Carbohydrate mouth rinse effects on exercise capacity in pre- and postprandial States

Carbohydrate mouth rinse failed to reduce central fatigue, lower perceived exertion, and improve performance during incremental exercise

We examined if carbohydrate (CHO) mouth rinse may reduce central fatigue and perceived exertion, thus improving maximal incremental test (MIT) performance. Nine recreational cyclists warmed up for 6 min before rinsing a carbohydrate (CHO) or placebo (PLA) solution in their mouth for 10 s in a double-blind, counterbalanced manner. Thereafter, they performed the MIT (25 W·min-1 increases until exhaustion) while cardiopulmonary and ratings of perceived exertion (RPE) responses were obtained. Pre- to post-MIT alterations in voluntary activation (VA) and peak twitch torque (Tw) were determined. Time-to-exhaustion (p = 0.24), peak power output (PPO; p = 0.45), and V̇O2MAX (p = 0.60) were comparable between conditions. Neither treatment main effect nor time-treatment interaction effect were observed in the first and second ventilatory threshold when expressed as absolute or relative V̇O2 (p = 0.78 and p = 0.96, respectively) and power output (p = 0.28 and p = 0.45, respectively) values, although with moderate-to-large effect sizes. RPE increased similarly throughout the tests and was comparable at the ventilatory thresholds (p = 0.56). Despite the time main effect revealing an MIT-induced central and peripheral fatigue as indicated by the reduced VA and Tw, CHO mouth rinse was ineffective in attenuating both fatigues. Hence, rinsing the mouth with CHO was ineffective in reducing central fatigue, lowering RPE, and improving MIT performance expressed as PPO and time-to-exhaustion. However, moderate-to-large effect sizes in power output values at VT1 and VT2 may suggest some beneficial CHO mouth rinse effects on these MIT outcomes.

Carbohydrate Oral Rinsing, Cycling Performance and Individual Complex Carbohydrate Taste Sensitivity

The aim of this pilot study was to determine the effect of individual complex carbohydrate taste sensitivity on cycling performance with complex carbohydrate oral rinsing. Ten male participants completed five cycling time trials in a fasted state with a seven-day washout period between each trial. Participants completed a fixed amount of work (738.45 ± 150.74 kJ) as fast as possible on a cycle ergometer while rinsing with an oral rinse for 10 s every 12.5% of the trial. An oral rinse (maltodextrin, oligofructose, glucose, sucralose or water control) was given per visit in a randomised, crossover, blinded design. Afterwards, participants had their taste assessed with three stimuli, complex carbohydrate (maltodextrin), sweet (glucose) and sour (citric acid), using taste assessment protocol to determine individual taste sensitivity status. Participants were subsequently grouped according to their complex carbohydrate taste sensitivity and complex carbohydrate taste intensity. There were no significant effects of the oral rinses on cycling performance time (p = 0.173). Participants who did not have improvements in exercise performance with the maltodextrin rinse experienced a stronger taste intensity with complex carbohydrate stimuli at baseline (p = 0.047) and overall (p = 0.047) than those who did have improvements in performance. Overall, a carbohydrate oral rinse was ineffective in significantly improving cycling performance in comparison with a water control. However, when participants were grouped according to complex carbohydrate taste intensity, differences in exercise performance suggest that individual sensitivity status to complex carbohydrates could impact the efficacy of a carbohydrate-based oral rinse.

Central effects of mouth rinses on endurance and strength performance

Rinsing the mouth with a carbohydrate (CHO) solution has been shown to enhance exercise performance while reducing neuromuscular fatigue. This effect is thought to be mediated through the stimulation of oral receptors, which activate brain areas associated with reward, motivation, and motor control. Consequently, corticomotor responsiveness is increased, leading to sustained levels of neuromuscular activity prior to fatigue. In the context of endurance performance, the evidence regarding the central involvement of mouth rinse (MR) in performance improvement is not conclusive. Peripheral mechanisms should not be disregarded, particularly considering factors such as low exercise volume, the participant's fasting state, and the frequency of rinsing. These factors may influence central activations. On the other hand, for strength-related activities, changes in motor evoked potential (MEP) and electromyography (EMG) have been observed, indicating increased corticospinal responsiveness and neuromuscular drive during isometric and isokinetic contractions in both fresh and fatigued muscles. However, it is important to note that in many studies, MEP data were not normalised, making it difficult to exclude peripheral contributions. Voluntary activation (VA), another central measure, often exhibits a lack of changes, mainly due to its high variability, particularly in fatigued muscles. Based on the evidence, MR can attenuate neuromuscular fatigue and improve endurance and strength performance via similar underlying mechanisms. However, the evidence supporting central contribution is weak due to the lack of neurophysiological measures, inaccurate data treatment (normalisation), limited generalisation between exercise modes, methodological biases (ignoring peripheral contribution), and high measurement variability.Trial registration: PROSPERO ID: CRD42021261714.

Mouth rinsing and ingesting salty or bitter solutions does not influence corticomotor excitability or neuromuscular function

PURPOSE

To explore the effect of tasting unpleasant salty or bitter solutions on lower limb corticomotor excitability and neuromuscular function.

METHODS

Nine females and eleven males participated (age: 27 ± 7 years, BMI: 25.3 ± 4.0 kg m^-2). Unpleasant salty (1 M) and bitter (2 mM quinine) solutions were compared to water, sweetened water, and no solution, which functioned as control conditions. In a non-blinded randomized cross-over order, each solution was mouth rinsed (10 s) and ingested before perceptual responses, instantaneous heart rate (a marker of autonomic nervous system activation), quadricep corticomotor excitability (motor-evoked potential amplitude) and neuromuscular function during a maximal voluntary contraction (maximum voluntary force, resting twitch force, voluntary activation, 0-50 ms impulse, 0-100 impulse, 100-200 ms impulse) were measured.

RESULTS

Hedonic value (water: 47 ± 8%, sweet: 23 ± 17%, salt: 71 ± 8%, bitter: 80 ± 10%), taste intensity, unpleasantness and increases in heart rate (no solution: 14 ± 5 bpm, water: 18 ± 5 bpm, sweet: 20 ± 5 bpm, salt: 24 ± 7 bpm, bitter: 23 ± 6 bpm) were significantly higher in the salty and bitter conditions compared to control conditions. Nausea was low in all conditions (< 15%) but was significantly higher in salty and bitter conditions compared to water (water: 3 ± 5%, sweet: 6 ± 13%, salt: 7 ± 9%, bitter: 14 ± 16%). There was no significant difference between conditions in neuromuscular function or corticomotor excitability variables.

CONCLUSION

At rest, unpleasant tastes appear to have no influence on quadricep corticomotor excitability or neuromuscular function. These data question the mechanisms via which unpleasant tastes are proposed to influence exercise performance.

A Narrative Review of Current Concerns and Future Perspectives of the Carbohydrate Mouth Rinse Effects on Exercise Performance

Previous systematic reviews have confirmed that carbohydrate (CHO) mouth rinse may boost physical exercise performance, despite some methodological aspects likely affecting its ergogenic effect. In this review, we discussed if the exercise mode, pre-exercise fasting status, CHO solutions concentration, CHO solutions temperature, mouth rinse duration, and CHO placebo effects may potentially reduce the CHO mouth rinse ergogenic effect, suggesting possible solutions to manage these potential confounders. The effectiveness of CHO mouth rinse as a performance booster is apparently related to the origin of the exercise-induced neuromuscular fatigue, as CHO mouth rinse unequivocally potentiates endurance rather than sprint and strength exercises performance. Furthermore, ergogenic effects have been greater in fasting than fed state, somehow explaining the varied magnitude of the CHO mouth rinse effects in exercise performance. In this regard, the CHO solution concentration and temperature, as well as the mouth rinse duration, may have increased the variability observed in CHO mouth rinse effects in fasting and fed state. Finally, placebo effects have challenged the potential of the CHO mouth rinse as an ergogenic aid. Therefore, we suggest that future studies should consider methodological controls such as sample size and sample homogeneity, proper familiarization with experimental procedures, and the use of alternative placebo designs to provide unbiased evidence regarding the potential of the CHO mouth rinse as an ergogenic aid.

Carbohydrate Mouth Rinse and Spray Improve Prolonged Exercise Performance in Recreationally Trained Male College Students

Mouth rinsing with a carbohydrate (CHO) solution has emerged as a sports nutrition strategy to increase endurance performance. This study aimed to clarify the effects of two forms of CHO sensing in the mouth (i.e., CHO mouth rinse (CMR) and CHO mouth spray (CMS)) on exercise performance during prolonged exercise, including ultra-high intensity intermittent exercise over time. We conducted the following experimental trials: (1) 6% glucose solution (G), (2) 6% CMR, (3) 6% CMS, and (4) water (WAT). These trials were conducted at least 1 week apart in a randomized crossover design. Eight male college students performed constant-load exercise for 60 min (intensity 40% VO2peak), four sets of the Wingate test (three 30 s Wingate tests with a 4 min recovery between each test), and a constant-load exercise for 30 min (intensity 40% VO2peak). The mean exercise power output (Watt), ratings of perceived exertion, and blood glucose levels were measured. We found that the mean power values of the CMR and CMS in the third and fourth sets was significantly higher than that of WAT (p < 0.05), and that the G trial did not show a significant difference from any other trial. Thus, when compared to G or WAT, CMR and CMS can help improve endurance exercise performance.

