Oxidation of carbohydrate ingested during prolonged endurance exercise

A comparative observational study of carbohydrate intake and continuous blood glucose levels in relation to performance in ultramarathon

Ultra-endurance events have gained global participation, whereas the critical factors of competition results remain to be well elucidated. This study used a nutritional approach to evaluate the association of competition results with carbohydrate intake and blood glucose control during a 100-mile ultramarathon. This observational study was conducted in the 2021 LAKE BIWA 100, which covered 100 miles (169 km) and 10,500 m elevation. The course was divided into 9 segments by aid station. According to the competition results, 22 participants (18 men and 4 women) were divided into higher finishers (n = 7), lower finishers (n = 9), and non-finishers (n = 6). The participants self-recorded their overall dietary intake throughout the race. Glucose levels were monitored every 15 min by a flash glucose monitoring system. Running speed in each segment was standardized to the average of the top five finishers for each gender. Among finishers, the carbohydrate intakes were significantly higher in the higher finishers than in the lower finishers during overall segments, especially in the first half of the race (p < 0.05). There was a significant positive correlation between running speed and carbohydrate intake in the lower finishers (rho = 0.700, p = 0.036). Two-way ANOVA analysis revealed that lowering glucose levels in each segment were more frequently observed in the lower finishers compared to the higher finishers (p = 0.012). Compared to the higher finishers, the lower finishers exhibited significantly greater fluctuations (⊿highest-lowest) in glucose levels (p < 0.001). The fluctuations in glucose levels were significantly and negatively correlated with the running speed of the finishers (rho =  - 0.612, p = 0.012). Faster runners consume high amounts of carbohydrates and maintain glucose levels during the 100-mile ultramarathon on the trail, especially at the beginning. Lowering and fluctuating glucose levels during the race are associated with lower running speed in endurance athletes.

Assessing exogenous carbohydrate intake needed to optimize human endurance performance across sex: insights from modeling runners pursuing a sub-2-h marathon

Carbohydrate (CHO) availability sustains high metabolic demands during prolonged exercise. The adequacy of current CHO intake recommendations, 30-90 g·h-1 dependent on CHO mixture and tolerability, to support elite marathon performance is unclear. We sought to scrutinize the current upper limit recommendation for exogenous CHO intake to support modeled sub-2-h marathon (S2M) attempts across elite male and female runners. Male and female runners (n = 120 each) were modeled from published literature with reference characteristics necessary to complete a S2M (e.g., body mass and running economy). Completion of a S2M was considered across a range of respiratory exchange rates, with maximal starting skeletal muscle and liver glycogen content predicted for elite male and female runners. Modeled exogenous CHO bioavailability needed for male and female runners were 93 ± 26 and 108 ± 22 g·h-1, respectively (P < 0.0001, d = 0.61). Without exogenous CHO, males were modeled to deplete glycogen in 84 ± 7 min, females in 71 ± 5 min (P < 0.0001, d = 2.21) despite higher estimated CHO oxidation rates in males (5.1 ± 0.5 g·h-1) than females (4.4 ± 0.5 g·h-1; P < 0.0001, d = 1.47). Exogenous CHO intakes ≤ 90 g·h-1 are insufficient for 65% of modeled runners attempting a S2M. Current recommendations to support marathon performance appear inadequate for elite marathon runners but may be more suitable for male runners in pursuit of a S2M (56 of 120) than female runners (28 of 120).NEW & NOTEWORTHY This study scrutinizes the upper limit of exogenous carbohydrate (CHO) recommendations for elite male and female marathoners by modeling sex-specific needs across an extreme metabolic challenge lasting ∼2 h, a sub-2-h marathon. Contemporary nutritional guidelines to optimize marathon performance appear inadequate for most elite marathon runners but appear more appropriate for males over their female counterparts. Future research examining possible benefits of exogenous CHO intakes > 90 g·h-1 should prioritize female athlete study inclusion.

Meta-Analysis of Carbohydrate Solution Intake during Prolonged Exercise in Adults: From the Last 45+ Years' Perspective

Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes' cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group-mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects' CRF level increased, with a 6-8% CHO solution composed of GL:FRU improving performance (exercise: 1-4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6-8% single-source CHO solution increasing performance in intermittent and 'stop and start' sports and an ~6% CHO solution appearing beneficial for 45-60 min exercises, but there were no significant differences between subjects' gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject's CRF.

Designing Functional Fruit-Based Recovery Drinks in Powder Form That Contain Electrolytes, Peptides, Carbohydrates and Prebiotic Fiber Taking into Account Each Component's Osmolality

High levels of osmolalities have been found in manufactured carbohydrate-based functional drinks that occasionally include added protein; however, fruit components rich in bioactive ingredients have been absent. It has proved difficult to obtain recovery drinks based on natural fruit components that deliver calories and nutrients to the body whilst simultaneously ensuring that the body is adequately hydrated after physical exertion; the problem being that it is difficult to ensure the drinks’ stability at low pH levels and maintain an appropriate sensory quality. This study aims to develop drinks based on natural fruit components that contain added electrolytes, carbohydrates, prebiotic fiber and protein; an improved water and electrolyte balance; the calories needed after intense physical exertion; a high content of nutrients; and a favorable sensory quality. Furthermore, the relationships between regressive osmolalities of beverage components are herein investigated. The study materials were raspberry powders (prepared via fluidized-bed jet milling, drying, freeze-drying and spray-drying) as well as citrated sodium, potassium, magnesium salts, isomaltulose, hydrolyzed collagen, whey protein isolate and prebiotic fiber. The drinks’ polyphenols and antioxidant properties were measured spectrophotometrically, whilst vitamin C content was determined using high-pressure liquid chromatography. The sensory qualities of each drink were assessed according to a scaling method. Six test versions of recovery drinks were prepared in which osmolalities ranged from 388 to 607 mOsm/kg water, total polyphenol content was 27–49 mg GAE/100 mL and vitamin C level was 8.1–20.6 mg/100 mL, following compositions defined by the study results. It is thus possible to obtain fruit-based recovery drinks of the recommended osmolality that contain added protein, prebiotics and fiber, as well as defined amounts of electrolytes and carbohydrates. All drinks were found to have a satisfactorily sensory quality. The design of appropriate recovery drink compositions was also greatly helped by investigating the relationships among the regressive osmolalities of beverage components (i.e., electrolytes, carbohydrates, fruit powders and protein).

Exogenous carbohydrate and regulation of muscle carbohydrate utilisation during exercise

PURPOSE

Carbohydrates (CHO) are one of the fundamental energy sources during prolonged steady state and intermittent exercise. The consumption of exogenous CHO during exercise is common place, with the aim to enhance sporting performance. Despite the popularity around exogenous CHO use, the process by which CHO is regulated from intake to its use in the working muscle is still not fully appreciated. Recent studies utilizing the hyperglycaemic glucose clamp technique have shed light on some of the potential barriers to CHO utilisation during exercise. The present review addresses the role of exogenous CHO utilisation during exercise, with a focus on potential mechanisms involved, from glucose uptake to glucose delivery and oxidation at the different stages of regulation.

METHODS

Narrative review.

RESULTS

A number of potential barriers were identified, including gastric emptying, intestinal absorption, blood flow (splanchnic and muscle), muscle uptake and oxidation. The relocation of glucose transporters plays a key role in the regulation of CHO, particularly in epithelial cells and subsequent transport into the blood. Limitations are also apparent when CHO is infused, particularly with regards to blood flow and uptake within the muscle.

CONCLUSION

We highlight a number of potential barriers involved with the regulation of both ingested and infused CHO during exercise. Future work on the influence of longitudinal training within the regulation processes (such as the gut) is warranted to further understand the optimal type, dose and method of CHO delivery to enhance sporting performance.

Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race

Background: The current study intended to evaluate the feasibility of the application of continuous glucose monitoring to guarantee optimal intake of carbohydrate to maintain blood glucose levels during a 160-km ultramarathon race. Methods: Seven ultramarathon runners (four male and three female) took part in the study. The glucose profile was monitored continuously throughout the race, which was divided into 11 segments by timing gates. Running speed in each segment was standardized to the average of the top five finishers for each gender. Food and drink intake during the race were recorded and carbohydrate and energy intake were calculated. Results: Observed glucose levels ranged between 61.9–252.0 mg/dL. Average glucose concentration differed from the start to the end of the race (104 ± 15.0 to 164 ± 30.5 SD mg/dL). The total amount of carbohydrate intake during the race ranged from 0.27 to 1.14 g/kg/h. Glucose concentration positively correlated with running speeds in segments (P < 0.005). Energy and carbohydrate intake positively correlated with overall running speed (P < 0.01). Conclusion: The present study demonstrates that continuous glucose monitoring could be practical to guarantee optimal carbohydrate intake for each ultramarathon runner.

Fructose co-ingestion to increase carbohydrate availability in athletes

Carbohydrate availability is important to maximize endurance performance during prolonged bouts of moderate- to high-intensity exercise as well as for acute post-exercise recovery. The primary form of carbohydrates that are typically ingested during and after exercise are glucose (polymers). However, intestinal glucose absorption can be limited by the capacity of the intestinal glucose transport system (SGLT1). Intestinal fructose uptake is not regulated by the same transport system, as it largely depends on GLUT5 as opposed to SGLT1 transporters. Combining the intake of glucose plus fructose can further increase total exogenous carbohydrate availability and, as such, allow higher exogenous carbohydrate oxidation rates. Ingesting a mixture of both glucose and fructose can improve endurance exercise performance compared to equivalent amounts of glucose (polymers) only. Fructose co-ingestion can also accelerate post-exercise (liver) glycogen repletion rates, which may be relevant when rapid (<24 h) recovery is required. Furthermore, fructose co-ingestion can lower gastrointestinal distress when relatively large amounts of carbohydrate (>1.2 g/kg/h) are ingested during post-exercise recovery. In conclusion, combined ingestion of fructose with glucose may be preferred over the ingestion of glucose (polymers) only to help trained athletes maximize endurance performance during prolonged moderate- to high-intensity exercise sessions and accelerate post-exercise (liver) glycogen repletion.

Fructose Metabolism from a Functional Perspective: Implications for Athletes

Substantial amounts of fructose are present in our diet. Unlike glucose, this hexose cannot be metabolized by most cells and has first to be converted into glucose, lactate or fatty acids by enterocytes, hepatocytes and kidney proximal tubule cells, which all express specific fructose-metabolizing enzymes. This particular metabolism may then be detrimental in resting, sedentary subjects; however, this may also present some advantages for athletes. First, since fructose and glucose are absorbed through distinct, saturable gut transporters, co-ingestion of glucose and fructose may increase total carbohydrate absorption and oxidation. Second, fructose is largely metabolized into glucose and lactate, resulting in a net local lactate release from splanchnic organs (mostly the liver). This 'reverse Cori cycle' may be advantageous by providing lactate as an additional energy substrate to the working muscle. Following exercise, co-ingestion of glucose and fructose mutually enhance their own absorption and storage.

Nutrition, Health, and Regulatory Aspects of Digestible Maltodextrins

Digestible maltodextrins are low-sweet saccharide polymers consisting of D-glucose units linked primarily linearly with alpha-1,4 bonds, but can also have a branched structure through alpha-1,6 bonds. Often, maltodextrins are classified by the amount of reducing sugars present relative to the total carbohydrate content; between 3 and 20 percent in the case of digestible maltodextrins. These relatively small polymers are used as food ingredients derived by hydrolysis from crops naturally rich in starch. Through advances in production technology, the application possibilities in food products have improved during the last 20 years. However, since glucose from digested maltodextrins is rapidly absorbed in the small intestine, the increased use has raised questions about potential effects on metabolism and health. Therefore, up-to-date knowledge concerning production, digestion, absorption, and metabolism of maltodextrins, including potential effects on health, were reviewed. Exchanging unprocessed starch with maltodextrins may lead to an increased glycemic load and therefore post meal glycaemia, which are viewed as less desirable for health. Apart from beneficial food technological properties, its use should accordingly also be viewed in light of this. Finally, this review reflects on regulatory aspects, which differ significantly in Europe and the United States, and, therefore, have implications for communication and marketing.

The performance effect of early versus late carbohydrate feedings during prolonged exercise

The purpose of this study was to determine how the timing of isoenergetic carbohydrate feedings during prolonged cycling affects performance in a subsequent 10-km cycling time trial. Recreationally trained male cyclists (n = 8; age, 34.5 ± 8.3 years; mass, 80.0 ± 6.3 kg; body fat, 16.0% ± 3.8%, peak oxygen uptake, 4.54 ± 0.42 L·min(-1)) completed 4 experimental trials consisting of cycling continuously for 2 h at 62.4% ± 1.9% of peak oxygen uptake, followed immediately by a self-paced 10-km time trial. The 4 conditions included no carbohydrate ingestion (PP), early carbohydrate ingestion (CP), late carbohydrate ingestion (PC), or carbohydrate ingestion throughout (CC). Blood samples were obtained at 0, 60, and 120 min of cycling as well as at the conclusion of the time trial. The 10-km time trial time to completion was faster in trials CC (17.70 ± 0.52 min) and PC (17.60 ± 0.62 min) as compared with trial PP (18.13 ± 0.52 min, p = 0.028 and p = 0.007, respectively) while trial CP (17.85 ± 0.58 min, p = 0.178) was not. Serum glucose increased with carbohydrate feedings (p < 0.05), while serum free fatty acid concentrations were lower in trials PC and CC than trials CP and PP (p < 0.05). There was no difference in oxygen uptake, heart rate, rating of perceived exertion, or substrate use between trials (p > 0.05). These data indicate that carbohydrate ingestion throughout or late during a 2-h cycling bout can improve subsequent 10-km time trial performance.

Impact of postprandial glycaemia on health and prevention of disease

Postprandial glucose, together with related hyperinsulinemia and lipidaemia, has been implicated in the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In this review, available evidence is discussed on postprandial glucose in relation to body weight control, the development of oxidative stress, T2DM, and CVD and in maintaining optimal exercise and cognitive performance. There is mechanistic evidence linking postprandial glycaemia or glycaemic variability to the development of these conditions or in the impairment in cognitive and exercise performance. Nevertheless, postprandial glycaemia is interrelated with many other (risk) factors as well as to fasting glucose. In many studies, meal-related glycaemic response is not sufficiently characterized, or the methodology with respect to the description of food or meal composition, or the duration of the measurement of postprandial glycaemia is limited. It is evident that more randomized controlled dietary intervention trials using effective low vs. high glucose response diets are necessary in order to draw more definite conclusions on the role of postprandial glycaemia in relation to health and disease. Also of importance is the evaluation of the potential role of the time course of postprandial glycaemia.

Fructose-maltodextrin ratio in a carbohydrate-electrolyte solution differentially affects exogenous carbohydrate oxidation rate, gut comfort, and performance

Solutions containing multiple carbohydrates utilizing different intestinal transporters (glucose and fructose) show enhanced absorption, oxidation, and performance compared with single-carbohydrate solutions, but the impact of the ratio of these carbohydrates on outcomes is unknown. In a randomized double-blind crossover, 10 cyclists rode 150 min at 50% peak power, then performed an incremental test to exhaustion, while ingesting artificially sweetened water or one of three carbohydrate-salt solutions comprising fructose and maltodextrin in the respective following concentrations: 4.5 and 9% (0.5-Ratio), 6 and 7.5% (0.8-Ratio), and 7.5 and 6% (1.25-Ratio). The carbohydrates were ingested at 1.8 g/min and naturally (13)C-enriched to permit evaluation of oxidation rate by mass spectrometry and indirect calorimetry. Mean exogenous carbohydrate oxidation rates were 1.04, 1.14, and 1.05 g/min (coefficient of variation 20%) in 0.5-, 0.8-, and 1.25-Ratios, respectively, representing likely small increases in 0.8-Ratio of 11% (90% confidence limits; ± 4%) and 10% (± 4%) relative to 0.5- and 1.25-Ratios, respectively. Comparisons of fat and total and endogenous carbohydrate oxidation rates between solutions were unclear. Relative to 0.5-Ratio, there were moderate improvements to peak power with 0.8- (3.6%; 99% confidence limits ± 3.5%) and 1.25-Ratio (3.0%; ± 3.7%) but unclear with water (0.4%; ± 4.4%). Increases in stomach fullness, abdominal cramping, and nausea were lowest with the 0.8- followed by the 1.25-Ratio solution. At high carbohydrate-ingestion rate, greater benefits to endurance performance may result from ingestion of 0.8- to 1.25-Ratio fructose-maltodextrin solutions. Small perceptible improvements in gut comfort favor the 0.8-Ratio and provide a clearer suggestion of mechanism than the relationship with exogenous carbohydrate oxidation.

