Effects of short-term fat adaptation on metabolism and performance of prolonged exercise

International society of sports nutrition position stand: ketogenic diets

POSITION STATEMENT

The International Society of Sports Nutrition (ISSN) provides an objective and critical review of the use of a ketogenic diet in healthy exercising adults, with a focus on exercise performance and body composition. However, this review does not address the use of exogenous ketone supplements. The following points summarize the position of the ISSN.

1. A ketogenic diet induces a state of nutritional ketosis, which is generally defined as serum ketone levels above 0.5 mM. While many factors can impact what amount of daily carbohydrate intake will result in these levels, a broad guideline is a daily dietary carbohydrate intake of less than 50 grams per day.

2. Nutritional ketosis achieved through carbohydrate restriction and a high dietary fat intake is not intrinsically harmful and should not be confused with ketoacidosis, a life-threatening condition most commonly seen in clinical populations and metabolic dysregulation.

3. A ketogenic diet has largely neutral or detrimental effects on athletic performance compared to a diet higher in carbohydrates and lower in fat, despite achieving significantly elevated levels of fat oxidation during exercise (~1.5 g/min).

4. The endurance effects of a ketogenic diet may be influenced by both training status and duration of the dietary intervention, but further research is necessary to elucidate these possibilities. All studies involving elite athletes showed a performance decrement from a ketogenic diet, all lasting six weeks or less. Of the two studies lasting more than six weeks, only one reported a statistically significant benefit of a ketogenic diet.

5. A ketogenic diet tends to have similar effects on maximal strength or strength gains from a resistance training program compared to a diet higher in carbohydrates. However, a minority of studies show superior effects of non-ketogenic comparators.

6. When compared to a diet higher in carbohydrates and lower in fat, a ketogenic diet may cause greater losses in body weight, fat mass, and fat-free mass, but may also heighten losses of lean tissue. However, this is likely due to differences in calorie and protein intake, as well as shifts in fluid balance.

7. There is insufficient evidence to determine if a ketogenic diet affects males and females differently. However, there is a strong mechanistic basis for sex differences to exist in response to a ketogenic diet.

Beneficial Physiological and Metabolic Effects with Acute Intake of New Zealand Blackcurrant Extract during 4 h of Indoor Cycling in a Male Ironman Athlete: A Case Study

New Zealand blackcurrant (NZBC) is known to alter exercise-induced physiological and metabolic responses with chronic (i.e., 7 days) dosing. We examined the effects of acute intake of New Zealand blackcurrant (NZBC) extract on 4 h indoor cycling-induced physiological and metabolic responses in a male amateur Ironman athlete (age: 49 years; BMI: 24.3 kg·m-2; V˙O2max: 58.6 mL·kg-1·min-1; maximal aerobic power: 400 W; history: 14 Ironman events in 16 years) three weeks before competition. Indirect calorimetry was used and heart rate was recorded at 30 min intervals during 4 h indoor (~22.4 °C, relative humidity: ~55%) constant power (165 W) cycling on a Trek Bontrager connected to a Kickr smart trainer. Blood lactate and rating of perceived exertion (RPE) were taken at 60 min intervals. Study was a single-blind placebo-controlled study with capsules (4 × 105 mg anthocyanins) taken 2 h before starting the 4 h of cycling. Water was allowed ad libitum with personalised consumption of gels [a total of eight with three with caffeine (100 mg)], two bananas and 8 × electrolyte capsules (each 250 mg sodium and 125 mg potassium) at personalised time-points. With NZBC extract (CurraNZ), during 4 h of cycling (mean of 8 measurements), minute ventilation was 8% lower than placebo. In addition, there was no difference for oxygen uptake, with carbon dioxide production found to be 4% lower with NZBC extract. With the NZBC extract, the ventilatory equivalents were lower for oxygen and carbon dioxide by 5.5% and 3.7%; heart rate was lower by 10 beats·min-1; lactate was 40% different with lower lactate at 2, 3 and 4 h; RPE was lower at 2, 3 and 4 h; and carbohydrate oxidation was 11% lower. With NZBC extract, there was a trend for fat oxidation to be higher by 13% (p = 0.096), with the respiratory exchange ratio being lower by 0.02 units. Acute intake of New Zealand blackcurrant extract (420 mg anthocyanins) provided beneficial physiological and metabolic responses during 4 h of indoor constant power cycling in a male amateur Ironman athlete 3 weeks before a competition. Future work is required to address whether acute and chronic dosing strategies with New Zealand blackcurrant provide a nutritional ergogenic effect for Ironman athletes to enhance swimming, cycling and running performance.

Peak fat oxidation, peak oxygen uptake, and running performance increase during pre-season in sub-elite male football players

PURPOSE

In Football, the high-intensity running bouts during matches are considered decisive. Interestingly, recent studies showed that peak fat oxidation rates (PFO) are higher in football players than other athletes. This study aimed to investigate whether PFO increases following a pre-season. Secondarily, and due to COVID-19, we investigated whether PFO is related to the physical performance in a subgroup of semi-professional male football players.

METHODS

Before and after 8 weeks of pre-season training, 42 sub-elite male football players (18 semi-professionals and 24 non-professionals) had a dual-energy x-ray absorptiometry scan and performed a graded exercise test on a treadmill for the determination of PFO, the exercise intensity eliciting PFO (Fatmax) and peak oxygen uptake (V̇O2peak). Additionally, the semi-professional players performed a Yo-Yo Intermittent Recovery Test level 2 (YYIR2) before and after pre-season training to determine football-specific running performance.

RESULTS

PFO increased by 11 ± 10% (mean ± 95% CI), p = 0.031, and V̇O2peak increased by 5 ± 1%, p < 0.001, whereas Fatmax was unchanged (+12 ± 9%, p = 0.057), following pre-season training. PFO increments were not associated with increments in V̇O2peak (Pearson's r2 = 0.00, p = 0.948) or fat-free mass (FFM) (r2 = 0.00, p = 0.969). Concomitantly, YYIR2 performance increased in the semi-professional players by 39 ± 17%, p < 0.001, which was associated with changes in V̇O2peak (r2 = 0.35, p = 0.034) but not PFO (r2 = 0.13, p = 0.244).

CONCLUSIONS

PFO, V̇O2peak, and FFM increased following pre-season training in sub-elite football players. However, in a subgroup of semi-professional players, increments in PFO were not associated with improvements in YYIR2 performance nor with increments in V̇O2peak and FFM.

Effectiveness of high-fat and high-carbohydrate diets on body composition and maximal strength after 15 weeks of resistance training

PURPOSE

The aim of this study was to compare High Carbohydrates Low Fat (HCLF) and Low Carbohydrate High Fat (LCHF) diets in terms of changes in body composition and maximal strength.

PATIENTS/METHODS

The study involved 48 men aged 25 ​± ​2.5, divided into two groups, one of which (n ​= ​23) was following the LCHF diet and the other (n ​= ​25) the HCLF diet. Both groups performed the same resistance training protocol for 15 weeks. Maximal strength in squat, bench press and deadlift was assessed pre- and post-intervention. Measurements of selected body circumferences and tissue parameters were made using the multifunctional, multi-frequency, direct bioelectric impedance InBody 770 analyzer from InBody Co., Ltd (Cerritos, California, USA). The team with the necessary qualifications and experience in research performed all the measurements and maintained participants' oversight throughout the entire length of the study.

RESULTS

Both nutritional approaches were effective in terms of reducing body fat mass. The HCLF group achieved greater skeletal muscle hypertrophy. Significant decreases in body circumferences, especially in the abdominal area, were observed for both dietary approaches. Maximal strength significantly increased in the HCLF group and decreased in the LCHF group.

CONCLUSION

Holistic analysis of the results led to the conclusion that both dietary approaches may elicit positive adaptations in body composition. The two approaches constitute useful alternatives for both recreational exercisers and physique athletes with body composition goals.

Preexercise High-Fat Meal Following Carbohydrate Loading Attenuates Glycogen Utilization During Endurance Exercise in Male Recreational Runners

ABSTRACT

Iwayama, K, Tanabe, Y, Yajima, K, Tanji, F, Onishi, T, and Takahashi, H. Preexercise high-fat meal following carbohydrate loading attenuates glycogen utilization during endurance exercise in male recreational runners. J Strength Cond Res 37(3): 661-668, 2023-This study aimed to investigate whether one preexercise high-fat meal can increase glycogen conservation during endurance exercise, as compared with one preexercise high-carbohydrate meal. Ten young male recreational runners (22.0 ± 0.6 years; 171.3 ± 0.9 cm; 58.3 ± 1.9 kg; maximal oxygen uptake [V̇ o2 max], 62.0 ± 1.6 ml·kg -1 ·min -1 ) completed 2 exercise trials after high-carbohydrate loading: eating a high-carbohydrate (CHO; 7% protein, 13% fat, 80% carbohydrate) meal or eating a high-fat (FAT; 7% protein, 42% fat, 52% carbohydrate) meal 3.5 hours before exercise. The order of the 2 trials was randomized, and the interval between trials was at least 1 week. The experimental exercise consisted of running on a treadmill for 60 minutes at 95% of each subject's lactate threshold. Muscle and liver glycogen content were assessed using noninvasive carbon magnetic resonance spectroscopy before the experimental meal as well as before and after exercise; respiratory gases were measured continuously during exercise. The respiratory exchange ratio during exercise was statistically lower in the FAT trial than in the CHO trial ( p < 0.01). In addition, muscle ( p < 0.05) and liver ( p < 0.05) glycogen utilization during exercise was less in the FAT trial than in the CHO trial. Therefore, one high-fat meal following carbohydrate loading reduced muscle and liver glycogen use during the 60-minute exercise. These results suggest that this dietary approach may be applied as a strategy to optimize energy utilization during endurance exercise.

