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No Placebo Effect from Carbohydrate Intake during Prolonged Exercise

Carl J. Hulston and Asker E. Jeukendrup

The purpose of this study was to investigate the possibility of a placebo effect from carbohydrate (CHO) intake during prolonged exercise. Ten endurance-trained male cyclists performed 3 experimental trials consisting of 120 min of steady-state cycling at 61% VO2max followed by a time trial (TT) lasting approximately 60 min. During exercise participants ingested either plain water (WAT), artificially colored and flavored water (PLA), or a 6% carbohydrate-electrolyte solution (CES). PLA and CES were produced with identical color and taste. To investigate the possibility of a placebo effect from CHO intake, participants were told that both flavored solutions contained CHO and that the purpose of the study was to compare CHO drinks with water. Mean power output during TT was 218 ± 22 W in WAT, 219 ± 17 W in PLA, and 242 ± 27 W in CES. Performance times were 66.35 ± 6.15, 65.94 ± 5.56, and 59.69 ± 2.87 min for WAT, PLA, and CES, respectively. Therefore, CES ingestion enhanced TT performance by 11.3% compared with WAT (p < .05) and 10.6% compared with PLA (p < .05), with no difference between PLA and WAT. In conclusion, during a prolonged test of cycling performance, in which participants were not fully informed of the test conditions, there was no placebo effect when participants believed they had ingested CHO. In contrast, the real effect of CHO intake was a 10.6% improvement in TT cycling performance.

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Carbohydrate Ingestion Improves Performance of a New Reliable Test of Soccer Performance

Kevin Currell, Steve Conway, and Asker E. Jeukendrup

The aim of the study was to investigate the reliability of a new test of soccer performance and evaluate the effect of carbohydrate (CHO) on soccer performance. Eleven university footballers were recruited and underwent 3 trials in a randomized order. Two of the trials involved ingesting a placebo beverage, and the other, a 7.5% maltodextrin solution. The protocol comprised a series of ten 6-min exercise blocks on an outdoor Astroturf pitch, separated by the performance of 2 of the 4 soccer-specific tests, making the protocol 90 min in duration. The intensity of the exercise was designed to be similar to the typical activity pattern during soccer match play. Participants performed skill tests of dribbling, agility, heading, and shooting throughout the protocol. The coefficients of variation for dribbling, agility, heading, and shooting were 2.2%, 1.2%, 7.0%, and 2.8%, respectively. The mean combined placebo scores were 42.4 ± 2.7 s, 43.1 ± 3.7 s, 210 ± 34 cm, and 212 ± 17 points for agility, dribbling, heading, and kicking, respectively. CHO ingestion led to a combined agility time of 41.5 ± 0.8 s, for dribbling 41.7 ± 3.5 s, 213 ± 11 cm for heading, and 220 ± 5 points for kicking accuracy. There was a significant improvement in performance for dribbling, agility, and shooting (p < .05) when CHO was ingested compared with placebo. In conclusion, the protocol is a reliable test of soccer performance, and ingesting CHO leads to an improvement in soccer performance.

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The Effect of Carbohydrate Gels on Gastrointestinal Tolerance during a 16-km Run

Beate Pfeiffer, Alexandra Cotterill, Dominik Grathwohl, Trent Stellingwerff, and Asker E. Jeukendrup

Two studies were conducted to investigate gastrointestinal (GI) tolerance of high carbohydrate (CHO) intakes during intense running. The first study investigated tolerance of a CHO gel delivering glucose plus fructose (GLU+FRC) at different rates. The second study investigated tolerance of high intakes of glucose (GLU) vs. GLU+FRC gel. Both studies used a randomized, 2-treatment, 2-period crossover design: Endurance-trained men and women (Study 1: 26 men, 8 women; 37 ± 11 yr; 73 ± 9 kg; 1.76 ± 0.07 m. Study 2: 34 men, 14 women; 35 ± 10 yr; 70 ± 9 kg; 1.75 ± 0.09 m) completed two 16-km outdoor-runs. In Study 1 gels were administered to provide 1.0 or 1.4 g CHO/min with ad libitum water intake every 3.2 km. In Study 2 GLU or GLU+FRC gels were given in a double-blind manner to provide 1.4 g CHO/min. In both studies a postexercise questionnaire assessed 17 symptoms on a 10-point scale (from 0 to 9). For all treatments, GI complaints were mainly scored at the low end of the scale. In Study 1 mean scores ranged from 0.00 ± 0.00 to 1.12 ± 1.90, and in Study 2, from 0.00 ± 0.0 to 1.27 ± 1.78. GI symptoms were grouped into upper abdominal, lower abdominal, and systemic problems. There were no significant treatment differences in these categories in either study. In conclusion, despite high CHOgel intake, and regardless of the blend (GLU vs. GLU+FRC), average scores for GI symptoms were at the low end of the scale, indicating predominantly good tolerance during a 16-km run. Nevertheless, some runners (~10–20%) experienced serious problems, and individualized feeding strategies might be required.

