11/5/19

Carbohidratos y Ejercicio

Magister Ciencias Salud y el Deporte: Entrenamiento Deportivo

Dr. Jorge Cancino L. PhD
jcancino@uft.cl

Avda. Pedro de Valdivia 1509

Providencia, Santiago
+56 2 2420 7100
www.finis terrae.cl

Egan, 2013

1
 11/5/19

Egan, 2013

Fase III
Carbohidratos
Vo2
Fase II
Grasas
Fase I Vo2 máx

Borg 15

Borg 13

Intensidad submáxima Intensidad máximal Intensidad supramáximal

2
 11/5/19

Metabolismo de Hidratos de Carbono

durante el ejercicio

• Músculo utiliza HC como combustible

• Cantidad depende de:
Metabolismo
1. Frecuencia de Hidratos de Carbono durante el ejercicio
2. Intensidad Ejercicio
3. Duración
4. Nivel de entrenamiento
5. Alimentación previa

3
 11/5/19

Metabolismo de Hidratos de Carbono

durante el ejercicio

H. Carbono

Reposo 40 % Eº

50 % Vo2 Máx. 50-50 % Eº

70-80 % Vo2 Máx. 70-80 % Eº

Melvin Williams. Nutrición para la Salud, la condición Física y el Deporte

Carbohidratos y ejercicio Sherman and

Costill 1984
No es necesario
Krogh y Lingard depletar glicógeno.
El trabajo es más Basta con aumentar la
económico realizado
Gordon Maratón cantidad en la dieta
con CHO que con de Boston
grasas Carga de CHO’s y
consumo durante

1924 1967

1920 1925 1984

Ahlborg et al. 1967

Levine. Maratón Dietas altas en CHO y
de Boston consumo durante retrasan
Bajos niveles de la fatiga
glicemia asociados a
ssíntomas de fatiga

4
 11/5/19

XXX. THE RELATIVE VALUE OF FAT AND CAR-

BOHYDRATE AS SOURCES OF MUSCULAR
ENERGY.
WITH APPENDICES ON THE CORRELATION BETWEEN
STANDARD METABOLISM AND THE RESPIRATORY

ENERGY VALUE OF FAT AND CARBOHYDRATE

QUOTIENT DURING REST AND WORK.

_Av~ ~ ~ ~ ~ elagc
By AUGUST KROGH AND JOHANNES LINDHARD,

r
'.,"t',,,',, ''.-',''',-...;JZo-''''
__ _
WITH THE COLLABORATION OF

0. , . . ,..D.. ;'. ,,''S'' ' '; z 1 ,

_m

* +. . 4f. . l-sO *S yg) : +.a-

GORAN LILJESTRAND AND KNUD GAD ANDRESEN.

.s-!,:w.;9X#.1t'o-i<,.s4S;X*._-D}oowist."4S.s.x@!E-'**1P!dw06rIWvF_yszzvw,i+.$t-s:'.erWW;f-<<eo7rlS.i:,tY.Xls,-t_a0}.!ob"w:ie.:j-+>/-..t*.:4\',,tr..X:.+sw}i3**'Lrae5.:4{,w
Fromn the Laboratory of Zoophysiology, Copenhagen UJniversity.
(Received August 26th, 1919.)

_' ':
ii
CONTENTS.

-'
_ :=-:
340 A. KROGH AND J. LINDHARD PAGE

-;
__S__
Introduction and choice of method . . . . . . . . 290

-- z '< ' -=Er7

a- :
Description of apparatus and method . . . . . . . 294

0
Sources of error and accuracy. . . . . . . . . 300

i
We are unable to decide whether the difference between the result of the third

.-
Preliminary,series of experiments . . . . . . . 304

O
Series 1. General Table of Exreriments . . . . . . . 306

L w
El trabajo es más

.
',. a' .,
> _
series and the other two is real or due to the unavoidable errors with which

i
Second series of experiments . . . . . . . . . 314

-
Third series of experiments . . . . . . . 322

>_

. .
our determinations of the waste of energy are infested. As the "best" curves Fourth series of experiments . . . . . . . . . 326

.,
económico cuando se
General results of the experiments . . . .
. SEARCH
. .
FOR
. 339
THE COMPETITIVE EDGE

..'.
for A. M. N. are not absolutely straight there is also the possibility that the The results of earlier investigations . . . . . 342

_ 5 bH.-r:

..

{
-, ...

fS:
The theoretical significance of the waste of energy from fat . . . 345

.,,t. . 1 j.
metabolism at the lowest quotients has been slightly increased by some special realiza con CHOs que
APPENDIX I. Statistical treatment of the determinations of standard meta-

-
P
practitioners do not exercise at all before an ev

}
bolism . . . . . . . . . . . . 346

;
influence. All the determinations (periods 1 and 2) made at quotients above

swt
T.n
APPENDI2X II. The correlation between the respiratory quotient and the

-.
con grasas. deplete glycogen storage to enhance glycogen dep

wo
x
standard metabolism . . . . . . . . . 350

r r ^
078 can be very accurately represented by a straight line giving eF = 4-6 Cal.

;
APPENDIX III. The change in respiratory quotient taking place on the
simply increase the quantity of carbohydrate in th

Fe
wn-;.

295
;'z'.

R
transition from rest to muscular work . . . . . . 354
and e0, = 4-1 Cal. or w = 05 Cal. = 109 %. APPENDIX IV. The variation of the respiratory quotient and' metabolism
during one hour of constant work . . . . . . . 357
man and Costill 1984, Applegate 1988).
The Scandinavian research on carbohydrate le
Table XVIII. Cuando el trabajo fue
SUMMARY .
REFERENCE-
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. . 361
. 363
velopment and application of the first sports nutrit
Calories per unit work Difference
severo, rindieron más INTRODUCTION. Gatoradet, in the 1960s. Evidence that carbohyd
Subject and from from carbo-
°/f
Number Disper- efflciency A NUMBER of researches on isolated muscles, made most of them during the could delay fatigue was implemented by researc
con CHOs que con
series fat hydrate Cal. of exp. sion Cal. Weight last decade by the Cambridge School of physiologists, have revived the old
10Ow n 100wn 200 problem about the immediate source of muscular energy, in so far as their University of Florida, Gainsville, with the objectiv
eF ec w n
e- eF main results cannot be reconciled to the commonly accepted view, that the ing the ‘‘Gators’’ football team performance (Cade
grasas
¢a'~ ~ a epa- ep+ec
J. L. 5*69 4.59 1.10 19*4 10 Gatorade, a mixture of glucose and sucrose in wate
G. L. 5-84 5 09 0 75 12-8 15 0-20 75 960 18.3 mately 6% solution, ultimately spawned a multim
A. K. 5 04 4 28 0*76 15.1 15 0-21 71 1072 21-6
R. E. 4-72 3-72 1 00 21*2 13 0-155 84 1780 23-7 sports beverage industry. Other beverages, among
M. N. Tb. XII 4 70 4-02 0-68 14-5 33 0-074 447 6485 23-0 were developed in the 1970s. At present, there ar
M. N. Tb. XIII 4-73 4-10 0-63 13-3 18 0-080 225 2993 22-7 20 different sports drinks creatively marketed in
0. H. Tb. IX 4-79 4-32 0-47 9-8 33 0-072 459 4500 22-0 States and abroad under labels as diverse as Powera
0. H. Tb. XVI 4-52 4-10 0-42 93 49 0-060 818 7600 23-2
0. H. Tb. XVII 4-57 4-15 0-42 9-2 24 0-060 400 3680 23-0 Sportt. These products are utilized by athletes and
alike and are readily available to the general pu
Sum 2579 29070
such as All Sport and Sport Toddyt, are fortifie
In Table XVIII we have put together the results obtained in all the mins.
different series. There is no definite reason to exclude any of theseFIGURE except 1 The breakdown of muscle glycogen during intense With the increased attention on adequate carb
the first on J. L. (on account of his illness during the fat diet period) but(cycling)
exercise it (adapted from Borgström et al. 1967). the diet, athletes, particularly those involved in
is evident that as determinations of the waste of energy from fat their value sports, struggled with meeting recommended level
is very different, and a simple average of the figures in column 100wactivity would known
be collectively today as ‘‘carbohydrate loading.’’ drate intake at ™60% or total energy intake (Bur
epF 1993). Diets based on potatoes, rice and grains
very misleading. We have therefore endeavoured to assign a definiteThis dietary
" weight ' manipulation was popularized by running maga- bulk, and many athletes complain of an inability to
to each series which should represent its relative reliability, but wezines and adopted by noted elite runners and other athletes. In
are aware
the classical ‘‘carbohydrate loading’’ manipulation, the athlete to maintain energy balance. Additionally, athletes
that our method of doing so is somewhat arbitrary. We have givenexercises the seriesto exhaustion to deplete glycogen stores, then ingests out high carbohydrate foods that could be consu
weight in proportion to the number of determinations in each and further
a carbohydrate-free diet for 2–5 d. The depletion phase is competition without causing gastric distress (Be
in inverse ratio of the dispersion of the determinations. Thefollowed approxi-by an intake pattern that is Ç70–85% carbohydrate, Applegate 1988). As a result, new categories
mate weightsActa (nearest whole numbers) are given in column na andupin to 600 g or more of carbohydrate, for 1–2 d (Bergström
column emerged that have been marketed for dietary c
physiol. scand. 1967. 71. 140-150 supplementation and pre-event nutrition.
lOOwn and Hultman 1972, Sherman and Costill 1984). This classical
epa- we have
1'1.oni thr Department the products
of Physiology, of theochweights
Gymnastik- with theand
Idrottshogskolan, percentage
thc Clinical waste of
L.nburatory.
scheme, however, was challenging for many endurance ath- Researchers had documented that consuming c

Relación entre glicógeno y

energy found in theS tseries. When the
. Erik's Sjukhus, sum of these
Stockholm, Swedenfigures is divided letesbyandthepresented difficulty in weight maintenance. At the 2–4 h before exercise increased performance; this
sum of the weights we have 29070 - 11-25 as the average percentage completion
waste of the classical manipulation (d 7), athletes typi- ucts such as Gator Prot to be consumed conveni
2579
cally had gained 2 to 3 kg of water, felt poorly, and were events, with little dietary residue. Recent developm
of energy from fat for the whole of our experimental material. event nutrition have seen the emergence of carbo

rendimiento
When the preliminary experiments are excluded and the wasteapprehensive (Sherman and Costill 1984). A modified carbo-
of energy
hydrate manipulation was then developed in which athletes such as Gut and Reloadt. These semisolid produ
observed in the third series is reduced to 11 % by taking into account merelyonlydepleted glycogen stores through intense, exhaustive are sucrose or glucose polymers that athletes can u
Diet,determinations
those Muscle Glycogen and Physical
showing quotients above 0-78, the Performance
remainingexercise
series can
and then consumed a high carbohydrate diet for sev- or during exercise (Hotell and Faria 1996). Com
be given weights simply in proportion to their number of determinations since
eral days before competition (Sherman and Costill 1984). Re- carbohydrate gels are various energy bars used
PJ\
their standard deviations will be practicallySEARCH primarily as a source of carbohydrate. Their co
equal and FORthe
THEaverage cently
works there
COMPETITIVE EDGEhas been a further carbohydrate manipulation
out 871S
1456 pattern, sometimes called ‘‘loaf-loading’’ by athletes, in which variable, and the varieties are extensive in this hig
aI18 -9.90/0 L ~ RHERMANSEN.
]ONAS BERGSTRORI,
. 1
S E R I C HI I T h l \U dnd BENGTSA.1 T I \
tive market, with names such as Cliff Bart, VO
practitioners do not exercise at all before an event, do not Powerbart to captivate and catch prospective co
ReLei\ed 23 Fcbiuarv l9h7
deplete glycogen storage to enhance glycogen deposition, and
simply increase the quantity of carbohydrate in the diet (Sher-
man and Costill 1984, Applegate 1988). VITAMINS AND ANTIOXIDANTS
The Scandinavian research on carbohydrate led to the de- ERGOGENIC AIDS
Abstract
velopment and application of the first sports nutrition product,
Gatoradet, in the 1960s. Evidence that carbohydrate feedings In addition to protein and carbohydrate, athlet
h z G b T R i j n i , J., L. HERMAXSEK;, E. HULTMAN a n d B. &\LrIN. Diet, mus& ghcogeii a i d
could delay fatigue was implemented by researchers at the interested in vitamin supplementation since the
p l y i c a l perJi,rmance. Xcta physiol. scand. 1967. 71. 1-10---150. University of Florida, Gainsville, with the objective of improv- the discovery and isolation of these compounds. B
de France cyclists—those at the front of the pack—
'l'hc m i i s c l r glycogen content of the quadriccps fcnioris m u s c l e was tlrtcrniincd ing in 9the I l t d‘‘Gators’’
i l i y 5111)- football team performance (Cade et al. 1972). performed better after taking vitamin supplements
jects \\ith the aid of t h r needlr biopsy technique. T h e glycogcn contvnt could Gatorade, br varird ainmixture th,. of glucose and sucrose in water at approxi-
individual subjects by instituting diffcrcrit dicts after rxhatistion of the glycogen mately
stow 6% I>>- solution,
hartl ultimately spawned a multimillion dollar Bullen 1960, Horstman 1972). Still, research com
cxrrcisc. Thus. the gl>-cogen contcnt aftcr a fat 1 protein ( P ) and a carbohydrate-rich sports beverage C:J c1iC.tindustry. Other beverages, among them ERGt, early 1940s did not support the role of vitamin s
varird maximally from 0.6 g 100 g musclc to 4.7 g . I n all suhjrcts. t h r glycogenwere content developed in the 1970s. At present, there are more than
aftcr tlic tion in enhancing athletic performance. Neverthe
Cl diet Tvas higher than t h r normal range for mriscle glycogen. drtermincd aftcr the20mixed different 11) dict.sports drinks creatively marketed in the United ~
have pursued heavy vitamin use in subsequent d
.iftrr each dirt prrincl. t h r subjects \vorked on a bicycle crgomctcr at a \vork load cirrrspondinq
States and abroad under labels as diverse as Poweradet and All today. Surveys completed on athletes competing
t o 71, pi'r cent of their maximal O Luptake. to complete exhaustion. 'l'he avcragr ivork time \va>
Sportt. These products are utilized by athletes and nonathletes Olympic Games in Munich reported heavy multi
-19. 126 and 189 min after diets P, .\I a n d C:; and a good correlation was noted bct\vren \\t,rk t i n i t .
and rhr initial musclc glycogen content. T h e total carbohydrate u t i l i a t i o n duringalike thr n and rare
~ ~ prriotls k readily available to the general public. Some, plementation (Darden 1973). Moving beyond m
i 4 798 g : was well correlated to the decrease in glycogen contrnt. I t is thrrefbrr such as All Sport
coricltidcd that and Sport Toddyt, are fortified with vita- supplementation, athletes have now sought use of
thr g1)cogt:n content of the \\orking musclc is a determinant for thr capacity to prrforni mins. Icinq-[crm mins for desired outcomes (Nieman et al. 198
heavy cxercisc. hlorru\-rr. it has Iwrn shoivn that t h
FIGURE 1 The breakdown of muscle glycogen during intenser glycogen content and, With
conseqrirntl
FIGURE the increased attention on
2 The relationship adequate
of muscle carbohydrate
glycogen content,inwork 1989b and 1994).
long-trrni exercise capacity(adapted
w o r k (cycling) can be from
appreciably
Borgströmvaried
et al.by inskitlttinS diEcrrnt diets
1967). the aftrr
timediet, and $1)athletes, particularlyintake
dietary carbohydrate those(adapted
involved from in Borgström
enduranceet al. Recent studies have provided the scientific bas
dcijl c,tio11. sports,
1967).struggled with meeting recommended levels of carbohy- athletes of some micronutrients, such as antioxida
activity known collectively today as ‘‘carbohydrate loading.’’ drate intake at ™60% or total energy intake (Burke and Read
1993). Diets based / 4p09$$0052
on potatoes, rice and grains04-03-97 are high20:49:42
in nutra LP: J Nut May Suppl
This dietary manipulation was popularized by running maga-Downloaded from https://academic.oup.com/jn/article-abstract/127/5/869S/4724164
zines and adopted by noted elite runners and other athletes. In by guest bulk, and many athletes complain of an inability to eat enough
1t \va\ slio\\-ti in prcvious htudics t h a t tlie muscle glycogenon rciriteut to maintain
24 April 2018 clrrrcascd energy balance. ActaAdditionally,
physiol. scand. athletes
1967. have sought
71. 140-150
the classical ‘‘carbohydrate loading’’ manipulation, the athlete
cluririg exercises
\vork !Reygstrom
to exhaustionaridtoHultnian 1966 a stores,
deplete glycogen ) , a n dthen during exhaurtivc
thatingests out high exe
1'1.oni carbohydrate
thr Department of foods that Gymnastik-
Physiology, could beoch consumed priora nto
Idrottshogskolan, d thc Clinical L.nburatory.

a carbohydrate-free
the gl!-cogen diet for
stores lvere almost 2–5 d. The
completely depletion
emptied competition
phase isand Hultman I96T I .
(Hergstrom without causing S t .gastric distress
Erik's Sjukhus, (Bensley
Stockholm, Sweden1951,

followed by an intake pattern that aisnÇ70–85% carbohydrate, Applegate 1988). As a result, new categories of products
In ;I \tudy 1)y Hermansen, Hultman d Saltin (1967). it was fbund that thr
emerged that ratc
have been marketed for dietary carbohydrate
up to 600 g or more of carbohydrate, for 1–2 d (Bergström
of c o i n h i s t i o n of carbohydrates xvas extremely high and constant tliroriglioiit supplementation tlic and pre-event nutrition.
and Hultman 1972, Sherman and Costill 1984). This classical
\vliole \vork
scheme, period. In thi.;
however, wasstudy, as \\-ell
challenging in that
fora\ many oli2hlborg
endurance ath-r t al. I 1967a Researchers . t h c whad documented that consuming carbohydrate
Diet, Muscle Glycogen and this Physical Performance
\vere some letes indications
and presentedthat difficulty in weight
the initial musclc maintenance.
g1yc~ogcnAt the
ronccritrat i o2–4 h before
r r \\.a\ I rlatctl
exercise increased performance; led to prod-
ucts such as Gator Prot to be consumed conveniently PJ\ before
t o the completion
ability to performof the classical manipulation
prolonged, (d 7), athletes
heav>- exercise ( m e a typi-
s u r d as the ivorli
events, with]ONAS l i m p
littleBERGSTRORI,
I.
dietary residue. Recent developments in pre-
cally had gained 2 to 3 kg of water, felt poorly, and were L ~ R HERMANSEN.
S E R I C HI I T h l \U dnd BENGTSA.1 T I \
provided that the subjects
apprehensive (Shermanworked \vith1984).
and Costill the sanic relativc
A modified load.
carbo- event nutrition have seen the emergence of carbohydrate gels
'l'he hydrate manipulation
muscle glycogen was then developed
concentration in man can in which athletes
lie conridera1)ly such as Gut
iricrcawd Iiy fir\t and Reloadt. TheseReLei\ed semisolid products
23 Fcbiuarv l9h7 typically

merely are sucrose or glucose polymers that athletes can utilize before
the depleted
glycogenglycogen stores through
hard 11intense,
ork, aridexhaustive
empt>-ing ztores through
exercise and then consumed a high carbohydrate diet for sev-
rich diet. Tlic cnlianccrnent of glycogen s)-nthesis is localized to the
eral days before competition (Sherman and Costill 1984). Re-
then giving a c a r l ~ o h ~ - t l r a t c -
or during exercise (Hotell and Faria 1996). Complementing
n i u ~ c l e \that
carbohydrate gels are various energy Abstract bars used by athletes,
5
h a w Tvorked, aiid does not affect othcr muscle
cently there has been a further carbohydrate manipulation groups {Bergstrorn primarily
arid hHultniari as a source of carbohydrate.
z G b T R i j n i , J., L. HERMAXSEK;,
Their a composition
E. HULTMAN
is
n d B. &\LrIN. Diet, mus& ghcogeii a i d
pattern, sometimes called ‘‘loaf-loading’’ by athletes, in which variable, and the varieties are extensive in this highly competi-
p l y i c a l perJi,rmance. Xcta physiol. scand. 1967. 71. 1-10---150.
 10
25.
20-

11/5/19
1.5-
1.0- d
0.5-
Blood Pyruvate, mM

0.05J
Acta physiol. scand. 1967. 71. 140-150
Blood Glucose, n-g/lOO
1'1.oni thr rnl
Department of Physiology, Gymnastik- och Idrottshogskolan, a n d thc Clinical L.nburatory.
S t . Erik's Sjukhus, Stockholm, Sweden

70
~ mall
i :i.~ . \.aiurs RQ. bioOcii;iet,rte. l ~ ~ l ~ l l vanti
~ltc
~ l t i c o s ein conneuion \vith exercise altrr diHercnt diets i i i
t i sub,jects. :< carbohydrate diet, 0 mixed dict. Eat
50
protrin diet. ( ;I denotes t h r ~ a l u e:it m d o f rsercisv.
LO
0 30 60 90 120 150 180 210
Diet,WorkMuscle
time, min Glycogen and Physical Performance

PJ\
]ONAS BERGSTRORI, L ~ R HERMANSEN.
S E R I C HI I T h l \U dnd BENGTSA.1 TI\

ReLei\ed 23 Fcbiuarv l9h7

rn q 1 0 0 mZ Abstract
7201 1 BLOOD G L U C O S f
hzGbTRijni, J., L. HERMAXSEK;, E. HULTMAN a n d B. &\LrIN. Diet, mus& ghcogeii a i d
i c a-l perJi,rmance. Xcta physiol. scand. 1967. 71. 1-10---150.
p l y700
'l'hc m i i s c l r glycogen content of the quadriccps fcnioris m u s c l e was tlrtcrniincd in 9 I l t d i l i y 5111)-
jects \\itha0 the- a i d of t h r needlr biopsy technique. T h e glycogcn
Y-X contvnt could br varird in th,.
individual subjects by instituting diffcrcrit dicts after rxhatistion of the glycogen stow I>>- hartl
cxrrcisc. Thus.
60 - the gl>-cogen contcnt aftcr a fat 1 protein ( P ) and a carbohydrate-rich C:J c1iC.t
varird maximally from 0.6 g 100 g musclc to 4.7 g . I n all suhjrcts. t h r glycogen content aftcr tlic
Cl diet Tvas higher than t h r normal range for mriscle glycogen. drtermincd aftcr the mixed 11) dict.
. i f t r r each - prrincl. t h r subjects \vorked on a bicycle crgomctcr at a \vork load cirrrspondinq
40dirt
~

t o 71, pi'r cent of their maximal O Luptake. to complete exhaustion. 'l'he avcragr ivork time \va>
-19. 126 and - min after diets P, .\I a n d C : ; a n d a good correlation was noted bct\vren \\t,rk t i n i t .
2 0 189
and rhr initial musclc glycogen content. T h e total carbohydrate u t i l i a t i o n during thr n ~ ~ prriotls
r k
i 4 798 g : was well correlated to the decrease in glycogen contrnt. I t is thrrefbrr coricltidcd that
thr g1)cogt:n content of the \\orking musclc is a determinant for t h r capacity to prrforni Icinq-[crm
heavy cxercisc. hlorru\-rr. it has Iwrn shoivn that t h r glycogen content a n d , conseqrirntl
long-trrni w o r k capacity can be appreciably varied by inskitlttinS diEcrrnt diets a f t r r $1)
Fig. -1. I 3 ldcijl
o x i c,tio c u s cconccntraticii in connrxion xvith esrrcise nftcr different clict> i i i suk>.icc t
~ l u11.
.i.l,. cnrbohydratc diet, mixed dirt, fat protcin dirt.

