Effect of Carbohydrate Mouth Rinse on Training Load Volume in Resistance Exercises

Carbohydrate Mouth Rinses before Exercise Improve Performance of Romanian Deadlift Exercise: A Randomized Crossover Study

(1) Background: This study compared the effects of mouth rinsing with a carbohydrate trial (CMR) and a placebo trial (PL) on concentric and eccentric contraction strength in multi-joint resistance exercise performance. (2) Methods: Twenty healthy adult men (age: 22.4 ± 3.7 years, body mass index: 26 ± 3.8, peak power: 378.3 ± 138.7 W) were recruited in this study. Participants were employed in a double-blind, randomized crossover design to divide participants into carbohydrate mouth rinsing trial (CMR) and placebo trial (PL). After warming up, participants used 6.6% maltodextrin (CMR) or mineral water (PL) to rinse their mouth for 20 s. Next, the participants underwent tests of maximum inertial Romanian deadlift resistance exercise comprising five sets of six reps, with 3 min rests between sets. After deducting the first repetition of each set, the mean values from the five sets were analyzed. (3) Results: The concentric peak power of the CMR trial was significantly higher than that of the PL trial (p = 0.001, Cohen's d = 0.46), the eccentric peak power of the CMR trial was significantly higher than that of the PL trial (p = 0.008, Cohen's d = 0.56), and the total work of the CMR trial was significantly higher than that of PL trial (p = 0.002, Cohen's d = 0.51). (4) Conclusions: These findings demonstrate that mouth rinsing with carbohydrates before exercise can improve concentric and eccentric contraction strength in multi-joint resistance exercise performance.

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.

Maximal Number of Repetitions at Percentages of the One Repetition Maximum: A Meta-Regression and Moderator Analysis of Sex, Age, Training Status, and Exercise

The maximal number of repetitions that can be completed at various percentages of the one repetition maximum (1RM) [REPS ~ %1RM relationship] is foundational knowledge in resistance exercise programming. The current REPS ~ %1RM relationship is based on few studies and has not incorporated uncertainty into estimations or accounted for between-individuals variation. Therefore, we conducted a meta-regression to estimate the mean and between-individuals standard deviation of the number of repetitions that can be completed at various percentages of 1RM. We also explored if the REPS ~ %1RM relationship is moderated by sex, age, training status, and/or exercise. A total of 952 repetitions-to-failure tests, completed by 7289 individuals in 452 groups from 269 studies, were identified. Study groups were predominantly male (66%), healthy (97%), < 59 years of age (92%), and resistance trained (60%). The bench press (42%) and leg press (14%) were the most commonly studied exercises. The REPS ~ %1RM relationship for mean repetitions and standard deviation of repetitions were best described using natural cubic splines and a linear model, respectively, with mean and standard deviation for repetitions decreasing with increasing %1RM. More repetitions were evident in the leg press than bench press across the loading spectrum, thus separate REPS ~ %1RM tables were developed for these two exercises. Analysis of moderators suggested little influences of sex, age, or training status on the REPS ~ %1RM relationship, thus the general main model REPS ~ %1RM table can be applied to all individuals and to all exercises other than the bench press and leg press. More data are needed to develop REPS ~ %1RM tables for other exercises.

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.

Effect of carbohydrate mouth rinse on muscle strength and muscular endurance: A systematic review with meta-analysis

The present systematic review with meta-analysis summarized studies that investigated the effect of carbohydrate (CHO) mouth rinse on muscle strength and muscular endurance. The search was performed in six databases. Thirteen randomized clinical trials were selected and the standardized mean difference between CHO mouth rinse and placebo for maximal strength and muscular endurance was determined via a random-effects model using Review Manager 5.4 software. Meta-regression was also performed to explore the influence of load, number of sets, number of exercises, fasting time, CHO concentration, and number of mouth rinses on the main outcomes. There was no significant effect of CHO mouth rinse on maximal strength (mean difference= 0.25 kg, 95%CI - 1.81 to 2.32 kg, z = 0.24, p = 0.810). However, there was a significant positive effect of CHO mouth rinse on muscular endurance (mean difference = 1.24 repetitions, 95%CI 0.70 to 1.77 repetitions, z = 4.55, p < 0.001). Meta-regression identified that CHO mouth rinse has greater benefits on muscular endurance when using high workloads, multiple exercises, and a smaller number of mouth rinses (p = 0.001). In conclusion, CHO mouth rinse has no effect on maximal muscle strength but has a positive effect on muscular endurance and seems to optimize when fewer mouth rinses, high workloads and numbers of exercises are used.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2057417.

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.