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The Effect of Sodium Acetate Ingestion on the Metabolic Response to Prolonged Moderate-Intensity Exercise in Humans

Gordon I. Smith, Asker E. Jeukendrup, and Derek Ball

At rest, administration of the short-chain fatty acid acetate suppresses fat oxidation without affecting carbohydrate utilization. The combined effect of increased acetate availability and exercise on substrate utilization is, however, unclear. With local ethics approval, we studied the effect of ingesting either sodium acetate (NaAc) or sodium bicarbonate (NaHCO3) at a dose of 4 mmol·kg-1 body mass 90 min before completing 120 min of exercise at 50% VO2peak. Six healthy young men completed the trials after an overnight fast and ingested the sodium salts in randomized order. As expected NaAc ingestion decreased resting fat oxidation (mean ± SD; 0.09 ± 0.02 vs. 0.07 ± 0.02 g·min-1 pre- and post-ingestion respectively, p < .05) with no effect upon carbohydrate utilization. In contrast, NaHCO3 ingestion had no effect on substrate utilization at rest. In response to exercise, fat and CHO oxidation increased in both trials, but fat oxidation was lower (0.16 ± 0.10 vs. 0.29 ± 0.11 g·min-1, p < .05) and carbohydrate oxidation higher (1.67 ± 0.35 vs. 1.44 ± 0.22 g·min-1, p < .05) in the NaAc trial compared with the NaHCO3 trial during the first 15 min of exercise. Over the final 75 min of exercise an increase in fat oxidation and decrease in carbohydrate oxidation was observed only in the NaAc trial. These results demonstrate that increasing plasma acetate concentration suppresses fat oxidation both at rest and at the onset of moderate-intensity exercise.

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Prevalence of Hypoglycemia Following Pre-exercise Carbohydrate Ingestion Is Not Accompanied by Higher Insulin Sensitivity

Roy L.P.G. Jentjens and Asker E. Jeukendrup

Pre-exercise carbohydrate feeding may result in rebound hypoglycemia in some but not all athletes. The aim of the present study was to examine whether insulin sensitivity in athletes who develop rebound hypoglycemia is higher compared with those who do not show rebound hypoglycemia. Twenty trained athletes (V̇O2max of 61.8 ± 1.4 ml · kg−1 · min−1) performed an exercise trial on a cycle ergometer. Forty-five minutes before the start of exercise, subjects consumed 500 ml of a beverage containing 75 g of glucose. The exercise trial consisted of · 20 min of submaximal exercise at 74 ± 1% V̇O2max immediately followed by a time trial. Based upon the plasma glucose nadir reached during submaximal exercise, subjects were assigned to a Hypo group (<3.5 mmol/L) and a Non-hypo group (≥3.5 mmol/L). An oral glucose tolerance test was performed to obtain an index of insulin sensitivity (ISI). The plasma glucose nadir during submaximal exercise was significantly lower (p < .01) in the Hypo-group (n = 10) compared with the Non-hypo group (n = 10) (2.7 ± 0.1 vs. 4.1 ± 0.2 mmol/L, respectively). No difference was found in ISI between the Hypo and the Non-hypo group (3.7 ± 0.4 vs. 3.8 ± 0.5, respectively). The present results suggest that insulin sensitivity does not play an important role in the occurrence of rebound hypoglycemia.

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Effect of Acute and Short-Term Administration of Vanadyl Sulphate on Insulin Sensitivity in Healthy Active Humans

Roy L.P.G. Jentjens and Asker E. Jeukendrup

Vanadium compounds have been shown to have insulin-like properties in rats and non-insulin-dependent diabetic humans. The purpose of the present study was to examine whether the effects of acute and short-term administration of vanadyl sulphate (VS) on insulin sensitivity also exist in healthy active individuals. Five male and 2 female participants (age: 24.9 ± 1.5 years; height: 176.1 ± 2.9 cm; body mass: 70.1 ± 2.9 kg) underwent 3 oral glucose tolerance tests (OGTT). The first OGTT was performed to obtain a baseline index of insulin sensitivity (ISI). On the night preceding the second OGTT, participants ingested 100 mg of VS, and the acute effects of VS on ISI were examined. For the next 6 days, participants were instructed to ingest 50 mg of VS twice daily, and a final OGTT was performed on day 7 to determine the short-term effects of VS on ISI. No differences were found in fasting plasma glucose and insulin concentrations after VS administration. Furthermore, ISI after 1 day and 7 days of VS administration was not different compared with baseline ISI (4.8±0.1 vs. 4.7±0.1 vs. 4.7 ± 0.1, respectively). These results demonstrate that there are no acute and short-term effects of VS administration on insulin sensitivity in healthy humans.