Nutrition concepts for elite distance runners based on macronutrient and energy expenditure

CONTEXT

Elite distance runners (EDR) must optimize their nutrition to maintain their demanding training schedules.

OBJECTIVE

To develop a nutrition concept for EDR based on energy and macronutrient expenditures.

DESIGN

This theoretical study provides calculations for macronutrient and energy expenditures of EDR. Anthropometric and metabolic characteristics of EDR were assumed based on average real EDR.

SETTING

University of Kiel.

PATIENTS OR OTHER PARTICIPANTS

Three prototypic types of male EDR described in the literature as type I (TI; body mass = 72 kg, respiratory quotient = 0.9 at rest, fast-twitch muscle fibers = 60% to 70%), type II (TII; body mass = 67 kg, respiratory quotient = 0.82 at rest, fast-twitch muscle fibers = 50%), and type III (TIII; body mass = 60 kg, respiratory quotient = 0.75 at rest, fast-twitch muscle fibers = 30% to 40%).

MAIN OUTCOME MEASURE(S)

We calculated the macronutrient and energy expenditures of the 3 types of EDR according to body mass, respiratory quotient, and percentage of fast-twitch muscle fibers.

RESULTS

We found that the average energy expenditure was 3750 kcal . d(-1) for TI runners, 3463 kcal . d(-1) for TII runners, and 3079 kcal . d(-1) for TIII runners. The carbohydrate (CHO) expenditure reached an average value of 10.0 g . kg(-1) . d(-1) for TI runners, 8.0 g . kg(-1) . d(-1) for TII runners, and 4.7 g . kg(-1) . d(-1) for TIII runners. When the EDR accomplished running sessions at a pace >or=100% of maximum oxygen consumption, all types of runners had a CHO demand of about 10 g . kg(-1) . d(-1). The TI and TII runners need a CHO intake of 8 to 10 g . kg(-1) . d(-1). For the TIII runners, a CHO intake >6 g . kg(-1) . d(-1) is necessary during anaerobic training sessions.

CONCLUSIONS

Nutrition concepts must be differentiated for EDR according to metabolic and anthropometric characteristics of the runners and their special training emphases.

High rates of exogenous carbohydrate oxidation from a mixture of glucose and fructose ingested during prolonged cycling exercise

A recent study from our laboratory has shown that a mixture of glucose and fructose ingested at a rate of 1·8 g/min leads to peak oxidation rates of approximately 1·3 g/min and results in approximately 55 % higher exogenous carbohydrate (CHO) oxidation rates compared with the ingestion of an isocaloric amount of glucose. The aim of the present study was to investigate whether a mixture of glucose and fructose when ingested at a high rate (2·4 g/min) would lead to even higher exogenous CHO oxidation rates (>1·3 g/min).Eight trained male cyclists (VO2max: 68±1 ml/kg per min) cycled on three different occasions for 150 min at 50 % of maximal power output (60±1 % VO2max) and consumed either water (WAT) or a CHO solution providing 1·2 g/min glucose (GLU) or 1.2 g/min glucose+1·2 g/min fructose (GLU+FRUC). Peak exogenous CHO oxidation rates were higher (P<0·01) in the GLU+FRUC trial compared with the GLU trial (1·75 (se 0·11) and 1·06 (se 0·05) g/min, respectively). Furthermore, exogenous CHO oxidation rates during the last 90 min of exercise were approximately 50 % higher (P<0·05) in GLU+FRUC compared with GLU (1·49 (se 0·08) and 0·99 (se 0·06) g/min, respectively). The results demonstrate that when a mixture of glucose and fructose is ingested at high rates (2·4 g/min) during 150 min of cycling exercise, exogenous CHO oxidation rates reach peak values of approximately 1·75 g/min.

Oxidation of combined ingestion of glucose and sucrose during exercise

The first purpose of the study was to examine whether combined ingestion of glucose and sucrose at an intake rate of 1.2 g/min would lead to higher oxidation rates compared with the ingestion of an isocaloric amount of glucose or sucrose alone. The second aim of the study was to investigate whether a mixture of glucose and sucrose when ingested at a high rate (2.4 g/min) would result in exogenous CHO oxidation rates higher than 1.2 to 1.3 g/min. Eight trained cyclists (maximal oxygen consumption: 64 +/- 2 mL . kg -1 . min -1 , mean +/- SE) performed 5 exercise trials in random order. Each trial consisted of 120 minutes of cycling at 50% maximum power output (63% +/- 2% maximal oxygen consumption), whereas subjects received a solution providing either 1.2 g/min of glucose (GLU), 1.2 g/min of sucrose (SUC), 0.6 g/min of glucose + 0.6 g/min of sucrose (M-GLU+SUC), 1.2 g/min of glucose + 1.2 g/min of sucrose (H-GLU+SUC), or water (WAT). Peak exogenous CHO oxidation rates in the H-GLU+SUC trial (1.20 +/- 0.07 g/min) were significantly higher ( P < .01) compared with the GLU, M-GLU+SUC, and SUC trials (0.77 +/- 0.04, 0.90 +/- 0.07, 0.98 +/- 0.04 g/min, respectively). Furthermore, peak exogenous CHO rates in M-GLU+SUC and SUC trials were significantly higher ( P < .05) compared with the GLU trial. In conclusion, combined ingestion of moderate amounts of glucose and sucrose (144 g) during cycling exercise resulted in approximately 21% higher exogenous CHO oxidation rates compared with the ingestion of an isocaloric amount of glucose. Furthermore, when a mixture of glucose and sucrose was ingested at high rates (2.4 g/min), exogenous CHO oxidation rates reached peak values of approximately 1.20 g/min.

Caffeine increases exogenous carbohydrate oxidation during exercise

Both carbohydrate (CHO) and caffeine have been used as ergogenic aids during exercise. It has been suggested that caffeine increases intestinal glucose absorption, but there are also suggestions that it may decrease muscle glucose uptake. The purpose of the study was to investigate the effect of caffeine on exogenous CHO oxidation. In a randomized crossover design, eight male cyclists (age 27 +/- 2 yr, body mass 71.2 +/- 2.3 kg, maximal oxygen uptake 65.7 +/- 2.2 ml x kg(-1) x min(-1)) exercised at 64 +/- 3% of maximal oxygen uptake for 120 min on three occasions. During exercise subjects ingested either a 5.8% glucose solution (Glu; 48 g/h), glucose with caffeine (Glu+Caf, 48 g/h + 5 mg x kg(-1) x h(-1)), or plain water (Wat). The glucose solution contained trace amounts of [U-13C]glucose so that exogenous CHO oxidation could be calculated. CHO and fat oxidation were measured by indirect calorimetry, and 13C appearance in the expired gases was measured by continuous-flow IRMS. Average exogenous CHO oxidation over the 90- to 120-min period was 26% higher (P < 0.05) in Glu+Caf (0.72 +/- 0.04 g/min) compared with Glu (0.57 +/- 0.04 g/min). Total CHO oxidation rates were higher (P < 0.05) in the CHO ingestion trials compared with Wat, but they were highest when Glu+Caf was ingested (1.21 +/- 0.37, 1.84 +/- 0.14, and 2.47 +/- 0.23 g/min for Wat, Glu, and Glu+Caf, respectively; P < 0.05). There was also a trend (P = 0.082) toward an increased endogenous CHO oxidation with Glu+Caf (1.81 +/- 0.22 g/min vs. 1.27 +/- 0.13 g/min for Glu and 1.12 +/- 0.37 g/min for Wat). In conclusion, compared with glucose alone, 5 mg x kg(-1) x h(-1) of caffeine coingested with glucose increases exogenous CHO oxidation, possibly as a result of an enhanced intestinal absorption.