1t \va\ slio\\-ti in prcvious htudics t h a t tlie muscle glycogen rciriteut clrrrcascd

cluririg \vork !Reygstrom arid Hultnian 1966 a ) , a n d that during exhaurtivc exe
the gl!-cogen stores lvere almost completely emptied (Hergstrom and Hultman I96T I .
In ;I \tudy 1)y Hermansen, Hultman a n d Saltin (1967). it was fbund that thr ratc
of c o i n h i s t i o n of carbohydrates xvas extremely high and constant tliroriglioiit tlic
\vliole \vork period. Acta In thi.;physiol. \\-ell a\ 1967.
study, asscand. in that71. 140-150 r t al. I 1967a . t h c w
oli2hlborg
1'1.oni thr
\vere someDepartment of Physiology,
indications that theGymnastik- och Idrottshogskolan,
initial musclc a n d thc Clinical
g1yc~ogcnronccritrat L.nburatory.
i o r r \\.a\ I rlatctl

t o the ability to perform Sprolonged, t . Erik's Sjukhus,

heav>-Stockholm,
exerciseSweden
( m e a s u r d as the ivorli l i m p I .
provided that the subjects worked \vith the sanic relativc load.
'l'he muscle glycogen concentration in man can lie conridera1)ly iricrcawd Iiy fir\t
empt>-ingthe glycogen ztores through hard 11ork, arid then giving a c a r l ~ o h ~ - t l r a t c -
rich diet. Tlic cnlianccrnent of glycogen s)-nthesis is localized to the n i u ~ c l e \that
Diet, Muscle Glycogen and Physical {Bergstrorn
h a w Tvorked, aiid does not affect othcr muscle groups
Performance arid Hultniari
14h JONAS BbRGSTROM ET AL.
PJ\
143 ~ o s B~E RsG S T R ~ ME‘r .AL.
RO

‘J’ABI.F
]ONAS BERGSTRORI, L ~ R S HERMANSEN. E R I C HI I T h l \U
111. Statistical treatment: mean values of data (Table I1 and Fig. 3 ) obtained brforc. during.
dnd BENGTSA.1 TI\

differences after the three diets (C. M. P)

ReLei\ed 23 Fcbiuarv l9h7
C: : c arboli)-drate dirt

-
1\.I ~~ iirixcd diet
P -- fat protein diet
Abstract Blood Lactate. mM
11 c 11 55-
50.
hzGbTRijni, incan S.E.E. HULTMAN
J., L. HERMAXSEK;, a n d B.
S.E. niraii &\LrIN.
L.5 Diet, mus& ghcogeii a i d
4.0. 1-10---150.
p l y i c a l perJi,rmance. Xcta physiol. scand. 1967. 71.
15-
hfusclc glycogen g/100 g before work 9
'l'hcafter m i i s c l r glycogen content of the quadriccps fcnioris m u s c l 10 e was tlrtcrniincd in 9 I l t d i l i y 5111)-
work !I
25.
jects \\ith the a i d of t h9r needlr biopsy technique. T h e glycogcn contvnt could br varird in th,.
W o r k tiiiir r n i n 20- of the glycogen stow I>>- hartl
individual subjects by instituting diffcrcrit dicts after rxhatistion
Utilized carbohydrarc 5 during work 9
cxrrcisc. Thus. the gl>-cogen contcnt aftcr a fat 1 protein ( P1.5- ) and a carbohydrate-rich C:J c1iC.t
Oxygen uptake I/min 9 1.0- d t h r glycogen content aftcr tlic
varird maximally from 0.6 g 100 g musclc to 4.7 g . I n all suhjrcts.
Blood pyruvate I n M 1 Cl diet at rest 0.5-
Tvas higher than tit h r normal range for mriscle glycogen. drtermincd aftcr the mixed 11) dict.
Blood Pyruvate, mM load cirrrspondinq
~

. i f t after
r r each30 n idirt prrincl. tit h r subjects \vorked on a bicycle crgomctcr
i n work at a \vork
t o 71, pi'rofcent
at end work of their tmaximal
i O Luptake. to complete exhaustion. 'l'he avcragr ivork time \va>
-19.a 126 t restand 189 min after (i diets P, .\I a n d C : ; a n d a good correlation was noted bct\vren \\t,rk t i n i t .
andafter rhr 30 initial
rriin narkmusclc glycogen
(1 content. T h e total carbohydrate u t i l i a t i o n during thr n ~ ~ prriotls
r k
i 4at end798ofg work: was well correlated
ti to the decrease in glycogen contrnt.
0.05J I t is thrrefbrr coricltidcd that
Rcspit atilry quotient thr atg1)cogt:n
rest content of f ithe \\orking musclc is a determinant for Bloodt h rGlucose,
capacity to prrforni
n-g/lOO rnl Icinq-[crm
heavy after cxercisc.
30 niin xvork hlorru\-rr.
(i it has Iwrn shoivn that t h r glycogen content a n d , conseqrirntl
long-trrni
at rnd of w o r k capacity
work t i can be appreciably varied by inskitlttinS diEcrrnt diets a f t r r $1)
dcijlatc,tiorest11.
after 45 rnin xvork
li
70
~ mall
i :i.~ . \.aiurs RQ. bioOcii;iet,rte. l ~
3
~ l t i c o s ein conneuion \vith exercise altrr diHer
at end of work (i t i sub,jects. :< carbohydrate diet, 0 mixed dic
50
protrin diet. ( ;I denotes t h r ~ a l u e:it m d o f
LO
1t \va\ slio\\-ti in prcvious htudics t h a t tlie muscle glycogen
initial muscle glj-cogen concentration and t h e maximal work time ovcr the cvliolc
0 30 60 rciriteut
90 120 clrrrcascd
150 180 210
Work time, min
range of initial glycogen cluririg
values,\vork
as \\.ell!Reygstrom arid Hultnian
as in each subject. 1966
The rniisc.le a ) , a n d that during exhaurtivc exe
glycmgen
averaged 1.75, 0.63 andthe 3.31gl!-cogen
g’100 g \vetstores afteralmost
lvere
muscle the M, completely
P and C: dirt, emptied
i-espec- (Hergstrom and Hultman I96T I .
live]?-. T h e mean maximalIn ;Ixvork\tudy times
1)yinHermansen,
the corresponding rituationr
Hultman r r rI 14.
a n d~ vSaltin (1967). it was fbund that thr ratc
37 and 167 niin, respectively. T h e niean decrease during exercise in rnusclr glycogen
of c o i n h i s t i o n of carbohydrates xvas extremely high and constant tliroriglioiit tlic
(irig 100 g tiwue ‘min) Ira5 1 4 . 2 2 1.40, 8.78 1.70 and 1 7 . 1 -1- 0.85 aftcr diet.
\vliolein\vork
,\Ii P and C:. ‘I’he differences decrease 51-- PIn
period. aridthi.; study,
C:~~--M had as \\-ell of’
p values in that oli2hlborg r t al. I 1967a . t h c w
a\ K.O.03
and -’. 0.003, respectively\vere some
(paired indications that the initial musclc g1yc~ogcnronccritrat i o r r \\.a\ I rlatctl
t testj.
’l’he three subjects ( Ct :o. F.,
theR.ability
E. and K.-G. G., given
to perform the C: diet prior
prolonged, heav>- t o the P
exercise ( m e a s u r d as the ivorli l i m p I .
one had markedl>-lo\\ provided values f’orthat
the muscle gll-cogcnworked
content after diet. relativc load. rn q 1 0 0 mZ
\vithtlicthe( 1 sanic
compared to theother six subjects (g.
the subjects
Table I1 and Fig. 2’1.Therefore, only six subject,
'l'he muscle glycogen concentration in man can lie conridera1)ly iricrcawd Iiy fir\t
7201 1
BLOOD G L U C O S f 6
folloI\-ing the main procedure are included in Figs. 3 and 6>\vhcrc a cmn>pai.isoiii \
niadc I,et\veen the averageempt>-ingvalues the glycogen
for hlood ztores
pyruvate, through
blood lactalc.hard
RQ;11)lood1ork, arid then giving a c a r l ~ o h ~ - t l r a t c -
700 -
 11/5/19

1986

- 7 Sujetos Sanos
- Biopsia Muscular Vastus Lateralis
- Placebo
- 2 gr CHO * Kg. / primeros 20 min.
- 0,4 gr CHO * Kg. / cada 20 min.
- Bicicleta Ergométrica al 71% VO2 max
pedaleando hasta la fatiga

1986

Una mayor ingesta de CHO, mejorará

la glucosa plasmática, la oxidación de
glucosa y la capacidad de trabajo

7
 11/5/19

Tasa de Utilización de Glucógeno

100
Glucógeno Muscular (mmol/kg)

80

60

31 %
40

64 %
20 120 % 83 %
150 %
0

0 30 60 90 120 150 180

Tiempo de Ejercicio (hrs.)

Saltin & Karlsson (1977)

8
 11/5/19

Hipoglicemia reactiva y
rendimiento

9
11/5/19

10
 11/5/19
Influence of glucose on endurance running capacity: C. Chryssanthopoulos et al.

Results
There were no differences in mean(s.e.) exercise
times to F1 (P trial, 105.38(7.42) min versus G trial,
119.52(12.02) min; P = 0.16) Brnor J Spin
Med the1994;times
28(2) to Exh (P
trial, 121.16(8.1) min versus G trial, 133.79(11.0) min; P 0
= 0.08). However, seven of the nine subjects ran for
longer during the G trial than during the P trial.
Furthermore, no order effectThe was foundinfluence for running of pre-exercise glucose ingestion on
times to exhaustion for the first and second trials. 0

endurance
Mean(s.e.) blood glucose concentration was higher running 0
capacity
2
(P < 0.01) immediately before the start of exercise in
the G trial (6.3(0.7) mmoll-1) thanChryssanthopoulos,
Costas at the same time Liam C. M. 1 Hennessy and Clyde Williams
during the P trial (4.1(0.3)Department mmoll-1).
Loughborough, UK
When
of Physical the Sports Science
Education, -30 and Recreation
0 30
Management, 90
60 Loughborough 120
University, 150
results of one subject, who experienced glucose Time (min)
intolerance, are omitted, then the mean blood Figure 1. Blood glucose concentration during the glucose
glucose concentrations at 15min and 30min during (G, *) and the placebo (P, 0) trials (mean(s.e.), n=8);
the G trial are lower (P < 0.01) than the values *Significantly different from P (P<0.01)
Influence of glucose on endurance running capacity: C. Chryssanthopoulos et al.
obtained, at the same sampling Drinkingtimes, duringglucose
a concentrated the Psolution less 8than has
before the start of prolonged submaximal exercise
1h There are only two studies which provide substan-
tial evidence for this view7 8. Costill and colleagues
Results trial (Figure 1). However, been afterreported
the first 30min
to reduce of capacity during reported
endurance that the ingestion of a concentrated glucose
There were no differences in mean(s.e.) exercise exercise, the mean blood glucose
purpose of this study
cycling. Theconcentrations inwasofto are-examine
7- the solution 45 min before the start of submaximal
influence of pre-exercise "ingestion concentrated treadmill running caused a greater rate of muscle
both trials remained above 4 mmol - 1. Atonexhaustion, running Nine
times to F1 (P trial, 105.38(7.42) min versus G trial, glucose solution endurance capacity. glycogen utilization than when exercise was per-
recreational runners (five in men and four women) ran to
119.52(12.02) min; P = 0.16) nor in the times to Exh (P the blood glucose concentrations exhaustion wereon asimilar
level treadmill, bothat speeds equivalent
E to formed after drinking water. This increased rate of
trial, 121.16(8.1) min versus G trial, 133.79(11.0) min; P trials. 70% VO2max, on two occasions separated by at6 least 1
-
glycogenolysis would, it was proposed, lead to an
= 0.08). However, seven of the nine subjects ran for
0
week. The runners ingested either a solution containing early onset of fatigue during prolonged exercise.
longer during the G trial than during the P trial. Blood lactate concentrations werein also
75 g of glucose 300 ml ofsimilar
water (G trial), or 300 ml of Foster and colleagues8 confirmed this hypothesis in a
30 minof
Furthermore, no order effect was found for running during the two trials with mean(s.e.)
sweetened water (P trial)values before each trial. As a study which showed that cycling time to exhaustion
was reduced by 19% when their subjects ingested a
times to exhaustion for the first and second trials. 3.5(0.4) mmol I1 and 3.3(0.5)
0
0
consequence, the blood glucose concentrations were
mmol
higher at the 1' for the
beginning G Gand
of the
- 1 55%
trial compared0 with those 25% glucose solution 30 min before exercise. Muscle
Mean(s.e.) blood glucose concentration was higher P trials respectively (Figure recorded 2). for the P trial (G trial, mean(s.e.) blood glucose = glycogen concentrations were not measured but the
(P < 0.01) immediately before the start of exercise in There2 was no overall 4.1(0.3)mmol 6.3(0.7) mmol 1-1 versus P trial, mean(s.e.) blood glucose =
difference-'; inP < R0.01).values study did show an elevation in serum insulin and a
Nevertheless, there were no
the G trial (6.3(0.7) mmoll-1) than at the same time -30 0 reduction
30 60in serum90 fatty120acid concentrations8.
150 The
during the P trial (4.1(0.3) mmoll-1). When the between-30the two
1
0 trials30 (Table 60 1), even
differences in90
the though
running
120
timesthe to
150
exhaustion
the two trials (G trial, mean(s.e.) 133.79(11.0) min versus P
between cause of the early onset of fatigue was, according to
Time (min)
results of one subject, who experienced glucose mean(s.e.) R value at exhaustion trial,(min)
Time during
mean(s.e.) the Gmin).trial
121.16(8.1) The results of this study the authors, a decrease in the availability of serum
Figureto1.be lower thanconcentration
the that ingesting
showvalue obtained glucose
25% glucose solution Figure 2. Blood fatty
30 min before lactateacids for muscle metabolism
concentrations during the which, in turn,
glucose
not reduce at thethe
intolerance, are omitted, then the mean blood appears Blood glucose during a the
endurance capacityand increased the rate of muscle glycogen depletion and
glucose concentrations at 15min and 30min during end (G, of *) and
the P the placebo
trial (G (P,exercise
trial 0) trials
0.86(0.03)
recreational
does(mean(s.e.),
versus
runners whenP the exercise (GC,
n=8);
trial, ) ofis the placebo
intensity caused the(P,early 0) onset
trialsof(mean(s.e.))
fatigue9.
the G trial are lower (P < 0.01) than the values *Significantly different from P (P<0.01)
equivalent to 70% VO2max.cost Therefore, the explanation offered by Foster and
obtained, at the same sampling times, during the P 0.90(0.01); P > 0.05). The mean(s.e.) energy (P colleagues8 for the paradoxical onset of fatigue
trial (Figure 1). However, after the first 30min of trial, 61.0(4.3) 8 kJ min-1 capacityversus GGlucose
Keywords: trial,ingestion,
61.5(4.0 values
blood glucose, (Table 1),
running nor water
following intake (P
the pre-exercise trial, of211.6(46.2)
ingestion a concentrated
exercise, the mean blood glucose concentrations in kJ min -) 7-
and mean(s.e.) amount of fuel derived from ml h-' versus Gexamination
glucose
trial, solution is, in h-'),
of the ml
187(42.3) theory, sound.
results ofortheirweight But closer
studyloss leaves
both trials remained above 4 mmol - 1. At exhaustion, fat (P trial, 0.5(0.1) gmin-1 versus G trial 0.6(0.1) (G trial, 2.65(0.27)
several kg versus
questions P trial,
unanswered. 2.47(0.18)
For example, kg)rates
the
the blood glucose concentrations were similar in both
trials. g min-1 E and mean(s.e.) Fatigue carbohydrates
during prolonged (P trial,exercise of submaximal
intensity occurs when muscle glycogenduring stores are
the of trials.
two carbohydrate oxidation were the same during the
glucose and water trials. If there had been an
Blood lactate concentrations were also similar 2.5(0.3) gmin-1 versus Greduced gmin-1)
6 -
trial, to2.3(0.3)
critically low concentrations1 2.There It is not differences
were increased
no in the mean(s.e.)
rate of glycogenolysis then this energy
latter result
during the two trials with mean(s.e.) values of calculated using a non-protein surprising, similar
R weretherefore, during
that there has been intakes
consider- of the
is difficult each trialBrthere
before Furthermore,
runnersto explain. J Sp Med 1994; 28(2)
(G trial,
were no
3.5(0.4) mmol I1 and 3.3(0.5) mmol 1' for the G and the two 1 conditions. able attention given to methods of increasing the differences in perceived rates of exertion recorded
9.1(1.1) forMJ versus during Pthe trial, and yetMJ)
9.1(1.5) their nor
cyclistsinexercised
the
0 -

P trials respectively (Figure 2). limited muscle glycogen stores in preparation two trials
There was no overall difference in R values There were no differences endurance betweenraces3. mean(s.e.)
Although there is mean(s.e.)
evidence to dailyfor carbohydrate
10 min less on theintake
glucosebefore
trial. each trial
oxygen uptake, heart rate, show 90 that
perceived rate 150of exertion
120 consuming carbohydrate foods
(G 5,trial,3-4 h Moreg versus trial, 306.3(26) g). and glucose
recently, however,
there 324.6(36)
between the two trials (Table 1), even though the -30 0 30 60 P Fielding et al.10 showed
mean(s.e.) R value at exhaustion during the G trial
before exercise improves exercise capacity4'
Time (min)
a widely held
Figure 2. Blood lactate concentrations viewthe
during thatglucose
consuming any carbohy-
is that the pre-exercise ingestion of fructose The influence of pre-exercise glucose
solutions had no greater influence on the rate of
i
appears to be lower than the value obtained at the
end of the P trial (G trial 0.86(0.03) versus P trial, (GC, ) and the placebo (P, exercise
drates within
0) trialscapacity6.
the
(mean(s.e.))
hour before exercise decreases muscle glycogen utilization during exerciseendurance
pre-exercise ingestion of water. McMurray et al. 1
than the running capacity
0.90(0.01); P > 0.05). The mean(s.e.) energy cost (PTable 1. Respiratory exchange ratio, oxygen uptake, perceived rate of exertion (PRE) and heart
provided rate (HR)
some evidence during
to show thatglucose (G)
the pre-exercise
trial, 61.0(4.3) kJ min-1 versus G trial, 61.5(4.0and placebo
values (Table 1), nor water intake (P trial, 211.6(46.2)
(P) trials ingestion of either glucose or fructose solutions by
kJ min -) and mean(s.e.) amount of fuel derived from ml h-' versus G trial, 187(42.3)
Address ml h-'), or weight
for correspondence: lossC. Williams, Department of
Professor female runners, before exercise, hasCostas Chryssanthopoulos, Liam C. M. Hennessy and Clyde Willi
no detrimental
fat (P trial, 0.5(0.1) gmin-1 versus G trial 0.6(0.1) Physical Education,
(G trial, 2.65(0.27) kg versus P trial, Sports Science and
2.47(0.18) kg)Recreation Management, influence on running performance.Department of Physical Education, Sports Science and Recreation Management, L
The exercise
g min-1 and mean(s.e.) carbohydrates (P trial, Loughborough University, Loughborough, Leicestershire LE11
Time (min) duration in this latter study was onlyLoughborough,
approximatelyUK
during the two trials. 3TU, UK 60 min, probably because of the high exercise
2.5(0.3) gmin-1 versus G trial, 2.3(0.3) gmin-1) There were no differences the mean(s.e.)45energy
calculated using a non-protein R were similar during 30inButterworth-Heinemann
(©) 1994
intakes of 15the runners 0306-3674/94/020105-05
before each trial (G trial,
Ltd 60 intensity
75 (80% VO2max)90which in turn resultedExh in
blood lactate concentrations of about 5mmol)1-1 at
the two conditions. 9.1(1.1) MJ versus P trial, 9.1(1.5) MJ) nor in the
There were no differences between mean(s.e.) Respiratory exchange ratio
daily (R)
carbohydrate intake before each trial

