guidelines for reporting on randomized clinical trials (17). 
40 
Participants 
41 
We recruited ten healthy male trained basketball players (age: 20.1 ± 0.3 year; body mass: 79.2 ± 11.1 
42 
kg; height: 181.9 ± 6.0 cm; body fat: 12.6 ± 6.0%). The sample size computation was based on the 
43 
study by Mark Stone (7). It revealed a significant improvement (p=0.01) in time to complete 40km 
44 
from baseline to post supplementation in the MACA trial with only 8 subjects (7). All participants were 
45 
college elite basketball players competing in a Taiwan university basketball association who 
46 
voluntarily participated in this study. The inclusion criteria were: (i) healthy male adults, those 
47 
individuals who are free of pain, insomnia, or other injuries recently, without any medication used in 
48 
recent 2 months, (ii) basketball players competing in a Taiwan university basketball association for 
49 
more than two years. Interested participants were excluded if they: (i) were below 20 years old, (ii) did 
50 
not have won at least eighth place in national-level basketball competitions, (iii) were with 
51 
cardiovascular diseases or any disease that made subjects feel ill. All exclusion criteria were 
52 
determined by interview.  
53 
 
54 
Study Setting 
55 
All the study was conducted in the indoor basketball stadium at the National Taiwan University of 
56 
Sport. We control the temperature and humidity of the basketball stadium via the air conditioner. The 
57 
study commenced in June 2022 and supplementation and sport performance tests were completed in 
58 
September 2022. 
59 

6 
 
Protocol 
60 
Experimental procedure 
61 
Participants completed a supplementation period of two weeks during which they were provided 
62 
with 2000mg of either MACA (MacaPro@ Gelatinized Maca Powder, Lytone, Taipei, Taiwan) or a 
63 
Placebo (100% corn-starch maltodextrin powder) after the daily training at 17:00 pm (7). The MACA 
64 
supplement is derived from a concentrated 6:1 blend of black, red, and yellow MACA root compounds, 
65 
with an 80:15:5 ratio respectively. The chemical composition of the MACA supplement, an extract 
66 
consists of macamides as discussed in Zheng et al. (18). The plant name has been checked with “World 
67 
Flora Online” (www.worldfloraonline.org). A ccording to the ingredient information of this product, 
68 
no other ingredients are mentioned, it is a purified extract powder. This company is a major 
69 
manufacturer of MACA. The main components of MACA have been analyzed by ultrahigh-
70 
performance liquid chromatography (HPLC) (19). The MACA supplement or Placebo were supplied 
71 
as orange-white capsules with the same appearance. After the supplement was given, the subject would 
72 
be confirmed to have finished taking it. The subjects were asked to record the dietary status for three 
73 
days since three days before each testing session to make sure the same diet was consumed, and 
74 
educated the subjects to avoid eating or drinking irritating food and taking any form of health 
75 
supplements or ergogenic agents until the end of the experiment, and ensured that ingesting the same 
76 
diet and avoiding strenuous exercise on the day before the next experiment. 
77 

7 
 
During the two weeks of the supplementation process, the subjects were asked about their usage 
78 
status and physical condition every day. If they felt any discomfort or took other medications, they 
79 
immediately stopped administering the supplements and then continued to observe and record the 
80 
participants’ physical condition and were excluded from the trial. They were replaced with different 
81 
participants. All ten athletes completed the entire protocol without adverse events after MACA 
82 
supplementation. 
83 
Three days before the test, we asked the participants to record their diet and to consume the same 
84 
diet at the same time in the next experiment. On the day of the experiment, we used photographs to 
85 
record the breakfast and lunch consumed by the participants and asked the participants to repeat the 
86 
same meals in the second experiment. The nutritional composition of breakfast and lunch was 
87 
11.9±2.4% protein, 41.6±16.7% carbohydrate, 26.8±6.1% lipid, and 1353.6±135.4 kcal. 
88 
After two weeks of the supplement, participants begin formal experimentation after arriving at 
89 
the basketball stadium at 15:00 p.m. First, the participants were asked to lie on a bench for 10 minutes 
90 
with a heart rate monitor (Polar, Finland). After 10 minutes resting, the pre-exercise blood lactate level 
91 
was collected by the nurses. The disposable pen needle was used for blood collection, and 75% alcohol 
92 
was used to sterilize the puncture site and the fingertips. 
93 
They performed two identical warm-up exercises and three court-based fitness tests: (1) 
94 
countermovement jump test, (2) Basketball Jump Shooting Accuracy Test and, (3) Interval sprint 
95 
training. All outcome measures presented acceptable test-retest reliability (20-23). During the test, 
96 
participants then provided ratings of perceived performance and perceived exertion (RPE) using 10-
97 