Short-Term Very High Carbohydrate Diet and Gut-Training Have Minor Effects on Gastrointestinal Status and Performance in Highly Trained Endurance Athletes

We implemented a multi-pronged strategy (MAX) involving chronic (2 weeks high carbohydrate [CHO] diet + gut-training) and acute (CHO loading + 90 g·h−1 CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON) in two groups of athletes. Nineteen elite male race walkers (MAX: 9; CON:10) undertook a 26 km race-walking session before and after the respective interventions to investigate gastrointestinal function (absorption capacity), integrity (epithelial injury), and symptoms (GIS). We observed considerable individual variability in responses, resulting in a statistically significant (p < 0.001) yet likely clinically insignificant increase (Δ 736 pg·mL−1) in I-FABP after exercise across all trials, with no significant differences in breath H2 across exercise (p = 0.970). MAX was associated with increased GIS in the second half of the exercise, especially in upper GIS (p < 0.01). Eighteen highly trained male and female distance runners (MAX: 10; CON: 8) then completed a 35 km run (28 km steady-state + 7 km time-trial) supported by either a slightly modified MAX or CON strategy. Inter-individual variability was observed, without major differences in epithelial cell intestinal fatty acid binding protein (I-FABP) or GIS, due to exercise, trial, or group, despite the 3-fold increase in exercise CHO intake in MAX post-intervention. The tight-junction (claudin-3) response decreased in both groups from pre- to post-intervention. Groups achieved a similar performance improvement from pre- to post-intervention (CON = 39 s [95 CI 15−63 s]; MAX = 36 s [13−59 s]; p = 0.002). Although this suggests that further increases in CHO availability above current guidelines do not confer additional advantages, limitations in our study execution (e.g., confounding loss of BM in several individuals despite a live-in training camp environment and significant increases in aerobic capacity due to intensified training) may have masked small differences. Therefore, athletes should meet the minimum CHO guidelines for training and competition goals, noting that, with practice, increased CHO intake can be tolerated, and may contribute to performance outcomes.

Comparing Acute, High Dietary Protein and Carbohydrate Intake on Transcriptional Biomarkers, Fuel Utilisation and Exercise Performance in Trained Male Runners

Manipulating dietary macronutrient intake may modulate adaptive responses to exercise, and improve endurance performance. However, there is controversy as to the impact of short-term dietary modification on athletic performance. In a parallel-groups, repeated measures study, 16 trained endurance runners (maximal oxygen uptake (V˙O_2max): 64.2 ± 5.6 mL·kg^-1·min^-1) were randomly assigned to, and provided with, either a high-protein, reduced-carbohydrate (PRO) or a high-carbohydrate (CHO) isocaloric-matched diet. Participants maintained their training load over 21-consecutive days with dietary intake consisting of 7-days habitual intake (T1), 7-days intervention diet (T2) and 7-days return to habitual intake (T3). Following each 7-day dietary period (T1-T3), a micro-muscle biopsy was taken for assessment of gene expression, before participants underwent laboratory assessment of a 10 km treadmill run at 75% V˙O_2max, followed by a 95% V˙O_2max time to exhaustion (TTE) trial. The PRO diet resulted in a modest change (1.37-fold increase, p = 0.016) in AMPK expression, coupled with a significant increase in fat oxidation (0.29 ± 0.05 to 0.59 ± 0.05 g·min^-1, p < 0.0001). However, a significant reduction of 23.3% (p = 0.0003) in TTE post intervention was observed; this reverted back to pre levels following a return to the habitual diet. In the CHO group, whilst no change in sub-maximal fuel utilisation occurred at T2, a significant 6.5% increase in TTE performance (p = 0.05), and a modest, but significant, increase in AMPK (p = 0.042) and PPAR (p = 0.029) mRNA expression compared to T1 were observed; with AMPK (p = 0.011) and PPAR (p = 0.044) remaining significantly elevated at T3. In conclusion, a 7-day isocaloric high protein diet significantly compromised high intensity exercise performance in trained runners with no real benefit on gene markers of training adaptation. A significant increase in fat oxidation during submaximal exercise was observed post PRO intervention, but this returned to pre levels once the habitual diet was re-introduced, suggesting that the response was driven via fuel availability rather than cellular adaptation. A short-term high protein, low carbohydrate diet in combination with endurance training is not preferential for endurance running performance.

Serum Branched-Chain Amino Acid Metabolites Increase in Males When Aerobic Exercise Is Initiated with Low Muscle Glycogen

This study used global metabolomics to identify metabolic factors that might contribute to muscle anabolic resistance, which develops when aerobic exercise is initiated with low muscle glycogen using global metabolomics. Eleven men completed this randomized, crossover study, completing two cycle ergometry glycogen depletion trials, followed by 24 h of isocaloric refeeding to elicit low (LOW; 1.5 g/kg carbohydrate, 3.0 g/kg fat) or adequate (AD; 6.0 g/kg carbohydrate 1.0 g/kg fat) glycogen. Participants then performed 80 min of cycling (64 ± 3% VO₂ peak) while ingesting 146 g carbohydrate. Serum was collected before glycogen depletion under resting and fasted conditions (BASELINE), and before (PRE) and after (POST) exercise. Changes in metabolite profiles were calculated by subtracting BASELINE from PRE and POST within LOW and AD. There were greater increases (p < 0.05, Q < 0.10) in 64% of branched-chain amino acids (BCAA) metabolites and 69% of acyl-carnitine metabolites in LOW compared to AD. Urea and 3-methylhistidine had greater increases (p < 0.05, Q < 0.10) in LOW compared to AD. Changes in metabolomics profiles indicate a greater reliance on BCAA catabolism for substrate oxidation when exercise is initiated with low glycogen stores. These findings provide a mechanistic explanation for anabolic resistance associated with low muscle glycogen, and suggest that exogenous BCAA requirements to optimize muscle recovery are likely greater than current recommendations.

Nutritional approaches to counter performance constraints in high-level sports competition

New Findings

What is the topic of this review?

The nutritional strategies that athletes use during competition events to optimize performance and the reasons they use them.

What advances does it highlight?

A range of nutritional strategies can be used by competitive athletes, alone or in combination, to address various event‐specific factors that constrain event performance. Evidence for such practices is constantly evolving but must be combined with understanding of the complexities of real‐life sport for optimal implementation.

Abstract

High‐performance athletes share a common goal despite the unique nature of their sport: to pace or manage their performance to achieve the highest sustainable outputs over the duration of the event. Periodic or sustained decline in the optimal performance of event tasks, involves an interplay between central and peripheral phenomena that can often be reduced or delayed in onset by nutritional strategies. Contemporary nutrition practices undertaken before, during or between events include strategies to ensure the availability of limited muscle fuel stores. This includes creatine supplementation to increase muscle phosphocreatine content and consideration of the type, amount and timing of dietary carbohydrate intake to optimize muscle and liver glycogen stores or to provide additional exogenous substrate. Although there is interest in ketogenic low‐carbohydrate high‐fat diets and exogenous ketone supplements to provide alternative fuels to spare muscle carbohydrate use, present evidence suggests a limited utility of these strategies. Mouth sensing of a range of food tastants (e.g., carbohydrate, quinine, menthol, caffeine, fluid, acetic acid) may provide a central nervous system derived boost to sports performance. Finally, despite decades of research on hypohydration and exercise capacity, there is still contention around their effect on sports performance and the best guidance around hydration for sporting events. A unifying model proposes that some scenarios require personalized fluid plans while others might be managed by an ad hoc approach (ad libitum or thirst‐driven drinking) to fluid intake.

Acute Ketogenic Diet and Ketone Ester Supplementation Impairs Race Walk Performance

PURPOSE

This study aimed to determine if LCHF and ketone ester (KE) supplementation can synergistically alter exercise metabolism and improve performance.

METHODS

Elite race walkers (n = 18, 15 males and 3 females; V˙O2peak, 62 ± 6 mL·min-1·kg-1) undertook a four-stage exercise economy test and real-life 10,000-m race before and after a 5-d isoenergetic high-CHO (HCHO, ~60%-65% fat; CHO, 20% fat; n = 9) or LCHF (75%-80% fat, <50 g·d-1 CHO, n = 9) diet. The LCHF group performed additional economy tests before and after diet after supplementation with 573 mg·kg-1 body mass KE (HVMN; HVMN Inc., San Francisco, CA), which was also consumed for race 2.