Respuesta glicémica al ejercicio

oxygen uptake, heart rate, perceived rate of exertion G (G trial, 0.90(0.01)
Table 1. Respiratory exchange ratio, oxygen uptake, perceivedG rate of exertion
and placebo (P) trials
15
Respiratory exchange ratio (R)
G 0.90(0.01) 0.90(0.02)
P 0.91(0.01) 0.90(0.01)
Vo2 (ml kg- 1min-1)
G 43.1(2.0)
P
42.8(2.1)
42.7(1.8)
43.2(2.1)
43.2(2.0)
PRE
G 10(0.5)
P 10(0.2)
HR (beats min-')
G 156(3)
P 152(3)
Values are mean(s.e.)
mean(s.e.) Drinking a concentrated glucose solution less than 1 h There are only two
P trial, 306.3(26)0.89(0.01)
324.6(36) g versus0.90(0.02) g). 0.89(0.02) 0.90(0.02) 0.89(C.02) 0.86(0.03)
Br J Sp Medbefore
1994; 28(2)start105of prolonged submaximal exercise has
the tial evidence for this
P 0.91(0.01) 0.90(0.01) 0.90(0.01) 0.89(0.01) 0.90(0.01) 0.90(0.01) been0.90(0.01)
reported to reduce endurance capacity during reported that the inge
cycling. The purpose of this study was to re-examine the solution 45 min befo
Vo2 (ml kg- 1min-1) influence of pre-exercise "ingestion of a concentrated treadmill running ca
glucose solution on endurance running capacity. Nine glycogen utilization
42.8(2.1) rate (HR) during 43.1(2.0)
43.2(2.1)
(PRE) and heart glucose (G) 43.6(2.1) 43.5(2.0) 43.9(2.0) 45.2(2.2)runners (five men and four women) ran to
recreational
P 42.7(1.8) 43.2(2.0) 42.8(2.1) 43.5(2.1) 43.6(2.2) 43.5(2.1) 44.8(2.1)on a level treadmill, at speeds equivalent to
exhaustion formed after drinking
glycogenolysis would,
PRE Ritmo estable
70% VO2max, on two occasions separated by at least 1
week. The runners ingested either a solution containing early onset of fatigu
G Time (min) 10(0.5) 11(0.3) 12(0.2) 13(0.3) 13(0.3) 14(0.6) 75 g17(0.7)
of glucose in 300 ml of water (G trial), or 300 ml of Foster and colleagues8
30 45 P 60 10(0.2) 75 11(0.1) 90 12(0.2) Exh 13(0.3) 14(0.5) 15(0.6) 18(0.7) water (P trial) 30 min before each trial. As a
sweetened study which showed
consequence, the blood glucose concentrations were 55% was reduced by 19%
HR (beats min-') higher at the beginning of the G trial compared with those 25% glucose solution
recorded for the P trial (G trial, mean(s.e.) blood glucose = glycogen concentratio
0.89(0.01) G 0.89(0.02) 156(3) 0.90(0.02) 161(4)0.89(C.02) 164(3)
0.86(0.03) 167(2) 172(2) 168(2) 171(2)
6.3(0.7) mmol 1-1 versus P trial, mean(s.e.) blood glucose = study did show an el
0.90(0.01) P 0.89(0.01) 152(3) 0.90(0.01) 158(3)0.90(0.01) 162(3)
0.90(0.01) 165(3) 164(3) 166(3) 167(3) -'; P < 0.01). Nevertheless, there were no
4.1(0.3)mmol reduction in serum f
differences in the running times to exhaustion between
the two trials (G trial, mean(s.e.) 133.79(11.0) min versus P cause of the early ons
43.9(2.0) 45.2(2.2) the authors, a decrea
42.8(2.1) Values43.6(2.1)
are mean(s.e.) 43.5(2.0)
43.5(2.1) 43.6(2.2) 43.5(2.1) 44.8(2.1)
trial, mean(s.e.) 121.16(8.1) min). The results of this study
show that ingesting a 25% glucose solution 30 min before fatty acids for muscl
exercise does not reduce the endurance capacity of increased the rate of
11(0.3) 12(0.2) 13(0.3) 13(0.3) 14(0.6) 17(0.7) recreational runners when the exercise intensity is caused the early onse
11(0.1) 12(0.2) 13(0.3) 14(0.5) 15(0.6) 18(0.7) equivalent to 70% VO2max. Therefore, the expl
Br J Sp Med 1994;Keywords:
28(2) 107 colleagues8 for the
Glucose ingestion, blood glucose, running following the pre-exer
161(4) 164(3) 167(2) 172(2) 168(2) 171(2) capacity glucose solution is,
158(3) 162(3) 165(3) 164(3) 166(3) 167(3) examination of the
several questions unan
Fatigue during prolonged exercise of submaximal of carbohydrate oxida
intensity occurs when muscle glycogen stores are glucose and water
reduced to critically low concentrations1 2. It is not increased rate of glyco
surprising, therefore, that there has been consider- is difficult to explain.
Br J Sp Med 1994; 28(2) 107 able attention given to methods of increasing the differences in perceiv
limited muscle glycogen stores in preparation for during the two trials
endurance races3. Although there is evidence to for 10 min less on the
show that consuming carbohydrate foods 3-4 h More recently, howe
before exercise improves exercise capacity4' 5, there is that the pre-exercise in
a widely held view that consuming any carbohy- solutions had no gre
drates within the hour before exercise decreases muscle glycogen utili
exercise capacity6. pre-exercise ingestion
provided some eviden
ingestion of either gl
Address for correspondence: Professor C. Williams, Department of female runners, befor
Physical Education, Sports Science and Recreation Management, influence on runnin
Loughborough University, Loughborough, Leicestershire LE11 duration in this latter
3TU, UK 60 min, probably be
(©) 1994 Butterworth-Heinemann Ltd intensity (80% VO2ma
0306-3674/94/020105-05 blood lactate concentr

11
 11/5/19

370 H. G. SIMÕES, ET AL.

ods were analyzed with Pearson’s product-moment correlations. The tech-

nique proposed by Bland and Altman (1986) was used to verify the agree-
ment among studied parameters considering the lactate threshold as a
gold standard. The level of significance was set at p < .05.
Results
Five to eight stages were necessary to conclude the incremental test
Ritmo incremental for most participants. Exhaustion was reached at a mean workload of 125
W (SD = 46.7) with mean VO2peak of 23.6 mL.kg-1.min-1 (SD = 7.5; Table 1).
Ventilatory, blood glucose, or lactate responses each accurately identified
exercise workloads related to the lactate threshold (LT) as shown in Fig. 1.

14 22
20
12 GT
18
10

Blood Glucose (mM)

Blood Lactate (mM)
16

VE/VCO2
8

VE/VO2
14

6 12

10
4 VT
8
2
6
LT
0 4
15 30 45 60 75 90
Workload (Watts)

Fig. 1. Example of testing in one participant, showing lactate (LT; ), ventilatory (VT;
VE/VO2: ; VE/VCO2: ), and glucose (GT; ) thresholds

All participants presented a well-defined lactate threshold and ventilatory

T. Webster et al. / Journal of Exercise Science & Fitness
threshold (VT), while the identification of the glucose threshold (GT) was
possible in about 80% (12 of 15 participants) of the sample. The second-or-
der equation originated from the polynomial modeling of VE/workload,
11 (2013) 6e11
and [lac]/workload ratios successfully allowed the identification of the VTp
Perceptual and Motor Skills, 2010, 111, 2, 365-378. © Perceptual and Motor Skills 2010

and LTp , respectively, as shown in Fig. 2. LACTATE THRESHOLD PREDICTION BY

The values of workload (Watts), VO BLOOD
, RPE, GLUCOSE
and heart AND rateRATING
correspond-OF PERCEIVED
2
EXERTION IN PEOPLE WITH TYPE 2 DIABETES 1, 2

ing to the lactate threshold, ventilatory threshold, glucose threshold, W13,

W14, VTp , and LTp did not differ; however, W12 underestimated the lac-
HERBERT GUSTAVO SIMÕES, WOLYSSON CARVALHO HIYANE, RONALDO ESCH
BENFORD, BIBIANO MADRID, AND FRANCISCO ANDRIOTTI PRADA
tate threshold workload while W15 overestimated it (Table 1). Also, blood
Catholic University of Brasília–UCB
lactate, glucose, and ventilatory SÉRGIO
thresholds
RODRIGUES as well
MOREIRA as W13, W14, RICARDOVTpJACÓ
, DE OLIVEIRA
and LTp were significantly correlated, as shown
Federal University in Francisco
of Vale do São Table 2. Besides the of Brasília–UnB
University
(UNIVASF), PE

FÁBIO YUZO NAKAMURA CARMEN SÍLVIA GRUBERT CAMPBELL

State University of Londrina–UEL Catholic University of Brasília–UCB

Summary.—The validity of rating of perceived exertion (RPE) in predicting

lactate threshold during an incremental test was analyzed in 15 men with type 2
diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventila-
tion (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds.
Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-
order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9–10,
12–13, and 16–17 also identified workloads above which there was an overpropor-
tional increase in VE and [lac]. These workload breakpoints did not differ, although
at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13
and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately
predicted lactate threshold.

It has been shown that during an incremental exercise test, blood glu-
cose concentration decreases until lactate threshold is attained, increas-
ing thereafter (Simões, Campbell, Kokubun, Denadai, & Baldissera, 1999).
This increase in blood glucose concentration after reaching the lactate
threshold was attributed to higher sympathetic activity which leads to a
greater rate of glycogenolysis in the liver. Therefore, the exercise intensity
(i.e., workload in Watts, speed in km/hr.) at which the blood glucose con-
centration begins to increase during the incremental test is called the in-
dividual glucose threshold and has been observed in young healthy subjects
during running (Sotero, Pardono, Landwehr, Campbell, & Simões, 2009),
1
Address correspondence to Prof. Herbert Gustavo Simões, Ph.D., QS07, LT1 s/n. Bloco G
Sala 116, CEP 72030-170 Águas Claras, Brasília, DF-Brazil or e-mail (hgsimoes@gmail.com).
2
Grant support was obtained from Conselho Nacional de Desenvolvimento Científico e
Tecnológic-CNPq (proc. 475575/2004-0), Fundação de Apoio à Pesquisa do Distrito Fede-
ral–FAP-DF, and from Sistema de Gestão de Pesquisa (SIGEP/UCB). The authors are grateful
to CNPq and FAP-DF for financial support and to Laboratório de Avaliação Física e Trein-
amento (LAFIT-UCB) and Micromed-DF for technical assistance.

DOI 10.2466/06.13.15.27.PMS.111.5.365-378 ISSN 0031-5125

De Oliveira, 2006

12
 11/5/19

Fuentes de los Hidratos de Carbono

durante el ejercicio

• Glucógeno muscular y hepático

• Glucosa sanguínea
• Producción endógena (gluco-neo-génesis hepática)
• HC ingeridos durante el ejercicio

Factores que afectan la gluco-neo-génesis

durante el ejercicio

1. Reservas de glucógeno disponibles previo al ejercicio

2. Provisión de glucosa durante el ejercicio (ingerida)
3. Duración e intensidad del ejercicio

13
 11/5/19

Gluconeogenesis

Músculo

Lactato Alanina Glicerol Piruvato

Hígado Hígado Hígado Hígado

Ciclo de Cori Ciclo alanina-

Luego de 3 horas al 58% VO2 max, la
glucosa
gluco-neo-génesis hepática aporta
el 60% de la glucosa utilizada

Ahlborg G, Felig P. Lactate and glucose exchange across the forearm, legs,
and splanchnic bed during and after prolonged leg exercise. J Clin Invest 1982;69:45-54.

Ciclo de Cori

14
 11/5/19

Ciclo Alanina-Glucosa

Control Hormonal de HC
durante el ejercicio

Cortisol Adrenalina Noradrenalina Glucagón Insulina

glucogénesis [ampc] Lipólisis ampc hígado ingreso de
glucosa

mov.AGL Glucogenolisis Glucogenólisis Gluconeogenolisis Síntesis

(musc+hígado) glucógeno

mov.AA Lipólisis Glucogenolisis Gluconeogenólisis

(adiposo)

glu+AGL Lipogénesis

Con el Ejercicio Con el Ejercicio

15
 11/5/19

Reserva CHO Corporales

Glucosa Sangre = 5 gm. (20 calorías)

Glucógeno Hepático Glucógeno Muscular

Antes de Comer: 75 - 100 gr. 300 - 400 gr (70 kg)

Post-comida: 120 gm = (1200 – 1600 kcals)

= (350-400 kcals)

Destino de CHO
Consumidos

Comida

25 - 30 % 30 - 50 % 20 - 50 %

Glucógeno Glucógeno Oxidación

Hepático Muscular

Flatt JP. Use and storage of carbohydrate and fat. Am J Clin Nutr 1995;61(suppl.):952S-9S.

16
 11/5/19

Physiological Reports ISSN 2051-817X

ORIGINAL RESEARCH

Carbohydrate dose influences liver and muscle glycogen

oxidation and performance during prolonged exercise
Andy J. King1 , John P. O’Hara1 , Douglas J. Morrison2, Tom Preston2 & Roderick F. G. J. King1
1 Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, United Kingdom
2 Scottish Universities Environmental Research Centre, East Kilbride, United Kingdom

LG: 60 g
HG: 75g
Liver and Muscle Glycogen Oxidation with Carbohydrate Ingestion
LGF: 90 g ratio 2:1 A. J. King et al.
Keywords Abstract
HGF: 112.5 g ratio 2:1 Carbohydrate ingestion, exercise,
metabolism, muscle glycogen, stable isotope. This study investigated the effect of carbohydrate (CHO) dose and composi-
tion on fuel selection during exercise, specifically exogenous and endogenous _ 2max .
Table 1. Respiratory gas exchange, heart rate, and substrate utilization over the first and second hour of the 2 h of exercise at 77% VO
Correspondence (liver and muscle) CHO oxidation. Ten trained males cycled in a double-blind
Data from the first h is presentedAndy
in the topCarnegie
J. King, line of School
each ofvariable,
Sport, and the second hour
randomized orderinonthe5 bottom
occasionsline.
at 77% VO _ 2max for 2 h, followed by a
Fairfax Hall, Leeds Beckett University, Leeds, 30-min time-trial (TT) while ingesting either 60 g!h (LG) or 75 g!h"1 13C-
"1
LS6 3QT, United Kingdom. Condition
glucose (HG), 90 g!h"1 (LGF) or 112.5 g!h"1 13C-glucose-13C-fructose ([2:1]
Tel: +44 113 812 6569
HGF) or placebo. CHO doses met or exceed reported intestinal transporter
Pla
E-mail: a.k.king@leedsbeckett.ac.uk LG HG LGF HGF
saturation for glucose and fructose. Indirect calorimetry and stable mass iso-
13
HR (b"min#1) Funding
146 ! Information
7 151 ! 8 tope [ C] tracer 151 ! techniques
6 were utilized
152 !to 7determine fuel use.153TT ! perfor-
6
No funding information provided. mance was 93% “likely/probable” to be improved with LGF compared with
154 ! 91 158 ! 11 160 ! 10 158 ! 10 161 ! 10
the other CHO doses. Exogenous CHO oxidation was higher for LGF and
_VO2 (L"min#1) 3.49 ! 29 0.45 3.61 4! 0.56HGF compared 3.52with! 0.58
Received: November 2017; Revised: LG and HG (ES 3.57 ! P0.69
> 1.34, 3.61
< 0.01), with the ! 0.67
relative con-
December
3.62 !2017; 0.42Accepted: 5 December
3.63 ! 0.49tribution of 3.49LGF ! 0.42
(24.5 3.62 ! higher
# 5.3%) moderately 0.64 than HGF3.71 (20.6!#0.63 6.2%,
_ #1 2017
VCO 2 (L"min ) 3.18 ! 0.41 3.22 ! 0.47ES = 0.68). Increasing
3.19 ! 0.50 CHO dose beyond 3.15intestinal
! 0.62 saturation 3.22 ! 0.56
increased abso-
"1
doi:3.18 ! 0.37
10.14814/phy2.13555 3.23 ! 0.38lute (29.2 #3.16 28.6 ! g!h0.36, ES = 1.28, P = 0.06)
3.25 and relative muscle
! 0.60 3.31 !glycogen
0.31
RER 0.91 ! 0.04 0.90 ! 0.08utilization (9.20.91# ! 0.01ES = 1.68, P0.90
6.9%, = 0.014) for glucose-fructose
! 0.03 0.90 ! ingestion.
0.04
Physiol Rep, 6 (1), 2018, e13555, Absolute muscle glycogen oxidation between LG and HG was not significantly
0.88 ! 0.03 0.90 ! 0.07 0.91 ! 0.01 0.87 ! 0.05 0.90 ! 0.03
https://doi.org/10.14814/phy2.13555 different, but was moderately higher for HG (ES = 0.60). Liver glycogen oxida-
CHOox (g) 186.1 ! 32.7 177.1 ! 31.3tion was not 199.1 ! 38.9 different between
significantly 182.5 !conditions,
48.8 217.2 !
but absolute and40.4rela-
167.6 ! 30.1 175.5 ! 24.4tive contributions
187.4 !were 26.1 moderately187.3 ! 35.5for LGF (19.3
attenuated 219.1 ! 41.7
# 9.4 g!h"1,
"1
Fatox (g) 36.2 ! 16.4 38.6 ! 20.46.8 # 3.1%)32.4 ! 7.13
compared with HGF (30.5 36.9 ! 13.9
# 17.7 25.3 ES
g!h , 10.1 # 4.0%, ! 8.2= 0.79
46.1 ! 13.8 36.5 ! 16.9& 0.98). Total 36.1fat !oxidation
9.4 was suppressed
38.3 !in11.4
HGF compared27.6 with!all10.8other
Energy expenditure (kCal) 1099.8 ! 182.3 1088.4 ! 151.7 CHO conditions
1126.4 (ES > 0.90, P = 0.024–0.17).
! 201.7 In conclusion,1050.1
1106.1 ! 220.1 there was ! no206.6lin-
ear dose response for CHO ingestion, with 90 g!h"1 of glucose-fructose being
Liver 1117.2
and Muscle ! Glycogen
129.3 Oxidation 1097.0 ! 112.6 Ingestion
with Carbohydrate 1115.2 ! 149.1 1132.6 ! 197.8 1187.1
A. J. King et!al.211.6
optimal in terms of TT performance and fuel selection.