Maltodextrin-Based Carbohydrate Oral Rinsing and Exercise Performance: Systematic Review and Meta-Analysis

Background

Carbohydrates are an important fuel for optimal exercise performance during moderate- and high-intensity exercise; however, carbohydrate ingestion during high-intensity exercise may cause gastrointestinal upset. A carbohydrate oral rinse is an alternative method to improve exercise performance in moderate- to high-intensity exercise with a duration of 30–75 min. This is the first systematic review and meta-analysis to comprehensively examine the isolated effect of maltodextrin-based rinsing on exercise performance.

Objective

The objective of this review was to establish the effect of a maltodextrin-based carbohydrate oral rinse on exercise performance across various modes of exercise. Furthermore, a secondary objective was to determine the effects of moderators [(1) participant characteristics; (2) oral rinse protocols; (3) exercise protocol (i.e. cycling, running etc.) and (4) fasting] on exercise performance while using a maltodextrin-based, carbohydrate oral rinse.

Methods

Five databases (MEDLINE, PsycINFO, Embase, SPORTDiscus and Global Health) were systematically searched for articles up to March 2021 and screened using Covidence (a systematic review management tool). A random effects robust meta-analysis and subgroup analyses were performed using Stata Statistical Software: Release 16.

Results

Thirty-five articles met the inclusion criteria and were included in the systematic review; 34 of these articles were included in the meta-analysis. When using a conventional meta-analytic approach, overall, a carbohydrate oral rinse improved exercise performance in comparison with a placebo (SMD = 0.15, 95% CI 0.04, 0.27; p = 0.01). Furthermore, when implementing an adjusted, conservative, random effects meta-regression model using robust variance estimation, overall, compared with placebo, a carbohydrate oral rinse demonstrated evidence of improving exercise performance with a small effect size (SMD = 0.17, 95% CI − 0.01, 0.34; p = 0.051).

Conclusion

This systematic review and meta-analysis demonstrates that a maltodextrin-based carbohydrate oral rinse can improve exercise performance. When comparing the two meta-analytic approaches, although non-significant, the more robust, adjusted, random effects meta-regression model demonstrated some evidence of a maltodextrin-based carbohydrate oral rinse improving exercise performance overall.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01658-3.

No independent or synergistic effects of carbohydrate-caffeine mouth rinse on repeated sprint performance during simulated soccer match play in male recreational soccer players

The study examined the synergistic and independent effects of carbohydrate-caffeine mouth rinse on repeated sprint performance during simulated soccer match play. Nine male soccer players (21 ± 3 years, 1.75 ± 0.05 m, 68.0 ± 9.0 kg) completed four trials with either 6 mg·kg^-1 caffeine + 10% maltodextrin (CHO+CAFMR), 6 mg·kg^-1 caffeine (CAFMR), 10% maltodextrin (CHOMR), water (PLA) in a block randomised, double-blinded, counterbalanced and crossover manner separated by minimum 96 h. All solutions were taste-matched and a carbohydrate-rich meal (2 g·kg^-1body mass) was provided 2 h before each trial. Each trial consisted of a 90-min soccer-specific aerobic field test (SAFT⁹⁰) and two bouts of repeated sprint ability tests (RSAT; 6 × 6 s sprints with 24 s recovery) completed at 0 min and 75^th min of SAFT⁹⁰. A 25 ml solution of either CHO+CAFMR, CAFMR, CHOMR or PLA was rinsed immediately before the second RSAT (75 min). Mean power output, peak power output (PPO) or fatigue index (FI) was not impacted by any treatment during the 75^th min RAST (p > 0.05). These results suggest that carbohydrate and/or caffeine mouth rinses do not have an ergogenic effect during simulated soccer exercise after a high carbohydrate meal.

Menthol Mouth Rinsing Is More Than Just a Mouth Wash-Swilling of Menthol to Improve Physiological Performance

Interventions that solely act on the central nervous system (CNS) are gaining considerable interest, particularly products consumed through the oral cavity. The oropharyngeal cavity contains a wide array of receptors that respond to sweet, bitter, and cold tastants, all of which have been shown to improve physiological performance. Of late, the ergogenic benefits of carbohydrate (CHO) and caffeine (CAF) mouth rinsings (MRs) have been widely studied; however, less is known about menthol (MEN). That the physiological state and environmental conditions impact the response each product has is increasingly recognized. While the effects of CHO and CAF MRs have been thoroughly studied in both hot and thermoneutral conditions, less is known about MEN as it has only been studied in hot environments. As such, this review summarizes the current knowledge regarding the MEN MR and exercise modality, frequency of the mouth rinse, and mouth rinse duration and compares two different types of study designs: time trials vs. time to exhaustion (TTE).

Effects of carbohydrate and caffeine combination mouth rinse on anaerobic performance of highly trained male athletes

The ergogenic effects of carbohydrate (CHO) and caffeine (CAF) mouth rinse (MR) methods on anaerobic performance remains unclear. Therefore, the aim of this study was to investigate the effects of CHO, CAF, and CHO + CAF combination solutions in mouth on repeated vertical jumping (RVJ) performance in highly trained male athletes. Eight male athletes (mean age: 22 years) underwent test sessions four times with minimum 24-h intervals under fasting conditions. Participants rinsed their mouths with four different 25-ml solutions, namely, CHO (6.4% maltodextrin = 1.6 g), CAF (1.2% caffeine = 300 mg), placebo (PLA, saccharin), or CHO + CAF (6.4%+1.2%) combination, for 10 s and performed a 30-s RVJ test twice with a 5-min interval. Peak power output, vertical jump height, blood lactate level, fatigue index, and rate of perceived exertion of the RVJ tests for different intervention sessions were compared. The statistical significance level was set at p ≤ 0.05. Analyses demonstrated that CHO- (Δ: 3.4), CAF- (Δ: -0.8), and CHO + CAF-MR (Δ: -1.8) interventions led to similar RVJ performance changes compared to PLA. All differences in the dependent variables were statistically insignificant and had moderate and lower effect sizes between interventions (p > 0.05, g < 0.94). Our study did not elicit sufficient evidence to recommend highly trained male athletes the use of CHO- and CAF-MR separately or in combination to enhance jump performance. However, the fact that some differences have medium to large effect sizes suggests that the issue is still worth to be a potential topic for further research.Highlights Effects of CHO + CAF-MR on anaerobic performance in highly trained athletes have not been investigated using performance tasks requiring high technical skills.There is not enough evidence to suggest that CHO, CAF and CHO + CAF-MR interventions have beneficial effects on RVJ performance compared to PLA in highly trained male athletes.Some statistically insignificant differences have medium to large effect sizes. Therefore, the issue is still worth to be a potential topic for further research.

Perceptual and Physiological Responses to Carbohydrate and Menthol Mouth-Swilling Solutions: A Repeated Measures Cross-Over Preliminary Trial

Carbohydrate and menthol mouth-swilling have been used to enhance exercise performance in the heat. However, these strategies differ in mechanism and subjective experience. Participants (n = 12) sat for 60 min in hot conditions (35 °C; 15 ± 2%) following a 15 min control period, during which the participants undertook three 15 min testing blocks. A randomised swill (carbohydrate; menthol; water) was administered per testing block (one swill every three minutes within each block). Heart rate, tympanic temperature, thermal comfort, thermal sensation and thirst were recorded every three minutes. Data were analysed by ANOVA, with carbohydrate intake controlled for via ANCOVA. Small elevations in heart rate were observed after carbohydrate (ES: 0.22 ± 90% CI: −0.09–0.52) and water swilling (0.26; −0.04–0.54). Menthol showed small improvements in thermal comfort relative to carbohydrate (−0.33; −0.63–0.03) and water (−0.40; from −0.70 to −0.10), and induced moderate reductions in thermal sensation (−0.71; from −1.01 to −0.40 and −0.66; from −0.97 to −0.35, respectively). Menthol reduced thirst by a small to moderate extent. These effects persisted when controlling for dietary carbohydrate intake. Carbohydrate and water may elevate heart rate, whereas menthol elicits small improvements in thermal comfort, moderately improves thermal sensation and may mitigate thirst; these effects persist when dietary carbohydrate intake is controlled for.