Nutrient intake and performance during a mountain marathon: an observational study

In order to study nutrient intake of amateur runners during a mountain marathon, compliance with recommendations, and association with performance, an intake of 42 participants in a Swiss mountain marathon was assessed by direct observation. Data on demographics, dietary preparation and race experience were obtained by questionnaires. Anthropometrical measures were performed before and after the race. Mean hourly intakes (SD) of fluid, carbohydrate, energy and sodium were 545 (158) ml, 31 (14) g, 141 (63) kcal [or 590 (264) kJ], and 150 (203) mg respectively. A third of the runners drank 600 ml h(-1) or more, 52% consumed less than 30 g h(-1 )carbohydrates, 95% consumed less than 500 mg h(-1) sodium. Mean weight loss was 4 (1.5) kg; 30 runners (71%) lost over 3% body mass. Mean running time was 7 h 3 min (1 h 17 min). Most participants failed to meet nutritional recommendations. None were at risk of overhydration. Body composition and race experience were correlated with performance, but not nutrient intake. Because experienced runners are well trained, fitter, and know better their personal needs during such a race, it is difficult to disentangle these associations. As causal relationship cannot be proven with this cross-sectional design, non-compliance with intake recommendations requires additional experimental research on the impact of nutrient intake on field performance.

Metabolic response to prolonged cycling with (13)C-glucose ingestion following downhill running

The purpose of this study was to describe the effect of muscle damage and delayed-onset muscle soreness (DOMS) on the metabolic response during a subsequent period of prolonged concentric exercise (120 min, approximately 61% V(.)O(2max), on a cycle ergometer), with ingestion of 3 g of (13)C-glucose/kg body mass. We hypothesized that the oxidation of plasma and exogenous glucose would be reduced, while the oxidation of glucose arising from muscle glycogen would be increased. Six male subjects were studied during exercise in a control situation and 2 days following downhill running, at a time when plasma creatine kinase (CK) activity was increased, and DOMS was present. Carbohydrate and lipid oxidation were computed from indirect respiratory calorimetry corrected for protein oxidation, while the oxidation of plasma glucose and muscle glycogen were computed from V(.)(13)CO(2) and the ratio of (13)C/(12)C in the plasma glucose. All data were presented as the mean and the standard error of the mean. The oxidation of protein (approximately 6% energy yield, in the control and the experimental trial), lipid (approximately 15 and approximately 18%), and carbohydrate (approximately 79 and approximately 76%), as well as that of plasma glucose (approximately 41 and approximately 46%), glucose from the liver (approximately 12 and approximately 14%), and glucose from muscle glycogen (approximately 38 and approximately 31%) were not significantly different between the control and experimental (DOMS) trials. The response of the plasma glucose, insulin, lactate, and free fatty acid concentrations was not modified by the previous eccentric exercise. These results indicate that the metabolic response to prolonged concentric exercise is not modified by muscle damage and DOMS resulting from a bout of eccentric exercise performed 2 days before.

Fat supplementation, health, and endurance performance

Pre-exercise fat ingestion (i.e., long chain triacylglycerol ingestion 1 to 4 h before exercise), medium-chain triacylglycerols, fish oil, and conjugated linoleic acid have been suggested to alter metabolism to achieve weight loss, alter lipid profiles, or improve performance. However, studies have demonstrated that ingestion of meals with long-chain triacylglycerols before exercise has little or no effect on metabolism and does not alter subsequent exercise performance. Also, medium-chain triacylglycerol supplementation before or during exercise has not been shown to be ergogenic, although this could be related to the small amounts of medium-chain triacylglycerol that can be ingested before gastrointestinal discomfort occurs. Fish oil may improve red blood cell deformability, but these effects are likely to be small and do not seem to influence maximum oxygen delivery or exercise performance. Conjugated linoleic acid has been implicated in weight loss, but based on the results of human studies it must be concluded that the effects of conjugated linoleic acid on body weight loss are far less clear than those observed in animal studies. Most studies have not found any evidence for a beneficial effect of conjugated linoleic acid.

Gender difference in the metabolic response to prolonged exercise with [13C]glucose ingestion

The metabolic response to a 120-min cycling exercise with ingestion of [(13)C]glucose (3 g kg(-1)) was compared in women in the follicular phase of the cycle [ n=6; maximum rate of oxygen uptake (VO(2max)) 44.7 (2.6) ml kg(-1) min(-1)] and in men [ n=6; VO(2max) 54.2 (4.3) ml kg(-1) min(-1)] working at the same relative workload (approximately 65% VO(2max): 107 and 179 W in women and men, respectively). We hypothesized that the contribution of endogenous substrate oxidations (indirect respiratory calorimetry corrected for protein oxidation) to the energy yield will be similar in men and women, but that women will rely more than men on exogenous glucose oxidation. Over the exercise period, the respective contributions of protein, lipid and carbohydrate oxidation to the energy yield, were similar in men [3.7 (0.9), 21.7 (2.9) and 74.6 (3.5)%] and women [3.4 (0.8), 21.5 (2.2), 75.1 (2.5)%]. The rate of exogenous glucose oxidation was approximately 45% lower in women than men (0.5 and 0.6 g min(-1) vs 0.7 and 0.9 g min(-1), between min 40 and 80, and min 80 and 120, respectively). However, when the approximately 39% difference in absolute workload and energy expenditure was taken into account, the contribution of exogenous glucose oxidation to the energy yield was similar in men and women: 22.5 vs 24.2% between min 40 and 80, and 25.7 and 28.5% between min 80 and 120, respectively. These data indicate that when fed glucose, the respective contributions of the oxidation of the various substrates to the energy yield during prolonged exercise at the same % VO(2max) are similar in men and in women in the follicular phase of the cycle.

Oxidation of exogenous glucose, sucrose, and maltose during prolonged cycling exercise

The purpose of the present study was to investigate whether combined ingestion of two carbohydrates (CHO) that are absorbed by different intestinal transport mechanisms would lead to exogenous CHO oxidation rates of >1.0 g/min. Nine trained male cyclists (maximal O(2) consumption: 64 +/- 2 ml x kg body wt(-1) x min(-1)) performed four exercise trials, which were randomly assigned and separated by at least 1 wk. Each trial consisted of 150 min of cycling at 50% of maximal power output (60 +/- 1% maximal O(2) consumption), while subjects received a solution providing either 1.8 g/min of glucose (Glu), 1.2 g/min of glucose + 0.6 g/min of sucrose (Glu+Suc), 1.2 g/min of glucose + 0.6 g/min of maltose (Glu+Mal), or water. Peak exogenous CHO oxidation rates were significantly higher (P < 0.05) in the Glu+Suc trial (1.25 +/- 0.07 g/min) compared with the Glu and Glu+Mal trials (1.06 +/- 0.08 and 1.06 +/- 0.06 g/min, respectively). No difference was found in (peak) exogenous CHO oxidation rates between Glu and Glu+Mal. These results demonstrate that, when a mixture of glucose and sucrose is ingested at high rates (1.8 g/min) during cycling exercise, exogenous CHO oxidation rates reach peak values of approximately 1.25 g/min.

Oxidation of combined ingestion of glucose and fructose during exercise

The purpose of the present study was to examine whether combined ingestion of a large amount of fructose and glucose during cycling exercise would lead to exogenous carbohydrate oxidation rates >1 g/min. Eight trained cyclists (maximal O(2) consumption: 62 +/- 3 ml x kg(-1) x min(-1)) performed four exercise trials in random order. Each trial consisted of 120 min of cycling at 50% maximum power output (63 +/- 2% maximal O(2) consumption), while subjects received a solution providing either 1.2 g/min of glucose (Med-Glu), 1.8 g/min of glucose (High-Glu), 0.6 g/min of fructose + 1.2 g/min of glucose (Fruc+Glu), or water. The ingested fructose was labeled with [U-(13)C]fructose, and the ingested glucose was labeled with [U-(14)C]glucose. Peak exogenous carbohydrate oxidation rates were approximately 55% higher (P < 0.001) in Fruc+Glu (1.26 +/- 0.07 g/min) compared with Med-Glu and High-Glu (0.80 +/- 0.04 and 0.83 +/- 0.05 g/min, respectively). Furthermore, the average exogenous carbohydrate oxidation rates over the 60- to 120-min exercise period were higher (P < 0.001) in Fruc+Glu compared with Med-Glu and High-Glu (1.16 +/- 0.06, 0.75 +/- 0.04, and 0.75 +/- 0.04 g/min, respectively). There was a trend toward a lower endogenous carbohydrate oxidation in Fruc+Glu compared with the other two carbohydrate trials, but this failed to reach statistical significance (P = 0.075). The present results demonstrate that, when fructose and glucose are ingested simultaneously at high rates during cycling exercise, exogenous carbohydrate oxidation rates can reach peak values of approximately 1.3 g/min.