Data are heart rate in b"min#1, VO _ 2 , VCO _ #1

2 in L"min , respiratory exchange ratio (RER), and CHO and ES fat
Liver and conditions > 0.18,
Muscle(PGlycogen <oxidation
0.45) andwith
Oxidation
in grams.
peaked Allmin
at 45
Carbohydrate
values are
in Ingestion A. J. Kin
mean ! SD. N = 11. (Stellingwerff and Cox 2014), indicating the mechanisms
Introduction all CHO conditions, except in LGF (see Fig. 4). Increasing
1 behind the ergogenic benefit of CHO ingestion are likely
Denotes PLA significantly lower than HGF. CHO dose did not alter serum insulin beyond a moderate,
During prolonged exercise, endogenous carbohydrate multi-factorial, but also sensitive to dose of CHO ingested conditions (P > 0.18, ES < 0.45) and peaked at 45 m
nonsignificant effect at any time point (ES < 1.01) until
(CHO) and fat act as metabolic substrates to provide (Wallis et al. 2007; Smith et al. 2013). all CHO conditions, except in LGF (see Fig. 4). Incre
the Muscle
end of exercise where a significant
Physiol large effect was
energy to the working muscle (Van Loon et al. Liver and
2001), The Glycogen Oxidation
major rate-limiting toRep,
stepwith 6 (1),
exogenous 2018,
Carbohydrate CHO e13555
Ingestion
oxida- CHO dose did not alter serum insulin beyond a A. modJ.
seen between LG and HGF (P = 0.01, ES = 1.61,) and
with both intra and extra-myocellular sources essential tion appears to be the transport of hexoses across the nonsignificant effect at any time point (ES < 1.01)
moderate (nonsignificant) effects between LG and HG &
for strenuous
In addition, the relative contribution of total CHO oxi-exercise. The protection of finite reserves
enriched LGF of CHO intestinal mucosa.
conditions Due to saturation of the glucose speci- the end of exercise where a significant large effec
(P = 0.50 and 0.53, ES (Fig.= 0.94 1A).
and 0.95). Each condition
conditions > 0.18, ES < 0.45)
liver and muscle glycogen, by provision of exogenous fic sodium dependent glucose transporter (SGLT1), glu- seen between(PLG and HGF and peaked
(P = 0.01, at 4
ES = 1.61,
dation to the total energy yield (Fig. 2) during the second reached maximal values at 120 min, with LGF
cose has an upper oxidation rate of ~1.0–1.1 g!min"1 moderate
sources of CHO just before and during exercise, may con- all CHO(nonsignificant) effects
conditions, except between
in LGF (see LG
Fig. and
4). IH
hour of exercise was significantly tribute tohigher a prolonged in HGF exercisecom-performance, (28.08 ! Time
especially 5.12&) trialand
during HGF
performance
exercise (29.2et!al. 9.5&)
(Jentjens being the
2004b), whereas signifi-
addi- LGF (P = 0.50 and 0.53, ES = 0.94 and 0.95).
"1 CHO dose did not alter serum insulin beyond a m
pared with PLA (difference =where 16.6,a high-intensity
8.7–24.6%,effort P =toward
0.024,the endcantly of exercisehigher
The effect compared
is tion of fructose canwith
of CHO ingestion was toLG
increase this to(11.35 ~1.6–1.8!g!min 4.47&, by
increase mean power nonsignificant effect at any time point (ES < 1.
ES = 1.88). Compared with required. the However, evidence of “sparing” glycogen with
other CHO conditions,
exogenous CHO feeding has received equivocal support
P = 0.001) and
output
exploiting the glucose transporter-5 (GLUT-5) intestinal
HG
during 30-min!time
(14.94
the 5.97&; P
trial compared= 0.0005–0.002),
transporter (Adopo et al. 1994; Jentjens et al. 132004a;
with pla- Time trial performance
the end of exercise where a significant large e
this effect was moderate and significant (LG; 9.4, 4.4– with verycebo large (Table 3). With
effects (ES = in1.80–3.48).
sizesa change performance The of 1.2% d CO2 The effect
seen of CHO
between LGingestion
and HGF was(P to =increase mean
0.01, ES = 1.p
used as the smallest meaningful improvement, the inges-
14.3%, P = 0.049, ES =Figure 0.90.
ª 2018 HG;
2. Percentage
The 8.4,contributions
energy
Authors. Physiological4.5–12.3%,
Reportsfrom various
published inPeriodicals,
expired
substrates
by Wiley Inc. ongas
tion behalf
was
of also significantly2018 higher
| Vol. 6for Iss.LGF
|“almost and
1 | e13555
output during the 30-min time trial compared with
moderate
The Physiological Society and the American Physiological Society
of CHO was at least 81% “likely” to 99%
Page 1 cebo (Table(nonsignificant)
3). With a changeeffects between LG of
in performance an
P = 0.023, ES = 1.18) or during large the second hour of the 2 h ride. (a) denotes LGF
This is but
an opennonsignificant (LGF;
access article under the terms of the CreativeHGFCommons from 60License,
certain”
Attribution min onwards
to improve compared
the chance Physiological with
of increasing Reports
mean LG ISSN and
power HG
2051-817X
LGFas(Pthe
used = 0.50
smallest 0.53, ES = improvement,
andmeaningful 0.94 and 0.95).the
significantly
ORIGINAL different to LG (P = 0.00), (b) denotes LGF significantly
permits use, RESEARCH
9.6, 3.1–16.1%, P = 0.17, different
ESwhich= to1.25).
HG (P = The increased
0.00–0.019), (c) denotesrela-
LGF significantly(P < Figure
distribution and reproduction in any medium, provided the
=The
original work
0.05,output.
ESPercentage
2. ischances
properly cited.
0.65–3.48).energy of CHO ingestionfrom
contributions causing
variousa detri-
substrates tion of CHO was at least 81% “likely” to 99% “a
different to HGF (P = 0.014) during mental
the effect
second were
hour less
of thethan
2 h 8%
ride. “unlikely/probably
(a) denotes LGF not” 13
certain” to improve the chance of increasing mean p
tive CHO oxidation in HGFCarbohydrate
was associated with dose a con- influences The isotopic
significantlyliver composition
different and
to LG (P muscleof plasma
= 0.00), glycogen
(b) denotes glucose (d C)
LGF significantly
comitant moderate (and significant) or large (but increaseddifferentbyto 2.6&
HG (P =from 60 to(c)120
0.00–0.019), minLGF
denotes ofsignificantly
exercise with Time The
output. trialchances
performance
of CHO ingestion causing a
oxidation and performance during
different to HGF (P prolonged
= 0.014) exercise mental effect were less than 8% “unlikely/probably
nonsignificant) reduction in the relative1 contribution of 1 ingestion of PLA 2(P = 0.09, ES = 0.9, Fig. 1B). In all The effect of CHO ingestion was to increase mea
Andy J. King , Douglas J. Morrison , Tom Preston2 & Roderick F. G. J. King1
fat to the energy yield compared with the, John otherP. O’Hara
CHO CHO conditions, there was a significant rise in plasma output during the 30-min time trial compared
1 Research Institute for Sport, Physical Activity and Leisure,
13 Leeds Beckett University, Leeds, United Kingdom
conditions (effect sizes, 95%2 Scottish
confidence intervals and P d C glucose between 60 and 90 min (P = 0.004–0.012,
Universities Environmental Research Centre, East Kilbride, United Kingdom cebo (Table 3). With a change in performance
LG: 60 g
values the same as reported for CHO). ES = 1.11–1.40), except in HG where it was moderate but used as the smallest meaningful improvement, t
HG: 75g
LGF: 90 g ratio 2:1 nonsignificant (P = 0.25,
Figure 2. Percentage energyES = 0.61). from
contributions various substrates
Between 90 and tion of CHO was at least 81% “likely” to 99%
Liver and Muscle Glycogen Oxidation with Carbohydrate Ingestion during the second hour 13 of the 2 h ride. (a) denotes LGF A. J. King et al.
HGF: 13
112.5 g ratio 2:1 120 min, plasma d C glucose remained similar for all certain” to improve the chance of increasing mea
d CO2 in expired gas Keywords and d 13C in plasma Abstractsignificantly different to LG (P = 0.00), (b) denotes LGF significantly
conditions (P > 0.32, ES = 0.11–0.21) except for a small,
different to HG (P = 0.00–0.019), (c) denotes LGF significantly
output. The chances of CHO ingestion causing
glucose Carbohydrate ingestion, exercise,
metabolism, muscle glycogen, stable isotope. This study investigated
nonsignificant
conditions
different
the
rise(P
to HGF
effect
(Pin
of
HG
0.18,(PES
=>0.014) = 1.00,
carbohydrate
< 0.45) ES =
(CHO)
anddose and
0.58).
peaked composi-
The at iso-45 minmental
in effect were less than 8% “unlikely/proba
13 tion on fuel selection during exercise, specifically exogenous and endogenous
The d CO2 in expired gas was similar between all condi- (liver
Correspondence
topic
and allcomposition
CHO
muscle) of plasma
CHOconditions,
oxidation. glucose
Ten except
trained in was
males cycledhighest
LGF (see for 4).
Fig. LGF
in a double-blind Increasing
tions at rest before exercise and
Andy J.theKing, ingestion
Carnegie Schoolof placebo randomized
of Sport, during CHO the last
order on 5hour
dose did of notexercise,
occasions atalter _ being
77% serum
VO 2max formoderately
2 h, followed
insulin beyondbutbynotaa moderate,
Fairfax Hall, Leeds Beckett University, Leeds,
or 13C enriched carbohydrate(s) (P < 0.52, ES < 0.50, 30-min time-trial (TT)
significantly while ingesting
higher than LG 60 g!h"1
either(66.3 ! (LG)
24.4&, or 75 g!h
P
"1 13
= 0.12,
C-
13
LS6 3QT, United Kingdom.
glucose (HG), nonsignificant
90 g!h"1 (LGF) effect
or 112.5 at any
g!h"1 13 time point
C-glucose-13C-fructose (ES < 1.01) until
([2:1]
Fig. 1A). In PLA, the d CO in113expired
Tel:2 +44 812 6569 gas increased ES = 0.71) CHO and HGF (68.7 ! 26.0&, P = 0.81,
E-mail: a.k.king@leedsbeckett.ac.uk the end ofdoses
HGF) or placebo. exercise wherereported
met or exceed a significant large effect was
intestinal transporter
over time by 5.4& (ES = 1.95) from the start to the end saturation ES = for 0.60) at 60
glucose and min. There
fructose. Indirectwere moderate
calorimetry to large
and stable and
mass iso-
13 seen between LG and HGF (P = 0.01, ES = 1.61,) and
of exercise. These data were Funding
used as the background cor-
Information tope [ C] tracer techniques were utilized
significant differences compared with LG at to determine fuel use. TT perfor-90
No funding information provided. mance wasmoderate (nonsignificant)
93% “likely/probable” to be improved effects between
with LGF compared LG withand HG &
rection for the calculation of exogenous CHO and plasma the (85.8 ! 20.3&, P = 0.045, ES = 1.17) and 120 min
other CHO doses. Exogenous CHO oxidation was higher for LGF and
glucose oxidation for each CHO condition. The d CO2 HGF(86.0
Received: 29 November 2017;
134
Revised: LGF
compared! 19.8, (P =
P=
with LG
0.50
and0.026,
and
HG (ESES
0.53,
> 1.34,
ES
= 1.31), = 0.94
as with
P < 0.01),
and
wellthe 0.95).
as relative
HG at con-90
December 2017; Accepted: 5 December
in expired gas significantly increased
2017 over time from the tribution (87.2of!LGF 12.9, = 0.04,
(24.5 #P5.3%) moderately = 1.44)
ES higher than HGF and(20.6120 # 6.2%,
min
13 ES = 0.68). Increasing CHO dose beyond intestinal saturation increased abso-
start of exercise following the ingestion of all four C lute(94.2 ! 11.5,trial
(29.2 Time
# 28.6 g!h
P , =ES0.034,
"1 ES = 1.14).
performance
= 1.28, P = 0.06) and relative muscle glycogen
doi: 10.14814/phy2.13555
utilization (9.2 # 6.9%, ES = 1.68, P = 0.014) for glucose-fructose ingestion.
Physiol Rep, 6 (1), 2018, e13555, The effect
Absolute muscle glycogenof CHObetween
oxidation ingestionLG andwas to not
HG was increase mean power
significantly
https://doi.org/10.14814/phy2.13555different, but was moderately higher for HG (ES = 0.60). Liver glycogen oxida-
2018 | Vol. 6 | Iss. 1 | e13555 ª 2018tionThewas
output during
not significantly
Authors. Physiologicaldifferent
thebetween
30-min
Reports published
time but
conditions,
trial
by Wiley Periodicals,
compared
absolute and
Inc. on rela-of
behalf
with pla-
Page 6 cebo (Table
tive contributions The 3). With
werePhysiological
moderately Society aandchange
attenuated thefor
American
LGFin(19.3
performance
Physiological
# 9.4 g!h "1
, of 1.2%
Society
Figure 3. Sources of oxidised glucose and muscle glycogen
6.8 during
# the second
3.1%) comparedhour of the HGF
with ride. A:(30.5
Carbohydrate
# 17.7 from
g!h exogenous
"1
, 10.1 # sources
4.0%, ES = 0.79
used
(g.min!1) B: Plasma glucose oxidation (g.min!1) C & D: Liver and Muscle as oxidation
glycogen the smallest meaningful
respectively (g.min !1 improvement,
) Data are means
& 0.98). Total fat oxidation was suppressed in HGF compared with all other
" sd. a the inges-
Figure 2. Percentage energy contributions
denotes from
LGF significantly lower various
than HG substrates
tion (ES of Sources
Figure
CHO conditions 3. >CHO P was
0.90, of at glucose
=oxidised
0.024–0.17).leastIn and81% “likely”
muscle
conclusion, glycogen
there toduring
was no99%lin- the“almost
second hour of the ride. A: Carbohydrate from exogenous sources
during the second hour of the 2 h ride. (a) denotes LGF (g.min!1) B: Plasma glucose oxidation (g.min
ear dose response for CHOimprove
ingestion, with 90 "1
g!h of of
!1
) C & D: Liver and Muscle glycogen oxidation respectively (g.min!1) Data are means " sd. a
glucose-fructose
certain” LGF to the chance increasingbeing mean power
significantly different to LG (P = 0.00), (b) denotes LGF significantlyoptimal indenotes significantly lower than
terms of TT performance and fuel selection.
HG

different to HG (P = 0.00–0.019), (c)6 denotes

2018 | Vol. LGF significantly
| Iss. 1 | e13555
Page 10
different to HGF (P = 0.014)
Introduction
During prolonged exercise, endogenous carbohydrate
(CHO) and fat act as metabolic substrates to provide
energy to the working muscle (Van Loon et al. 2001),
with both intra and extra-myocellular sources essential
for strenuous exercise. The protection of finite reserves of
liver and muscle glycogen, by provision of exogenous
sources of CHO just before and during exercise, may con-
tribute to a prolonged exercise performance, especially
where a high-intensity effort toward the end of exercise is
required. However, evidence of “sparing” glycogen with
exogenous CHO feeding has received equivocal support
output. The chances of CHO ingestion causing a detri-
ª 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of
mental effect wereandless
(Stellingwerff Cox than
2014), 8% “unlikely/probably not”
The Physiological Society and the American Physiological Society
indicating the mechanisms
2018 | Vol.behind
6 | Iss.the
1 ergogenic ª 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on b
| e13555benefit of CHO ingestion are likely
Page 10 The Physiological Society and the American Physiologica
multi-factorial, but also sensitive to dose of CHO ingested
(Wallis et al. 2007; Smith et al. 2013).
The major rate-limiting Physiol
step toRep, 6 (1), 2018, e13555
exogenous CHO oxida-
tion appears to be the transport of hexoses across the
intestinal mucosa. Due to saturation of the glucose speci-
fic sodium dependent glucose transporter (SGLT1), glu-
cose has an upper oxidation rate of ~1.0–1.1 g!min"1
during exercise (Jentjens et al. 2004b), whereas the addi-
tion of fructose can increase this to ~1.6–1.8 g!min"1 by
exploiting the glucose transporter-5 (GLUT-5) intestinal
transporter (Adopo et al. 1994; Jentjens et al. 2004a;

ª 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of 2018 | Vol. 6 | Iss. 1 | e13555
The Physiological Society and the American Physiological Society Figure 3. Sources of oxidised glucose and muscle glycogen during Page 1 the second hour of the ride. A: Carbohydrate from exogenous sou
!1
This is an open access article under the terms of the Creative Commons Attribution
(g.min Plasma glucose oxidation (g.min!1) C & D: Liver and Muscle glycogen oxidation respectively (g.min!1) Data are means "
) B:License,
17
which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
denotes LGF significantly lower than HG
 11/5/19

Liver and Muscle Glycogen Oxidation with Carbohydrate Ingestion A. J. King et al.

_ 2max
Table 3. Comparison of performance and changes in performance in the 30 minute time trial following 2 h of exercise at 77% VO

% Improvement in average power

Performance (W) LG HG LGF HGF

Placebo 187 # 43 11.2, 1.8–21.4 (0.45) 5.1, "2.4–13.1 (0.20) 21.1, 9.0–34.5 (0.86) 14.9, 5.8–24.7 (0.60)
96%, very likely 81%, likely 99%, almost certainly 99%, very likely
P = 0.046 P = 0.20 P = 0.012 P = 0.015
LG 206 # 41 "5.5, "16.4–6.8 (0.23) 8.9, 0.4–18.2 (0.41) 3.3, "1.8–8.6 (0.16)
17%, unlikely 93%, likely, probable 76%, likely
P = 0.41 P = 0.087 P = 0.26
HG 196 # 46 15.2, 2.6–29.4 (0.63) 9.3, "0.9–20.5 (0.38)
96%, very likely 91% likely, probable
P = 0.064 P = 0.12
LGF 225 # 45 "5.1, "0.2–9.8 (0.27)
2%, probably not
P = 0.11
HGF 213 # 43

Data are: mean power outputs during the 30-minute time trial with ingestion of LG (60 g!h"1), HG (75 g!h"1), LGF (90 g!h"1) and HGF
(112.5 g!h"1) (mean # SD). [first line: % difference between conditions following log transformation of data with associated 90% confidence
intervals; second line: Cohen’s d effect size (in parentheses); third line: chances of (% and qualitative) of meaningful improvement; fourth line:
P value from ANOVA with LSD post hoc comparison]. N = 11.

this study is that the manipulation of CHO dose at and
above intestinal CHO transport limits can have a poten-
tially meaningful impact on endogenous fuel use and sub-
sequent time trial performance.
The ingestion of glucose-fructose resulted in a higher
peak rate of exogenous CHO oxidation (1.33 g!min"1)
than with glucose alone (0.88 g!min"1), which is consis-
tent with the existing literature (Jentjens et al. 2005;
Smith et al. 2010). This study adds further support for
the efficacy of using MTC to maximize exogenous CHO
oxidation, (Jentjens et al. 2004a, b; Jeukendrup et al.
2006; Hulston and Jeukendrup 2008; Rowlands and
Clarke 2011). As the rate of cellular glucose uptake is not
rate limiting in the normal physiological range of plasma
glucose concentration with CHO ingestion (Hawley et al.
1994), using MTC maximizes intestinal CHO transport
by concurrently using both SGLT1 and GLUT-5 transport
proteins, increasing the availability of CHO for oxidation,
which explains the difference in the rates of exogenous
CHO oxidation. This study further supports the evidence
(Jentjens et al. 2004b, 2006; Jentjens and Jeukendrup
2005; Wallis et al. 2007) that when ingesting glucose or
glucose-fructose, that increasing the dose beyond intesti-
nal saturation of SGLT1 and GLUT-5 transport proteins
provides no further increases in exogenous CHO oxida-
tion. This is likely due to an accumulation of the CHO in
the gut (Jeukendrup and Moseley 2010). This delay in
CHO absorption across the intestinal lumen may explain
the moderately reduced relative contribution of exogenous
CHO to the total energy yield in HGF compared with
LGF when these data are considered for the whole of the
second hour of exercise, rather than just the peak oxida-
tion rates. It should be noted that a recent review high-
lights potential individual variability in exogenous CHO
oxidation rates with fructose (co)ingestion, and at inges-
tion rates approximate or lower than 0.5–0.6 g!min"1 for
Physiol Rep, 6 (1), 2018, e13555
fructose, the ratio of fructose to glucose ingestion may
exceed that reported in this study (Rowlands et al. 2015).
The current study also partially supports previous evi-
dence that maintaining high rates of exogenous glucose
oxidation, seen with elevated plasma glucose concentra-
tions, may explain the ergogenic benefit of CHO ingestion
during prolonged exercise (Coyle et al. 1986; Jeukendrup
et al. 2006). In the present study glucose-fructose inges-
tion only marginally resulted in higher plasma glucose
concentrations than glucose ingestion, but both ingestion
of glucose and glucose-fructose significantly increased
plasma glucose concentrations compared with placebo.
While plasma glucose concentrations do not reflect rates
of glucose flux (i.e., rates of appearance and disappear-
ance of circulatory glucose), the current exogenous CHO
glucose oxidation data provide evidence for a greater dis-
posal of glucose into the working muscle in the LGF con-
dition. Therefore, the proposed mechanism of increasing
CHO as a substrate to the working muscle may have an
upper limit in its effect, as demonstrated by the differing
time trial performances with low and high glucose-fruc-
tose conditions.
Small alterations in exogenous CHO oxidation will
alter endogenous substrate oxidation where the energy
cost of exercise is unchanged. Due to the finite energy
resource that glycogen stores provide, it stands that

2018 | Vol. 6 | Iss. 1 | e13555 ª 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of
Page 12 The Physiological Society and the American Physiological Society