Carbohydrate mouth rinse improves resistance exercise capacity in the glycogen-lowered state

The effect of carbohydrate mouth rinse (CHO MR) on resistance exercise performance is equivocal and may be moderated by carbohydrate availability. This study determined the effect of CHO MR on low-load resistance exercise capacity completed in a fed but glycogen-lowered state. Twelve resistance-trained men (age: 22 ± 4 years; height: 1.79 ± 0.05 m; mass: 78.7 ± 7.8 kg; bench press one-repetition maximum (1RM): 87 ± 21 kg; squat 1RM: 123 ± 19 kg) completed two fed-state resistance exercise bouts consisting of six sets of bench press and six sets of squat to failure at 40% 1RM. Each bout was preceded by glycogen-depleting cycling the evening before, with feeding controlled to create acute energy deficit and maintain low muscle glycogen. During resistance exercise, participants rinsed with either a 6% CHO MR solution or a taste-matched placebo (PLA) between sets. Total volume workload was greater with CHO MR (9354 ± 2051 vs. 8525 ± 1911 kg, p = 0.010). Total number of repetitions of squat were greater with CHO MR (107 ± 26 vs. 92 ± 16, p = 0.017); the number of repetitions of bench press were not significantly different (CHO MR: 120 ± 24 vs. PLA: 115 ± 22, p = 0.146). This was independent of differences in feeling or arousal. CHO MR may be an effective ergogenic aid for athletes completing resistance exercise when in energy deficit and with low carbohydrate availability. Novelty: CHO MR can increase low-load resistance exercise capacity undertaken in a glycogen-lowered but fed state. This effect was driven by a greater number of repetitions-to-failure in the squat - using muscles lowered in glycogen content with exhaustive cycling on the evening prior to resistance exercise - but not bench press.

Can taste be ergogenic?

Taste is a homeostatic function that conveys valuable information, such as energy density, readiness to eat, or toxicity of foodstuffs. Taste is not limited to the oral cavity but affects multiple physiological systems. In this review, we outline the ergogenic potential of substances that impart bitter, sweet, hot and cold tastes administered prior to and during exercise performance and whether the ergogenic benefits of taste are attributable to the placebo effect. Carbohydrate mouth rinsing seemingly improves endurance performance, along with a potentially ergogenic effect of oral exposure to both bitter tastants and caffeine although subsequent ingestion of bitter mouth rinses is likely required to enhance performance. Hot and cold tastes may prove beneficial in circumstances where athletes' thermal state may be challenged. Efficacy is not limited to taste, but extends to the stimulation of targeted receptors in the oral cavity and throughout the digestive tract, relaying signals pertaining to energy availability and temperature to appropriate neural centres. Dose, frequency and timing of tastant application likely require personalisation to be most effective, and can be enhanced or confounded by factors that relate to the placebo effect, highlighting taste as a critical factor in designing and administering applied sports science interventions.

Effects of Carbohydrate Mouth Rinsing on Salivary Lysozyme, Mood States and Running Performance Among Recreational Runners

Introduction

Carbohydrate (CHO) mouth rinsing can enhance sports performance through a central action mediated by receptors in the mouth. This study examined the effect of a CHO mouth rinse on salivary lysozyme concentrations, mood states and running performances.

Methods

Ten males recreational runners were randomised to three running trials with a 1 week recovery period between the trials. Each trial involved running at 75% maximum heart rate (HRmax) for 1 h, followed by a 15 min time trial. The participants used a CHO mouth rinse, placebo (PLA) solution or control (CON, no solution) every 15 min during the exercise. Heart rate (HR), rating of perceived exertion (RPE) and mood states were recorded pre-, during and post-exercise. Saliva samples were collected pre-, post- and 1 h post-exercise.

Results

There was no significant interaction and time effect (P > 0.05) on the salivary lysozyme concentration and running performance, but it was significant (P < 0.05) for HR and RPE (increase in all trials). However, there was no significant difference (P > 0.05) in salivary lysozyme concentrations, running performances, HR values or RPE between the trials. Mood states were not significantly different (P > 0.05) between the trials, but one of the mood sub-scales showed a significant (P < 0.001) time effect (increase fatigue in all trials).

Conclusion

CHO mouth rinsing did not affect physiological parameters, salivary lysozyme concentrations, mood states or running performance among recreational runners.

Effect of glucose and sodium chloride mouth rinses on neuromuscular fatigue: a preliminary study

Carbohydrate (CHO) mouth rinse has been shown to improve endurance performance and maintain the central drive of contracting muscles. Salt (NaCl) mouth rinse solution, often used in dentistry to desensitise the oral cavity to pain, could also activate cortical areas of the brain. Hence, the objective of this preliminary study was to investigate whether CHO (glucose) and NaCl mouth rinses could attenuate the reduction in maximum voluntary contraction (MVC) and sustained MVC (sMVC) following an endurance exercise (30-minute cycling at 70% VO₂max). Ten subjects (male, age: 22 ± 1 years, weight: 65.3 ± 12.4 kg, height: 164.5 ± 7.5 cm, VO₂max: 48.3 ± 6.1 mL kg^-1 min^-1) completed three trials of 30-minute cycling exercise. In a randomised cross-over study, in each trial, the participants rinsed using either water, 6% glucose, or 6% NaCl solution for 5 s immediately prior to and every 10 min during the cycling exercise. The MVC and sMVC were measured pre and post cycling. Analysis of variance showed significant interaction and time effects for MVC, while for sMVC there was a significant interaction with time and group effects. Both MVC and sMVC were higher post cycling in the glucose and NaCl groups compared to the water group, which suggests that activation of glucose and NaCl oral receptors could better preserve post-exercise force production. This is the first study to show that NaCl mouth rinse can produce a comparable effect on glucose. Hence, mouth rinses may be able to activate other distinct pathways that could attenuate fatigue.

Mouth Rinsing Cabohydrates Serially Does Not Improve Repeated Sprint Time

Sensing carbohydrates via the oral cavity benefits performance outcomes during brief high intensity bouts of exercise. However, the extent to which carbohydrates need to be present in the oral cavity to influence sprint performance is less understood. The purpose of this study was to determine if serial increases in carbohydrate rinse time across sprint sets attenuates increases in sprint time compared to no serial increases in carbohydrate rinse time across sprint sets. Fifteen sprint trained participants completed three repeated anaerobic sprint tests (RAST), 3 sets of 6 x 35-m sprints, under two different carbohydrate mouth rinsing (CMR) conditions; (1) rinsing for only 5 seconds (s), and (2) rinsing for 5 s, 10 s and 15 s (serial rinse). Prior to a RAST, participants provided perceived recovery status (PRS) and perceived feeling of arousal (FAS). Upon completion of each individual sprint, participants gave a rating of perceived exertion (RPE). A lactate sample was taken upon completion of each individual sprint set and after all 3 RASTs a session rating of perceived exertion (S-RPE) was measured. There were no significant differences in peak (p = 0.18) and average sprint time (p = 0.41). There were no significant differences in perceptual measures: RPE, PRS, FAS, S-RPE or for blood lactate concentration between CMR conditions. Overall, serial rinsing resulted in changes that were most likely trivial, but showed a 50% chance in perceiving a sprint session as less difficult. Rinsing carbohydrates in a serial manner between repeated sprint sets produces trivial changes of sprint speed and perceptual measures from sprint performance.

The ergogenic potency of carbohydrate mouth rinse on endurance running performance of dehydrated athletes

PURPOSE

To examine the effect of carbohydrate (CHO) mouth rinsing on endurance running responses and performance in dehydrated individuals.

METHODS

In a double blind, randomised crossover design, 12 well-trained male runners completed 4 running time to exhaustion (TTE) trials at a speed equivalent to 70% of VO_2peak in a thermoneutral condition. Throughout each run, participants mouth rinsed and expectorated every 15 min either 25 mL of 6% CHO or a placebo (PLA) solution for 10 s. The four TTEs consisted of two trials in the euhydrated (EU-CHO and EU-PLA) and two trials in the dehydrated (DY-CHO and DY-PLA) state. Prior to each TTE run, participants were dehydrated via exercise and allowed a passive rest period during which they were fed and either rehydrated equivalent to their body mass deficit (i.e., EU trials) or ingested only 50 mL of water (DY trials).

RESULTS

CHO mouth rinsing significantly improved TTE performance in the DY compared to the EU trials (78.2 ± 4.3 vs. 76.9 ± 3.8 min, P = 0.02). The arousal level of the runners was significantly higher in the DY compared to the EU trials (P = 0.02). There was no significant difference among trials in heart rate, plasma glucose and lactate, and psychological measures.

CONCLUSIONS

CHO mouth rinsing enhanced running performance significantly more when participants were dehydrated vs. euhydrated due to the greater sensitivity of oral receptors related to thirst and central mediated activation. These results show that level of dehydration alters the effect of brain perception with presence of CHO.