Breath [13CO2] recovery from an oral glucose load during exercise: comparison between [U-13C] and [1,2-13C]glucose

The purpose of the present experiment was to compare 13CO2 recovery at the mouth, and the corresponding exogenous glucose oxidation computed, during a 100-min exercise at 63 +/- 3% maximal O2 uptake with ingestion of glucose (1.75 g/kg) in six active male subjects, by use of [U-13C] and [1,2-13C]glucose. We hypothesized that 13C recovery and exogenous glucose oxidation could be lower with [1,2-13C] than [U-13C]glucose because both tracers provide [13C]acetate, with possible loss of 13C in the tricarboxylic acid (TCA) cycle, but decarboxylation of pyruvate from [U-13C]glucose also provides 13CO2, which is entirely recovered at the mouth during exercise. The recovery of 13C (25.8 +/- 2.3 and 27.4 +/- 1.2% over the exercise period) and the amounts of exogenous glucose oxidized computed were not significantly different with [1,2-13C] and [U-13C]glucose (28.9 +/- 2.6 and 30.7 +/- 1.3 g, between minutes 40 and 100), suggesting that no significant loss of 13C occurred in the TCA cycle. This stems from the fact that, during exercise, the rate of exogenous glucose oxidation is probably much larger than the flux of the metabolic pathways fueled from TCA cycle intermediates. It is thus unlikely that a significant portion of the 13C entering the TCA cycle could be diverted to these pathways. From a methodological standpoint, this result indicates that when a large amount of [13C]glucose is ingested and oxidized during exercise, 13CO2 production at the mouth accurately reflects the rate of glucose entry in the TCA cycle and that no correction factor is needed to compute the oxidative flux of exogenous glucose.

Functional foods and food supplements for athletes: from myths to benefit claims substantiation through the study of selected biomarkers

The development of the sports food market and industrial involvement have led to numerous nutritional studies to define the type of nutrients that are most suited to support energy metabolism, fluid balance and muscle function. The key question in many of these studies was: 'Does the product lead to a significant product/consumer benefit that can be used as a claim on the package?' New methods and techniques have been developed, partly with sponsorship of the food industry, with the goal of measuring the effects of specific nutrients and supplements on athletic performance and metabolism. In line with this development, a wide variety of supplements and sports foods/drinks labelled with various performance or health benefit statements have been launched on the sports nutrition market. Although a variety of products have been tested clinically, there are also many products on the market with benefit claims that cannot be supported by sound nutritional and sports physiological science. The current short review highlights some of the methods and biomarkers that are used to substantiate product/consumer benefit claims for foods and drinks that are marketed as functional foods for athletes.

Heat stress increases muscle glycogen use but reduces the oxidation of ingested carbohydrates during exercise

The aim of the present study was to test the hypothesis that the oxidation rate of ingested carbohydrate (CHO) is impaired during exercise in the heat compared with a cool environment. Nine trained cyclists (maximal oxygen consumption 65 +/- 1 ml x kg body wt(-1) x min(-1)) exercised on two different occasions for 90 min at 55% maximum power ouptput at an ambient temperature of either 16.4 +/- 0.2 degrees C (cool trial) or 35.4 +/- 0.1 degrees C (heat trial). Subjects received 8% glucose solutions that were enriched with [U-13C]glucose for measurements of exogenous glucose, plasma glucose, liver-derived glucose and muscle glycogen oxidation. Exogenous glucose oxidation during the final 30 min of exercise was significantly (P < 0.05) lower in the heat compared with the cool trial (0.76 +/- 0.06 vs. 0.84 +/- 0.05 g/min). Muscle glycogen oxidation during the final 30 min of exercise was increased by 25% in the heat (2.07 +/- 0.16 vs. 1.66 +/- 0.09 g/min; P < 0.05), and liver-derived glucose oxidation was not different. There was a trend toward a higher total CHO oxidation and a lower plasma glucose oxidation in the heat although this did not reach statistical significance (P = 0.087 and P = 0.082, respectively). These results demonstrate that the oxidation rate of ingested CHO is reduced and muscle glycogen utilization is increased during exercise in the heat compared with a cool environment.

Oral [(13)C]glucose and endogenous energy substrate oxidation during prolonged treadmill running

Six male subjects were studied during running exercise (120 min, 69% maximal oxygen consumption) with ingestion of a placebo or 3.5 g/kg of [(13)C]glucose (approximately 2 g/min). Indirect respiratory calorimetry corrected for urea excretion in urine and sweat, production of (13)CO(2) at the mouth, and changes in plasma glucose (13)C/(12)C were used to compute energy substrate oxidation. The oxidation rate of exogenous glucose increased from 1.02 at minute 60 to 1.22 g/min at minute 120 providing approximately 24 and 33% of the energy yield (%En). Glucose ingestion did not modify protein oxidation, which provided approximately 4-5%En, but significantly increased glucose oxidation by approximately 7%, reduced lipid oxidation by approximately 16%, and markedly reduced endogenous glucose oxidation (1.25 vs. 2.21 g/min between minutes 80 and 120, respectively). The oxidation rate of glucose released from the liver (0.38 and 0.47 g/min, or 10-13%En at minutes 60 and 120, respectively), and of plasma glucose (1.30-1.69 g/min, or 34 and 45%En and 50 and 75% of glucose oxidation) significantly increased from minutes 60 to 120, whereas the oxidation of muscle glycogen significantly decreased (1.28 to 0.58 g of glucose/min, or 34 and 16%En and 50 and 25% of glucose oxidation). These results indicate that, during moderate prolonged running exercise, ingestion of a very large amount of glucose significantly reduces endogenous glucose oxidation, thus sparing muscle and/or liver glycogen stores.

Nutritional practices of male and female endurance cyclists

The nutritional requirements of the training and competition programmes of elite endurance cyclists are challenging. Notwithstanding the limitations of dietary survey techniques, studies of high-level male road cyclists provide important information about nutrient intake and food practices during training and major stage races. Typically, male cyclists undertaking intensive training programmes report a high energy intake (> or = 250 kJ/kg/day) and carbohydrate (CHO) intakes of 8 to 11 g/kg/day. Intakes of protein and micronutrients are likely to meet Recommended Dietary Intake levels, because of high energy intakes. Data on female cyclists are scarce. Stage racing poses an increased requirement for energy and CHO, with daily energy expenditure often exceeding 25 MJ. This must be achieved in the face of practical constraints on the time available for eating, and the suppression of appetite after exhausting exercise. However, studies show that male cyclists riding for professional teams appear to meet these challenges, with the assistance of their medical/scientific support crews. Current dietary practices during cycle tours appear to favour greater reliance on pre-stage intake and post-stage recovery meals to achieve nutritional goals. Recent reports suggest that current riding tactics interfere with previous practices of consuming substantial amounts of fluid and CHO while cycling. Further study is needed to confirm these practices, and to investigate whether these or other dietary strategies produce optimal cycling performance. Other issues that should receive attention include dietary practices of female cyclists, beliefs and practices regarding bodyweight control among cyclists, and the use of supplements and sports foods.

Guidelines for daily carbohydrate intake: do athletes achieve them?