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Protein Plus Carbohydrate Does Not Enhance 60-km Time-Trial Performance

Asker E. Jeukendrup, Kevin D. Tipton, Martin J. Gibala, and Michael J. Saunders

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Effect of Pre-exercise Carbohydrate Ingestion on Plasma Cytokine, Stress Hormone, and Neutrophil Degranulation Responses to Continuous, High-Intensity Exercise

Graeme I. Lancaster, Roy L.P.G. Jentjens, Luke Moseley, Asker E. Jeukendrup, and Michael Gleeson

The purpose of the present study was to examine the effect of pre-exercise carbohydrate (CHO) ingestion on circulating leukocyte numbers, plasma interleukin (IL)-6, plasma cortisol, and lipopolysaccharide (LPS)-stimulated neutrophil degranulation responses in moderately trained male cyclists who completed approximately 1-h of high-intensity cycling. The influence of the timing of pre-exercise CHO ingestion was investigated in 8 subjects who consumed 75 g CHO as a glucose solution at either 15 (–15 trial), or 75 (–75 trial) min before the onset of exercise. The influence of the amount of pre-exercise CHO ingestion was investigated in a further 10 subjects who consumed either 25 g or 200 g CHO as a glucose solution or a placebo 45 min before the onset of exercise. At the onset of exercise in the timing experiment, the plasma glucose concentration was significantly (p < .05) lower on the –75 trial compared with pre-drink values, and the plasma cortisol concentration and neutrophil to lymphocyte (N/L) ratio were significantly (p < .05) elevated in the post-exercise period. In the –15 trial, plasma glucose concentration was well maintained, and the plasma cortisol concentration and N/L ratio were not significantly elevated above resting levels. However, LPS-stimulated neutrophil degranulation was similar in the –15 and –75 trials. The amount of CHO ingested had no effect on the magnitude of the rise in the N/L ratio compared with placebo when consumed 45 min pre-exercise. Finally, although an exercise-induced increase in the plasma IL-6 concentration was observed, this effect was independent of pre-exercise CHO ingestion.

Open access

Contemporary Nutrition Strategies to Optimize Performance in Distance Runners and Race Walkers

Louise M. Burke, Asker E. Jeukendrup, Andrew M. Jones, and Martin Mooses

Distance events in Athletics include cross country, 10,000-m track race, half-marathon and marathon road races, and 20- and 50-km race walking events over different terrain and environmental conditions. Race times for elite performers span ∼26 min to >4 hr, with key factors for success being a high aerobic power, the ability to exercise at a large fraction of this power, and high running/walking economy. Nutrition-related contributors include body mass and anthropometry, capacity to use fuels, particularly carbohydrate (CHO) to produce adenosine triphosphate economically over the duration of the event, and maintenance of reasonable hydration status in the face of sweat losses induced by exercise intensity and the environment. Race nutrition strategies include CHO-rich eating in the hours per days prior to the event to store glycogen in amounts sufficient for event fuel needs, and in some cases, in-race consumption of CHO and fluid to offset event losses. Beneficial CHO intakes range from small amounts, including mouth rinsing, in the case of shorter events to high rates of intake (75–90 g/hr) in the longest races. A personalized and practiced race nutrition plan should balance the benefits of fluid and CHO consumed within practical opportunities, against the time, cost, and risk of gut discomfort. In hot environments, prerace hyperhydration or cooling strategies may provide a small but useful offset to the accrued thermal challenge and fluid deficit. Sports foods (drinks, gels, etc.) may assist in meeting training/race nutrition plans, with caffeine, and, perhaps nitrate being used as evidence-based performance supplements.

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Carbohydrate Mouth Rinsing in the Fed State: Lack of Enhancement of Time-Trial Performance

Milou Beelen, Jort Berghuis, Ben Bonaparte, Sam B. Ballak, Asker E. Jeukendrup, and Luc J.C van Loon

It has been reported previously that mouth rinsing with a carbohydrate-containing solution can improve cycling performance. The purpose of the current study was to investigate the impact of such a carbohydrate mouth rinse on exercise performance during a simulated time trial in a more practical, postprandial setting. Fourteen male endurance-trained athletes were selected to perform 2 exercise tests in the morning after consuming a standardized breakfast. They performed an ~1-hr time trial on a cycle ergometer while rinsing their mouths with either a 6.4% maltodextrin solution (CHO) or water (PLA) after every 12.5% of the set amount of work. Borg’s rating of perceived exertion (RPE) was assessed after every 25% of the set amount of work, and power output and heart rate were recorded continuously throughout the test. Performance time did not differ between treatments and averaged 68.14 ± 1.14 and 67.52 ± 1.00 min in CHO and PLA, respectively (p = .57). In accordance, average power output (265 ± 5 vs. 266 ± 5 W, p = .58), heart rate (169 ± 2 vs. 168 ± 2 beats/min, p = .43), and RPE (16.4 ± 0.3 vs. 16.7 ± 0.3 W, p = .26) did not differ between treatments. Furthermore, after dividing the trial into 8s, no differences in power output, heart rate, or perceived exertion were observed over time between treatments. Carbohydrate mouth rinsing does not improve time-trial performance when exercise is performed in a practical, postprandial setting.