18
11/5/19

19
 11/5/19

1,80 1,80 1,80

1,20

1,26 1,25

0,80 0,83

Oxidacion CHO en grs./min Ingesta CHO en grs./min

2,40 2,40 2,40

1,80

1,70 1,75
1,50
1,30

Oxidacion CHO en grs./min Ingesta CHO en grs./min

20
 11/5/19

Jeukendrup, 2013

21
 Peter Peeling,6,7 Stuart M Phillips,8 Eric S Rawson,9 Neil P Walsh,10 Ina Garthe,11
Hans Geyer,12 Romain Meeusen,13 Lucas J C van Loon,3,14 Susan M Shirreffs,1
11/5/19
15
Lawrence
Downloaded from http://bjsm.bmj.com/ on March 15, 2018 L Spriet,
- Published Mark Stuart,16 Alan Vernec,17 Kevin Currell,18 Vidya M Ali,19
by group.bmj.com
Richard GM Budgett,20 Arne Ljungqvist,
Consensus
21
Margo Mountjoy,22,23 Yannis P Pitsiladis,19
statement
Torbjørn Soligard,20 Uğur Erdener,19 Lars Engebretsen20
Table 2 Summary of common sports foods and functional foods used by
For numbered athletes. 
affiliations see ABSTRACT good health by contributing to the required intake
end of article.
Nutrition usually makes a smallsports-related
but potentially use of specific nutrients, the management of micro-
Sports food Form Typical composition Common
valuable contribution to successful performance in elite nutrient deficiencies, and the provision of energy
Sports drink Powder or ready to drink liquid 5%–8% CHOCorrespondence to athletes, and dietarySimultaneous
supplements can delivery
makeofa minor
fluid+CHO during exercise
and macronutrient needs that might be difficult to
Professor Ronald J Maughan,
10–35 mmol/L sodium
School of Medicine, St Andrews contribution to thisPostexercise
nutrition rehydration
programme. and
Nonetheless, refuelling achieve through food intake alone. Other specific
3–5 mmol/L potassium
University, St Andrews, UK; supplement use is widespread at all levels of sport. uses of supplements reported by athletes include
Energy drink Ready-to-drink liquid or Carbohydrate, ronmaughan@st-andrews.ac.uk Products described as supplements target different
especially in typical ready-to-drink Pre-exercise caffeine supplement direct performance enhancement or the indirect
concentrated shot varieties issues, including (1)Carbohydrate
the management andofcaffeine
micronutrient
intake during benefits
exercise that arise from the provision of support
Accepted 3 February 2018
deficiencies, (2) supply of convenient forms of energy and for hard training, the manipulation of physique, the
Caffeine
macronutrients, and (3) provision of direct benefits to alleviation of musculoskeletal pain, rapid recovery
Note: may contain taurine, B vitamins and other
performance or (4) indirect benefits such as supporting from injury and enhancement of mood.
ingredients with variable supporting evidence intenseand someregimens. The appropriate use of some
training Some sporting bodies now support the pragmatic
level of concern supplements can benefit the athlete, but others may use of supplements that have passed a risk-ver-
Sports gel or sports Gel: 30–40 g sachets confectionery:
Downloaded ~25 g CHO per sachet
from http://bjsm.bmj.com/ onor ~5
March g CHO harm-the
15,per2018 athlete’s health,
confectionery
Published performance,
Carbohydrate
by group.bmj.com intakeand/or
during exercise sus-benefit analysis of being effective, safe and
livelihood
confectionery jelly-type confectionery (generally in piece and reputation (if an antidoping rule violation results). A permitted for use, while also being appropriate to
pouch of ~40–50 g) Some contain caffeine or electrolytes complete nutritional assessment should be undertaken the athlete’s age and maturation in their sport. This
before decisions regarding supplement use are made.
Consensus statement
review summarises the issues faced by high-per-
Electrolyte Powder sachets or tablets 50–60 mmol/L sodium Rapid rehydration following dehydration undertaken for
Supplements claiming to directly or indirectly enhance formance athletes and their support team (coach,
replacement 10–20 mmol/L potassium weight-making trainer, nutritionist, physician) when considering
performance are typically the largest group of products
Table 2 Summary of common sports foods and functional
supplements foods
Typically, low used by athletes. 
carbohydrate (2–4 g/100 mL)
marketed to athletes, Replacement
but only a few of large sodium
(including losses during
caffeine, the useultra-
of supplements, with the goal of providing
endurance
creatine, specific buffering activities
agents and nitrate) have good information to assist them to make informed
Sports food Form Typical composition Common sports-related use
Rapid postexercise rehydration
evidence of benefits. However, responses are affected following moderate
decisions. to
Sports drink Powder or ready to drink liquid 5%–8% CHO by the scenario of use Simultaneous
largeandfluid varydelivery
mayand sodium of fluid+CHO during exercise
deficits
widely between
10–35 mmol/L sodium individuals because Postexercise
of factors that rehydration
include and the
genetics, refuelling
Protein supplement Powder (mix with water or milk) or Provides 20–50 g protein in a single serve from high- Postexercise recovery following key training WHATsessions or
IS A SUPPLEMENT?
3–5 mmol/L potassium microbiome
ready-to-drink liquid quality types of animal (whey, casein, milk, egg) or and habitual
eventsdiet.
whereSupplements
adaptation intended
requiring proteinThere synthesis is definition, either legal or within
is no single
Energy drink Ready-to-drink
Protein-rich bar,liquid orlow in CHO vegetable
usually Carbohydrate, especially
(eg, soy) to enhance performance
origin in typical ready-to-drink should becaffeine
Pre-exercise
desired thoroughly trialled
supplement
nutritional science, of what constitutes a dietary
concentrated shot varieties in training or simulated competitionand
Carbohydrate before being intake
caffeine used during exercise
Note: may contain other ingredients, some of which Achievement of increase in lean mass during growthThe
supplement. or US Congress, for example, in
Caffeine in competition. Inadvertent ingestion of substances
are not evidence-based and may increase the risk of response to resistance training framing the 1994 Dietary Supplement Health and
Note: may contain taurine, B vitamins prohibited
and other under the antidoping codes that govern
contamination elite sport is a knownPortable
risk of nutrition
taking some busy schedule or Education
forsupplements. travel Act (DSHEA; https://ods.od.nih.gov/
ingredients with variable supporting evidence and some About/DSHEA_Wording.aspx), described a dietary
Liquid meal Powder (mix with water or milk) or 1–1.5 kcal/mL: 15%–20% protein and 50%–70% Protection ofCHO Supplement
the athlete’s healthhigh-energy
and awareness dietof (especially during heavy
level of concern supplement as:
supplement ready-to-drink liquid Low to moderate fat the potential for harm training/competition
must be paramount;orexpert weight gain)
Sports gel or sports Gel: 30–40 g sachets confectionery: Vitamins/minerals:
~25 g CHO per sachet or ~5 gmL
500–1000 CHO per confectionery
professional
supplies Carbohydrate
RDI/RDAs opinionLow-bulk meal intake
and assistance during
is strongly
replacement exercise pre-event
advised
(especially meal)other than tobacco, which is used in
‘…a product,
confectionery jelly-type confectionery (generally in piece before an athlete embarks on supplement use.
Postexercise recovery (CHO and protein) conjunction with a healthy diet and contains one or
pouch of ~40–50 g) Some contain caffeine or electrolytes Portable nutrition for busy schedule or travel more of the following dietary ingredients: a vitamin,
mineral, herb or other botanical, an amino acid, a
Electrolyte
Sports bar Powder sachets or tablets
Bar 50–60gmmol/L
40–50 CHO sodium Rapidsource
CHO rehydration
during following
exercise dehydrationdietary undertaken for
substance for use by man to supplement
replacement 10–20
5–10 g mmol/L
protein potassium weight-making
Postexercise recovery—provides CHO, protein the dietandby increasing the total daily intake, or a
supplements Typically,
Usually lowlow
in carbohydrate INTRODUCTION
fat and fibre (2–4 g/100Downloaded
mL) Replacement of large
micronutrients
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on March 15, losses
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Publishedultra-
concentrate, metabolite, constituent, extract, or
by group.bmj.com
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First,supplements
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activities
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levelsasor10.1136/bjsports-2018-099027
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► http://dx.doi.org/10.1136/
Note: may contain other ingredients,
of sport, reflectingRapid
some of which
the prevalence
postexercise of their use in the
rehydration following moderate to Consensus statement
bjsports-2018- 099199 wider society. About largehalf
fluidofand
thesodium
adult US popula- This definition is unsatisfactory, as it depends on
deficits
are not evidence-based and may increase the risk of
Protein supplement Powder (mix with water or milk) or contamination
ready-to-drink liquid
Provides 20–50 g protein in a single serve from high-
quality types of animal (whey, casein, milk, egg) or
IOC consensus statement: dietary supplements and
tion uses some form of dietary supplements,1 and whether or not a ‘healthy diet’ is consumed. For
Postexercise recovery following key training sessions or
although there are regional, cultural and economic the purposes of this overview, we define a dietary
events wherefood adaptation requiringprotein
proteintarget
synthesis is following:
Protein-enhanced food Milk, yoghurt, ice cream, cereal bars Increased protein content from normal food variety
differences, Value-added
a similar prevalence isable in many supplement
to achieve
likely foras the
Protein-rich
and bar,forms
other food usually low in CHO achieved
vegetableby(eg,
Note: may
Tosoy)
cite: origin
adding
Burke LM,
contain
Maughan RJ,
protein sources
Dvorak J,
otheroningredients,
or other countries.
filtration
et al. 15,some of
of
which
desired
postexercisethe high-performance athlete
Athletes describe
Achievement
use or to aimprove
of increase
range protein
in lean
of content
A food, of food
other component, nutrient, or non-food
diet compound thatoris purposefully ingested in addition
mass during growth
Downloaded from http://bjsm.bmj.com/ March 2018 - Published
different reasons meals by
for their group.bmj.com 2
water from product
Br J Sports Med Epub ahead andsupplement choices, and
snacks in an athlete’s
are not evidence-based and mayDayincrease the risk that
products of fit response 1 to resistance
the description training
of Burke, 2,3
‘supplement’ 4 5
Consensus statement
of print:
Typically allows
contamination
normal[please include
portion Ronald
to provide ~20 g J Maughan,
Portable
Louise
nutrition
Mfor busy
Jiri Dvorak, D Enetteconsumed
to the habitually Larson-Meyer,
diet with the aim of
protein to meetMonth Year]. doi:10.1136/
sports nutrition target Peter can target various 6,7roles within the athlete’s8 schedule
perfor- or travel
achieving
9 a specific health
10 and/or performance
11
Liquid meal
bjsports-2018-099027 mance Peeling,
plan.
Powder (mix with water or milk) or 1–1.5 kcal/mL: 15%–20% protein and 50%–70% CHO12 Supplement high-energy These Stuart
include M Phillips,
the maintenanceEric S Rawson,
of Neil
benefit. P Walsh, Ina Garthe,
CHO, carbohydrate. 13 diet (especially during heavy 3,14 1
supplement ready-to-drink liquid Low to moderate fat
Table 4 Nutritional supplements for immune health in athletes: proposed mechanism ofMaughan RJ,
Hans Geyer,
action and
Romain Meeusen,
training/competition or Lucas
weight J C
gain) van Loon, Susan M Shirreffs,
et al.evidence for2018;0:1–17.
Br15J Sports Med efficacy 16 doi:10.1136/bjsports-2018-099027
17 18 1
Vitamins/minerals: 500–1000 mL supplies
Copyright Evidence Article author
Lawrence
RDI/RDAs L Spriet, Low-bulk
(or their employer)
Mark
meal Stuart,
replacement Alan Vernec,
(especially Kevinmeal)
pre-event Currell, Vidya M Ali,19
Supplement Proposed mechanism of action for efficacy 20 2018. Produced by BMJ Publishing 22,23
(CHO and21protein)
Group Ltd under licence.
Richard GM Budgett, Postexercise recovery
Arne Ljungqvist, Margo Mountjoy, Yannis P Pitsiladis,19
immunity in Dthese scenarios
Vitamin and
This is an at other
essential times
fat-soluble when
vitamin knownthey are Moderate
to influence Supplements
support that assist 20an nutrition
Portable athletefor tobusy
train harder,
19 schedule recover20more
or travel
either susceptible to
Torbjørn Soligard, Uğur Erdener, Lars Engebretsen
Sports bar Bar infection
several aspects (eg,of immunity,
during particularly
the40–50 common ginnate
CHO immunitycold Evidence quickly and prevent
for deficiency in some athletes injury,
CHO andor
source accelerate
soldiers,
during particularlyreturn
exercise to play
in the winter (decreasedwhen
(eg, expression of antimicrobial proteins). Skin exposure to skin sunlight exposure)
season and after long-haul travel) or suffering5–10 from g proteinan infec- injury does occur can Postexercise
obviously recovery—provides
enhance the CHO, protein prepara-
athlete’s and
sunlight accounts for 90% of the source of vitamin For D.
numbered Deficiency
affiliations see has been
ABSTRACT associated with increased URS. good health by contributing to the required intake
tion. Table 4 summarises evidence for some ofUsually the low in fat
commonly and fibre
end of article. tion and,
Recommend 1000 indirectly,
IU/day
micronutrients
their
D3 autumn-spring competition
to
butmaintain outcomes. Many
sufficiency prod- the management of micro-
Nutrition usually makes a small for busy schedule oroftravel
potentially specific nutrients,
promoted ‘immune supportive’ supplements, Vitamins/minerals: noting that the 50%–100% of RDA/RDIs
uctssupport
Further claim to
required
valuable
98
provide
Portable
contributionbenefits to successful
nutrition
ofperformance
this nature; in elitetablenutrient
5 summarises
deficiencies, and the provision of energy
Note: may contain other ingredients,
Correspondence to some of which
most promising
Probiotics candidates to assist
Probiotics are livein the prevention
micro-organisms that when or treat-
administered
are not evidence-based
Professor Ronaldand
Moderate
the increase
may
J Maughan,
athletes,
support
evidence in
the risk forofsome of the most popular compounds. Finally,needs that might be difficult to
and
athletes dietary
with supplements
daily dose can
of ~10 make
10
a
live minor
bacteria and macronutrient
ment of upper respiratory symptoms
orally for several weeks arecan vitamin
increase the D numbers
andSchool probi-
ofof Medicine,Cochrane
St Andrewsreview contribution
of 12 studies to this(n=3720)
nutritionshows ~50%
programme. Nonetheless,
decrease in URS incidence achieve and ~2
through dayfood intake alone. Other specific
contamination
beneficial bacteria in the gut. These have beenUniversity, associated
the
shortening
St Andrews, UK;
manipulation
of supplement
URS; minor use
of widespread
body composition,
sideiseffects. at all levels of sport. including usesgaining lean reported by athletes include
of supplements
otics. Vitamin food C during periods of cereal
heavy barsexertion and zinc (muscle) mass and reducing
Protein-enhanced Milk, yoghurt,
with a rangeice cream,
of potential benefits Increased
to gut health, protein content
ronmaughan@
as well from
asst-andrews.
More normal
ac.uk food
evidence Products
is variety
requireddescribed
supportingas efficacybody
Value-added
supplements food
to target
reduce fat
able levels,
to achievecan
different
gastrointestinal protein contribute
direct
distress and for to enhancement or the indirect
target
performance
lozenges at the onset andofother
symptoms
food forms of may befunction.
useful, but high
achieved by addingdoses proteininfection,
sources or
forfiltration of (1) postexercise
athlete.23 use 99 or to improve protein content of other
modulation immune
Accepted 3 February 2018 performance issues, including
example, inin amanytravellingtheevents.
management This explains thebenefits
of micronutrient large that numberarise from the provision of support
of single antioxidants,
Vitamin C particularly
This is an essential vitamins C and
water-soluble water E,from
antioxidant may blunt Moderate support
product
vitamin deficiencies, (2) supply
for ‘preventing meals and snacks
of convenient
URS’ in an athlete’s
forms of energy anddiet for hard training, the manipulation of physique, the
20–22 of to‘weight gainers’ and ‘fat burners’ in the general and ofsports
exercise-induced training adaptations.
that quenches ROS and augments Typically
Probiotic allowssupple- Cochrane review of 5 studies in heavy exercisers (n=598) shows ~50% decrease in URS musculoskeletal pain, rapid recovery
immunity. It reduces normal portion macronutrients,
provide ~20 g and (3) provision of direct benefits to alleviation
protein todiarrhoea
meet sports nutrition supplement
vitaminperformance
target market, org/day). although
(4) indirect benefitsmany such as of these arefrom
supporting prohibited in
injury and enhancement of mood.
mentation may reduce interleukin-6 the incidence and cortisolof responses
travellers’ to exercise in humans. taking C (0.25–1.0
intense training regimens. The appropriate Some sporting in bodies now support the pragmatic
CHO, carbohydrate. sport.
Further support Protein
required is considered to be use theof some
premier ingredient
and gastrointestinal infection. Cochrane Downloadedreviews have noted the on March
from http://bjsm.bmj.com/ 15, 2018 supplements- Publishedcanadaptation by group.bmj.com
benefit theinathlete, but others may use of supplements that have passed a risk-ver-
low quality of many studies on nutritional supplements that are Relatively small weight
Unclear gain-promoting
if antioxidants blunt supplements,well-trained and evidence-based reviews
harm the athlete’s
effects on cortisol health,
comparedperformance, and/or livelihood
with carbohydrate; immunesus-benefit
measures noanalysis of being effective, safe and
claimedConsensus
to support immunity;statement specifically, small samples, poor different conclude fromand
that
placebo
protein
reputation is effective
(if an antidoping at promoting
rule violation results). A
25
lean
permittedmass for gain
use, while also being appropriate to
immunity in these scenarios and at other times
controls and unclear procedures for randomisation and blinding No support forbefore when they are when Supplements
combined
complete
‘treating URS’ that
with
nutritional assistresistive
assessmentan athleteexercise.
should beto train
undertaken Evidence
harder, the of efficacy
recover
athlete’s more
age and maturation in their sport. This
decisions regarding supplement use Caresupplementation
made. review summarises the issues faced by high-per-
either susceptible to
23 infection
24
Table 4 Nutritional supplements
were commonplace. Clearly, there (eg, during
for immune the common
health in athletes:
is a pressing need for cold quickly
for
Cochrane
proposed mechanism ‘fatreviews and
burning’ showprevent
no supplements
benefit injury,
of initiating
of action and evidence for efficacy or is accelerate
far
vitamin from return
conclusive, to
(>200 play
however,
mg/day)when
after onset of Supplements
URS. 100 101 claiming to directly or indirectly enhance formance athletes and their support team (coach,
season Supplement
randomised and controlled
after long-haul trials travel)
in high-level
Proposed
or suffering
mechanism athletes
of during
from an infec- Evidence
with sufficient
actionexercise, injury
and fordoes
there is aoccur
performance
efficacy completearecantypically obviously
absence
the largestof enhance
evidence
group of productstheforathlete’s
the prepara- physician) when considering
effectiveness
trainer, nutritionist,
Carbohydrate
tion. Table numbers, (drinks,
4 summarises It maintains blood
evidence for and glucose
some of the commonly lowers stress Low-moderate support
participant rigorous tion
of theand, vast indirectly,
marketed majority
to athletes, oftheir onlycompetition
butsupplementsa few (including outcomes.
marketed
caffeine, Many
inthethis
use prod- with the goal of providing
category.
of supplements,
gels)
Vitamin D This is ancontrols
hormones, essential countersprocedures,
and thusfat-soluble immune
vitamindysfunction.
known to appro-
influence Ingestion
Moderate of carbohydrate (30–60 g/hour) attenuates stress hormone and some, but not all,
support
promoted
priate ‘immune supportive’
supplementation regimens,
several
supplements,
aspects ofand immunity, clinically noting
particularly meaningful
that the immune
innate immunity Evidence for
creatine,
ucts perturbations
Table claim
6 deficiency
summarises specific buffering
to provide
during the
in someexercise. benefits
athletes
agents of
evidence andfor
and soldiers,
nitrate)
this somehave good
nature;
particularly of table information
thewinter
in the 5 (decreased
most summarises
common to assist them to make informed
most promising candidates to assistofin the prevention orexposure
treat-to Very evidence of benefits. However, responses are
25 affected19 102 decisions.
measures of immunity. (eg, expression antimicrobial proteins). Skin skinthe evidence
ingredients
limited
sunlight by theor
evidence
exposure) for
products
that
scenario some
this modifies
of use and of
of maythe
thisvary
infectionmost
type.risk in
widely popular
between compounds. Finally,
athletes
ment ofBovineupper respiratory
colostrum First symptoms
sunlight
milk accounts
of the cow forare
that vitamin
90%contains
of the source D ofand
antibodies, vitaminprobi-
growth D. Deficiency
Low-moderate hasindividuals
the manipulation been
support associated
that
because ofwith
bovine ofbodyincreased
colostrum
factors URS.
composition,
thatblunts
include thegenetics,
decreaseincluding gaining lean
thein saliva antimicrobial
otics. Vitamin
Maughan RJ, et al. BrCJ Sports
duringMed periods
2018;0:1–17.
factors of doi:10.1136/bjsports-2018-099027
and cytokines heavy exertion and zinc proteins Recommend after1000heavy IU/day
microbiome exercise D3 autumn-spring
and habitual to maintain sufficiency
diet. Supplements WHAT IS A SUPPLEMENT? 5
Claimed to improve
(muscle)
Further support mass
required and
98 reducing body fatintended
levels, can contribute
There no singleto
isURS definition, either legal or within
lozenges at the onset of symptoms maymucosal immunity
be useful, but andhigh increasedoses Some evidencetoinenhance small numbers
performance of participants
should be that bovinetrialled
thoroughly colostrum decreases
Probiotics resistance
Probiotics to areinfection
live micro-organisms that when administered Further performance
Moderate support
support
in required inor103many
in athletes
training
104
with daily
simulated
events.
dose of ~10
competition
This 10 explains the
before live bacteria
being used
large number
nutritional science, of what constitutes a dietary
of single antioxidants, particularly vitamins C and E, may blunt supplement. The
Polyphenols, for orally are
These for several weeks can increase
plant flavonoids. In vitro
20–22 the numbers
studies show strong of of ‘weight
Cochrane
Low-moderate review ofgainers’
insupport 12 studiesInadvertent
competition. and ‘fat
(n=3720) burners’
shows ~50%
ingestion in the
decrease
of substances in URS general
incidenceand day US Congress, for example, in
and ~2sports
exercise-induced training adaptations.
beneficial bacteria antioxidant Probiotic
in the gut. These have been supple-
associated Human shortening of prohibited
URS; minor side effects. framing the 1994 Dietary Supplement Health and
example, Quercetin anti-inflammatory, and antipathogenic supplement
studies show market,
some under thealthough
reduction antidoping
in URS during many
codes that of
shortgovern these
periods are
of intensifiedprohibited
training and in
Education
mentation may reduce effects. the a incidence
with range
Animalofdata of benefits
potential travellers’
to gut in diarrhoea
health, as well as mild Morestimulation
evidenceelite isof required
sport is asupporting riskefficacy
knownbiogenesis of taking to some
reduce gastrointestinal distress and in small(DSHEA; https://ods.od.nih.gov/
Act
indicate an increase mitochondrial
sport.for Protein mitochondrial
istravelling
considered and
23 to besupplements.
endurance
theperformance,
premierAbout/ although
ingredient
DSHEA_Wording. in aspx), described a dietary
and gastrointestinal infection. modulation
biogenesis Cochrane
of immune
and endurance reviews
function.
performance. have noted the numbers infection,of example,
untrained inofa the
Protectionsubjects. athlete’s athlete. 99
health and awareness of
weight gain-promoting supplements, supplement
and evidence-based reviews as:
low qualityVitaminofC many studies This ison nutritional
an essential supplements
water-soluble antioxidant vitaminthat are Limited Moderate influence the potential
support onformarkers for of
‘preventing harm URS’must
immunity be paramount; expert
claimed to support immunity; that quenches ROS and augments
specifically, smallimmunity. It reduces
samples, poor Cochrane conclude
Putative review that
professional
antiviral effect
of 5 studiesprotein
for opinion
Quercetin and
in heavy is exercisers
effective
assistance is
(n=598)at promoting
strongly advised
shows ~50% decrease lean inmass
‘…a URS gainthan tobacco, which is used in
product, other
105 106
interleukin-6 and cortisol responses to exercise in humans. Further when
taking support
vitamin before
Crequired
combined an athlete
(0.25–1.0 with
g/day). embarks on supplement
resistive exercise. use. 25 Evidence conjunction with a healthy diet and contains one or
of efficacy
controlsZincand unclear procedures for randomisation
This is an essential mineral that is claimed to reduce
and blinding Further
No support
support required URS’ more of the following dietary ingredients: a vitamin,
were commonplace.23 24incidence Clearly, there ofis colds. a pressing need for High for ‘fatforburning’
‘preventing
supplements is far from conclusive, mineral,however,
herb or other botanical, an amino acid, a
and duration Zinc is required for DNA Uncleardosesif antioxidants blunt adaptation
of zinc can decrease immuneinfunction well-trainedand should be avoided.
and there isfora‘treating
complete absence dietary substance for use by man to supplement
randomised controlled trials synthesisin andhigh-level
as an enzyme athletes
cofactor withfor immune sufficient
cells. Relatively
Moderate small
support effects on cortisol URS’ compared withof evidenceimmune
carbohydrate; for the effectiveness
measures
the dietno by increasing the total daily intake, or a
participant numbers, rigorous Zinc deficiencycontrolsresults inand procedures,
impaired immunity (eg,appro- lymphoid Cochrane of the
different vast
review
from shows
placebo majority
INTRODUCTION benefit ofof zincsupplements
acetate lozenges (75 marketed
mg) to decrease in concentrate,
this category.
duration of metabolite, constituent, extract, or
priate supplementation atrophy) regimens, and zinc deficiency is not uncommon in athletes. URS;
and clinically meaningful NoTable however,
support zinc
6forDietary must
‘treating
summarises be taken <24
URS’
supplements theare hours
usedafter
evidence
24
onset
for
by athletes ofatURS
some for
of
all levelsduration
the of coldcommon
most only. of these ingredients’.3
combinations
► http://dx.doi.org/ Side effects
Cochrane
10.1136/ include
reviews
of sport, badreflecting
show taste
no and the
benefit nausea.
of initiating
prevalence vitamin
of theirC supplementation
25 use in the (>200 mg/day)
measures of immunity. ingredients
after
bjsports-2018-099199 onset of URS.100 or101products of this type. This definition is unsatisfactory, as it depends on
Glutamine This is a non-essential amino acid that is an important Limited support wider society. About half of the adult US popula-
1
Carbohydrate (drinks, energy substrate
It maintains bloodforglucose
immune cells,exercise,
during particularly lymphocytes.
lowers stress Low-moderatetion
Supplementation uses some
before
support form
and after of dietary
exercise supplements,
does not alter immuneand whether or not a ‘healthy diet’ is consumed. For
perturbations.
Maughan RJ, et al. Br J Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027 of this5 overview, we define a dietary
gels) Circulating
hormones, glutamine is lowered
and thus counters after prolonged
immune exercise
dysfunction. Some
Ingestion evidence although
of carbohydrate there
of a reduction areURS
in
(30–60 regional, culturalstress
afterattenuates
g/hour) endurance and economic
events and the
in competitors
hormone purposes
receiving
some, but not all,
and very heavy training. glutamine differences,
supplementation
immune perturbations during exercise.a similar
(2×5 g) prevalence is likely in many supplement as the following:
To cite: Maughan RJ,
Mechanism other countries. Athletes describe 107 108 19 102
a range of
Burke LM, Dvorak J, et al.limited for
Very therapeutic
evidence that thiseffect requires
modifies investigation.
infection risk in athletes
2 A food, food component, nutrient, or non-food
Caffeine
Bovine colostrum This
Firstismilk
a stimulant
of the cowfound
thatincontains
a varietyantibodies,
of foods and
Br J drinks
growthSports Med EpubLimited
aheadsupport
Low-moderate different
support thatreasons
bovineforcolostrum
their supplement
blunts thechoices,
decrease and compound that is purposefully ingested in addition
in saliva antimicrobial
(eg, coffee
factors andandcytokines of print: [please include
sports drinks). Caffeine is an adenosine Evidence
proteins that products
Day after caffeine
heavy that fit the description
supplementation
exercise of ‘supplement’
activates lymphocytes and attenuatesto the habitually
the fall in consumed diet with the aim of
Month Year]. doi:10.1136/ can target variousofroles within the
receptor
Claimed antagonist
to improve and immune
mucosal cells express
immunity adenosine
and increase
bjsports-2018-099027
neutrophil
Some evidence function afternumbers
in small exercise participants thatathlete’s perfor- decreases
bovine colostrum achieving
URS a specific health and/or performance
receptors.
resistance to infection Efficacy mance
for altering
Further support URS
required
plan.
in 104
103 These remains
athletes includeunknown.
the maintenance
109 110 of benefit.