Official dietary guidelines for athletes are unanimous in their recommendation of high carbohydrate (CHO) intakes in routine or training diets. These guidelines have been criticised on the basis of a lack of scientific support for superior training adaptations and performance, and the apparent failure of successful athletes to achieve such dietary practices. Part of the problem rests with the expression of CHO intake guidelines in terms of percentage of dietary energy. It is preferable to provide recommendations for routine CHO intake in grams (relative to the body mass of the athlete) and allow flexibility for the athlete to meet these targets within the context of their energy needs and other dietary goals. CHO intake ranges of 5 to 7 g/kg/day for general training needs and 7 to 10 g/kg/day for the increased needs of endurance athletes are suggested. The limitations of dietary survey techniques should be recognised when assessing the adequacy of the dietary practices of athletes. In particular, the errors caused by under-reporting or undereating during the period of the dietary survey must be taken into account. A review of the current dietary survey literature of athletes shows that a typical male athlete achieves CHO intake within the recommended range (on a g/kg basis). Individual athletes may need nutritional education or dietary counselling to fine-tune their eating habits to meet specific CHO intake targets. Female athletes, particularly endurance athletes, are less likely to achieve these CHO intake guidelines. This is due to chronic or periodic restriction of total energy intake in order to achieve or maintain low levels of body fat. With professional counselling, female athletes may be helped to find a balance between bodyweight control issues and fuel intake goals. Although we look to the top athletes as role models, it is understandable that many do not achieve optimal nutrition practices. The real or apparent failure of these athletes to achieve the daily CHO intakes recommended by sports nutritionists does not necessarily invalidate the benefits of meeting such guidelines. Further longitudinal studies of training adaptation and performance are needed to determine differences in the outcomes of high versus moderate CHO intakes. In the meantime, the recommendations of sports nutritionists are based on plentiful evidence that increased CHO availability enhances endurance and performance during single exercise sessions.

First-pass effect of an intravenous bolus of [13C]bicarbonate displayed breath-by-breath

The dilution of an intravenous bolus dose of [13C]bicarbonate is used as an estimate for the metabolic rate under certain conditions. It is a consistent finding in all studies that the total amount of intravenous [13C]bicarbonate cannot be recovered as breath 13CO2. In this study, we used a breath-by-breath analysis of 13CO2 to depict the washout of 13CO2 at a high temporal resolution to analyze the extent to which a probable first-pass effect is responsible for the reduced recovery. Eight healthy men were tested at seated rest and with bicycle exercise at a constant load relative to 40 and 75% maximal O2 consumption (V˙o 2 max). [13C]bicarbonate (0.0125 g/kg body wt) was administered as an intravenous bolus in each test. Respiratory mass spectrometry was used to derive the course of the end-tidal13CO2-to-12CO2 ratio from the breath-by-breath data. Approximately 2 min after13C administration, the washout curve could be fitted well by a two-exponential curve describing a two-compartment mammillary model. Immediately after administration of the bolus dose, an excess peak in the end-tidal13CO2-to-12CO2 ratio appeared. This peak could not be included in the two-exponential fitting. The area under the first peak resulted in 3.8 ± 1.3% of the total [13C]bicarbonate dose at rest, 11.5 ± 2.9% at moderate exercise (40%V˙o 2 max), and 16.9 ± 4.0% at intensive exercise (75% V˙o 2 max). The first-pass effect had an increasing impact of up to about two-thirds of the lacking bicarbonate with higher exercise intensity. The “loss” of tracer via this first-pass effect must be considered when the results of studies with parenteral administration of [13C]bicarbonate are considered, especially when it is given as a bolus dose and during exercise.

Oxidation of [(13)C]glycerol ingested along with glucose during prolonged exercise

The respective oxidation of glycerol and glucose (0.36 g/kg each) ingested simultaneously immediately before exercise (120 min at 68 +/- 2% maximal oxygen uptake) was measured in six subjects using (13)C labeling. Indirect respiratory calorimetry corrected for protein and glycerol oxidation was used to evaluate the effect of glucose + glycerol ingestion on the oxidation of glucose and fat. Over the last 80 min of exercise, 10.0 +/- 0.8 g of exogenous glycerol were oxidized (43% of the load), while exogenous glucose oxidation was 21% higher (12.1 +/- 0.7 g or 52% of the load). However, because the energy potential of glycerol is 18% higher than that of glucose (4.57 vs. 3.87 kcal/g), the contribution of both exogenous substrates to the energy yield was similar (4.0-4.1%). Total glucose and fat oxidation were similar in the placebo (144.4 +/- 13.0 and 60.5 +/- 4.2 g, respectively) and the glucose + glycerol (135.2 +/- 12.0 and 59.4 +/- 6.5 g, respectively) trials, whereas endogenous glucose oxidation was significantly lower than in the placebo trial (123.7 +/- 11.7 vs. 144.4 +/- 13.0 g). These results indicate that exogenous glycerol can be oxidized during prolonged exercise, presumably following conversion into glucose in the liver, although direct oxidation in peripheral tissues cannot be ruled out.

Nutritional needs for exercise in the heat

Although hot conditions are not typically conducive to optimal sports performance, nutritional strategies play an important role in assisting an athlete to perform as well as possible in a hot environment. A key issue is the prevention of hypohydration during an exercise session. Fluid intake strategies should be undertaken in a cyclical sequence: hydrate well prior to the workout, drink as much as is comfortable and practical during the session, and rehydrate aggressively afterwards in preparation for future exercise bouts. There is some interest in hyperhydration strategies, such as hyperhydration with glycerol, to prepare the athlete for a situation where there is little opportunity for fluid intake to match large sweat losses. Recovery of significant fluid losses after exercise is assisted by the simultaneous replacement of electrolyte losses. Carbohydrate (CHO) requirements for exercise are increased in the heat, due to a shift in substrate utilization towards CHO oxidation. Daily food patterns should focus on replacing glycogen stores after exercise, and competition strategies should include activities to enhance CHO availability, such as CHO loading for endurance events, pre-event CHO intake, and intake of sports drinks in events lasting longer than 60 min. Although CHO ingestion may not enhance the performance of all events undertaken in hot weather, there are no disadvantages to the consumption of beverages containing 4-8% CHO and electrolytes. In fact, the palatability of these drinks may enhance the voluntary intake of fluid. Although there is some evidence of increased protein catabolism and cellular damage due to production of oxygen radicals during exercise in the heat, there is insufficient evidence to make specific dietary recommendations to account for these issues.

Substrate utilization during exercise with glucose and glucose plus fructose ingestion in boys ages 10--14 yr

We measured substrate utilization during exercise performed with water (W), exogenous glucose (G), and exogenous fructose plus glucose (FG) ingestion in boys age 10-14 yr. Subjects (n = 12) cycled for 90 min at 55% maximal O(2) uptake while ingesting either W (25 ml/kg), 6% G (1.5 g/kg), or 3% F plus 3% G (1.5 g/kg). Fat oxidation increased during exercise in all trials but was higher in the W (0.28 +/- 0.023 g/min) than in the G (0.24 +/- 0.023 g/min) and FG (0.25 +/- 0.029 g/min) trials (P = 0.04). Conversely, total carbohydrate (CHO) oxidation decreased in all trials and was lower in the W (0.63 +/- 0.05 g/min) than in the G (0.78 +/- 0.051 g/min) and FG (0.74 +/- 0.056 g/min) trials (P = 0.009). Exogenous CHO oxidation, as determined by expired (13)CO(2), reached a maximum of 0.36 +/- 0.032 and 0.31 +/- 0.030 g/min at 90 min in G and FG, respectively (P = 0.04). Plasma insulin levels decrease during exercise in all trials but were twofold higher in G than in W and FG (P < 0.001). Plasma glucose levels decreased transiently after the onset of exercise in all trials and then returned to preexercise values in the W and FG (approximately 4.5 mmol/l) trials but were elevated by approximately 1.0 mmol/l in the G trial (P < 0.001). Plasma lactate concentrations decreased after the onset of exercise in all trials but were lower by approximately 0.5 mmol/l in W than in G and FG (P = 0.02). Thus, in boys exercising at a moderate intensity, the oxidation rate of G plus F is slightly less than G alone, but both spare endogenous CHO and fat to a similar extent. In addition, compared with flavored W, the ingestion of G alone and of G plus F delays exhaustion at 90% peak power by approximately 25 and 40%, respectively, after 90 min of moderate-intensity exercise.

