Repeated-sprints exercise in daylight fasting: carbohydrate mouth rinsing does not affect sprint and reaction time performance

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

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

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.

Single and Serial Carbohydrate Mouth Rinsing Do Not Improve Yo-Yo Intermittent Recovery Test Performance in Soccer Players

Carbohydrate (CHO) mouth rinsing seems to improve performance in exercises lasting 30-60 min. However, its effects on intermittent exercise are unclear. It is also unknown whether serial CHO mouth rinses can promote additional ergogenic effects when compared with a single mouth rinse. The aim of this study was to evaluate the effect of single and serial CHO mouth rinses on Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) performance in soccer players. In a randomized, crossover, double-blind, placebo-controlled design, 12 male (18.9 ± 0.5 years) soccer players performed eight serial mouth rinses under three different conditions: placebo solution only (noncaloric juice), seven placebo mouth rinses plus a single CHO mouth rinse (8% maltodextrin), or eight CHO mouth rinses (8-CHO). Following the final mouth rinse, individuals performed the Yo-Yo IR1 test to evaluate the maximal aerobic endurance performance measured via total distance covered. There were no differences in Yo-Yo IR1 performance between sessions (p = .32; single CHO mouth rinse (8% maltodextrin): 1,198 ± 289 m, eight CHO mouth rinses: 1,256 ± 253 m, placebo: 1,086 ± 284 m). In conclusion, single and serial CHO mouth rinsing did not improve performance during the Yo-Yo IR1 for soccer players. These data suggest that CHO mouth rinsing is not an effective ergogenic strategy for intermittent exercise performance irrespective of the number of rinses.

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

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

No Improvement in Running Time to Exhaustion at 100% VO2max in Recreationally Active Male Runners With a Preexercise Single-Carbohydrate Mouth Rinse

BACKGROUND

Carbohydrate (CHO) mouth rinse has been used as an ergogenic strategy due to its central effect; however, the effects of this intervention during short-duration high-intensity exercises are not fully understood.

PURPOSE

To investigate the effect of CHO mouth rinse on time to exhaustion in a short-duration high-intensity exercise performed on a treadmill.

METHODS

A randomized double-blind, placebo-controlled, crossover study was conducted with 10 (24.1 [4.3] y) recreationally active male runners. The protocol consisted of a warm-up at 65% of VO2max for 5 min followed by 3 min passive rest. At the end of this rest period, the individuals performed their mouth rinse either with CHO (maltodextrin, 6%) or with placebo (industrialized noncaloric juice with the same taste). Immediately after mouth rinse, the subjects ran at velocity equivalent to 100% of individual VO2max until voluntary exhaustion. The perceived effort was obtained through a Borg scale. Blood lactate was quantified before and after the protocol, and heart rate was evaluated during the protocol.

RESULTS

No difference was found (P = .90) in time to exhaustion between placebo (193.9 [46.5] s) and CHO mouth rinse (195.1 [51.8] s). Blood lactate, heart rate, and perception of effort increased in both groups, but with no differences (all variables, P > .05) between groups.

CONCLUSION

The findings showed that a preexercise single-CHO mouth rinse was ineffective to improve running time to exhaustion at velocity equivalent to 100% VO2max on a treadmill in recreationally active male runners.