8 
 
point Likert scales (with 1 indicating a minimum response and 10 indicating a maximum response). 
98 
Capillary blood samples were collected to assess the blood lactate concentration before and after the 
99 
interval sprints test. All testing sessions were completed with a period of rest of at least 14 days for 
100 
complete recovery and MACA wash-out.  
101 
 
102 
Countermovement jump test 
103 
The countermovement jump test is performed using GymAware (GymAware, Kinetic 
104 
Performance Technology, Canberra, Australia) equipment (24). The participants first stands in front of 
105 
the instrument with his feet shoulder-width apart, crosses his arms and squats down quickly until his 
106 
thighs are parallel to the ground then immediately jumped upward as high as they could. Three jumps 
107 
were measured with 1 minute rest for each participant. The mean height of the three jumps was 
108 
obtained. 
109 
 
110 
Basketball Jump Shooting Accuracy Test 
111 
The first test was the basketball jump shooting Accuracy Test (BJSAT), which has been used in 
112 
the past with sufficient reliability to two and three-point shooting accuracy (22). All athletes were given 
113 
a demonstration and performed a 2-min shooting warm-up from the shot locations. They were 
114 
instructed to attempt four shots with an even spread from the left and right sides of the court and from 
115 
two- and three-point distance. In total, the test consisted of 8 x jump shot attempts at predetermined 
116 
locations on the court. The shot order for the BJSAT ensured that athletes alternate between two-point 
117 

9 
 
and three-point distances and do not take consecutive jump shots from either distance throughout the 
118 
test. All shots were attempted with athletes placing both feet within a marked area at each shot location 
119 
(60 cm x 60 cm). If an athlete attempted a jump shot with one or both feet outside of the marked area, 
120 
the athlete continued the trial; however verbal instruction was given immediately to ensure both feet 
121 
were placed within the marked area for the remaining shot attempts. The scoring methods is shown in 
122 
Table 1. The male athletes used standard size 7 basketballs.  
123 
 
124 
Table 1. Scoring criteria for the Basketball Jump Shooting Accuracy Test. 
125 
Score 
Description 
3 
The basketball passes through the basket without touching the rim 
or backboard. 
2 
The basketball make contact with the rim or backboard before 
passing through the basket. 
1 
The basketball makes contact with the rim or backboard, but does 
not pass through the basket. 
0 
The basketball does not come in contact with the rim or backboard 
and does not pass through the basket. 
 
126 
Repeated Sprint Ability Test 
127 
After the 10 minutes rest and recovery, the participants perform the next test of Repeated Sprint 
128 
Ability test (40× 15m with a 1:4, exercise : rest time ratio, such as 2 seconds :8 seconds) (24). This 
129 
test has been proven to reflect the sprinting ability of basketball players (25). Sprint direction was 
130 
alternated for each sprint so the finish became the start for each consecutive sprint. There were several 
131 

10 
 
types of repeat sprints test protocols. Half court, multiple change of direction protocol may not a typical 
132 
repeat sprint test method, but it’s a routine of their daily basketball training in Taiwan. Previous studies 
133 
within the field have reported that familiarization is a crucial component as athletes typically find a 
134 
preferable movement repertoire that enables them to achieve their best result (26). 
135 
 