Carbohydrate Mouth Rinse Decreases Time to Complete a Simulated Cycling Time Trial

Rinsing carbohydrate solutions in the mouth can produce positive effects on the central nervous system via mouth/tongue receptors, ultimately increasing cycling performance. However, previous investigations on this topic have used complex carbohydrate solutions and time trials on a cyclergometer to complete a set amount of work. The purpose of the present study was to examine the effects of carbohydrate mouth rinsing on physical performance by using a commercially available drink during a cycling time trial with varying slopes. In a double-blind, placebo-controlled and randomized manner, 16 well-trained cyclists (37.6 ± 3.5 years; 76.9 ± 7.9 kg) performed two simulated cycling time trial (25.3 km) with their own bikes on a 3D virtual trainer. In one occasion, participants mouth-rinsed a 6.4% carbohydrate mixed solution for 5 s each 12.5% of total completion of the trial; in other occasion participants rinsed with a taste-matched placebo with 0.0% of carbohydrate. During the trials, participants were instructed to perform as fast as possible at a self-chosen pace while time, cycling power output and ratings of perceived exertion were obtained during the trials. When compared to the placebo, carbohydrate mouth rinse decreased the time employed to complete the distance (2,960 ± 412 vs. 2,888 ± 396 s; P = 0.04, respectively), while it increased overall cycling power (222 ± 51 vs. 231 ± 46 w, P = 0.04) and cycling power during the climbing sections (238 ± 46 vs. 248 ± 47 w, P = 0.03). Carbohydrate mouth rinse also increased the rating of perceived exertion at the end of the trial (18.3 ± 1.7 vs. 18.9 ± 1.1 arbitrary units, P = 0.04). In summary, mouth rinsing with a commercially available carbohydrate drink might be considered as an effective strategy to increase physical performance during cycling time trials. However, due to the performance downsides of breaking the aero-position or interrupting the breathing pattern for rising during a time trial, carbohydrate mouth rinse protocols might be more suitable for high-intensity training sessions, particularly those sessions intentionally performed with low carbohydrate intake.

The Effect of Caffeine Ingestion and Carbohydrate Mouth Rinse on High-Intensity Running Performance

The aim of the current study was to investigate whether carbohydrate mouth rinsing works synergistically with caffeine to augment high-intensity running in a fed state. Eight participants completed a total of three trials; (1) placebo (PLA) trial (placebo capsule + placebo mouth rinse), (2) caffeine (CAF) trial (400 mg caffeine + placebo mouth rinse) and (3) carbohydrate mouth rinse + caffeine (CMR + CAF) trial (400 mg caffeine + 6% carbohydrate mouth rinse). Each trial consisted of a 45 min steady-state run at 65% VO_2max, followed by 90% VO_2max high-intensity intervals (HIIT) at 1 min and subsequently by a 1 min recovery walking at 6 km·h⁻¹, until exhaustion. Both CAF (46.8 ± 20.1 min) and CMR + CAF (46.9 ± 18.4 min) time to exhaustion were significantly greater than the PLA group (36.2 ± 14.8 min, p < 0.001). Post hoc analysis revealed that there was a significant increase in time to exhaustion between PLA and CMR + CAF (p = 0.006) and PLA and CAF (p = 0.017) but not between CAF and CMR + CAF (p = 0.99). In conclusion, we provide novel data that suggest that caffeine alone would likely suffice as an ergogenic aid during high-intensity running while in a fed state.

Caffeine Ingestion With or Without Low-Dose Carbohydrate Improves Exercise Tolerance in Sedentary Adults

Caffeine (CAF) and carbohydrate (CHO) ingestion delay fatigue during prolonged exercise; however, this is primarily documented in endurance trained (ET) athletes. Our purpose was to determine if these ergogenic aids are also effective to improve exercise tolerance in age-matched sedentary (SED) adults. Using a double-blind crossover design, ET and SED (n = 12 each group) completed four exercise trials consisting of 30 min cycling at standardized matched work rates 10% below lactate threshold (MOD-EX) followed by a time to fatigue (TTF) ride at individually prescribed intensity of 5% above lactate threshold. After standardized breakfast, the following drink treatments were given before and throughout exercise: CAF (3 mg/kg of body mass, equivalent to 1.5 cups premium brewed coffee), low calorie CHO (LCHO) (0.4% solution, 2 g total CHO), CAF+LCHO, and artificially-sweetened placebo (PLA). SED and ET had similar perceived exertion (RPE) during MOD-EX and TTF (23.8 ± 3.1 and 24.1 ± 2.6 min in ET, SED, respectively). LCHO did not benefit exercise tolerance compared to PLA and was less effective (p < 0.05) compared to CAF+LCHO for all participants combined. Thus, the two CAF treatments were averaged, resulting in ~5% lower RPE (p < 0.05) and 21% longer TTF (26.3 ± 10.4 min) compared to the no-CAF (21.7 ± 9.9 min) treatments. Blood glucose and lactate were higher (p < 0.05) with CAF vs. no-CAF. SED and ET only differed in metabolic oxidation rates during exercise (higher overall fat oxidation with ET compared to SED). CAF reduces the perceived effort during exercise and increases the capacity for sedentary individuals, as well as trained athletes, to tolerate higher intensity exercise for greater duration; and, these benefits were not further enhanced by ingesting doses of low carbohydrate regularly during exercise.

Carbohydrate Mouth Rinse Improves Relative Mean Power During Multiple Sprint Performance

Multiple investigations have confirmed carbohydrate mouth rinse (CMR) enhances high intensity endurance performance lasting under 1 hour, but the effects of CMR on high intensity intermittent exercise has received less attention. This study examined the effect of CMR on high intensity multiple sprint performances in a protocol designed to emulate a cyclocross or mountain biking event. Seven trained men (28.2 ± 6.8 years, 185 ± 9 cm, 85.3 ± 14.8 kg, VO₂peak 51.4 ± 7.3 ml/kg*min-1) completed two, 48 min high intensity intermittent cycling protocols that consisted of 6 bouts of 5 min cycling at 50% _VO2 peak followed by sets of three, 10-s Wingate sprints with 50 s of recovery between sprints. Prior to each set of Wingate sprints, either a 6.4% carbohydrate solution (CMR) or placebo (PLA) were rinsed for 10 s using a counterbalanced crossover design. There was a significant main effect (CMR 10.51 ± 0.82, PLA 10.33 ± 0.87 W/kg; p < 0.05 ES=0.21) for mean power, but post hoc tests only revealed statistically significant performance improvement with CMR during the 6th bout (CMR 10.5 ± 0.75, PLA 10.22 ± 0.92 W/kg; p = 0.01 ES=0.33). No treatment effect was exhibited for peak power, fatigue index, ratings of perceived exertion, or blood glucose. Most team sport situations provide multiple opportunities for access to beverages, but gastrointestinal distress associated with fluid intake may reduce desire for significant beverage consumption. Under such circumstances, a small but practical ergogenic advantage may be exhibited if the fluid rinsed in the mouth contains carbohydrates.

The effect of carbohydrate mouth rinse on performance, biochemical and psychophysiological variables during a cycling time trial: a crossover randomized trial

BACKGROUND

The hypothesis of the central effect of carbohydrate mouth rinse (CMR) on performance improvement in a fed state has not been established, and its psychophysiological responses have not yet been described. The aim of this study was to evaluate the effect of CMR in athletes fed state on performance, biochemical and psychophysiological responses compared to ad libitum water intake.

METHODS

Eleven trained male cyclists completed a randomized, crossover trial, which consisted of a 30 km cycle ergometer at self-selected intensity and in a fed state. Subjects were under random influence of the following interventions: CMR with a 6% unflavored maltodextrin solution; mouth rinsing with a placebo solution (PMR); drinking "ad libitum" (DAL). The time for completion of the test (min), heart rate (bpm) and power (watts), rating of perceived exertion (RPE), affective response, blood glucose (mg/dL) and lactate (mmol/DL), were evaluated before, during and immediately after the test, while insulin (uIL/mL), cortisol (μg/dL) and creatine kinase (U/L) levels were measured before, immediately after the test and 30 min after the test.

RESULTS

Time for completion of the 30 km trial did not differ significantly among CMR, PMR and DAL interventions (means = 54.5 ± 2.9, 54.7 ± 2.9 and 54.5 ± 2.5 min, respectively; p = 0.82). RPE and affective response were higher in DAL intervention (p < 0.01). Glucose, insulin, cortisol and creatine kinase responses showed no significant difference among interventions.

CONCLUSIONS

In a fed state, CMR has not caused metabolic changes, and it has not improved physical performance compared to ad libitum water intake, but demonstrated a possible central effect. ReBec registration number: RBR-4vpwkg. Available in http://www.ensaiosclinicos.gov.br/rg/?q=RBR-4vpwkg.