RESULTS

The oxygen cost of exercise (relative V˙O2, mL·min-1·kg-1) increased across all four stages after LCHF (P < 0.005). This occurred in association with increased fat oxidation rates, with a reciprocal decrease in CHO oxidation (P < 0.001). Substrate utilization in the HCHO group remained unaltered. The consumption of KE before the LCHF diet increased circulating KB (P < 0.05), peaking at 3.2 ± 0.6 mM, but did not alter V˙O2 or RER. LCHF diet elevated resting circulating KB (0.3 ± 0.1 vs 0.1 ± 0.1 mM), but concentrations after supplementation did not differ from the earlier ketone trial. Critically, race performance was impaired by ~6% (P < 0.0001) relative to baseline in the LCHF group but was unaltered in HCHO.

CONCLUSION

Despite elevating endogenous KB production, an LCHF diet does not augment the metabolic responses to KE supplementation and negatively affects race performance.

Paleolithic Diet-Effect on the Health Status and Performance of Athletes?

The aim of this meta-analysis was to review the impact of a Paleolithic diet (PD) on selected health indicators (body composition, lipid profile, blood pressure, and carbohydrate metabolism) in the short and long term of nutrition intervention in healthy and unhealthy adults. A systematic review of randomized controlled trials of 21 full-text original human studies was conducted. Both the PD and a variety of healthy diets (control diets (CDs)) caused reduction in anthropometric parameters, both in the short and long term. For many indicators, such as weight (body mass (BM)), body mass index (BMI), and waist circumference (WC), impact was stronger and especially found in the short term. All diets caused a decrease in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), albeit the impact of PD was stronger. Among long-term studies, only PD cased a decline in TC and LDL-C. Impact on blood pressure was observed mainly in the short term. PD caused a decrease in fasting plasma (fP) glucose, fP insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) in the short run, contrary to CD. In the long term, only PD caused a decrease in fP glucose and fP insulin. Lower positive impact of PD on performance was observed in the group without exercise. Positive effects of the PD on health and the lack of experiments among professional athletes require longer-term interventions to determine the effect of the Paleo diet on athletic performance.

Effects of 8 wk of 16:8 Time-restricted Eating in Male Middle- and Long-Distance Runners

PURPOSE

Eight weeks of time-restricted eating (TRE) in concert with habitual exercise training was investigated for effects on body composition, energy and macronutrient intakes, indices of endurance running performance, and markers of metabolic health in endurance athletes.

METHODS

Male middle- and long-distance runners (n = 23) were randomly assigned to TRE (n = 12) or habitual dietary intake (CON; n = 11). TRE required participants to consume all of their dietary intake within an 8-h eating window (so-called 16:8 TRE), but dietary patterns, food choices, and energy intake were ad libitum during this window. Participants continued their habitual training during the intervention period. Participants completed an incremental exercise test before (PRE) and after (POST) the 8-wk intervention for the assessment of blood lactate concentrations, running economy, and maximal oxygen uptake. Fasted blood samples were analyzed for glucose, insulin, and triglyceride concentrations. Dietary intake was assessed at PRE, MID (week 4), and POST using a 4-d semiweighed food diary.

RESULTS

Seventeen participants (TRE, n = 10; CON, n = 7) completed the intervention. Training load did not differ between groups for the duration of the intervention period. TRE resulted in a reduction in body mass (mean difference of -1.92 kg, 95% confidence interval = -3.52 to -0.32, P = 0.022). Self-reported daily energy intake was lower in TRE at MID and POST (group-time interaction, P = 0.049). No effect of TRE was observed for oxygen consumption, respiratory exchange ratio, running economy, blood lactate concentrations, or heart rate during exercise, nor were there any effects on glucose, insulin, or triglyceride concentrations observed.

CONCLUSION

Eight weeks of 16:8 TRE in middle- and long-distance runners resulted in a decrease in body mass commensurate with a reduction in daily energy intake, but it did not alter indices of endurance running performance or metabolic health.

The relationship between peak fat oxidation and prolonged double-poling endurance exercise performance

The peak fat oxidation rate (PFO) and the exercise intensity that elicits PFO (Fat_max ) are associated with endurance performance during exercise primarily involving lower body musculature, but it remains elusive whether these associations are present during predominant upper body exercise. The aim was to investigate the relationship between PFO and Fat_max determined during a graded exercise test on a ski-ergometer using double-poling (GET-DP) and performance in the long-distance cross-country skiing race, Vasaloppet. Forty-three healthy men completed GET-DP and Vasaloppet and were divided into two subgroups: recreational (RS, n = 35) and elite (ES, n = 8) skiers. Additionally, RS completed a cycle-ergometer GET (GET-Cycling) to elucidate whether the potential relationships were specific to exercise modality. PFO (r²  = .10, P = .044) and Fat_max (r²  = .26, P < .001) were correlated with performance; however, V ˙ O 2 peak was the only independent predictor of performance (adj. R²  = .36) across all participants. In ES, Fat_max was the only variable associated with performance (r²  = .54, P = .038). Within RS, DP V ˙ O 2 peak (r²  = .11, P = .047) and ski-specific training background (r²  = .30, P = .001) were associated with performance. Between the two GETs, Fat_max (r²  = .20, P = .006) but not PFO (r²  = .07, P = .135) was correlated. Independent of exercise mode, neither PFO nor Fat_max were associated with performance in RS (P > .05). These findings suggest that prolonged endurance performance is related to PFO and Fat_max but foremost to V ˙ O 2 peak during predominant upper body exercise. Interestingly, Fat_max may be an important determinant of performance among ES. Among RS, DP V ˙ O 2 peak , and skiing experience appeared as performance predictors. Additionally, whole-body fat oxidation seemed specifically coupled to exercise modality.

Effects of electrolyzed hydrogen water ingestion during endurance exercise in a heated environment on body fluid balance and exercise performance

Electrolyzed hydrogen water (EHW) is generated at a cathode. It contains many hydrogen molecules with high alkaline properties. The physiological effects of ingesting EHW during endurance exercise are unclear. The purpose of this study was to determine the effects of ingesting EHW during endurance exercise in a heated environment on body fluid balance and exercise performance. Twelve triathletes (20.0 ± 1.3 years, 171 ± 6 cm, 60.6 ± 3.9 kg, V̇O_2max 67.1 ± 3.8 mL/kg/min) performed pedaling exercise for 60 min at 65% of V̇O_2max consuming either purified water (CON trial) or EHW (EHW trial) and then conducted an incremental pedaling test. Blood parameters, tissue temperature, and respiratory variables were determined during 60 min of exercise. The time to exhaustion (TTE) during the incremental pedaling test was also determined. Body weights were 1.1 ± 0.4 kg lower after exercise, with no significant differences between trials. Plasma volume and serum osmolality and blood sodium and potassium concentrations significantly changed with exercise, but no significant differences were observed between trials. The pH, blood lactate and bicarbonate concentrations, and changes in skin and muscle temperature did not significantly differ between the two trials. Energy expenditure during exercise was significantly (P = 0.04) lower in the EHW trial (13.2 ± 0.5 kcal/min) than in the CON trial (13.7 ± 0.4 kcal/min). TTE did not significantly differ between the trials. In conclusion, EHW ingestion during endurance exercise in a heated environment decreased energy expenditure but did not affect body fluid balance or exercise performance. Abbreviations: CON: control trial; CV: coefficient of variation; EHW: electrolyzed hydrogen water; HR: heart rate; RPE: rating of perceived exertion; SE: standard error; TP: total protein; TTE: time to exhaustion.

Ergogenic Properties of Ketogenic Diets in Normal-Weight Individuals: A Systematic Review

Ketogenic diets (KDs) have received increasing attention among athletes and physically active individuals. However, the question as to whether and how the diet could benefit this healthy cohort remains unclear.Purpose: This study was designed to systematically review the existing evidence concerning the effect of KDs on body composition, aerobic and anaerobic capacity, muscle development, and sports performance in normal-weight individuals including athletes.Methods: A systematic search of English literature was conducted through electronic databases including PubMed, EBSCOhost, and Google Scholar. Upon the use of search criteria, 23 full-text original human studies involving non-obese participants were included in this review. For more stratified and focused analysis, these articles were further categorized based on the outcomes being examined including 1) body mass (BM) and %fat, 2) substrate utilization, 3) blood substrate and hormonal responses, 4) aerobic capacity and endurance performance, and 5) strength, power, and anaerobic capacity.Results: Our review indicates that a non-calorie-restricted KD carried out for ≥3 weeks can produce a modest reduction in BM and %fat, while maintaining fat-free mass. This diet leads to augmented use of fat as fuel, but this adaptation doesn't seem to improve endurance performance. Additionally, ad libitum KDs combined with resistance training will pose no harm to developing strength and power, especially when protein intake is increased modestly.Conclusions: It appears that a non-calorie-restricted KD provides minimal ergogenic benefits in normal-weight individuals including athletes, but can be used for optimizing BM and body composition without compromising aerobic and anaerobic performance. Key teaching pointsKetogenic diets have received increasing attention among athletes and physically active individuals.It remains elusive as to whether ketogenic diets could confer ergogenic benefits for those who are normal weight but want to use the diet to improve fitness and performance.An interesting dilemma exists in that ketogenic diets can reduce body mass and %fat and increase fat oxidation, but they can also decrease glycogen stores and limit sports performance.This review concludes that a non-calorie-restricted ketogenic diet provides minimal ergogenic benefits in normal-weight individuals, but can be used to optimize body mass and composition without compromising athletic performance.This finding can be important for esthetic or weight-sensitive athletes because the diet may allow them to reach a target body mass without having to sacrifice athletic performance.The ketogenic diet-induced metabolic adaptations require a state of ketosis, and thus caution should be taken because an excessive increase in ketone bodies can be detrimental to health.