Echinacea
Polyphenols, for This
Theseis aare
herbal
plantextract claimed to enhance
flavonoids. In vitro immunity
studies show strongvia Limited
Low-moderatesupportsupport Maughan RJ, et al. Br J Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027 1
example, Quercetin stimulatory effects on
anti-inflammatory, macrophages.
antioxidant There is some
and antipathogenic in vitro Early
Copyright Human
Article human
studiesstudies
author indicated
show(orsome possible
reduction
their in beneficial
employer) URS during
2018. effects,
short but more
periods
Produced recent,
ofby larger
intensified
BMJ scale and Group Ltd under licence.
training
Publishing
evidence for this.
effects. Animal data indicate an increase in mitochondrial and mildbetter controlled
stimulation studies indicate
of mitochondrial no effect
biogenesis andofendurance
Echinacea performance,
on infection incidence
although or cold
in small
111 112
biogenesis and endurance performance. symptom
numbers of severity.
untrained subjects.
Omega-3 PUFAs Found in fish oil Limited influence
support for onblunting
markersinflammation
of immunity and functional changes after muscle-damaging
May influence immune function by acting as a fuel, in their eccentric Putative antiviral
exerciseeffect and no evidence of reducing URS in athletes113 114
for Quercetin
in humans
role as membrane constituents or by regulating eicosanoid Further support required105 106
Zinc formation, for example,
This is an essential prostaglandin
mineral that is claimed to reduce No support for ‘preventing URS’
Prostaglandin
incidence and isduration
immunosuppressive.
of colds. Zinc is required for DNA High doses of zinc can decrease immune function and should be avoided.
Claimed
synthesistoand exert
as anti-inflammatory
an enzyme cofactoreffects postexercise
for immune cells. Moderate support for ‘treating URS’
Vitamin E An
Zincessential fat-soluble
deficiency results inantioxidant vitamin that
impaired immunity quenches
(eg, lymphoid No supportreview shows benefit of zinc acetate lozenges (75 mg) to decrease duration of
Cochrane
exercise-induced
atrophy) and zincROS and augments
deficiency immunity in athletes.
is not uncommon Immune-enhancing effects
URS; however, zinc must beintaken <24
the frail elderly but no
hours after benefit
onset in young,
of URS healthy
for duration of humans
cold only.
One
Side study
effectsactually
includeshowed that
bad taste andvitamin
nausea. E 24supplementation increased URS in those under
Glutamine This is a non-essential amino acid that is an important heavy
energy substrate for immune cells, particularly lymphocytes. High
exertion.
Limited support
doses may be
Supplementation pro-oxidative.
before
115 116
and after exercise does not alter immune perturbations. 22
Circulating glutamine is lowered after prolonged exercise Some evidence of a reduction in URS after endurance events in competitors receiving Continued
and very heavy training. glutamine supplementation (2×5 g)
107 108
 11/5/19

Recuperación de Glicógeno

Wilmore y Costill, 1994

CHOs post esfuerzo

23
 11/5/19

NUTRITIONAL SUPPLEMENTATION AFTER EXERCISE

ignificantly lower during the CHO-Pro

mpared with the HCHO and LCHO treat-
0, 180, 210, and 240 min. There were no
plasma lactate between HCHO and
ents at any time point during recovery.
sma insulin levels did not differ at any
eatments (Fig. 4B). After ingestion of the
ent, insulin levels rose significantly and
a plateau until the second supplement
Insulin levels then increased during the
declined steadily thereafter.
asma glucose declined during exercise
mol/l for each treatment (Fig. 4C). Within
ingestion of the first supplement, blood
sed significantly regardless of the treat-
. However, the increase was significantly
the HCHO and LCHO treatments than Fig. 3. Percent recovery of depleted glycogen stores of the vastus
-Pro treatment. Blood glucose during the lateralis from 0 to 40, 40 to 120, and 120 to 240 min of recovery.
ment remained significantly elevated Initial and postexercise muscle glycogen stores were not different
O-Pro treatment through the first 3 h of among treatments.
ilar results were found when comparing J Appl Physiol 93: 1337–1344, 2002.
First published July 12, 2002; 10.1152/japplphysiol.00394.2002.

and LCHO treatments, except that blood

ot different between these treatments at but during this time the
Early postexercise muscleplasma glycogenconcentration
recovery is of nor-
covery. epinephrine declined. During recovery,
enhanced with a carbohydrate-protein supplement there was a
ferences in plasma FFA occurred during rapid decline in epinephrine back to baseline values
overy for the three treatments (Fig. 5A). within 30JOHN
min, L. IVY,whereas 1
norepinephrine
HAROLD W. GOFORTH,
3
JR., BRUCE M. DAMON, approached
2
THOMAS R. M CAULEY,
3
3
C
3

EDWARD C. PARSONS, AND THOMAS B. PRICE

increased significantly during exercise.
precipitously during the first 60 min of
hen continued declining at a slower rate,
line values by 180 min of recovery.
baseline more
Exercise slowly.
1
Physiology and Metabolism Laboratory, Department of Kinesiology and Health
Education, University of Texas at Austin, Austin, Texas 78712; 2Department of Biology,
Point Loma Nazarene University, San Diego, California; and 3Department of Diagnostic
DISCUSSION
Radiology, Yale University School of Medicine, New Haven, Connecticut 06510
Received 3 May 2002; accepted in final form 2 July 2002
24
In the present study, the addition of a CHO-Pro
Ivy, John L., Harold W. Goforth, Jr., Bruce M. the greater the return of performance capacity. In
 11/5/19

Figure 2-Muscle glycogen concentration immediately after (0), 8 and 24 h post-exercise with
immediate feeding (IT) or following a 2-h delay (DT)(
Muscle glycogen storage following
prolonged exercise: effect of timing of
ingestion of high glycemic index food

PARKIN, JO ANN M.; CAREY, MICHAEL F.;

MARTIN, IVA K.; STOJANOVSKA, LILLIAN;
FEBBRAIO, MARK A.

Medicine & Science in Sports &

Exercise29(2):220-224, February 1997.

doi:

N = 6). a indicates difference(P < 0.01) from

0 h; b indicates difference(P < 0.01) from
24 h.

Copyright © 2018 by the American College of Sports Medicine 50

25
 11/5/19

Chapter 8
The Regulation and Synthesis of Muscle Glycogen by
Means of Nutrient Intervention
t h e r e g u l a t i o n a n d s y n t h eJOHN
s i L.sIVYo f m u s c l e g ly c o g e n 117
Exercise Physiology and Metabolism Laboratory, Department of Kinesiology and Health Education,
University of Texas, Austin, TX, USA

final 3 days, the carbohydrate content of the diet was 120

Introduction the muscle glycogen concentration is substantially
increased to 70%. Sherman et al. (1981) found that reduced or depleted (Hultman, 1967).
100
Glycogen is a branched polymer of glucose, stored

(µmol/g wet wt/24 h)

Because of the importance of muscle glycogen
this regimen raised muscle glycogen stores in excess predominately in the skeletal muscle and liver,

of 200 μmol/g wet wt similar to the more stringent
protocols previously used, but without the risk of
muscle soreness or injury. Therefore, these results
Glycogen stored
as a fuel source, considerable research has been
although other tissues such as brain and adipose
conducted to determine how it is synthesized and
80
can store glycogen. The basic polymerization of gly-
cogen is via α-1,4-glycosidic linkages between glu-
regulated, and how best to increase its rate of recov-
ery when depleted. Early research also investigated
cose residues, with branch points introduced by the
60
occurrence of α-1,6-glycosidic linkages about every
means of raising the muscle glycogen stores above
normal levels, or glycogen supercompensation, in
six to seven glucose residues. This creates a com-
pact molecular structure referred to as a β-particle
preparation for endurance competitions such as a

suggest that in preparation for competition, and 40

when time permits, athletes can substantially raise
their muscle glycogen stores with a normal training
taper and only small modification to their diets.
Daily Replenishment of Muscle
in mammalian muscle and as an α-particle in liver.
marathon. The current chapter begins with a brief
discussion of the structure of glycogen and its regu-
Glycogen stored in the liver provides a carbo-
lation. Next, protocols for glycogen supercompen-
hydrate reserve for blood glucose whereas muscle
20
glycogen serves as a major fuel source for muscle
sation are reviewed, followed by means of insuring
muscle glycogen replenishment from one day to
work. Although muscle glycogen represents less
than 4% of total energy storage in the body, it is the
the next. Since many athletes are involved in mul-
0 tiple training sessions and competitive events on
most important fuel source during prolonged exer-
0 2 4
cise of moderate to high intensity, high intensity6 8
the same day, the final topic discussed is nutritional
10 12 14
interventions that maximize the rate of muscle
interval exercise, and resistance exercise. Supporting
glycogen synthesis during the hours immediately
the importance of muscle glycogen are early CHO ingested
following exercise. The chapter concludes with rec-
research findings demonstrating that the capacity
(g/kg body mass/day)
ommendations for increasing and maintaining mus-
for prolonged strenuous exercise is directly related
to the pre-exercise muscle glycogen concentration,
cle glycogen stores for training and competition.

Glycogen Stores that perception of effort during prolonged exercise

Figure 8.2 Muscle glycogen storage
Glycogen during theand
Formation
parallels the declining muscle glycogen stores, and first
Structure
24 hours after exercise when different
The initial amounts
that strenuous exercise cannot be maintained once of of a glycogen
step in the formation
During periods of intense training or consecutive carbohydrate are ingested. (Studies
particle is glycosylation of glycogenin on a tyros-
analyzed
ine residue. Glycogenin are Blomdiphosphate
is a uridine et
days of competition, it can be difficult for the athlete al.,
Sports 1987a;
Nutrition, Burke
1st Edition. et
Edited by al.,
Ronald 1995,
J. Maughan. 1996, 1993; Costill et al., 1981,
(UDP)-glucosyltransferase that sits at the core of
the glycogen particle. The current model for glyco-
© 2014 International Olympic Committee. Published 2014 by

to maintain muscle glycogen stores from one day to 1990;

John Wiley &Keizer
Sons, Ltd. et al., 1987; Parkin genin et al., 1997;
action Piehl, 1974;
is for self-glycosylation within a dimer,

the next. Unless sufficient carbohydrate is ingested,
muscle glycogen will not be normalized on a day-
to-day basis when training bouts are repeated daily.
This was first demonstrated by Costill et al. (1971).
They had runners train by completing 16.1 km runs
on a treadmill at 80% VO2 max on three consecu-
tive days while consuming a low carbohydrate diet.
By the third day, glycogen stores were significantly
below baseline levels and several of the runners
were unable to complete their 16.1 km runs. Similar
results were found by Sherman et al. 122 (1993).chapter
They 8wt when providing 10 g of carbohydrate/kg body
fed cyclists and distance runners either low or high
carbohydrate diets composed of 5 or 10 g of carbo-
hydrate/kg body mass, respectively, during 7 days
of controlled training. The low carbohydrate diet
Sherman et al., 1983; and Starling et al., 1997).
113 Sports Nutrition, 2014
et al. (1997) reported a 24-hour glycogen storage
rate of ~77 μmol/g wet wt/day when 10 g carbo-
hydrate/kg body mass/day were ingested follow-
ing exercise, but a rate of only 8 μmol/g wet wt/day
when 2.0 g carbohydrate/kg body mass were pro-
vided. Burke et al. (1993) reported the highest rates
of glycogen synthesis during a 24-hour period after
exercise, with rates in excess of 100 μmol/g wet
mass/day. To achieve this rate of synthesis, how-
ever,6 a high-glycemic carbohydrate had to be used.
Nevertheless, these results a indicate that the amount
of muscle 5 glycogen stored following exercise is
b
Skeletal muscle glycogen

resulted in a significant 30% decrease in muscle gly- directly related to the amount of carbohydrate b con-
4
cogen by the fifth day of training, but no decrease in sumed. Consumption of 10 g carbohydrate/kg body
(mg/g muscle)

muscle glycogen occurred in the athletes provided mass/day 3

appears, c however, to maximizec storage
with high carbohydrate diet. rate at ~100 μmol/g wet wt/day (Figure 8.2).
When attempting to replenish muscle glycogen As2 suggested d by Burke et al. (1993), the type of
stores during the 24-hour period after exercise, the carbohydrate ingested may be of significance. Costill
1
amount of carbohydrate to consume is likely the et al. (1981) found that when runners received either
most important consideration (Figure 8.2). Costill et 650 0g/day of starch or simple carbohydrate, glyco-
al. (1981) found that muscle glycogen storage during gen storage Immediaterates were similar over the first 24 hours
2 h post-ex
post-ex
a 24-hour recovery period increased as the amount of recovery. During Glucose Glucose the next 24 hours,
Glucose Glucose muscle
Glucoseglyco-
of carbohydrate consumed increased. Consumption gen storage was 22.1WPH μ+ mol/g WP
+
wet wt
BCAA
+
for +
the
CH
starch
of 2.3, 4.6, 6.5, and 7.8 g carbohydrate/kg body diet and only 7.8 μmol/g wet wt for the simple
Figure 8.4 Muscle glycogen content immediately after exercise and after 2 hours of recovery grouped according to
mass/day resulted in a glycogen storagethe differentrate carbohydrate
ofsupplements
types of ingested (n = 8diet. per group). Burke Valueset area1.
means (1993),
± SEM. Mean however,
values within a column
0, 25, 55, and 70 μmol/g wet wt/day, withrespectively. found
unlike superscript letters are signifi thatcantly during
differentthe (p < fi rst Supplement
0.05). 24 hoursabbreviationsafter exercise, are WPH, a whey protein
hydrolysates; WP, whey protein; BCAA, branched-chain amino acids; CH, casein hydrolysates. From Morifuji et al. (2010),
In agreement with Costill et al. (1981), diet incorporating
Starling from Springer
with kind permission Science+Business Media. high glycemic carbohydrates was

stores following supplementation with whey or
BCAA. Supplementing with casein hydrolysates
plus glucose provided no additional benefit to
glycogen storage beyond that of glucose alone
(Figure 8.4).
The reason for the improved glycogen storage
efficiency with carbohydrate–protein supplemen-
tation is not known. Although an increase in the
plasma insulin response is typically observed when
protein or amino acids are added to a carbohydrate
supplement (van Loon et al., 2000; Zawadzki et al.,
1992), this increase does not always correspond with
an increase in muscle glycogen synthesis (van Loon
the absence of insulin (Doi et al., 2005; Kleinert
Sports Nutrition, 2014
et  al., 2011). Also, they have been found to func-
tion additively with insulin to stimulate these pro-
cesses (Kleinert et al., 2011). It, therefore, seems
possible that by co-ingesting a carbohydrate–
protein supplement, muscle glucose transport and
glycogen synthesis can be activated by two separ-
ate signaling pathways resulting in a more efficient
conversion of the carbohydrate portion of the
supplement to glycogen.
26
The Addition of Caffeine
 11/5/19

Enjuague bucal con CHO

27
 11/5/19

Requerimientos

Análisis de ingestas de H.C. 


(1971-99)

Atletas de Resistencia

Hombres (n = 503) 7.29 gm CHO/kg 49% E

Mujeres (n = 293) 5.38 gm CHO/kg 50% E

Atletas otros deportes

Hombres 5.71g CHO/kg 44% E

Mujeres 4.87 g CHO/kg 49% E

Burke, L. et al (2001)

28
 11/5/19

120
Depósitos Glucógeno Muscular (mm/kg.)

100

80

60

40

20

2 4 6 8 10 12 14
Ingesta CHO en 24 hrs. (grs. * kg. peso)

Australian Institute of Sport - 2000

29
 11/5/19

Jeukendrup, Asker. Carbohydrate Intake during exercise and performance.

Nutrition 20: 669- 677, 2004

Recomendaciones Ingesta CHO

para Atletas

Tipo de Situación Recomendación

Actividad Situación Crónica Situación Crónica

Ligera Actividades de Baja Intensidad o Trabajo técnico (deporte) 3 – 5 gr.* kg peso

Programas de Ejercicios Moderada Intensidad

Moderada 5 - 7 gr. * kg. peso
Ej: entrenamiento 1 hora al día

Programas de Resistencia
Alta 6 – 10 gr. * kg. peso
Ej: entrenamiento 1-3 horas al día

Entrenamientos Alta Intensidad

Muy Alta Ej: ejercicios de moderada a alta intensidad 8 – 12 gr. * kg. peso
Entrenamientos > 4-5 horas al día

Burke, L. (2014) Sports Nutrition

Burke, L. Carbohydrates for training and competition. 2011

30
 11/5/19

Ejercicio

Comienzo del Fin del

entrenamiento entrenamiento

Recuperación

106 chapter 7

Table 7.3 2010 IOC guidelines for carbohydrate intake in the training diet

Preparación para TipoCarbohydrate

de EJercicio Comments on type and timing of
el entrenamiento óSituation targets
Duración carbohydrate intake
competencia
TOTAL Intensidad
DAILY NEEDS FOR FUEL AND RECOVERY
• When it is important to train hard or with high intensity, daily carbohydrate intakes should match the fuel needs of
training and glycogen restoration
• These general recommendations should be fine-tuned with individual consideration of total energy needs, specific
training needs, and feedback from training performance Hidratos
Hidratos Hidratos
• Since training commitments change due to periodization Carbono
in sport, an athlete’s daily carbohydrate intake should also
De De
be varied y
Carbono Carbono
Light • Low intensity or skill-based 3–5 g/kg of athlete’s Proteínas
• Intake may be timed to provide fuel
activities body mass (BM)/ intake around training sessions in the day.
day Otherwise, as long as total fuel needs are
Moderate • Moderate exercise program 5–7 g/kg/day provided, the pattern of meals/snacks
(i.e., ~1 h/day) may simply be guided by convenience
High • Endurance program (e.g., 6–10 g/kg/day and individual choice
1–3 h/day moderate high • Carbohydrate foods or meal combinations
intensity exercise) that are protein and nutrient rich will
allow the athlete to meet other acute or
Very high • Extreme commitment (i.e., 8–12 g/kg/day
chronic sports nutrition goals
>4–5 h/day moderate high
intensity exercise

SPECIAL TIMING OF INTAKE TO SUPPORT KEY TRAINING SESSIONS

• Consuming carbohydrate around key training sessions to include pre-workout intake, and refueling during and after
the session is likely to enhance performance and recovery
• A focus on eating around training sessions helps the athlete to automatically match their energy and carbohydrate
intake with changing needs
Pre-exercise 1–4 g/kg consumed 1–4 h before training • Timing, amount, and type of carbohydrate
fueling foods and drinks should be chosen to suit
individual preferences/experiences
• It may be useful to experiment with
intended competition practices in some
training sessions to fine time plans
Refueling during 45–75 min duration Small amounts • Even when supplementary muscle fuel is
training throughout training not needed, the brain responds to mouth
(including “mouth contact with carbohydrate; the athlete may
rinsing”) feel better and train harder. This may be
useful if the athlete is “training low” with
low muscle carbohydrate stores
1–2.5 h 30–60 g/h • Practicing with intended competition
intake strategies will allow the plan to be
fine tuned and for the athlete to adapt to it
2.5–3 h Up to 90 g/h • As for events of 1–2.5 h
(when simulating optimum • Products providing multiple transportable
competition practices and/or carbohydrates (Glucose:fructose mixtures)
to support high daily energy will achieve high rates of oxidation of
needs) carbohydrate consumed during exercise
Post-exercise 1–1.2 g/kg/h in first hour • Nutrient-dense forms of carbohydrate
(especially when (i.e., carbohydrate-rich foods and food
there is <8 h combinations that also provide protein
recovery between and micronutrients) can promote other
fuel-demanding goals of recovery as well as nutritional
sessions) goals for overall health and well-being
Source: From Burke et al. (2011).