Carbohydrate Mouth Rinse Fails to Improve Four-Kilometer Cycling Time Trial Performance

We investigated if a carbohydrate (CHO) mouth rinse may attenuate global fatigue and improve 4-km cycling time trial (TT_4km) performance. After a preliminary session, cyclists (n = 9) performed a TT_4km after a CHO or placebo (PLA) mouth rinse. Mean power output, time, and ratings of perceived exertion (RPE) were recorded throughout the TT_4km. Twitch interpolation responses (%VA; voluntary activation and ∆Tw; delta peak twitch torque) were compared pre and post TT_4km with traditional statistics and effect size (ES) analysis. Time-to-complete the 4 km and mean power output were comparable between CHO (386.4 ± 28.0 s) and PLA (385.4 ± 22.4 s). A lower central (p = 0.054) and peripheral (p = 0.02) fatigue in CHO than in PLA were suggested by an extremely-large ES in %VA (manipulation main effect: p = 0.052, d = 1.18; manipulation-by-time interaction effect: p = 0.08, d = 1.00) and an extremely, very-large ES in ∆Tw (manipulation main effect: p = 0.07, d = 0.97; time-by-manipulation interaction effect: p = 0.09, d = 0.89). The RPE increased slower in CHO than in PLA (p = 0.051; d = 0.7). The apparent reduction in global fatigue (central and peripheral) and RPE_SLOPE with only one CHO mouth rinse were not translated into improved TT_4km performance. Further tests may be required to verify if these likely differences in global fatigue might represent an edge in the short-lasting cycling time trial performance.

Impact of carbohydrate mouth rinsing on time to exhaustion during Ramadan: A randomized controlled trial in Jordanian men

Mouth rinsing using a carbohydrate (CHO) solution has been suggested to improve physical performance in fasting participants. This study examined the effects of CHO mouth rinsing during Ramadan fasting on running time to exhaustion and on peak treadmill speed (V_peak). In a counterbalanced crossover design, 18 sub-elite male runners (Age: 21 ± 2 years, Weight: 68.1 ± 5.7 kg, VO_2max: 55.4 ± 4.8 ml/kg/min) who observed Ramadan completed a familiarization trial and three experimental trials. The three trials included rinsing and expectorating a 25 mL bolus of either a 7.5% sucrose solution (CHO), a flavour and taste matched placebo solution (PLA) for 10 s, or no rinse (CON). The treatments were performed prior to an incremental treadmill test to exhaustion. Three-day dietary and exercise records were obtained on two occasions and analysed. Anthropometric characteristics were obtained and recorded for all participants. A main effect for mouth rinse on peak velocity (V_peak) (CHO: 17.6 ± 1.5 km/h; PLA: 17.1 ± 1.4 km/h; CON: 16.7 ± 1.2 km/h; P < .001, η_p² = 0.49) and time to exhaustion (CHO: 1282.0 ± 121.3 s; PLA: 1258.1 ± 113.4 s; CON: 1228.7 ± 98.5 s; P = .002, η_p² = 0.41) was detected, with CHO significantly higher than PLA (P < .05) and CON (P < .05). Oxygen consumption, heart rate, respiratory exchange ratio, and rating of perceived exertion were not significantly different between treatments or trials (P > .05). Energy availability from dietary analysis, body weight, and fat-free mass did not change during the last two weeks of Ramadan (P > .05). This study concludes that carbohydrate mouth rinsing improves running time to exhaustion and peak treadmill speed under Ramadan fasting conditions.

Evidence supporting oral sensitivity to complex carbohydrates independent of sweet taste sensitivity in humans

Compared to simple sugars, complex carbohydrates have been assumed invisible to taste. However, two recent studies proposed that there may be a perceivable taste quality elicited by complex carbohydrates independent of sweet taste. There is precedent with behavioural studies demonstrating that rats are very attracted to complex carbohydrates, and that complex carbohydrates are preferred to simple sugars at low concentrations. This suggests that rats may have independent taste sensors for simple sugars and complex carbohydrates. The aim of this paper is to investigate oral sensitivities of two different classes of complex carbohydrates (a soluble digestible and a soluble non-digestible complex carbohydrate), and to compare these to other caloric and non-nutritive sweeteners in addition to the prototypical tastes using two commonly used psychophysical measures. There were strong correlations between the detection thresholds and mean intensity ratings for complex carbohydrates (maltodextrin, oligofructose) (r = 0.94, P < 0.001). There were no significant correlations between the detection thresholds of the complex carbohydrates (maltodextrin, oligofructose) and the sweeteners (glucose, fructose, sucralose, Rebaudioside A, erythritol) (all P > 0.05). However, moderate correlations were observed between perceived intensities of complex carbohydrates and sweeteners (r = 0.48–0.61, P < 0.05). These data provide evidence that complex carbohydrates can be sensed in the oral cavity over a range of concentrations independent of sweet taste sensitivity at low concentrations, but with partial overlap with sweet taste intensity at higher concentrations.

Effects of carbohydrate mouth rinse and caffeine on high-intensity interval running in a fed state

The current study aims to identify if mouth rinsing with a 6% carbohydrate mouth-rinse (CMR) solution and mouth rinsing and ingestion of caffeine (CMR+CAFF) can affect exercise performance during steady-state (SS) running and high-intensity intervals (HIIT) in comparison with a 0% control solution (PLA) when in a fed state. Eight recreationally trained males completed 3 trials (CMR, CMR+CAFF, and PLA) of 45 min SS running and an HIIT protocol (90% peak treadmill velocity) until fatigue in a double blinded, repeated-measures study. Participants ingested a capsule of either CAFF or PLA before and after SS. Participants received a 25-mL bolus of carbohydrate solution (CMR and CMR+CAFF trials) or taste-matched PLA (PLA trial) prior to HIIT protocol and after every second effort. Heart rate and lactate responses were recorded throughout the SS and HIIT protocol. CMR+CAFF was significantly different when compared with PLA (p = 0.001; Cohens d = 1.34) and CMR (p = 0.031; Cohens d = 0.87) in relation to distance covered before fatigue. Although there was no significant difference between CMR and PLA, there was a small benefit for CMR (p = 0.218; Cohens d = 0.46). Results indicate that CMR and ingestion of CAFF leads to improvements in performance during interval sessions while participants were in a fed state. These findings indicate that the regular use of CMR can decrease the risk of gastrointestinal distress reported by athletes, which can be applicable to athletes in a real-world setting.

The Effect of a Carbohydrate Mouth Rinse on Upper-Body Muscular Strength and Endurance

Dunkin, JE and Phillips, SM. The effect of a carbohydrate mouth rinse on upper-body muscular strength and endurance. J Strength Cond Res 31(7): 1948-1953, 2017-Carbohydrate (CHO) mouth rinsing rapidly increases corticomotor output and maximal muscle force production, which could enhance muscular strength and endurance during resistance exercise. However, previous research has found no effect of CHO rinsing on muscular strength or endurance. The current study altered the CHO rinse composition and frequency and the muscular endurance test to further investigate the effects of a CHO mouth rinse on upper-body muscular strength and endurance. Twelve recreationally resistance-trained men (mean ± SD age 22 ± 1 year, height 179.2 ± 1.8 cm, body mass 80.9 ± 6.1 kg) completed a bench press protocol (1 repetition maximum [RM] test followed by repetitions to failure at 40% of 1RM) on 3 occasions. Subjects rinsed 25 ml of an 18% CHO solution or a placebo for 10 seconds before 1RM and repetitions to failure and completed a no-rinse control condition. Felt arousal (FA) was measured before and after each rinse, heart rate (HR) was measured before and after both exercise protocols, and rating of perceived exertion (RPE) was recorded after repetitions to failure. Rinsing did not influence 1RM (p = 0.680, (Equation is included in full-text article.)= 0.03), repetitions to failure (p = 0.677, (Equation is included in full-text article.)= 0.04), or exercise volume (load × reps; p = 0.600, (Equation is included in full-text article.)= 0.05). There were no significant treatment effects on heart rate (p = 0.677, (Equation is included in full-text article.)= 0.04), FA (p = 0.674, (Equation is included in full-text article.)= 0.04) or rating of perceived exertion (p = 0.604, (Equation is included in full-text article.)= 0.05). A CHO mouth rinse does not improve upper-body muscular strength or endurance.