The impact of keto-adaptation on exercise performance and the role of metabolic-regulating cytokines

The ketogenic diet (KD) is a normocaloric diet composed of high-fat, low-carbohydrate, and adequate protein that induces fasting-like effects and results in the production of ketone bodies. Initially used widely for children with refractory epilepsy, the KD gained popularity due to its beneficial effects on weight loss, diabetes, and cancer. In recent years, there has been a resurgence in interest surrounding the KD and exercise performance. This review provides new insights into the adaptation period necessary for enhancement in skeletal muscle fat and ketone oxidation after sustained nutritional ketosis. In addition, this review highlights metabolically active growth factors and cytokines, which may function as important regulators of keto-adaptation in the setting of exercise and the KD.

Exercising with low muscle glycogen content increases fat oxidation and decreases endogenous, but not exogenous carbohydrate oxidation

BACKGROUND

Initiating aerobic exercise with low muscle glycogen content promotes greater fat and less endogenous carbohydrate oxidation during exercise. However, the extent exogenous carbohydrate oxidation increases when exercise is initiated with low muscle glycogen is unclear.

PURPOSE

Determine the effects of muscle glycogen content at the onset of exercise on whole-body and muscle substrate metabolism.

METHODS

Using a randomized, crossover design, 12 men (mean ± SD, age: 21 ± 4 y; body mass: 83 ± 11 kg; VO_2peak: 44 ± 3 mL/kg/min) completed 2 cycle ergometry glycogen depletion trials separated by 7-d, followed by a 24-h refeeding to elicit low (LOW; 1.5 g/kg carbohydrate, 3.0 g/kg fat) or adequate (AD; 6.0 g/kg carbohydrate, 1.0 g/kg fat) glycogen stores. Participants then performed 80 min of steady-state cycle ergometry (64 ± 3% VO_2peak) while consuming a carbohydrate drink (95 g glucose +51 g fructose; 1.8 g/min). Substrate oxidation (g/min) was determined by indirect calorimetry and ¹³C. Muscle glycogen (mmol/kg dry weight), pyruvate dehydrogenase (PDH) activity, and gene expression were assessed in muscle.

RESULTS

Initiating steady-state exercise with LOW (217 ± 103) or AD (396 ± 70; P < 0.05) muscle glycogen did not alter exogenous carbohydrate oxidation (LOW: 0.84 ± 0.14, AD: 0.87 ± 0.16; P > 0.05) during exercise. Endogenous carbohydrate oxidation was lower and fat oxidation was higher in LOW (0.75 ± 0.29 and 0.55 ± 0.10) than AD (1.17 ± 0.29 and 0.38 ± 0.13; all P < 0.05). Before and after exercise PDH activity was lower (P < 0.05) and transcriptional regulation of fat metabolism (FAT, FABP, CPT1a, HADHA) was higher (P < 0.05) in LOW than AD.

CONCLUSION

Initiating exercise with low muscle glycogen does not impair exogenous carbohydrate oxidative capacity, rather, to compensate for lower endogenous carbohydrate oxidation acute adaptations lead to increased whole-body and skeletal muscle fat oxidation.

Determination and validation of peak fat oxidation in endurance-trained men using an upper body graded exercise test

Peak fat oxidation rate (PFO) and the intensity that elicits PFO (Fat_max ) are commonly determined by a validated graded exercise test (GE) on a cycling ergometer with indirect calorimetry. However, for upper body exercise fat oxidation rates are not well elucidated and no protocol has been validated. Thus, our aim was to test validity and inter-method reliability for determination of PFO and Fat_max in trained men using a GE protocol applying double poling on a ski-ergometer. PFO and Fat_max were assessed during two identical GE tests (GE1 and GE2) and validated against separated short continuous exercise bouts (SCE) at 35%, 50%, and 65% of V̇O_2peak on the ski-ergometer in 10 endurance-trained men (V̇O_2peak : 65.1 ± 1.0 mL·min^-1 ·kg^-1 , mean ± SEM). Between GE tests no differences were found in PFO (GE1: 0.42 ± 0.03; GE2: 0.45 ± 0.03 g·min^-1 , P = .256) or Fat_max (GE1: 41 ± 2%; GE2: 43 ± 3% of V̇O_2peak , P = .457) and the intra-individual coefficient of variation (CV) was 8 ± 2% and 11 ± 2% for PFO and Fat_max , respectively. Between GE and SCE tests, PFO (GE_avg : 0.44 ± 0.03; SCE; 0.47 ± 0.06 g·min^-1 , P = .510) was not different, whereas a difference in Fat_max (GE_avg : 42 ± 2%; SCE: 52 ± 4% of V̇O_2peak , P = .030) was observed with a CV of 17 ± 4% and 15 ± 4% for PFO and Fat_max , respectively. In conclusion, GE has a high day-to-day reliability in determination of PFO and Fat_max in trained men, whereas it is unclear if PFO and Fat_max determined by GE reflect continuous exercise in general.

Swifter, higher, stronger: What’s on the menu?

The exploits of elite athletes delight, frustrate, and confound us as they strive to reach their physiological, psychological, and biomechanical limits. We dissect nutritional approaches to optimal performance, showcasing the contribution of modern sports science to gold medals and world titles. Despite an enduring belief in a single, superior “athletic diet,” diversity in sports nutrition practices among successful athletes arises from the specificity of the metabolic demands of different sports and the periodization of training and competition goals. Pragmatic implementation of nutrition strategies in real-world scenarios and the prioritization of important strategies when nutrition themes are in conflict add to this variation. Lastly, differences in athlete practices both promote and reflect areas of controversy and disagreement among sports nutrition experts.

Select Skeletal Muscle mRNAs Related to Exercise Adaptation Are Minimally Affected by Different Pre-exercise Meals that Differ in Macronutrient Profile

Background: Substantial research has been done on the impact of carbohydrate and fat availability on endurance exercise adaptation, though its role in the acute adaptive response to resistance exercise has yet to be fully characterized. Purpose: We aimed to assess the effects of a pre-resistance exercise isocaloric mixed meal containing different amounts of carbohydrates and fat, on post-resistance exercise gene expression associated with muscle adaptation. Methods: Thirteen young (age 21.2 ± 1.6 year), recreationally trained (VO_2max 51.3 ± 4.8 ml/kg/min) men undertook an aerobic exercise session of 90-min continuous cycling (70% VO_2max) in the morning with pre- and post-exercise protein ingestion (10 and 15 g casein in a 500 ml beverage pre- and post-exercise, respectively). Subjects then rested for 2 h and were provided with a meal consisting of either 3207 kJ; 52 g protein; 51 g fat; and 23 g carbohydrate (FAT) or 3124 kJ; 53 g protein; 9 g fat; and 109 g carbohydrate (CHO). Two hours after the meal, subjects completed 5 × 8 repetitions (80% 1-RM) for both bilateral leg press and leg extension directly followed by 25 g of whey protein (500 ml beverage). Muscle biopsies were obtained from the vastus lateralis at baseline (morning) and 1 and 3 h post-resistance exercise (afternoon) to determine intramuscular mRNA response. Results: Muscle glycogen levels were significantly decreased post-resistance exercise, without any differences between conditions. Plasma free fatty acids increased significantly after the mixed meal in the FAT condition, while glucose and insulin were higher in the CHO condition. However, PDK4 mRNA quantity was significantly higher in the FAT condition at 3 h post-resistance exercise compared to CHO. HBEGF, INSIG1, MAFbx, MURF1, SIRT1, and myostatin responded solely as a result of exercise without any differences between the CHO and FAT group. FOXO3A, IGF-1, PGC-1α, and VCP expression levels remained unchanged over the course of the day. Conclusion: We conclude that mRNA quantity associated with muscle adaptation after resistance exercise is not affected by a difference in pre-exercise nutrient availability. PDK4 was differentially expressed between CHO and FAT groups, suggesting a potential shift toward fat oxidation and reduced glucose oxidation in the FAT group.

Re-examination of the contribution of substrates to energy expenditure during high-intensity intermittent exercise in endurance athletes

BACKGROUND

It has been believed that the contribution of fat oxidation to total energy expenditure is becoming negligible at higher exercise intensities (about 85% VO_2max). The aim of the present study was to examine the changes in substrate oxidation during high-intensity interval exercise in young adult men.