31
 11/5/19

Sobrecarga de Hidratos de Carbono

Objetivos:

• Consumir desde 4 horas antes de la actividad

4 – 5 gr. * kg. Peso

• 1 hora antes de la actividad

1 – 2 gr. * kg. Peso

• 1 hora después de la actividad

1 – 2 gr. * kg. Peso

Williams, Melvin Rev. Nutrición para la salud, la Condición Física y el Deporte

Carbohidratos
Individuo Tipo 70 kilos
Recomendación Antes (1 hora antes)

1 gr. H.C. x kg. peso = 70 gramos

(500 cc.)

ó = 36 gramos

= 30 gramos

32
 11/5/19

Alimentación e Hidratación
Durante el Ejercicio

1 gr. H.C. x kg. peso = 70 gramos

(600 cc.)
150 - 200 ml
cada 15 a 20 minutos
ó
Aproximadamente
1 botella por hora
+

+ 2 unidades por hora

Actividad Física y Salud

Hidratación con diferentes bebidas y su incidenc
rendimiento en un raid de spinning de 2 hor
Hydration with different beverages and their impact on per
in a raid of two hours of spinning

Actividad Física y Salud 1

2
Cancino López, J.1; Rodríguez Salas, Díaz Aguilera, L.2; Campos Valenzuela, M. J.

Facultad de Ciencias de la Actividad Física y la Salud, Universidad de las Américas, Chile

Gimnasio, Club Arena, Chile

Hidratación con diferentes bebidas y su incidencia en el Direc

CONCLUSIONES
rendimiento en un raid de spinning de 2 horas
En un raid de spinning de dos horas, consumir una be- lorado a través de la distancia recorrida, en comparación
Jorge Cancino López: jorg
Fecha de recepción: 30
Hydration
bida con hidratos de carbono mejora el desempeño, with de
va- a la ingesta different
agua. beverages and their impact on performance Fecha de aceptación: 1

in a raid of two hours of spinning

Líquido ingerido Distancia

Cancino López, J.1; Rodríguez Salas, Díaz Aguilera, L.2; Campos Recorrida
Valenzuela, M. J. 2

1
Facultad de Ciencias de la Actividad Física y la Salud, Universidad de las Américas, Chile p<0,05
* RESUMEN
2
Gimnasio, Club Arena,* Chile
p<0,05 p<0,05
2500 * El Spinning es una actividad que se realiza sobre una bicicleta estática al ritmo de la mús
50 tipo de actividades no está relacionada con el rendimiento deportivo, y debido a la n
2000 bicicletas empleadas, se desconoce aspectos como la potencia, velocidad o distancia
Dirección de contacto
clase o raids de mayor duración. Por otra parte, la hidratación durante la actividad física
Jorge Cancino López: jorgecancino@vtr.net
importante sobre todo cuando se desarrollan actividades de más de una hora de dura
1500 Fecha de recepción: 30 de marzopósito
de 2008
de esta investigación el cuantificar el rendimiento a través de la distancia recorrid
ml

Fecha de aceptación: 16 octubrespinning

de 2008de dos horas de duración y determinar el efecto de la hidratación con diferente
km

1000 40
el rendimiento. 10 sujetos (5 hombres y 5 mujeres) fueron sometidos a 4 raid de dos ho
espaciados por 7 días cada uno. Bebieron ad libitum; agua, bebida con carbohidratos
500 saborizante y nuevamente agua. La distancia recorrida promedio de los 4 raids fue de
La distancia recorrida para el primer raid fue de 40,62±4,37 km, para el segundo raid fu
0 km, para el tercer raid fue de 42,34±4,66 km, para el cuarto raid fue de 40,93±3,97 km.
1er Ride 2° Ride 3er Ride 4° Ride significativa entre el 1er y 2° raid (p<0,05) y entre el 2° y 4° raid (p<0,05). No hubo diferen
30
1er Ride 2° Ride 3er Ride en 4° la frecuencia cardiaca promedio de los 4 raids. En conclusión, en un raid de spinnin
Ride
Figura. 1 Líquido ingerido durante los 4 raids de Spinning consumir una bebida con hidratos de carbono mejora el desempeño, valorado a travé
recorrida, en comparación a la ingesta de agua.
RESUMEN Figura 3. Distancia recorrida durante los 4 raids de Spinning
El Spinning es una actividad que se realiza sobre una bicicleta estática al ritmo de la música. Si bien, este
Palabras claves: Spinning, raid, hidratación, escala de Borg, distancia recorrida, frecuen
tipo de actividades no está relacionada con el rendimiento deportivo, y debido a la naturaleza de las
bicicletas empleadas, se desconoce aspectos como la potencia, velocidad o distancia recorrida en una
clase o raids de mayor duración. Por otra parte, la hidratación durante la actividad física es unAño VII - VOLUMEN VII Nº 14
elemento
importante sobre todo cuando se desarrollan actividades de más de una hora de duración. Fue el pro-
pósito de esta investigación el cuantificar el rendimiento a través de la distancia recorrida en un raid de
spinning de dos horas de duración y determinar el efecto de la hidratación con diferentes bebidas sobre
el rendimiento. 10 sujetos (5 hombres y 5 mujeres) fueron sometidos a 4 raid de dos horas de spinning
ndi e espaciados
de er e pori n 7de días cada
ueruno.
o Bebieron ad libitum; agua, bebida con carbohidratos (6%), agua con
saborizante y nuevamente agua. La distancia recorrida promedio de los 4 raids fue de 42,05±1,68 km.
La distancia recorrida
p<0,05 para el primer raid fue de 40,62±4,37 km, para el segundo raid fue de 44,31±4,02
*
km, para el tercer raid fue de 42,34±4,66 km, para el cuarto raid fue de 40,93±3,97 km. Hubo diferencia
1 * p<0,05
significativa entre el 1er y 2° raid (p<0,05) y entre el 2° y 4° raid (p<0,05). No hubo diferencia significativa
en la frecuencia cardiaca promedio de los 4 raids. En conclusión, en un raid de spinning de dos horas,
15
consumir una bebida con hidratos de carbono mejora el desempeño, valorado a través de la distancia
14 recorrida, en comparación a la ingesta de agua.

33
13
Palabras claves: Spinning, raid, hidratación, escala de Borg, distancia recorrida, frecuencia cardiaca
12
11
Año VII - VOLUMEN VII Nº 14 59
10
 11/5/19

Índice glicémico

Carga Glicémica

CG=(IG*gHC)/100

34
 11/5/19

SCHOLARLY REVIEWS

International Journal of Sport Nutrition and Exercise Metabolism, 2010, 20, 154-165
© 2010 Human Kinetics, Inc.

Downloaded by New York University on 09/17/16, Volume 20, Article Number 2

Glycemic Index and Endurance Performance

156
Carolyn M. Donaldson, Tracy L. Perry, and Meredith C. Rose

The aim of this review is to provide an up-to-date summary of the evidence surrounding glycemic index (GI)
and endurance performance. Athletes are commonly instructed to consume low-GI (LGI) carbohydrate (CHO)
before exercise, but this recommendation appears to be based on the results of only a few studies, whereas
Table 1 Studies of Glycemic Index
others have and Preexercise
found that the GI CHOof CHO ingested 1 hr before
ingested or Lessexercise
Before Exercise
has no impact on performance. Only 1 study
was designed to directly investigate the impact of
Participant the of
Timing GI of CHO ingested during exercise on Performance endurance per-
Study characteristics
formance. Although the results indicate that GI is not as important asresponse
Exercise protocol CHO feeding feeding Metabolic consuming CHO itself, more response
research in
Thomas et al., 8 trained male Cycled to exhaus- Lentils (LGI), potato (HGI), 60 min LGI produced lower glucose and insulin Time to exhaustion
1991 cyclists
this area is clearly
tion at 65–70%
needed. Initial research investigating
glucose, or water; CHO-con- before exer-
the impact of GI on postexercise
response at rest but higher blood glucose
recovery indicated
longer with LGI
consuming high-GI (HGI)
VO2max CHO
taining increased
foods muscle
fed to provide cise glycogenconcentration
resynthesis. However,
and higher recent studies indicate an
FFA concentra-
interaction between LGI 1CHO g CHO/kgand fat oxidation, which may play
tions at thea end
role in enhancing performance in subse-
of exercise.
Thomas, Broth- 6 trained male exercise.
quent Cycled to Despite
exhaus- Potato
the flakes
fact (HGI),
that therice 60 min between
relationship BothGILGIandfoodssporting
produced lower glucose
performance No difference
has in time
been a topic
erhood, & cyclists tion at 65–70% cereal (HGI), lentil flakes before exer- and insulin response at rest but higher blood to exhaustion
Miller, 1994 of research for more than(LGI),
VO2max 15 yr,branthere
cereal is no consensus
(LGI), cise on whether consuming
glucose concentration and CHO of differing
higher FFA con- GI improves
endurance performance. Until furtherfoods
CHO-containing well-designed
fed to research is carried
centration out,ofathletes
at the end exercise. are encouraged to follow
provide 1 g CHO/kg
standard recommendations for CHO consumption and let practical issues and individual experience dictate
Febbraio & 6 endurance- Cycled at 70% Lentils (LGI), instant 45 min HGI produced higher blood glucose 15 min No difference in total
Stewart, 1996 the
trained men use of HGI or LGI
VO2peak for 120 meals and supplements
mashed potato (HGI), diet before, during,
before exer- and after exercise.
postingestion, but blood glucose concen- work performed in
min, followed by jelly (control), CHO-con- cise tration was not different at any other time 15-min performance
Keywords: carbohydrate,
15 min at maxi- exercise,
taining nutrition
foods fed to provide point. trial
mum work output 1 g CHO/kg
Sparks, Selig, & 8 male triath- Cycled at 70% Lentils (LGI), instant 45 min HGI produced significantly higher blood No difference in total
Febbraio, 1998 letes VO2peak for 50 min, mashed potato (HGI), non- before exer- glucose levels 30 and 15 min after ingestion work performed in
Researchfollowed
in thebyearly
15 min1980s demonstrated
carbonated diet soft drinkthat con-
cise calbuteffect CHO
significantly hadblood
lower on glucose
actuallevels
blood 15-min
glucose and insulin
performance
suming carbohydrate
at maximum work(CHO)(control),
couldCHO-containing
improve exercise response (Jenkins
10 and 20 min after theet al., 1981).
initiation The trial
of exercise. GI classifies CHO-
capacity during outputprolonged bouts foods fedof
to provide
exercise1 g (Coyle rich foods based on their postprandial blood glucose
CHO/kg
DeMarco, ettrained
10 al., 1983). Sinceat 70%
male Cycled then, research hasmilk,
Cornflakes, investigated
banana themin
30 response
HGI producedcompared
significantlywith a reference
higher blood foodto(usually
Time exhaustion white
Sucher, Cisar, & optimal amount,
cyclists VO2maxtype, and timing
for 2 hr (HGI), of CHOapple
All-Bran, to maximize
and before exer- bread
glucoseorlevels
a glucose solution;
15 min after ingestion.Jenkins
LGI et al., 1981).trial
in performance The GI
Butterfield, 1999 followed by perfor-
endurance performance. The yogurt
early(LGI),
1980s water (con-heralded
also cise is also produced blood
calculated glucose levelsthe
by measuring higher longer with
incremental LGI
area under the
mance-trial cycling trol), CHO-containing meals than control at this time point. Blood glu-
the introduction of VO
at 100% the2maxconcept
to ofprovide
fed to glycemic index (GI)
1.5 g CHO/kg blood glucose
cose levels responselower
were significantly curve (IAUC) after the ingestion
than
as a means of classifying CHO (Jenkins et al., 1981).
exhaustion ofcontrol
a reference
in both LGIfoodand HGI containing
15 min after 50 g of available CHO
the initiation of exercise. After 120 min of
However, it was not until the early 1990s that GI was and a test food also containing
exercise blood glucose concentrations were
50 g of available CHO.
first investigated for its potential role in optimizing sport The reference
significantly higherfood is usually tested two or three times in
in LGI.
performance (Thomas, Brotherhood, & Brand, 1991). each individual (FAO/WHO, 1998). The response to the
(continued)
Although CHO feeding before, during, and after recovery test food is then expressed as a percentage of the mean
SCHOLARLY REVIEWS
is now generally accepted as a means of improving endur- response to the reference food in the same participant
ance performance, the role of high-GI (HGI) and low-GI (Wolever, Jenkins,
International Journal of Jenkins, &and
Sport Nutrition Josse, 1991).
Exercise The2010,
Metabolism, GI20,value
154-165
(LGI) foods in sport nutrition is still being debated. Taken for a© food is based
2010 Human Kinetics,onInc.the mean GI value tested in 10–12

together, the reviews of Burke, Collier, and Hargreaves individuals (FAO/WHO, 1998).
(1998), Siu and Wong (2004), and Wright (2005) provide
a comprehensive overview of the first 14 years of research GI = glucoseIAUC test food ÷ glucoseIAUC reference
in this area. The aim of the current review is to provide a Glycemic × 100 Index and Endurance Performance
follow-up, up-to-date summary of the evidence regarding
GI and endurance performance. Essentially, the GI is designed to indicate the overall
Carolyn M. Donaldson, Tracy L. Perry, and Meredith C. Rose
rate of digestion and absorption of the CHO in a food.
Downloaded by New York University on 09/17/16, Volume Foods
20, Articlewith
The
Number an
aim2 ofHGI (>70)is are
this review generally
to provide digested
an up-to-date and of the evidence surrounding glycemic index (GI)
summary
GI absorbed andquickly,
endurance whereas foods
performance. with are
Athletes an commonly
LGI (<55) are to consume low-GI (LGI) carbohydrate (CHO)
instructed
digestedbefore exercise, but
and absorbed this slowly.
more recommendation appears to be based on the results of only a few studies, whereas
For a comprehensive
GI was first introduced as a concept in response to others have found that the GI of CHO ingested before exercise has no impact on performance. Only 1 study
list of up-to-date GI values of common foods the reader
was designed to directly investigate the impact of the GI of CHO ingested during exercise on endurance per-
research that suggested that CHO-exchange lists used is directed to Atkinson,
formance. AlthoughFoster-Powell,
the results indicateandthatBrand-Miller
GI is not as important as consuming CHO itself, more research in
by patients with diabetes did not reflect the physiologi- (2008). The GI of
this area a foodneeded.
is clearly can be Initial
influenced byinvestigating
research the physical the impact of GI on postexercise recovery indicated
and chemicalconsuming high-GI (HGI)ofCHO
characteristics the increased
food muscle glycogen resynthesis. However, recent studies indicate an
(Foster-Powell,
interaction between LGI CHO and fat oxidation, which may play a role in enhancing performance in subse-
The authors are with the Dept. of Human Nutrition, University Holt, & quent
Brand-Miller, 2002),the
exercise. Despite and although
fact an individual’s
that the relationship between GI and sporting performance has been a topic
of Otago, Dunedin, New Zealand. glycemic of response
research forcan be than
more highly variable
15 yr, there is(Venn & Green,
no consensus on whether consuming CHO of differing GI improves
endurance performance. Until further well-designed research is carried out, athletes are encouraged to follow
standard recommendations for CHO consumption and let practical issues and individual experience dictate
the use of HGI or LGI meals and supplements before, during, and after exercise.
Table 1 (continued)
154 Keywords: carbohydrate, exercise, Performance
nutrition
Participant Timing of
Study characteristics Exercise protocol CHO feeding feeding Metabolic response response
Febbraio, 8 endurance- Cycled at 70% Muesli (LGI), instant 30 min HGI produced
Research significantly higher
in the early blooddemonstrated
1980s No difference in total
that con- cal effect CHO had on actual blood glucose and insulin
Keenan, Angus, trained men VO2peak for 120 mashed potato (HGI), diet before exer- glucose
sumingconcentration
carbohydrate10, 20,(CHO)
and 30 min work performed
could improve exercisein response (Jenkins et al., 1981). The GI classifies CHO-
Campbell, & min, followed by jelly (control), CHO-con- cise after consumption
capacity duringand prolonged
significantly lower 30-min performance
bouts of exercise (Coyle rich foods based on their postprandial blood glucose
Garnham, 2000 30 min at maxi- taining foods fed to provide blood glucose
et al., concentrations
1983). Since then, 15 research
and 30 minhas trial
investigated the response compared with a reference food (usually white
mum work output 1 g CHO/kg after the initiation of exercise.
optimal amount, type, and timing of CHO to maximize bread or a glucose solution; Jenkins et al., 1981). The GI
Garcin, Bresil- 10 endurance- Cycled at 80% Glucose (HGI), whole- Ingested HGI produced aperformance.
endurance decrease in blood
Theglucose Notalso
early 1980s measured
heralded is calculated by measuring the incremental area under the
lion, Piton, & trained male VO2max for 60 min wheat biscuit (LGI), water every 30 concentration 30 min after
the introduction initiation
of the concept of of glycemic index (GI) blood glucose response curve (IAUC) after the ingestion
Peres, 2001 triathletes (placebo), CHO-containing min for 3 hr, exercise (blood glucose levels not measured
as a means of classifying CHO (Jenkins et al., 1981). of a reference food containing 50 g of available CHO
foods fed to provide 0.3 g up until 10 before exercise).
CHO/kg min before
However, it was not until the early 1990s that GI was and a test food also containing 50 g of available CHO.
exercise first investigated for its potential role in optimizing sport The reference food is usually tested two or three times in
performance (Thomas, Brotherhood, & Brand, 1991). each individual (FAO/WHO, 1998). The response to the
Kirwan, 6 active men Cycled at ~60% Whole-grain rolled oats 45 min HGI produced higher blood glucose con- Time to exhaustion
O’Gorman, et VO2max until (MGI) or puffed rice (HGI) before exer-
Although CHO feeding before, during, and after recovery
centration 15, 30, and 45 min after ingestion ~23% longer in MGI
test food is then expressed as a percentage of the mean
al., 2001 exhaustion each with 300 ml of water, cise is now generally
compared with control accepted
and 45 minas aafter
means of improving endur-and
trial than control response to the reference food in the same participant
or water alone ance performance, the role
ingestion compared with MGI. MGI pro- of high-GI (HGI) and low-GI
5% longer in HGI (Wolever, Jenkins, Jenkins, & Josse, 1991). The GI value
(LGI)
duced foods
higher in sport
blood nutrition
glucose is still
than control at beingthan
debated.
control;Taken
no dif- for a food is based on the mean GI value tested in 10–12
15 together,
and 30 min.theAtreviews ofexercise
the start of Burke, HGICollier, ference
and Hargreaves
between HGI individuals (FAO/WHO, 1998).
(1998),higher
produced Siu and Wong
blood (2004),
glucose and Wrightand
than control, (2005)
MGI provide
butaatcomprehensive
60 and 90 min MGI overview of the
produced first 14 years of research
higher GI = glucoseIAUC test food ÷ glucoseIAUC reference
in this
blood area.than
glucose TheHGIaimorof the current review is to provide a
control. × 100
Moore, Midg- 10 trained 40-km time trial Bran flakes, semiskim milk, 45 min HGIfollow-up,
produced up-to-date
higher bloodsummary
glucose and of the evidence regarding
Time trial on average
ley, Thurlow, cyclists and water (LGI) or corn- before exer- GI and
insulin endurance
concentration 45performance.
min after ingestion, 3 min faster after con-
Essentially, the GI is designed to indicate the overall
Thomas, & flakes, semiskim milk, and cise but blood glucose concentrations were not sumption of LGI than rate of digestion and absorption of the CHO in a food.
McNaughton, in water (HGI) different during exercise. with HGI Foods with an HGI (>70) are generally digested and
press GI absorbed quickly, whereas foods with an LGI (<55) are
digested and absorbed more slowly. For a comprehensive
Note. CHO = carbohydrate; VO2max = maximal oxygen uptake; LGI = low glycemic index; HGI = high glycemic index; FFA = free
GIfatty
wasacids; VO2peak
first = peak oxygen
introduced as uptake; MGI = in
a concept medium glycemic
response toindex. list of up-to-date GI values of common foods the reader
research that suggested that CHO-exchange lists used is directed to Atkinson, Foster-Powell, and Brand-Miller
by patients with diabetes did not reflect the physiologi- (2008). The GI of a food can be influenced by the physical
and chemical characteristics of the food (Foster-Powell,
The authors are with the Dept. of Human Nutrition, University Holt, & Brand-Miller, 2002), and although an individual’s
of Otago, Dunedin, New Zealand. glycemic response can be highly variable (Venn & Green,
157

154

35
 11/5/19

Sports Med
DOI 10.1007/s40279-016-0632-8

SYSTEMATIC REVIEW

Effect of Glycemic Index of a Pre-exercise Meal on Endurance

Exercise Performance: A Systematic Review and Meta-analysis
Catriona A. Burdon1,2 • Inge Spronk3 • Hoi Lun Cheng1,4,5 • Helen T. O’Connor1,6