Carbohydrate Mouth Rinse Increases High but Not Low Intensity Repetitions to Failure in Resistance-Trained Males

Carbohydrate mouth rinsing (CMR) has been shown to enhance exercise performance. However, the influence of CMR on repetitions to failure with different intensities (40% or 80% of 1 RM) is unknown. Therefore, the purpose of this study was to examine the effects of a 6% CMR solution on muscular endurance assessed at 40% and 80% of 1 RM in resistance-trained males. Sixteen resistance-trained males (age: 25 ± 3 years, height: 182 ± 6 cm, body mass: 86 ± 3 kg, body fat: 16 ± 3%, bench press 1 RM: 106 ± 16 kg, resistance training experience: 5 ± 1 years) completed four conditions in random order. The four conditions consisted of ten seconds of mouth rinsing with 25 mL solutions containing either maltodextrin or placebo (sweetened water) prior to performing a bench press muscular endurance test at either 40% of 1 RM or 80% of 1 RM. Total repetitions, heart rate (HR), ratings of perceived exertion (RPE), glucose (GLU) and felt arousal (FA) were recorded for each condition. There was a significant condition by intensity interaction (p = 0.02). CMR significantly increased total repetitions compared with placebo at the higher intensity (80% of 1 RM; p = 0.04), while there was no effect at the lower intensity (p = 0.20). In addition, HR, RPE, GLU and FA did not differ between conditions or across intensities (p > 0.05). In conclusion, CMR-enhanced muscular endurance performed at higher but not lower intensities.

Effects of carbohydrate and caffeine mouth rinsing on strength, muscular endurance and cognitive performance

Background

Carbohydrate (CHO) and caffeine (CAF) mouth rinsing have been shown to enhance endurance and sprint performance. However, the effects of CHO and CAF mouth rinsing on muscular and cognitive performance in comparison between male and female athletes are less well-established. The aim of this study was to examine the effect of CHO and CAF rinsing on squat and bench press 1 repetition maximum (1-RM) strength, 3 sets of 40% of 1-RM muscular endurance and cognitive performance in both male and female athletes.

Methods

Thirteen male and fourteen female resistance-trained participants completed four testing sessions following the rinsing of 25 ml of i) 6% of CHO (1.5 g); ii) 2% CAF (500 mg), iii) combined CHO and CAF (CHOCAF) solutions or iv) water (PLA) for 10 s. Heart rate (HR), felt arousal (FA), ratings of perceived exertion (RPE) and glucose (GLU) were recorded throughout the test protocol.

Results

There were no significant differences in squat and bench press 1-RM, HR, RPE and GLU (p > 0.05) for males and females, respectively. FA was significantly increased with CAF (p = 0.04, p = 0.01) and CHOCAF (p = 0.03, p = 0.01) condition in both males and females, respectively. Squat endurance performance in the first set was significantly increased with CHOCAF condition compared to PLA in both males (p = 0.01) and females (p = 0.02). Bench press endurance was similar for all conditions in both genders (p > 0.05). Cognitive performance was significantly increased with CHOCAF compared to PLA in males (p = 0.03) and females (p = 0.02).

Conclusion

Combined CHO and CAF mouth rinsing significantly improved lower body muscular endurance and cognitive performance in both males and females.

Effects of Carbohydrate Mouth Rinsing on Upper Body Resistance Exercise Performance

Carbohydrate mouth rinsing has been shown to enhance aerobic exercise performance, but there is limited research with resistance exercise (RE). Therefore, the purpose of this investigation was to examine the effects of carbohydrate mouth rinsing during a high-volume upper body RE protocol on performance, heart rate responses, ratings of perceived exertion, and felt arousal. Recreationally experienced resistance-trained males (N = 17, age: 21 ± 1 years, height: 177.3 ± 5.2 cm, mass: 83.5 ± 9.3 kg) completed three experimental sessions, with the first serving as familiarization to the RE protocol. During the final two trials, the participants rinsed a 25-ml solution containing either a 6% carbohydrate solution or an artificially flavored placebo in a randomized, counterbalanced, and double-blinded fashion. The participants rinsed a total of nine times immediately before beginning the protocol and 20 s before repetitions to failure with the exercises bench press, bent-over row, incline bench press, close-grip row, hammer curls, skull crushers (all completed at 70% one-repetition maximum), push-ups, and pull-ups. Heart rate, ratings of perceived exertion, and felt arousal were measured at the baseline and immediately after each set of repetitions to failure. There were no differences for the total repetitions completed (carbohydrate = 203 ± 25 repetitions vs. placebo = 201 ± 23 repetitions, p = .46, Cohen's d = 0.10). No treatment differences were observed for heart rate, ratings of perceived exertion, or felt arousal (p > .05). Although carbohydrate mouth rinsing has been shown to be effective in increasing aerobic performance, the results from this investigation show no benefit in RE performance in resistance-trained males.

Carbohydrate mouth rinsing does not affect 6-min walk test performance and blood glucose responses in older adults

PURPOSE

Carbohydrate (CHO) mouth rinsing (MR) prior to exercise has been shown to elicit enhanced performance and energy availability in some studies. Previous literature has concentrated on examining CHO MR strategies for improving aerobic endurance performance in younger athletic adults. Knowledge of the impact of CHO MR on functional performance in older adults is scarce. The purpose of this investigation was to determine if CHO MR would improve 6-min walk test (6MWT) performance, perceived exertion, and blood glucose responses in older adults.