136 
The lactate clearance rate 
137 
Between every 10 sprints, the participants walked back to the start point and rested. The capillary 
138 
blood lactate, mean heart rate and RPE were measured after completion of each 10 times repeated 
139 
sprint ability protocol. After full completion and resting in standing position for 5 minutes, the capillary 
140 
blood lactate was taken and analyzed to measure the lactate clearance rate. The lactate clearance rate 
141 
was calculated using the equation: Decreased percentage (%) = [(data during recovery period - data at 
142 
exhaustion) / data at exhaustion ] × 100%. Finally, three vertical jump tests were measured after the 
143 
whole test to be used as indicators of neuromuscular fatigue in the legs. 
144 
 
145 
Statistical Analysis 
146 
Data analysis was performed using SPSS software (version 20, Chicago, IL, USA).  A 
147 
descriptive analysis was performed using means and standard deviations. Normality of distribution 
148 
was tested using the Shapiro-Wilk test. A two-way ANOVA Paired t-test was used to assess the 
149 
differences in every 10 times repeated sprints, mean heart rate and RPE between MACA group and 
150 

11 
 
placebo trials. Paired t-test was used to assess the differences in the Fatigue index, BJSAT score and 
151 
lactate clearance rate. The statistical power was s performed using G*Power software package (Version 
152 
3.1.9.4, Kiel University). Statistical significance was set at p < 0.05. 
153 
 
154 
 
 
155 

12 
 
References 
156 
1. 
Maca.  LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda 
157 
(MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012. 
158 
2. 
Gonzales GF, Gonzales C, Gonzales-Castaneda C. Lepidium meyenii (Maca): a plant from the 
159 
highlands of Peru–from tradition to science. Complementary Medicine Research. 2009;16(6):373-
160 
80. 
161 
3. 
Hermann M. Andean roots and tubers: ahipa, arracacha, maca and yacon: International Potato 
162 
Center; 1997. 
163 
4. 
Gonzales GF, Gonzales C, Gonzales-Castañeda C. Lepidium meyenii (Maca): a plant from the 
164 
highlands of Peru--from tradition to science. Forsch Komplementmed. 2009;16(6):373-80. 
165 
5. 
Tang W, Jin L, Xie L, Huang J, Wang N, Chu B, et al. Structural Characterization and Antifatigue 
166 
Effect In Vivo of Maca (Lepidium meyenii Walp) Polysaccharide. J Food Sci. 2017;82(3):757-64. 
167 
6. 
da Silva Leitão Peres N, Cabrera Parra Bortoluzzi L, Medeiros Marques LL, Formigoni M, Fuchs 
168 
RHB, Droval AA, et al. Medicinal effects of Peruvian maca (Lepidium meyenii): a review. Food Funct. 
169 
2020;11(1):83-92. 
170 
7. 
Stone M, Ibarra A, Roller M, Zangara A, Stevenson E. A pilot investigation into the effect of 
171 
maca supplementation on physical activity and sexual desire in sportsmen. J Ethnopharmacol. 
172 
2009;126(3):574-6. 
173 
8. 
Zhu H, Xu W, Wang N, Jiang W, Cheng Y, Guo Y, et al. Anti-fatigue effect of Lepidium meyenii 
174 
Walp.(Maca) on preventing mitochondria-mediated muscle damage and oxidative stress in vivo and 
175 
vitro. Food & Function. 2021;12(7):3132-41. 
176 
9. 
Choi EH, Kang JI, Cho JY, Lee SH, Kim TS, Yeo IH, et al. Supplementation of standardized lipid-
177 
soluble extract from maca (Lepidium meyenii) increases swimming endurance capacity in rats. 
178 
Journal of Functional Foods. 2012;4(2):568-73. 
179 
10. Tang W, Jin L, Xie L, Huang J, Wang N, Chu B, et al. Structural characterization and antifatigue 
180 
effect in vivo of maca (Lepidium meyenii Walp) polysaccharide. Journal of food science. 
181 
2017;82(3):757-64. 
182 
11. Li R-W, He J-C, Song D-H. Anti-physical fatigue effect of polysaccharides from Lepidium meyenii. 
183 
Walp. and the possible mechanisms. BIOMEDICAL RESEARCH-INDIA. 2017;28. 
184 
12. Lee MS, Lee HW, You S, Ha K-T. The use of maca (Lepidium meyenii) to improve semen quality: 
185 
a systematic review. Maturitas. 2016;92:64-9. 
186 
13. McInnes SE, Carlson JS, Jones CJ, McKenna MJ. The physiological load imposed on basketball 
187 
players during competition. J Sports Sci. 1995;13(5):387-97. 
188 
14. Stojanović E, Stojiljković N, Scanlan AT, Dalbo VJ, Berkelmans DM, Milanović Z. The Activity 
189 
Demands and Physiological Responses Encountered During Basketball Match-Play: A Systematic 
190 
Review. Sports Med. 2018;48(1):111-35. 
191 
15. Gottlieb R, Shalom A, Calleja-Gonzalez J. Physiology of Basketball–Field Tests. Review Article. 
192 
Journal of human kinetics. 2021;77(1):159-67. 
193 