Carbohydrate loading failed to improve 100-km cycling performance in a placebo-controlled trial

We evaluated the effect of carbohydrate (CHO) loading on cycling performance that was designed to be similar to the demands of competitive road racing. Seven well-trained cyclists performed two 100-km time trials (TTs) on separate occasions, 3 days after either a CHO-loading (9 g CHO. kg body mass(-1). day(-1)) or placebo-controlled moderate-CHO diet (6 g CHO. kg body mass(-1). day(-1)). A CHO breakfast (2 g CHO/kg body mass) was consumed 2 h before each TT, and a CHO drink (1 g CHO. kg(.)body mass(-1). h(-1)) was consumed during the TTs to optimize CHO availability. The 100-km TT was interspersed with four 4-km and five 1-km sprints. CHO loading significantly increased muscle glycogen concentrations (572 +/- 107 vs. 485 +/- 128 mmol/kg dry wt for CHO loading and placebo, respectively; P < 0.05). Total muscle glycogen utilization did not differ between trials, nor did time to complete the TTs (147.5 +/- 10.0 and 149.1 +/- 11.0 min; P = 0.4) or the mean power output during the TTs (259 +/- 40 and 253 +/- 40 W, P = 0.4). This placebo-controlled study shows that CHO loading did not improve performance of a 100-km cycling TT during which CHO was consumed. By preventing any fall in blood glucose concentration, CHO ingestion during exercise may offset any detrimental effects on performance of lower preexercise muscle and liver glycogen concentrations. Alternatively, part of the reported benefit of CHO loading on subsequent athletic performance could have resulted from a placebo effect.

Carbohydrate and exercise

Total body carbohydrate stores are limited, and are often less than the carbohydrate requirements of athletic training and competition. However, the availability of carbohydrate as a substrate for muscle metabolism is a critical factor in the performance of both high-intensity intermittent work and prolonged aerobic exercise. The rate of carbohydrate oxidation during exercise is tightly regulated, with glucose availability closely matching the needs of the working muscles. Both the absolute and relative work rate play important roles in the regulation of substrate metabolism: carbohydrate-based fuels predominate at moderate to high power outputs, with muscle glycogen and glucose utilization scaling exponentially to the relative work rate. As such, strategies to maintain or enhance carbohydrate availability, such as the ingestion of carbohydrate before, during and after exercise, are critical to the performance of a variety of sports events, and are a key recommendation in current sports nutrition guidelines.

Effect of training status on fuel selection during submaximal exercise with glucose ingestion

In this study, an oral glucose load was enriched with a [U-(13)C]glucose tracer to determine differences in substrate utilization between endurance-trained (T) and untrained (UT) subjects during submaximal exercise at the same relative and absolute workload when glucose is ingested. Six highly trained cyclists/triathletes [maximal workload (Wmax), 400 +/- 9 W] and seven UT subjects (Wmax, 296 +/- 8 W) were studied during 120 min of cycling exercise at 50% Wmax ( approximately 55% maximal O(2) consumption). The T subjects performed a second trial at the mean workload of the UT group (148 +/- 4 W). Before exercise, 8.0 ml/kg of a (13)C-enriched glucose solution (80 g/l) was ingested. During exercise, boluses of 2.0 ml/kg of the same solution were administered every 15 min. Measurements were made in the 90- to 120-min period when a steady state was present in breath (13)CO(2) and plasma glucose (13)C enrichment. Energy expenditure was higher in T than in UT subjects (58 vs. 47 kJ/min, respectively; P < 0.001) at the same relative intensity. This was completely accounted for by an increased fat oxidation (0.57 vs. 0.40 g/min; P < 0.01). At the same absolute intensity, fat oxidation contributed more to energy expenditure in the T compared with the UT group (44 vs. 33%, respectively; P < 0.01). The reduction in carbohydrate oxidation in the T group was explained by a diminished oxidation rate of muscle glycogen (indirectly assessed by using tracer methodology at 0.72 +/- 0.1 and 1.03 +/- 0.1 g/min, respectively; P < 0.01) and liver-derived glucose (0.15 +/- 0.03 and 0.22 +/- 0.02 g/min, respectively; P < 0.05). Exogenous glucose oxidation rates were similar during all trials (+/-0.70 g/min).

Carbohydrate ingestion can completely suppress endogenous glucose production during exercise

The purposes of this study were 1) to investigate the effect of carbohydrate (CHO) ingestion on endogenous glucose production (EGP) during prolonged exercise, 2) to study whether glucose appearance in the circulation could be a limiting factor for exogenous CHO oxidation, and 3) to investigate whether large CHO feedings can reduce muscle glycogen oxidation during exercise. Six well-trained subjects exercised three times for 120 min at 50% maximum workload while ingesting water (FAST), a 4% glucose solution (LO-Glc), or a 22% glucose solution (HI-Glc). A primed continuous intravenous [6, 6-2H2]glucose infusion was given, and the ingested glucose was enriched with [U-13C]glucose. Glucose ingestion significantly elevated CHO oxidation as well as the rates of appearance (Ra) and disappearance. Ra glucose equaled Ra of glucose in gut (Ra gut) during HI-Glc, whereas EGP was completely suppressed. During LO-Glc, EGP was partially suppressed, whereas Ra gut provided most of the total glucose Ra. We conclude that 1) high rates of CHO ingestion can completely block EGP, 2) Ra gut may be a limiting factor for exogenous CHO oxidation, and 3) muscle glycogen oxidation was not reduced by large glucose feedings.

Glucose kinetics during prolonged exercise in highly trained human subjects: effect of glucose ingestion

1. The objectives of this study were (1) to investigate whether glucose ingestion during prolonged exercise reduces whole body muscle glycogen oxidation, (2) to determine the extent to which glucose disappearing from the plasma is oxidized during exercise with and without carbohydrate ingestion and (3) to obtain an estimate of gluconeogenesis. 2. After an overnight fast, six well-trained cyclists exercised on three occasions for 120 min on a bicycle ergometer at 50 % maximum velocity of O2 uptake and ingested either water (Fast), or a 4 % glucose solution (Lo-Glu) or a 22 % glucose solution (Hi-Glu) during exercise. 3. Dual tracer infusion of [U-13C]-glucose and [6,6-2H2]-glucose was given to measure the rate of appearance (Ra) of glucose, muscle glycogen oxidation, glucose carbon recycling, metabolic clearance rate (MCR) and non-oxidative disposal of glucose. 4. Glucose ingestion markedly increased total Ra especially with Hi-Glu. After 120 min Ra and rate of disappearance (Rd) of glucose were 51-52 micromol kg-1 min-1 during Fast, 73-74 micromol kg-1 min-1 during Lo-Glu and 117-119 micromol kg-1 min-1 during Hi-Glu. The percentage of Rd oxidized was between 96 and 100 % in all trials. 5. Glycogen oxidation during exercise was not reduced by glucose ingestion. The vast majority of glucose disappearing from the plasma is oxidized and MCR increased markedly with glucose ingestion. Glucose carbon recycling was minimal suggesting that gluconeogenesis in these conditions is negligible.

The effect of a preexercise meal on time to fatigue during prolonged cycling exercise

PURPOSE AND METHODS

Seven subjects exercised to exhaustion on a bicycle ergometer at a workload corresponding to an intensity of 70% maximal oxygen uptake (VO2max). On one occasion (FED), subjects consumed a preexercise carbohydrate (CHO) containing breakfast (100 g CHO) 3 h before exercise. On the other occasion (FASTED), subjects exercised after an overnight fast. Exercise time to fatigue was significantly longer (P < 0.05) when subjects consumed the breakfast (136+/-14 min) compared with when they exercised in the fasted state (109+/-12 min).

RESULTS

Pre- and post-exercise muscle glycogen concentrations, respiratory exchange ratio, carbohydrate and fat oxidation, and lactate and insulin concentrations were not significantly different between the two trials. Insulin concentrations decreased significantly (P < 0.05) from 4.7+/-0.05 microIU.mL(-1) to 2.8+/-0.4 microIU.mL(-1) in FED and from 6.6+/-0.6 microIU.mL(-1) to 3.7+/-0.6 microIU.mL(-1) in FASTED subjects and free fatty acid concentrations (FFA) increased significantly (P < 0.05) from 0.09+/-0.02 mmol.L(-1) to 1.4+/-0.6 mmol.L(-1) in FED and from 0.17+/-0.02 mmol.L(-) to 0.74+/-0.27 mmol.L(-1) in FASTED subjects over the duration of the trials.