Quantifying the Effect of Carbohydrate Mouth Rinsing on Exercise Performance

The purpose of this study was to review the existing literature investigating carbohydrate mouth rinsing as an ergogenic aid using the effect sizes (ES) and percentage change in performance of the respective studies as outcome measures. A trivial-small average overall ES was present for the 25 studies included in the review (0.18, 95% confidence interval [CI] = 0.10-0.27). Effect sizes for the subgroups were ≥25 minutes (0.25, 95% CI = 0.14-0.36), ≤180 seconds (0.06, 95% CI = -0.03 to 0.15), resistance exercise (-0.09, 95% CI = -0.20 to 0.03) but the ES is still small. A subanalysis of ∼1-h cycling time trial performance resulted in an overall ES of 0.20 (95% CI = 0.02-0.38), and ES for performance time and power output of 0.31 (95% CI = -0.02 to 0.64) and 0.19 (95% CI = -0.09 to 0.46), respectively. Although ES were small, the average percentage change in performance in ∼1-hour trials was 2.48%, which may have implications for elite performers as this is greater than the 1.30% smallest worthwhile change recommended in the past research.

Cognitive Performance Enhancement Induced by Caffeine, Carbohydrate and Guarana Mouth Rinsing during Submaximal Exercise

The aim of this study was to investigate the influence of serial mouth rinsing (MR) with nutritional supplements on cognitive performance (i.e., cognitive control and time perception) during a 40-min submaximal exercise. Twenty-four participants completed 4 counterbalanced experimental sessions, during which they performed MR with either placebo (PL), carbohydrate (CHO: 1.6 g/25 mL), guarana complex (GUAc: 0.4 g/25 mL) or caffeine (CAF: 67 mg/25 mL) before and twice during exercise. The present study provided some important new insights regarding the specific changes in cognitive performance induced by nutritional supplements. The main results were: (1) CHO, CAF and GUA MR likely led participants to improve temporal performance; (2) CAF MR likely improved cognitive control; and (3) CHO MR led to a likely decrease in subjective perception of effort at the end of the exercise compared to PL, GUA and CAF. Moreover, results have shown that performing 40-min submaximal exercise enhances information processing in terms of both speed and accuracy, improves temporal performance and does not alter cognitive control. The present study opens up new perspectives regarding the use of MR to optimize cognitive performance during physical exercise.

Carbohydrate mouth rinse improves morning high-intensity exercise performance

Oral carbohydrate (CHO) rinsing has been demonstrated to provide beneficial effects on exercise performance of durations of up to one hour. The aim of the present study was to investigate the effects of CHO mouth rinsing on morning high-intensity exercise performance. Following institutional ethical approval and familiarisation, 12 healthy males (mean ± SD age: 23 ± 3 years, height: 175.5 ± 7.4 cm, body mass: 75.4 ± 7.5 kg) participated in this study. Countermovement jump (CMJ) height, isometric mid-thigh pull peak force, 10 m sprint time and bench press and back squat repetitions to failure were assessed following CHO and placebo (PLA) rinsing or a control condition (CON). All testing took place at 07:30 following an 11 hour overnight fast. Performance of CMJ height (CHO: 39 ± 7 cm; PLA: 38 ± 7 cm; CON: 36 ± 6 cm; P = .003, [Formula: see text] = 0.40), 10 m sprint time (CHO: 1.78 ± 0.07 s; PLA: 1.81 ± 0.07 s; CON: 1.85 ± 0.05 s; P = .001, [Formula: see text] = 0.47), the number of bench press (CHO: 25 ± 3; PLA: 24 ± 4; CON: 22 ± 4; P < .001, [Formula: see text] = 0.55) and squat (CHO: 31 ± 4; PLA: 29 ± 5; CON: 26 ± 6; P < .001, [Formula: see text] = 0.70) repetitions and mean felt arousal (CHO: 5 ± 1; PLA: 4 ± 0; CON: 4 ± 0; P = .009, [Formula: see text] = 0.25) improved following CHO rinsing. However, isometric mid-thigh pull peak force was unchanged (CHO: 2262 ± 288 N; PLA: 2236 ± 354 N; CON: 2212 ± 321 N; P = .368, [Formula: see text] = 0.08). These results suggest that oral CHO rinsing solution significantly improved the morning performance of CMJ height, 10 m sprint times, bench press and squat repetitions to failure and felt arousal, although peak force during an isometric mid-thigh pull, rating of perceived exertion and heart rate were unaffected.

Effect of Carbohydrate Intake on Maximal Power Output and Cognitive Performances

The present study aimed to assess the beneficial effect of acute carbohydrate (7% CHO) intake on muscular and cognitive performances. Seventeen high levels athletes in explosive sports (fencing and squash) participated in a randomized, double-blind study consisting in series of 6 sprints (5s) with a passive recovery (25s) followed by 15 min submaximal cycling after either maltodextrine and fructose (CHO) or placebo (Pl) intake. Cognitive performances were assessed before and after sprint exercise using a simple reaction time (SRT) task at rest, a visual scanning task (VS) and a Go/Nogo task (GNG) during a submaximal cycling exercise. Results showed a beneficial effect of exercise on VS task on both conditions (Pl: −283 ms; CHO: −423 ms) and on SRT only during CHO condition (−26 ms). In the CHO condition, SRT was faster after exercise whereas no effect of exercise was observed in the Pl condition. According to a qualitative statistical method, a most likely and likely positive effect of CHO was respectively observed on peak power (+4%) and tiredness (−23%) when compared to Pl. Furthermore, a very likely positive effect of CHO was observed on SRT (−8%) and a likely positive effect on visual scanning (−6%) and Go/Nogo tasks (−4%) without any change in accuracy. In conclusion acute ingestion of 250 mL of CHO, 60 min and 30 min before exercise, improve peak power output, decrease muscular tiredness and speed up information processing and visual detection without changing accuracy.

Carbohydrate Mouth Rinsing Enhances High Intensity Time Trial Performance Following Prolonged Cycling

There is good evidence that mouth rinsing with carbohydrate (CHO) solutions can enhance endurance performance (≥30 min). The impact of a CHO mouth rinse on sprint performance has been less consistent, suggesting that CHO may confer benefits in conditions of ‘metabolic strain’. To test this hypothesis, the current study examined the impact of late-exercise mouth rinsing on sprint performance. Secondly, we investigated the effects of a protein mouth rinse (PRO) on performance. Eight trained male cyclists participated in three trials consisting of 120 min of constant-load cycling (55% W_max) followed by a 30 km computer-simulated time trial, during which only water was provided. Following 15 min of muscle function assessment, 10 min of constant-load cycling (3 min at 35% W_max, 7 min at 55% W_max) was performed. This was immediately followed by a 2 km time trial. Subjects rinsed with 25 mL of CHO, PRO, or placebo (PLA) at min 5:00 and 14:30 of the 15 min muscle function phase, and min 8:00 of the 10-min constant-load cycling. Magnitude-based inferential statistics were used to analyze the effects of the mouth rinse on 2-km time trial performance and the following physiological parameters: Maximum Voluntary Contract (MVC), Rating of Perceived Exertion (RPE), Heart Rate (HR), and blood glucose levels. The primary finding was that CHO ‘likely’ enhanced performance vs. PLA (3.8%), whereas differences between PRO and PLA were unclear (0.4%). These data demonstrate that late-race performance is enhanced by a CHO rinse, but not PRO, under challenging metabolic conditions. More data should be acquired before this strategy is recommended for the later stages of cycling competition under more practical conditions, such as when carbohydrates are supplemented throughout the preceding minutes/hours of exercise.

Effects of various concentrations of carbohydrate mouth rinse on cycling performance in a fed state

The objective of this study was to identify the effects of mouth rinsing with a 6% and 16% carbohydrate solution (CHO) on time trial performance when compared to a 0% control (PLA) when in a fed state. Twelve recreationally active males underwent three trials by which they had to complete a set workload (600 ± 65 W) in a fed state. Throughout each trial, participants rinsed their mouths with a 25 ml bolus of a 0% PLA, 6% or 16% CHO (maltodextrin) for every 12.5% of work completed. Rating of perceived exertion (RPE) and heart rate were recorded every 12.5% of total work. Performance times and power output improved significantly when using the 6% and 16% CHO versus the PLA trial (6% versus PLA, p = .002 and 16% versus PLA, p = .001). When comparing the performance times of the 6% to 16% CHO, no significance was observed (p = .244). There was no significant difference between heart rate levels or RPE values across the three trials. In conclusion, mouth rinsing with a 6% or 16% CHO solution has a positive effect on a cycling time trial performance undertaken in a fed state.