METHOD

Thirty-three individuals (16 males, 17 females), age ≥ 70 years performed two 6MWT trials, one of which utilized a 6.4% maltodextrin CHO MR and one of which utilized a placebo MR. Participants held the MR in their mouth for 20 s prior to the 6MWT, and trials occurred in a counterbalanced fashion. Total distance walked and rating of perceived exertion (RPE) were recorded upon completion of each 6MWT. Heart rate (HR), peripheral blood oxygen saturation (SpO₂), systolic and diastolic blood pressures (BP), blood glucose, and blood lactate were measured before and after each 6MWT.

RESULT

CHO MR did not alter the response of any study parameter compared to the placebo MR (p = 0.13-0.94). HR, systolic BP, and blood lactate increased and SpO₂ decreased across time (p < 0.01).

CONCLUSION

A 6.4% maltodextrin CHO MR did not alter total distance walked, perceived exertion, or other physiological responses elicited by the 6MWT in older adults.

Different Doses of Carbohydrate Mouth Rinse Have No Effect on Exercise Performance in Resistance Trained Women

Carbohydrate (CHO) mouth rinse has been shown to enhance aerobic endurance performance. However, the effects of CHO mouth rinse on muscular strength and endurance are mixed and may be dependent on dosage of CHO. The primary purpose was to examine the effects of different dosages of CHO rinse on strength (bench press 1 repetition maximum [1-RM]) and muscular endurance (40% of 1-RM repetitions to failure) in female athletes. Sixteen resistance-trained females (age: 20 ± 1 years; height: 167 ± 3 cm; body mass: 67 ± 4 kg; BMI: 17 ± 2 kg/m²; resistance training experience: 2 ± 1 years) completed four conditions in random order. The four conditions consisted of a mouth rinse with 25 mL solutions containing either 6% of CHO (Low dose of CHO: LCHO), 12% CHO (Moderate dose of CHO: MCHO), 18% CHO (High dose of CHO: HCHO) or water (Placebo: PLA) for 10 s prior to a bench press strength and muscular endurance test. Maximal strength (1-RM), muscular endurance (reps and total volume), heart rate (HR), ratings of perceived exertion (RPE) and glucose (GLU) were recorded each condition. There were no significant differences in strength (p = 0.95) or muscular endurance (total repetitions: p = 0.06; total volume: p = 0.20) between conditions. Similarly, HR (p = 0.69), RPE (p = 0.09) and GLU (p = 0.92) did not differ between conditions. In conclusion, various doses of CHO mouth rinse (6%, 12% and 18%) have no effect on upper body muscular strength or muscular endurance in female athletes.

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.

Effect of Carbohydrate Mouth Rinse on Resistance Exercise Performance

Green, MS, Kimmel, CS, Martin, TD, Mouser, JG, and Brune, MP. Effect of carbohydrate mouth rinse on resistance exercise performance. J Strength Cond Res XX(X): 000-000, 2020-A carbohydrate mouth rinse (CMR) has been shown to enhance short duration endurance performance and raises the possibility that a similar strategy could improve performance during resistance exercise. Eighteen male and female (N = 36) resistance trained subjects (mean values ± SD; age: 21.5 ± 1.6 years, height: 1.72 ± 0.09 m, body mass: 72.8 ± 13.4 kg, and body fat: 16.7 ± 5.8%) performed 3 experimental visits during which bench press resistance exercise (4 × 10 repetitions at 65% of 1 repetition maximum [1RM] with 120 seconds recovery) and repetitions to failure at 60% 1RM were performed. Subjects rinsed 25 ml of water (WAT), noncaloric placebo (PLA), or 6.4% maltodextrin (CHO) solution for 10 seconds during exercise in a crossover, counter-balanced manner. Rating of perceived exertion (RPE), pleasure-displeasure (FS), number of repetitions to fatigue (REPS), and postexercise blood glucose (GLU) and lactate (LA) were measured. Compared with WAT (17.7 ± 0.8), PLA (19.0 ± 0.7; p = 0.025), and CHO (18.7 ± 0.8; p = 0.039) resulted in higher REPS, with no difference between PLA and CHO treatments (p = 0.310). Rating of perceived exertion progressively increased each set (p < 0.0001), but was not affected by treatment (p = 0.897). Pleasure-displeasure declined during recovery from sets 3 and 4 (p < 0.05) but was also not affected by treatment (p = 0.692). Postexercise GLU (p = 0.103) and LA (p = 0.620) were not different between treatments. Although a placebo effect was present for REPS, this study failed to detect an effect of CMR on REPS, RPE, FS, GLU, or LA on upper-body resistance exercise.

Nutritional Recommendations for Physique Athletes

The popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one’s skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the “energy budget” to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.

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.