METHODS

A total of 18 healthy well-trained (aged 19.60 ± 0.54 years, BMI = 22.19 ± 0.64 kg/m², n = 10) and untrained (aged 20.25 ± 0.41 years, BMI = 22.78 ± 0.38 kg/m², n = 8) young men volunteered to participate in this study. After an overnight fast, subjects were tested on a cycle ergometer and completed six 4-min bouts of cycling (at ∼80% VO_2max) with 2 min of rests between intervals. Energy expenditure and the substrate oxidation rate were measured during the experiment by using indirect calorimetry. The blood lactate concentration was collected immediately after each interval workout.

RESULTS

The fat oxidation rate during each workout was significantly different between the untrained and the athlete groups (p < 0.05), and the carbohydrate (CHO) oxidation rate during the experiment was similar between groups (p > 0.05). Moreover, lactate concentration significantly increased in the untrained group (p < 0.05), whereas it did not significantly change in the athlete group during the workouts (p > 0.05). Fat contribution to energy expenditure was significantly higher in the athlete group (∼25%) than in the untrained group (∼2%).

CONCLUSIONS

The present study indicates that 17 times more fat oxidation was measured in the athlete group compared to the untrained group. However, the athletes had the same CHO oxidation rate as the recreationally active subjects during high-intensity intermittent exercise. Higher fat oxidation rate despite the same CHO oxidation rate may be related to higher performance in the trained group.

Ketogenic diet benefits body composition and well-being but not performance in a pilot case study of New Zealand endurance athletes

Background

Low-carbohydrate, high-fat and ketogenic diets are increasingly adopted by athletes for body composition and sports performance enhancements. However, as yet, there is no consensus on their efficacy in improving performance. There is also no comprehensive literature on athletes’ experiences while undertaking this diet. The purpose of this pilot work was two-fold: i. to examine the effects of a non-calorie controlled ketogenic diet on body composition and performance outcomes of endurance athletes, and ii. to evaluate the athletes’ experiences of the ketogenic diet during the 10-week intervention.

Methods

Using a case study design, five New Zealand endurance athletes (4 females, 1 male) underwent a 10-week ketogenic dietary intervention. Body composition (sum of 8 skinfolds), performance indicators (time to exhaustion, VO₂ max, peak power and ventilatory threshold), and gas exchange thresholds were measured at baseline and at 10 weeks. Mean change scores were calculated, and analysed using t-tests; Cohen’s effect sizes and 90% confidence limits were applied to quantify change. Individual interviews conducted at 5 weeks and a focus group at 10 weeks assessed athletes’ ketogenic diet experiences. Data was transcribed and analysed using thematic analysis.

Results

All athletes increased their ability to utilise fat as a fuel source, including at higher exercise intensities. Mean body weight was reduced by 4 kg ± SD 3.1 (p = 0.046; effect size (ES):0.62), and sum of 8 skinfolds by 25.9 mm ± SD 6.9; ES: 1.27; p = 0.001). Mean time to exhaustion dropped by ~2 min (±SD 0.7; p = 0.004; ES: 0.53). Other performance outcomes showed mean reductions, with some increases or unchanged results in two individuals (VO2 Max: −1.69 ml.kg.min ± SD 3.4 (p = 0.63); peak power: -18 W ± SD 16.4 (p = 0.07), and VT2: -6 W ± SD 44.5 (p = 0.77). Athletes reported experiencing reduced energy levels initially, followed by a return of high levels thereafter, especially during exercise, but an inability to easily undertake high intense bouts. Each athlete reported experiencing enhanced well-being, included improved recovery, improvements in skin conditions and reduced inflammation.

Conclusions

Despite performance decrements and some negative experiences, athletes were keen to pursue a modified low-carbohydrate, high-fat eating style moving forward due to the unexpected health benefits they experienced.

Trial registration

ACTRN: ACTRN12617000613303. Registered 28 April 2017, retrospectively registered.

Low-Carbohydrate-High-Fat Diet: Can it Help Exercise Performance?

Low-carbohydrate-high-fat (LCHF) diets have been used as a means of weight loss and control of symptoms in several clinical conditions. There is emerging evidence that the metabolic changes induced by LCHF diets enhance endurance performance. The aims of this review are to examine the evidence of LCHF diets in improving various aspects of athletic performance. Long-term LCHF dietary intake may help control body weight and fat mass while maintaining lean body mass in athletes in weight-sensitive sports. LCHF-adapted endurance athletes can reach the maximal fat oxidation rate of approximately 1.5 g/min, with a lower carbohydrate oxidation rate and similar muscle glycogen content and a resynthesis rate compared to their counterparts consuming high-carbohydrate-low-fat (HCLF) diets. The elevated fat oxidation rate and glycogen sparing effect may improve performance in ultra-endurance events. These metabolic changes may also prevent the decline in performance in later stages of repeated high-intensity movements, in which the aerobic metabolism becomes more important. However, elevated blood concentrations of non-esterified fatty acids and ammonia during exercise after LCHF diets may lead to early development of central fatigue. It appears that at least several months of adaptation to a LCHF diet are required for the metabolic changes and restoration of muscle glycogen to occur. Further investigations on LCHF diets are needed regarding (1) performance after weight loss in weight-categorized sports; (2) repeated high-intensity exercise performance; (3) development of central fatigue during endurance events; (4) perceptual-motor performance during prolonged intermittent sports; and (5) ideal dietary fatty acid compositions.

Periodized Nutrition for Athletes

It is becoming increasingly clear that adaptations, initiated by exercise, can be amplified or reduced by nutrition. Various methods have been discussed to optimize training adaptations and some of these methods have been subject to extensive study. To date, most methods have focused on skeletal muscle, but it is important to note that training effects also include adaptations in other tissues (e.g., brain, vasculature), improvements in the absorptive capacity of the intestine, increases in tolerance to dehydration, and other effects that have received less attention in the literature. The purpose of this review is to define the concept of periodized nutrition (also referred to as nutritional training) and summarize the wide variety of methods available to athletes. The reader is referred to several other recent review articles that have discussed aspects of periodized nutrition in much more detail with primarily a focus on adaptations in the muscle. The purpose of this review is not to discuss the literature in great detail but to clearly define the concept and to give a complete overview of the methods available, with an emphasis on adaptations that are not in the muscle. Whilst there is good evidence for some methods, other proposed methods are mere theories that remain to be tested. 'Periodized nutrition' refers to the strategic combined use of exercise training and nutrition, or nutrition only, with the overall aim to obtain adaptations that support exercise performance. The term nutritional training is sometimes used to describe the same methods and these terms can be used interchangeably. In this review, an overview is given of some of the most common methods of periodized nutrition including 'training low' and 'training high', and training with low- and high-carbohydrate availability, respectively. 'Training low' in particular has received considerable attention and several variations of 'train low' have been proposed. 'Training-low' studies have generally shown beneficial effects in terms of signaling and transcription, but to date, few studies have been able to show any effects on performance. In addition to 'train low' and 'train high', methods have been developed to 'train the gut', train hypohydrated (to reduce the negative effects of dehydration), and train with various supplements that may increase the training adaptations longer term. Which of these methods should be used depends on the specific goals of the individual and there is no method (or diet) that will address all needs of an individual in all situations. Therefore, appropriate practical application lies in the optimal combination of different nutritional training methods. Some of these methods have already found their way into training practices of athletes, even though evidence for their efficacy is sometimes scarce at best. Many pragmatic questions remain unanswered and another goal of this review is to identify some of the remaining questions that may have great practical relevance and should be the focus of future research.

Carbohydrate intake and resistance-based exercise: are current recommendations reflective of actual need?

Substantial research has been completed examining the impact of carbohydrate (CHO) intake on endurance exercise, whereas its role in resistance-based exercise performance, adaptation and cell signalling has yet to be fully characterised. This empirical shortcoming has precluded the ability to establish specific CHO recommendations for resistance exercise. This results in recommendations largely stemming from findings based on endurance exercise and/or anecdotal evidence despite the distinct energetic demands and molecular responses mediating adaptation from endurance- and resistance-based exercise. Moreover, the topic of CHO and exercise has become one of polarising nature with divergent views - some substantiated, others lacking evidence. Current literature suggests a moderately high daily CHO intake (3-7 g/kg per d) for resistance training, which is thought to prevent glycogen depletion and facilitate performance and adaptation. However, contemporary investigation, along with an emerging understanding of the molecular underpinnings of resistance exercise adaptation, may suggest that such an intake may not be necessary. In addition to the low likelihood of true glycogen depletion occurring in response to resistance exercise, a diet restrictive in CHO may not be detrimental to acute resistance exercise performance or the cellular signalling activity responsible for adaptation, even when muscle glycogen stores are reduced. Current evidence suggests that signalling of the mammalian target of rapamycin complex 1, the key regulatory kinase for gene translation (protein synthesis), is unaffected by CHO restriction or low muscular glycogen concentrations. Such findings may call into question the current view and subsequent recommendations of CHO intake with regard to resistance-based exercise.