Mouth Rinsing with Maltodextrin Solutions Fails to Improve Time Trial Endurance Cycling Performance in Recreational Athletes

The carbohydrate (CHO) concentration of a mouth rinsing solution might influence the CHO sensing receptors in the mouth, with consequent activation of brain regions involved in reward, motivation and regulation of motor activity. The purpose of the present study was to examine the effects of maltodextrin mouth rinsing with different concentrations (3%, 6% and 12%) after an overnight fast on a 20 km cycling time trial performance. Nine recreationally active, healthy males (age: 24 ± 2 years; V ˙ O 2 m a x : 47 ± 5 mL·kg(-1)·min(-1)) participated in this study. A double-blind, placebo-controlled randomized study was conducted. Participants mouth-rinsed every 2.5 km for 5 s. Maltodextrin mouth rinse with concentrations of 3%, 6% or 12% did not change time to complete the time trial and power output compared to placebo (p > 0.05). Time trial completion times were 40.2 ± 4.0, 40.1 ± 3.9, 40.1 ± 4.4, and 39.3 ± 4.2 min and power output 205 ± 22, 206 ± 25, 210 ± 24, and 205 ± 23 W for placebo, 3%, 6%, and 12% maltodextrin conditions, respectively. Heart rate, lactate, glucose, and rating of perceived exertion did not differ between trials (p > 0.05). In conclusion, mouth rinsing with different maltodextrin concentrations after an overnight fast did not affect the physiological responses and performance during a 20 km cycling time trial in recreationally active males.

Mouth Rinsing With Carbohydrate Solutions at the Postprandial State Fail to Improve Performance During Simulated Cycling Time Trials

Mouth rinsing with carbohydrate (CHO) solutions during cycling time trials results in performance enhancements; however, most studies have used approximately 6% CHO solutions. Therefore, the purpose of this study was to compare the effectiveness of mouth rinsing with 4, 6, and 8% CHO solutions on 1-hour simulated cycling time trial performance. On 4 occasions, 7 trained male cyclists completed at the postprandial period, a set amount of work as fast as possible in a randomized counterbalanced order. The subjects rinsed their mouth for 5 seconds, on completion of each 12.5% of the trial, with 25 ml of a non-CHO placebo and 4, 6, and 8% CHO solutions. No additional fluids were consumed during the time trial. Heart rate (HR), ratings of perceived exertion (RPE), thirst (TH), and subjective feelings (SF) were recorded after each rinse. Furthermore, blood samples were drawn every 25% of the trial to measure blood glucose and blood lactate concentrations, whereas whole-body CHO oxidation was monitored continuously. Time to completion was not significant between conditions with the placebo, 4, 6, and 8% conditions completing the trials in 62.0 ± 3.0, 62.8 ± 4.0, 63.4 ± 3.4, and 63 ± 4.0 minutes, respectively. There were no significant differences between conditions in any of the variables mentioned above; however, significant time effects were observed for HR, RPE, TH, and SF. Post hoc analysis showed that TH and SF of subjects in the CHO conditions but not in the placebo were significantly increased by completion of the time trial. In conclusion, mouth rinsing with CHO solutions did not impact 1-hour cycling performance in the postprandial period and in the absence of fluid intake. Our findings suggest that there is scope for further research to explore the activation regions of the brain and whether they are receptive to CHO dose, before specific recommendations for athletic populations are established. Consequently, mouth rinsing as a practical strategy for coaches and athletes is questionable under specific conditions and should be carefully considered before its inclusion. Emphasis should be focused on appropriate dietary and fluid strategies during training and competition.

Thermal and Cardiovascular Strain Mitigate the Potential Benefit of Carbohydrate Mouth Rinse During Self-Paced Exercise in the Heat

Purpose: To determine whether a carbohydrate mouth rinse can alter self-paced exercise performance independently of a high degree of thermal and cardiovascular strain.

Methods: Eight endurance-trained males performed two 40-km cycling time trials in 35°C, 60% RH while swilling a 20-ml bolus of 6.5% maltodextrin (CHO) or a color- and taste-matched placebo (PLA) every 5 km. Heart rate, power output, rectal temperature (T_re), and mean skin temperature (T_sk) were recorded continuously; cardiac output, oxygen uptake (VO₂), mean arterial pressure (MAP), and perceived exertion (RPE) were measured every 10 min.

Results: Performance time and mean power output were similar between treatments, averaging 63.9 ± 3.2 and 64.3 ± 2.8 min, and 251 ± 23 and 242 ± 18 W in CHO and PLA, respectively. Power output, stroke volume, cardiac output, MAP, and VO₂ decreased during both trials, increasing slightly or remaining stable during a final 2-km end-spurt. T_re, T_sk, heart rate, and RPE increased throughout exercise similarly with both treatments. Changes in RPE correlated with those in T_re (P < 0.005) and heart rate (P < 0.001).

Conclusions: These findings suggest that carbohydrate mouth rinsing does not improve ~1-h time trial performance in hot-humid conditions, possibly due to a failure in down-regulating RPE, which may be influenced more by severe thermal and cardiovascular strain.

Carbohydrate mouth rinse enhances time to exhaustion during treadmill exercise

Mouth rinsing with a CHO solution has been suggested to improve short (<1 h) endurance performance through central effect. We examined the effects of mouth rinsing with a CHO solution on running time to exhaustion on a treadmill. Six well-trained subjects ran to exhaustion at 85% VO_2max , on three separate occasions. Subjects received either an 8% CHO solution or a placebo (PLA) every 15 min to mouth rinse (MR) or a 6% CHO solution to ingest (ING). Treatments were assigned in a randomized, counterbalanced fashion, with the mouth-rinsing treatments double-blinded. Blood samples were taken to assess glucose (Glu) and lactate (Lac), as well as the perceived exertion (RPE). Gas exchange and heart rate (HR) were collected during all trials. Subjects ran longer (P = 0·038) in both the MR (2583 ± 686 s) and ING (2625 ± 804 s) trials, compared to PLA (1935 ± 809 s), covering a greater distance (MR 9685 ± 3511·62 m; ING 9855 ± 4118·62; PLA 7295 ± 3727 m). RER was significantly higher in both ING and MR versus PLA. No difference among trials was observed for other metabolic or cardiovascular variables (VO₂ , Lac, Glu, HR), nor for RPE. Endurance capacity, based on time to exhaustion on a treadmill, was improved when either mouth rinsing or ingesting a CHO solution, compared to PLA.

The effect of a carbohydrate mouth-rinse on neuromuscular fatigue following cycling exercise

Carbohydrate (CHO) mouth-rinsing, rather than ingestion, is known to improve performance of high-intensity (>75% maximal oxygen uptake) short-duration (≤1 h) cycling exercise. Mechanisms responsible for this improvement, however, are unclear. The present study aimed to investigate the effect of a CHO mouth-rinse on cycling time-trial (TT) performance and mechanisms of fatigue. On 2 separate occasions, 9 male cyclists (mean ± SD; maximal oxygen uptake, 61 ± 5 mL·kg−1·min−1) completed 45 min at 70% maximum power output (preload) followed by a 15-min TT. At 7.5-min intervals during the preload and TT, participants were given either a tasteless 6.4% maltodextrin mouth-rinse (CHO) or water (placebo (PLA)) in a double-blind, counterbalanced fashion. Isometric knee-extension force and electromyographic responses to percutaneous electrical stimulation and transcranial magnetic stimulation were measured before, after the preload, and after the TT. There were greater decreases in maximal voluntary contraction after the TT in PLA (20% ± 10%) compared with the CHO (12% ± 8%; P = 0.019). Voluntary activation was reduced following exercise in both trials, but did not differ between conditions (PLA –10% ± 8% vs. CHO –5% ± 4%; P = 0.150). The attenuation in the manifestation of global fatigue did not translate into a TT improvement (248 ± 23 vs. 248 ± 39 W for CHO and PLA, respectively). Furthermore, no differences in heart rate or ratings of perceived exertion were found between the 2 conditions. These data suggest that CHO mouth-rinsing attenuates neuromuscular fatigue following endurance cycling. Although these changes did not translate into a performance improvement, further investigation is required into the role of CHO mouth-rinse in alleviating neuromuscular fatigue.

Exercise, nutrition and the brain

Accumulating evidence suggests that diet and lifestyle can play an important role in delaying the onset or halting the progression of age-related health disorders and can improve cognitive function. Exercise has been promoted as a possible prevention for neurodegenerative diseases. Exercise will have a positive influence on cognition and it increases the brain-derived neurotrophic factor, an essential neurotrophin. Several dietary components have been identified as having effects on cognitive abilities. In particular, polyphenols have been reported to exert their neuroprotective actions through the potential to protect neurons against injury induced by neurotoxins, an ability to suppress neuroinflammation, and the potential to promote memory, learning, and cognitive function. Dietary factors can affect multiple brain processes by regulating neurotransmitter pathways, synaptic transmission, membrane fluidity, and signal-transduction pathways. Flavonols are part of the flavonoid family that is found in various fruits, cocoa, wine, tea and beans. Although the antioxidant effects of flavonols are well established in vitro, there is general agreement that flavonols have more complex actions in vivo. Several cross-sectional and longitudinal studies have shown that a higher intake of flavonoids from food may be associated with a better cognitive evolution. Whether this reflects a causal association remains to be elucidated. Several studies have tried to 'manipulate' the brain in order to postpone central fatigue. Most studies have clearly shown that in normal environmental circumstances these interventions are not easy to perform. There is accumulating evidence that rinsing the mouth with a carbohydrate solution will improve endurance performance. There is a need for additional well controlled studies to explore the possible impact of diet and nutrition on brain functioning.