CONCLUSIONS

In conclusion, the important finding of this study is the increased time to fatigue when subjects ingested the CHO meal with no negative effects ascribed to increased insulin concentrations and decreased FFA concentrations after CHO ingestion.

Carbohydrate intake during prolonged cycling minimizes effect of glycemic index of preexercise meal

We studied the effects of the glycemic index (GI) of preexercise meals on metabolism and performance when carbohydrate (CHO) was ingested throughout exercise. Six well-trained cyclists performed three counterbalanced trials of 2-h cycling at approximately 70% of maximal oxygen uptake, followed by a performance ride of 300 kJ. Meals consumed 2 h before exercise consisted of 2 g CHO/kg body mass of either high-GI potato (HGI trial) or low-GI pasta (LGI trial), or of a low-energy jelly (Con trial). Immediately before and throughout exercise, subjects ingested a 10 g/100 ml [U-14C]glucose solution for a total of 24 ml/kg body mass. Despite differences in preexercise glucose, insulin, and free fatty acids concentrations among trials, both total CHO oxidation for HGI, LGI, and Con trials, respectively, during steady-state exercise [403 +/- 16, 376 +/- 29, and 373 +/- 24 (SE) g/2 h] and oxidation of the ingested CHO (65 +/- 6, 57 +/- 6, and 63 +/- 5 g/2 h) were similar. There was no difference in time to complete the subsequent performance ride (946 +/- 23, 954 +/- 35, and 970 +/- 26 s for HGI, LGI, and Con trials, respectively). When CHO is ingested during exercise in amounts presently recommended by sports nutrition guidelines, preexercise CHO intake has little effect on metabolism or on subsequent performance during prolonged cycling (approximately 2.5 h).

Oral [13C]glucose oxidation during prolonged exercise after high- and low-carbohydrate diets

The effect of a diet either high or low in carbohydrates (CHO) on exogenous 13C-labeled glucose oxidation (200 g) during exercise (ergocycle: 120 min at 64.0 +/- 0.5% maximal oxygen uptake) was studied in six subjects. Between 40 and 80 min, exogenous glucose oxidation was significantly higher after the diet low in CHO (0.63 +/- 0.05 vs. 0.52 +/- 0.04 g/min), but this difference disappeared between 80 and 120 min (0.71 +/- 0.03 vs. 0.69 +/- 0.04 g/min). The oxidation rate of plasma glucose, computed from the volume of 13CO2 produced the 13C-to-12C ratio in plasma glucose at 80 min, and of glucose released from the liver, computed from the difference between plasma glucose and exogenous glucose oxidation, was higher after the diet low in CHO (1.68 +/- 0.26 vs. 1.41 +/- 0.17 and 1.02 +/- 0.20 vs. 0.81 +/- 0.14 g/min, respectively). In contrast the oxidation rate of glucose plus lactate from muscle glycogen (computed from the difference between total CHO oxidation and plasma glucose oxidation) was lower (0.31 +/- 0.35 vs. 1.59 +/- 0.20 g/min). After a diet low in CHO, the oxidation of exogenous glucose and of glucose released from the liver is increased and partly compensates for the reduction in muscle glycogen availability and oxidation.

Functional food science and substrate metabolism

The present review addresses the role of food constituents in the aetiology of metabolic conditions and chronic diseases, mostly related to energy metabolism and substrate regulation, such as obesity and non-insulin-dependent diabetes mellitus. Second, attention is paid to malnutrition, a major cause of mortality and morbidity in developing countries, which may be a cause of concern in Europe because of the increasing number of elderly people in the population. Finally, the role of diet during exercise, a condition of enormous substrate demands, is evaluated. Based on a critical evaluation of the existing knowledge in the literature, implications for future research in relation to functional foods are discussed.

Exogenous carbohydrate utilisation: effects on metabolism and exercise performance

It is generally recognized that a decrease in carbohydrate availability can lead to the development of fatigue during prolonged exercise in humans. Administration of glucose or other carbohydrates before or during exercise has been shown to postpone fatigue, conserve muscle glycogen and improve performance. Carbohydrates can be categorised according to their ability to increase blood glucose concentration (known as glycaemic index) and by the extent they stimulate the release of insulin. The glycaemic index is reflected in the rate at which consumed carbohydrate is made available in the blood. Glucose is the only type of carbohydrate that can readily be oxidised by skeletal muscle for energy production. Gastric emptying is the primary factor limiting the rate of carbohydrate delivery to the blood and therefore influences the utilisation of exogenous carbohydrate ingested before or during exercise. Various methods have been used to assess the oxidation of exogenous carbohydrates during exercise. Peak rates of CHO oxidation during exercise have been reported between 0.4 and 1.0 g/min, and the rates of oxidation do not appear to be influenced to a major extent by the use of multiple drinking schedule in comparison with a single bolus schedule. Previous studies also suggest that the ingestion of fructose during exercise does not offer any additional benefits over ingestion of glucose or glucose polymer solutions of similar concentration. The hormones insulin, glucagon and adrenaline together with cortisol and growth hormone play key roles in the regulation of carbohydrate metabolism during exercise. Ingestion of moderately concentrated carbohydrate solutions (4-8%) enhances prolonged exercise performance and is appropriate for optimising energy and fluid delivery without causing adverse effects. The ergogenic effects of carbohydrate ingestion on performance during intermittent exercise such as competitive sports are less well established, although the evidence to date suggests diminished performance when carbohydrate are limiting.

Effect of meal frequency and timing on physical performance

Two areas of sports nutrition in which the periodicity of eating has been studied relate to: (1) the habitually high energy intakes of many athletes, and (2) the optimization of carbohydrate (CHO) availability to enhance performance. The present paper examines how the timing and frequency of food and fluid intake can assist the athlete and physically-active person to improve their exercise performance in these areas. Frequent eating occasions provide a practical strategy allowing athletes to increase energy intake while concomitantly reducing the gastric discomfort of infrequent large meals. The optimization of CHO stores is a special challenge for athletes undertaking prolonged training or competition sessions. This is a cyclical process with post-exercise CHO ingestion promoting muscle and liver glycogen re-synthesis; pre-exercise feedings being practised to optimize substrate availability and feedings during exercise providing a readily-available source of exogenous fuel as endogenous stores become depleted. The timing and frequency of CHO intake at these various stages are crucial determinants for optimizing fuel availability to enhance exercise capacity.

Exogenous glucose oxidation during exercise in endurance-trained and untrained subjects

To investigate the effect of training status on the fuel mixture used during exercise with glucose ingestion, seven endurance-trained cyclists (Tr; maximum O2 uptake 67 +/- 2.3 ml.kg-1.min-1) and eight untrained subjects (UTr; 48 +/- 2 ml.kg-1.min-1) were studied during 120 min of exercise at approximately 60% maximum O2 uptake. At the onset of exercise, 8 ml.kg-1.min-1 of an 8% naturally enriched [13C]glucose solution was ingested and 2 ml/kg every 15 min thereafter. Energy expenditure was higher in Tr subjects compared with UTr subjects (3,404 vs. 2,630 kJ; P < 0.01). During the second hour, fat oxidation was higher in Tr subjects (37 +/- 2 g) compared with UTr subjects (23 +/- 1 g), whereas carbohydrate oxidation was similar (116 +/- 8 g in Tr subjects vs. 114 +/- 4 g in UTr subjects). No differences were observed in exogenous glucose oxidation (50 +/- 2 g in Tr subjects and 45 +/- 3 g in UTr subjects, respectively). Peak exogenous glucose oxidation rates were similar in the two groups (0.95 +/- 0.07 g/min in Tr subjects and 0.96 +/- 0.03 g/min in UTr subjects). It is concluded that the higher energy expenditure in Tr subjects during exercise at the same relative exercise intensity is entirely met by a higher rate of fat oxidation without changes in the rates of exogenous and endogenous carbohydrates.