Independent effects of diet and exercise training on fat oxidation in non-alcoholic fatty liver disease

AIM

To investigate the independent effects of 6-mo of dietary energy restriction or exercise training on whole-body and hepatic fat oxidation of patients with non-alcoholic fatty liver disease (NAFLD).

METHODS

Participants were randomised into either circuit exercise training (EX; n = 13; 3 h/wk without changes in dietary habits), or dietary energy restriction (ER) without changes in structured physical activity (ER; n = 8). Respiratory quotient (RQ) and whole-body fat oxidation rates (Fat_ox) were determined by indirect calorimetry under basal, insulin-stimulated and exercise conditions. Severity of disease and steatosis was determined by liver histology; hepatic Fat_ox was estimated from plasma β-hydroxybutyrate concentrations; cardiorespiratory fitness was expressed as VO_2peak. Complete-case analysis was performed (EX: n = 10; ER: n = 6).

RESULTS

Hepatic steatosis and NAFLD activity score decreased with ER but not with EX. β-hydroxybutyrate concentrations increased significantly in response to ER (0.08 ± 0.02 mmol/L vs 0.12 ± 0.04 mmol/L, P = 0.03) but remained unchanged in response to EX (0.10 ± 0.03 mmol/L vs 0.11 ± 0.07 mmol/L, P = 0.39). Basal RQ decreased (P = 0.05) in response to EX, while this change was not significant after ER (P = 0.38). VO_2peak (P < 0.001) and maximal Fat_ox during aerobic exercise (P = 0.03) improved with EX but not with ER (P > 0.05). The increase in β-hydroxybutyrate concentrations was correlated with the reduction in hepatic steatosis (r = -0.56, P = 0.04).

CONCLUSION

ER and EX lead to specific benefits on fat metabolism of patients with NAFLD. Increased hepatic Fat_ox in response to ER could be one mechanism through which the ER group achieved reduction in steatosis.

Carbohydrate dependence during prolonged simulated cycling time trials

PURPOSE

We determined the effect of suppressing lipolysis via administration of Nicotinic acid (NA) and pre-exercise feeding on rates of whole-body substrate utilisation and cycling time trial (TT) performance.

METHODS

In a randomised, single-blind, crossover design, eight trained male cyclists/triathletes completed two series of TTs in which they performed a predetermined amount of work calculated to last ~60, 90 and 120 min. TTs were undertaken after a standardised breakfast (2 g kg(-1) BM of carbohydrate (CHO)) and ingestion of capsules containing either NA or placebo (PL).

RESULTS

Plasma [free fatty acids] were suppressed with NA, but increased in the later stages of TT90 and TT120 with PL (p < 0.05). There was no treatment effect on time to complete TT60 (60.4 ± 4.1 vs. 59.3 ± 3.4 min) or TT90 (90.4 ± 9.1 vs. 89.5 ± 6.6 min) for NA and PL, respectively. However, TT120 was slower with NA (123.1 ± 5.7 vs. 120.1 ± 8.7 min, p < 0.001), which coincided with a decline in plasma [glucose] during the later stages of this ride (p < 0.05). For TTs of the same duration, the rates of whole-body CHO oxidation were unaffected by NA, but decreased with increasing TT time (p < 0.05). CHO was the predominant substrate for all TTs contributing between 83 and 94 % to total energy expenditure, although there was a small use of lipid-based fuels for all rides.

CONCLUSION

(1) NA impaired cycling TT performance lasting 120 min, (2) cycling TTs lasting from 60 to 120 min are CHO dependent, and (3) there is an obligatory use of lipid-based fuels in TTs lasting 1-2 h.

Day to day variability in fat oxidation and the effect after only 1 day of change in diet composition

Indirect calorimetry is a common and noninvasive method to estimate rate of fat oxidation (FatOx) during exercise, and test-retest reliability should be considered when interpreting results. Diet also has an impact on FatOx. The aim of the present study was to investigate day to day variations in FatOx during moderate exercise given the same diet and 2 different isoenergetic diets. Nine healthy, moderately-trained females participated in the study. They performed 1 maximal oxygen uptake test and 4 FatOx tests. Habitual diets were recorded and repeated to assess day to day variability in FatOx. FatOx was also measured after 1 day of fat-rich (26.8% carbohydrates (CHO), 23.2% protein, 47.1% fat) and 1 day of CHO-rich diet (62.6% CHO, 20.1% protein, 12.4% fat). The reliability test revealed no differences in FatOx, respiratory exchange ratio (RER), oxygen uptake, carbon dioxide production, heart rate, blood lactate concentration, or blood glucose between the 2 habitual diet days. FatOx decreased after the CHO-rich diet compared with the habitual day 2 (from 0.42 ± 0.15 to 0.29 ± 0.13 g·min(-1), p < 0.05). No difference was found in FatOx between fat-rich diet and the 2 habitual diet days. FatOx was 31% lower (from 0.42 ± 0.14 to 0.29 ± 0.13 g·min(-1), p < 0.01) after the CHO-rich diet compared with the fat-rich diet. Using RER data to measure FatOx is a reliable method as long as the diet is strictly controlled. However, even a 1-day change in macronutrient composition will likely affect the FatOx results.

Carbohydrate Dependence During Prolonged, Intense Endurance Exercise

A major goal of training to improve the performance of prolonged, continuous, endurance events lasting up to 3 h is to promote a range of physiological and metabolic adaptations that permit an athlete to work at both higher absolute and relative power outputs/speeds and delay the onset of fatigue (i.e., a decline in exercise intensity). To meet these goals, competitive endurance athletes undertake a prodigious volume of training, with a large proportion performed at intensities that are close to or faster than race pace and highly dependent on carbohydrate (CHO)-based fuels to sustain rates of muscle energy production [i.e., match rates of adenosine triphosphate (ATP) hydrolysis with rates of resynthesis]. Consequently, to sustain muscle energy reserves and meet the daily demands of training sessions, competitive athletes freely select CHO-rich diets. Despite renewed interest in high-fat, low-CHO diets for endurance sport, fat-rich diets do not improve training capacity or performance, but directly impair rates of muscle glycogenolysis and energy flux, limiting high-intensity ATP production. When highly trained athletes compete in endurance events lasting up to 3 h, CHO-, not fat-based fuels are the predominant fuel for the working muscles and CHO, not fat, availability becomes rate limiting for performance.

Re-Examining High-Fat Diets for Sports Performance: Did We Call the 'Nail in the Coffin' Too Soon?

During the period 1985-2005, studies examined the proposal that adaptation to a low-carbohydrate (<25 % energy), high-fat (>60 % energy) diet (LCHF) to increase muscle fat utilization during exercise could enhance performance in trained individuals by reducing reliance on muscle glycogen. As little as 5 days of training with LCHF retools the muscle to enhance fat-burning capacity with robust changes that persist despite acute strategies to restore carbohydrate availability (e.g., glycogen supercompensation, carbohydrate intake during exercise). Furthermore, a 2- to 3-week exposure to minimal carbohydrate (<20 g/day) intake achieves adaptation to high blood ketone concentrations. However, the failure to detect clear performance benefits during endurance/ultra-endurance protocols, combined with evidence of impaired performance of high-intensity exercise via a down-regulation of carbohydrate metabolism led this author to dismiss the use of such fat-adaptation strategies by competitive athletes in conventional sports. Recent re-emergence of interest in LCHF diets, coupled with anecdotes of improved performance by sportspeople who follow them, has created a need to re-examine the potential benefits of this eating style. Unfortunately, the absence of new data prevents a different conclusion from being made. Notwithstanding the outcomes of future research, there is a need for better recognition of current sports nutrition guidelines that promote an individualized and periodized approach to fuel availability during training, allowing the athlete to prepare for competition performance with metabolic flexibility and optimal utilization of all muscle substrates. Nevertheless, there may be a few scenarios where LCHF diets are of benefit, or at least are not detrimental, for sports performance.

Exercise and Regulation of Lipid Metabolism

The increased prevalence of hyperlipidemia, hypertriglyceridemia, hypercholesterolemia, and fatty liver disease has provided increasingly negative connotations toward lipids. However, it is important to remember that lipids are essential components supporting life. Lipids are a class of molecules defined by their inherent insolubility in water. In biological systems, lipids are either hydrophobic (containing only polar groups) or amphipathic (possess polar and nonpolar groups). These characteristics lend lipids to be highly diverse with a multitude of functions including hormone and membrane synthesis, involvement in numerous signaling cascades, as well as serving as a source of metabolic fuel supporting energy production. Exercise can induce changes in the lipid composition of membranes that effect fluidity and cellular function, as well as modify the cellular and circulating environment of lipids that regulate signaling cascades. The purpose of this chapter is to focus on lipid utilization as metabolic fuel in response to acute and chronic exercise training. Lipids utilized as an energy source during exercise include circulating fatty acids bound to albumin, triglycerides stored in very-low-density lipoprotein, and intramuscular triglyceride stores. Dynamic changes in these lipid pools during and after exercise are discussed, as well as key factors that may be responsible for regulating changes in fat oxidation in response to varying exercise conditions.