13 
 
16. Orhan C, Gencoglu H, Tuzcu M, Sahin N, Ojalvo SP, Sylla S, et al. Maca could improve endurance 
194 
capacity possibly by increasing mitochondrial biogenesis pathways and antioxidant response in 
195 
exercised rats. J Food Biochem. 2022;46(7):e14159. 
196 
17. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting 
197 
parallel group randomised trials. Journal of Pharmacology and pharmacotherapeutics. 
198 
2010;1(2):100-7. 
199 
18. Zheng Y, Zhang WC, Wu ZY, Fu CX, Hui AL, Gao H, et al. Two macamide extracts relieve physical 
200 
fatigue by attenuating muscle damage in mice. Journal of the Science of Food and Agriculture. 
201 
2019;99(3):1405-12. 
202 
19. McCollom MM, Villinski JR, McPhail KL, Craker LE, Gafner S. Analysis of macamides in samples 
203 
of Maca (Lepidium meyenii) by HPLC-UV-MS/MS. Phytochemical Analysis: An International Journal 
204 
of Plant Chemical and Biochemical Techniques. 2005;16(6):463-9. 
205 
20. Claudino JG, Cronin J, Mezêncio B, McMaster DT, McGuigan M, Tricoli V, et al. The 
206 
countermovement jump to monitor neuromuscular status: A meta-analysis. J Sci Med Sport. 
207 
2017;20(4):397-402. 
208 
21. Gathercole R, Sporer B, Stellingwerff T, Sleivert G. Alternative countermovement-jump analysis 
209 
to quantify acute neuromuscular fatigue. Int J Sports Physiol Perform. 2015;10(1):84-92. 
210 
22. Boddington BJ, Cripps AJ, Scanlan AT, Spiteri T. The validity and reliability of the Basketball 
211 
Jump Shooting Accuracy Test. J Sports Sci. 2019;37(14):1648-54. 
212 
23. Paulauskas R, Kamarauskas P, Nekriošius R, Bigwood NM. Physical and Physiological Response 
213 
to Different Modes of Repeated Sprint Exercises in Basketball Players. J Hum Kinet. 2020;72:91-9. 
214 
24. Little T, Williams AG. Effects of sprint duration and exercise: rest ratio on repeated sprint 
215 
performance and physiological responses in professional soccer players. The Journal of Strength & 
216 
Conditioning Research. 2007;21(2):646-8. 
217 
25. Figueira B, Gonçalves B, Abade E, Paulauskas R, Masiulis N, Kamarauskas P, et al. Repeated 
218 
Sprint Ability in Elite Basketball Players: The Effects of 10 × 30 m Vs. 20 × 15 m Exercise Protocols on 
219 
Physiological Variables and Sprint Performance. J Hum Kinet. 2021;77:181-9. 
220 
26. Sekulic D, Spasic M, Mirkov D, Cavar M, Sattler T. Gender-specific influences of balance, speed, 
221 
and power on agility performance. The Journal of Strength & Conditioning Research. 
222 
2013;27(3):802-11. 
223 
 
224 
 
225