Mouth rinsing with a bitter solution without ingestion does not improve sprint cycling performance

PURPOSE

Recently, we have shown that combining mouth rinsing with the ingestion of a 2 mM quinine solution immediately before a 30-s cycling sprint significantly improves performance. However, the strong bitterness of such a solution produces an unpleasant taste and evokes nausea at higher concentrations. Given the possibility that mouth rinsing with quinine without ingesting it may not produce nausea, a mouth rinse only protocol may be a more practical approach to administer quinine for improving exercise performance. The purpose of the present study was to determine whether mouth rinsing with quinine without ingesting it improves 30-s sprint cycling performance.

METHODS

Twelve competitive male cyclists performed a 30-s maximal cycling sprint immediately after rinsing their mouth for 10 s with either a 10 mM bitter quinine solution (QUI), plain water (WAT), a 7.1 % w/v sweet glucose solution (GLU), or no solution at all (control; CON). Sprint performance was assessed, and heart rate, ratings of perceived exertion and blood variables were measured pre- and post-exercise.

RESULTS

Mean power output during the 30-s sprint (QUI 888 ± 38; CON 873 ± 39; WAT 885 ± 37; GLU 873 ± 42 W; p = 0.431) as well as peak power (QUI 1230 ± 61; CON 1,208 ± 65; WAT 1,220 ± 70; GLU 1,202 ± 59 W; p = 0.690) were similar between the four conditions. There were no significant differences in any other performance measures, heart rate, subjective ratings or blood variables between conditions.

CONCLUSIONS

Mouth rinsing with a bitter tasting quinine solution without ingestion does not improve 30-s sprint cycling performance.

The Influence of Serial Carbohydrate Mouth Rinsing on Power Output during a Cycle Sprint

The objective of the study was to investigate the influence of serial administration of a carbohydrate (CHO) mouth rinse on performance, metabolic and perceptual responses during a cycle sprint. Twelve physically active males (mean (± SD) age: 23.1 (3.0) years, height: 1.83 (0.07) m, body mass (BM): 86.3 (13.5) kg) completed the following mouth rinse trials in a randomized, counterbalanced, double-blind fashion; 1. 8 x 5 second rinses with a 25 ml CHO (6% w/v maltodextrin) solution, 2. 8 x 5 second rinses with a 25 ml placebo (PLA) solution. Following mouth rinse administration, participants completed a 30 second sprint on a cycle ergometer against a 0.075 g·kg(-1) BM resistance. Eight participants achieved a greater peak power output (PPO) in the CHO trial, resulting in a significantly greater PPO compared with PLA (13.51 ± 2.19 vs. 13.20 ± 2.14 W·kg(-1), p < 0.05). Magnitude inference analysis reported a likely benefit (81% likelihood) of the CHO mouth rinse on PPO. In the CHO trial, mean power output (MPO) showed a trend for being greater in the first 5 seconds of the sprint and lower for the remainder of the sprint compared with the PLA trial (p > 0.05). No significant between-trials difference was reported for fatigue index, perceived exertion, arousal and nausea levels, or blood lactate and glucose concentrations. Serial administration of a CHO mouth rinse may significantly improve PPO during a cycle sprint. This improvement appears confined to the first 5 seconds of the sprint, and may come at a greater relative cost for the remainder of the sprint. Key pointsThe paper demonstrates that repeated administration of a carbohydrate mouth rinse can significantly improve peak power output during a single 30 second cycle sprint.The ergogenic effect of the carbohydrate mouth rinse may relate to the duration of exposure of the oral cavity to the mouth rinse, and associated greater stimulation of oral carbohydrate receptors.The significant increase in peak power output with the carbohydrate mouth rinse may come at a relative cost for the remainder of the sprint, evidenced by non-significantly lower mean power output and a greater fatigue index in the carbohydrate vs. placebo trial.Serial administration of a carbohydrate mouth rinse may be beneficial for sprint athletes as a method of performance enhancement that minimizes the risk of performance decrement through body mass increase and gastrointestinal disturbances associated with ingesting carbohydrate solutions.

Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations

This systematic review examines the efficacy of carbohydrate (CHO) supplementation on exercise performance of varying durations. Included studies utilized an all-out or endurance-based exercise protocol (no team-based performance studies) and featured randomized interventions and placebo (water-only) trial for comparison against exclusively CHO trials (no other ingredients). Of the 61 included published performance studies (n = 679 subjects), 82% showed statistically significant performance benefits (n = 50 studies), with 18% showing no change compared with placebo. There was a significant (p = 0.0036) correlative relationship between increasing total exercise time and the subsequent percent increase in performance with CHO intake versus placebo. While not mutually exclusive, the primary mechanism(s) for performance enhancement likely differs depending on the duration of the exercise. In short duration exercise situations (∼1 h), oral receptor exposure to CHO, via either mouthwash or oral consumption (with enough oral contact time), which then stimulates the pleasure and reward centers of the brain, provide a central nervous system-based mechanism for enhanced performance. Thus, the type and (or) amount of CHO and its ability to be absorbed and oxidized appear completely irrelevant to enhancing performance in short duration exercise situations. For longer duration exercise (>2 h), where muscle glycogen stores are stressed, the primary mechanism by which carbohydrate supplementation enhances performance is via high rates of CHO delivery (>90 g/h), resulting in high rates of CHO oxidation. Use of multiple transportable carbohydrates (glucose:fructose) are beneficial in prolonged exercise, although individual recommendations for athletes should be tailored according to each athlete's individual tolerance.

Can carbohydrate mouth rinse improve performance during exercise? A systematic review

The purpose of this review was to identify studies that have investigated the effect of carbohydrate (CHO) mouth rinse on exercise performance, and to quantify the overall mean difference of this type of manipulation across the studies. The main mechanisms involving the potential benefit of CHO mouth rinse on performance was also explored. A systematic review was conducted in the following electronic databases: PubMed, SciELO, Science Direct, MEDLINE, and the Cochrane Library (Cochrane Central Register of Controlled Trials), without limit of searches. Eleven studies were classified as appropriate and their results were summarized and compared. In nine of them, CHO mouth rinse increased the performance (range from 1.50% to 11.59%) during moderate- to high-intensity exercise (~75% Wmax or 65% VO₂max, ~1 h duration). A statistical analysis to quantify the individual and overall mean differences was performed in seven of the 11 eligible studies that reported power output (watts, W) as the main performance outcome. The overall mean difference was calculated using a random-effect model that accounts for true variation in effects occurring in each study, as well as random error within a single study. The overall effect of CHO mouth rinse on performance was significant (mean difference = 5.05 W, 95% CI 0.90 to 9.2 W, z = 2.39, p = 0.02) but there was a large heterogeneity between the studies (I² = 52%). An activation of the oral receptors and consequently brain areas involved with reward (insula/operculum frontal, orbitofrontal cortex, and striatum) is suggested as a possible physiological mechanism responsible for the improved performance with CHO mouth rinse. However, this positive effect seems to be accentuated when muscle and liver glycogen stores are reduced, possibly due to a greater sensitivity of the oral receptors, and require further investigation. Differences in duration of fasting before the trial, duration of mouth rinse, type of activity, exercise protocols, and sample size may account for the large variability between the studies.

Mouth rinsing improves cycling endurance performance during Ramadan fasting in a hot humid environment

This study examined the effect of mouth rinsing during endurance cycling in a hot humid environment (32 °C and 75% relative humidity) on athletes in the Ramadan fasted state. Nine trained adolescent male cyclists completed 3 trials that consisted of a carbohydrate mouth-rinse (CMR), a placebo mouth-rinse (PMR), and a no-rinse (NOR) trial during the last 2 weeks of Ramadan. Each trial consisted of a preloading cycle at 65% peak rate of oxygen consumption for 30 min followed by a 10-km time trial (TT10 km) under hot humid condition. During the CMR and PMR trials, each cyclist rinsed his mouth with 25 mL of the solution for 5 s before expectorating the solution pre-exercise, after 5, 15, and 25 min of the preloading cycle, and 15 s prior to the start of TT10 km. Time to complete the TT10 km was significantly faster in the CMR and PMR trials compared with the NOR trial (12.9 ± 1.7 and 12.6 ± 1.7 vs. 16.8 ± 1.6 min, respectively; p < 0.017). Ratings of perceived exertion taken at the end of the TT10 km was lower in both CMR and PMR trials compared with the NOR trial, although the difference was significant only between CMR and NOR (p < 0.05). In conclusion, mouth rinsing with either carbohydrate or placebo solution provided ergogenic benefits compared with a no-rinse condition on TT10 km performance in acute Ramadan fasted subjects during endurance cycling in a heat stress environment.