C. A. Burdon et al.

Study n ES (95% CI) p value

TT (no CHO during exercise)
! Springer International
] 8 29Switzerland
Publishing - -
2016 )
] 10 29 - - )
Abstract ] 14 31 (- ) using an adapted version of the validated Downs and Black
Background] Low glycemic 13 index56 -(GI) pre-exercise
- )
meals tool. Effect size (ES) and 95 % confidence interval were
Pooled effect
may(no CHO)endurance performance
enhance - by maintaining
- )
eug- calculated for each study and pooled according to perfor-
lycemia and altering fuel utilization. However, evidence mance test type and whether exogenous carbohydrate
TT (CHO forduring exercise)benefits is equivocal.
performance (CHO) was given during exercise. Potential effect modi-
Objective To ] evaluate the effect
40 of -a low GI - (LGI) versus) a fiers including exercise duration, pre-exercise meal timing,
high GI (HGI) pre-exercise meal on endurance perfor- -
glycemic -load (GL), and fitness were assessed using meta-
mance using meta-analyses. regression. Favors HGI
Methods Data sources included MEDLINE, SPORTDis- Results The search netted 3431 citations with 19 studies
cus,vs.
Fig. 2 Forest plot showing HGI AUSPORT, AusportMed,
LGI pre-exercise Web ofon
meal effects Science, and Sco-
pooled eligible
effect from for inclusion
studies without CHO(totaling 188 participants;
ingestion 91 %
during exercise.
pus.without
performance in time trials (TT) Eligibility
(n =criteria weresquares)
4; white randomized,
and crossover trials
CHO carbohydrate, male;CIVO 2max: [50interval,
confidence ml/kg/min). Meals withES0.18–2
Diff, difference, effectg
with (n = 1; gray square) CHOwith an endurance
ingestion exercise (C60
during exercise. Studiesmin)
arecomponent,
size, GLe.g., CHO/kg
glycemic load, body
HGI mass, and a mean
high glycemic GI and
index, LGIglycemic load of
low glycemic
time trial (TT),
arranged according to GL differences timethe
between to HGI
exhaustion
and LGI (TTE) test,indexor sub- 82 (GL: 72) and 35 (GL: 32) for HGI and LGI, respec-
maximal
meals and size varies with subject bout followed
number. Diamondbyrepresents
TT or TTE. theParticipants were tively, were given between 30 and 210 min before
healthy, active individuals aged C16 years. Interventions exercise. All test types without CHO ingestion during
included a LGI (B55) and HGI (C70) meal ingested exercise showed slightly improved performance with
Study 30–240 min before exercise. n Study qualityESwas (95% CI)
assessed pLGI,
valuebut no significant pooled effects were observed
Submax+TT (no CHO during exercise) (ES: -0.17 to -0.36; p [ 0.05). Studies where exoge-
Febbraio ] 8 20 (- ) nous CHO was ingested during exercise showed con-
& Helen T.] O’Connor 8 36 - - flicting results (ES: -0.67 to 0.11; p = 0.04 to 0.94). No
Febbraio helen.oconnor@sydney.edu.au
] 6 - - ) significant relationship was observed with any of the
1
Discipline] of Exercise and Sport
8 Science,
38 -Faculty-of Health ) effect modifiers (p [ 0.05). No consistent metabolic
] The University of8Sydney,
Sciences, 4175 East
- Street,
- ) responses (glucose, insulin, lactate, respiratory exchange
Hulton Lidcombe, ] Sydney, NSW 2141,
8 Australia
52 - - ) ratio) during exercise were observed with either meal
Pooled effect
2
(no CHO)
School -
of Medicine, University of Wollongong, -
Wollongong, ) type. C. A. Burdon et al.
NSW, Australia Limitations There were small numbers of studies within
Submax+TT 3
(CHO during exercise) each exercise testing protocol and limited statistical power
Wageningen University, Wageningen, The Netherlands
Study ] n 9 43 ES (95% (- CI) p) value
within studies. Pre-exercise meal timing, GL, meal com-
] Department of Adolescent
8 (- ) position and participant fitness varied across studies, lim-
4
Academic Medicine, The
TT (no CHO during
Children’s
]exercise)
Hospital at Westmead, Westmead, Sydney, NSW,
6 (- ) iting the capacity to assess the influence of these factors on
Australia
Pooled effect
5
(with CHO) ] 8 29 - - (- ) ) study outcomes.
Discipline of Child and Adolescent Health, Sydney Medical
] 10 29 - -
School, The University of Sydney, Westmead, Sydney, NSW,
) -
Conclusion - There was no clear benefit of consuming a LGI
Australia ] 14 31 (- ) Favors HGI
pre-exercise meal for endurance performance regardless of
6 ]
Charles Perkins 13The University
Centre, 56 - of Sydney, - ) carbohydrate ingestion during exercise.
Fig. 3 Forest plot Pooled
showingeffect
HGI (no
vs. CHO)
LGI pre-exercise
Camperdown,
Sports Med meal
Sydney, NSW, - on -
effects
Australia ) with subject number. Diamonds represent the pooled
size varies
performance in submaximal exercise plus time trial (submax ? TT)
DOI 10.1007/s40279-016-0632-8 effects from studies without and with CHO ingestion during exercise.
studies without (nTT =(CHO during
6; white exercise)
squares) and with (n = 3; gray CHO carbohydrate, CI confidence interval, Diff, difference, ES effect
squares) CHO ingestion during E M]A T I CStudies
S Y S Texercise. REVIEW 40 arranged
are - - 123
size, GL )glycemic load, HGI high glycemic index, LGI low glycemic
according to GL differences between the HGI and LGI meals and index - -
Favors HGI
Effect
to 17.1 %. One study [31] of aGlycemic
provided CHO drink Index
during ofperformance
a Pre-exercise
patterns Meal on Endurance
with varying GL. This is consistent
Fig. 2 Forest plot showing HGI vs. LGI pre-exercise meal effects on pooled effect from studies without CHO ingestion during exercise.
exercise (consistent
performance with
in time trials Exercise
the
(TT) GI value
without Performance:
of4;the
(n = pre-test
white meal),
squares) A Systematic
and with
CHO carbohydrate,Review
results from CIthe and interval,
Meta-analysis
meta-regression
confidence (Fig.
Diff, 5) where
difference, no
ES effect
and(nfound
with a significant
= 1; gray square) CHO7.7 ingestion
% performance benefitStudies
during exercise. after the
are association was load,
size, GL glycemic observed between
HGI high performance
glycemic index, LGI loweffect and
glycemic
1,2 • 3 • 1,4,5 • 1,6
LGI meal
arranged (ES:to -0.49;
according 95 % A.between
GL differences
Catriona CI -0.97
Burdon to Spronk
the Inge
HGI -0.02;
and meal
LGI Hoi Lun GL differences
indexCheng Helen T. across the studies (coefficient: 0.01;
O’Connor
meals and sizeOnly
p = 0.04). varies with
one subject
study usednumber. Diamond
a submax ? TTE represents the
protocol standard error: 0.01; p = 0.31). Similarly, no significant
[37], which reported significantly better performance after relationships were found for pre-exercise meal timing (co-
consumption of Study
a LGI meal. This contrasted with n the cal- ES (95% CI) 0.00;
efficient: p value
standard error: 0.00; p = 0.38) and partici-
Submax+TT
culated effect size (no CHOaduring
which showed exercise) 36.1 %
non-significant pant fitness (coefficient: -0.01; standard error: 0.03;
improvement inFebbraio
performance after] the LGI 8 meal20 (ES: (-p = 0.74),) even when studies without CHO provision during
] 8 36 - -
-0.67, 95 % CI -1.57 to! 0.23;
SpringerpInternational
= 0.13).Publishing Switzerland 2016 exercise were analyzed independently (data not shown).
Febbraio ] 6 - - )
] 8 38 - - )
3.6 Potential Effect Modifiers:
Abstract ]Glycemic Load, 8 41 - -3.7 Metabolic Responses
) using During
an adapted version Exercise
of the validated Downs and Black
Pre-exercise Hulton Background
Meal Timing, ] Low
and glycemic8 index52(GI) -pre-exercise
Fitness - meals ) tool. Effect size (ES) and 95 % confidence interval were
Pooled effect (no CHO)
may enhance endurance performance -
by -The response
maintaining eug- ) calculated for each
of thetestmetabolic
study and pooled according to perfor-
lycemia and altering fuel utilization. However, evidence mance type and variables during exercise
whether exogenous is
carbohydrate
Submax+TT
Qualitative evaluation of for(CHO
forest during(Figs.
plots
performance exercise)
2,is3,equivocal.
benefits 4), where summarized (CHO)
in Tablewas 3. Allduring
given studies measured
exercise. Potentialblood
effect glu-
modi-
] 9 43 (- )
studies were arranged fromObjective
lowest To to evaluate
highest the
GLeffect of a low GI (LGI)
differences versus
cose fiers including
anda observed exercise
normal duration,
values at pre-exercise
rest prior meal timing,
to meal
high GI ](HGI) pre-exercise 8 meal on endurance(- perfor- ) glycemic load (GL), and fitness were assessed using meta-
between the HGI and LGI meals,] showed no6 consistent (-consumption. )
mance using meta-analyses. regression.
Pooled effect (with CHO)
Methods Data sources included MEDLINE,(-SPORTDis- ) Results The search netted 3431 citations with 19 studies
cus, AUSPORT, AusportMed, Web of Science, and Sco- - for- inclusion (totaling 188 participants; 91 %
eligible
123 pus. Eligibility criteria were randomized, crossover trials Favors HGIMeals with 0.18–2 g
male; VO2max: [50 ml/kg/min).
with an endurance exercise (C60 min) component, e.g., CHO/kg body mass, and a mean GI and glycemic load of
Fig. 3 Forest plot showing HGI vs.trial
time LGI(TT),
pre-exercise
time to meal effects(TTE)
exhaustion on sizeorvaries
test, sub- with subject
82 (GL: 72) number.
and 35 (GL:Diamonds
32) for represent
HGI and LGI, the respec-
pooled
performance in submaximal exercise
maximalplusbouttime trial by
followed (submax
TT or ? TT)Participants
TTE. effectswere
from studies
tively,without and with
were given CHO ingestion
between 30 and during
210 min exercise.
before
studies without (n = 6; white squares)
healthy, active and with (n
individuals = 3;
aged C16gray CHO carbohydrate,
years. Interventions CI confidence
exercise. interval,
All test types withoutDiff,CHO
difference,
ingestionES during
effect
squares) CHO ingestion during exercise.
included a LGI Studies
(B55) and are HGI
arranged
(C70) meal size, GL glycemic
ingested load, showed
exercise HGI high glycemic
slightly index, LGI
improved low glycemic
performance with
according to GL differences between
30–240 min thebefore
HGI and LGI Study
exercise. meals quality
and was index
assessed LGI, but no significant pooled effects were observed
(ES: -0.17 to -0.36; p [ 0.05). Studies where exoge-
to 17.1 %. One study [31] provided a CHO drink during performance nous CHO was ingested during exercise showed con-
patterns with varying GL. This is consistent
& Helen T. O’Connor flicting results (ES: -0.67 to 0.11; p = 0.04 to 0.94). No
exercise (consistent with the helen.oconnor@sydney.edu.au
GI value of the pre-test meal), with results significant
from therelationship
meta-regression
was observed (Fig. with
5) where
any of nothe
and found a significant 7.71 % performance benefit after the association was effectobserved
modifiers between
(p [ 0.05).performance
No consistenteffect and
metabolic
Discipline of Exercise and Sport Science, Faculty of Health
LGI meal (ES: -0.49; 95 % CI -0.97 to -0.02;
Sciences, The University of Sydney, 75 East Street,meal GL responses
differences (glucose,
across insulin,
the lactate,
studies respiratory
(coefficient: exchange
0.01;
Lidcombe, Sydney, NSW 2141, Australia ratio) during exercise were observed with either meal
p = 0.04). Only one study used a submax ? TTE protocol standard error: type.
0.01; p = 0.31). Similarly, no significant
2
School of Medicine, University of Wollongong, Wollongong,
[37], which reported significantly better performance after
NSW, Australia
relationships Limitations
were found forwere
There pre-exercise
small numbers meal timingwithin
of studies (co-
consumption of a LGI meal. 3 This contrasted
Wageningen with the The
University, Wageningen, efficient: 0.00;
cal-Netherlands eachstandard error:protocol
exercise testing 0.00; andp =limited
0.38)statistical
and partici-
power
culated effect size which 4showed
Academic a Department
non-significant 36.1
of Adolescent % Thepant fitness within
Medicine,
studies. Pre-exercise
(coefficient: -0.01; meal timing, GL,
standard error:meal0.03;
com-
position and participant fitness varied across studies, lim-
improvement in performance afterHospital
Children’s the atLGI meal
Westmead, (ES: Sydney,
Westmead, p= 0.74), even
NSW,
itingwhen studies
the capacity without
to assess CHO provision
the influence during
of these factors on
Australia
-0.67, 95 % CI -1.57 to5 0.23; p = 0.13). exercise werestudy analyzed
outcomes.independently (data not shown).
Discipline of Child and Adolescent Health, Sydney Medical
School, The University of Sydney, Westmead, Sydney, NSW, Conclusion There was no clear benefit of consuming a LGI
3.6 Potential Effect Modifiers:
6
Pre-exercise Meal Timing,
Australia
Glycemic Load,
Charles Perkins Centre, The University of Sydney,
and Fitness
3.7 Metabolic pre-exercise meal for endurance performance regardless of
Responses During Exercise
carbohydrate ingestion during exercise. 36
Camperdown, Sydney, NSW, Australia
The response of the metabolic variables during exercise is
 11/5/19

Sports Med
DOI 10.1007/s40279-016-0632-8

SYSTEMATIC REVIEW

Effect of Glycemic Index of a Pre-exercise Meal on Endurance

Exercise Performance: A Systematic Review and Meta-analysis
Catriona A. Burdon1,2 • Inge Spronk3 • Hoi Lun Cheng1,4,5 • Helen T. O’Connor1,6

Effect of Glycemic Index of a Pre-exercise Meal on Endurance Performance

St u d y n ES (95% CI) p value

TTE (no CHO during exercise)
]
! Springer International 6
Publishing 43
Switzerland (-
2016 )
] - - )
] 8 56 - - )
Abstract using an adapted version of the validated Downs and Black
Pooled effect (no CHO) - - )
Background Low glycemic index (GI) pre-exercise meals tool. Effect size (ES) and 95 % confidence interval were
Submax+TTE
may(no CHO during
enhance exercise)
endurance performance by maintaining eug- calculated for each study and pooled according to perfor-
DeMarco lycemia and altering
] 10utilization.- However,
fuel - )
evidence mance test type and whether exogenous carbohydrate
for performance benefits is equivocal. (CHO) was given during exercise. Potential effect modi-
TTE (CHOObjective
during exercise)
To evaluate the effect of a low GI (LGI) versus a fiers including exercise duration, pre-exercise meal timing,
Reljic high GI (HGI)] 34 meal
pre-exercise 9 on - endurance
- -
perfor- ) glycemic load (GL), and fitness were assessed using meta-
mance using meta-analyses. -
regression.-
Methods Data sources included MEDLINE, SPORTDis- Results The search netted Favors HGI
3431 citations with 19 studies
cus, AUSPORT, AusportMed, Web of Science, and Sco- eligible for inclusion (totaling 188 participants; 91 %
Fig. 4 Forest plot showing HGIpus.vs.Eligibility criteria were
LGI pre-exercise meal randomized,
effects on crossover
represents male; VO
trialsthe pooled effect [50 studies
2max:from ml/kg/min).
withoutMeals
CHO with 0.18–2 g
ingestion
with (TTE)
performance in time to exhaustion an endurance exercise
trials without (n =(C60 min) component,
3; white e.g.,
during exercise. CHO/kg body mass, andCI
CHO carbohydrate, a mean GI and interval,
confidence glycemic Diff,
load of
squares) and with (n = 1; graytime trial (TT),CHO
square) time ingestion
to exhaustion (TTE) test,
during or sub-ES effect
difference, 82 (GL: 72) GL
size, and glycemic
35 (GL: 32) forHGI
load, HGI high
and LGI, respec-
glycemic
exercise. Studies are arrangedmaximal
according bout
to followed by TT or
GL differences TTE. Participants
between index, LGIwerelow tively,
glycemic were
indexgiven between 30 and 210 min before
the HGI and LGI meals and sizehealthy, activesubject
varies with individuals
number.aged C16 years. Interventions
Diamond exercise. All test types without CHO ingestion during
included a LGI (B55) and HGI (C70) meal ingested exercise showed slightly improved performance with
30–240 min before exercise. Study quality was assessed LGI, but no significant pooled effects were observed
-0.17 to -0.36; p [ 0.05). Studies where exoge-
3.7.1 No Carbohydrate (CHO) Consumed During Exercise HGI and LGI(ES: trials for circulating insulin, blood lactate,
nous CHO was ingested during exercise showed con-
& Helen T. O’Connor
FFA, RER, or CHO
flicting and(ES:
results fat-0.67
oxidation
to 0.11; during
p = 0.04 exercise
to 0.94). No
Of the 14 studies that did nothelen.oconnor@sydney.edu.au
provide CHO during exercise, [31–35]. One significant
study by relationship
Reljic et al. wasreported
observedhigher
with any blood
of the
seven reported no difference 1 in blood glucose between the glucose levels effect
during modifiers
exercise (p [ 0.05).
after theNoLGI consistent
meal metabolic
[31].
Discipline of Exercise and Sport Science, Faculty of Health
responses (glucose, insulin, lactate, respiratory exchange
HGI and LGI trials, six found lowerSciences,blood glucose
The University of with a 75
Sydney, HGIEast Street,
Lidcombe, Sydney, NSW 2141, Australia ratio) during exercise were observed with either meal
meal at some point during exercise,
2
and one reported superior 3.8 Methodological type. Quality
School of Medicine, University of Wollongong, Wollongong,
blood glucose maintenance with a LGI meal. Circulating
NSW, Australia Limitations There were small numbers of studies within
insulin was measured in 133 studies,
Wageningenwith 11 reporting
University, no dif-
Wageningen, Methodological
The Netherlands
eachquality
exerciseoftesting protocol andstudies
the included limited statistical
was mixed power
within studies. Pre-exercise meal timing, GL, meal com-
ference between the trials,4 and two Department
Academic (both with a short Medicine,
of Adolescent pre- The (Table 4). Studies scored an average of 14 points out of 21
Children’s Hospital at Westmead, Westmead, Sydney, NSW,
position and participant fitness varied across studies, lim-
exercise meal timing of 30 Australiaand 45 min) showing higher (range 11–17), itingwith excellent
the capacity reporting
to assess of some
the influence of these items.
factors on
insulin in the first 20 min5 ofDiscipline
exercise after the HGI meal Reporting of study
of Child and Adolescent Health, Sydney Medical
participant
outcomes.description, adverse events, and
[37, 44]. A total of 12 studies School,
measured blood oflactate.
The University Ten of Sydney,
Sydney, Westmead, actual Conclusion
NSW, probability There was no clear benefit
values was poor. Only four of consuming a LGI
Australia pre-exercise meal for endurance performance regardless of
these showed no difference6 between the HGI and LGI trials, [16, 22, 40, 48] of the 19 studies blinded participants to the
Charles Perkins Centre, The University of Sydney, carbohydrate ingestion during exercise.
one reported higher levels throughout
Camperdown, exercise after
Sydney, NSW, a HGI
Australia meal, 12 [16, 22, 30, 32, 33, 37–41, 45, 48] to exercise
meal [22], and one found significantly higher lactate at the performance as an outcome, and six [22, 31, 32, 38, 40, 45]

En resumen
beginning and mid-way through exercise on the HGI trial [16].
Free fatty acid (FFA) concentration was measured in nine
studies, with three finding no difference between trials; the
remaining six observed lower FFA with a HGI meal
throughout or at some point during exercise.
Respiratory exchange ratio (RER) was measured in 12
blinded researchers. Two [33, 40] studies verified compli-
123
ance with pre-trial instructions; however, another nine
[22, 30, 32, 34, 39, 41, 44, 45, 47] reported checking
compliance but did not report results. Confounding factors
(glucose tolerance, pre-trial diet, and exercise control) were
generally well controlled for, although only four studies

• El uso de carbohidratos durante el ejercicio se ha

studies; four reported no difference between trials. Six
studies observed higher and two observed lower RER
screened for glucose tolerance. Only three studies were
adequately powered [16, 37, 45].

extendido por casi 100 años.

throughout or at some point during exercise after a HGI
meal. Carbohydrate and fat oxidation were measured in 11
4 Discussion
and 10 studies respectively, with four reporting no differ-
• La ingesta previa de carbohidratos
ence in oxidation rates of either fuel. Higher CHO oxida-
tion in five and lower CHO oxidation in two studies were
no parece influir
This is the first systematic review with meta-analysis
negativamente en el rendimiento
observed during the HGI trial. Fat oxidation was lower in
four and higher in two studies after the HGI meal.
durante la
evaluating the impact of the GI of a pre-exercise meal on
endurance performance. The review demonstrates no sig-
competencia.
3.7.2 CHO Consumed During Exercise
nificant ergogenic benefit of a LGI over a HGI pre-exercise
meal. This was the case regardless of whether exogenous

•TheElfive studies
usowherede CHO wascarbohidratos deblood bajo IG secretion,
no FFAhaoxi-
CHO was consumed during exercise. Metabolic responses
given as a part of the including glucose and insulin

demostrado, salvo situaciones en las que no se

performance test protocol found no differences between dation and RER were inconsistent between studies. Despite

cuenta con carbohidratos durante el ejercicio, 123 ser

mejor que los de alto IG

37
 11/5/19

En resumen
• El consumo de carbohidratos durante el ejercicio puede
oscilar según duración e intensidad del ejercicio entre
30 – 90 g/h.
• La combinación de carbohidratos puede incrementar la
oxidación exógena durante el ejercicio,
• La reposición de carbohidratos luego del ejercicio
ayuda a reponer las reservas de glicógeno y debe ser
inmediatamente terminado el ejercicio, si se requiere
una rápida reposición.
• La adición de proteínas luego del ejercicio mejora la
reposición de glicógeno.

En resumen
• Atletas que son “peores” oxidadores de grasa
podrían requerir cantidades mayores de
carbohiratos durante el ejercicio que aquellos que
oxidan más grasa durante el ejercicio.

38
 11/5/19

Carbohidratos y Ejercicio

Magister Ciencias Salud y el Deporte: Entrenamiento Deportivo

Dr. Jorge Cancino L. PhD
jcancino@uft.cl

Avda. Pedro de Valdivia 1509

Providencia, Santiago
+56 2 2420 7100
www.finis terrae.cl

39