Performance Enhancing Diets and the PRISE Protocol to Optimize Athletic Performance

The training regimens of modern-day athletes have evolved from the sole emphasis on a single fitness component (e.g., endurance athlete or resistance/strength athlete) to an integrative, multimode approach encompassing all four of the major fitness components: resistance (R), interval sprints (I), stretching (S), and endurance (E) training. Athletes rarely, if ever, focus their training on only one mode of exercise but instead routinely engage in a multimode training program. In addition, timed-daily protein (P) intake has become a hallmark for all athletes. Recent studies, including from our laboratory, have validated the effectiveness of this multimode paradigm (RISE) and protein-feeding regimen, which we have collectively termed PRISE. Unfortunately, sports nutrition recommendations and guidelines have lagged behind the PRISE integrative nutrition and training model and therefore limit an athletes' ability to succeed. Thus, it is the purpose of this review to provide a clearly defined roadmap linking specific performance enhancing diets (PEDs) with each PRISE component to facilitate optimal nourishment and ultimately optimal athletic performance.

Effect of fat- and carbohydrate-rich diets on metabolism and running performance in trained adolescent boys

OBJECTIVES

A randomized crossover trial was designed to analyze the impact of a short-term, isoenergetic fat-rich or carbohydrate (CHO)-rich diet on substrate oxidation rates during submaximal exercise and on performance in a 10,000-m running time trial in trained, mid- to late-pubertal boys.

METHODS

An incremental test was performed to determine the peak oxygen uptake (VO2peak). After 2 days on a fat-rich (24.2% ± 0.8% CHO, 60.4% ± 0.3% fat, and 15.5% ± 1.0% protein), CHO-rich (69.3% ± 1.2% CHO, 15.9% ± 2.1% fat, and 15.1% ± 1.1% protein), or habitual (56.1% ± 7.0% CHO, 27.5% ± 4.9% fat, and 16.5% ± 4.0% protein) diet, 19 trained adolescent boys (15.2 ± 1.5 years) performed a 10-minute constant run at 65% VO2peak to determine the respiratory exchange ratio (RER) during exercise and 10,000-m running on an outdoor track.

RESULTS

During the constant run, the RER and CHO contribution to energy expenditure were lower, and fat contribution higher, in the fat-rich diet than in the CHO-rich diet (P < 0.05), but the results were not different from those of the habitual diet. Performance in the 10,000-m run after consuming CHO- and fat-rich diets was similar to performance after a habitual diet (50.0 ± 7.0, 51.9 ± 8.3, and 50.9 ± 7.4 minutes, respectively), but consuming a CHO-rich diet enhanced performance compared with that after a fat-rich diet (P = 0.03).

CONCLUSIONS

These findings indicate that a CHO-rich diet provides additional benefits to 10,000-m running performance in trained adolescent boys compared with a fat-rich diet.

The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists

The main objective of this research was to determine the effects of a long-term ketogenic diet, rich in polyunsaturated fatty acids, on aerobic performance and exercise metabolism in off-road cyclists. Additionally, the effects of this diet on body mass and body composition were evaluated, as well as those that occurred in the lipid and lipoprotein profiles due to the dietary intervention. The research material included eight male subjects, aged 28.3 ± 3.9 years, with at least five years of training experience that competed in off-road cycling. Each cyclist performed a continuous exercise protocol on a cycloergometer with varied intensity, after a mixed and ketogenic diet in a crossover design. The ketogenic diet stimulated favorable changes in body mass and body composition, as well as in the lipid and lipoprotein profiles. Important findings of the present study include a significant increase in the relative values of maximal oxygen uptake (VO_2max) and oxygen uptake at lactate threshold (VO₂ LT) after the ketogenic diet, which can be explained by reductions in body mass and fat mass and/or the greater oxygen uptake necessary to obtain the same energy yield as on a mixed diet, due to increased fat oxidation or by enhanced sympathetic activation. The max work load and the work load at lactate threshold were significantly higher after the mixed diet. The values of the respiratory exchange ratio (RER) were significantly lower at rest and during particular stages of the exercise protocol following the ketogenic diet. The heart rate (HR) and oxygen uptake were significantly higher at rest and during the first three stages of exercise after the ketogenic diet, while the reverse was true during the last stage of the exercise protocol conducted with maximal intensity. Creatine kinase (CK) and lactate dehydrogenase (LDH) activity were significantly lower at rest and during particular stages of the 105-min exercise protocol following the low carbohydrate ketogenic diet. The alterations in insulin and cortisol concentrations due to the dietary intervention confirm the concept that the glucostatic mechanism controls the hormonal and metabolic responses to exercise.

Pre-exercise nutrition: the role of macronutrients, modified starches and supplements on metabolism and endurance performance

Endurance athletes rarely compete in the fasted state, as this may compromise fuel stores. Thus, the timing and composition of the pre-exercise meal is a significant consideration for optimizing metabolism and subsequent endurance performance. Carbohydrate feedings prior to endurance exercise are common and have generally been shown to enhance performance, despite increasing insulin levels and reducing fat oxidation. These metabolic effects may be attenuated by consuming low glycemic index carbohydrates and/or modified starches before exercise. High fat meals seem to have beneficial metabolic effects (e.g., increasing fat oxidation and possibly sparing muscle glycogen). However, these effects do not necessarily translate into enhanced performance. Relatively little research has examined the effects of a pre-exercise high protein meal on subsequent performance, but there is some evidence to suggest enhanced pre-exercise glycogen synthesis and benefits to metabolism during exercise. Finally, various supplements (i.e., caffeine and beetroot juice) also warrant possible inclusion into pre-race nutrition for endurance athletes. Ultimately, further research is needed to optimize pre-exercise nutritional strategies for endurance performance.

The effect of high vs. low carbohydrate diets on distances covered in soccer

The purpose of this study was to compare the distances covered during a 11-a-side soccer match after players had consumed either a high carbohydrate (CHO) or a low CHO diet. Twenty-two male professional soccer players formed 2 teams (A and B), of similar age, body characteristics, and training experience. The 2 teams played against each other twice with a week interval between. For 3.5 days before the first match, the players of team A followed a high CHO diet that provided 8 g CHO per kg body mass (BM) (HC), whereas team B players followed a low CHO diet that provided 3 g CHO per kg BM (LC) for the same time period. Before the second match the dietary treatment was reversed and followed for the same time period. Training during the study was controlled, and distances covered were measured using global positioning system technology. Every player covered a greater total distance in HC compared with the distance covered in LC (HC: 9,380 ± 98 m vs. LC: 8,077 ± 109 m; p < 0.01). All distances covered from easy jogging (7.15 km·h-1) to sprinting (24.15 km·h-1) were also higher in HC compared with LC (p < 0.01). When players followed the HC treatment, they won the match (team A vs. team B: 3-1 for the first game and 1-2 for the second game). The HC diet probably helped players to cover a greater distance compared with LC. Soccer players should avoid eating a low (3 g CHO per kg BM) CHO diet 3-4 days before an important soccer match and have a high CHO intake that provides at least 8 g CHO per kg BM.

Strategies of dietary carbohydrate manipulation and their effects on performance in cycling time trials

The relationship between carbohydrate (CHO) availability and exercise performance has been thoroughly discussed. CHO improves performance in both prolonged, low-intensity and short, high-intensity exercises. Most studies have focused on the effects of CHO supplementation on the performance of constant-load, time-to-exhaustion exercises. Nevertheless, in the last 20 years, there has been a consistent increase in research on the effects of different forms of CHO supplementation (e.g., diet manipulation, CHO supplementation before or during exercise) on performance during closed-loop exercises, such as cycling time trials (TTs). A TT is a highly reproducible exercise and reflects a more realistic scenario of competition compared with the time-to-exhaustion test. CHO manipulation has been performed in various time periods, such as days before, minutes before, during a TT or in a matched manner (e.g. before and during a TT). The purpose of this review is to address the possible effects of these different forms of CHO manipulation on the performance during a cycling TT. Previous data suggest that when a high-CHO diet (~70% of CHO) is consumed before a TT (24-72 h before), the mean power output increases and reduces the TT time. When participants are supplemented with CHO (from 45 to 400 g) prior to a TT (from 2 min to 6 h before the TT), mean power output and time seem to improve due to an increase in CHO oxidation. Similarly, this performance also seems to increase when participants ingest CHO during a TT because such consumption maintains plasma glucose levels. A CHO mouth rinse also improves performance by activating several brain areas related to reward and motor control through CHO receptors in the oral cavity. However, some studies reported controversial results concerning the benefits of CHO on TT performance. Methodological issues such as time of supplementation, quantity, concentration and type of CHO ingested, as well as the TT duration and intensity, should be considered in future studies because small variations in any of these factors may have beneficial or adverse effects on TT performance.

Carbohydrates for training and competition

An athlete's carbohydrate intake can be judged by whether total daily intake and the timing of consumption in relation to exercise maintain adequate carbohydrate substrate for the muscle and central nervous system ("high carbohydrate availability") or whether carbohydrate fuel sources are limiting for the daily exercise programme ("low carbohydrate availability"). Carbohydrate availability is increased by consuming carbohydrate in the hours or days prior to the session, intake during exercise, and refuelling during recovery between sessions. This is important for the competition setting or for high-intensity training where optimal performance is desired. Carbohydrate intake during exercise should be scaled according to the characteristics of the event. During sustained high-intensity sports lasting ~1 h, small amounts of carbohydrate, including even mouth-rinsing, enhance performance via central nervous system effects. While 30-60 g · h(-1) is an appropriate target for sports of longer duration, events >2.5 h may benefit from higher intakes of up to 90 g · h(-1). Products containing special blends of different carbohydrates may maximize absorption of carbohydrate at such high rates. In real life, athletes undertake training sessions with varying carbohydrate availability. Whether implementing additional "train-low" strategies to increase the training adaptation leads to enhanced performance in well-trained individuals is unclear.

Fat adaptation in well-trained athletes: effects on cell metabolism

The performance of prolonged (>90 min), continuous, endurance exercise is limited by endogenous carbohydrate (CHO) stores. Accordingly, for many decades, sports nutritionists and exercise physiologists have proposed a number of diet-training strategies that have the potential to increase fatty acid availability and rates of lipid oxidation and thereby attenuate the rate of glycogen utilization during exercise. Because the acute ingestion of exogenous substrates (primarily CHO) during exercise has little effect on the rates of muscle glycogenolysis, recent studies have focused on short-term (<1-2 weeks) diet-training interventions that increase endogenous substrate stores (i.e., muscle glycogen and lipids) and alter patterns of substrate utilization during exercise. One such strategy is "fat adaptation", an intervention in which well-trained endurance athletes consume a high-fat, low-CHO diet for up to 2 weeks while undertaking their normal training and then immediately follow this by CHO restoration (consuming a high-CHO diet and tapering for 1-3 days before a major endurance event). Compared with an isoenergetic CHO diet for the same intervention period, this "dietary periodization" protocol increases the rate of whole-body and muscle fat oxidation while attenuating the rate of muscle glycogenolysis during submaximal exercise. Of note is that these metabolic perturbations favouring the oxidation of fat persist even in the face of restored endogenous CHO stores and increased exogenous CHO availability. Here we review the current knowledge of some of the potential mechanisms by which skeletal muscle sustains high rates of fat oxidation in the face of high exogenous and endogenous CHO availability.

Effect of the classic 1-week glycogen-loading regimen on fat-loading in rats and humans

The purpose of this study was to elucidate the fat-loading effect of the classic 1-wk glycogen-loading regimen histologically in rats and physiologically in humans. In the rat and human studies, an exhaustive swimming exercise and cycle ergometer exercise were loaded on day 1 of a 6-d feeding period, respectively. Thereafter, both the rats and humans were divided into a glycogen-loading regimen consisting of a 3-d high-fat diet and a 3-d high-carbohydrate diet or a 6-d high-carbohydrate diet. After the feeding period in the human study, the human subjects performed a test exercise on day 7 using a cycle ergometer. In the rat study, the intramuscular triglyceride (IMTG) content was 69% greater (p<0.05) after the glycogen-loading regimen than after the high-carbohydrate diet feeding on day 7. In the human study, the respiratory exchange ratios (RER) after the glycogen-loading regimen were 4.9-6% lower than those after the high-carbohydrate diet during the test exercise on day 7 (p<0.05). Our findings suggest that the classical 1-wk glycogen-loading regimen maintained the storage and enhanced the utilization of energy sources during exercise in the skeletal muscle, and that it provides a fat-loading effect, in addition to the glycogen-loading effect, to the skeletal muscle.

Nutritional modulation of training-induced skeletal muscle adaptations

Skeletal muscle displays remarkable plasticity, enabling substantial adaptive modifications in its metabolic potential and functional characteristics in response to external stimuli such as mechanical loading and nutrient availability. Contraction-induced adaptations are determined largely by the mode of exercise and the volume, intensity, and frequency of the training stimulus. However, evidence is accumulating that nutrient availability serves as a potent modulator of many acute responses and chronic adaptations to both endurance and resistance exercise. Changes in macronutrient intake rapidly alter the concentration of blood-borne substrates and hormones, causing marked perturbations in the storage profile of skeletal muscle and other insulin-sensitive tissues. In turn, muscle energy status exerts profound effects on resting fuel metabolism and patterns of fuel utilization during exercise as well as acute regulatory processes underlying gene expression and cell signaling. As such, these nutrient-exercise interactions have the potential to activate or inhibit many biochemical pathways with putative roles in training adaptation. This review provides a contemporary perspective of our understanding of the molecular and cellular events that take place in skeletal muscle in response to both endurance and resistance exercise commenced after acute and/or chronic alterations in nutrient availability (carbohydrate, fat, protein, and several antioxidants). Emphasis is on the results of human studies and how nutrient provision (or lack thereof) interacts with specific contractile stimulus to modulate many of the acute responses to exercise, thereby potentially promoting or inhibiting subsequent training adaptation.

Carbohydrate availability and training adaptation: effects on cell metabolism

Several markers of endurance training adaptation are enhanced to a greater extent when individuals undertake selected training sessions with low compared with normal muscle glycogen content or with low exogenous carbohydrate availability. The potential mechanisms underlying the cellular responses arising from such nutrient-exercise interactions are discussed in the context of promoting training adaptation.

The effect of exercise on the skeletal muscle phospholipidome of rats fed a high-fat diet

The aim of this study was to examine the effect of endurance training on skeletal muscle phospholipid molecular species from high-fat fed rats. Twelve female Sprague-Dawley rats were fed a high-fat diet (78.1% energy). The rats were randomly divided into two groups, a sedentary control group and a trained group (125 min of treadmill running at 8 m/min, 4 days/wk for 4 weeks). Forty-eight hours after their last training bout phospholipids were extracted from the red and white vastus lateralis and analyzed by electrospray-ionization mass spectrometry. Exercise training was associated with significant alterations in the relative abundance of a number of phospholipid molecular species. These changes were more prominent in red vastus lateralis than white vastus lateralis. The largest observed change was an increase of ~30% in the abundance of 1-palmitoyl-2-linoleoyl phosphatidylcholine ions in oxidative fibers. Reductions in the relative abundance of a number of phospholipids containing long-chain n-3 polyunsaturated fatty acids were also observed. These data suggest a possible reduction in phospholipid remodeling in the trained animals. This results in a decrease in the phospholipid n-3 to n-6 ratio that may in turn influence endurance capacity.

Nutritional aspects of post exercise skeletal muscle glycogen synthesis in horses: a comparative review

Carbohydrate (CHO) stored in the form of skeletal muscle glycogen is the main energy source for glycolytic and oxidative ATP production during vigorous exercise in mammals. In man, horse and dog both short-term high intensity and prolonged submaximal exercise deplete muscle glycogen. In horses, however, muscle glycogen synthesis is 2-3-fold slower than in man and rat, even when a diet high in soluble CHO is fed. There appear to be significant differences in CHO and glycogen metabolism between horses and other mammals, and it is becoming increasingly clear that many conclusions drawn from human exercise physiology do not apply to horses. This review aims to provide a comprehensive, comparative summary of the research on muscle glycogen synthesis in horse, man and rodent. Species differences in CHO uptake and utilisation are examined and the issues with feeding high soluble CHO diets to horses are discussed. Alternative feeding strategies, including protein and long and short chain fatty acid supplementation and the importance of rehydration, are explored.

No variation of physical performance and perceived exertion after adrenal gland stimulation by synthetic ACTH (Synacthen) in cyclists

There is anecdotal evidence that athletes use the banned substance Synacthen because of its perceived benefit with its associated rise in cortisol. To test the performance-enhancing effects of Synacthen, eight trained cyclists completed two, 2-day exercise sessions separated by 7-10 days. On the first day of each 2-day exercise session, subjects received either Synacthen (0.25 mg, TX) or placebo (PLA) injection. Performance was assessed by a 20-km time trial (TT) after a 90-min fatigue period on day 1 and without the fatiguing protocol on day 2. Plasma androgens and ACTH concentrations were measured during the exercise bouts as well as the rate of perceived exertion (RPE). Spot urines were analyzed for androgens and glucocorticoids quantification. Basal plasma hormones did not differ significantly between PLA and TX groups before and 24 h after the IM injection (P > 0.05). After TX injection, ACTH peaked at 30 min and hormone profiles were significantly different compared to the PLA trial (P < 0.001). RPE increased significantly in both groups as the exercise sessions progressed (P < 0.001) but was not influenced by treatment. The time to completion of the TT was not affected on both days by Synacthen treatment. In the present study, a single IM injection of synthetic ACTH did not improve either acute or subsequent cycling performance and did not influence perceived exertion. The investigated urinary hormones did not vary after treatment, reinforcing the difficulty for ACTH abuse detection.